In the U.S., as early as the period following WWI, many soldiers were diagnosed with PTSD. In England it was called “shell shock”, in Germany it was known as the “tremors of war”. After the Vietnam war, post-traumatic stress disorder enjoyed wide public reception in the media for the first time. In Germany, the prevalence of the disease among police, rescue workers, and soldiers was hotly discussed following the air show disaster in Ramstein in 1988 and the deployment to Kosovo. During the deployment to Afghanistan, the German armed forces set up trauma centers in Germany due to these experiences.
The daily life of such a soldier differs in many ways from the norm. They alter their lives in the extreme due to the disease. These soldiers have a very strong need for peace and quiet and they avoid places and events where large numbers of people may be present; for example, pedestrian zones, public transportation, shopping centers, and concerts. Their self-imposed isolation is also a source of suffering for them. The world that they inhabit is reduced to a few places: their living room, yard, therapy center, army base, and training grounds.
The soldiers suffer from nightmares in which they spontaneously experience traumatic events all over again. These symptoms can return suddenly, years later, often set off by harmless unforeseeable situations known as triggers. Normal day-to-day smells, sounds, or even a certain model of Toyota pick-up truck that the soldier often saw in Afghanistan can set off such flashbacks. Further limitations are also present, such as poor short-term memory and poor concentration. The soldiers are unable to consolidate their day-to-day environment with their deployment experience, which proves an insurmountable hindrance to personal relationships and “normal” communication.
The source of trauma is often hard to pinpoint. It can be a single event, but the permanent latent danger in military camp can lead to trauma as well. One soldier told me that the first traumatic experience of soldiers deployed abroad is the moment they get off the plane. The results are devastating: The Süddeutsche Zeitung (German regional newspaper) recently reported that “more American soldiers die from suicide than in action” and that “experiences in war often play a role; however, many victims had never seen action.” There are no comparable studies in Germany. Nevertheless, the topic of suicide plays a role here, as well as its correlation with PTSD.
PTSD therapy is long and complex. Often the training of learned behavior proves useless in overcoming experience with war. Soldiers are trained to follow commands decisively, to be disciplined, and to subdue fear and feelings in action. The goal is to perform perfectly all of the time. Therefore, PTSD can be seen as the failure to display this behavioral pattern in the face of the subconscious. Therapy calls for tracking down the cause and processing it little by little.
The images don't show the cause of the trauma, explain the illness, or exemplify the therapeutic process. What can be seen is how this illness manifests and the visual clues that indicate it.
Post-traumatic stress disorder is not a disease to be discerned with the eye. We cannot recognize a soldier with PTSD at first glance. This war is one that takes place in the mind.