Post Traumatic Stress Disorder was first classified as a mental disorder in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-lll) published by the American Psychiatric Association –the text book psychologists and psychiatrists use to determine diagnoses.
But the disorder has a much longer history. Ancient Assyrian medical texts from Mesopotamia, dating from around 3500 to 1300 BC, written in cuneiform on clay tablets, found in Uruk, Iraq, relate that Assyrian doctors were diagnosing and treating psychological conditions related to war. Ancient Assyrians, and many other ancient cultures believed that the spirits of dead people haunt living people, especially if that person had a hand in the death. So warriors who experienced mental trauma were thought to be under attack by the ghosts of people they killed in battle.
This research was conducted by Walid Khalid Abdul-Hamid of Queen Mary University in London and Jamie Hacker Hughes of Anglia Ruskin University. Some of these cuneiform translations read:
“If in the evening, he sees either a living person or a dead person or someone known to him or someone not known to him or anybody or anything and becomes afraid; he turns around but, like one who has [been hexed with?] rancid oil, his mouth is seized so that he is unable to cry out to one who sleeps next to him, ‘hand’ of ghost
“[If ] his mentation is altered so that he is not in full possession of his faculties, ‘hand’ of a roving ghost; he will die.”
“If his words are unintelligible for three days […] his mouth [F…] and he experiences wandering about for three days in a row.
Deuteronomy 20:1-9, of the King James version of the Bible reads: When thou goest out to battle against thine enemies, and seest horses, and chariots, and a people more than thou… the officers shall say, What man is there that is fearful and fainthearted? Let him go and return unto his house, lest his brethren’s heart faint as well as his heart.
Marc-Antoine Crocq, of the Institute for Research in Neuroscience and Neuropsychiatry, Rouffach, France; and Louis Crocq of the Cellule d’Urgence Médico-Psychologique, in Paris, refers to Gilgamesh personality that changed after the death of his friend Enkidu. And Herodotus in his book History in 440 BC wrote about the Battle of Marathon, when the Greeks defeated the Persian invasion: Epizelus, the son of Cuphagorus, an Athenian soldier, was fighting bravely when he suddenly lost sight of both eyes, though nothing had touched him anywhere – neither sword, spear, nor missile. From that moment he continued blinded as long as he lived. I am told that in speaking about what happened to him he used to say that he fancied he was opposed by a man of great stature in heavy armour, whose beard overshadowed his shield but the phantom passed him by and killed the man at his side.
Vision of a killed comrade—
Hippocrates (fourth century BC), and in Lucretius’ poem, De Rerum Natura, written in 50 BC refer to recurring nightmares of battles: The minds of mortals… often in sleep will do and dare the same… Kings take the towns by storm, succumb to capture, battle on the field, raise a wild cry as if their throats were cut even then and there. And many wrestle on and groan with pains, and fill all regions round with mighty cries and wild, as if then gnawed by fangs of panther or of lion fierce.
Jean Froissart was the most representative chronicler of the Hundred Years’ War between England and France. In 1388 he lived at the court of Gaston Phoebus, Comte de Foix, and narrated the case of the Comte’s brother, Pierre de Beam, who could not sleep near his wife and children, because of his habit of getting up at night and seizing a sword to fight oneiric enemies.
Army physicians during the French Revolutionary wars (1792-1800) and the Napoleonic wars (1800-1815 observed that soldiers collapsed into protracted stupor after shells brushed past them, although they emerged physically unscathed. This led to the description of the “vent du boulet” syndrome, where subjects were frightened by the wind of passage of a cannonball.
In more modern times during the First World War – 1914 – 1918 PTSD was referred to as Shell Shock or War Neurosis and military hospitals were filled with soldiers, suffering no physical injuries, but totally incoherent.
In 1915, the French psychiatrist Régis commented on witnessing the horrible death of comrades: “20% only presented with a physical wound, but in all cases fright, emotional shock, and seeing maimed comrades had been a major factor.
Obviously this continued during the Second World War, Vietnam, Korean and all wars since up to the current Russian-Ukraine and Israel-Palestine-Lebanon wars.
But PTSD is not just related to war. The DSM – Diagnostic Statistical Manual criteria reads:
The person has experienced an event that is outside the range of human experience and that would be markedly distressing to almost anyone, for example serious threat to one’s life or physical integrity, serious threat to harm one’s children, spouse or other close relatives or friends, sudden destruction of one’s home or comm unity, or seeing another person who has recently been or is being seriously injured or killed as the result of an accident or physical violence.
Most modem textbooks concur in describing this syndrome as comprising three groups of symptoms: (i) the recurrent and distressing reexperiencing of the event in dreams, thoughts, or flashbacks; (ii) emotional numbing and avoidance of stimuli reminiscent of the trauma; (iii) and a permanent state of increased arousal.
Anyone working on a serial killer investigation, the profiler, the detective, the crime scene analyst, the mortuary attendant, the pathologist…all breathe, see, smell and hear the horror – and may develop idiosyncratic symptoms – I remember hearing maggots eating at rotten flesh to me sounded like someone crumpling a newspaper. To deny the existence of Port Traumatic Stress, to demean it or belittle or joke about it or ignore it, is an offence against the humanity of the person afflicted with it. Thank the gods that you had not seen or experienced what these people have and show some compassion and encourage them to see a therapist.
Featured image: Combatting PTSD is slaying the dragon inside your mind. Detail of St George slaying the dragon by Jost Holler (1445) Unterlinden Museum