Who Are You? (36 page)

My son loves the Army and let me confirm straight away that I have huge respect for him and for our armed forces; I am immensely proud of him and of what he does. Most people serving will cope with their experiences on tour in war zones, but I’m not sure that coping is the same as remaining unchanged. I remember when my son came home and I clumsily started to ask him about his experiences. He didn’t want to talk about it at first. It took a few days for snippets to come out such as the fact that he thought, drily, it was a little bit unfair to have his first contact – i.e. being shot at – on his birthday. Bit by bit, other stories came out and it was only months later that he admitted the extent of the danger he had been in at times. I sensed he had changed. I felt I had said goodbye to a boy (albeit a 23-year old) and he returned a man, a little more self-contained, a little more worldly, a little more aware of the value of life, or lack of it.

Spending time in a war zone, thankfully, is not something most of us will have to experience, and without being there it is impossible to understand what it must be like. But as a mother I find myself drawn to anything that provides me with a vicarious experience of it. News items, documentaries, books – things that will help me to understand what our sons, daughters, husbands and wives are going through and the effects it will have on them both physically and mentally.

In January 2013 a young man called Jake Wood published a book called
Among You
–
The Extraordinary True Story of a Soldier Broken by War.
I heard Jake being interviewed on the radio, and also on television. The book exposed, first hand, what it was like to be on the front line, and the awful cost to a brave soldier who found himself – as a reservist – unable to cope,
‘broken’ through serving his country. I read his book; it is beautifully written and heartbreaking, and it inspired me to begin researching the subject of Post Traumatic Stress Disorder (PTSD) and combat stress, the hidden wounds, in depth.

I live in Herefordshire, home of what we proudly refer to as ‘the Regiment’, the elite SAS, and I spoke to several friends associated with the Regiment about the subject and was reassured that most soldiers love their jobs, carrying out their duties with professionalism and a finely developed sense of morality. Most come home undamaged and proud of the job they are doing.

So why do some people succumb to PTSD while others don’t? And what can the armed forces do to detect an individual’s vulnerability to the condition?

Recent research by the Association for Psychological Science focused on a study of 260 male veterans from the National Vietnam Veterans Readjustment Study.
¹
Not surprisingly the study found that 97 per cent of sufferers had been exposed to traumatic events. However only just under a third of these went on to develop PTSD over the long term; and of those exposed to the most extreme combat trauma, just under a third of those didn’t go on to develop long-term PTSD. This suggested that there were other factors at work, needing to be identified, which could lead to a pre-disposition of developing PTSD. Childhood physical abuse was one; and another was the inflicting of harm on civilians or prisoners of war during combat. Bruce Dohrenwend, the author of the research and his colleagues stress that the recent conflicts in Iraq and Afghanistan are, like Vietnam, ‘wars amongst the people’ where there are risks of ‘devastating violations of the rules of war.’ Sadly there are many examples from recent conflicts which fulfill Dohrenwend’s warning.

In 2009 a regiment of Danish soldiers was deployed on a six- month tour to Afghanistan. An award-winning documentary film,
Armadillo
, was made during that tour; and at the same time a psychological evaluation of a large number of troops, including these men, was carried out by psychological scientist Dorthe Berntsen of Aarhus University in Denmark, together with a team of Danish and American researchers.
²
The results of the two studies were similar. Most troops exposed to traumatic combat were resilient, either recovering quickly from any psychological distress, or having no symptoms at all. Of those who did suffer any long- lasting damage, a large majority were much more likely to have suffered psychological distress prior to deployment, such as physical abuse during childhood, and they often could not, or would not, talk about these past experiences. “We were surprised that stressful experiences during childhood seemed to play such a central role in discriminating the resilient versus non-resilient groups,” says Berntsen. “These results should make psychologists question prevailing assumptions about PTSD and its development.”

So these important findings seem to challenge the previously held perception that PTSD/Combat Stress is caused by repeated exposure to trauma during extreme combat; rather it may be more related to experiences of violence during childhood. Even more interestingly, 13 per cent of the Danish study that had exhibited symptoms of stress prior to deployment actually found their symptoms eased during their tour, finding social support and a sense of self-esteem, which they hadn’t experienced before. However, upon return from combat their symptoms of stress returned.

Alex and Juliet are both victims of childhood abuse; two damaged halves of an imperfect whole. Alex is not meant to be representative of a soldier developing PTSD as a result of his war- time experiences alone; but as someone who was ill-equipped to deal with both the emotional and physical abuse suffered during his childhood, and who sought self-definition and security within the Army. Without his ‘back story’ he might easily have had the resilience to deal with his combat experiences. Both Alex and Juliet have an ill-defined sense of self, building up defensive layers in order to cope with the unresolved trauma from their childhoods. They create their own war zone and as the battles go on – as in most long term wars with an ill-defined objective - it is sometimes hard to tell who is the victim and who is the aggressor.

I admit Who Are You? is not meant to be an easy read. It has been a difficult subject to write about and some of the scenes are very uncomfortable. But I have tried, so far as is possible, to ensure that they are all based on fact; indeed, since starting to write this novel I have found it uncanny how much ‘life has imitated art’.

In recent weeks – and days – PTSD has been very much at the forefront of the news. On the 12th May the charity Combat Stress marked its 95th anniversary by revealing a 57 per cent increase between 2012 and 2013 in Afghanistan veterans seeking help from them.
³
Knowledge and understanding of the condition was shown by Judge Peter Heywood in Swansea Crown Court last week when he granted leniency to Jonathan Dunne, stating: ‘Our servicemen come home from the theatres of conflict and we consider that they are all robust by the very nature of their training. But, of course, seeing colleagues and friends fall is not easy and I suspect many of them clearly need psychological help.’ The Sunday Telegraph on the 25th of May headed a feature article ‘PTSD: The Bomb Waiting to Explode’.
⁴
If the book brings the subject of PTSD, its affect on the sufferers and their families to a wider and different audience, especially as the newly-released figures show an increase in the incidence of it as more soldiers return from combat, then I will have achieved everything that I set out to do.

I have been fortunate in being able to show the manuscript to some senior, but unnamed, sources within the Army and am grateful to them for their advice on authenticity, and for their endorsement of the facts.

Lastly, out of respect for our service men and women who are suffering from PTSD, I would like to stress that many have not suffered from any sort of childhood abuse, nor do they display violent tendencies. I want to finish with a few words from Jake Wood, which seems only fitting as he was there at the birth (little did he know it!).

“While childhood abuse is a recognized predisposing factor to PTSD, most veterans with PTSD, such as myself, will not have been abused as children – and therefore will not (or certainly should not) be abusive to their partners and children.”

Elizabeth
Forbes
,
27th
May
2014

¹
B. P. Dohrenwend, T. J. Yager, M. M. Wall, B. G. Adams. The Roles of Combat Exposure, Personal Vulnerability, and Involvement in Harm to Civilians or Prisoners in Vietnam War-Related Posttraumatic Stress Disorder.
Clinical Psychological Science
, 2013; DOI: 10.1177/2167702612469355

²
D. Berntsen, K. B. Johannessen, Y. D. Thomsen, M. Bertelsen, R. H. Hoyle, D. C. Rubin. Peace and War: Trajectories of Posttraumatic Stress Disorder Symptoms Before, During, and After Military Deployment in Afghanistan.
Psychological Science
, 2012; DOI: 10.1177/0956797612457389

³
http://www.combatstress.org.uk/about-us/

⁴
http://www.telegraph.co.uk/news/uknews/defence/10853636/Post-traumatic-stress-disorder-the-bomb-waiting-to-explode.html

ACKNOWLEDGEMENTS

An enormous thank you to the following people without whom this book would not have been possible, and who between them helped fill in the potholes along the road to publication.

Paul Swallow of Cutting Edge Press, for being brilliant, supportive and patient, 24/7; for giving me the faith and encouragement to explore the ‘dark’ side, and who I am proud to call my dear friend. Broo Doherty of DHH Literary Agency who is the epitome of a writer’s dream agent. Loyal and dear friend, counsellor, adviser; the patience of Job and a cracking sense of humour. No one could possibly work harder nor more generously.

Martin Hay and the team at Cutting Edge Press for supporting me a second time. Hatty Ash and her predecessor Saffeya Shebli for their great work on the publicity front. Alessandro Massarini for once more providing us with a stunning cover image. Sean Costello for his eagle-editorial eye. He is a joy to work with. Anira Rowanchild, my friend and ex-tutor for her unswerving honesty and encouragement. Clare John who gives feedback at the speed of light and who, as an Army wife, gave much needed encouragement at the outset of this project. Jake Wood, author of
Among You – The Extraordinary True Story of a Soldier Broken by War.
Two senior commanding officers for checking the military detail. My son for advice on military detail. Mandy at Eyetek Surveillance regarding spy cameras and tracking devices. Harriet Gordon and Deborah Herbert for advice on psychological issues. Anne Cater and BC@booksandswearing for their jacket quotes and support. Fiona Field, author of Soldier’s Wives, who was herself a soldier, is married to a soldier, and has a son who is a soldier. To my friends on Twitter: the bloggers and fellow authors – new friends who are kind enough to share their tweets with me; and also to my face book friends who can bring a whole world of entertainment, chat and much-needed distraction into my garrett and who are saving the world from even more of my words.

My long suffering husband Jamie – my best friend in the world – and to my children Jamie and Poppy of whom I am immensely proud and who may be spared the ordeal of having to read their mother’s words.

ORGANISATIONS FOR SUPPORT

If you have been affected by the issues raised in this book, the following organisations can help.

Mind –
http://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-%28ptsd%29/#.U6GNQ0AuLYQ
(ptsd)/#.U3C_p_ldVi0

Combat Stress –
http://www.combatstress.org.uk/

SSAFA –
https://www.ssafa.org.uk/
/

Royal British Legion –
http://www.britishlegion.org.uk/

Samaritans –
http://www.samaritans.org/

The NHS –
http://www.nhs.uk/conditions/Post-traumatic-stress-disorder/Pages/Introduction.aspx

Refuge –
http://refuge.org.uk/

National Domestic Violence Helpline –
http://www.nationaldomesticviolencehelpline.org.uk/

Women’s Aid –
http://www.womensaid.org.uk/

National Centre for Domestic Violence –
http://www.ncdv.org.uk/

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