Is Combat Trauma the Most Common Source of Trauma Among Warriors? (No, not usually).

Many people in society—including a fairly large number of therapists—seem to think that veterans come back traumatized by what they see and do in combat. Through public and private funding, we have invested hundreds of millions of dollars to develop effective treatments for post-traumatic stress, and to diagnose and better understand TBI. We are told that these are the “invisible wounds of war.” We have trained up thousands of clinicians across the VA to deliver empirically supported treatments for the “trauma of being exposed to war.”

And yet, the idea that veterans die by suicide because they deploy to war zones is a misconception: A 2015 study of nearly four million U.S. service members and veterans found that deployment to Iraq and Afghanistan is not associated with an increased risk of suicide. There are some injuries that are even more invisible, more insidious, and more lethal than the “invisible wounds of war” that we have focused so much time and money to address.

Consider this insight from Sgt. Eddie Wright, a Recon Marine who wrote an incredibly thoughtful foreword for my book WARRIOR: How to Support Those Who Protect Us.

“As I progressed through the procedure, we spoke about personal concerns of mine and of trauma. I explained to Doc Springer that what I struggled with daily was not the loss of my hands or the disability it implied. She nodded with a look of recognition and said to me, “I bet a lot of people assume that your biggest trauma, the one that has been the most challenging, is the loss of your arms, but I can see that that’s not the case for you. You’ve adapted and overcome in that area the way that Marines do. Your trauma is not what most people assume.”

And this is the truth that many people—even people with advanced clinical training—cannot see. What I struggled with was the trauma I had experienced throughout my entire life, not just my combat experience—least of all my combat wounds. By the time I got injured in Iraq, my trauma was already in place.”

  • Sgt Eddie Wright

Based on more than a decade of supporting warriors as a trusted Doc, I’ve repeatedly observed that Sgt Wright’s experience is all too common. Much of the trauma that many of our warriors experience has not come from the military – but from the years prior. In relation to this, we need to correct that myth that military service necessarily causes trauma. And there is another myth related to this, which is that if you have pre-trauma, trauma from before the military, service in the military will leave you worse off. In Sgt. Wright’s case, as with many other warriors I’ve served, his early trauma actually helped inoculate him against the impact of subsequent trauma.

As I’ve written about for Psychology Today, it is no coincidence that individuals who have suffered trauma as children are often drawn to military service.

For many who enlist in the military, the promise of becoming a professional-grade fighter is an alluring defense against hidden feelings of vulnerability. Many have explained to me that the military also offered the promise of an environment with predictability and clear rules and expectations. In other words, they are seeking safety in the structure and shared ethos of warriorship.

In some cases, service members have experiences that make their trauma much more deeply ingrained. For example, in the context of toxic leadership, where they encounter bullying, hazing, or sexual abuse, this further trauma can lead to profound psychological damage.

But you know who we don’t typically account for? The countless number of people that come away from their time in the military feeling empowered and much healthier than when they entered the service. For example, when a service member with a history of bullying or childhood abuse lands within a healthy chain of command, the military can be an ideal place to chart a new, more self-empowered path in life. This I’ve seen repeatedly with those in my network of veteran friends and warriors I’ve served over the past decade.

Based on these kinds of observations, I would love to see us all start thinking critically about these kinds of widespread myths and start to develop a more nuanced understanding of the interaction between military service and trauma.

Want to Learn More?  Here is a link to where you can pick up a copy of my book WARRIOR

M. A. Reger, D. J. Smolenski, N. A. Skopp, M. J. Metzger-Abamukang, H. K. Kang, T, A. Bullman, S. Perdue, and G. A. Gahm. “Risk of Suicide Among US Military Service Members Following Operation Enduring Freedom or Operation Iraqi Freedom Deployment and Separation From the US Military,” JAMA Psychiatry, 72 (2015): 561–569.