Battle toll | |
Military stress and performance. The Australian Defence Force experience. George E Kearney, Mark Creamer, Ric Marshall, Anne Goyne. Melbourne: Melbourne University Press, 2003 (xv + 278 pp). ISBN 0 522 85054 5. |
It is wise
for the Australian Defence Forces to pay attention to the consequences of stress in military service. In World War II, psychiatric disorder was by far the most frequent cause of discharge from the services. There was a time when the immediate stress of battle was the essential consideration, but the authors recognise that there may be significant problems before going away and on returning, and that activities such as “peace keeping” can confront those taking part in them with quite horrible experiences. It took a long time before it was accepted that all human beings have their limits. General Alexander urged the return of the firing squad for “cowardice” in World War II, but wisdom prevailed.
Twenty-one authors contributed chapters to this book. Many have military and academic associations and all except one, who was a captain of frigates, are psychologists. With some six hundred references in the bibliography I sometimes felt that I was reading a review of the literature, rather than a combination of experience and science. The scope of the information is very wide, and anyone with an interest in this area — or with the need to have an interest — should buy the book. Having said that, I do have some criticisms. There is a heavy emphasis on post traumatic stress disorder (PTSD). In past wars distress presented with somatic rather than psychological symptoms, and this is happening again with Gulf War syndrome. The management of PTSD is considered at length without a mention of current literature which shows that selective serotonin reuptake inhibitors can be of marked benefit in some cases. Secondary gain gets a paragraph, but needs much more emphasis. During the invasion of North Africa in World War II, epidemics of tremor in riflemen and pilots — badly handled — provided such a flood of casualties that for a while the strength of the United States Forces shrank. Professor Kearney (Colonel Commandant of the Australian Army Psychology Corps) provides a useful history of military stress at the end of the book, but most chapters leave the reader with the impression that all the useful learning on the topic has been recent. One statistic is relevant: the rate of discharge for psychiatric disorder in the United States Forces in Vietnam was one seventeenth that of the rate in World War II — because of preventive programs that were introduced. Perhaps some gains had been made in the interval. The first Australian example of the modern treatment of military stress was that of Lieutenant Colonel Alex Sinclair of the Royal Australian Medical Corps in Tobruk in World War II. The contribution of the Medical Corps, past and present, scarcely gets a mention. John H T Ellard
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