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Panic! Battle Fatigue in WWII


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The more I learned about the realities of combat in WWII the more I wondered how on earth men withstood it. I found, however, that sometimes they didn’t. 

Below is a link to an overview of battle fatigue in US forces in WWII. I found some rather astounding numbers, and also that the army studied the issue of men’s breaking points very meticulously. Given the numbers involved, they had to. 

The morale model in Combat Mission’s WWII titles are remarkable in their reflection of reality. There have been studies that found that the “soft factors” that determine when and why men will break are not as abstract as one would think. 

Battle fatigue in WWII is a fascinating - even if heartbreaking - topic that I thought deserved some study. Figured you guys might be interested as well 

 

https://battlelines.blog/2019/01/09/the-spirit-of-the-infantry-battle-fatigue-in-the-second-world-war/

 

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I haven’t finished all of your post yet, but so far it is fantastic. Really appreciate you posting this here so we can see it!

i remember the first time I read a book that covered the extensive effect of battle fatigue and how common it was. The book was With the Old Breed by Eugene Sledge and covers his experiences in the Pacific theater during WWII. Highly recommend to any here who have not read it. 

In the ETO, many are aware of the manpower issues the Army faced, and how replacement depots were hastily put together in an attempt to solve the issue. But what I think many do not realize is that the Army wasn’t suffering a manpower crisis because of KIA/WIA (though the numbers were quite high) but due to the psychiatric casualties suffered. 

Anyways just wanted to say well done on the write up and thanks again for posting it here. Very much looking forward to finishing it, and to future writings by you!

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Thanks. It’s essentially a collection of dog -wares and bookmarks from reading that I thought pertinent to write about.

The numbers are pretty stark. One thing I’ve found really interesting is that veterans were quite candid about it in their memoirs, some even treating it matter-of-factly as if it was an obvious phenomenon. Yet WWII is not known for its astonishing numbers of psychiatric casualties. I mentioned that censorship kept that fact from the public, but it almost seems as if the War Department or OWI’s version of events is the prevailing one in popular consciousness even now. I don’t think they’re any less worthy of admiration for being simply human beings; perhaps even more so. 

 

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@Swervin11b not sure if you’ve read it (and all other controversies aside) On Killing by David Grossman provides really good figures on psychiatric casualties in the ETO. 

I was also a bit surprised the first time I read Sledges book about how frank and common they seemed to treat psychiatric casualties. They all knew that everyone had a breaking point, and what’s more there was a really fatalistic attitude that it was only a matter of time before it claimed them. Gives a whole new perspective to the idea of the million dollar wound. Not only would it save you from death or more serious injury, but it would save your sanity as well. 

7 minutes ago, Ivanov said:

A great book on battlefield psychology is Brains & Bullets.

https://www.bitebackpublishing.com/books/brains-bullets

 

I’ll definitely check this out. Thanks for the recommendation!

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Very enlightening thread. Those statistics are grim. Talking about combat fatigue was discouraged, for the sake of both military and civilian morale. Even then, it's not really a pleasant topic for those who were at the front, and they preferred not to talk about it. My great grandfathers, generally, spoke very little of WW2. One of them served as an infantry officer from '39 to V-J day. Lots of various awards and medals, but very few war stories.

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I was just able to finish the entire article and wanted to say another well done! I really appreciate that you cite your sources and include them at the bottom. Aside from it lending credibility and support to what you're writing, it also provides readers with some good book recommendations which is always a plus. 

One of the many reasons I like CM so much is how well it simulates soft factors, such as suppression and morale. Most games don't even bother to include these factors, and most that do try to simulate them fall short in my opinion. Speaking of those soft factors, @Josey Wales put together an excellent video series detailing how the soft factors work. Highly recommended for those who have not seen them. 

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CPT Miller, yes I’ve read On Killing and found it to be really educational. I was going to use some stats from On Combat but had trouble verifying some of the numbers he used. It’s still an enlightening book, of course. 

Ill check out Brains and Bullets.

EB Sledge’s book is one I haven’t read. I’ve only seen portions of it. I agree that it is really frank about everything, actually, and it’s a tough read. 

The study that I cite throughout that article discusses the perception of their inevitable death or maiming as a significant factor in morale. Anyone that found the article interesting would find that study fascinating. I’m not sure how well received it was by the brass, but they did develop a rotation policy for Vietnam. 

Now they take full advantage of both unit cohesion and a finite number of days in combat by deploying entire units with fixed tours 

 

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Given that the whole point of war is to break the will of the enemy, it should come as no surprise that men (women too now I guess) do break under the stress of battle. The whole evolution of warfare has been to make existence as unpleasant as possible for enemy soldiers. Only in some armies has a comparable effort been made to alleviate the stress and discomfort of fighting. For thousands of years soldiers were told simply to "stick it out" or "show some grit". That has worked to some extent, but the environment of battle has become so cataclysmic that even the best efforts of the best soldiers can be overridden. The organism simply breaks down and can't take any more. And even before the point of complete breakdown occurs, efficiency begins to tail off, mistakes increase and the whole organization begins to falter.

Michael

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That’s a very, very good point. It’s true in both symmetrical and asymmetrical warfare, perhaps even more so in the latter given that one side lacks the capability for wholesale destruction of their opponents.  Iraqi insurgents fought primarily to undermine our confidence in ourselves and make us fearful.

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Nice article, man. My only criticism is that it ended. LOL. I was just starting to really dig in and it was over. Well done!

Here's something that came to mind just before I started reading. Did it always exist (PTSD, Shell Shock, Battle Fatigue) or is it a symptom of modern-ish (gun powder) warfare and civilization? Is shooting and bombing a man less "violent" than bashing his head in with an axe or spilling his guts with a sword? Killing was surely much more intimate when it was almost solely waged hand-to-hand and eye to eye. Were Romans, Vikings, feudal kingdoms etc. living so close with death on a daily basis and so steeped in their warrior ethos, that we lost the ability to compartmentalize and absorb the barbarity the further we civilized and moved away from day-to-day killing? Was it bred out of us? Ultra violence was the order of the day for Samurai, American Indian tribes, Mongols etc. Just about every continent had warrior cultures. Or was there always a breaking point and just no one to recognize or record it?

EDITED: I recognized that Fred Salter description almost right away. I read that book just last year. I was like, man that sounds familiar! Oh, that's that recon book you read about the dude in Italy.

Mord.

Edited by Mord
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4 hours ago, IICptMillerII said:

The book was With the Old Breed by Eugene Sledge and covers his experiences in the Pacific theater during WWII. Highly recommend to any here who have not read it.

That is a dark book. If there's a WWII memoir that would make you thankful you weren't there that'd be the one. Really good read.

 

Mord.

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On my bookshelf I have a hardbound copy of 'Achilles in Vietnam: Combat Trauma and the Undoing of Character" by Shay (an autographed copy, no less). The book dates from 1994 so it predates the last 5(?) American wars, which is why it focuses on Vietnam vets. At the time it was considered revolutionary on the topic of combat trauma and PTSD. Now its considered basic required reading by people in the field. The follow-up volume 'Odysseus in America' chronicling the emotional trials of returned combat vets is a really tough read.

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5 hours ago, IICptMillerII said:

@Swervin11b not sure if you’ve read it (and all other controversies aside) On Killing by David Grossman provides really good figures on psychiatric casualties in the ETO. 

I was also a bit surprised the first time I read Sledges book about how frank and common they seemed to treat psychiatric casualties. They all knew that everyone had a breaking point, and what’s more there was a really fatalistic attitude that it was only a matter of time before it claimed them. Gives a whole new perspective to the idea of the million dollar wound. Not only would it save you from death or more serious injury, but it would save your sanity as well. 

I’ll definitely check this out. Thanks for the recommendation!

I think it's been recently re-published as War Games: The Psychology of Combat. https://www.amazon.com/War-Games-Psychology-Leo-Murray-ebook/dp/B079DC9WVN Not sure why the re-branding. It is an interesting read though. 

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4 hours ago, Mord said:

Did it always exist (PTSD, Shell Shock, Battle Fatigue) or is it a symptom of modern-ish (gun powder) warfare and civilization? Is shooting and bombing a man less "violent" than bashing his head in with an axe or spilling his guts with a sword? Killing was surely much more intimate when it was almost solely waged hand-to-hand and eye to eye.

Yes and no...sort of. I expect combat has always been scary, and getting bashed on the head or hacked into pieces has always been exceedingly unpleasant, but the warrior ethos (for those cultures steeped in it) offered a certain amount of psychological protection. Sure, you might be killed, but if you died bravely your praises would be sung for generations to come. When war started to become industrialized along with everything else about three centuries ago, it changed the nature of the battlefield. Before, battles took place in an environment more or less like one's familiar everyday environment, the one your animal nature was comfortable with. But with the coming of industrialization, and particularly in the twentieth century with its rapid evolution of weaponry, that comforting environment is stripped away. The modern battlefield is a noisy chaotic place in ways that your animal nature may not be able to recognize and adapt to. In the olden days of face to face combat, a soldier's fate was largely in his own hands and dependent on how skilled he was with his arms. This is less true on a battlefield where a soldier can be killed by a bomb or shell dropping out of the sky. It's not all black and white and it is certainly much better to know how to use one's weapons and techniques of survival than not, and it is also good if your training has exposed you to shells going off nearby and all the other craziness that occurs during combat, and to know that you can survive all that and still function. But still, there are limits to how much one can absorb and still be combat effective, let alone sane for the rest of their lives. Some can take a lot, some crumble almost at once. Most fall somewhere in between.

Michael

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5 hours ago, Michael Emrys said:

In the olden days of face to face combat, a soldier's fate was largely in his own hands and dependent on how skilled he was with his arms. This is less true on a battlefield where a soldier can be killed by a bomb or shell dropping out of the sky.

I've brought this up with my brother, before. That a big difference in modern war is that there's a huge random factor thrown in the mix. No matter how elite your training, no matter how experienced you are in battle, there's a much greater risk of being killed by something completely outside your ability to counteract with combat skills. The WWII memoirs I have read are replete with examples. One I can give is where an officer was found dead after a shelling that was fairly benign comparatively speaking, possibly a few wayward mortars or something to that effect, as memory serves. Basically, his training and their position should've kept him safe. At first they couldn't figure out what happened to him. He was in a pristine state. Later a pinhole sized wound was found in his head where a minute sliver of shell had pierced his brain. As far as I remember no one else was even wounded—just a bad random dice generator.

So, yeah, I can imagine that the chaotic randomness of battle could also play a major factor on the modern mind and especially conscience. Why did I live unscathed and that guy next to me in the foxhole got blown in half?

Bulletpoint sent me a link on Roman PTSD that pretty much reaffirmed my thoughts on my semi-rhetorical questions above.

Mord.

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Mord, 

Check out David Morris, The Evil Hours: A Biography of Post-Traumatic Stress. It goes into detail about some of the things you brought up. According to him, it’s been around forever. There are references to it in Sumer and Ancient Greece. One has to remember, too, that not everyone exposed to the violence of war was so steeped in any kind of warrior ethos. It wasn’t everyone’s mantra, per se. Plenty of places got sacked and the women and children there were seen as part of the spoils of war.  Gnarly stuff. 

In the 18th century they called battle fatigue “cannon fever.” Christopher Duffy did a book called Military Experience in the Age of Reason that is pretty seminal for that era.  

I was thinking while I was writing that it almost seems like modern technology has made war so awful that our brain can hardly handle it. The randomness sucks. As humans we like to have some kind of logic and order in our universe. 

As far as training goes, yeah, it’s as highly stressful as possible exactly for conditioning our brains to function in times of extreme stress. 

Its all rather fascinating stuff. I definitely need to read Shay’s stuff 

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56 minutes ago, Swervin11b said:

One has to remember, too, that not everyone exposed to the violence of war was so steeped in any kind of warrior ethos. It wasn’t everyone’s mantra, per se. Plenty of places got sacked and the women and children there were seen as part of the spoils of war.  Gnarly stuff. 

Oh, I definitely agree with that but I'd also add, as a slight counter, that death was very much a common part of life back then even in the civilian sectors. By that I mean, by the time you were ten (if you made it) you'd probably have seen hundreds of dead people, due to disease, pneumonia, birthing fatalities, sport, work accidents, starvation, crime, etc, let alone war. In modern culture, at least Western societies, we have been sheltered from a good deal since about the 50's onward. It's not as common place in our day-to-day, I guess is what I am trying to say. Epidemics are rare, modern medicine keeps a broken leg, severe cut, or flu from becoming a life ending event, modern food production staves off starvation, extreme crime is usually relegated to specific areas, babies and mothers are more likely to survive pregnancy than not, etc. I am not saying that is 100% the case for everyone, but as a whole, I'd say the majority of us don't live with tragedy month by month or even year by year. To put it in perspective, I didn't see my first dead body until I was 22, and that was at my grandfather's funereal. I've known people that were murdered but they were on the periphery of my life and I never witnessed it.

But I will check out that book. I am gonna put it on my Amazon wishlist so I don't forget it.

56 minutes ago, Swervin11b said:

I was thinking while I was writing that it almost seems like modern technology has made war so awful that our brain can hardly handle it.

I agree and disagree at the same time LOL. On one hand our ability to destroy humans is on a level never imagined. Then on the other hand, it seems to be distant and removed. I mean most soldiers probably don't see up close the act as it happens, considering some of the engagement ranges, it's usually the aftermath. But four or five hundred years ago you were right in a dude's face, nothing but your axe and his sword to decide who was gonna eat breakfast the next day. And the guy who didn't, well you sure saw, smelled, heard, and felt the effects when you ended him. I think it boils down to that Stalin quote (paraphrased) "The death of one man is a tragedy, the death of a million is a statistic."

 

56 minutes ago, Swervin11b said:

As humans we like to have some kind of logic and order in our universe. 

Yeah, that's the part that I think can really screw with you even if it has nothing to do with war. That survivor's guilt thing. Why him not me? Or conversely, where I've had a couple incidents where I almost got myself killed or seen someone killed and that twisted me the hell up for a few hours with all the what ifs. Made me feel surreal.

 

56 minutes ago, Swervin11b said:

Its all rather fascinating stuff.

Yep it sure is. I've always been a morbid and macabre person (intellectually) so it's right up my alley. But I don't like violence in reality, if that makes sense. I have a book on the history of execution and it's one of my favorites. But man, LOL if I saw any of it in real life I'd puke and run screaming like a three-year-old girl.

 

Mord.

Edited by Mord
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Yeah I totally agree that death and for the lack of a better word, gore, was very much a part of people’s lives in the past. Even thinking of how far removed people are from the source of their food is indicative of this trend. A farmer understands how one gets a steak. Most know but they’ve never seen it, can’t visualize it. 

Grossman had some interesting points in On Killing about the distance of engagements. One of the things that stuck out was that if one personally views the aftermath of shooting up close, the psychological effects are the same as if it happened at point blank. Example scenario being a fellow gets tagged by a grunt, then the grunt moves up to search the body. That’s legit. A lot of times in counter-insurgency that’s exactly what happens. 

Which brings up something I didn’t write about in that piece...moral injury. It’s the idea that there is some psychological damage as a result of doing things that go against a moral code, say, like modern people killing one another. It’s not true for everyone (there are sociopaths out there), but 98% of modern people are deeply disturbed by killing or helping in a situation in which someone was killed. It goes against core human values, somewhat illustrated by Judeo-Christian beliefs and moral codes. 

What’d be interesting to see is if ancient people who viewed warfare as normal, and even good, had the same adverse reaction to killing. I don’t suspect they did, as you indicated. They’re just very different cultures with far different mores and traditions. 

I didn’t write about moral injury in that piece because I couldn’t find much on it pertaining to WWII. In a lot of ways it’s a different ball game than PTSD - moral injury being based on something you did (or didn’t do) and PTSD on something that happened to you. It’s kind of a dichotomy of guilt or fear. 

Really great discussion. Not at all surprised that fans of this game are an erudite bunch. 

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15 hours ago, Mord said:

Were Romans, Vikings, feudal kingdoms etc. living so close with death on a daily basis and so steeped in their warrior ethos, that we lost the ability to compartmentalize and absorb the barbarity the further we civilized and moved away from day-to-day killing? Was it bred out of us?

This seems to be the crux of the matter.  Life was short and cheap and death was everywhere from one source of another until the 20th Century.  The idea that we are all valuable individuals and that life is precious is a new concept.

It would be interesting to know if PTSD exists in the Taliban or ISIS or any other outfit where death is not seen as a big deal.

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21 minutes ago, Swervin11b said:

Even thinking of how far removed people are from the source of their food is indicative of this trend. A farmer understands how one gets a steak. Most know but they’ve never seen it, can’t visualize it. 

Yep. Most hunters I've known are very aware and respectful of the animals they take. And I'd argue that it boils down to the fact that they are intimate with the process of killing and harvesting the meat. With killing, dressing and such they get that a life was given so another life could benefit. I don't think I've ever met a dude that said he be happy to have to shoot a deer twelve times. they want to bring it down with one shot, ideally an insatant death following.

 

25 minutes ago, Swervin11b said:

Grossman had some interesting points in On Killing about the distance of engagements. One of the things that stuck out was that if one personally views the aftermath of shooting up close, the psychological effects are the same as if it happened at point blank. Example scenario being a fellow gets tagged by a grunt, then the grunt moves up to search the body. That’s legit. A lot of times in counter-insurgency that’s exactly what happens.  

I can see that. It's partly what I meant about the aftermath. They walk up and search the bodies and/or confirm the kill. But I'd still argue it's gotta be much worse on your psyche if you say went one on one with a guy. The trauma has to be ratcheted at that point. I mean think about the difference of being in a fire fight, even say at 20 yards compared to, the VC just over ran your foxhole and it gets down to your shovel and his bayonet. Much more (savage) intimate. The adrenaline dump after surviving that situation has to be like a transformer blowing.

 

32 minutes ago, Swervin11b said:

Which brings up something I didn’t write about in that piece...moral injury. It’s the idea that there is some psychological damage as a result of doing things that go against a moral code, say, like modern people killing one another. It’s not true for everyone (there are sociopaths out there), but 98% of modern people are deeply disturbed by killing or helping in a situation in which someone was killed. It goes against core human values, somewhat illustrated by Judeo-Christian beliefs and moral codes.  

Oh, yeah. LOL. From the second we can speak (or even before), we are told don't hit, don't bite, don't kick, don't kill. It's pounded into your brain from birth basically. Then as you go into the world it's reinforced by your peers, church/synagogue, school, neighbors, family, laws. Then along comes a war and the military and they proceed to teach you the opposite. Then you go forth and do exactly what you've been told not to do since your were filling your diapers. It's quite a contradiction to come to terms with.  And I imagine it's those quiet moments, years later when it's all done, when you truly start reflecting on it and struggling with it.

 

41 minutes ago, Swervin11b said:

What’d be interesting to see is if ancient people who viewed warfare as normal, and even good, had the same adverse reaction to killing. I don’t suspect they did, as you indicated. They’re just very different cultures with far different mores and traditions.  

My guess is that it was probably easier the less personal it was. The closer to home the closer to hurt. Kinda like now but much more casual than our modern minds could fathom. I mean executions were a family event. LOL. Grab some popcorn and let's watch them disembowel Alistair the Counterfeiter. Or pop down to the local fighting pit and bet on some death sports. Then you look at slavery and what those lives were worth. Life was pretty cheap from the inside looking out. When we hear about a man being killed say, in another state, we can at least sympathize, back then, it probably didn't even register unless you knew the dude. Hard to say, though.

Oh and here's the link Bulletpoint PMed me. It's an interesting little read.

 

http://www.historiamag.com/roman-ptsd/

 

44 minutes ago, rocketman said:

I can highly recommend a well made documentary called "War Torn" about the history of PTSD in the US armed forces from the Civil War to the modern age.

I watched that way back when it first aired. It's pretty good. He did another one on surviving war too, I believe.

 

Mord.

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11 minutes ago, Erwin said:

This seems to be the crux of the matter.  Life was short and cheap and death was everywhere from one source of another until the 20th Century.  The idea that we are all valuable individuals and that life is precious is a new concept.

That's a VERY good point. The individual. The only time that concept came into play was when the "individual" was the guy with the power. Everyone below him was a cog. Grist.

 

The idea freed us and maybe softened us at the same time.

 

Mord.

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5 hours ago, Swervin11b said:

Which brings up something I didn’t write about in that piece...moral injury. It’s the idea that there is some psychological damage as a result of doing things that go against a moral code, say, like modern people killing one another. It’s not true for everyone (there are sociopaths out there), but 98% of modern people are deeply disturbed by killing or helping in a situation in which someone was killed. It goes against core human values, somewhat illustrated by Judeo-Christian beliefs and moral codes. 

What’d be interesting to see is if ancient people who viewed warfare as normal, and even good, had the same adverse reaction to killing. I don’t suspect they did, as you indicated. They’re just very different cultures with far different mores and traditions.

The Navajos (and possibly some other NA tribes as well) have an interesting approach to this problem. That is that when they go to war they put on a different persona from their normal one, and this new persona is understood to perform acts that would be taboo to their normal persona. If they return alive from the war, they undergo a healing ceremony in which their society restores their normal persona. That is as much as I know on the subject, so I can't say how effective it is in protecting the mental health of veterans, but it is an intriguing approach to the issue.

Michael

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One factor more common in more modern wars is traumatic brain injury (TBI) due to concussion. TBI and PTSD have overlapping symptoms and can occur in the same person, but treatments are different and incorrect diagnosis of either as the other can lead to ineffective treatments and bad outcomes. Before there was a lot of HE and big guns around, TBI caused by blast concussion was comparatively rare. 

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