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This essay argues that the Greeks experienced and understood combat trauma, and that they used tragedy and the catharsis that it effected as a means of restoring the order of souls traumatized in war. Our examination of the horrors of hoplite warfare should leave us with no question that ancient warfare was no more clean, decent, or glorious than modern war. To treat the trauma induced those horrors, the Greeks did indeed practice certain societal mechanisms, which our own society seems to so sadly lack. One of these was Attic tragedy. Certain of the tragedies explicitly speak to military experience, but the very nature of the tragic genre itself is a perfect portrayal of choices a soldier must make in combat. This is the case, I argue, with tragedies that are not ostensibly related with warfare, such as the Oedipus. If this is the case, the structure of the tragic narrative itself should imitate or re-present the sort of impossible choices that soldiers face. Hamartia, a key element of tragedy according to Aristotle's account, represents just this situation. Hamartia serves to bring about an anagnorisis, and, in association with this anagnorisis, a change in fortune, peripateia in Greek, for the tragic hero. The narrative structure that presents these elements of the story brings about a certain pleasure. But more importantly, the purpose or telos of tragedy is the working out of a certain catharsis, through pity and fear, of such emotions. Aristotle's remarks in the Politics on the end of mimetic arts in general and tragedy in particular seem to indicate that it serves an educative function in the polis. This statement should be taken quite loosely, however, as he says that it provides an emotional rest from past labor and a preparation for future pains, rather than any strictly cognitive education. If it provides this cleansing of the emotions, what emotions does it cleanse? According to the Rhetoric, the emotions similar to pity and fear mentioned in the Poetics are all thumetic emotions: all of those passions originate in the spirited part of the soul, or the thumos. Thumos is the seat of the political passions in every human being, and even more specifically, the passions most proper to the military profession. These passions are also the tragic emotions. An analysis of their role in tragedy reveals that they almost universally drive the action of the plot and exacerbate the hamartia, if they are not themselves part of the hamartia. They form the perfect candidate for this place, because we do not assign moral blame to someone who has committed a bad action out of thumos, as his action was due to a "necessary or natural" passion. Thus, thumos forms the perfect candidate for causing a tragic hero to run afoul of the hamartia in himself and his surroundings. All of this also establishes thumos as the perfect target for catharsis: that which brings about the tragedy can be cleansed by means of the tragedy. Having concluded that catharsis is the restoration of balance in the thumos, I addressed several possible theories that seek to explain how catharsis works, testing them against the definition we had established. Each contains elements of truth, but was found lacking in explaining how catharsis functions due to misunderstandings of the role of tragedy as an antidote to combat trauma. An alternative theory, that catharsis functions through communalizing traumatic narratives, seems to fit both Aristotle's Poetics and the effective methods of modern clinical psychology as practiced by Jonathan Shay and others.

BACKGROUND: The goal of this work was to examine associations among childhood trauma, combat trauma and substance use (alcohol problems, frequent heavy drinking (FHD), current cigarette smoking, and current/lifetime drug use) and the interaction effects of childhood trauma and combat exposure on those associations among National Guard/Reserve soldiers. METHODS: Participants (n=248) completed an electronic survey asking questions about their military experiences, physical and mental health, and substance use. Childhood trauma and combat exposure were examined jointly in regression models, controlling for age, marital satisfaction, and number of deployments. RESULTS: Childhood trauma was associated with current drug use (trend level, OR = 1.44, 95% CI: 0.97, 2.14; p = .072) in the main effect model; however, there was not a significant interaction with combat. Combat exposure had a significant interaction with childhood trauma on alcohol problems (b = −0.56, 95% CI: −1.12, −0.01; p = .048), FHD (b = −0.27, 95% CI: −0.47, −0.08; p = .007), and lifetime drug use (OR = 1.78, 95% CI: 1.04, 3.04; p = .035). There were no associations with either of the trauma measures and current cigarette smoking. CONCLUSIONS: Our results demonstrate that childhood and combat trauma have differential effects on alcohol use, such that combat trauma may not add to the effect on alcohol use in those with greater child maltreatment, but may contribute to greater alcohol use among those with low child maltreatment. As expected, childhood and combat trauma had synergistic effects on lifetime drug use. Screening for multiple types of trauma prior to enlistment and/or deployment may help to identify at-risk individuals and allow time for early intervention to prevent future adverse outcomes.

The police fight a different kind of war, and the enemy is the police officerís own civilian population: those who engage in crime, social indignity, and inhumane treatment of others. The result for the police officer is both physical and psychological battering, occasionally culminating in the officer sacrificing his or her life to protect others. This book focuses on the psychological impact of police civilian combat. During a police career, the men and women of police agencies are exposed to distressing events that go far beyond the experience of the ordinary citizen, and there is an increa

Background: Little is known about trauma and its mental health impact on Native Hawaiians/Pacific Islanders (NH/PI), an understudied Indigenous-colonized population that endures severe mental health disparities. Aims: This novel investigation assessed trauma prevalence and its mental health and substance use correlates in NH/PIs in the U.S. Method: Using community-based participatory research methods, survey data on NH/PI trauma, depression, anxiety, substance use, and treatment need were collected from 306 NH/PI adults using online, telephone, and in-person methods. Descriptive statistics and adjusted regression models were employed. Results: Sixty-nine percent of participants experienced lifetime trauma, reporting mean exposure to 2.5 different trauma types. Childhood physical and sexual abuse, and lifetime forced sexual assault rates were 34%, 25%, and 27%, respectively, exceeding general population rates. Women and men reported equivalent total mean exposure to different trauma types, as well as equal prevalence for every trauma type examined (e.g. sexual abuse/assault). Confirming hypotheses, after controlling for key demographic and mental health risk factors, increased exposure to multiple trauma types uniquely associated with greater depression, anxiety, alcohol symptomology, and greater likelihood for needing treatment and using illicit substances. Conclusions: Trauma is prevalent in NH/PI populations and significantly impacts NH/PI mental health; serving as an important but overlooked contributor to NH/PI mental health disparities. Current findings fill critical gaps in our knowledge of NH/PI trauma and mental health while revealing the importance of screening and treating NH/PIs for trauma exposure to alleviate existing mental health disparities.

Über das Medium Computerspiel findet zunehmend eine Auseinandersetzung mit psychologischen Traumata statt. Posttraumatische Belastungsstörung, Krankheit und Tod sowie Depressionen und Phobien sind hierbei vorherrschende Themen und Motive. Der Autor zeigt in einem historischen Überblick und in vergleichenden Analysen Tendenzen der kulturellen Repräsentation auf. Die Beschäftigung mit Titeln wie "Papers, Please", "Hellblade: Senua's Sacrifice" und "Disco Elysium" lässt deutlich werden, wie Computerspiele zunehmend medienspezifische Möglichkeiten finden, die Vielfalt und Komplexität traumatischer Erfahrungen zu vermitteln.

Über das Medium Computerspiel findet zunehmend eine Auseinandersetzung mit psychologischen Traumata statt. Posttraumatische Belastungsstörung, Krankheit und Tod sowie Depressionen und Phobien sind hierbei vorherrschende Themen und Motive. Thomas Spies zeigt in einem historischen Überblick und in vergleichenden Analysen Tendenzen der kulturellen Repräsentation auf. Die Beschäftigung mit Titeln wie »Papers, Please«, »Hellblade: Senua's Sacrifice« und »Disco Elysium« lässt deutlich werden, wie Computerspiele zunehmend medienspezifische Möglichkeiten finden, die Vielfalt und Komplexität traumatischer Erfahrungen zu vermitteln.

Abstract Cold regions are a special combat environment in which low temperatures have a great impact on human metabolism and other vital functions, including the nervous, motion, cardiovascular, circulatory, respiratory, and urinary systems; consequently, low temperatures often aggravate existing trauma, leading to high mortality rates if rapid and appropriate treatment is not provided. Hypothermia is an independent risk factor of fatality following combat trauma; therefore, proactive preventative measures are needed to reduce the rate of mortality. After summarizing the basic research on battlefield environments and progress in the prevention and treatment of trauma, this article concludes that current treatment and prevention measures for combat trauma in cold regions are inadequate. Future molecular biology studies are needed to elucidate the mechanisms and relevant cell factors underlying bodily injury caused by cold environment, a research goal will also allow further exploration of corresponding treatments.

"The Korean War (1950-53), was a ferocious and brutal conflict that produced over four million casualties in the span of three short years. Despite this, it remains relatively absent from most accounts of mental health and war trauma. Invisible Scars provides the first extended exploration of Commonwealth Division psychiatry during the Korean War and examines the psychiatric care systems in place for the thousands of soldiers who fought in that conflict. Fitzpatrick demonstrates that although Commonwealth forces were generally successful in returning psychologically traumatized servicemen to duty and fostering good morale, they failed to compensate or support in a meaningful way veterans returning to civilian life. Moreover, ignorance at home contributed to widespread misunderstanding of their condition, and veterans were often deprived of public space in which to grieve. This book offers an intimate look into the history of psychological trauma and assesses the impact of the Korean War on the development of military psychiatry. In addition, it engages with current disability, pensions and compensation issues that remain hotly contested and reflects on the power of commemoration in the healing process."--

Author Powell enlisted with the US Marines in April 1966. His journey from naive civilian to battle-hardened combat veteran shows us how fragile our humanity really is. In addition to killing the enemy, he was witness to countless cruelties, including cold-blooded, casual murder, cowardice under fire, and callous disregard for life. Upon returning to civilian life after two years, he found himself with nightmares, intrusive thoughts, an exaggerated startle reaction, and a seeming inability to control basic emotions. The price he paid for what would be diagnosed only decades later as Post-Traumatic Stress Disorder was broken marriages and relationships, inability to hold down jobs, and alcohol abuse. In 1989, David recovered through a simple but powerful technique known as Traumatic Incident Reduction (TIR) and is now symptom-free. His story shows what is possible for anyone who has suffered traumatic stress, and that hope, healing, and recovery can be theirs too.--From publisher description

Background: Trauma readiness is a Department of Defense requirement for military healthcare providers. Surgeons must maintain readiness to optimize surgical care on the battlefield and minimize preventable death. The objective of this study was to validate a predictive model for trauma operative exposure by applying the model prospectively. Methods: The predictive model for operative trauma exposure was prospectively applied to predict the number of emergent operative cases that would be experienced over predetermined time periods at four separate trauma sustainment military-civilian partnerships (TS-MCP). Notional courses were designed to be 2 or 4 weeks long and consisting of 5 and 12 overnight call periods, respectively. A total of 51 separate 2-week courses and 49 4-week courses were evaluated using the model. The outcome measure was the number of urgent (occurring within a day of arrival) operative trauma cases. Results: Trauma/general surgery case volumes during call periods of notional courses were within the predicted range at least 98% of the time. Orthopedic volumes were more variable with a range of 82%-98% meeting expectation depending on the course length and institution. Conclusion: The previously defined model accurately predicted the number of urgent trauma/general surgery cases course participants would likely experience when applied prospectively to TS-MCP; however, the model was less accurate in predicting acute orthopedic trauma exposure. While it remains unknown how many cases need to be performed meet a trauma sustainment requirement, having a model with a predictive capability for case volume will facilitate metric development. This model may be useful when planning for future TS-MCP. Level of evidence Economic and Value Based Evaluations Level II. Copyright Author(s) (or their employer(s)) 2019. ; https://doi.org/10.1136/tsaco-2019-000373