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Combat related posttraumatic stress disorder (PTSD) is a long-standing problem that dates back to antiquity. Homer's epic poems The Iliad and The Odyssey are filled with descriptions of war-related psychological damage. Throughout the Middle Ages, religious rituals of penance were used to resolve varied conflicts that emanated from combat.
In American history, each successive war has led to new names for the condition and new theories about its causes. In the post-Civil War era, there were two models that attempted to explain combat-related trauma suffered by soldiers who fought in the Civil War. On the physiological side, doctors called such trauma Soldier's Heart or Da Costa's Syndrome (named after Joseph Mendes Da Costa, who investigated and described the condition during the Civil War), as many soldiers reacted to the strain of the Civil War with cardiac disorders. On the psychological side, soldiers were also labeled as suffering from nostalgia-the idea being that soldiers who fought on alien terrain developed symptoms because they yearned to be back home.
In WWI, it was called shell shock-a response to artillery fire and warfare that resulted in feelings of powerlessness that could manifest as fear, panic, flight, or incapacity to reason, sleep, walk, or talk. Charles Myers, a Cambridge psychologist, was the first to use the phrase "shell shock" in an article he published in The Lancet in 1915.' Though no longer employed in medical or military discourse, the label "shell shock," an alliterative and rather catchy expression, resonated with the public, and many associated it as the emblematic injury of the WWI.
During WWII, doctors dubbed combat-related trauma as battle fatigue, combat neurosis, and combat exhaustion. Some generals, most notably George S. Patton Jr. who is said to have slapped two soldiers recuperating from posttraumatic stress in a military hospital and referred to one as a "yellow bastard" who should not be admitted to the hospital, made the false inference that combatrelated trauma was based on weakness and cowardice (an inference that a number of generals throughout history have made). The U.S. Army refuted this notion when, reflecting a consensus that all soldiers were vulnerable to battle fatigue, it adopted in 1944 the official slogan, "Every man has his breaking point."
In the Korean War, mental health professionals...