Wars have been fought ever since men started using fists, sticks and stones to get what they couldn't get by less violent means. Now wars are fought by men and women who are paid to kill those humans who are fingered as enemies of the state by those above them in the chain of command. The sense of honor in "just doing my job," the threat of court martial, the fear of summary execution if one refuses to kill in battle, the promise of rape and pillage, a false sense of patriotism: all these are motivating factors for the soldier who risks his body, psyche and soul in making murder for the state. Instilling a strong sense of patriotic duty to "Volk und Vaterland" is a constant among all militaristic societies who have to fool recruits into the anti-human willingness to kill and be killed.

But if history is read honestly, every war has been fabricated and has therefore been avoidable. The exhortations to go to war always come from the elite economic and political war profiteers, the military careerists and many others who have ulterior motives. In other words, the warriors who do the killing are not consulted; they are simply expected to unthinkingly "serve their nation" and act like patriots rather than the paid mercenaries they are. They are compelled to "just follow orders" -- even if the orders are illegal, immoral or result in an actual war crime.

One of the most common yet covered-up consequences of war is a mental disorder called posttraumatic stress disorder (PTSD). The killing, raping and wounding of civilians, animals and property are predictable outcomes of the war zone (the civilian casualties are euphemistically called "collateral damage"), but the psychological trauma that "surviving" soldiers experience often results in devastating mental anguish for them and their loved ones back home, suffering that lasts a lifetime -- or two or three.

PTSD is a mental disorder caused by the effects of a psychologically distressing event or events usually of a severity or duration that is beyond the range of normal human experience.

War zone PTSD results from the perpetrating or witnessing of gruesome death or injury or experiencing the threat of death or injury of oneself or of other human beings. The psychological terror of living in a "kill or be killed" situation is stress enough to cause PTSD in most people. But the "adrenalin rush" that accompanies violence in all its many forms can be additive and each traumatic experience, starting with the psychological rape that is a routine part of basic training, proceeds inexorably toward a breaking point.

Anybody (except those soldiers who have been hardened into quasi-criminals and who thrive on the violence) can and will crack under the strain of combat war. In the post-mortem analysis of WWII, the Department of War (now called the Department of Defense) observed that after approximately 200 to 240 days of combat, virtually everybody got disabling, full-blown PTSD (aka combat fatigue in WWII). About the only ones who weren't affected psychologically were the conscienceless psychopaths who actually enjoyed the killing.

Another relatively unaffected group were those rare individuals who were able to maintain their spiritual selves during the war. These men tried to find meaning in their circumstances, avoided acts of cruelty, did not participate in mutilation of enemy corpses, did not rape or do violence to civilians, were merciful to those around them and then were lucky enough to have a nurturing family group to genuinely care for them after their discharges from their hellish existence.

Because of the military experience gained in WWII, limits were placed on the length of front line tours of duty for the combat soldier in Vietnam. Therefore, 12-13 month tours were instituted (vs. "for the duration plus 6 months" in WWII). This strategy, hotly debated at the time in the Pentagon, backfired in many ways. Unit cohesiveness and effectiveness suffered dramatically. Green recruits were continuously being rotated into every unit to replace those who had been killed or injured in battle, and they were inexperienced soldiers who couldn't be trusted for months. In addition, the "shorts" (those who were nearing the end of their tours of duty) started thinking more about ways to survive than about being effective soldiers -- and were therefore a liability to the unit.

To make things worse, the officers of combat units were on 6 month, rather than 12 month rotations, resulting in a similar problem, i.e., as soon as they obtained the necessary experience that would make them useful and trustworthy leaders, they were rotated out, making way for another dangerous greenhorn officer that took another 3-6 months of seasoning!

12 month tours and PTSD were related in another way. The discharged survivors were sent back to the states abruptly, oftentimes arriving home within 48 hours. Returning from the hell of jungle warfare -- where smells and sights and sounds of gruesome death were all around -- to an oblivious citizenry who had no concept of the realities of war, was the ultimate culture shock. And to top it off, the soldier was often subjected to verbal attacks from both anti-war activists, who were outraged over the atrocities of the war, and veterans of past wars, who abused them for being "losers."

However, those psychological abuses were minor compared to the malignant combat experiences that couldn't be unremembered. The horrific images of death, cruelty, rape and mutilation -- of both the enemy and the suffering innocent civilians -- were indelibly etched into their brains, just waiting to emerge at the most unwelcome times. Nightmare images of terror and suffering often made sleep a horrific experience to be avoided, with terrible consequences flowing from the resultant sleep deprivation.

It is not difficult to understand why insomnia, depression, chronic fatigue, guilt, drug abuse, anxiety and hostility are common in combat-induced PTSD. Because of the sleep disturbances, PTSD victims have trouble concentrating, making understandable their inability to hold onto creative jobs. Disastrous marriages and troubled parent-child relationships are common. And, because of the resulting mental anguish, mood-altering drugs, tobacco and alcohol are commonly used to relieve the pain, thus aggravating every other mind/body problem.

PTSD now represents real science and psychology; it is not just theory anymore. A massive amount of research has been done into the science and is expanding exponentially. This new knowledge, however, is slow to reach the mainstream of medicine. And thus the benefits of the new understandings are also slow to trickle down to the affected veterans.

And to make everything even worse, short-sighted economic cutbacks, many made to fund future crazy-making wars, are happening in medical programs that affect all segments of society, especially for veterans programs. VA hospitals and clinics everywhere are downsizing precisely when the need for attention is increasing.

Despite the brevity of the Gulf War I, the incidence of PTSD turned out to be substantial and, like Vietnam, is getting worse rather than better. Studies have shown a high incidence of both full-blown and partial PTSD. Those studies have confirmed particularly high rates of PTSD in the military police, medical units and graves registration units (those who handle the bloody dead bodies and putrid body parts of the dead). We can be certain that a substantial part of the Gulf War Syndrome is due to the psychological trauma of war.

One disturbing characteristic of PTSD is that the onset of the disease is unpredictable, sometimes not manifesting itself for decades after the original trauma. Some WWII vets only started manifesting the syndrome after the 1995 50th anniversary media events started being aired on television. Many new cases of PTSD were brought on by the graphic battle scenes in "Saving Private Ryan."

Because PTSD is "contagious," there are numerous secondary victims of the affected perpetrator soldiers, mainly the families -- the ones who sent their adolescent boys off as innocent recruits and received them back unrecognizable, "insane," addicted, criminal and "changed forever," as the Marine Corps ironically advertises itself.

Communication problems between the traumatized veteran, his family and therapy team were often insurmountable, the soldiers being unable to talk about their painful war experiences, and the rest of us not wanting to hear their stories anyway. So misunderstandings were common, with frustrations, anger, fear, and hostility easily emerging. Family dysfunction and marital breakdowns were the norm, and the ingrained homicidal violence of combat, which took too much effort to suppress continuously, often erupted -- with disastrous results for the family and society.

Veterans tried everything they could think of to cope, but nothing helped for very long. Very few trusted the VA system, which seemed unresponsive to their needs, in denial over the realities of PTSD and therefore unprepared to deal with issues they couldn't understand. And besides, the Pentagon didn't want the public to know there were problems in the war business, so it was the rare Vietnam vet that stuck with the system. And, when they did partake in VA treatment programs they were given large doses, in various combinations, of experimental prescription drugs, which only seemed to "zombify" them which just seemed to keep the demons in the brain only partially under control. So, with no effective help and considerable confusion about what was going on, the traumatized vets wandered from one unsatisfactory, addicting self-treatment to another, getting more disillusioned, more hopeless and more homeless as time went on.

Sadly, the depression and guilt was often too much to bear and suicide was an attractive way out of the pain, sometimes preceded by violent retribution along the way. (It is often said that 200,000 Vietnam vets have committed suicide since they came home from the war, although, with 30% of the huge US homeless population being nameless and homeless Vietnam veterans, the precise number is unknown and actually may be larger!)

The comprehensive National Vietnam Veteran Readjustment Study (NVVRS), published in 1988, revealed that 480,000 Vietnam vets have full-blown PTSD, with another 350,000 having partial PTSD. Over 50% of the Vietnam combat vets were victims of the full-blown disorder, as were 20-30% of Vietnam theater vets overall!

With, on average, 4 other people being significantly psychologically traumatized by the original affected vet, America's massive mental health problem is understandable. As surely as love begets love, violence begets violence, but violence spreads more quickly through the generations, and it is acting like a plague. Therefore PTSD can be truly regarded as a contagious, familial and epidemic disease, often spreading exponentially through the generations and through the neighborhoods, with the victimized children at high risk of victimizing others later, especially their own children, spouses, siblings, parents, neighbors and assorted "loved ones."

What can be done? Veteran's organizations must do their part in raising this serious issue to the consciousness of the public as well as to themselves and their traumatized families. War zone PTSD is eminently preventable, but the killing has to stop first.

Since PTSD is a serious spiritual issue, the churches must become involved as well by starting to teach and implement the clear nonviolent teachings of Jesus. (As a sobering example of how serious this issue is for the churches, 75% of Vietnam era pre-recruits attended worship services regularly, but when they returned home from the war, church attendance dropped precipitously to below 25% -- actually approaching zero in the PTSD-affected population!) Retention, and not just recruitment, of souls should be job #1 for any church that wants to grow. Combat violence is a sure-fire way to lose church members and their families.

Combat-induced PTSD is as complex as it is serious, but it can be easily understood if intentionally taught. And since effective treatment is difficult and real "cures" virtually impossible, prevention appears to be the only real hope.

And that prevention can only be accomplished if society and its policy-makers are willing to be totally truthful about the real costs of war, a highly taboo subject for militarists, superpatriots, conservatives and nationalists and therefore one that has so far not been adequately dealt with.

Total truthfulness is the only way to start any healing of this or any dysfunctional group or nation, and it's the only way to start the reversal of the disastrous economic costs of American militarism.

But, what is more important is this: the immeasurable and unaffordable costs of war and violence must be thoroughly understood if the decline and fall of the American Empire is to be averted.

© Gary G. Kohls, MD, 1306 E.8th St., Duluth, MN 55805 Ph/fax (218) 728-9756, email: gkohls@cpinternet.com, Midwest Coordinator for Every Church A Peace Church (http://www.ecapc.org).