The Persistence of War

War seems always to be with us. Its persistence in the affairs of nations is an evil we have yet to explain, a puzzle we have yet to solve, a nut we have yet to crack. Many simply say that war comes from Evil itself, or that it is essentially inexplicable. Or they say that it comes from Original Sin — an essential flaw in human nature.

Yet we make attempts to explain war, in hopes that we can reduce it, or control it. Violence begets violence we say, and indeed this is written in the Bible: "An eye for an eye, a tooth for a tooth." Hammurabi's Code and the Ten Commandments of Moses were early attempts to regulate human behavior and thus to reduce causes for conflict. After all, coveting your neighbor's wife is what led to the Trojan War. Greed, envy, pride, anger: at least four of Christianity's seven deadly sins lead to war.

Sometimes we are overwhelmed by kinds of violence and armed conflict which seem very hard to understand indeed, mystifying in their horror. How do we explain a Hitler or a Pol Pot? Even more puzzling: how do we explain those who follow and obey the orders of those who in retrospect were clearly madmen? And most germane to our era: How can we explain — and how can we stop — those who are willing to kill themselves to inflict terror and death on others?

Despite the ominous and seemingly endless basso continuo of violence in the world, there are grace notes of hope, rests in the deadly music, changes from dissonance to harmony. How does this happen? How can it be that the nations of Scandinavia, for example, despite their bloody Viking and medieval history, have not started a war for almost two full centuries (since 1814)? What do they know, do, believe, or practice which others do not? Is the transformation of a once war-torn Europe into an economic and relatively harmonious union of peoples over the past fifty years something temporary? Or are there grounds for hope; more particularly, are there changes that could be made in the lives of individuals, institutions, societies, governments that would foster peace rather than war?

Medical versus Moral Perspectives

We would like to suggest that instead of looking at the problem of war as a moral issue — of Good vs. Evil, or of the depravity of human nature versus the more noble instincts — we should use a medical model to examine the relative health of societies which are prone to warlike behavior, as opposed to those who have a more peaceable bent. In other words, let us consider violence to be a symptom of illness, identify the illness, and then study its social epidemiology.

There are many historical precedents for moving from the moral to the medical perspective. For example, numerous disorders which we now recognize as diseases — tuberculosis, cancer, multiple sclerosis, addictions and mental illnesses — were once regarded as moral issues. There was even a moral theory of disease: the idea that many diseases are divine retribution for sin, or the result of satanic influence on people of weak moral character.

When medical science finally understood the germ theory of disease, late in the 19th century, the epidemiology of a group of moral diseases became comprehensible, and the society gradually abandoned the practice of ascribing character faults to those infected with leprosy and tuberculosis. A similar evolution occurred in the 20th century with auto-immune diseases, such as multiple sclerosis and lupus, and with cancer of all types. It appears that mental illnesses and addictions are now also in the process of changing from character or moral defect to medical condition.

This essay presents a theory that explains the persistence of European war, based on three social processes: post-traumatic stress disorder (PTSD), attachment disorders, and the relationship between shame and violence. It is not a comprehensive theory of the root causes of war. Instead, this theory seeks only to explain both the historical persistence of war in Europe and its recent absence.

The foundation of this theory is firmly rooted in psychophysiology: the now well-known deleterious physiological effects of traumatic events on adults and children, of a failure of attachment on infants and children, and of abject abuse and neglect on children. These effects are well-known in their individual medical contexts, but the implications for the development of societies have not yet received widespread attention.

A Reinterpretation of European History

The history of Europe can be reinterpreted in the light of modern knowledge of post-traumatic stress disorder (PTSD), attachment disorders (AD), and the connection between shame and violence. Very briefly, here is the core of that reinterpretation:

• The populations of ancient and medieval Europe were exposed to sufficient trauma due to epidemic disease and alcoholism alone to guarantee higher levels of PTSD and attachment disorder than are seen in healthy populations today.

• Several specific symptoms of untreated PTSD are particularly troublesome for the social institutions of a society suffering from epidemic levels of these disorders. These symptoms are: hypervigilance, emotional numbing, denial and avoidance, seeing the world in black and white, magical thinking, and apocalyptic thinking. These thought patterns colored the behavior of religion, government, the military, and the law. Frequent warfare was the result, and this warfare increased PTSD levels even further.

• Among the many psychological consequences of childhood emotional neglect are attachment disorders, and the somewhat less serious insecure attachment styles. The adult consequences, if present on a widespread basis, may be troublesome for social institutions. Adults who as children suffered from a lack of attachment to a primary caregiver are thought to have a diminished capacity for empathy; in extreme cases these adults are often said to have sociopathic or psychopathic personalities. When the children of a society suffer from attachment disorder on an epidemic scale, then its social institutions will tend to conduct their affairs with brutality and disregard for pain and suffering; large categories of people will be considered subhuman or nonhuman; animal maltreatment will be widespread.

• Slavery and other forms of bondage were nearly universal in ancient Europe, diminishing slightly during the medieval era. These violent and coercive social institutions were made possible by the emotional effects of PTSD and AD. They also contributed to the incidence of PTSD in children born in slavery, and non-slave children who witnessed the extreme violence that slavery so often requires.

• The industrial revolution and improvements in public health gradually reduced infant mortality and the severity of epidemics during the 18th and 19th centuries, particularly in Britain and Scandinavia. Alcoholism receded, and in Northern Europe the education of women improved and slavery declined to near zero. Thus Scandinavia became the first region in Europe to experience a decline in PTSD and AD from very high levels. As a consequence, the avoidance of war was first practiced in the Nordic countries.

• Scandinavia escaped the period of the Napoleonic Wars almost unscathed, but the populations of all other nations of Europe from Spain to Russia suffered terribly. The countries of Scandinavia remained largely uninvaded and militarily uninvolved for the rest of the century, while a succession of deadly wars ripped back and forth across the continent. Every nation-state in Europe outside of Scandinavia was involved in these wars, and also in numerous colonial wars fought abroad. In addition, there were bloody revolutions and civil wars in France, Portugal, Spain, Italy, Poland, Austria, Germany, Ireland, and Russia.

• German theories of child-rearing were influential throughout Europe during the 18th and 19th centuries, and well into the 20th. The essential idea of German pedagogy of that era was to break a child's willfulness (Eigensinn) through harsh discipline and punishment, at an age early enough so that the memories of this treatment would be masked by the normal process of early childhood amnesia. The willfulness that so concerned German parents was what we now recognize as the healthy process of separation of a child's sense of identity from his or her parents at roughly two years of age. The methods recommended in German pedagogical books involved whippings, withdrawal of love, isolation, shame, humiliation, scorn, ridicule, and coercion by methods akin to torture. All of this was done in what were thought to be the best interests of the child. The consequences were generations of children who grew up intensely traumatized, numb to the suffering of others, obsessed with obedience to higher authority, terrified of shame and dishonor, and prone to dissociation and denial.

• These developments, together with the rapid advances of technology, made possible World Wars I & II. Only in the aftermath of World War II was the cycle broken, as new social and political institutions were created, initially by the Allies and then later by the European states that comprise the European Union. High levels of PTSD lingered on in Germany for two generations, most visibly in the eastern zone, but their effects on social institutions were buffered by Allied oversight.

• Harsh medieval child-rearing practices and domestic violence remained high in the Balkans long after they disappeared in the rest of Europe. It is likely not a coincidence that warfare in the Balkans has persisted longer than in the rest of Europe.

The following sections discuss these points in greater detail, with references.

Psychophysiology of Trauma and Neglect

Loss of a job, divorce, the natural death of a parent: these are examples of very stressful events that have well-documented temporary health consequences [1]. However, these events do not ordinarily rise to the level of trauma, in the psychiatric sense of the term.

By one definition, psychological trauma is an experience of a threat to life, body, or sanity, so severe as to overwhelm the ordinary process of emotional integration [2].

Experiences such as rape, abuse by a parent, the violent death of a loved one, warfare, loss of home, the onset of major psychosis, and massive natural disasters: all of these events cause trauma in a fraction of the people who experience them. The more severe the event, the greater the fraction traumatized.

The chronic condition known as post-traumatic stress disorder, or PTSD, is a frequent consequence of overwhelming traumatic experience in every culture and every era of history. Shakespeare accurately enumerated its symptoms in Henry IV, Part I [3]. Some two millennia earlier, Homer depicted similar symptoms in his portrait of Achilles in The Iliad, and made a clear connection between battlefield trauma and the atrocities of war [4].

PTSD entails recurrent and intrusive flashbacks to the traumatic event, in the form of hallucinations, nightmares and dissociative episodes. PTSD causes people to suffer from hypervigilance and an exaggerated startle response, sleep disturbances, outbursts of anger, and extreme sensitivity to any event that resembles the original trauma. As a defense against this extreme sensitivity, many people suffer amnesia with respect to the traumatic event, avoid thoughts or feelings or situations associated with the event, turn to alcohol or opiates for emotional relief, feel detached or estranged from others, or feel emotionally numb. They tend to see the world in black-and-white terms, e.g. good and evil, with nothing in between, and feel that life could end at any moment (apocalyptic thinking). People with severe PTSD dissociate when confronted with reminders of the traumatic event: they feel disconnected from their immediate circumstances, as though they were observing a scene with complete emotional detachment, sometimes they also feel physically removed as though floating overhead.

Not every severe event causes trauma, and not every trauma leads to PTSD, but when it does the symptoms continue to haunt the lives of traumatized people for decades. The prevalence of PTSD varies with the severity and duration of the traumatic event. Some representative estimates from recent studies:

• 20% of firefighters suffer PTSD,
• 25% of the victims of violent crime and rape,
• 25% of the American combat soldiers in the Vietnam War,
• 50% of prisoners of war,
• 50% of wartime refugees,
• 60% of those who survive catastrophic natural disasters, and
• 65% of soldiers in the heaviest combat,

Adults and children who already have PTSD are extremely susceptible to retraumatization by milder events with which normal people easily cope. This effect is very strong; the life history of many people with untreated PTSD is one of endless retraumatization.

Infants and children can suffer PTSD from traumatic events, but they have additional important issues that arise from damaging effects on their developing nervous systems. Compared to adults, children who are physically or sexually abused are far more likely to develop a deep-seated sense of shame and inherent worthlessness. Chronic fear in children causes irreversible damage to the hypothalamic-pituitary-adrenal axis, and to the parasympathetic and catecholamine responses. These changes are the physiological basis for most of the psychological symptoms of abuse and neglect, such as dissociation, memory flashbacks, reduced fear response, and passive fear, also known as learned helplessness. Children who have been emotionally neglected during the critical first four years of life grow up to be adults with varying deficits of attachment, ranging from difficulties with empathizing or forming stable relationships all the way up to borderline and frankly psychopathic personalities. Addiction, depression, anxiety disorders, violent and suicidal behavior, and other conditions are concomitant among these adults.

The connection between psychological trauma, shame, and violence has been documented by researchers from many different perspectives and disciplines, including FBI profilers, criminologists, anthropologists, psychotherapists, psychiatrists, and psychoanalysts. The core of the theory is that badly traumatized children tend to lose the ability to form an internal positive sense of self-worth, and come to depend on the opinions of others. Their sense of honor and pride is thus brittle and easily threatened, by real or imagined disrespect from those around them. When they are shamed as adults, they are more likely to react with violence than those who were not traumatized as children. As prison psychiatrist James Gilligan writes,

• Why are these feelings of shame and self-contempt so bottomless, chronic, and almost ineradicable in the most violent men? Because, in the men I knew, they had been subjected to a degree of child abuse that was off the scale of anything I had previously thought of describing with that term. Many had been beaten nearly to death, raped repeatedly or prostituted, or neglected to a life-threatening degree by parents too disabled themselves to care for their child. And of course those who had not experienced those extremes of physical abuse or neglect, my colleagues and I found that they had experienced a degree of emotional abuse that had been just as damaging: being focused on as the parents' emotional "whipping boy," in which they served as the scapegoat for whatever feelings of shame and humiliation their parents had suffered and then attempted to rid themselves of by transferring them onto their child, by subjecting him to systematic and chronic shaming and humiliation, taunting and ridicule. [5]

• They [violent prisoners] have not (yet) developed the capacity for the feelings that prevent most of us from behaving violently no matter how much shame, disrespect, dishonor, or insult we are subjected to, such as guilt and remorse over hurting someone else; empathy, love, and concern for others; and even the rational self-interested fear of the retribution that violent behavior provokes from others. [6]

The Intergenerational Epidemiology of Trauma and Neglect

A large majority of parents who suffer from untreated PTSD and insecure attachment styles do not traumatize or neglect their children. However, a small proportion of parents do reenact their childhood traumas on their children, and others are seriously neglectful due to alcohol and drug addictions, major depression, and other consequences of their untreated PTSD. The net effect is that the children who have at least one parent with PTSD are at greater risk for trauma and neglect than those who do not. In addition, a few people who were very badly abused and/or neglected as children become prolific criminal perpetrators, each inflicting massive trauma on scores of unrelated children and teenagers.

For each adult with PTSD, how many children will be traumatized or neglected? This number is thought to be somewhat less than one, on average. In other words, over many generations there will be a gradual reduction in PTSD and attachment disorders, but only if there are no external events that create new cases of trauma — no wars, no plagues, no natural disasters, no masses of refugees.

Of course, no real society can ever achieve this ideal. Ancient and medieval societies were particularly susceptible to catastrophes such as natural disasters and epidemics. Each such event created many new cases of PTSD among the survivors, some of whom suffered serious mental illness or became addicted to alcohol and drugs, and hence neglectful and dysfunctional parents. The random occurrence of natural disasters and epidemics fuels the flames of the intergenerational epidemic, providing ever more fresh cases.

With increasing levels of psychological trauma come increasing levels of violence, and the gradual development of social customs for the maintenance of pride and honor. The "shame-based cultures" identified by Ruth Benedict are also the cultures that are the most violent and prone to warfare. In the extreme cases, such as the Kwakiutl tribe of Vancouver Island, these societies practice "... headhunting, cannibalism, burning slaves alive, and undiscriminating merciless war and murder, even against totally innocent, unsuspecting, hospitable, sleeping friends, neighbors, relatives, or hosts — men, women, and children." [7]

Levels of Trauma and Neglect in European History

Infant mortality in medieval Europe was very high, due primarily to poor sanitation and the absence of vaccinations against communicable diseases. Most families lost half their children to disease, until comparatively recently in history. Families were much larger then, and deaths were very frequent. The loss of even a single child is a serious emotional blow to any family, though normally not so severe as to cause PTSD. However, plagues and epidemics were another matter entirely. When a village had to bury half its population in one week, as happened from time to time during the plague centuries, the catastrophic level of social disruption certainly caused mass PTSD among the survivors. Europe was swept repeatedly with lethal epidemic diseases, not merely plague but also cholera, smallpox, typhus, typhoid fever, measles, and diphtheria. Each such wave left populations struggling not only with economic hardship, broken families, and famine, but also with widespread trauma and PTSD.

Water in medieval Europe was thoroughly polluted, and was considered dangerous to drink. Instead of water, people drank beer and wine. The average consumption of wine in the 14th century, for example, was about 2/3 liter per person per day in Florence, and well over a liter in Sienna. Monastery rations in England were one gallon of beer per monk per day, and similar quantities were consumed by the rest of the populace. At these levels alcoholism must have reached extraordinary prevalence, bringing with it all the neglect and abuse of children that alcoholism entails.

Warfare as carried out by medieval Europeans contributed mightily to the maintenance of high PTSD prevalence. The trauma of bloody combat is merely the beginning of this story. Civilian populations have suffered in almost every war throughout history, despite enormous changes in the conduct and technology of warfare; in fact the ratio of civilian to military deaths in European wars ranges from 1:1 to over 10:1 [5]. Further, for every civilian death there are many more non-fatal casualties and illnesses. Every war generates refugees, of whom an estimated 50% suffer PTSD. In short, almost every war in Europe entailed a huge surge in PTSD among the local populations, with diminishing echoes in subsequent generations.

Slavery was omnipresent in ancient and medieval Europe, only gradually yielding to serfdom and indentured servitude before its eventual prohibition in modern times. The violence necessary to maintain a system of slavery provided yet another major source of PTSD, not only in the enslaved populations but also among the children who witnessed the violent treatment of slaves.

Based on these figures and the far greater rates of trauma in medieval Europe, it is not unreasonable to suppose that European populations had a PTSD prevalence well in excess of 50% during most of the past two millennia: certainly enough to have had a profound impact on the history of European social institutions.

The Effects of Epidemic Psychological Trauma on Social Institutions

It is reasonable to suppose that if a large majority of the population suffers from PTSD and attachment disorders, then there will be serious consequences for all social institutions. The specific individual symptoms most likely to affect institutions are hypervigilance, emotional numbing, dissociation, denial, and apocalyptic thinking (PTSD), and the diminished capacity for empathy (AD).

Copyright © 2009 by Loren Cobb

Religious leaders who suffer from PTSD may favor apocalyptic views of the world, and the concept of inherent shame. Religious institutions can be expected to become more authoritarian, rigid, shame-based, and violent. The processes of dissociation and denial protect religious leaders from empathy with the victims of religiously motivated violence. Religions founded on violence and PTSD are stable and self-perpetuating.

When hypervigilance and apocalyptic thinking are widespread for many generations due to PTSD, then they are likely to become enshrined in religious writings and doctrine. It is quite possible that the Judeo-Christian concept of original sin ultimately derives from the sense of inherent badness that so easily appears in children who are disciplined before they are able to understand why. At the very least, widespread PTSD means that certain religious themes that echo the psychology of PTSD will resonate with large numbers of people, including many who chose a religious vocation. These themes will be reinforced in preference to others that have no such resonance.

Slavery is a peculiar social institution that has psychological effects on those enslaved and also on their masters. Psychologically healthy populations abhor slavery, but when a significant fraction of the population is emotionally numbed by PTSD and AD then slavery can flourish. Children in slave-owning families inevitably witness the violent discipline that slavery requires, causing PTSD in a certain proportion of them as well. It is for this reason that slavery tends to be a stable and self-perpetuating social institution.

Emotional numbing, dissociation, denial, and diminished empathy all make possible the objectification and ill-treatment of all categories of humanity that are less able to defend themselves: children, women, ethnic minorities, the poor, the disabled. Therefore it is reasonable to suppose that a society with epidemic PTSD and AD will tend to become less egalitarian and more discriminatory.

Finally, when a large proportion of a society suffers from combat PTSD, there are consequences for the political life of the nation. As Jonathan Shay wrote:

Conclusion

This theory cannot explain all or even most of the nature of war, nor does it explain the immediate cause of any particular war. It does, however, show how warfare interacts with the psychological trauma, in a vicious cycle that keeps the probability of war at very high levels.

When the demographic transition lowered infant mortality rates during the industrial revolution, one of the major generators of trauma was removed. The consequent reduction in epidemic PTSD permitted slavery to be abolished, which further reduced the prevalence of PTSD, except in Germany where war trauma and theories of child-rearing maintained the epidemic well into the Hitler era.

World War II caused another surge in PTSD in the countries most traumatized by warfare and massive numbers of refugees: Germany, Japan, and the Soviet Union. In the first two countries all social institutions were rebuilt almost from zero by the occupying powers, and were closely supervised for about a decade. This supervision protected them from influence by the epidemic levels of PTSD in the population.

In the Soviet Union, which suffered more civilian death and displacement than any other nation, there was no rebuilding and no benevolent supervision. The Communist Party of the USSR slipped almost immediately into deep paranoia, seeing dangerous enemies everywhere, both in and outside the state.

After two generations of post-war peace and growing prosperity, the prevalence of PTSD in Germany has subsided to the 5–10% range. This is a good indicator that peace will persist in Europe. PTSD prevalence is probably higher in the Balkans and Russia, but no current data is available.

Elsewhere in the world, of course, the story is different. Israel was founded by a people in the grip of near universal PTSD, and Palestine today is clearly suffering the same. Many Islamic societies still practice female circumcision, and harbor hidden epidemics of child abuse. The nations of southern Africa are suffering from the AIDS epidemic and wars fought with child soldiers, and other social problems that are guaranteed to raise PTSD rates. It is no coincidence that these are the parts of the world in which the threat of war is greatest.

Notes

1. Mental Health: A Report of the Surgeon General, Chapter 4. Available on the web at http://www.surgeongeneral.gov/library/mentalhealth/chapter4/sec1_1.html
2. Paraphrased from Perlman & Saakvitne, 1995.
3. Shay, 1994, Chapter 10. I believe that Jonathan Shay was the first to note the correspondence between Shakespeare's description of Harry Hotspur and the symptoms of PTSD.
4. Shay, 1994, Chapter 2. In particular, Shay compares the occurrences of berserk rage in the Trojan War and the Vietnam War.
5. Based on statistics on European wars of the 19th and 20th centuries (White, 2003). The much publicized article by Amnesty International on this subject contains serious historical errors, and should not be used. The estimates by White are the best that I have seen anywhere.
6. Gilligan, 2001, p.36.
7. Gilligan, 2001, p.37.
8. Gilligan, 2001, p.51.
9. Shay, 1994, p.181.

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Copyright © 2004, 2005 by Loren Cobb. All rights reserved. This is a work in progress. Most recent revision: February 2008.

How to cite: Cobb, Loren & Barbara F., The Persistence of War. Lousiville, CO: Aetheling Consultants, 2005. Available on the web at <http://www.Aetheling.com/docs/Persistence.html>.

Want to hear more? Here is a Pacifica Radio interview with Loren Cobb: TQE #156.