Peacekeeping too passive for peace of mind, says psychiatrist
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July 5, 2006
Soldiers better off fighting Peacekeeping too passive for peace of mind, says psychiatrist By CHRIS LAMBIE Staff Reporter
Fighting war might be easier on the head than peacekeeping, says a Halifax military psychiatrist who recently returned from Afghanistan.
Canadian troops are now involved in combat operations in the volatile southern province of Kandahar.
""In some ways, combat is psychologically better for people, for soldiers, because you’re not as helpless as you are as a peacekeeper,"" said Maj. Rakesh Jetly, the psychiatrist in charge of the Canadian Forces Trauma Centre in Halifax.
""As a peacekeeper, you have to sort of stand there as a passive witness to terrible things that are happening.""
Maj. Jetly returned to Halifax recently after spending two months with a mental health team treating coalition soldiers and civilians in Kandahar.
In 1994, he served as a doctor with Canadian troops deployed to Rwanda. The central African country’s bloody genocide of more than 800,000 members of the Tutsi ethnic minority and politically moderate Hutus, orchestrated by Hutu extremists, is widely seen as one of the worst humanitarian disasters of recent times.
""When we were in Rwanda, you were trying to help people, but then there were so many rules in place and so many things that you can’t do, that you start to feel unhealthy,"" he said.
The same phenomenon was at play with Canadian troops in the former Yugoslavia, Maj. Jetly said.
""You may see something bad happening, but the rules of engagement say it’s not your job to intervene,"" he said.
""In Afghanistan, if you see something bad happening, you can intervene.""
That means soldiers can react the way they’re trained to, Maj. Jetly said.
""Which I think could be psychologically healthy. But, by the same token, the intensity of the combat is incredible, so there is a very, very large number of threats that people are feeling. People are being hurt. We’ve had casualties; we’ve had deaths, so those will take their toll.""
Since 2002, 16 Canadian soldiers and one diplomat have died in Afghanistan. Many others have been injured in rocket attacks, bombings and road accidents.
While the Halifax psychiatrist is quick to say ""there really isn’t a lot of strong evidence"" to support the theory, he said the concept of a ""psychologically good war versus a psychologically bad war"" is often the topic of conversation among conferences of his peers.
""For a soldier, being shot at or shooting at somebody is likely less harmful to them than watching a four-year-old get hurt.""
Military mental health experts are on the lookout for soldiers suffering from post-traumatic stress disorder.
While the diagnosis has only been around for about a quarter of a century, people have long known that when soldiers return from war, they’re different, Maj. Jetly said. They can experience ""massive changes in personality,"" become more aggressive and may use drugs, alcohol and gambling as coping mechanisms.
""They may have been the life of the party and now they’re quiet.""
Returning soldiers bogged down with depression and apathy may need treatment.
""Basically an event occurs, or a series of events occur, that overwhelms a patient’s coping mechanisms,"" Maj. Jetly said. ""As the event is occurring, the person will react with extreme horror, helplessness (and) fear.""
It could be triggered by a roadside bombing ""where you see friends blowing up in front of you,"" he said.
People tend to revisit such traumatic events, Maj. Jetly said.
""It can be re-experienced in many ways, including nightmares and flashbacks where you feel like you’re back there again. You might get physiological arousal; you might start to feel chest pain or headache or funny feelings in your gut when you’re reminded of the event. You might have psychological reaction when reminded of the event in the sense that you might feel irritable or angry . . . or sad.""
People start experiencing ""avoidance symptoms,"" he said, staying away from anything that reminds them of the traumatic event, such as crowded places.
""The last group of symptoms are called hyper-arousal, which is irritability, difficulty sleeping, and also just hyper-vigilance — just being on guard all the time. ""
( clambie@herald.ca)
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