Post Traumatic Stress Disorder – a debilitating psychiatric condition usually experienced after witnessing traumatic events – is all too common in the modern military, but did ancient warfare have the same effects? Anthony Riches, Roman specialist and author of the bestselling Empire series, considers the evidence.
To be very clear, before I delve into this interesting and unfortunately topical subject, I’m obviously not the best qualified person in the world to talk about Post Traumatic Stress Disorder (PTSD). I haven’t served in the armed forces, or been exposed to any profession with a high PTSD risk. I haven’t been subjected to any sort of abuse, or witnessed the type of events that can result in the condition. That said, I do have some limited experience of the effects of PTSD, as the result of living for twenty years with my father who was undoubtedly a victim.
Edwin served in the Royal Armoured Corps in France, Belgium, Holland and Germany in 1944/45, firstly in Sherman tanks – suffering two events that destroyed his tank and on each occasion killed two of his friends. When his courage was deemed (quite sympathetically, it seems) to have been exhausted, he was placed into the ‘safer’ role of driving fuel and ammunition lorries up to his tank squadron at night. His stories are a good deal gorier than I’m relating here, but suffice to say it would have been enough to mentally scar anyone, let alone a nineteen year old who by his own admission was hardly ready for or suited to war despite coming from a family with a long infantry tradition. He suffered from PTSD symptoms for the rest of his life, refusing for a long time to discuss the horrors he had witnessed.
Seeing him suffer at close quarters, I felt a small degree of qualification (and a large portion of unpreparedness) when it was suggested that I might like to give a talk to Norwich’s Richard the Third society on the subject of ‘PTSD in Roman Times – fact or fiction’. I agreed, partially because I like the society’s keen audiences and because the subject promised to be interesting. More interesting, it turned out, than I could have guessed.
There are two schools of thought regarding the possibility of PTSD featuring in the Roman world (and indeed the wider ancient world stretching back into pre-history, myth and legend) – universalism and relativism. Put simply, the universalists argue that we all carry the same ‘wetware’ in our heads, since the human brain probably hasn’t developed in evolutionary terms in the eyeblink that is the two thousand years or so since the Roman era. If we’re subject to PTSD now, they posit, then the Romans must have been equally vulnerable. The relativists, on the other hand, argue that the circumstances under which the individual has received their life conditioning – the experiences which programme the highly individual software running that identical wetware, if you will – is of critical importance to an individual’s capacity to absorb the undoubted horrors of any battlefield, ancient or modern. To properly understand both cases it is important to consider them in rather more detail – after a brief overview of just what PTSD is.
The term PTSD was first used in 1980, but various terms have been used to describe its symptoms since the middle of the 19th century. Soldier’s Heart (the American civil war), Railway Spine (coined to describe the mental aftermath of early rail accidents), Shell Shock (World War 1) and Combat Fatigue (World War 2 and Korea) were all terms used at various times to characterise the mental manifestations of stress arising from ‘exposure to death or serious injury, resulting in recurring memories, flashbacks or nightmares, physical reactions to trauma-related stimuli, the avoidance of thoughts, feelings and reminders of the trauma and negative changes in mood’. A landmark paper on the syndrome – Diagnostic and Statistical Manual of Manual Disorders, published in 1994, stated that ‘there are competing theories about what causes PTSD but, in terms of experiences that make it manifest, there are three possible triggers: witnessing horrific events, and/or being in mortal danger, and/or the act of killing – especially close kills where the reality of one’s responsibility cannot be doubted’.
It is without doubt that all three of these triggers would have existed for the combat experienced legionary, given the extremely personal nature of ancient world combat. So, is there evidence for such a phenomenon in the historical sources? Somewhat unhelpfully, the evidence that we do have is extremely scarce, usually written from the perspective of the commander, and not the common soldier, often decades after the events being described, and never considers the soldiers’ homecoming, when PTSD would be most likely to arise with the withdrawal of the soldier’s peer group support. So much for what we haven’t got – what do we have?
Appian describes a legion veteran called Cestius Macedonicus who, when his town was under threat of capture by the emperor-to-be Octavian, set fire to his house and burned himself alive. Plutarch’s Life of Marius speaks of the great man’s behaviour under severe stress at the end of his life, with ‘nightly terrors and harassing dreams, excessive drinking (substance abuse is a recognised symptom of modern day PTSD) and flashbacks to previous battles. PTSD, of a sort, or some form of dementia? And a young soldier, Ulpius Optatus, is recalled in a fragmentary inscription for having ‘unleashed his excessive anger in its entirety, that familiar rage of battle itself sent this young Roman into enemy-inflicted wounds’. Is this the hyper-arousal berserk state experienced by some modern PTSD sufferers?
Surely Roman soldiers were subject to the three classic PTSD triggers – horrific events, mortal danger and the act of killing? And surely that’s evidence enough, especially if you side with the universalists? Well…not necessarily. To accept that Romans soldiers experienced PTSD *as we know it* we must also accept that we map the modern world back onto their experience. Can we?
Ancient world combat was usually fought toe-to-toe, lacking any ambiguity as to who was killer and who was victim, physically violent on a very personal basis and filled with immediate physical risk in battle (that’s going to be important). And it was linear – threats tended to come from expected directions.
By contrast, modern warfare is fast moving due to mechanisation and radio communication, multi-directional due to the resulting tactics of mobility and manouevre, long distance and impersonal due to ranged weapons, artillery and air power, ferociously destructive, impersonal for the most part, twenty-four hour and thus exhausting, fragmented and brutally systemised by the use of crew served and computer guided weapons systems. The modern soldier does not control his destiny to anything like the same degree as his ancient world counterpart, and his battlefield is quite literally anywhere that enemy weapons can reach, at any time.
And here’s a very interesting fact, to do with concussion. 2,500 US Iraq War veterans were studied after combat. Of those with no injuries, 10% suffered PTSD symptoms. Let’s call that the ‘norm’. Of those wounded but without concussion, the rate was 16% – higher than the first group, but not massively so. But of those who suffered concussion – minor brain injuries – only 5% of the total population studied, 45% suffered PTSD. That seems to be a very significant piece of evidence as to what causes PTSD to occur in an age where the use of explosives is a battlefield constant, and concussion somewhat more likely than in the age of edged iron weapons. Minor brain injuries would have happened on the ancient battlefield, but it’s unlikely that their incidence was anywhere near as high as is the case now.
Roman and 21st century combat are very different in a variety of ways that subject the modern soldier to a good deal more stress than the legionary was ever likely to suffer. And the Roman’s societal preparation – his life before the battle – was far more robust than that we enjoy today: 50% infant mortality, ultra-violent arena entertainment, mob justice, frequent and bloody warfare as a fact of life, religious and societal encouragement to see war as natural and beneficial, open butchering of food animals, a total lack of support structures for the poor and less able…the list goes on and on. Compared to the legionary our modern soldier has been protected from such realities to a greater degree than at any other point in history, and will thus be far less well prepared for the horror of a warfare that contains far more stress factors than for a man who might fight a handful of battles in his military career, with long periods of relative calm in between, state of war notwithstanding. Modern special and elite forces training often emphasises the brutalisation and ‘rebuilding’ of the recruit in readiness for this step into darkness, but it seems likely that no such conditioning would have been needed two thousand years ago.
The Roman warrior would have brought a different perspective to lethal violence, and would have had a far more restricted moral circle to his modern counterpart – his friends and familiy, clan, patron and clients, as opposed to millions of fellow citizens via the internet and social media.
So let’s bring this consideration of what we actually know (and what we can only guess at) to some sort of conclusion. The surviving evidence – which is painfully thin – hints at adverse reactions to traumatic events, but was this PTSD as we know it? Probably not. Research indicates that manifestations of the syndrome vary significantly by race and (probably more importantly) culture. The Bushmen of the Kalahari, for example, studied in the mid-20th century, were found to show some symptoms, but others were missing, and those found were less strong due (it was concluded) to pre-existing coping mechanisms. In another study North Korean defectors only showed symptoms some time after entering the more liberal South Korean society, which also hints at societal factors in the victims ‘allowing themselves’ to develop the symptoms resulting from their experiences.
Psychologists believe that modern PTSD cases are the result of the loss of ‘ontological security’ – ‘an individual’s inability to reconcile their traumatic memories with their moral codes, self-concepts, beliefs about human nature and notions of cosmic justice through which they seek to impose a sense of order and meaning on the world’ (anthropologist Ian Young in 1995). The psychological conflict arising from trauma ensures that the trauma lives on as ‘a source of socially and psychologically maladaptive behaviour’. But…and here’s the crux of it…the definition of what is a traumatic memory is as variable as the sufferer is individual, and this is culturally dependent even in the most homogenous societies.
In this debate of nature versus nurture it can hardly be reasonable to conclude that a legionary would have experienced trauma in the same way as a modern day combat veteran – surely his vastly different upbringing, cultural background and combat experience would have resulted in a culturally unique variant of response to that trauma? So to state that the legionary *must* have suffered PTSD seems simplistic and poorly evidenced. Some men would undoubtedly have experienced trauma induced psychological disorder – that 10 to 16% mentioned above, perhaps – but what that response was, its nature, causes, symptoms, is simply impossible to know, given the current paucity of relevant sources. Perhaps when we understand PTSD better we’ll have an ability to interpret that thin evidence and put it into a cultural and technological frame of reference that will get us close to a definitive answer.
Until then, to be frank, it’s a game of grim conjecture. My guess is that we’re talking about two very different cases with wildly different causal factors and conditioning to meet those stressors, but that’s all I can offer – a guess. And your guess is as good as mine.
Anthony Riches began his lifelong interest in war and soldiers when he first heard his father’s stories about World War II. This led to a degree in Military Studies at Manchester University. He began writing the story that would become Wounds of Honour after a visit to Housesteads in 1996. His latest book, Onslaught: The Centurions II, is out now.
- Detail of the Ludovici Battle sarcophagus, Palazzo Altemps, Rome © Miguel Hermoso Cuesta
- Floor mosaic detailing gladiatorial combat, from Galleria Borghese, Rome circa 300 A.D
- Detail from the ‘Great Hunt’ mosiac, Villa Romana del Casale.
Read about how the horrors of the slave trade led to slaves and sailors suffering from PTSD in A respectable trade in brutality by Laura Shepherd-Robinson.