As many as one-third of the U.S. veterans returning to civilian life after tours of duty in Afghanistan and Iraq suffer post-traumatic stress disorder, according to published reports. Although the diagnosis of PTSD is comparatively new, it describes a syndrome of long-lasting effects which have been around, under different names, for centuries. Symptoms include recurring nightmares, edginess, a pervasive sense of danger, anger, isolation and depression -- sometimes even leading to suicide.
In the United States, a returning veteran's predicament is often made worse by the unfounded fear among civilians that those with PTSD are potentially violent and pose a danger to others -- a belief which only exacerbates their suffering. Although counseling and medication can help people cope more effectively with their PTSD, it is not a curable disorder.
But PTSD isn't unique to soldiers or to Americans or to adults. It is a global phenomenon which is seen differently in different societies.
Ten years ago, after the fall of Saddam Hussein, I returned to my native Iraq from Libya, where I had worked as a professor of psychology. Back in Baghdad, I became involved in a study looking into the incidence of PTSD among children ages 6 to 16. It was a randomly selected sample, and the younger children -- those under 10 -- were given help in completing the survey.
The results were horrifying. Almost all of the children were affected by PTSD, and they displayed lots of symptoms -- incontinence, terror, uncontrolled outbursts and more. Although the study was limited to the Baghdad area, it would not surprise me if the same pattern were found in other provinces of the country as well. In effect, there is an entire generation of Iraqis -- perhaps even more than one -- who have been forced to live with the consequences of trauma.
Its causes are easy to see. For the past 30 years, Iraq has experienced a series of traumatizing events: war with Iran, war with the United States, civil war, terror attacks, suicide bombings, al-Qaida strikes. Many of these conflicts involved unspeakable acts of cruelty, often in the homes of private citizens, and frequently before the eyes of their children.
However, Iraqi society works differently than it does here. Acknowledging one's psychological injury carries a far greater stigma than it does in the United States. Seeking professional help for an emotional problem amounts to an admission of weakness in a society which places a premium on resilience and self-reliance. Toughing it out is the norm. In fact, there isn't even a word in the Arabic language for "psychotherapist" or "clinical psychologist."
But Iraq has an arrangement of social networks without any real parallel here. Iraqis embrace each other in a warm web of tribal relatives, friends and acquaintances. It is a support system which pervades every aspect of Iraqi life. It can be exhausting to keep up with. But it is also tremendously therapeutic to have a nonstop stream of sympathetic people stopping by to listen and to share life experiences.
Religious faith is another distinguishing quality of life in Iraq. References to God pervade every conversation. Underlying that is the belief that whatever happens in a person's life has come about because God willed it, and accepting God's will is a fundamental tenet of the faith. So, no matter how much a person has suffered, the responsibility for that suffering is something they can attribute to God's will. As a result, people are much less likely to blame themselves or others for their pain and misfortunes than they are here.
This past summer, along with a friend, I visited Pennsylvania's Amish country. Even though I was only able to have a brief glance, it reminded me of the powerful social networks I had grown up with in Iraq -- where constant face-to-face contact and conversation is an inescapable part of people's lives.
Since arriving in Pittsburgh as part of a government refugee program last year, I also have had the opportunity to glimpse life in mainstream American households. There, my impression is that both the amount and types of contact between family members are diminished from what they had been in the past. Of course, texting, emailing and voice-messaging one another are not bad things; any form of communication is good. Yet they appear to be mere shadows of the social support systems which once were in place here.
In Iraq, it really does take a whole village to help members in pain. In America, it may take something similar to truly help returning soldiers who suffer with PTSD.
Mumtaz Alobaidi is a psychologist now living in Bellevue (firstname.lastname@example.org).