We usually think that trauma from war is relate to the fact that soldiers; have been under constant threat of death. New research shows a slightly different picture. The types of trauma that Norwegian soldiers were expose; to in Afghanistan greatly affect the psychological aftermath of their experiences. Psychologist Andreas Espetvedt Nordstrand and his research team; have look at how exposure to different types of traumatic experiences influence Norwegian veterans who were in Afghanistan.

The study shows that being expose to life-threatening situations results in fewer post-traumatic stress symptoms; for soldiers than when they experience suffering and death without being in danger themselves. Nordstrand is affiliate with the Norwegian University of Science and Technology’s (NTNU) Department of Psychology; and is one of the authors of the study, publish in the European Journal of Psychotraumatology. The study is part of a comprehensive survey of how veterans are faring after the war in Afghanistan.

Just over 7000 Norwegian soldiers participate in the war in Afghanistan between 2001 and 2011; and 4053 of them participate in this investigation. Trauma is roughly divide into danger-based and non-danger-based stressors. Soldiers can be expose to danger-based trauma in classic military settings; such as being shot or ambushed. It is an active threat that is linked to anxiety.

Non-danger-based trauma divide into 2 subgroups:

Witnessing: seeing suffering or death of others; without being in danger oneself. Moral Challenges: seeing or performing an act that violates a person’s own moral beliefs. An example of witnessing might be that a suicide bomber triggers; a bomb that hurts or kills children and civilians. Then our soldiers come in to clean up or secure the area; after the bomb has gone off and experience the devastation.” Andreas Espetvedt Nordstrand, Psychologist, Norwegian University of Science and Technology

Performing actions that violate moral principles can involve killing an innocent person. “For example, an officer may order a person shot because it looks as if he is wearing a suicide vest. But then it turns out that he wasn’t; and a civilian ends up being killed,” he says. “Another example could be when an officer supervises and instructs an Afghan unit; and then learns that someone in that unit is abusing small children. It can be difficult to intervene in that kind of situation; but easy for a Norwegian officer to think afterwards that he should have done something,” Nordstrand explains.

Appreciate life more

The research results also show that exposure to personal life threats often leads to positive personal development. This type of trauma can contribute to the individual appreciating life more; getting closer to relatives and experiencing greater faith in their ability to handle situations. Non-danger-based stressors; on the other hand, usually lead to negative personal development; where the person values life less, feels more distant from others and has less faith in himself.

Nordstrand said he didn’t expect there to be such a big difference. Nordstrand’s idea for the study came to him through his job as a psychologist in the Norwegian Armed Forces stress management service; where he notice that often other issues than having been shot at were plaguing the soldiers. “A lot of soldiers told stories of how witnessing someone else’s suffering; especially of children who became victims of the war  were tough to work through,” says Nordstrand.

According to Nordstrand, a lot of people hide their non-danger-based trauma and don’t talk about it to their family; friends or colleagues. He thinks this relates to the fact that non-danger-based trauma is often link to shame and guilt; and that it can be more difficult to talk about than that they were scared in an exchange of fire. “A lot of soldiers are probably afraid of feeling alienate if they would tell their family; and civilian friends of all the horrors they saw and experience. Such experiences often don’t fit very well with the world view we protect Norwegians have,” says Nordstrand.

Wants to focus on the spectrum

The researcher hopes the study can help direct attention to the fact; that there is a wide range of traumatic experiences. He would like to see the focus be not only on people who have been in life-threatening situations; but also on assistance personnel, police and firefighters who are expose to non-danger-based stressors in their occupations on a daily basis. Other studies, including Swedish ones; show that firefighters are a group that is vulnerable to depression and suicide.

“We tend to turn on the blue light and rush to help when someone has been in a life-threatening situation. I think we can do a much better job of helping people by acknowledging that there’s a real risk of mental illness after being exposed to non-danger-based trauma. We should develop protocols so that we can capture those who are vulnerable and figure out how we can better utilize our resources,” says Nordstrand.