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Destroying Hearts and
Minds? Psychiatry and Delusion in the
Gulf
War By Helen
Spandler |
There are many
pressing and ongoing concerns following the latest Gulf war. The
intense
media focus on Iraq during the military invasion has quietened down
after
'our troops' returned home, supposedly victorious over the 'axes of
evil'.
We won't know for many years the full extent of casualties, or the
environmental, cultural and economic consequences of the war. There
are
concerns about the continued occupation of Iraq; the imposition of a
US
led corporate 'democracy'; the incursion of western imperialism and
the
fight for economic power through access to oil and dominance over
global
markets. It is nonsense to even ask if anyone has 'won' in the midst
of
the catastrophe that has been unleashed on the middle- east.
Leaving these
concerns
aside, there are other questions that need consideration. It is
doubtful
whether the allied forces will ever 'win the hearts and minds' of the
Iraqi people, but there is another battle being fought, that of the
definition and treatment of the mental distress that is inevitably
produced by war. We do not know if psychiatry will emerge as a
'winner' in
this battle over the bodies and minds of those physically and
emotionally
effected by the invasion. All the propaganda about finding weapons of
mass
destruction has led critics to suggest that the media has become a
weapon
of mass distraction during the war. In a similar way we can question
the
role of psychiatry during war. Is it a weapon of delusion or a weapon
against delusion? And finally, what should be the response of a
radical
democratic psychiatry?
Psychiatric
Consequences of War
One of the
immediate
consequences of the attack on Iraq was to render many of its
hospitals
unworkable and unsafe. During the war hospitals became the targets of
looters and attacks against women and sexual assaults increased.
Psychiatric hospitals and patients were not exempt from these
attacks. The
bombing of Baghdad resulted in a mass exodus of patients and staff
from
hospitals and consequently the looting of Rashad Psychiatric hospital
in
North East Baghdad. The International Committee of the Red Cross
reported
that many patients were subsequently attacked and some raped. Many of
these patients had been hospitalised as a consequence of their
experiences
of the previous gulf war in 1991.
It is clear that
the
emotional after-effects of war can be severe. We know little about
the
long-term effects on soldiers and even less about effects on
civilians.
However, what we do know is that in the UK many organisations have
estimated that about a quarter of all homeless people have served in
the
military forces and over 5,000 ex service men and women are in
prison. The
Ministry of Defence's own figures from the 1991 Gulf war, record that
nearly five times as many service personnel killed themselves as died
in
combat. The National Gulf Veterans and families Association claim
that 70%
of service men who died since 1991 committed suicide. Ironically, the
anti
war movement was chastised for not supporting 'our troops', yet UK
health
ministers have made it clear that there will be no extra resources
for any
specialist mental health support following the latest Gulf war. There
seems to be a strong case for more mental health support and the
increased
use of psychiatry to intervene in the aftermath of war. However,
although
greater support and resources is necessary, the role of psychiatry in
such
circumstances is not always straightforward.
Gulf War
Syndrome and
Chemical Poisoning
Despite the lack
of
mental health support for war veterans, psychiatry frequently plays a
mediating role between the Government, the military and the
population
effected by war. The role of psychiatry in the aftermath of war is a
complex and conflictual one. The obvious place to explore this
complexity
is in the debates about 'Gulf War Syndrome'. This medical-psychiatric
diagnosis emerged following the last gulf war in 1991. The Ministry
of
Defence has contested both the existence and the causes of Gulf War
Syndrome. Yet, many former gulf war veterans have claimed that they
are
suffering from a specific condition arising from their action in the
Gulf,
which is not simply a post trauma reaction. The US Department of
Defence
have also refused to recognise its existence. They advise military
doctors
to treat any symptoms not clearly related to military combat as Post
-Traumatic Stress Disorder. Because the experience of Gulf War
Syndrome
includes a variety of physiological complaints this is effectively
drawing
upon the old diagnosis of 'hysteria' whereby psychological
difficulties
are experienced as if they were physical ones. Doctors often order an
assessment for mental illness and usually treat the symptoms with a
variety of drugs including muscle relaxants and sleeping pills. The
emotional trauma of war is hard enough for Governments to accept, yet
there are other possible factors in Gulf War Syndrome which the
Department
of Defence is even less inclined to reveal. The most important of
which is
the effect of Depleted Uranium which was used for the first time on a
wide
scale in the 1991 Gulf War.
Another
contributing
factor to the experience of Gulf War Syndrome may be the extensive
use of
pesticides and insecticides in army base camps. These chemicals are
known
to be carcinogenic and may play a role in the development of M.E. and
Chronic Fatigue. Combination vaccinations are also given to soldiers
as
protection against nerve and biological warfare agents and soldiers
may
have been affected by chemical and smoke pollution caused by burning
oil
wells or electromagnetic radiation from the use of radar devices. The
only
contributory factor to the poor health of veterans that the US
Department
of Defence has openly acknowledged in the 1991 Gulf War was the
allied
force's destruction of Iraq's chemical, nerve and biological weapons
resulting in widespread spread of toxins. They have focused on this
as the
only possible external cause, thereby in effect, blaming Iraq.
In the absence of
any
discovery of Iraqi weapons of mass destruction in the latest
conflict,
where can the US and UK administrations place the blame as the
consequences of this war emerge? Even The US State Department's
generous
offer of a million dollars to anyone who might be able to 'find' any
such
weapons has yet to throw up any 'evidence'. On the subject of weapons
of
mass destruction, it is important to note that the use of depleted
uranium
is considered to cause wide scale and long term damage. Depleted
Uranium
is a by-product of the manufacture of nuclear weapons and wherever it
has
been used will remain radioactive for about 4.5 billion years. It
can
be inhaled, enter the food chain, contaminate water and is likely to
remain in human organs for many years. It can cause cancer,
leukaemia,
kidney damage, neuro-cognitive problems, birth defects and many other
difficulties. The wide spread use of Depleted Uranium in the last
Gulf War
effectively made it a nuclear war. The health effects of exposure to
Depleted Uranium were already known before the war, but it was used
anyway. It has then used in Bosnia during the 1990's and more
recently in
Kosovo and Serbia in 1999, the same year that a UN sub-commission
called
for the use of Depleted Uranium to be banned world-wide. This ban was
blocked, primarily by the US administration, just as they have
refused to
recognise the International Criminal Court (recognition of which
might
have led to an international criminal investigation into the legality
of
the invasion of Iraq). We know Depleted Uranium has been used in the
latest Gulf War, but its extent is a well kept secret.
Depleted Uranium
may
not in itself be the sole cause of the experience of Gulf War
Syndrome.
However, it seems clear that the intensive and wide scale use of
chemical
poisons and radiation in war can cause profound and lasting
physiological
and psychological damage. When Christine Gosden visited the survivors
of
Iraq's chemical attack on the Kurdish town of Halabja in 1998, ten
years
after the attack, she found that many were suffering very similar
health
problems as war veterans in the gulf.
Psychiatry: A
Weapon
of Delusion?
What has this to
do
with psychiatry? The Pentagon is still playing down their use of
Depleted
Uranium and the effects of chemicals, poisons and radiation used in
the
Gulf wars. Apologists for the nuclear industry claim that there are
no
observable health effects that can be attributed to it. On occasion,
they
have even argued that contact with low does of toxicity and radiation
from
Depleted Uranium might be actually be beneficial to people.
Psychiatry has
often been used to discredit people when they have become suspicious
of
these claims. For example, Clint Jensen worked for Bechtel at an
engineering laboratory, where they develop Depleted Uranium to use in
Army
tanks. He raised concerns about the safety conditions at the factory
and
the experience of symptoms similar to that of Gulf War Syndrome
amongst
his fellow workers. His employer, Bechtel attempted to silence him
by,
amongst other means, referring him repeatedly to psychiatrists.
However,
recent independent research in the UK suggests that many Gulf War
veterans
are suffering from brain and neurological damage caused by toxic
exposure
to Depleted Uranium. However, this has not prevented its continued
use.
Some have suggested that psychiatry has directly benefited from this
ongoing denial or 'cover up'. The classification of effects of the
war as
a psychiatric problem essentially labels it an individual problem and
ensures that it is individuals and their families who pay for the
damage.
It is worth noting that it is companies such as Bechtel who are
directly
benefiting from receiving contracts for the 'rebuilding' of Iraq
following
the invasion.
It is easier and
cheaper if psychiatrists, wedded to drug companies, treat people as
suffering from a individual illness rather than face up to massive
financial liabilities if the US Military, the Government and the
Nuclear
Industry were considered culpable. In the same way that US
corporations
have stitched up the major contracts and deals in the reconstruction
of
Iraq, so the drug companies can gain their own share of the market
following the destruction of the bodies, hearts and minds of men and
women
serving in the Gulf.
Psychiatry: A
Weapon
against Delusion?
But, this isn't
the
whole story. It is clear that there are vested interests at play in
maintaining the status of 'Gulf War Syndrome' as a psychiatric
disorder.
However, Elaine Showalter, in Hystories: Hysterical Epidemics and
Modern
Media, has argued that there is a problem of machismo in pleas for
the
recognition of Gulf War Syndrome. There is also a profound stigma
associated with the diagnosis of 'mental illness'. Many veterans and
their
families have strong negative reactions to any suggestion that they
many
be suffering from mental health difficulties. Showalter argues that
thousands of men and women subsequently deny themselves therapy
because
they are encouraged to look for medical causes and pursue legal
cases. The
idea that people may be suffering, not from toxic poisoning, or
battle
wounds, but 'just' a human response to mass suffering, killing and
trauma
may be too hard to stomach. The idea of experiencing mental distress
or
trauma can be too readily viewed as weak or wimpish. However,
Showalter
claims that war veterans are wasting their time looking for chemical
causes of their distress and illness and should seek help at the
hands of
psychotherapists. She even suggests that they are suffering from a
'plague
of paranoia' because they insist on a high level Government cover-up.
Showalter's attempts to highlight the 'moral panics' of our century
are
laudable, but in denying the lived experience of veterans she does
herself
a disservice. Children born with extraordinary birth defects,
congenital
deformities, cancers and leukaemia, all found to be linked to contact
with
chemicals used in war, cannot be put down to trauma. However, this
does
not, and should not, minimise the effects of trauma itself, as that
would
also be culpable.
Democratic
Psychiatry
A radical
democratic
psychiatry should oppose war and be critical of the role of
psychiatry,
and the drug companies, both during and after war. Both psychiatry
and the
corporate drug companies have colluded with the silence around
Depleted
Uranium and other chemical toxins used in war. They have contributed
to
the silencing and blaming of individuals for the wider impact of war
and
patched people up to send them back to fight in dubious causes.
However,
critical practitioners also need to respond sensitively in the
aftermath
of war. Here psychiatric diagnosis is insufficient and actually
evades the
crucial problems. It need not be an either/or cause or solution that
is
suggested by Showalter or the Gulf war veterans. The Gulf war is
causing
widespread chemical destruction, the true effects and extent to which
we
are yet to see. It also causes massive ongoing emotional and
psychological
damage. The real treatment in both cases is neither compensation,
psychiatric drugs, nor psychotherapy. More important perhaps is to
increase our awareness of, and opposition to, the use of chemical and
biological agents such as Depleted Uranium. The distress and illness
caused by war are real and affects individuals, yet ultimately the
only
solution is to prevent war itself, something which can only be a
collective enterprise.
For more
Information about Depleted Uranium see the Campaign against Depleted
Uranium at http//:www.cadu.org.uk
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