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J.R. Browning
History 490
5 November 2012
Combat Stress in Antiquity: The Timeless Cost of Being a Warrior
In the ancient world, war was a common occurrence. Whether it was largescale war between nation states or smaller clashes between rival tribes, conflict was
more common than peace. The stark contrast between war and peace can have a
permanent effect on a soldier who goes off to fight and then returns home. Although
the term was coined in the 20th century, there is evidence that warriors throughout
time have been known to suffer from symptoms of Post Traumatic Stress Disorder
(PTSD). This diagnosis is well known today, but was not recognized in antiquity.
With war being so common—in some cases frequent—people at the time may not
have noticed such a condition, much less recognize and treat it.
Did soldiers in the ancient Mediterranean suffer from PTSD? Since it was not
diagnosed or treated by ancient medicine examples of ancient PTSD do not fit
perfectly into the modern definition of the disorder. However, it can be argued that
they unquestionably experienced some of the symptoms. It may have gone by other
names, most often referred to by ancient commanders as low morale, intense fear,
or attributed to cowardice. When compared to currently recognized symptoms,
examples from ancient writing not only define the disorder but also show its’
presence in ancient war veterans. Aside from defining PTSD and showing its’
presence in antiquity, this comparison makes it clear that PTSD—while it has not
always been recognized—is as old as war itself. It is important to study the effects of
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combat on ancient soldiers for a number of reasons. Examining the mental
exhaustion of constant warfare lasting years at a time provides a glimpse into the
emotional trauma that links war veterans to each other regardless of time and place.
From the shores of Troy, to the jungles of Vietnam, to the deserts of the modern
Middle East, war veterans throughout recorded history share common
characteristics that transcend both time and location. Such a study can also provide
an intimate glimpse into the mindset of some of the best-known warriors of Ancient
Greece and Rome. Ultimately, researching and finding evidence of PTSD leads to a
much better understanding of ancient warfare by describing what these soldiers
were frightened of, how much they loved their comrades, and how remarkably
typical they were despite being soldiers.
The subject of combat stress in antiquity has not been extensively
researched, in part due to its lack of recognition in ancient culture. Since the
American conflict with Vietnam in the 1960s and 70s—and the latest generation of
American combat veterans--interest in combat-related mental illness has peaked.
With this peak, research has begun to take shape, with American veterans looking
for a link between their illness and the ancient world. Books written by Vietnam
veterans like From Melos to My Lai: War and Survival by Lawrence Tritle, and
Odysseus In America by Dr. Jonathan Shay, compare the experiences of modern
combat trauma to that of the ancient soldier. By using the current standard
reference to diagnose PTSD and other mental illness, Diagnostic and Statistical
Manual of Mental Disorders, it is possible to make the link between the criteria for
diagnosis and stories told in antiquity. Excerpts from primary sources like Ajax by
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Sophocles, and Homer’s epic poems Odyssey and Illiad provide descriptions of
ancient trauma by authors of the period. While these are stories or dramatic fictions
and not concrete, realistic examples, the fact that these authors felt compelled to
write about such trauma still shows its’ relevance in ancient society. Fiction may
have been the most convenient method to write about a condition like PTSD since
ancient Greek or Roman soldiers would not have admitted to such cowardice in
war-driven societies. Outside of fiction, authors like Lucretius described PTSD
flashbacks in The Nature of Things. Another non-fiction source, Alexander The Great:
Selected Texts From Arrian, Curtius, and Plutarch, provides a description of
Alexander’s army and the fear they experienced in war through the writings of his
biographers.
Before attempting to find examples of PTSD in antiquity, it is necessary to
define it. Defining PTSD is a complicated matter. In its’ simplest form, PTSD is
broadly defined as an anxiety disorder. In reality, PTSD is anything but simple. The
criteria associated with PTSD are complex and numerous. The Diagnostic and
Statistical Manual of Mental Disorders: DSM-IV-TR assigns six different criteria for
diagnosing PTSD, some having five to seven sub-criteria that accompany them.1 The
condition itself affects each diagnosed individual differently, hence the need for subcriteria. Some may have recurring nightmares and flashbacks of traumatic events,
some may experience guilt for surviving when others died or for killing, and some
1American
Psychiatric Association, Diagnostic and Statistical Manual of
Mental Disorders: DSM-IV-TR (Washington, D.C.: American Psychiatric Association,
2000), 467-468.
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may dissociate themselves by slipping into a deep depression.2 Given the complexity
of PTSD and the number of symptoms and sub-symptoms associated with it, each
individual case varies. This was no different in antiquity. Although some cases of
PTSD share symptoms, there are examples of many different types of PTSD in
ancient writing.
One of the most vivid examples of dissociative flashbacks resulting from
combat trauma comes from the ancient play Ajax by Sophocles. The title character
Ajax displayed classic symptoms of a PTSD induced psychotic breakdown. In the
play, the hero Ajax was enraged when Odysseus was awarded the honor of wearing
Achilles’ armor after Achilles died in Troy. Feeling dishonored, Ajax returned home
to his wife but he was angry and completely detached from reality.3 His jealousy
towards Odysseus--combined with his dissociation from reality—led Ajax to grab
his sword and butcher a number of livestock.4 In a conversation with Athena,
Goddess of war, Ajax explained that he had killed his enemies. Ajax did not realize
that he had only killed animals. When Athena asked him what happened to
Odysseus Ajax answered proudly “Mistress, he sits inside, the most welcome of
prisoners! I do not want him to die yet…He has perished, after first having his back
whipped by me.”5 In reality, Odysseus was standing next to Athena during this
conversation. He was hidden from Ajax by Athena, who told him: “Are you afraid to
see a man who is obviously mad?...I shall place his eyes in darkness, even though
Ibid.
Phillipe Birmes, “Psychotraumatology in Antiquity”, Stress and Health 93
(2006): 26.
4 Sophocles, Ajax. Trans. Hugh Lloyd-Jones (Cambridge: Harvard University
Press: 1994): 33.
5 Ibid, 43.
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they see.”6 This behavior by Ajax is in keeping with PTSD symptoms of flashbacks,
evidenced by the fact that he not only killed several animals, he also tied up many
other animals and led them back to his hut as prisoners of his personal war. Ajax
may have returned home physically, yet his mind was never able to overcome the
mentality of warfare or his perceived disgrace after not receiving Achilles’ armor. In
the end, Ajax felt so disgraced after butchering the animals that he committed
suicide, which is an unfortunate final act of many veterans suffering from PTSD who
are unable to recover.
Nightmares and flashbacks did not happen only in ancient fiction, it was very
much a reality. Soldiers were reported to battle even in their sleep, an unmistakable
symptom of PTSD. The Roman author Lucretius is credited by some as providing the
first realistic example of traumatic nightmare in his epic poem On the Nature of
Things.7 Lucretius offered an incredibly descriptive and insightful observation:
And the minds of men, that do big things in thought, Will often act out big
things in their dreams: They’ll slug it out with kings, be caught, pitch battles
And holler as if their throats were cut, in bed; Many lose title bouts and groan
in pain, And as if ripped and champed by a pan- there’s jaws or a fierce lion,
fill the house with cries; ... Are seized with terror and wake like madmen,
hardly returning to themselves, in the seethe of the body.8
Ibid, 39.
Menachem Ben-Ezra, “ Traumatic Reactions From Antiquity to the Sixteenth
Century: Was There a Common Denominator?” Stress and Health 27 (2011): 229.
8 Lucretius, On the Nature of Things, 150, qtd. in Menachem Ben-Ezra,
“Traumatic Reactions From Antiquity to the Sixteenth Century: Was There a
Common Denominator?” , Stress and Health 27 (2011), 229.
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Nightmares like the ones described by Lucretius are characteristic of PTSD, and it is
extraordinary to see these kinds of examples in Romans. Such symptoms show a
strong connection between ancient Romans and currently recognized criteria for
diagnosing PTSD.
Many veterans call PTSD an invisible enemy. Soldiers are trained to
recognize danger. Soldiers in antiquity were undoubtedly trained to see swords,
avoid spears, and steer clear of visible danger as much as possible. PTSD is not only
invisible, it is indiscriminant and can affect any soldier. Nobody is immune. The
Roman general Gaius Marius was one of the most successful consuls in Roman
history. Despite his success as a general, he was reported by Plutarch as having
suffered traumatic reactions:
But Marius himself, now worn out with toils, deluged, as it were, with
anxieties, and wearied, could not sustain his spirits, which shook within him
as he again faced the overpowering thought of a new war, of fresh struggles,
of terrors known by experience to be dreadful, and of utter weariness. 9
As the name Post Traumatic Stress Disorder implies, PTSD sneaks up on an
unsuspecting soldier in the way an untreated wound might develop an infection.
Any human being subjected to an environment as extreme as war risks haunting
flashbacks; whether it is the lowest soldier on the battlefield or the highest leader.
Although flashbacks are the most easily recognizable symptoms of PTSD,
there are others that are just as impactful. A common PTSD symptom pertaining to
loss, survivors’ guilt, is also present in ancient writing. It is often described in three
9
Plutarch, Parallel Lives, qtd. in Birmes, 25.
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stages: grief, followed by rage, and finally revenge. The story of Achilles in Homers’
Illiad is a great example of this. Author Lawrence Tritle, when describing Achilles,
wrote that “ Still there emerges also a picture of a valiant warrior, one who does not
strike down the helpless…The death of Patroclus changed all this.”10 At that point,
the grieving Achilles took a very dark psychological turn. He was devastated by the
loss of Patroclus. Before the death of Patroclus, Achilles had little interest in fighting
after a disagreement with Agamemnon. Afterwards, Achilles turned from grief to
absolute anger. Tritle also wrote that “Patroclus’ death brings Achilles back to the
fight, but he is a changed man.”11 Achilles had changed from a soldier seeking glory
to a madman thirsting for revenge, helpless against the guilt resulting from
Patroclus’ death. Winning the war became less important to Achilles. Instead, the
war had become deeply personal. Such a deep seeded anger drove Achilles to swear
revenge for the lost Patrolcus. Homer paints this picture well, with Achilles vowing:
neither food nor drink shall go down my very throat, since my companion
perished and lies inside my shelter…Food and drink mean nothing to my
heart but blood does, and slaughter, and the groaning of men in hard work. 12
Tritle tied it together by noting that “Achilles’ reaction to Patroclus’ death…’going
berserk’…it is a reaction to the stress of battle that knows no time or place.”13 Loss,
perhaps more so than any other force, can motivate a warrior to make rash and
Lawrence Tritle, From Melos to My Lai: War and Survival (New York:
Routledge, 2000). 36.
11 Ibid, 36.
12 Homer, Illiad 19.209-14, qtd. in Lawrence Tritle, From Melos to My Lai, 37.
13 Tritle, 37.
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sometimes irreparable decisions. Achilles’ lust for revenge is a classic example of the
motivation provided by the guilt of losing a friend in combat.
Even though surviving combat while close friends die can cause a great deal
of guilt, killing can cause far more. Even Achilles, after exacting his revenge by killing
and mutilating Hector, showed a degree of guilt by returning Hectors’ body to King
Priam for a proper funeral.14 This may have been as close to admitting guilt as
Achilles ever came, yet it still shows the consequences of killing. Taking a human life
is the most horrible and unnatural act imaginable. Killing is, in a sense, a betrayal of
the human condition; an intentional disregard for the ability to improve life. The
guilt associated with killing is crucially linked to PTSD. Xenophon took notice of the
same kind of guilt in Anabasis, describing the situation for Cyrus’ men after his
death:
After the generals had been seized and such of the captains and soldiers as
accompanied them had been killed, the Greeks were naturally in great
perplexity…they could not kill anyone…Full of these reflections and
despondent as they were, but few of them tasted food at evening…many did
not come that night to their quarters…unable to sleep for grief…Such was the
state of mind in which they all lay down to rest.15
It is understandable that Cyrus’ men felt defeated after losing their leader. After the
loss of Cyrus, his men began to feel the guilt associated with combat. This guilt,
compounded by the loss of Cyrus, left the men feeling hopeless and defeated.
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Ibid.
Xenophon, Anabisis, 215-216, qtd. in Ben-Ezra, 228.
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Even though it causes unbearable guilt, soldiers in combat do not have the
luxury of refusing to kill. In combat, killing is a necessity, fueled by an
understandable desire not to be killed. That does not mean that the guilt subsides
after killing an enemy. What might be necessary at the time often comes back to
haunt the veteran years after the event took place. A soldiers’ first kill is always just
as unforgettable—if not more—than their first love, as it marks an unmistakable
turning point in the course of their life. In his book On Killing author and retired
Army officer Lieutenant Colonel Dave Grossman described this impact:
Looking another human being in the eye, making an independent decision to
kill him, and watching as he dies due to your action combine to form one of
the most basic, important, primal, and potentially traumatic occurrences of
war.16
This impact is greatly increased by close quarters combat, when fighting is primarily
hand to hand (or in the case of ancient warfare, sword to sword). Such close combat
can lead a soldier to risk their safety out of a strong desire not to kill. Grossman has
a psychological explanation for the reluctance of Roman soldiers to stab their
enemies:
To reach out and penetrate the enemy’s flesh…is deeply akin to the sexual
act…and is therefore strongly repulsive to us. The Romans apparently had a
serious problem with their soldiers no wanting to use piercing blows.17
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Dave Grossman, On Killing (New York: Back Bay books, 2009), 31.
Grossman, 121.
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While many former warriors come back from combat feeling guilty, angry, or
just lost, others come back and simply shut down emotionally. Numbness and
depression are common sub-symptoms of PTSD. The DSM-IV criterion C specifies
that PTSD may be present if an individual experiences “Persistent avoidance of
stimuli associated with the trauma and numbing of general responsiveness (not
present before the trauma).”18 It further specifies that an individual may exhibit
“markedly diminished interest or participation in significant activities [criterion C4], feeling of detachment or estrangement from others [criterion C-5], or a restricted
range of affect or ability to have loving feelings [criterion C-6].”19 There are strong
examples of these criteria being exhibited in antiquity.
When examined closely, Homer’s Odyssey provides an emotional tale of PTSD.
Odysseus, the hero of the Odyssey, spent several years wandering and drifting after
fighting the Trojan War.20 In a wonderfully emotional scene, Odysseus exhibited the
type of depression often exhibited by combat veterans throughout history and
described in the DSM-IV. After washing up on the Phaiacian beach, Odysseus goes in
search of shelter and safety, which he eventually finds under the protection of the
king and queen of the Land of the Phaiacians.21 Shay describes the awkward
situation for Odysseus: “ The Phaiacians are rich and secure. Odysseus identifies
himself as a ‘man of pain’ without saying anything specific about his identity.”22
Although he is in a safe place, a guest of royalty, and under their protection
DSM-IV, 468.
DSM-IV, 468.
20 Jonathan Shay, Odysseus in America (New York: Scribner, 2002), 12.
21 Ibid.
22 Shay, 13.
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Odysseus struggles with an overwhelming sadness. His desire to leave the war
behind him tortures Odysseus at times. When asked to compete with Phaiacian
athletes in their games, Odysseus gave a very morose answer:
Why do you taunt me with such a challenge? Pains weighs on my spirits now,
not your sports—I’ve suffered much already, struggled hard. But here I sit
amid your assembly still, starved for passage home, begging your king,
begging all your people.23
In this specific example, Odysseus exhibited not just major depression and a loss of
interest in activities—both of which fall into DSM-IV criteria for PTSD—he also
exemplified another common characteristic associated with combat trauma: an
overwhelming desire to go home.
After war, whether at home or not, veterans prefer to leave the war on the
battlefield and not recount it endlessly in stories. Generally, when veterans are
asked about their military service, there is a prescription answer—“I would rather
not talk about it”—or some slight variation of that answer. There is an urge to hide
the mental anguish of war from those who have never fought, in part to protect a
courageous reputation, but also to shield non-combatants from the psychological
damage caused by war. This was no different for Odysseus. Later in the story, while
still in the care of the Phaiacian royalty, Odysseus suffered another major depressive
episode. While the royal musicians sing songs about the Trojan War—and ironically
Odysseus himself —Odysseus had a reaction that can be expected from a war weary
veteran:
Homer, The Odyssey, trans. Robert Fagles (New York: Penguin Books,
1996), 196.
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That was the song the famous harper sang but Odysseus, clutching his flaring
sea-blue cape in both powerful hands, drew it over his head and buried his
handsome face, ashamed his hosts might see him shedding tears. Whenever
the bard would pause in the song, he’d lift his cape from his head, wipe off his
tears, and hoisting his double-handed cup, pour it out to the gods. But as
soon as the bard would start again…Odysseus hid his face and wept.24
In this case Odysseus was in the care of Phaiacian royalty, and most likely had his
reputation in mind by trying to mask his grief. The fact that Odysseus cried while
being sang about as a hero exhibits a common characteristic of veterans: he would
have preferred that his service (heroic or otherwise) not be brought up at all.
While the examples provided by Homer are descriptive and dramatized for
effect, realistic examples of PTSD in Alexander the Great’s army are much more
subtle. There are no records of men crying at a celebration, and certainly none of his
soldiers would have been foolish enough to murder Alexander’s livestock. There are
examples of a demoralized, exhausted army who had followed Alexander across the
known world before they were ready to give up. Arrian, one of Alexander’s
biographers, recorded that “Within the camp, meetings were taking place where the
more moderate among them complained about their predicament, while others
refused to follow any further, even though Alexander was leading them.”25 Leading
up to their refusal to fight any further, the Macedonians under Alexander had
endured years of nearly constant conquering and warfare. They were also
Homer, The Odyssey, trans. Robert Fagle, 194.
Arrian, Alexander The Great, ed. Tania Gergel (New York: Penguin Books,
2004), 124.
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traumatized after fighting elephants. Another of Alexander’s biographers, Curtius,
recorded: “The beasts caused great panic. Their strange trumpeting unsettled not
only the horses—animals always very easily startled—but also the men in their
ranks. Victors moments before, the Macedonians were now casting around for a
place to flee.”26 After enduring conditions like these in India, many of Alexander’s
men were determined to leave war behind them and go home.
While their desire to stop fighting does not exhibit widespread PTSD shown
through vivid flashbacks or emotional scenes of sobbing, the fear exhibited by this
army is an example of widespread demoralization. While fear is usually listed as an
acute or short-term symptom instead of a long-term response to trauma, the DSM-IV
does account for the presence of fear in PTSD. Criterion A-2 states that an individual
may experience PTSD if “the person’s response involved intense fear, helplessness,
or horror.”27 Fear and horror undoubtedly played a part in the refusal of Alexander’s
troops to fight. In the absence of a formal diagnosis of PTSD, low morale may be the
best evidence of PTSD found in antiquity. Low morale is the result of losing the will
to fight, fear, being worn down by years of war, and an emotional detachment from
the cause of the war. Alexander attempted to rally his men, meeting with his
generals, and giving speeches to urge his men forward. In the end his men won, and
not even the incredibly charismatic (and feared) Alexander could convince them to
continue after years of war and hardship. Alexander withdrew from his men for
three days, and isolated himself in his tent. Arrian wrote that “Then they
Curtius, Alexander The Great, ed. Tania Gergel (New York: Penguin Books,
2004), 117.
27 DSM-IV, 467.
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approached Alexander’s tent and called down great blessings upon him for allowing
them to win over him, his sole defeat.”28 After all the time they spent following
Alexander through the hell that is war, even some of his most battle hardened
veterans were ready to leave war behind and go home.
Soldiers who make it home do not always find it as comforting as they might
have hoped. War has a way of maintaining an unbreakable grip on the human
psyche. Soldiers in ancient and war driven societies like Greece and Rome were no
exception to psychological damage. They loved their fellow soldiers, and were
broken hearted by loss. Even the most seasoned veterans experienced fear, and
guilt. These remarkable traits break down the image of the invincible Greek warrior,
and the driven Roman general, to expose a vulnerable human being. Before any of
them were soldiers or generals they were children, sons, and husbands. The
struggles experienced after war stripped them down to the most basic and
emotional level.
One thing has not changed throughout history: symptoms of PTSD have been
exhibited (in myth and reality) since the wars of the Ancient Mediterranean. The
symptoms simply went largely unnoticed, existing mostly under the surface. It is
understandable that symptoms of PTSD were not reported in large numbers. Greek
and Roman soldiers were not known for their willingness to show emotion. They
were conditioned to be incredibly strong of body and spirit. Soldiers of ancient
Greece and Rome would not have been willing to shame themselves or their families
by admitting to cowardice or fear. This reluctance to acknowledge the symptoms
Arrian, Alexander The Great, ed. Tania Gergel, (New York: Penguin Books,
2004), 126.
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makes it difficult to find examples. Further complicating the situation is that—much
like modern cases—no two cases recorded in antiquity were the same. The
symptoms were different both in the type and severity of each. Nevertheless the
symptoms were present. It took thousands of years to refine our understanding of
PTSD as a brain disorder. What was once attributed to the Gods by both Greeks and
Romans is now factually attributed to psychological damage.
Even with the established presence of symptoms, it is not possible to go back
in time thousands of years and diagnose ancient soldiers with PTSD, it is only
possible to pinpoint examples of symptoms. Much like history, our understanding of
PTSD in our own time is constantly evolving. The flexible nature of both subjects
makes the comparison difficult. Yet even with fluctuations, the experience of war
and life after war remains eerily similar for both ancient veterans and modern era
veterans.
It is astounding to think that modern day veterans have something in
common with Gaius Marius, soldiers in Alexander’s legendary army, and even the
mythical heroes Achilles and Odysseus. It seems that war, despite all the destruction
it brings, has an extraordinary ability to unite its participants. It does not matter if a
soldier fought for Greece, Troy, Rome, or any modern nation. The names of soldiers
involved may have changed over the course of thousands of years, and the nature of
war has become increasingly more frightening, but the deepest aspects of life after
war have forged a timeless link between veterans. While soldiers throughout history
have fought drastically different battles during war, the battles waged by each after
war have been remarkably similar.
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Bibliography
Primary Sources:
Gergel, Tania, ed., Alexander The Great: Selected Texts From Arrian, Curtius, and
Plutarch. New York: Penguin Books, 2004.
Homer, The Odyssey. Translated by Robert Fagles. New York: Penguin Books, 1996.
Sophocles, Ajax. Translated by Hugh Lloyd-Jones. Cambridge, MA: Harvard
University Press, 1994.
Secondary Sources:
Aislinn, Melchoir. “Caesar in Vietnam: Did Roman Soldiers Suffer from
Post-Traumatic Stress Disorder?” Greece & Rome 58 (2011): 209-223
American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.
2000.
Ben-Ezra, Menachem. “Traumatic Reactions From Antiquity to the Sixteenth
Century: Was There a Common Denominator?” Stress and Health 27 (2011):
223-240.
Birmes, Phillipe J. “Psychotraumatology in Antiquity.” Stress and Health 26 (2010):
21-31.
Grossman, Dave. On Killing: The Psychological Cost of Learning to Kill in War and
Society. New York: Back Bay Books, 2009.
Shay, Jonathan. Achilles in Vietnam: Combat Trauma and the Undoing of Character.
New York: Touchstone, 1994.
Shay, Jonathan. Odysseus in America: Combat Trauma and the Trauma of
Homecoming. New York: Scribner, 2002.
Tritle, Lawrence. From Melos to My Lai: War and Survival. New York: Routledge,
2000.