How did Ancient warriors deal with Post Traumatic Stress Disorder?

This article was originally published on 12th of February 2019.

“My past is an armour I cannot take off, no matter how many times you tell me the war is over.” - unknown

Post-Traumatic Stress Disorder (PTSD) is often thought to have arisen with the advent of mechanised warfare—think shell shock and the First World War—but the examination of ancient texts offers sufficient evidence that PTSD may be as old as the act of war itself. This raises the question of how might have ancient cultures dealt with PTSD in their soldiers and, more importantly, whether any lessons can be drawn from these experiences.

Human Performance forms a cornerstone of the Army’s ongoing research and interest, and learning lessons—past, present and future—from anything that may impact this performance is crucial. Learning from ancient warriors’ personal experience of battle and its aftermath—much in the way we learn our strategy from history’s great tacticians and philosophers—could help us address the root causes of afflictions such as PTSD.

While making an association between a Greek Hoplite, a Roman legionary and a modern soldier might seem a long bow to draw, the fact remains that they were members of the profession of arms and they were all warriors. It needs to be remembered that, despite the passage of several thousand years, the fundamentals of what makes us human have changed little, if at all. This includes being highly reliant on creating filters with which we perceive our surrounding environment.

The idea of a Spartan with PTSD might stretch the imagination, particularly since the simple act of reaching adulthood in the ancient world was—in some societies—a better preparation for warfare than any training an average, modern soldier can be ethically subjected to prior to battle. Before an ancient soldier ever saw battle he had outlived 60% of his siblings, witnessed the consequences of swift justice in the form of public executions and likely had watched ultra-violent entertainment occasioning human deaths. However, the ancient soldier, unlike his modern counterpart, had much on his mind as he went into battle. What would happen if his side lost? A loss might result in the state ceasing to exist, being sentenced to the arena, summary execution, or, if he was lucky, simply being sold into slavery.

These possibilities must have weighed heavily on the minds of ancient soldiers and long-term effects upon their mental wellbeing are suggested throughout ancient texts. Inscriptions originating with the Assyrian Dynasty in Mesopotamia (1300-609 BC) record traumas suffered by soldiers who were called upon to fight every third year during their military service. Herodotus observed that Epizelus, an Athenian spear carrier, suffered what appeared to be psychological problems following the Marathon Wars in 490 BC. Appian of Alexandria (c. 95? – c. AD 165) described 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 within it.  Plutarch’s Life of Marius speaks of Caius Marius’ behaviour who, when he found himself under severe stress towards the end of his life, suffering from night terrors, harassing dreams, excessive drinking and flashbacks to previous battles. These examples are just a few instances which seem to demonstrate that PTSD, or culturally similar phenomena, may be as old as warfare itself.

If we are able to accept that PTSD is not a product of mechanised warfare and very likely did occur in ancient societies, then the question should be asked: how did ancient cultures deal with individuals who experienced PTSD? While many ancient cultures were able to recognise the significant changes in soldiers following a battle, the precise reasons as to what created these changes were elusive. A common explanation was that the occurrence of (what I describe as) PTSD was caused by the actions of malevolent ghosts or spirits of those who were killed in battle and now sought vengeance on their killer. While it is unlikely that a vengeful spirit explanation is correct, it does contain the insight that the sickness originated from an inward or unseeable wounding, and these invisible wounds could be just as deadly as any outward wound.  

Many ancient cultures sought to deal with and create specific rituals to heal the unseeable and drive off the ghosts who caused them. The central purpose of these often culturally unique rituals was to welcome the returning soldier back into society and allow for the release of trauma. The Romans directed the Vestal Virgins to bathe returning soldiers, purging them of the corruption of war. Native Americans performed sweat lodge purification rituals, in which the returning warriors would share their stories and sweat out their perceived ‘inner pollution’.

While the plethora of writings describing PTSD-like signs in ancient veterans indicate that these rituals did not always work, given the sheer numbers of ancient soldiers who went into battle and through these rituals, it would seem likely that for many something about them did work. However, it might not have been the welcome back into society alone that worked. What might have been even more important, and what is often overlooked, was that the reintegration process would begin in the aftermath of the battle when the survivors began to walk home. Given that ancient soldiers sometimes fought far from their homeland, when the war was over they had to the walk home. The speed of this return was dictated by the pace of the slowest pack animals and the slow pace, while frustrating, may well have given the soldiers much needed time to reflect upon what they had experienced, grieve for comrades lost and perhaps find solace in a shared group experience. The long march back culminated in a ritual cleansing and a return to home, as mentioned earlier.

One of the reasons this slow decompression might have aided the efficacy of the return rituals can be seen in its complete opposite in contemporary conflict, where the advent of improved transport has made it possible to move troops quickly and efficiently. Perhaps too quickly and too efficiently. While troops might be happy to be back at home far more quickly, there might be a lost opportunity for soldiers to properly process what they have seen and experienced within a like-minded group.

Although PTSD is no longer considered the actions of vengeful and angry ghosts, its effects would still be recognisable to an ancient physician or shaman, and it is still as damaging to the individual. While no absolute solution can be drawn from the experiences of ancient soldiers, there may be sufficient clues to warrant studying what benefits might be gained from delaying the return of groups of individuals from conflicts in a structured manner, thereby lessening the propensity for PTSD to occur. Particularly, if it were possible to enact rituals of our own—rituals which recognise and free returning soldiers from their traumas and assuage any sense of guilt and culpability—and reinforce that society values them for what they did, we may be better able to deal with PTSD.