Experts say that soldiers and Marines serving overseas undergo training that can make them more able to handle the types of fear-inducing situations that would overwhelm a civilian.
“They are quite bored without being in it and being in battle," Litz said. "It’s part of their ethos.”
Yet not everyone handles this stress in the same way. Increasingly, medical researchers are worried about the long-term effects of battle on the human brain.
“More and more, we are noticing our servicemen are coming home with significant problems with brain function,” said Daniel Perl, a neuropathologist at the Uniformed Services University for the Health Sciences in Rockville, Md. “Some is psychological and some have long term effects. Some of it is post-concussive. We don’t know much about the biology of this.”
Perl is trying to understand whether some individuals have a genetic predisposition to developing long-term damage from brain-rattling explosions, while others seem to rebound.
“We need to get down to cellular level of resolution,” he said. “And how the brain starts to repair itself.”
While Perl is focused on diagnosing the physical trauma of war, researchers like Litz are looking at psychological scars of battle.
Litz believes some servicemembers can suffer a “moral injury” if they violate their own code of what’s right and wrong. This moral injury is connected to the guilt of killing an enemy or innocent civilian, for example, or the shame of not being able to save the life of a squad member.
“A moral injury is the idea that if you transgress deeply held believes about how the world works and what is good and bad, or what you think you should be doing in war, then that is harming,” Litz said. “Those harms are likely to be very toxic. They lead to shame and withdrawal, and feelings of being unforgivable.”
Litz and his colleagues have developed a treatment plan for moral injury to help process these feelings in a program offered to Marines stationed at Camp Pendleton, Calif. The program has support from military leaders who are worried about the well-being of their men. At the same time, Litz realizes that the military isn’t about to stop the use of violence because of the side effects on its soldiers.
“I don’t want to medicalize this,” Litz said. “There are immense political and military culture conflicts that arise if you create a medical disease for doing their job.”