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Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan
"If you consider Iraq―like I do, probably twenty-nine out of thirty days―to be the pinnacle of your life, then where do you go from there? And I'm sure that a lot of veterans feel that way. To them, that was it. That was everything. So now what? They have to find something meaningful and purposeful." "When I got back from Afghanistan, there was not even so much as a briefing that said, 'Let us know if you're having problems.' There wasn't so much as a phone number. There was literally nothing." "I knew it was crazy. I was thinking, the guy on the roof's either a sniper or he's going to radio ahead. And then I thought, this is San Antonio. There's not snipers on the roof, nobody's going to blow me up here." "Whenever I look at people back here at home, I know what they're going to look like dead. I know what they look like with their brains blown out or jaws blown off or eyes pulled out. When I look at somebody I see that, to this day." ―Voices of veterans interviewed in Fields of Combat For many of the 1.6 million U.S. service members who have served in Iraq and Afghanistan since 2001, the trip home is only the beginning of a longer journey. Many undergo an awkward period of readjustment to civilian life after long deployments. Some veterans may find themselves drinking too much, unable to sleep or waking from unspeakable dreams, lashing out at friends and loved ones. Over time, some will struggle so profoundly that they eventually are diagnosed with post-traumatic stress Disorder (PTSD). Both heartbreaking and hopeful, Fields of Combat tells the story of how American veterans and their families navigate the return home. Following a group of veterans and their personal stories of war, trauma, and recovery, Erin P. Finley illustrates the devastating impact PTSD can have on veterans and their families. Finley sensitively explores issues of substance abuse, failed relationships, domestic violence, and even suicide and also challenges popular ideas of PTSD as incurable and permanently debilitating. Drawing on rich, often searing ethnographic material, Finley examines the cultural, political, and historical influences that shape individual experiences of PTSD and how its sufferers are perceived by the military, medical personnel, and society at large. Despite widespread media coverage and public controversy over the military's response to wounded and traumatized service members, debate continues over how best to provide treatment and compensation for service-related disabilities. Meanwhile, new and highly effective treatments are revolutionizing how the Department of Veterans Affairs (VA) provides trauma care, redefining the way PTSD itself is understood in the process. Carefully and compassionately untangling each of these conflicts, Fields of Combat reveals the very real implications they have for veterans living with PTSD and offers recommendations to improve how we care for this vulnerable but resilient population.
240 pages, Hardcover
First published April 7, 2011
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Displaying 1 - 10 of 10 reviews
August 1, 2018
A handful of interesting summations, but reads more like an opinion piece or social commentary than it does a practical guidebook or in-depth look at causes and treatments. Just not what I was expecting.
December 12, 2024
Following the Iraq invasion in 2003 and the subsequent years of military operations in Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) there was a growing concern about the mental well being of American veterans upon their return. Amidst the growing numbers of service members reporting mental health issues, the media spotlight on the 2007 Walter Reed scandal exposed the shortcomings in veteran care, propelling PTSD into the national awareness. In this context, anthropologist Erin P. Finley’s ethnographic work, "Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan" (2011), delves into the personal and cultural aspects of PTSD. By immersing herself in fieldwork with veterans, their families, social workers and healthcare providers, Finley uncovers how personal trauma and cultural-political influences intersect to shape combat related experiences in present day America, as part what came to be known as Deployment Stress (PSD) study.
In her research, Finley conducted twenty months of ethnographic fieldwork during 2007-2008 in San Antonio, selected for its large population of retired service members and extensive military and VA health-care infrastructure. This particular setting offers a rich ground for Finley to study veterans' post-deployment experiences. Finley's methodological approach includes in-depth interviews with 62 veterans, mostly men of Latino descent. She also engages conversations as well as observations involving family members, healthcare providers, social workers, and local veterans’ service representatives. These methods, supplemented by survey questionnaires and some materials from other studies or published articles/news, cover topics such as military service, combat experiences, family life, and interactions with the military and VA health-care systems. The research encompasses a range of veterans spanning from different backgrounds and experiences, including those from the Vietnam era to recent Iraq and Afghanistan returnees, across various branches of the military. In total, 133 veterans, family members, clinicians, and community members participated in her research.
The narrative of the book revolves around two themes: the personal journeys of veterans diagnosed with PTSD and the cultural-political dimensions surrounding their experiences. Finley begins by defining PTSD as a disease characterized by a complex of symptoms that arise in the wake of trauma, such as wartime encounters. These symptoms include reexperiencing, avoidance, and hyperarousal. She starts to explore the reasons why many young people decided to join the military, particularly in San Antonio, where limited economic and educational opportunities make military service an appealing option: a classic example of "structural violence" as the military is portrayed as “their only way out.” Finley then examines the war experiences of veterans, illustrating how traumatic experiences in Iraq and Afghanistan result in “triggers” of PTSD. Through vivid storytelling, she captures the profound impact of combat on veterans' mental well-being, recounting their struggles of surviving constant bombings, dealing with limited resources in remote places, and facing the horror of being surrounded by dead bodies or not being able to save friends, comrades, and strangers. Drawing from these experiences, she explains that the varying accumulation of stressful events over a lifetime is the reason why some soldiers develop PTSD while others do not.
The book further highlights the challenges veterans face upon returning home, portraying their experiences as “the state of being displaced” into a familiar yet profoundly different environment. Veterans often struggle with emotional attachment, even with family, leaving them detached, and struggling to adapt to civilian norms after being “highly alert” during wartime, an adjustment that may lead to displays of aggression or violence in their behavior. This often results in marital instability, divorce, child neglect, and losing friends, further weakening their key social support networks. This pressure often leads to the misinterpretation of their behavior as a character failure rather than signs of suffering. Finley also delves into the family issues, cultural and gendered expectations that influence veterans' willingness to seek help for PTSD, especially in men within the context of "masculinism," where they feel obligated to fulfill their roles as men, partners, fathers, and veterans. This makes them feel like they have failed if they seek treatment and acknowledge their vulnerabilities. Cultural perceptions of veterans as dangerous men and stigma running in the family also make many veterans choose to keep their symptoms to themselves, fearing they might be treated differently.
Another major theme of the book is the complexities of PTSD treatment and the political dynamics involved. Finley argues that despite advancements in treating PTSD by the U.S. military and the Department of Veterans Affairs (VA), systemic issues and political factors often impede effective care. She highlights the tension between the need for mental health services and the military's culture of toughness, which stigmatizes seeking help and results in many veterans not receiving necessary care. The book explores the VA's bureaucratic challenges, where policies sometimes prioritize cost-saving over comprehensive treatment, leading to long wait times and inconsistent care quality. She underscores the role of political advocacy in improving PTSD treatment, noting that media exposure and public outcry have led to policy changes and increased funding. However, she argues that without a comprehensive understanding of trauma and its cultural and systemic-political context, these improvements may fall short of providing necessary support for veterans.
A notable strength of Erin P. Finley's "Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan" is its comprehensive approach to understanding PTSD from multiple perspectives by including veterans, family members, clinicians, and community members, even providing historical evolution of perceptions and treatments of combat-related stress from the Civil War to the present. Finley’s research also humanizes the experiences of PTSD in veterans, framing it as an illness rather than merely a disease. Furthermore, the book is rich with explorations of global debates and evolving research around the topic, not only focusing on ethnographical findings, such as the potential overdiagnosis of PTSD among recent veterans, adding rich discussion to the pages. Another aspect to be deeply appreciated is Finley's choice to respectfully anonymize participants’ identities, which honors and preserves the integrity of their original narratives, ensuring that their stories are told with dignity and utmost respect. This detailed attention to ethical considerations enhances the credibility and trustworthiness of her findings.
On a note, although Finley mentions that she tries to balance the focus on men by including seven female veterans in her research, this analysis only appears in several paragraphs in the conclusion part. Her attempts to balance the research didn’t fully achieve this goal. The book could benefit from a more detailed exploration of the differences in how men and women experience PTSD by dedicating an entire chapter to this topic rather than confining it to the conclusion. Moreover, some parts of the book tend to repeat descriptions of veterans experiences which could be refined for better readability.
All in all, "Fields of Combat” proves to be a valuable asset for academics and professionals particularly in the fields of anthropology, psychology, and sociology. Its ethnographic insights are insightful for understanding the intersection between culture, trauma, and mental well-being. The military and families who have a member with PTSD might also benefit from the struggles and resilience shown in the book, gaining a deeper understanding of PTSD, its emergence as well as the triggers and their impact to everyday life. To close the book, Finley offers practical strategies for preventing combat PTSD, decreasing its impact on families, minimizing its severity, and supporting resilience at the national and community levels. This makes her book not only an insightful academic resource but also a pragmatic handbook for those directly involved in designing and implementing support systems for veterans. Thus, mental health professionals, community leaders, and policymakers will also find Finley’s strategies particularly beneficial in formulating effective interventions and establishing support networks that cater to the complex needs of those who suffer from post-war PTSD.
In her research, Finley conducted twenty months of ethnographic fieldwork during 2007-2008 in San Antonio, selected for its large population of retired service members and extensive military and VA health-care infrastructure. This particular setting offers a rich ground for Finley to study veterans' post-deployment experiences. Finley's methodological approach includes in-depth interviews with 62 veterans, mostly men of Latino descent. She also engages conversations as well as observations involving family members, healthcare providers, social workers, and local veterans’ service representatives. These methods, supplemented by survey questionnaires and some materials from other studies or published articles/news, cover topics such as military service, combat experiences, family life, and interactions with the military and VA health-care systems. The research encompasses a range of veterans spanning from different backgrounds and experiences, including those from the Vietnam era to recent Iraq and Afghanistan returnees, across various branches of the military. In total, 133 veterans, family members, clinicians, and community members participated in her research.
The narrative of the book revolves around two themes: the personal journeys of veterans diagnosed with PTSD and the cultural-political dimensions surrounding their experiences. Finley begins by defining PTSD as a disease characterized by a complex of symptoms that arise in the wake of trauma, such as wartime encounters. These symptoms include reexperiencing, avoidance, and hyperarousal. She starts to explore the reasons why many young people decided to join the military, particularly in San Antonio, where limited economic and educational opportunities make military service an appealing option: a classic example of "structural violence" as the military is portrayed as “their only way out.” Finley then examines the war experiences of veterans, illustrating how traumatic experiences in Iraq and Afghanistan result in “triggers” of PTSD. Through vivid storytelling, she captures the profound impact of combat on veterans' mental well-being, recounting their struggles of surviving constant bombings, dealing with limited resources in remote places, and facing the horror of being surrounded by dead bodies or not being able to save friends, comrades, and strangers. Drawing from these experiences, she explains that the varying accumulation of stressful events over a lifetime is the reason why some soldiers develop PTSD while others do not.
The book further highlights the challenges veterans face upon returning home, portraying their experiences as “the state of being displaced” into a familiar yet profoundly different environment. Veterans often struggle with emotional attachment, even with family, leaving them detached, and struggling to adapt to civilian norms after being “highly alert” during wartime, an adjustment that may lead to displays of aggression or violence in their behavior. This often results in marital instability, divorce, child neglect, and losing friends, further weakening their key social support networks. This pressure often leads to the misinterpretation of their behavior as a character failure rather than signs of suffering. Finley also delves into the family issues, cultural and gendered expectations that influence veterans' willingness to seek help for PTSD, especially in men within the context of "masculinism," where they feel obligated to fulfill their roles as men, partners, fathers, and veterans. This makes them feel like they have failed if they seek treatment and acknowledge their vulnerabilities. Cultural perceptions of veterans as dangerous men and stigma running in the family also make many veterans choose to keep their symptoms to themselves, fearing they might be treated differently.
Another major theme of the book is the complexities of PTSD treatment and the political dynamics involved. Finley argues that despite advancements in treating PTSD by the U.S. military and the Department of Veterans Affairs (VA), systemic issues and political factors often impede effective care. She highlights the tension between the need for mental health services and the military's culture of toughness, which stigmatizes seeking help and results in many veterans not receiving necessary care. The book explores the VA's bureaucratic challenges, where policies sometimes prioritize cost-saving over comprehensive treatment, leading to long wait times and inconsistent care quality. She underscores the role of political advocacy in improving PTSD treatment, noting that media exposure and public outcry have led to policy changes and increased funding. However, she argues that without a comprehensive understanding of trauma and its cultural and systemic-political context, these improvements may fall short of providing necessary support for veterans.
A notable strength of Erin P. Finley's "Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan" is its comprehensive approach to understanding PTSD from multiple perspectives by including veterans, family members, clinicians, and community members, even providing historical evolution of perceptions and treatments of combat-related stress from the Civil War to the present. Finley’s research also humanizes the experiences of PTSD in veterans, framing it as an illness rather than merely a disease. Furthermore, the book is rich with explorations of global debates and evolving research around the topic, not only focusing on ethnographical findings, such as the potential overdiagnosis of PTSD among recent veterans, adding rich discussion to the pages. Another aspect to be deeply appreciated is Finley's choice to respectfully anonymize participants’ identities, which honors and preserves the integrity of their original narratives, ensuring that their stories are told with dignity and utmost respect. This detailed attention to ethical considerations enhances the credibility and trustworthiness of her findings.
On a note, although Finley mentions that she tries to balance the focus on men by including seven female veterans in her research, this analysis only appears in several paragraphs in the conclusion part. Her attempts to balance the research didn’t fully achieve this goal. The book could benefit from a more detailed exploration of the differences in how men and women experience PTSD by dedicating an entire chapter to this topic rather than confining it to the conclusion. Moreover, some parts of the book tend to repeat descriptions of veterans experiences which could be refined for better readability.
All in all, "Fields of Combat” proves to be a valuable asset for academics and professionals particularly in the fields of anthropology, psychology, and sociology. Its ethnographic insights are insightful for understanding the intersection between culture, trauma, and mental well-being. The military and families who have a member with PTSD might also benefit from the struggles and resilience shown in the book, gaining a deeper understanding of PTSD, its emergence as well as the triggers and their impact to everyday life. To close the book, Finley offers practical strategies for preventing combat PTSD, decreasing its impact on families, minimizing its severity, and supporting resilience at the national and community levels. This makes her book not only an insightful academic resource but also a pragmatic handbook for those directly involved in designing and implementing support systems for veterans. Thus, mental health professionals, community leaders, and policymakers will also find Finley’s strategies particularly beneficial in formulating effective interventions and establishing support networks that cater to the complex needs of those who suffer from post-war PTSD.
This entire review has been hidden because of spoilers.
July 6, 2017
This book offers a completely different approach to PTSd than others I have read and it is an exceptionally valuable piece of work. It is an ethnography, providing details of the experiences of veterans returning from Iraq and Afghanistan. though it all rings true for Vietnam veterans as well.
This is a complicated and often confused field. There are, as there have always been competing demands of the military, the politicians, the veterans and the society at large from which they are drawn. What we do with the broken soldiers of whom we ask so much, has been an emotionally charged see saw since the days of the Civil War in America and probably WW1 in Australia. Once the drum bashing and teeth gnashing are done the politicians and bureaucrats involved with veterans' care tend to be more than obsessed with issues of costs and containing them than with the needs of the veterans no matter what they may say. The public at large tends to be apathetic or oblivious, that is except on days of national commemoration or unless some scandal about veterans hits the press. As happened in the US around delays with critical care.
Clinicians are divided on how to proceed and veterans are often just left dangling. The rewrite of the DSM has meant that the waters of combat related ptsd have been muddied by a surge of new claims that often relate to other issues not necessarily related to service. This confuses not only society's perception of service personnel suffering from ptsd but critically derails the development of effective treatment.
The situation in Australia is far worse than that in the US. Confusion reigns supreme and the privatisation of medical services for veterans has meant the dissipation of expertise and a general fall in the quality of treatment. Notwithstanding those problems the profession seems stuck in the frameworks developed in the 1980's none of which were very effective and the principle of "you're broken it may get a little better but all you can do is manage the condition and live with it!"
My own experience has proven this approach to be both lazy and criminally negligent. The direction towards Buddhist psychology as a guiding treatment principle is a light at the end of the tunnel but the general ignorance and lack of professionalism of many hospital staff involved in treatment in Australia just continues to lock veterans into their suffering and sustains it. The quality of their lives blighted by over medication and the want to collect the cash from a Government too slack to meet its obligations.
This whole area needs a revolution. About the only way I can see that happening is if veterans themselves train and become the professional staff serving their fellows.
A great academic work, very readable and enlightening to me. It certainly firmed up many of my own views and placed much of my personal experience into perspectives I just didn't have. Should be required reading for anyone working in the field
This is a complicated and often confused field. There are, as there have always been competing demands of the military, the politicians, the veterans and the society at large from which they are drawn. What we do with the broken soldiers of whom we ask so much, has been an emotionally charged see saw since the days of the Civil War in America and probably WW1 in Australia. Once the drum bashing and teeth gnashing are done the politicians and bureaucrats involved with veterans' care tend to be more than obsessed with issues of costs and containing them than with the needs of the veterans no matter what they may say. The public at large tends to be apathetic or oblivious, that is except on days of national commemoration or unless some scandal about veterans hits the press. As happened in the US around delays with critical care.
Clinicians are divided on how to proceed and veterans are often just left dangling. The rewrite of the DSM has meant that the waters of combat related ptsd have been muddied by a surge of new claims that often relate to other issues not necessarily related to service. This confuses not only society's perception of service personnel suffering from ptsd but critically derails the development of effective treatment.
The situation in Australia is far worse than that in the US. Confusion reigns supreme and the privatisation of medical services for veterans has meant the dissipation of expertise and a general fall in the quality of treatment. Notwithstanding those problems the profession seems stuck in the frameworks developed in the 1980's none of which were very effective and the principle of "you're broken it may get a little better but all you can do is manage the condition and live with it!"
My own experience has proven this approach to be both lazy and criminally negligent. The direction towards Buddhist psychology as a guiding treatment principle is a light at the end of the tunnel but the general ignorance and lack of professionalism of many hospital staff involved in treatment in Australia just continues to lock veterans into their suffering and sustains it. The quality of their lives blighted by over medication and the want to collect the cash from a Government too slack to meet its obligations.
This whole area needs a revolution. About the only way I can see that happening is if veterans themselves train and become the professional staff serving their fellows.
A great academic work, very readable and enlightening to me. It certainly firmed up many of my own views and placed much of my personal experience into perspectives I just didn't have. Should be required reading for anyone working in the field
August 6, 2013
Accessible, strong overview of combat PTSD. Definitely from an anthropologist, so you're looking at a lot of bigger picture systemic, historical, and cultural understanding and responses, but she also delves into some of the personal experiences and treatment. As a psychologist, I was hoping for a bit more of the latter. Worth reading if it's a topic of interest.
October 25, 2020
At the end of the book a point really hit me: Combat is less likely to break a woman's mind than sexual assault. Sexual violation is more likely to harm the mind than physical violence. This takes me back to the Evil Hours, where David J. Morris says natural disasters are much less likely to result in PTSD than war because we accept them as natural. War is more personal, and so perhaps sexual assault is the most personal. I'm inspired to do what I can to foster optimal peace and respect for the human body by books like this.
October 28, 2020
Very helpful perspective on PTSD
I read this a few years ago when I was about to start working at a VA hospital. I just finished rereading it now with a few years of experience with the VA. It will certainly help to steer anyone with an interest in PTSD in the right direction.
I read this a few years ago when I was about to start working at a VA hospital. I just finished rereading it now with a few years of experience with the VA. It will certainly help to steer anyone with an interest in PTSD in the right direction.
October 7, 2012
glad i read it.very eye opening. decided to just because i'm working on an enlistment with the Marines.gave me some valuable insight on the reality of war.
March 15, 2013
Informative read. Great blend of the empirical, historical and clinical....gives knowldge and perspctive to the struggles and the current issues.
December 29, 2016
A rather interesting review of PTSD, how it develops, what to do about it, and how to prevent it.
April 12, 2017
While the author did a pretty good job of explaining what can cause PTSD, and what it's like to live with it, there was not very much on really treating it, which was what I was interested in. I also felt like the way she presented four "people", then told in the notes at the end that they were just composites of many people, was a bit dishonest, and made me wonder if any of what she wrote actually happened.
Displaying 1 - 10 of 10 reviews