Can drone operators get PTSD?

By David J. Morris
Best Defense office of the consequences of war

Personally, I have yet to be convinced that they can. One of the things I learned writing a book on the history of PTSD is that soon after it was formally recognized by psychiatry it began to suffer from crowd control problems. PTSD today is an incredibly popular diagnosis, one of those rarest of instances where a mental health disorder suffers from a kind of positive stigma. PTSD represents so many things to so many people but to some claiming PTSD has become a way of saying, “Hey man, I’ve seen some heavy shit, too.” Today’s academic controversies about “trigger warnings,” whereby undergraduates claim they find novels like The Great Gatsby retraumatizing are a product of the trauma culture that PTSD helped create.

It has also become an incredibly problematic diagnosis in the sense that some well-meaning clinicians have started to see it everywhere, in some instances asserting that virtually all survivors of overwhelming events will develop diagnosable PTSD. One researcher from Duke University, talking about the 2004 tsunami in Sri Lanka and quoted in Ethan Watters’ Crazy Like Us, said “It is likely that 50 to 60 percent of the population will suffer from PTSD.” Adding that, “The effect is likely to be multigenerational.” As one therapist in private practice in Oregon told me recently, “I don’t know how any thinking person doesn’t have PTSD now.”

With respect to drone operators being diagnosed with PTSD, I have several concerns. First and foremost is that the PTSD diagnosis originally grew out of the experiences of veterans, rape survivors and burn victims and has always centered around a pretty basic existential question: Did you think you were going to die? If yes, then it’s possible that you are suffering from post-traumatic stress. By extending the diagnosis to technicians watching video monitors in air-conditioned trailers outside of Las Vegas, I fear we may be diluting what has up to this point been a powerful diagnostic concept which has reduced an untold amount of human suffering.

Second, the science behind drone operators being diagnosed with PTSD is thin and fragmentary. One study conducted by the New York Psychiatric Institute which looked at people who had observed the 9/11 attacks on television found that most of the subjects who were interviewed exhibited at least some PTSD symptoms five to seven days after the attacks, but that after thirty days, most of these symptoms had dissipated. Obviously, watching 9/11 on television and orchestrating drone strikes for months on end aren’t the exactly same thing but they do share one important commonality: they are both mediated experiences, i.e. both the drone operators and the 9/11 television viewers in the New York Psychiatric Institute were not personally present where the violence took place. Which brings me to my next point: currently there are no studies that indicate that drone operators suffer from the same sort of long-term debilitating symptoms that infantrymen and rape survivors do, which ought to give us pause. Further, the only major studies conducted on the subject so far have been conducted by the air force, which has a vested interest in proving that their servicemembers suffer from operational stress just like the other services, services which deploy on average more often and for longer periods of time.

In truth, this argument is partly academic. If a drone operator came to me and told me he couldn’t sleep, was having nightmares, and was thinking about killing himself, I would tell him the same thing I would tell a Marine rifleman who had done two tours in Helmand Province, Afghanistan: Go and get help. Symptoms are symptoms and to a degree it doesn’t matter how you get them.

But to me applying the same diagnostic rubric to drone operators and grunts just doesn’t feel right. The original PTSD concept grew out of a moral argument made by Vietnam vets, a recognition that something needed to be done about the pain they were experiencing. So far, all we have about the pain of drone operators are a few scattered anecdotes in popular magazines like “Wired” and “GQ,” which ran an article about one troubled drone operator in 2013, though the author of the piece, the late Matthew Power, focused more on the possible “moral injury” that drone operators are apparently suffering from than on the specifics symptoms of PTSD like hypervigilance and hallucinations.

Nevertheless, this debate, which I am perfectly willing to concede I may be wrong about, raises a ton of fascinating questions, many of which are at the heart of our historical moment: What is real? How “real” are the digitally-mediated narratives we are bombarded with every day? What happens to our reality when most of our emotional traffic on a given day is conducted through a series of screens we compulsively stare at? What is war now when major portions of it have come to resemble a video game? What do you call a warrior who doesn’t actually put himself in harm’s way? Is he still a warrior, or he something else?

I’m not Philip K. Dick and I can’t pretend to answer any of these questions with any kind of authority, but as a storyteller I can offer the following vignette that speaks to how my own mind has processed these sorts of situations. In 2007 at the height of the surge, I spent two weeks in Dora, Baghdad, with 2nd Battalion, 12th Infantry, one of the best army units I have ever seen. Toward the end of my time with 2-12, I was in a company outpost watching an infrared surveillance feed as some soldiers lit up two Iraqis who had been caught red-handed on camera burying an IED in the street. I remember seeing one Iraqi as he was dismembered by automatic fire, his calf seeming to collapse like a camp chair, a mere four hundred meters from the company patrol base where I was located. Looking back on this event what I recall as much as anything else was how all of us in the company operations center laughed at the time and demanded that the soldier working the feed replay it for us, over and over again. Standing there in my body armor surrounding by video monitors, I probably watched that Iraqi lose his leg a dozen times. First, in regular time, then in slo-mo, then super slo-mo. As far as we were concerned it was entertainment, not unlike watching Joe Theismann being sacked by Lawrence Taylor in 1985 on “Monday Night Football.” I claim no moral high ground here. I laughed just like everyone else in the COC that night. Watching that Iraqi get shot seemed something other than fully real. It seemed, well, deeply interesting, a break from the boredom of a long sweaty day in a never-ending war.

For reasons that are hard to explain, I have never had nightmares about this event, even though I knew the shooters and later walked the street where the ambush took place. Instead my nightmares have tended to revolve around other “real life” close calls I had and other emotionally-laden but completely non-violent events that happened in Iraq. What are we to make of this? Does this mean that mediated death is somehow less traumatic to those who bring it about? Yes, almost certainly, for that is very point of drone warfare: it reduces our vulnerability to almost zero. Does this mean that drone operators experience no trauma at all in the line of duty? Well that there seems to me to be one of the major moral questions of our time, one that researchers so far have not addressed with any serious level of scrutiny. What is real trauma? What happens to it when it is transferred to the screen big or small? Nobody seems to know yet.

David J. Morris is a former Marine infantry officer and the author of The Evil Hours: A Biography of Post-traumatic Stress Disorder. Tom note: And that’s my favorite book published this year.

U.S. Air Force Air Combat Command