Combat Fatigue and Sociopaths

     Combat fatigue is an important topic mostly ignored in professional military education. Units involved in serious combat can expect to lose as many men to mental problems as from physical injuries. Just a few minutes of intense combat make many men dysfunctional, especially if they already suffer from a lack sleep, rest, warmth, or food.  While fleeing toward the rear is one symptom, others include uncontrolled shaking, crying, or jumping up and down and screaming.  Some soldiers turn into unresponsive zombies, which became known as the "thousand yard stare" during World War II (below). Sergeants yelling to "snap out of it" does no good.

     The best treatment is to evacuate such soldiers to a rear area where they are fed hot chow, allowed to sleep in a warm bed, then allowed to shower and shave and eat hot chow again. This cures most problems if they are quickly returned to their unit at the front.  If they are allowed to linger in the rear longer, they begin to feel guilty about failing in combat and fearful of being called a coward if they return. They also dwell on the horrible experience and may refuse to move.  Therefore, idle time must be avoided: eat, sleep, clean, eat and then a brief consultation with a medical officer who assures them that combat fatigue is common and a truck is waiting to take them back to their buddies at the front. There may be reluctance, but with assurances from a medical doctor and maybe some stern words from a sergeant, back the front they go, less than 24 hours after they became dysfunctional.

     While combat fatigue affects some soldiers quickly, it affects all soldiers over time. Competent brave soldiers with years of combat experience often break down from accumulated stress.  This was illustrated by the character Sergeant Oleonowski in the great movie "Go Tell the Spartans" and by the chief mechanic in the great movie "Das Boot."  Most soldiers feel they are special and will survive untouched, but soldiers involved in months of heavy combat eventually realize they will die or end up maimed for life, usually after one of their buddies suffers that fate. This is why the US Army Air Corps promised bombers crews during World War II that they only had to fly 25 dangerous missions before returning home.

     One study during World War II showed that after 90 days of combat action, 98% of soldiers showed signs of combat fatigue, the other 2% were sociopaths.  This is why it is important to pull entire units off the line for a couple days or a couple weeks depending on the combat intensity and hardships associated with food quality and weather conditions. During World War II, the US Marine Corps developed a rotation technique so that frontline infantrymen spent no more than 48 hours in direct combat with the enemy.

     The problem with sociopaths is never discussed within the US military because it is not understood.  Sociopaths have a mental condition in which death and destruction excites them rather than causing depression. It is a common mental illness and most all sociopaths live normal lives keeping their violent impulses under control; others become serial killers. Many seek occupations that allow a socially acceptable chance to vent their rage. This is why police departments keep an eye on rookie cops who seem enthusiastic about "kicking some butt."  Many rookie cops are fired for bad temperament, often after shooting someone for no reason.  Police departments do not try to retrain them knowing that sociopathic behavior is difficult to control.

     Sociopaths are attracted to military service as well, wanting to serve in infantry units where they can see violent action.  While most all infantrymen are motivated by the excitement of combat and the accomplishment of the mission, sociopaths are motivated by the chance to cause death and destruction. They can be identified by the wild-eyed excitement they show when talking of how they plan to kill the enemy.  Another sign is a love of knives and violent movies. This behavior is usually dismissed as dark humor or enthusiasm, but it may be sign of trouble.  Sociopathic behavior is depicted in the movie "The Dirty Dozen."

     While sociopaths are often excellent soldiers, they are dangerous if they lose control.  Officers and NCOs must be aware of this mental illness and take note of soldiers who demonstrate sociopathic tendencies.  Before a unit enters combat, suspected sociopaths need counseling to let them know they demonstrate sociopathic tendencies and that they must keep those urges in check. They should be warned that if they show any sign of losing control by harming prisoners or civilians, they will be transferred to a rear area unit.  They are likely to be shocked by such a warning, and thus keep their demons in check.

     However, many sociopaths are unable to retain control and commit vicious war crimes.  Officers will not be confused about what triggered this odd behavior if they understand this mental illness. This does not excuse such behavior, it merely explains it.  Hopefully, such incidents can be prevented by identifying sociopathic behavior beforehand and taking steps to deal with this mental illness. Given that some 2% of the general population shows sociopathic tendencies, and a volunteer military attracts a much higher percentage, keeping sociopaths in check is a major leadership challenge. A good policy is for Sergeants Major to visit units and tell soldiers that sociopaths are among them and to report such behavior.