Ana Margarida Sousa Santos reviews Adam Montgomery’s The Invisible Injured: Psychological trauma in the Canadian military from the first world war to Afghanistan (McGill-Queen’s University Press: 2017).

Adam Montgomery’s The Invisible Injured: Psychological trauma in the Canadian military from the first world war to Afghanistan offers a contextualized account of the experience of trauma within the Canadian military from 1914 to 2014. Montgomery specifically details changes within military and public perception of trauma, alongside a discussion of the enduring stigma surrounding trauma in Canada. This nuanced investigation advances important arguments on the specific context of the Canadian military experience, together with the historical trajectories of trauma in Canada. Montgomery makes good use of a wide range of sources (news reports, archival material, oral history, the personal accounts of military veterans and clinical experts) to carefully trace the tensions that arise between different hierarchies within the military, and between the military, the political, and the public spheres. In doing so he frequently challenges contemporary Canadian public understandings of the harrowing experiences of military forces deployed in peacekeeping missions.

The book is set among a growing number of studies that purport to investigate the aftermath of war, particularly with a focus on mental health. These texts trace the history of a long line of illnesses with differing etiologies and symptoms that have developed after war, corresponding to distinctive discourses of trauma and situated within specific socio-cultural, political, and historical moments (Young 1997, Fussell 2009, Shephard 2003). Along with the history of Post-Traumatic Stress Disorder (PTSD), this book addresses the development of Operational Stress Injury (OSI), the diagnostic category used by the Canadian military to avoid the stigma associated with PTSD.

A concise introduction sets out the lay of the theoretical land, with an overview of the history of trauma literature, introducing the main concerns, and presenting personal accounts from peacekeepers that will be revisited throughout the book. Montgomery then proceeds to develop the argument through six chapters. These are usefully organized chronologically, to provide an overview of the changes and transformations experienced by the members of the armed forces. The chapters all focus on Canada with one exception. Chapter 3 introduces the American experience in Vietnam, and its impact on new approaches to the mental health of veterans. This is an especially important departure, addressing a war that Canada had no part in but whose repercussions included the arrival of PTSD as a diagnostic tool (as first established in the third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1980). The enduring influence of PTSD in medical care in the Canadian armed forces is detailed in the chapters that follow, bringing us closer to the current understandings of PTSD in the military. Chapters 4, 5, and 6 discuss Canadian military engagements after 1991, opening up a new area of focus in studies of PTSD, by considering PTSD in connection with peacekeeping missions rather than war.

The book takes on three main tasks: firstly, understanding the changing nature of trauma discourse across different eras and war experiences in Canada, secondly, adding to the ‘incipient trauma history field in Canada’ (p. 16), and thirdly, offering an ‘in-depth examination of how trauma and peacekeeping both intermingled and conflicted with medical theories and cultural discussions after the cold war’ (p. 17). It does all three well, developing new questions  on the consequences of peacekeeping missions for mental health, for future comparative research in Canada and elsewhere. These include investigating not only the medical consequences of trauma, but also its social and economic impact for veterans from different eras, building on earlier analyses of shell shock and remarking upon ‘the persistence of trauma narratives’ (p.212) throughout Canada’s war participation. Montgomery carefully contextualizes Canada’s changing military engagements, focusing on the experience and ethos of peacekeeping, and the need to take trauma into consideration for the veterans involved in peacekeeping operations.  Masculinity is often part of research studies of PTSD, but it is not always an explicit concern. Montgomery takes masculinity as a lens through which the experience of trauma and care-seeking are introduced throughout the book.

The Invisible Injured offers important contributions to a growing body of literature on mental health and military studies, adding the focus on Canadian experiences and peacekeeping. The focus on the Canadian military and its peacekeeping activities exposes the potential traumatic experiences that arise from peacekeeping missions, and the developing context of mental healthcare, reinforcing the specificity of trauma narratives and their contingent historical nature. Many of the current dynamics covered in the book emerge through decades of incremental shifts and changes in the Canadian Armed forces, well-documented concerns and public scandals which are well detailed in the book. This includes the 1993 murder of a teenage boy by Canadian soldiers in Somalia, the Croatia Board of Inquiry’s investigations into ‘the high number of peacekeeping injuries stemming from UNPROFOR [United Nations Protection Force] service’ (p. 144), and the very public accounts of suffering from Lieutenant-General Dallaire after the Rwandan genocide. The strength of the book lies in the discussion of public debates that took place in the 1990s and 2000s and have slowly shifted the policy towards PTSD sufferers among Canadian peacekeepers, recognizing structural barriers to care, and highlighting the historical contingencies of understandings and experiences of trauma. Montgomery’s approach has the advantage of a large temporal scope from which to analyze the changes within the Canadian military and the ways in which care provision changed. By analytically foregrounding the experience of peacekeepers, Montgomery develops an analysis of the contradictions between the experience of soldiers and the many cases of failure among the military hierarchy.

References:

Fussell, P. (2009) The Great War and modern memory, Sterling Publishing Company, Inc.

Shephard, B. (2003) A War of Nerves: Soldiers and psychiatrists in the twentieth century, Harvard University Press.

Young, A. (1997) The Harmony of Illusions: Inventing post-traumatic stress disorder, Vol. 11, Princeton University Press.

Ana Margarida Sousa Santos has a DPhil in Social Anthropology from Oxford. Her research addresses the experience and memory of violence in Mozambique and Portugal. Ana has done research and taught in the UK (Oxford, Birmingham, SOAS, Roehampton, Brunel, and Durham), and is currently a research associate at ICS – University of Lisbon. ORCID: 0000-0002-3440-7250

 

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