‘Aftershock: The Untold Story of Surviving Peace’ reviewed by Seth Messinger

Aftershock: The Untold Story of Surviving Peace by Matthew Green (Portobello Books, 2015).

417zV+WrcVL._SX323_BO1,204,203,200_In Aftershock Matthew Green has written an important, fascinating and bleak overview of post war suffering among British veterans who have been afflicted with a variety of post-combat trauma syndromes. Green launches twin journeys, one is across the UK interviewing veterans and their family members about their after-war experiences, and the second is to explore both traditional and pioneering healthcare / rehabilitative sites devoted to the care of these veterans and other sufferers like them. Green’s book has joined a growing genre of journalistic accounts of the afterlives of war. We are introduced to former UK forces combatants returning from combat and war environments in Afghanistan, Iraq, Ireland, the Balkans, the Falklands Island, and Northern Ireland who face a number of difficult challenges that reintegration into civilian life can bring.

Green’s findings are troubling. Even in the absence of specific numbers on the rate of post-war struggles among former UK Forces, the breadth and depth of individual suffering he uncovers is staggering. The “spiral” is Matthew Green’s central metaphor of the helical downward trajectory experienced by those afflicted with what he refers to as psychological wounds of war. Throughout the book he recounts the experiences of several veterans and their families who describe their post-conflict afflictions and their difficulties adjusting back to civilian life. More often than not the individuals who Green focuses on suffer from an affliction that is multifactorial in origin. There should be no doubt that their suffering is real, painful, and sometimes fatal.

One of the main challenges facing these veterans and their families is where to turn to for care. Green discovers that there is no one place or system that is prepared to manage the problems faced by these veterans. The seeming absence of a comprehensive network of effort to treat these veterans compounds the challenges these veterans and their families face. Green shows that there are significant structural gaps in care provided by both the small military health system and the much larger National Health Service. These include long waiting times, missed connections, weak efforts to ensure follow up and a lack of experienced clinicians who are trained to work with military and veteran patients. In order to meet the needs of prospective patients there has emerged a number of private health care initiatives and entrepreneurial efforts from a variety of alternative practitioners including equine therapeutics, Buddhist meditations, and animal spirit guardians.

The tragic narrative of Aaron Black — from his youth, his time in the military, to his suicide — form the bookends for Green’s work. A young infantryman, Aaron Black had, by all accounts, a successful deployment to Afghanistan during 2009, one of the more violent years for the British contingent of ISAF (the International Security Assistance Force — the name for the allied war effort in Afghanistan). Black and his comrades experienced a number of sharp, violent engagements, but in official reports and interviews Black was portrayed as a very good soldier who developed the kind of ‘well controlled aggression’ (p. 18) that military leaders seek in their men.

In spite of the official reports there were increasingly apparent warning signs of ‘the spiral’ — while Black’s aggression might have been controlled in combat situations, it became rampantly uncontrolled when directed inward. During both his mid-tour leave and after his unit returned from their deployment Black, both alone and with army and civilian friends, engaged in cycles of binge drinking as well as lethargy that made it difficult for him to keep up with his garrison duties or adjust to the civilian workforce. As the warning signs mounted Aaron, and his mother — who comes across as his fiercest advocate – sought out medical help ultimately to no avail. In 2011 Aaron took his own life.

What caused Aaron Black to end his life? Was it the overall stress and intensity of his several months long deployment in Afghanistan? Was it the instantaneously horrifying experience of seeing a comrade killed in an explosion? In considering some of the material Green presents these are likely candidates for attribution. Like other authors in this genre Green is fascinated by the history of what used to be referred to as ‘war neuroses.’ The chapter following the account of Aaron Black entitled Case One explores the “discovery” of shell shock, with both its pre-history in the US Civil War and its later developments through World War II and forward. But in those cases the “war” is the necessary condition for the onset of the disorder. However when the view moves from the aggregate of suffering soldiers to the suffering of an individual soldier more complicating factors emerge.

Matthew Green’s book provides a helpful road map to the terrain of post combat afflictions, and like a road map, the main, secondary and, even, tertiary routes are all laid out. But the complexity of the suffering experienced by Green’s interlocutors defies easy understanding. The mix of pre-military problems faced by many, the intensity of the deployment experience, and the challenges of finding meaningful lives after war presents a bedeviling mix of problems that have proven to be very difficult to manage. To an extent the reader is left with a sense that war can wreak havoc with individuals. For many the experience can be integrated into one’s sense of a life. For others it continues to reverberate and disorient. Throughout the book Green is at pains to point out that the seeming majority of former British Forces going back to the Northern Ireland conflict have successfully adjusted to life after conflict. Millions have readjusted and thousands have not. Researchers, clinicians, veterans and journalists need to continue to ponder why.

Reading Green’s account of Aaron Black and other anguished veterans and questioning family members it is clear that a more robust and intensive effort to alleviate their suffering is needed. But a careful reading of Green’s interlocutor’s accounts of their battlefield experiences and their lives ends up leading to more questions than answers.

Reviewed by Seth Messinger (PhD), an Anthropologist and Research Director with the Center for Rehabilitation Sciences Research at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA. His views are not automatically a reflection of those held by the United States Department of Defense.

Correspondence to Dr Seth Messinger

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