Hans Reihling, Ph.D., LMFT
Trauma among Veterans: What has Masculinity to do with it?
“Veterans who report a strong identification with military culture and the emphasis on emotional stoicism may be at greater risk to develop PTSD than those who do not,” argue psychologists Elisabeth Neilson, Sonia Sigh, Kelly Harper, and Ellen Teng. Over the past decade, it has become very clear that the seemingly never-ending U.S. American-lead wars in Iraq, Afghanistan, and other countries around the world have taken a toll on many U.S. military service members. The suicide rates among veterans are notoriously high and many of those who return from combat suffer from Post-traumatic Stress (PTSD). What has masculinity to do with it?
The results of a recent systematic review of research on Traditional Masculinity Ideology and PTSD among active-duty members and veterans are sobering. The studies show that men who conform to a masculinity ideology that encourages the repression of emotions are not only more likely to experience PTSD, they also experience more severe symptoms, including flashbacks, problems with depressed mood, impaired cognition, as well as hyperarousal and overt reactivity. Moreover, the ideal of emotional toughness seems to keep those men from seeking help and from engaging in psychotherapy in ways that are healing trauma.
These are the insights from a systematic review of 17 studies (Neilson et al 2020):
Endorsing ‘traditional masculinity ideology’ is associated with PTSD symptom severity.
Emotional toughness and restrictive emotionality are associated with more severe PTSD symptoms.
Mental health symptoms tied to PTSD contribute to a sense of personal failure and harms a sense of masculinity.
Trauma exposure, particularly sexual abuse, may lead to heightened aggression and hypersexuality to compensate and reaffirm masculinity.
Military culture creates an environment in which injury and mental health problems are perceived as weakness. Psychologists give treatment or therapy recommendations, but do not dare to advocate for a change of military culture that endorses masculine gender norms that lead to mental health problems. Challenging the primacy of work and status, self-reliance, and emotional control may go against the grain of applying violence, which is the military’s primary task. If the institution was more collaborative, less hierarchical, and allow for emotional vulnerability, men’s (and women’s) willingness to go to war may be seriously undermined.
Not everything about ‘traditional’ masculinity is bad or detrimental to trauma recovery, as the above-mentioned psychologists seem to suggest. Some masculine gender ideals such as taking up responsibility for the wellbeing of one’s family and community can encourage post-traumatic growth. More flexible ways of being a man and embodying masculinity can help overcome the effects of traumatic stress on a man’s relationships and mental health. Feel free to contact me, to figure out what kind of man you want to be after having gone through something no human being should be exposed to.