Did ancient civilians get PTSD? What do we know of the psychological effects of war on noncombatants, and how they dealt with them?

by EnclavedMicrostate
Iphikrates

Content warning: mention of sexual violence, suicide, casual misogyny

 

PTSD is a label we use to describe a group of symptoms connected to trauma and moral injury. The label was created in the 1970s to get Vietnam veterans in the US the support and mental health treatment they needed. As such, it was originally focused on making sense of the symptoms shown by soldiers, and connected to earlier diagnoses like shell shock and battle fatigue. Only when the label was well-established did people begin to realise that victims of other traumatic experiences (accidents, crime, violence, loss, abuse) often showed the same combination of symptoms. Today the most common causes of PTSD are domestic violence and sexual abuse. But the origin of the term in the treatment of veterans means it's still most commonly associated with war trauma.

The scholarly search for historical PTSD has the same origin. When Jonathan Shay wrote his groundbreaking Achilles in Vietnam (1994), it was not to examine Antiquity for its own sake, but to explore similarities in ancient and modern experience in order to help modern veterans. Shay is not a historian but a clinical psychologist; his work was prompted by his own practice treating veterans in Boston. Understandably, his focus was on warriors and their experiences with war and combat. The Ancient Greeks have helpfully left us a rich collection of material on just that topic, which allows us to examine their thoughts on warfare in detail.

Later scholars followed Shay's lead. Classicists and ancient historians arguing over whether or not the Greek experience was comparable to that of modern soldiers have made this a debate about war trauma rather than trauma in general. Their search for evidence has been focused entirely on trauma in men returning from war. As debate raged over whether Greek soruces really described war-related psychological disorders (on which see this great post by u/hillsonghoods as well as the answers in our FAQ section on PTSD in past societies), the fact that there are many recognised causes of PTSD besides war has been largely ignored.

The result is that we don't (yet) know the answer to your question. Put simply, there is no study of trauma and the effects of moral injury in Antiquity that does not focus on warriors. The search for specifically military experiences was baked into the question when it was first asked. It's only now that the study of the psychology of Antiquity has become more established that scholars have started looking beyond this extremely limited perspective and considered that there were other groups in Ancient society besides warriors.

We do know that there were many potential causes of moral injury in Antiquity. In a world of endemic violence, high mortality and little protection for vulnerable groups, in which enslavement was common and sexual violence was an accepted part of the relation between the powerful and the powerless, many people would have experienced things traumatic enough to leave lasting psychological damage. War made this particularly true for non-combatants, since it was understood that a defeated population was subject to rape, enslavement and murder. Many tragedies written in 5th-century Athens contain women lamenting their fate if their city were to fall, or bitterly grieving for themselves and their relatives once their city has fallen. The horrors that awaited a city that fell into the hands of the enemy were enough to inspire radical acts of defiance including women taking up arms to defend their city or, in a final act of desperation, choosing mass suicide over enslavement.

But unfortunately there is almost nothing that tells us how non-combatants dealt with their traumatic memories afterwards. There is no parallel to the cases of lasting changes in personality or lasting psychological disorders that have prompted modern authors to argue that Greek warriors suffered from what we would call PTSD. Since most of those scholars use partial and tenuous evidence to build their case to an excessive degree of confidence, it seems quite likely they might be able to do the same with what scraps of evidence we have for non-combatants' lives after trauma. But the evidence is even thinner, since our best evidence is for war, and since ancient sources overwhelmingly focus on the experiences of elite men of military age. So if this study were ever undertaken, no doubt its basis would be extremely thin. For instance, a study by Ustinova and Cardeña^1 - while still entirely focused on warriors and military experience - cites Hippokrates' On Diseases in Maidens 5-10 as evidence for ancient awareness of trauma-related psychological disorder in teenage girls:

My topic relates to (...) terrors of the sort that people fear so strongly, that they are beside themselves and seem to see certain hostile spirits, sometimes by night, sometimes by day, and sometimes at both times. Then as a result of this kind of vision, many have already hanged themselves, more women than men, for female nature is weaker and more troublesome. (tr. Rebecca Flemming)

But what Hippokrates goes on to describe is blood going the wrong places inside the body and causing these fears and suicidal thoughts. He does not identify any traumatic experience as the cause, and does not regard the problem as one of mental health. His solution, moreover, is for young girls who suffer this form of disorder to get married and get pregnant as quickly as possible, for "if they become pregnant, they become healthy" (42-3). This hardly counts as treatment - especially if, as we may suppose, the cause of the girls' unexplained terrors is not past trauma but the anticipation of marriage into a strange home and pregnancy at an early age. But even if we do consider these symptoms to be caused by some unspoken trauma, they fall very far short of the requirements for a modern diagnosis.

In other words, a study of the possible effects of trauma on non-combatants in Antiquity has not been done; it would be an uphill struggle both against the scholarly tradition as it stands, and against the source base available. I hope it will one day be undertaken. Myhtic stories such as that of Klytemnestra, Penelope and Persephone will probably end up being very important, since they represent some of the few examinations of what it was like to be a non-combatant and a dependant in a brutish patriarchy - but how closely such stories reflect real experiences will always be a matter of debate.

 

  1. Y. Ustinova, E. Cardeña, 'Combat stress disorders and their treatment in Ancient Greece', Psychological Trauma: Theory, Research, Practice and Policy (2014), 1-10.