Perpetration-Induced Traumatic Stress
[a form of Posttraumatic Stress Disorder (PTSD) symptoms;
also called
Participation-Induced Traumatic Stress]


Personal Stories

For information on the book explaining PITS in more detail, Perpetration-Induced Traumatic Stress: The Psychological
Consequences of Killing ,
or for a DVD of a workshop presentation on Killing as Trauma, click here.

There is also a basic explanation of PITS, a page on PITS in world literature, notes on therapy, and a bibliography.  



From excerpts of biographical or autobiographical accounts, the expressions of PITS are expanded into many types of
groups of those who engage in killing. Some kinds were killing that the society approved of, and some were not. Cases
vary widely on how controversial the practices are, what conclusions people may draw, and on what policy implications
they have. The similarities across the different types of killing, however, are found in the symptoms of PTSD.



Narrative of the Life of Frederick Douglass, an American Slave, 1845

[His slave-master would] "walk alone . . . muttering to himself, and he occasionally stormed about as if defying an army
of invisible foes. Most of his leisure was spent in walking around, cursing and gesticulating as if possessed by a demon.
He was evidently a wretched man at war with his own soul and all the world around him."


Jane Addams

Jane Addams was an activist with the Women's International League for Peace and Freedom at the time of World War I.
As such, she went to Europe and visited soldiers in hospitals. She is most famous for establishing Hull House in
Chicago, and being instrumental in the development of the profession of social work. Here she describes her visits to
the hospitals.

I recall a spirited young man who said: . . ."all the time you loathe the squalor, the brutality, the savages around you,
and the savage you are yourself becoming . . ."

It is such a state of mind which is responsible for the high percentage of insanity among the soldiers.  In the trains for
the wounded, there is often a closed van in which are kept the men who have lost their minds.  Sometimes they recover
after due care, and sometimes they prove to be hopelessly insane.  A young Russian wrote home:  "men have fought
from the beginning of history, yet no one has ever recorded that so many soldiers lost their minds, were driven mad by
war.  Do you suppose it was true always, or is it only true in this generation?"

In every country we heard of the loathing against the use of the bayonet felt by this type of young man to whom primitive
warfare was especially abhorrent, although he was a brave soldier and serving his country with all his heart.  We heard
from interned soldiers in Holland that they had escaped across the border dazed and crazed after a bayonet charge;
from hospital nurses who said that delirious soldiers are again and again possessed by the same hallucination -- that
they are in the act of pulling their bayonets out of the bodies of men they have killed; from the returned soldiers one of
whom said to use:  "A bayonet charge does not show courage, but madness.  Men must be brought to the point by
stimulants and once the charge is begun they are like insane men.  I have been in it and after it was over I was utterly
dazed.  I did not know what had happened to me any more than if I had been picked up from the water after an explosion
on shipboard."

Jane Addams:
A Centennial Reader, ed. Emily Cooper Johnson (New York: The Macmillian Company, 1960) pp. 272-73.


The Reluctant Hangman: James Berry, by Justin Atholl

James Berry was a hangman in Great Britain from 1884-1892. Unlike most executioners, he kept an extensive diary that
included his feelings. Justin Atholl wrote a book using this diary, published in 1956. Erving Goffman, a prominent
sociological thinker, cited this as a case of how people manage a stigma. The symptoms of PTSD are also detailed, and
since this comes from actions done by Berry rather than done to him, it qualifies as Perpetration-Induced Traumatic
Stress (PITS).

It seems therefore worthwhile to record now the life of the last English hangman able to speak freely about his work and
the only one to give some insight into the feelings and difficulties of an executioner. The numerous predecessors of
James Berry, going back to the sixteenth century-hangman Bull, the first public hangman whose name is recorded, were
for the most part illiterate and incapable of recording their thoughts and activities, even if they had been inclined to do
so. . .

With the end of public executions in 1868 and even more with the later exclusion of the Press from the scaffold, a
change took place. The executioner became more a man of mystery and his methods and personality a subject for
speculation. The change also resulted in a different type of man becoming eligible for the position of executioner. It is
doubtful whether it, in 1883, the hangman had still been required to operate in public under the gaze of thousands of
spectators, James Berry would ever have considered offering his services to the Sheriffs of the City of London.

From many points of view, therefore, it is fortunate that James Berry, the first of the new type of executioner, was both
literate and communicative. His period of service as hangman was comparatively short, but it was full of incident.
Hanging by the new technique of the long drop to get instant death was in its infancy and it was during Berry's period
that it was officially recognized and scientifically studied for the first time.

Berry was a considerable personality. He carried out his work as executioner conscientiously, but it was not his life's
work. He was one of the few executioners to give up his work, not because he felt he was past it but because he did not
like it. Not a few English hangmen have themselves been hanged. Some have committed suicide. But Berry is unique as
a man who, having hanged well over a hundred men and women, said it was a shameful business and spent the rest of
his life demanding an end to hanging. All these things have made it seem worthwhile recording his life.

The conversations and thoughts I attribute to Berry are based on his own words as recorded, reported and
remembered. He discussed his work and his feelings without inhibition and it had not been necessary to invent.  
[pp. 9-10]

#     #

The photographs were carefully selected . . . and they were all of executions where there had been no "mishap" or
where the "victim" was of some exceptional interest. When visitors mistook them for his relations, he would consider it
proof of his firmly held opinion that the popular idea there was something special about the face of a murderer was a
myth. His experience convinced him that "criminal physiognomy" was a fallacy.

But we may find a deeper explanation of these photographs. Berry wanted to convince himself that he felt no guilt
because of his actions. To be able to see daily the faces of those he had killed and feel no particular emotion was proof
to himself that no "blood guiltiness" attached to his occupation. The photographs, of which many more were stored in
albums, and the relics of all kinds from ropes to personal possessions of the people he had executed, which filled
cupboards and drawers, subconsciously reassured him. If he could handle these souvenirs and display them to
interested visitors with no different emotion than any ordinary man feels for the tools and souvenirs of his craft, then
obviously he was blameless. . . .

It is worth noting that when, eventually, revulsion set in, one of his first actions was to sweep from the house everything
that reminded him of his past hangings. His explanation was an almost superstitious one, that these things had brought
him "bad luck." What had been souvenirs of duty competently done became reminders of a past which weighed heavily
on him. The result of getting rid of the relics and mementos was like laying a ghost. He never forgot his victims or any
details of their end, but he was no longer proud of them. "It was a different house when they were gone," he wrote. "I
found I could sleep and no longer had an uncanny feeling when I entered a room where they were kept," and he talked
of "the evil influences of my victims clinging to these relics."

[pp. 52-53]

#     #

The women were as wicked as any of the 100 odd men he hanged and yet at the end of his career he said, "I may not
live to see the capital sentence abolished, but I do hope and pray fervently I will not die without hearing the good news
that never again will a woman suffer the fate of the women victims I sometimes see in my waking dreams."
[p. 140]

#     #

Chapter X: Nightmares

Outwardly Berry was unchanged after seven years during which no month had passed without his taking his leading part
in the ceremony to which the tolling bell supplied the descant. . . . After a hundred hangings, signs began to appear that
Berry's nerves were being affected. He had been a teetotaler when he started. Now he was drinking a good deal. Where
formerly he had always been genial he was inclined to become snappy with reporters. His nights were sometimes
sleepless and when he slept he was agitated by dreams. When he started as an executioner his nightmares had been
the products of his secret fears that things would go wrong, "of things that never happened and never could happen,"
as he put it. Now they were not products of imagination, but the re-playing by shadowy figures of real scenes which
needed no embellishment from a troubled mind to make them nightmares.

The figure that returned to haunt him in his dreams most often, he said, was that of Dr. Philip Henry Eustace Cross. Not
because the hanging of Dr. Cross had involved any struggle on the scaffold or sanguinary scenes like some other
executions. On the contrary, Berry used to say: "when you read of a man walking firmly to the scaffold, it is nonsense.
Some walk, some are carried. Of all the men I hanged Dr. Cross was the only one who walked firmly." The doctor was
also one of the few "gentleman," perhaps the only one, that Berry had hanged. He had gone to his death completely
unmoved. Dr. Cross had faced death in the army and he did not fear it when it was certain and only minutes away. For
all the notice that the man he was going to kill took of him, Berry might not have been there. He did not speak a word
and perhaps for the first time Berry felt the full force of contempt for the hangman.

Why did Dr. Cross who gave so little trouble haunt Berry more than the scores of other prisoners who in various stages
of collapse, terror, exaltation and madness he followed from the condemned cell to the gallows? Berry himself probably
did not fully realize the reason but expressed it in the general way that "Dr. Cross was a gentleman." It was the very
indifference to him of Dr. Cross which impressed him. . . .

In his waking dreams he relived another execution which had gone smoothly enough but which had exhausted his
emotions. He saw again Israel Lipski going to his death accompanied by a Rabbi reading something he did not
understand but which perhaps just because he did not understand it impressed him far more than the English service
for the burial of the dead which he knew by heart from much repetition. The Rabbi somehow had impressed Berry with
the awful solemnity of death as he had never been impressed before and he saw himself again after he had pulled the
lever putting his arm round the beam that supported the dying man, feeling he was going to faint, swearing to himself he
would never hang another Jew. From outside the prison he heard the cheers of the crowd which greeted the raising of
the Black Flag and thought, that if they had watched it, they would not be cheering but would be feeling sick in body and
mind as he did.

But for every dream in which he saw his victim going impassively to a death he did not fear, there were a dozen in which
men shivered or fainted in terror, fought or struggled as if they could by resistance postpone their dying, called to their
God or blasphemed.

There was Joseph Lowson, for instance, whom he had hanged at Durham Gaol early in his career and who had refused
the ministrations of the chaplain on the ground that he knew more about the after life than any minister. It was bad
enough that he laughed when he was being pinioned, offering to help Berry so as to finish the job faster, that he thought
it a joke when he stumbled on the walk to the scaffold which he had greeted with "Is that what you are going to hang me
on?" When Berry had put him in position and pulled down the white cap, he heard a stream of what he called foul and
blasphemous language coming through the cloth. The moment which turned Berry's dream into a nightmare was that
when he was pulling the lever and it would not move while the man on the trap continued to talk. It was probably only
seconds before signs from a warder reminded Berry that in his nervousness he was trying to move the lever the wrong
way, but it seemed like an eternity, and when the man fell Berry had to prop himself against the wall to avoid fainting. In
his sleep the sweat would break out on him again as it had done that morning in Durham.

And there was that worst execution of all, or so it seemed, until he thought of the others. He saw himself again peeping
at Alfred Sowrey in the death cell at Preston, the doomed man's face turning form blue to pink and then to white as fear
took complete control of his mind and body. Sowrey had shot his sweetheart and then had sought death by turning his
pistol on himself. But he had survived the wound and now the thought of death which a few weeks before he would have
welcomed had unhinged his mind. He cried as if being tortured and the chaplain could not quieten him. Warders held
him while Berry struggled with the pinions. Fear had given him unnatural strength so that even when his arms were
pinioned, he fought every inch of the way to the scaffold. In his dream, Berry again and again saw the five warders
forcing him down the corridor and heard his wild screams echoing through the prison. . . .

The voices of the wretched men continuing to call on their God and their families -- the God they feared would desert
them and the families they knew they were deserting, until the drop cut them short -- rang clearly across the years in
Berry's mind.
. . .

Berry had always asked his prisoners for forgiveness and most of them had given it, taking his proffered hand in the
knowledge that he was merely a cog in the wheels of the law, glad of a friendly gesture in their last moments even from
their own executioner. But in the small hours of the night when sleep would not come or memories tormented his dreams
Berry was oppressed by the thought that his victims might forgive him but they could not make him forget. . . .

MacDonald, Delvin, Horton -- the names came back to him in and endless procession, and it was in vain that he tried to
think of them in terms of weighing so much and requiring a drop of so many feet. They would insist on haunting him as
men of flesh and blood, which lives and families of their own, families which only too often Berry had seen arriving at the
prison to pay their last visits, women dressed in black, trying to hide their faces form the curious, already mourning the
men he was preparing to kill.

MacDonald he remembered as a man who was half out of his mind before he stabbed a girl to death at Bolton, and
almost wholly out of it by the time he arrived in his cell to pinion him. He had found a trembling wreck of a man, unable to
speak or to stand. He remembered how he had urged him to try and pull himself together and then realized that the
greatest kindness he could do him as to put him out of his misery as quickly as possible. The black flag had gone up
that morning well before eight and at the time he had glowed with pleasure at the compliments he had received from the
surgeon and Press about his speed, but now there was no pleasure in the memory of his skill, only shame at the
recollection of the man's fear, like that in the eyes of a sheep smelling the blood in the slaughter house to which it is
being driven.

Delvin he remembered as another man in the grip of the same kind of fear, stumbling between warders on the way to his
death, making a farce of the solemn procession to the scaffold with city officials in full regalia the Scots insisted upon. He
would have saved Delvin the agony of seeing the scaffold with its dangling noose by drawing the white cap down, but
the Governor in frock-coat, silk hat and back scarf had insisted the prisoner's face must be left uncovered so that he
could be officially identified. Delvin haunted him because he had suffered unnecessarily not only before the drop, but
afterwards. Trying to put courage into him he had whispered, "Don't be frightened, it will all be over in a minute," but it
was not all over in a minute, nor even two or three. It had seemed the rope would never stop vibrating. At the time he
had justified himself with the thought that Delvin was a murderous brute for whom no punishment was too great, but now
he found no consolation in that argument and the picture of the man slowly dying on the end of the rope appeared
again and again in his nightmares.

George Horton was another who had taken minutes to die. The surgeon had said his neck was broken, but if it was true
it only showed that there could be no certainty in hanging. It was a fearful thing to have to admit to himself. Once he had
been proud of his skill, sure that he could bring death instantly and mercifully to any man, now he was no longer sure.
Things had gone wrong too many times for reasons which nobody could explain.

He had seen more than a hundred men and women die on the end of the rope he had prepared, some quickly, some
slowly, a few bravely, many fearfully. He had lowered more than a hundred bodies into their flimsy coffins, each one with
its head lolling horribly on an elongated neck no longer able to support it. He put his hands to his eyes to shut out the
memory, but found that he could not forget one of them.
[pp. 158-166]

#     #

Chapter XI

The Last Execution

By 1891 Berry had been a hangman for seven years and sent more than 130 men and women to their death. Outwardly
at any rate he seemed little changed. At intervals, after some mishap or particularly harrowing experience, he may have
resolved to throw in his hand and have done with the business, but when it came to making an irrevocable decision, he
had always decided to go on. On more than one occasion he experienced what he described as a "nervous breakdown"
after an execution from which it had taken him two or three weeks to recover. But he was completely successful in
concealing his feelings of depression from the public and the officials with whom he was concerned and there is no
record of his missing an execution because of his health. H. Snowden Ward, who had been working with him on a book it
was planned to publish, found him genial, humorous and apparently in good health.

But there were signs that for some time he had been under strain. When he started as an executioner, he did not drink.
Now, although he was never anything but sober when he was on duty, he was sometimes drinking heavily. He had
suffered from sleeplessness and other "nervous" troubles. A curious point was that while at the beginning of his career
he had proclaimed he was completely without superstitions and thought dreams and omens all nonsense, he had come
to be haunted not merely by memories, but by relics. I have mentioned that he had many "souvenirs" of the men and
women he had hanged. He came to have the idea that these were responsible for the nightmares that disturbed his
nights and in 1880 he sold them all to Madame Tussaud's. He said the effect was immediate and beneficial, that his
depression lifted and a curse seemed to have gone from the house. The conclusion that subconsciously "blood-
guiltiness" lay on him heavily is difficult to escape, and it seems probable any relief he obtained by ridding himself of
these souvenirs would in any case have been temporary.
[p. 167]

James Berry resigned from the position and entered the lecture circuit in opposition to capital punishment. He later had
a revivalist conversion and spent many years in evangelical work.

Atholl, Justin. (1956).
The Reluctant Hangman: The Story of James Berry, Executioner 1884-1892. Great Britain: The
Anchor Press. Ltd.


What Happened in Thanh Phong, New York Times Magazine

The incident related here was much in news in spring of 2001. This is an example where the symptoms don't make up a
"disorder." The man afflicted became a governor and a U.S. Senator, so a diagnosis of dysfunction would be difficult to
justify. Still, there is some evidence that workaholism is associated with PITS, in that immersion in work is a way to crowd
out the intrusive memories and other problems. In some cases, there is actually a delay before symptoms become
severe. In many more cases, symptoms never do become severe enough to be a disorder, but knowing about the
symptoms and how common they are can be helpful to those who find them not debilitating but still distressing.

Senator Bob Kerrey's hands trembled slightly as he began to read six pages of documents that had just been handed to
him. It was late 1998; the papers were nearly 30 years old. On the face of it, they were routine "after action" combat
reports of the sort filed by the thousands during the Vietnam War. But Kerrey knew the pages held a personal secret --
of an event so traumatic that he says it once prompted fleeting thoughts of suicide.

Pulling the documents within inches of his eyes, he read intently about this time as a member of the Navy Seals and
about a mission in 1969 that somehow went horribly wrong. As an inexperienced, 25-year-old lieutenant, Kerrey led a
commando team on a raid of an isolated peasant hamlet called Thanh Phong in Vietnam's eastern Mekong Delta. While
witnesses and official records give varying accounts of exactly what happened, one thing is certain: around midnight on
February 26, 1969, Kerrey and his men killed at least 13 unarmed women and children. The operation was brutal; for
months afterward, Kerrey says, he feared going to sleep because of the terrible nightmares that haunted him.

The restless nights are mostly behind him now, his dreams about Vietnam more reflective. One of those, which he says
recurs frequently, is about an uncle who disappeared in action during World War II. "In my dream I am about to leave for
Vietnam," Kerrey wrote in an e-mail message last December. "He warns me that the greatest danger of war is not losing
your life but the taking of others', and that human savagery is a very slippery slope."

Kerrey -- who left the Senate in January and is now president of the New School University in New York -- says he has
spent the last three decades wondering if he could have done something different that night in Thanh Phong. "It's far
more than guilt," he said that morning in 1998. "It's the shame. You can never, can never get away from it. It darkens
your day. I thought dying for your country was the worst thing that could happen to you, and I don't think it is. I think
killing for your country can be a lot worse. Because that's the memory that haunts." . . .


Vistica, Gregory L. (2001). What Happened in Thanh Phong.
New York Times Magazine, April 29, pp. 50-57, 66, 68.


Court Testimony of Larry Myers

In 1971 when I served on the Parole Board, the Chairman was a man named John Greenholtz . . . in 1959 this same
John Greenholtz had also been the Assistant Warden at the Nebraska Penal Complex, and he was the official in charge
of executing Charles Starkweather, the last execution in Nebraska . . .

John and I were chatting about various subjects when out of the blue he asked me if  had ever witnessed an execution? I
replied that I had not, and I hoped that I never would. Then John said, "If you've never seen an execution, you'll never
want to see another one." And without my saying another word, John continued on to describe the gruesome details of
the execution. It was sickening, and I am not going to reiterate the grisly details, but I want to emphasize that John's
words flowed out like a '"stream of consciousness," as if he wanted to tell me some things in order to "get it off his chest."

I just sat there driving and quietly listening, and at the end John made the following very important remarks: He said that
he participated in organizing the execution and carrying it out because that was his job, and he had been ordered to do
it. But he said that he "hated" being involved and he "hated" witnessing the act itself! He said that he was physically sick
two days afterwards, he was vomiting and had fits of depression. He said he had nightmares for years after, and that the
gruesome images still haunted him, even 12 years later! And then he cried. . . . John Greenholtz was a good man, but
he had psychological and emotional scars for the rest of his life.

page 35-36, testimony of Larry Myers on June 28, 1991, before the State of Nebraska Pardons Board (Governor Ben
Nelson, Secretary of State Allen Beerman and Attorney General Don Stenberg). It concerns the Application of Harold
Otey to commute his death sentence to a sentence of life imprisonment without parole.


Transcript: All Things Considered

Mr. WILLETT [Warden, Huntsville Prison]: The procedure is almost always over by 6:25 and we're free to go. The
executions seem to affect all of us differently. Some get quiet and reflective afterwards, others less so, but I have no
doubt that it's disturbing for all of us. It always bothers you. It does me. Fred Alien, who used to be part of the tie-down
team, participated in about 120 executions before he had to stop. This is the first time Fred has ever talked about his
experience publicly.

Mr. FRED ALLEN (Former Tie-Down Team Member):  I was just working in the shop, then all of a sudden something just
triggered in me and I started shaking and I walked back into the house, and my wife asked, 'What's the matter?' and I
said, 'I don't feel good,' and tears, uncontrollable tears, was coming out of my eyes. And she said, 'What's the matter?'
and I said, 'I just thought about that execution that I did two days ago, and everybody else's that I was involved with.'  
And what it was, was something triggered within and it just—everybody, all of these executions, all of a sudden all
sprung forward.

Mr. WILLETT: Three years later. Fred can still see the eyes of the men he helped tie down.

Mr. ALLEN: Just like taking slides in a film projector and having a button and just pushing a button and just watching
over and over, him, him, him. I don't know if it's a mental breakdown, I don't know if—it will probably be classified more as
a traumatic stress, similar to what the individuals in war had, you know, and they'd come back from the war and it might
be three months, it might be two years, it might be five years, all of a sudden they relive it again, and all that has to
come out. You see, I can barely even talk because I'm thinking more and more of it, you know. There was just so many
of them.

"Witness to the Execution",
All Things Considered, National Public Radio, October 12, 2000


Autobiography of Rudolf Hoess, Commandant of Auschwitz

In 1924, Hoess received a 10-year sentence for a savage murder. This memory comes from that time of imprisonment.
After his early release by amnesty he rose in the Nazi hierarchy. He later assumed command of Auschwitz and oversaw
the gassing of around 2 million people from July 1941 to the end of 1943. He wrote his autobiography while in prison
awaiting trial for war crimes in 1947, and was executed by hanging soon thereafter.
Note that the psychiatrist's response indicates this is not all that uncommon a condition in what he sees. He attributes it
to prison, and that may indeed be the case, but PITS is another possible interpretation.
Since this is pre-Nazi, it shows the potential dangers of this condition. German psychiatrists treated PTSD resulting from
World War I as caused by desires for compensation, and were quite cruel in their "treatment." This deserves exploration
as one of the possibilities (among many) for why the Holocaust was as widespread and vicious as it was.

Toward the end of the first two years, which had passed monotonously and without any special incident, I was overcome
by a most peculiar state of mind. I became very irritable, nervous, and excited. I felt a disinclination to work, although I
was in the tailoring shop at the time and had hitherto thoroughly enjoyed this work. I could no longer eat and I brought
up every mouthful that I forced myself to swallow. I could not read any more and became completely unable to
concentrate. I paced up and down my cell like a wild animal. I lay awake all night, although I had up to then always fallen
at once into a deep and almost dreamless sleep. I had to get out of bed and walk round my cell, and was unable to lie
still. Then I would sink exhausted on to the bed and fall asleep, only to wake again after a short time bathed in sweat
from my nightmares. In those confused dreams I was always being pursued and killed, or falling over a precipice.

The hours of darkness became a torment. Night after night I heard the clocks strike the hour. As morning approached,
my dread increased. I feared the light of day and the people I should have to see once more. I felt incapable of seeing
them again. I tried with all my strength to pull myself together, but without success. I wanted to pray, but my prayers
dissolved into a distressed stammering. I had forgotten how to pray, and had lost the way to God. In my misery I believed
that God had no wish to help me, since I had forsaken Him. I was tormented by the memory of my definite secession
from the Church in 1922. Yet this had been the ratification of a state of affairs that had existed since the end of the war.
In my heart I was already leaving the Church during the last years of the war. I reproached myself bitterly for not having
followed the wishes of my parents, for my lack of piety. It was strange how all this worried me while I was in this plight.

My nervous agitation increased day to day, even from hour to hour. I nearly went raving mad. My health gave way. My
foreman noticed my unaccustomed absent-mindedness and the mess I made of even the simplest tasks, and although I
worked furiously I could not finish my daily task.

For several days I had fasted, thinking that after this I would be able to eat once more. The guard in charge of my
section caught me in the act of throwing my dinner into the garbage pail. Although he usually did his job in a weary and
indifferent manner, and hardly bothered about the prisoners, yet even he had noticed my behavior and appearance,
and on this account had been keeping a sharp watch over me, as the later told me. I was taken immediately to the
doctor. He was an elderly man who had been attached to the prison staff for a great many years. He listened patiently to
my story, thumbed through the pages of my file and then said with the greatest nonchalance. "Prison psychosis. You'll
get over it. It's not serious!"

Hoess, R. (1959).
Commandant of Auschwitz: The autobiography of Rudolf Hoess,  C. FitzGibbon  (Trans.). London:
Weidenfeld and Nicolson.


The Nazi Einsatzgruppen

These are excerpts from The Nazi Doctors by psychiatrist Robert Jay Lifton. Lifton is a psychiatrist who did extensive
interviews with this group.

I was able to obtain direct evidence on this matter during an interview with a former Wehrmacht neuropsychiatrist who
had treated large numbers of Einsatzgruppen personnel for psychological disorders. He told me that these disorders
resembled combat reactions of ordinary troops: severe anxiety, nightmares, tremors, and numerous bodily complaints.
But in this "killer troops," as he called them, the symptoms tended to last longer and to be more severe. He estimated
that 20 percent of those doing the actual killing experienced these symptoms of psychological decompensation. About
half of that 20 percent associated their symptoms mainly with the "unpleasantness" of what they had to do, while the
other half seemed to have moral questions about shooting people in that way. The men had greatest psychological
difficulty concerning shooting women and children, especially children. Many experienced a sense of guilt in their
dreams, which could include various forms of punishment or retribution. Such psychological difficulty led the Nazis to
seek a more "surgical" method of killing.  
[p. 15]

#     #

The Wehrmacht neuropsychiatrist who had treated these psychological difficulties in Einsatzgruppen troops described
them to me -- the general manifestations of anxiety, including anxiety dreams -- in the most detached clinical tones.
When I asked him whether he had ever experienced anxiety dreams in response to all this killing or to his treating the
killers, he answered that he had not: "I never killed anybody"; and, "As doctors . . . we were outsiders." It also became
clear that he and his colleagues did not alter their medical approach in any significant way when treating these "killer
troops" (as he called them during our interviews) but simply did what they could to relieve symptoms and help the men to
return to duty. He would even sometimes gently warn them, "Be careful now, you're complaining but you're well." He was
trying to suggest to me that, in doing so, he was considering the interests of the individual killer soldier. But there was no
doubt that he was playing the role of the physician suspicious of malingering, who insisted upon holding to strictly
medical criteria in decisions concerning sending these men back to duty where they could continue their killing.
[p. 454]



Transcript: NYPD Blues
NBC Dateline

We turn now to a case where most people are sympathetic with the person who killed -- the police officer who shot
someone in the line of duty, which was later officially judged as justified. Unlike other types of killing, in which PTSD as a
result isn't admitted, police officers are commonly known to not only get PTSD from having shot someone, but to have
more severe symptoms from shooting than from being shot at.  Researchers looking at PTSD in police commonly
mention this, and the news program below also understood it and expected its audience to. In this case, it's regarded
not as the fault of the officer but of the person whose belligerent action made the shooting necessary. The idea that this
caused the officer further grief is no insult to the officer. Still, officers have met many obstacles to recognition, as the
following story shows.

Kotbe is the reporter on this story. Al Benner is a 35-year veteran of the San Francisco Police Force and a psychologist
who helped write national guidelines advising police departments on how to support officers after shootings; Michael
Julian is former public information officer for the NYPD.

Mr. MICHAEL JULIAN: We looked at this case and said that this—these officers did the right thing, they maintained the
zone of safety. But at some point, he approached
them and they had nowhere to turn, and that's why they shot.

KOTBE: (Voiceover) According to Julian, the cops performed so well that night by
keeping an armed man at a distance
for as long as they could, and then firing only
when they perceived their lives to be in danger, their tactics actually
became part of
new departmental procedures for dealing with similar situations. . . .

Sal said he was OK, but his wife. Nancy, began to notice subtle changes. He
seemed a little edgy and was slightly more
irritable with the kids. And then there was
this: Sal had begun a folder documenting the shooting, which he showed to
Nancy
and even their friends. In it, to Nancy's horror, was this: a close-up photograph of the man he'd shot just moments
after he died. And there was something else Sal saved
a copy of: the police dispatch tape, which he listened to over and
over again. . . .

Sal wasn't telling anyone, even his wife, what he was really going through:
flashbacks, horrifying nightmares of the
shooting, panic attacks triggered by sirens or
cop shows on TV. These he kept secret from everyone. . . .

Nancy was prepared for many things in her marriage, but not for this.
Gradually, over the next few years, she watched
as Sal became jumpy and
developed insomnia, symptoms of a mental disorder they wouldn't learn about for several
years. But even now, Sal still wasn't going for help, and when he finally did tell
Nancy about his haunting symptoms, she
didn't push him to go get help, either. . . .

In 1994, more than six years after the shooting, Sal learned that his safe haven,
the racetrack unit, was being disbanded
and he'd be forced back on patrol. The
very thought that he might have to shoot someone again horrified him. Nancy
says he became irritable and his nightmares increased. . . .

Psych services says it did provide Sal with excellent help He began to see
therapists regularly, and they said his
nightmares, flashbacks, extreme
indigestion, maybe even the six years of avoiding stress while at the racetrack were all
classic symptoms of a horrifying psychological problem, post-traumatic
stress disorder, or PTSD, a mental illness usually
associated with Vietnam veterans
' Sal's disorder,' they said, 'was caused by the shooting.'

(Voiceover) In addition to providing therapy, Sal's police health insurance
did something else:  referred him to
independent psychiatrist William Kaplan. He
agreed with the NYPD's own therapists saying Sal suffered from a classic
and
unmistakable case of PTSD and prescribed anti-depressants and sleeping pills. With the family's permission, Dr.
Kaplan agreed to talk to us about the case.

Dr. WILLIAM KAPLAN: He talked about the terror of actually looking down
to see the individual whom he had just shot
and the individual's face looking
up at him. These are the kinds of terrifying images that are indelibly marked in a
person who's suffering post-traumatic stress disorder . . . .

KOTBE: (Voiceover) But behind the smiles, depression still consumed him Over and
over, in his dreams, Sal faced a
man with a knife. In one dream, he faced him alone.
In another, alone and unarmed. And in the worst of all, alone, stark
naked and terrified.
He returned again and again to his folder about the shooting to this photo of Sanders lying dead
just seconds after Sal had shot him from close range, and to the terror of
his own voice on the dispatch tape. . . .

We know that around the country each year about 300 police officers shoot
and kill. And according to some studies, at
least 15 percent of them are likely to
develop post-traumatic stress disorder. And yet some argue that even in cities with
psych services, like New York's, the help they get just isn't good enough.

Mr. BENNER: Ask a police department, 'What is the line-item budget for maintaining
your vehicle fleet? And then say,
OK, what's the line-item budget for maintaining the
people who drive those vehicles?'

KOTBE:   (Voiceover) Benner believes departments need to create completely
confidential counseling programs, where
cops don't have to report to therapists who
are tied to management. To him, losing a gun and being transferred to light
duty are
public humiliations that keep cops from getting help. And in the case of PTSD, he says timing is everything
because the longer you wait, the harder it is to get well. . . .

After two years of unsuccessful therapy and light duty, psych services
encouraged Sal to retire. To Sal, it was like being
put out to pasture. He was only 36
years old. . . .By the end of 1995, eight years after the shooting, Sal began the
retirement process. The police department medical board would decide between two
pension plans. The First—the
lower pension—would give Sal about $800 a month,
after taxes, for 10 years. That's well below the poverty line for a
family of five in 1996.
The second, the line-of-duty disability pension, would give Sal $2200 a month—tax-free—for life.
Still not a lot of money, but enough for a family of five to get by on.
(Voiceover) More importantly to Sal, his family says
the higher pension recognized that
his trauma was caused, on the job, the night of the shooting. The difference was
critical
to Sal, and not just for the financial security of his family.

In November of 1996, Sal went before the board for the first time to make his
case for the higher pension   His father
accompanied him, and waited for him
downstairs.

Mr. GLIBBERY: He came down, like, he had a smile from ear to ear I said, 'Good?'
'Yeah, Dad,' he says 'Thank God,' he
says, 'This way at least I know they recognize
me now .'

KOTBE: He learned that day that he had been approved for the higher pension.

Ms. GLIBBERY: He was approved for three-quarters.

KOTBE:  That means that the medical board confirmed that he had post-traumatic stress disorder?

Ms. GLIBBERY: Right. He—he was so happy that they finally—finally, you know, agreed with him and were on his side.

KOTBE: (Voiceover) After the hearing, the medical board issued this document, clearly saying PTSD and LOD—or Line
of Duty pension—"approved," next to Sal's name. Now Sal knew he would have enough for his family to live on, plus the
vindication he'd been longing for. It was almost nine years after the shooting, and Sal could finally put that cold night in
1987 behind him. Or so it seemed . . .

Ms. GLIBBERY: I had thought maybe now he could finally try to turn his life around, get back on his feet and try to do
something.

KOTBE: (Voiceover) But within weeks, Sal received the doctors' report from the hearing and it said something else
altogether. Even though nine other specialists, including the police department's own experts, ultimately diagnosed Sal
as having PTSD, the medical board doctors denied it. They had reversed themselves.

KOTBE: So first they said he had post-traumatic stress disorder.

Ms. GLIBBERY: Mm-hmm.

KOTBE:   And then, three weeks later, they said, 'no, he doesn't'?

Ms. GLIBBERY: Right.

KOTBE: What did Sal say when he learned that they were pulling their original statement?

Ms. GLIBBERY: He was devastated.

KOTBE: (Voiceover) Cop and therapist Pete Volkmann wants to know why the board's doctors reversed their decision in
Sal's case with no explanation.

Mr. PETE VOLKMANN: I am just amazed that they would put something in writing, that this officer has disability, then
three weeks later, come back and say, 'Oops. You're denied ' Where is the accountability? And why can't the family, or
the individual officer, question that, and say, ' What changed?'

KOTBE: (Voiceover) The NYPD's medical board system is like many others around the country three doctors, one
appointed by the city, one by the pension fund and one by the police union They sit in judgment of the pension requests
of local officers. According to one source at the NYPD, once the doctors are hired, there is no system of oversight to fire
them if they're doing a bad job.

KOTBE: How do other departments handle these hearings, Al?

Mr. BENNER: Badly. I mean, NYPD is not alone in this. Part of the deal is the medical boards are doing what the city
fathers and mothers ask them to do. They're putting guarding the coffers above taking care of the troops.

KOTBE: (Voiceover) In Sal's case, the medical board doctors mentioned his own psychiatrist's opinion, but rejected the
diagnosis of the five experts from the NYPD psych services. The board blamed marital problems and Sal's own
vulnerability, not the shooting, for his mental illness.

KOTBE: The medical board said Sal was probably depressed because of other things—problems at home That's their
argument as to why they didn't give him PTSD diagnosis So what do you say to that?

Ms. GLIBBERY: I think they're wrong. They're just refusing to believe it, because once they do admit to this, then they'll
see how many more cops out there there are that need then help, and they're not getting it. . . .

KOTBE: (Voiceover) Over the next few years, Sal saw three more doctors. All three believed he suffered from PTSD.
With each new diagnosis, he went back to the board, each time with the complete backing of the NYPD's psych services.
Yet, each time he was rejected. In one report, the board referred to his career as a Marine, implying he was trained to
kill and one death wouldn't bother him. In another, the board cited what it called his "excessive sick records" from 1983
through 1994. The NYPD denies Sal had excessive sick records during those years. And, in fact, Sal earned these
certificates for perfect attendance in 1992 and 1993. The board's reasons varied, but its conclusion was always the
same. Sal suffered from general depression, not PTSD caused by the shooting. The higher pension was denied.
According to Benner, Sal's experience was not unusual. Many officers around the country arc repeatedly rejected for a
PTSD diagnosis . . .

# # #

KOTBE: (Voiceover) Once again, Sal had taken an overdose of prescribed sleeping pills This time, help didn't arrive
soon enough. He was dead. He was just 40 years old. Four days later, Sal Glibbery was buried, one of 386 cops
nationwide who committed suicide in 1999. Each year, for every one cop who dies in the line of duty, nearly three others
take their own lives. To Pete Volkmann, many of these deaths are caused by stress on the job. He estimates 20
percent—and others estimate more than 30 percent—of all police officers suffer from post-traumatic stress disorder at
some point in their careers.

Mr. VOLKMANN: If there was cancer on 20 percent of police officers in the New York City Police Department, the unions
would be up in arms, the people would be up in arms. Well, 20 percent of police officers today have diagnosable PTSD—
a debilitating  illness—and nothing is being done. . . .

Mr. GLIBBERY: If they gave my son a disability pension, my son would be alive today—would be alive today, would be
sitting here with me. Guaranteed. And he said that he had this mental problem. They didn't believe him. And he says,
'You know what? I'll show you I have a mental problem. ' And he took his life And there is no return when you die. He
didn't break his leg. He broke his poor mind. And now he's dead.

KOTBE: (Voiceover) For Sal Glibbery's three children, there is little now except sadness and loss. It is a family trying
hard to make sense of Sal's death, which to them, at least, is the second casualty of shots fired 13 years before. . . .

Dateline NBC. (2000). NYPD Blues (transcript). December 26, 2000. Livingston, NJ: Burrelle's Information Services.



The Wretched of the Earth, Frantz Fanon

Police under repressive regimes are often given the task of torture. Below is the entire case mentioned by a psychiatrist
during revolutionary activity against the French in Algeria. By the time the book was written in French in 1963, the
author's sympathies were with the rebels. While giving a short mention of sleep troubles and nightmares, the symptom of
explosive outbursts in inappropriate situations is especially prominent here.

Case No. 5: A European police inspector who tortured his wife and children.

R—  thirty years old. Came of his own accord to consult us. He was a police inspector and stated that for several weeks
"things weren't working out." Married, had three children. He smoked a lot: five packets of cigarettes a day. He had lost
his appetite and his sleep was frequently disturbed by nightmares. These nightmares had no special distinguishing
features. What bothered him most were what he called "fits of madness." In the first place, he disliked being contradicted:

Can you give me an explanation for this, doctor: as soon as someone goes against me I want to hit him. Even outside
my job. I feel I want to settle the fellows who get in my way, even for nothing at all. Look here, for example, suppose I go
to the kiosk to buy the papers. There's a lot of people. Of course you have to wait. I hold out my hand (the chap who
keeps the kiosk is a pal of mine) to take my papers. Someone in the line gives me a challenging look and says "Wait
your turn." Well, I feel I want to beat him up and I say to myself, "If I had you for a few hours my fine fellow you wouldn't
look so clever afterwards."

The patient dislikes noise. At home he wants to hit everybody all the time. In fact, he does hit his children, even the baby
of twenty months, with unaccustomed savagery.

But what really frightened him was one evening when his wife had criticized him particularly for hitting his children too
much. (She had even said to him. "My word, anyone'd think you were going mad.") He threw himself upon her, beat her,
and tied her to a chair, saying to himself "I'll teach her once and for all that I'm master in this house."

Fortunately his children began roaring and crying. He then realized the full gravity of his behavior, untied his wife and
the next day decided to consult a doctor, "a nerve specialist." He stated that "'before, he wasn't like that"; he said that he
very rarely punished his children and at all events never fought with his wife. The present phenomena had appeared
"since the troubles." "The fact is" he said: "nowadays we have to work like troopers. Last week, for example, we
operated like as if we belonged to the army. Those gentlemen in the government say there's no war in Algeria and that
the arm of the law, that's to say the police, ought to restore order. But there is a war going on in Algeria, and when they
wake up to it it'll be too late. The thing that kills me most is the torture. You don't know what that is, do you? Sometimes I
torture people for ten hours at a stretch. . . ."

"What happens to you when you are torturing?"

You may not realize, but it's very tiring. . . . It's true we take it in turns, but the question is to know when to let the next
chap have a go. Each one thinks he's going to get the information at any minute and takes good care not to let the bird
go to the next chap after he's softened him up nicely, when of course the other chap would get the honor and glory of it.
So sometimes we let them go; and sometimes we don't.

Sometimes we even offer the chap money, money out of our own pockets, to try to get him to talk. Our problem is as
follows: are you able to make this fellow talk? It's a question of personal success. You see, you're competing with the
others. In the end your fists are ruined. So you call in the Senegalese. But either they hit too hard and destroy the
creature or else they don't hit hard enough and it's no good. In fact, you have to be intelligent to make a success of that
sort or work. You have to know when to lay it on and when to lay it off. You have to have a flair for it. When the chap is
softened up, it's not worth your while going on hitting him. That's why you have to do the work yourself; you can judge
better how you're getting on. I'm against the ones that have the chap dealt with by others and simply come to see every
hour or so what state he's in. Above all, what you mustn't do is to give the chap the impression that he won't get away
alive from you. Because then he wonders what's the use of talking if that won't save his life. In that case you'll have no
chance at all of getting anything out of him. He must-go on hoping: hope's the thing that'll make him talk.

But the thing that worries me most is this affair with my wife. It's certain that there's something wrong with me. You've got
to cure me, doctor.

His superiors refused to give him sick leave, and since moreover the patient did not wish to have a psychiatrist's
certificate, we tried to give him treatment "while working full time." The weaknesses of such a procedure may easily be
imagined. This man knew perfectly well that his disorders were directly caused by the kind of activity that went on inside
the rooms where interrogations were carried out, even though he tried to throw the responsibility totally upon "present
troubles." As he could not see his way to stopping torturing people (that made nonsense to him for in that case he would
have to resign) he asked me without beating about the bush to help him to go on torturing Algerian patriots without any
prickings of conscience, without any behavior problems, and with complete equanimity.

Fanon, F. (1968).
The Wretched of the Earth. New York: Grove Press, Inc., pp. 267-269.



Letter from Helena
from
No Future Without Forgiveness, Desmond Tutu

Archbishop Desmond Tutu served as chair of South Africa's Truth and Reconciliation Commission after democracy was
established and apartheid abolished in South Africa. The Commission held hearings for perpetrators and victims, and
the perpetrators were offered amnesty for specific incidents if they made full disclosure of what had happened. In his
book about the reasoning and work of the Commission, Tutu shares a letter from an Afrikaner woman who tells what
she saw of those who participated in torture and brutal killings under the apartheid regime

. . . I met another policeman . . . a bubbly, charming personality. Humorous, grumpy, everything in its time and place.
Then he says: he and three of our friends have been promoted "We're moving to a special unit. Now, now, my darling.
We are real policemen now." We were ecstatic . . .

After about three years with the Special Forces, our hell began. He became very quiet. Withdrawn. Sometimes he would
just press his face into his hands and shake uncontrollably. I realized he was drinking too much. Instead of resting at
night, he would wander from window to window. He tried to hide his wild, consuming fear, but I saw it. In the early hours
of the morning between two and half past two, I jolt awake from his rushed breathing. Rolls this way, that side of the bed.
He's pale. Ice cold in a sweltering night -- sopping wet with sweat. Eyes bewildered, but dull like the dead. And the
shakes. The terrible convulsions and bloodcurdling shrieks of fear and pain from the bottom of his soul. Sometimes he
sits motionless, just staring in front of him.

Spiritual murder is more inhumane than a messy, physical murder. At least a murder victim rests . . .
                                

Tutu, D. M. (1999).
No future without forgiveness. New York: Doubleday, pp. 51-54.



Memoir: We Do Abortions Here; A nurse's story, Sallie Tisdale

Sallie Tisdale wrote the article from which this is excerpted while working as a registered nurse in an abortion clinic.

. . . It is when I am holding a plastic uterus in one hand, a suction tube in the other, moving them together in imitation of
the scrubbing to come, that women ask the most secret question. I am speaking in a matter-of-fact voice about "the
tissue" and "the contents" when the woman suddenly catches my eye and asks, "How big is the baby now?" These
words suggest a quiet need for a definition of the boundaries being drawn. It isn't so odd, after all, that she feels relief
when I describe the growing bud's bulbous shape, its miniature nature. Again I gauge, and sometimes lie a little,
weaseling around its infantile features until its clinging power slackens.

But when I look in the basin, among the curdlike blood clots, I see an elfin thorax, attenuated, its pencilline ribs all in
parallel rows with tiny knobs of spine rounding upwards. A translucent arm and hand swim beside . . .

I have fetus dreams, we all do here: dreams of abortions one after the other; of buckets of blood splashed on the walls;
trees full of crawling fetuses. I dreamed that two men grabbed me and began to drag me away. "Let's do an abortion,"
they said with a sickening leer, and I began to scream, plunged into a vision of sucking, scraping pain, of being spread
and torn by impartial instruments that do only what they are bidden. I woke from this dream barely able to breathe and
thought of kitchen tables and coat hangers, knitting needles sniped with blood, and women all alone clutching a pillow in
their teeth to keep the screams from piercing the apartment-house walls. Abortion is the narrowest edge between
kindness and cruelty. Done as well as it can be, it is still violence -- merciful violence, like putting a suffering animal to
death . . .

Harper's Magazine, October, 1987


Psychological Experiments

The famous Milgram obedience experiments are one of the few sets of experiments where actual infliction of harm was
simulated. Here is the report of what this did to the participants, who thought they were inflicting painful electric shocks
under instruction from authority in what they understood to be a learning experiment:

The procedure created extreme levels of nervous tension in some [subjects]. Profuse sweating, trembling, and stuttering
were typical expressions of this emotional disturbance. One unexpected sign of tension – yet to be explained – was the
regular occurrence of nervous laughter, which in some Ss developed into uncontrollable seizures . . . [trembling,
stuttering, biting of lips, groaning, digging fingernails into flesh were] characteristic rather than exceptional responses to
the experiment .. . . I observed a mature and initially poised businessman enter the laboratory smiling and confident.
Within 20 minutes he was reduced to a twitching, stuttering wreck, who was rapidly approaching a point of nervous
collapse.

-- Stanley Milgram, 1963, (pp. 371, 375, 377)
Behavioral Study of Obedience. Journal of Abnormal and Social Psychology, 67, 371-378.

The other major experiment in which some of the participants were cast in the role of actual perpetration was the
Stanford Prison Experiment. This famous human experiment involved a simulated prison. It was supposed to last for two
weeks, but it was shut down after six days. The dehumanization had gotten out of hand. Here is a report of one of the
experimenters:

As the prison atmosphere evolved and became thick and real, I sensed the growing hostility and distrust on all sides. On
one of the nights that it was my turn to sleep overnight at the prison, I had a terribly realistic dream in which I was
suddenly imprisoned by guards in an actual prison that Zimbardo, Banks, and I supposedly had created. Some of the
prisoners in our study, the ones who in retrospect had impressed me as most in distress, were now decked out in
elaborately militaristic guard uniforms. They were my most angry and abusive captors, and I had the unmistakable sense
that there was to be no escape or release from this awful place. I awoke drenched in sweat and shaken from the
experience. The dream required no psychoanalytic acumen to interpret and should have given me some pause about
what we were doing. But it didn't. I pressed on without reflection. After all, we had a prison to run and too many day-to-
day crises and decisions to allow myself the luxury of pondering the ultimate wisdom of this noble endeavor that had
already started to go wrong.

-- Craig Haney
pp. 226-227 in Chapter 11, "Reflections on the Stanford Prison Experiment: Genesis, Transformations, Consequences",
pp. 193-237
Thomas Blass (ed.)
(2000) Obedience to Authority: Current Perspectives on the Milgram Paradigm. Mahwah, NJ:
Lawrence Erlbaum Associates


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For information on the book explaining PITS in more detail, Perpetration-Induced Traumatic Stress: The Psychological
Consequences of Killing, or for a DVD of a workshop presentation on Killing as Trauma,
click here.

There is also  basic explanation of PITS, a page on PITS in classical literature, and a bibliography.   

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