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Defense & Security Analysis

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Stolen trauma: why some veterans elaborate theirpsychological experience of military service

Edgar Jones & Hugh Milroy

To cite this article: Edgar Jones & Hugh Milroy (2016) Stolen trauma: why some veteranselaborate their psychological experience of military service, Defense & Security Analysis, 32:1,51-63, DOI: 10.1080/14751798.2015.1130318

To link to this article: http://dx.doi.org/10.1080/14751798.2015.1130318

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Stolen trauma: why some veterans elaborate theirpsychological experience of military serviceEdgar Jonesa and Hugh Milroyb

aInstitute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; bVeteran’s Aid,London, UK

ABSTRACTThe embellishment of a warrior biography has a long history butexamples of veteran elaboration of traumatic experience havebecome increasingly apparent. Although legislative change in theUK has removed the penalties for fabrication and a progressivedecline in the military footprint may have increased the likelihoodof such false trauma narratives, a paradigm shift in explanationsfor mental illness underpins this phenomenon. The recognition ofpost-traumatic stress disorder (PTSD) in 1980, followed by studiesto identify risk factors, led to a greater appreciation ofpsychological vulnerability. As a result, the use of shame todiscourage acts formerly labelled as “cowardly” or “lacking inmorale fibre” is no longer considered appropriate. Recent conflictsin Iraq and Afghanistan generated popular sympathy for servicepersonnel, whilst media focus on PTSD has led the UK public tobelieve that most veterans have been traumatised by their toursof duty.

ARTICLE HISTORYReceived 14 June 2015Accepted 21 October 2015

KEYWORDSVeteran; warrior narrative;military footprint; post-traumatic stress disorder;cowardice

Introduction

The status of the veteran in the UK is not static nor, indeed, is there agreement about howthe term should be defined. Derived from the Latin “vetus” meaning old, a veteran wastraditionally regarded as a regular soldier who had completed a lengthy period ofservice overseas during which he had experienced the dangers of combat.1 Charles Car-rington having survived three “tours” of duty in a front-line trench at the Battle of theSomme wrote “we gave ourselves airs as veteran soldiers.”2 Associated with elderlymales, the public were often supportive of such ex-servicemen as witnessed by therespect shown to Chelsea Pensioners. The esteem attached to the veteran in fiction wasreflected by the character of Dr John H. Watson, who Arthur Conan Doyle portrayedas having been invalided from India with enteric fever and a shoulder wound sufferedin the Second Afghan War whilst serving with the Army Medical Department.3

However, two world wars broadened the membership of the veteran category extendingit to volunteers and conscripts with shorter periods of military service, though oftenrequiring no less resolve. The dramatic increase in the ex-service population removedsome of the mystique attached to the warrior. Furthermore, the mobilisation of the UK

© 2016 Taylor & Francis

CONTACT Edgar Jones edgar.jones@kcl.ac.uk

DEFENSE & SECURITY ANALYSIS, 2016VOL. 32, NO. 1, 51–63http://dx.doi.org/10.1080/14751798.2015.1130318

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population during World War Two and the consequent sharing of suffering and loss bycivilians and the military undermined support for veteran special status.4 During thepost-1945 period, for example, ex-servicemen reported prejudice from civilians whobelieved that they threatened their job prospects.5

With the end of National Service in 1960, the UK returned to an earlier model of mili-tary service: a small, professional force composed of volunteers deployed overseas albeit indiverse roles. Popular interest in the UK armed forces remained muted throughout theTroubles in Northern Ireland and by the late 1980s some military charities were consider-ing merger to compensate for dwindling revenues.6 However, the deployment of 45,000UK troops to Iraq in 2003 brought the armed forces to the fore. In the context of anunpopular war and claims that the government had failed to protect its troops by the pro-vision of body armour and appropriately armoured vehicles, attention increasinglyfocused on the demands made of the individual soldier.7 A campaign by military charitiesand the UKmedia suggested that successive governments neglected service personnel oncethey had been discharged, whilst arguing that the unique nature of their duties grantedthem a right to special status in terms of commemoration and state benefits.8 In May2004, the issue of a veteran lapel badge marked a change in emphasis. On 27 June2006, the first official “Veterans’ Day” (chosen to coincide with the first investiture ofthe Victoria Cross in 1857) was held to acknowledge the contribution of ex-servicemenand women.

The Armed Forces Compensation Scheme of April 2005 introduced an inclusive defi-nition for the UK veteran: a single day of paid service in regular or reserve forces.9 Usingthis low-bar criterion, the Royal British estimated that there are 4.8 million ex-service per-sonnel in Britain and Northern Ireland (7.5% of the UK population of 64.1 million in2014), a figure predicted to decline to 3.1 million by 2020.10 However, the UK definitionstood in marked contrast to other nations. To receive benefits from the US Department ofVeterans Affairs (VA) requires at least 90 days of active duty service, with at least one dayduring a VA recognised wartime period, though the 90-day active service requirementdoes not apply to veterans discharged from the military due to a service-connected disabil-ity.11 In Australia, under the Veterans’ Entitlements Act of 1986, a veteran is defined as aperson who has rendered “eligible war service” and who has “engaged in warlike oper-ations against hostile forces outside Australia.”12 Despite the low bar set for veteran qua-lification in Britain, a survey conducted by Lord Ashcroft in 2012 found that members ofthe UK armed forces were rated highly (at 7.7 on a scale of 10) significantly above staff inthe National Health Service (NHS) (6.6), the British Broadcasting Corporation (BBC) (6.4)or the police (6.2), largely because they were considered “brave” and “courageous.”13

Although a number of studies have explored the fabrication of service experience byveterans,14 there has been less research into the motivation for an illness narrative. Thisarticle focuses on the case of UK veterans to explore the context behind exaggeratedtrauma narratives. An extensive literature review was conducted by hand searchingleading medical and psychological journals relating to World Wars One and Two,whilst for more recent publications, Medline, PsychLit and Web of Knowledge weresearched using combinations of keywords, which included veteran, fabrication, militaryfootprint and psychological disorder. The article discusses whether recent changes in legis-lation (the Armed Forces Act of 2006) and cultural shifts have increased the likelihood ofsuch cases and explores the implications for UK policy.

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Elaboration of traumatic experience

In December 2013, Jan Trethowan was tried at Plymouth Magistrates Court for drivingwhilst disqualified and without car insurance. In mitigation, his lawyer argued that he suf-fered from post-traumatic stress disorder (PTSD), a consequence of four tours to Iraq andAfghanistan with the Royal Marines and subsequent service in the French Foreign Legion.Confirmation of Trethowan’s service was sought and, though it was discovered he hadserved with the Devon and Dorset Regiment between 2003 and 2005 and a year withthe Royal Artillery leaving the forces in 2007, much of his story was false.15 With thereport of a number of similar cases, the question was asked whether the elaboration ofpsychological trauma is a contemporary phenomenon.16

Evidence from earlier conflicts suggests that such illness narratives have a long history.During World War One, the Ministry of Pensions was concerned that servicemen dis-charged with a diagnosis of shell shock could exaggerate their symptoms either toobtain a higher award or to extend payment beyond a time when the disorder hadremitted. Established in December 1916 with a schedule of compensation for grades ofinjury and disablement, the UK war pension system included shell shock and other psy-chosomatic illnesses within its remit.17 To guard against elaborated claims, the Ministryroutinely verified applicants’ service records and medical files, requesting a specialistopinion in the case of disputed claims.18 In the six years following the Workmen’sCompensation Act of 1906, the sums paid in accident compensation rose by 63.5%despite the fact that the number of people in employment remained the same.19 Soconcerned was the Ministry that it had appointed John Collie, a pre-war expert in theassessment of compensation for industrial injury as its chief medical officer. Collie alsochaired the committee that considered claims for shell shock and other psychosomaticillnesses. In 1917, he revised his textbook, Malingering and Feigned Sickness with Noteson the Workmen’s Compensation Act, 1906, adding a chapter on the military in whichhe observed that “the thin line which divides genuine functional [without organic basis]nerve disease and shamming is exceedingly difficult to define.”20 Collie believed thatpsychological trauma was more readily fabricated than its physical counterpart. Whilstthe extent to which trauma was fabricated remains unknown, the scale of psychologicalinjury was significant with 65,000 pensions for neurasthenia and shell shock inpayment in February 1921.21

During World War Two, military psychiatrists faced the accusation that they increasedopportunities for malingering (the deliberate falsification of symptoms to evade duties)because they reclassified behaviour traditionally considered an expression of low moraleor poor discipline as symptomatic of psychological disorder.22 To address these accusa-tions, Lt Colonel Roy Grinker and Captain J.P. Spiegel, two psychoanalytically-traineddoctors, deployed to treat US forces in Tunisia argued that “war neuroses cannot be mal-ingered, even superficially.”23 They rejected the proposition that most symptoms weresimulated and reasoned that the so-called “secondary gain” (in this case release fromcombat duty) did not outweigh the long-term “suffering of the war neurotic.” Further-more, a study conducted for the War Office in August 1941 by Lt Colonels Tom Mainand A.T.M. Wilson of 300 British servicemen with persistent misconduct showed that50% suffered from learning disabilities.24 When the creation of a special section of thePioneer Corps with educational and welfare support for such soldiers reduced sickness

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and disciplinary rates, military psychiatrists could argue that their interventions had out-comes that reduced malingering.25

The case of Vernon Scannell indicated that by the end of the war military psychiatristswere attuned to the deceptions of veterans. In 1945, before his demobilisation papers hadarrived, Scannell deserted from the British Army. Arrested two years later and broughtbefore a military court, his defending officer cited his service as an infantry soldier inNorth Africa and Normandy, arguing that his aberrant behaviour was the consequenceof shattered nerves. Finding himself referred to an army psychiatrist, Scannell recalledthat he “had flirted with the idea of parading alarming symptoms of mental disorderbut common sense warned me that I would be unlikely to deceive a man who had probablyseen through the pretences of scores of more skilled malingerers.”26 In the event, he wasreferred to the army’s psychiatric unit at Northfield. There, after a brief admission, anothermilitary psychiatrist discharged Scannell on the grounds that he could find no sign offormal psychiatric illness.27

An opportunity to study the scale of malingering arose in autumn 1943 when the repa-triation of British prisoners-of-war by the Germans allowed researchers in the Royal ArmyMedical Corps to investigate the psychological effects of captivity.28 Most of those in thestudy group (numbering 1154) were medical orderlies who had been imprisoned for atleast three years. To assess the impact of imprisonment, they were compared with acontrol population of RAMC recruits who had not served overseas. The repatriateswere assessed as suffering from low morale and 60% were judged to exhibit “minorpsychological disturbances.” However, their rate of psychosomatic illness (4.8%) wasnot significantly higher than that of the control population (2.8%), though they werealso significantly more likely to commit minor military offences (9.1% compared with0.2%).29 This data suggested that psychosomatic illness and its effect on behaviour,though at a low level, was likely to present a significant problem for the health serviceand employers when the vast army of conscripts was demobilised. In May 1945, theWar Office set up 20 Civil Resettlement Units for returning POWs designed to providewelfare support during transition. They offered re-education, training and “re-socialisa-tion” programmes under light military discipline with input from a Ministry of Labourvocational officer and, when needed, psychiatric social workers.30 Attendance was volun-tary for Army personnel and 53,000 veterans (1.4% of the 3.8 million who served in theBritish Army during the conflict) attended the six-week residential courses.31 This evi-dence, together with the fact that most veterans readily found work on discharge fromthe forces, led the War Office to believe that psychological disorder and its elaborationwere at a low levels.

Elaboration for financial gain is more likely to occur during economic recession whenopportunities for well-paid employment are limited. The demobilisation of British forcesafter World War Two occurred at an opportune time. An upswing in the trade cycle andthe colossal demand for goods and services, the immediate post-1945 period witnessed fullemployment. In contrast to the 1930s, when UK unemployment was never less than 9.3%and rose to a peak of 22.1%, the six years from 1945 saw those out of work remain below3.1% and fall as low as 1.3%.32 Under the 1944 Reinstatement of Civil Employment Act,companies were required to re-engage former members of staff, who had served in thearmed forces, for at least 6–12 months, depending on the length of their pre-war employ-ment record.33 By contrast, the recent spate of cases reported in the UK media

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corresponded with a sustained recession in the British economy (2008–2013), the deepestdownturn of the post-1945 period.

Retreat of cowardice

The 50 years following the end of WorldWar Two saw psychology take root in UK culturenot only as an academic discipline and in myriad forms of therapy but also as a popularway of explaining behaviour.34 These new perspectives influenced traditional beliefs aboutthe appropriateness and value of using the term cowardice to shame individuals. Duringthe nineteenth and early twentieth centuries, it was a powerful construct designed to regu-late behaviour of soldiers on the battlefield. Those accused of cowardly actions were notonly vilified, they also ran the risk of being executed. Chris Walsh has argued that theretreat of the term in popular usage (falling from an incidence of 5.5 per million wordsin the 1830s to only 1.4 per million in the 2000s) reflected the advance of psychologicalmedicine into areas formerly categorised as issues of morality and the law.35

Questionable military behaviour that was traditionally labelled “cowardice” has beenreframed in terms of vulnerability. Research conducted into the psychological demandsof combat during and immediately after World War Two provided evidence about howlong individuals could be expected to cope when exposed to extreme threat or stress.Studies of Royal Air Force (RAF) aircrew in 1943–1944 by C.P. Symonds and Denis Wil-liams, two neuropsychiatrists, were used to frame guidelines about the number of sortiesthat pilots were expected to fly in particular commands.36 RAF clinicians used this data tolobby against the use of the term “lack of morale fibre,” a euphemism for cowardice intro-duced in April 1940 to shame airmen who refused to fly without a demonstrable mental orphysical illness.37 As psychological constructs were increasingly used to explain aberrantbehaviour, the space occupied by cowardice was eroded, undermining its ethical weight. Amajor survey of US armed forces published in 1949 by Samuel Stouffer and his team foundthat between 67% and 77% of junior officers in infantry units agreed that “men who crackup in action… blow their top, go haywire” should be “treated as sick men.” Fewer than 6%thought that such cases “should be treated as cowards and punished.”38 Similar scores andresponses were given by enlisted men (private soldiers and non-commissioned officers)from combat divisions. When set against executions for cowardice during World WarOne, this evidence suggested not only a growing familiarity with psychological ideasbut also a greater tolerance of fear reactions.

The formal recognition of PTSD by the American Psychiatric Association in 1980 rep-resented a fundamental change in the causal explanation attached to psychological break-down.39 During both World Wars, the soldier himself had been held responsible for hisinability to function. To explain why only a minority suffered from enduring symptomsafter a terrifying or stressful event, combat itself was interpreted as a trigger. Familyhistory of mental illness, pre-existing psychological disorder or childhood conflict werefactors highlighted to explain why some became psychiatric casualties and others didnot. By assigning primacy to the traumatic event and relegating personality factors to asecondary role, PTSD reversed causality.40 Subsequent research into the incidence ofPTSD in military populations generated a range of risk factors, which have been cate-gorised as psychological vulnerability.41 These include temperament, family history, edu-cation and pre-enlistment experience.42 Thus, the adoption of PTSD as a recognised illness

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was part of a process that replaced traditional notions of character weakness by scientifi-cally validated measures of risk for psychological disorder. As a consequence of this re-evaluation, researchers have conducted retrospective studies of combat veterans ofWorld War Two only to discover significant rates of PTSD.43 However, such studiesencounter methodological problems such as recall bias, issues of verification and thefact that, in retirement, elderly veterans often take strength from recall of wartimeexperiences.44

The “culture of trauma,” the historian Ben Shephard argued, weakens a core defenceagainst cowardice: if the fear of being judged cowardly is reduced then there is less pressureto resist the impulse to flee the battlefield.45 However, a contemporary study of UK armedforces deployed to Afghanistan suggested that stigma of mental illness has taken on therole formerly performed by the construct of cowardice in encouraging stoicism and tough-ness. Servicemen were found to be less tolerant of psychological disorder in theatre com-pared with home postings.46

Contemporary focus on emotion, combined with growing acceptance of PTSD as alegitimate response to a terrifying event, has led to a re-evaluation of the deserter.Charles Carrington, a decorated infantry officer, recalled of his World War One service,“it was one thing to make jokes about swinging the lead (shirking duty)… and quiteanother to avoid a dangerous task which someone else must do if you did not.”47 Ifsoldier who left his post without permission was shown to have been suffering from apsychological disorder, then his desertion could be reframed not as cowardice but thefinal act of an exhausted warrior. “The astounding fact,” concluded Glass, “is not thatso many men deserted but that the deserters were so few.”48 The success of psychologicalvulnerability in supplanting cowardice was demonstrated in August 2006 when PrivateHarry Farr, who had been executed for desertion in October 1916, was pardoned by theUK government.49 The judgement was justified because a hospital admission for shellshock suggested that Farr’s behaviour could be explained in terms of continuing mentalillness. Commentators and the media concluded that Farr had suffered from an illnessakin to PTSD. In fact, the official pardon reflected rather than led popular opinion asFarr and the other 305 UK servicemen executed in World War One had been commemo-rated in the Shot at Dawn Memorial opened in June 2001 at the National MemorialArboretum.

Whilst motives for elaborating traumatic experience can be readily identified, it is lessobvious why some veterans falsely claim to have committed atrocities against civilians.In 1988, Columbia Broadcasting System (CBS) television broadcast a documentaryentitled The Wall Within, which featured five Vietnam veterans who had all been diag-nosed with PTSD. Three of the five stated on camera that they had committed violentacts against innocent civilians.50 Several years later B.G. Burkett, a Vietnam veteran,obtained copies of their military records and discovered that these events were fictionaland significantly that only one of the five had taken part in combat.51 It appears, there-fore, that the false atrocity was cited to support a claim of combat-induced PTSD. InMay 2000, Edward Daily, a US veteran of the Korean War, made a much publicisedreturn to the village of No Gun Ri, where he sought forgiveness from the localpeople for his participation in a massacre of civilians by a company of the SeventhCavalry. However, research into military records revealed that Daily had not takenpart in the shooting, nor indeed had he been in the area.52 Indeed, at the time of the

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atrocity, he was a mechanic in the 27 Ordnance Maintenance Company. During the1980s, Daily attended reunions of the Seventh Cavalry and in 1990 published ahistory of the unit’s operations in Korea,53 so that his elaboration served, in part, toauthenticate membership of an elite unit. In extreme cases, a veteran may cite an atro-city narrative and the severe trauma that it entailed to explain personality change. Thisappears to be a post-PTSD phenomenon. Whilst there are several cases of individualsfalsely claiming to have been Holocaust survivors,54 there are no documented cases ofveterans purporting to have been perpetrators of Nazi war crimes.

Fabrication of traumatic exposure

Formal study of traumatic elaboration was facilitated by US Freedom of Information legis-lation, which allowed Burkett and Glenna Whitely, an investigative journalist, to obtainthe service records of individual Vietnam veterans. Although they hypothesised that “asmany as three-quarters of those receiving PTSD compensation are pretenders,” a proposalfor clinical study supported by verifiable data was shelved.55 Subsequently, ChristopherFreuh reviewed the records of 100 US Vietnam veterans attending a VA treatment pro-gramme for combat-related PTSD. Documented evidence of combat exposure wasfound in only 41 cases, whilst three ex-servicemen had not been deployed to Vietnamand two subjects had never served in the US armed forces.56 In the UK, Baggaley foundthat 13% of ex-servicemen referred to a military psychiatric centre for the treatment ofcombat-related PTSD had falsified their traumatic exposure.57 Further study by Palmerof 150 UK veterans referred for the assessment of medically unexplained symptoms at aMinistry of Defence clinic found that 10% had fabricated or significantly exaggeratedthe account of their traumatic exposure when accounts were verified against theirmedical records and unit war diaries.58

The willingness to falsify psychological trauma by a sub-group of veterans stands incontrast to the stigma exhibited by most UK and US ex-service personnel who equatethe disclosure of mental illness with a form of weakness.59 A study of a representativesample of 496 UK veterans showed that only half of those reporting mental health pro-blems during service had sought help, a proportion that increased only slightly when indi-viduals left the armed forces.60 Their unwillingness to disclose related, in part, to self-stigma and the belief that the veteran should be able to overcome such issues unaided.Military culture, which emphasises resilience and toughness, may inhibit service personnelfrom contacting health professionals to address psychological trauma, many preferring tocontact informal sources of help such as chaplains and colleagues.61 Why some veteransare willing to present false or exaggerated mental health problems when the majority oftheir former colleagues prefer to conceal their psychological symptoms remains an inter-esting question. Some evidence suggests that elaborators may have felt marginalised whenserving or feel rejected as a result of demobilisation. A study of 153 UK veterans in receiptof a war pension for PTSD or a physical disability by Chris Brewin and colleagues foundthat psychological illness was associated not with negative views of the self but a growingsense of alienation from civilian life.62 Elaboration for some may be an attempt to com-municate the sense of isolation and loss of self-worth expressed by this group of warpensioners.

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Legislative change

Recent legislative change in the UK removed penalties for elaboration. Section 197 of the1955 Army Act stated that any person, who “uses or wears any decoration, badge, woundstripe or emblem… as to be calculated to deceive” or “falsely represents himself to be aperson who is or has been entitled to use or wear such decoration, badge, stripe oremblem… shall be guilty of an offence” and liable to a fine or imprisonment.63

However, the Armed Forces Act of 2006, which replaced this legislation, contained nolegal sanctions against military deception.64 By contrast, the US government introducedthe Stolen Valor Act in December 2006, which made it a federal crime to fraudulentlyclaim to be a recipient of certain military decorations or medals in order to obtainmoney, property, or other tangible benefit. Although revoked in June 2012 as an uncon-stitutional abridgement of the freedom of speech, a second Stolen Valor Act was signedinto law by President Barak Obama on 3 June 2013 which reintroduced penalties for mili-tary falsification. In the UK, a recent spate of ex-servicemen falsifying traumatic exposureshas led to calls for new legislation to restore the penalties of the 1955 Army Act.65

Reduction of the military footprint

As the UK military footprint has been eroded by the end of National Service, progressivedefence cuts and a decline in the number of opinion formers (not least in government)with military experience, so public understanding of veteran issues has also diminished.66

By 1945, conscription had raised UK armed forces to 4.65 million,67 whilst the introduc-tion of National Service maintained numbers in uniform at around half a million duringthe 1950s.68 This stands in contrast to the 146,980 comprising UK regular forces inOctober 2014.69 Knowledge of military culture was widespread during the 1950s and1960s, whilst many civilians who had served in the emergency services or suffered thestresses of air-raids had direct experience of combat. With a significant proportion ofdoctors, nurses and other health professionals having served in the armed forces orhaving treated civilian casualties, false warrior narratives were more readily identifiedthan today.

Although understanding of UK veterans and their needs by the public and employers isinconsistent, popular support for the individual soldier or veteran is at a high level.70 Forexample, Help for Heroes, the military charity set up in October 2007, raised over £200million by September 2012 from donations and fund-raising activities. With a desire tohelp, civilians have become increasingly reliant on the media and military charities forinformation about ex-service personnel. Yet these sources are not without bias orspecial interest. Both the press and the third sector are attracted to narratives of distressas they engage popular interest and sympathy. By 2008, when the House of CommonsDefence Committee investigated the recruitment and retention of UK armed forces, thebelief that the conflict in Iraq had generated a significant number of traumatised veteranshad taken root. The Committee concluded that there had been “a failure in the part of theMinistry of Defence adequately to deal with the forthcoming PTSD bow wave.”71 In April2009, Commodore Toby Elliott, chief executive of the military, mental-health charityCombat Stress, was quoted in the Sunday Times as reporting that the number of troopswith psychological disorders was “beginning to mount up” and that this represented

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“the bow wave of a much greater problem.”72 That the British public had been persuadedby the media, charities and politicians was confirmed by a survey conducted in 2012 byLord Ashcroft, which found that:

more than nine out of ten of the public thought it was common or very common for person-nel leaving the Forces to have some kind of physical, emotional or mental health problem(though personnel themselves did not seem to share this view).73

This popular belief stands in sharp contrast to a recent study of UK armed forces whichfound that rates of probable PTSD were 4% for the army as a whole and 7% for front-lineunits, not significantly elevated from the 3% recorded for the entire British population.74

Conclusion

The place of the veteran in UK culture continues to evolve with ambivalence expressed byboth the public and ex-service personnel themselves. A study of a random sample of 200former UK regulars and reservists conducted in 2012 found that only 52% described them-selves as a “veteran” despite meeting the Ministry of Defence criterion for the term.75 Thissuggests that service personnel themselves continue to observe the culturally-embeddedmeaning of the term as an elderly ex-soldier with campaign experience. Indeed, of the200 in the sample, 41 (21%) had served for less than 6 years and 94 (47%) for less than12 years, whilst 59 (29.5%) were under 30 at the time of the interview, only 44 (22%)being aged 45 or older. The withdrawal of UK forces from Afghanistan and furtherreductions to government expenditure (which impacts not only on the numbers in theregular forces but also on a willingness to deploy troops in operations overseas) are likelyto take the spotlight away from veteran issues. BeforeWorldWar One and the recruitmentof a vast citizen army, the armed forces in Britain were held with pride but at the margins ofsociety, a perception reinforced by deployment to distant territories on imperial duties.76

Although respectful of their army and navy, the British people felt no great responsibilityfor their ex-service personnel. Should the UK return to this traditional position, the inci-dence of psychological elaborationmay fall because of an increasingly unreceptive audience.

Elaboration of trauma in a military context offends more than in civilian life becausethe deception draws on the status of the heroic warrior.77 Extreme courage commonlyinvolves death (295 Victoria Crosses were posthumous) and the fabrication is judged dis-respectful to the memory of servicemen and women who have experienced genuinetrauma. As a result, discovery of a falsehood often invokes outrage rather than anattempt at understanding. Whilst penalties for such deceptions are indicated, theyshould not impede an attempt to discover why some veterans feel compelled to invent nar-ratives of distress.

Notes

1. C.G.T. Dean, The Royal Hospital Chelsea (London: Hutchinson, 1950).2. Charles Edmonds [Charles Carrington], A Subaltern’s War (London: Anthony Mott, 1964), 92.3. Arthur Conan Doyle, A Study in Scarlet (London: Ward Lock & Co, 1888; reprinted London:

John Murray, 1974), 15–16.

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4. A. Wyatt, Development of the Veterans Initiative by the Ministry of Defence, Case Study (Sun-ningdale Park: The International Comparisons in Policy Making Team, the Civil ServiceCollege, 2002), 10.

5. Paul Addison, Now the War is Over, A Social History of Britain 1945–51 (London: JonathanCape, 1985), 23; David Kynaston, Austerity Britain 1945–51 (London: Bloomsbury, 2007), 97–8.

6. Lindsey A. Hines et al., ‘Are the armed forces understood and supported by the public? A viewfrom the UK’, Armed Forces and Society (2014), 1–26: 3–4. doi:10.1177/0095327X14559975.

7. Frank Ledwidge, Losing Small Wars, British Military Failure in Iraq and Afghanistan (NewHaven, CT: Yale University Press, 2011).

8. Christopher Dandeker et al., ‘What’s in a name? Defining and caring for “veterans”’, ArmedForces and Society 32 (2006): 161–77.

9. R.H.T. Rice, The Next Generation of Veterans: Their Critical Needs and Their Emerging Rights(London: Royal College of Defence Studies, 2009); The Armed Forces Covenant (London: Min-istry of Defence, 2011), 4.

10. Charlotte Woodhead et al., ‘An estimate of the veteran population in England: Based on datafrom the 2007 adult psychiatric morbidity survey’, Population Trends 138 (2009): 50–4.

11. US Department of Veterans Affairs, Federal Benefits for Veterans, Dependents and Survivors,http://www.va.gov/opa/publications/benefits_book/benefits_chap04.asp (accessed March 20,2014).

12. Report of the Review of Veterans’ Entitlements, 1: 237–48.13. Lord Ashcroft, The Armed Forces and Society, The Military in Britain through the Eyes of

Service Personnel, Employers and the Public (London: Lord Ashcroft Polls, 2012), 13–14.14. B.G. Burkett and Glenna Whitley, Stolen Valor, How the Vietnam Generation was Robbed of its

Heroes and History (Dallas: Verity Press, 1998).15. Rebecca Ricks, ‘Did former soldier lie about combat experience to cut court sentences?’ Ply-

mouth Herald (December 12, 2013), http://www.plymouthherald.co.uk/Did-soldier-lie-combat-experience-cut-court/story-20312379-detail/story.html (accessed March 20, 2014).

16. A former Royal Navy rating, Rhiannon Mackay, claimed to be suffering from PTSD anddepression, reported in West Briton, ‘Jailed for telling a lie on her CV’, (March 26, 2010),http://www.westbriton.co.uk/Jailed-telling-lie-CV/story-11397440-detail/story.html (accessedMarch 20, 2014). Alan Clayton said he had PTSD and won the Victoria Cross in NorthernIreland rescuing a child from a building that was about to explode, reported by DailyRecord, James Moncur, ‘Walter’s whoppers’, (September 7, 2012), http://www.dailyrecord.co.uk/news/scottish-news/walter-mitty-alan-claytons-lies-1309088 (accessed March 20, 2014).David Edwards falsely claimed to have served in the Parachute Regiment and to be sufferingfrom PTSD, reported in Lancashire Evening Post, ‘Veteran tells on on-line hate campaign’,(February 5, 2013), http://www.lep.co.uk/news/local/veteran-tells-of-online-hate-campaign-1-5377299 (accessed March 20, 2014). Gordon Hoggan claimed PTSD as a result of close-quarter fighting with an Argentinian soldier in the Falklands War and suffered from“mental health issues” ever since, reported inMail On Line, Mark Nicol, ‘Did phoney Falklandsveteran fool world media?,’ (November 30, 2014), http://www.dailymail.co.uk/news/article-2854550/Did-phoney-Falklands-veteran-fool-world-media-Gordon-Hoggan-55-accused-fabricating-story-killing-Argentine-soldier-stabbing-neck-bayonet.html (accessed March 20,2014). Simon Buckden claimed to have served in the SAS and to be suffering from PTSD,reported by ITV News, ‘Ex-soldier turned war veteran in court’, (March 18, 2015), http://www.itv.com/news/calendar/update/2015-03-18/ex-soldier-turned-war-veteran-in-court-over-fraud-charges (accessed March 20, 2014).

17. Edgar Jones, Ian Palmer, and SimonWessely, ‘War pensions (1900–1945): Changing models ofpsychological understanding’, British Journal of Psychiatry 180 (2002): 374–9.

18. Helen Bettinson, ‘“Lost souls in the house of restoration”? British ex-servicemen and war dis-ability pensions’ (PhD diss., University of East Anglia, 2002), 290–4.

19. Michael Trimble, Post-traumatic Neurosis (Chichester: John Wiley, 1981), 59.20. John Collie,Malingering and Feigned Sickness with notes on the Workmen’s Compensation Act,

1906 (London: Edward Arnold, 1917), 375.

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21. William Johnson and R.G. Rows, ‘Neurasthenia and the war neuroses’, in History of the GreatWar, Diseases of the War, Vol. 2, ed. W.G. MacPherson, W.P. Herringham, and T.R. Elliott(London: HMSO, 1923), 57.

22. R.H. Ahrenfeldt, Psychiatry in the British Army (London: Routledge, 1958), 103; H.J.C.JL’Etang, ‘A criticism of military psychiatry during the Second World War’, Journal of theRoyal Army Medical Corps 97 (1951): 316–27.

23. R.R. Grinker and J.P. Spiegel, War Neuroses in North Africa: the Tunisian Campaign(New York: Josiah Macy, 1943), 7, 95–6.

24. T.F. Main and A.T.M. Wilson, Observations on Absence without Leave (London: War OfficeReport, 1941).

25. Ahrenfeldt, op. cit., 86.26. Vernon Scannell, The Tiger and the Rose, An Autobiography (London: Hamish Hamilton,

1971), 54.27. Ibid., 59–60.28. Edgar Jones and Simon Wessely, ‘Prisoners-of-War: From resilience to psychological vulner-

ability, reality or perception’, Twentieth Century British History 21 (2010): 163–83.29. The National Archives, Kew (hereafter TNA), WO32/10950, A.T.M. Wilson, ‘Report to the

War Office’, February 1944, graphs of sickness and absenteeism.30. Adam Curle and Eric Trist, ‘Transitional communities and social reconnection, part II’’,

Human Relations 1 (1947): 240–88.31. TNA, LAB12/352, Minutes of a conference on Civil Resettlement, October 5, 1945, 2.32. Peter Hennessy, Never Again, Britain 1945–51 (London: Jonathan Cape, 1992), 450.33. Alan Allport, Demobbed, Coming Home after the Second World War (New Haven, CT: Yale,

2009), 136–7.34. Mathew Thomson, ‘The psychological body’, in Companion to Medicine in the Twentieth

Century, ed. Roger Cooter and John Pickstone (London: Routledge, 2003), 291–306.35. Chris Walsh, Cowardice, A Brief History (Princeton, NJ: Princeton University Press, 2014), 8.36. Edgar Jones, ‘LMF: The use of psychiatric stigma in the Royal Air Force during the Second

World War’, Journal of Military History 70 (2006): 439–58.37. Mark K. Wells, Courage and Air Warfare, The Allied Aircrew Experience in the Second World

War (London: Cass, 1997), 194–205.38. Samuel A. Stouffer, Arthur A. Lumsdaine, and Marion Harper Lumsdaine, The American Soldier,

Combat and Aftermath, Volume Two (Princeton, NJ: Princeton University Press, 1949), 198–9.39. Edgar Jones and Simon Wessely, ‘A paradigm shift in the conceptualization of psychological

trauma in the twentieth century’, Journal of Anxiety Disorders 21 (2007): 164–75.40. Allan Young, The Harmony of Illusions, Invention Post-Traumatic Stress Disorder (Princeton,

NJ: Princeton University Press, 1995), 120–1.41. C.R. Brewin, B. Andrews, and J.D. Valentine, ‘Meta-analysis of risk factors for posttraumatic

stress disorder in trauma-exposed adults’, Journal of Consulting and Clinical Psychology 68(2000): 748–66.

42. L. Stephen O’Brien, Traumatic Events and Mental Health (Cambridge: Cambridge UniversityPress, 1998), 88–100.

43. Nigel Hunt and Ian Robbins, ‘The long-term consequences of war: the experience of WorldWar Two’, Ageing and Mental Health 5 (2001): 183–90.

44. Nigel C. Hunt,Memory, War and Trauma (Cambridge: Cambridge University Press, 2010), 40.45. Ben Shephard, ‘Risk factors and PTSD: A historian’s perspective’, in Post-traumatic Stress Dis-

order, Issues and Controversies, ed G. Rosen (London: Wiley, 2004), 57–8.46. Carlos Osorio et al., ‘Changes in stigma and barriers to care over time in UK armed forces’,

Military Medicine 178 (2013): 846–53.47. Charles Carrington, Soldier from the Wars Returning (London: Hutchinson, 1965), 224.48. Charles Glass, Deserter, The Last Untold Story of the Second World War (London: Harper

Press, 2012), xii.49. Simon Wessely, ‘The life and death of Private Harry Farr’, Journal of the Royal Society of Medi-

cine 99 (2006): 440–3.

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50. Allan Young, ‘The self-traumatized perpetrator as ‘transient mental illness’’, Évolution Psychia-trique 67 (2002): 630–50.

51. Burkett and Whitley, op. cit., 91–8.52. Felicity Barringer, ‘Ex-GI in Associated Press account concedes he didn’t see Korean massacre’,

New York Times, May 26, 2000, http://www.nytimes.com/2000/05/26/world/ex-gi-in-ap-account-concedes-he-didn-t-see-korea-massacre.html (accessed March 20, 2014).

53. Edward L. Daily, The Legacy of Custer’s 7th US Cavalry in Korea (Turner, ME: Turner Publish-ing, 1990).

54. Binjamin Wilkomirski, for example, claimed to have survived internment in Majdanek andAuschwitz but was discovered to have lived the entire war in Switzerland, Fragments, Memoriesof a Childhood 1939–1948 (London: Picador, 1996). Doubt has also been cast on the claim ofDenis Avey, a British prisoner-of-war held near Monowitz, as to whether he exchanged placeswith a Jewish inmate of Auschwitz on two occasions. Inconsistences in his narrative have beenexplained by the effect of post-traumatic stress disorder. Denis Avey, The Man who broke intoAuschwitz (London: Hodder and Stoughton, 2011).

55. Burkett and Whitley, op. cit., 279.56. B. Christopher Frueh et al., ‘Documented combat exposure of US veterans seeking treatment

for combat-related post-traumatic stress disorder’, British Journal of Psychiatry 186 (2005):467–72.

57. Martin Baggaley, ‘“Military Munchausen’s”: Assessment of factitious claims of military servicein psychiatric patients’, Psychiatric Bulletin 22 (1998): 153–4.

58. Ian P. Palmer, ‘UK extended medical assessment programme for ex-service personnel: The first150 individuals seen’, The Psychiatrist 36 (2012): 236–70.

59. C.W. Hoge et al., ‘Combat duty in Iraq and Afghanistan, mental health problems and barriersto care’, New England Journal of Medicine, 351 (2004): 13–22.

60. Amy Iversen et al., ‘“Goodbye and good luck”: The mental health needs and treatment experi-ences of British ex-service personnel’, British Journal of Psychiatry 186 (2005): 480–6.

61. Amy C. Iversen et al., ‘Help-seeking and receipt of treatment amongst UK service personnel’,British Journal of Psychiatry 197 (2010): 149–55.

62. C.R. Brewin, R. Garnett, and Bernice Andrews, ‘Trauma, identity and mental health in UKmilitary veterans’, Psychological Medicine 41 (2011): 733–40.

63. Army Act 1955 c. 18 (Regnal 3 & 4 Elizabeth 2).64. Armed Forces Act 2006 (c. 52).65. Joe Shute, The Walter Mitty hunters exposing fake veterans, Daily Telegraph, February 21, 2015,

http://www.telegraph.co.uk/news/uknews/defence/11425203/The-Walter-Mitty-Hunters-exposing-fake-veterans.html (accessed March 20, 2014).

66. C. Dandeker, op. cit., 172.67. Richard Vinen, National Service, Conscription in Britain 1945–1963 (London: Allen Lane,

2014), 55.68. R. Phillipson, ‘Army psychiatry 1948–1958’, Journal of the Royal Army Medical Corps 104

(1958): 151–4.69. Ministry of Defence, UK Armed Forces Quarterly Personnel Report, 1 October 2014 (London:

Defence Statistics, 2014), 1.70. Ashcroft, op. cit., 13–14; Lord Ashcroft, The Veterans’ Transition Review (London: Lord Ash-

croft, 2014), 176–8.71. House of Commons Defence Committee, Recruiting and Retaining Armed Forces Personnel,

Fourteenth Report of 2007–08 (London: The Stationery Office, 2008), 158.72. Michael Smith, ‘Scores of troops traumatised by Afghan War’, Sunday Times, April 26, 2009,

http://www.thesundaytimes.co.uk/sto/Test/politics/article165197.ece (accessed March 20,2014).

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mental health of the UK armed forces’, Lancet 375 (2010): 1783–97.

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75. Howard Burdett et al., ‘“Are you a veteran?” Understanding the term “veteran” among UK ex-service personnel, a research note’, Armed Forces and Society 39 (2013): 751–9.

76. Hew Strachan, Politics of the British Army (Oxford: Clarendon Press, 1997), 195–233; Dande-ker, op. cit., 165.

77. Helen McCartney, Hero, victim or villain? The public image of the british soldier and its impli-cations for defense policy’, Defense and Security Analysis 27 (2011): 43–54.

Disclosure statement

No potential conflict of interest was reported by the authors.

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