Book Review: Perpetration-Induced Traumatic Stress

Perpetration-Induced Traumatic Stress: The Psychological Consequences of Killing by Rachel M. MacNair (2002) Praeger, Westport, CT. (Preview in Google Books.) This review was first published in Survivorship Journal 14(3).

Here is a book review I wrote for Survivorship back in 2007. When I looked it over, I found I remembered the book vividly. Since the topic has not been written about much, even in survivor circles, I thought it was worth sharing here.

This is the first work I read on PTSD in perpetrators, and it confirmed many of my hunches.  The book draws material from history, literature, sociology, research studies, and biology, as well as psychology. It was difficult to read emotionally, and I was grateful for the slightly dry tone, for it distanced me a little from my feelings. It also validated that my reactions of distancing are normal, given the circumstances.

There are chapters on combat veterans, executioners, the Nazis, law enforcement, murderers, and abortion practitioners – all adults who have killed as adults (if you consider abortion as killing). Although there is no material on children who have killed or on cults, where I harmed people, I could relate to almost every point.

It appears that PTSD symptoms, especially intrusive images, intrusive thoughts, and hyper-vigilance, are more intense among people who have killed than among people who have been victimized. The less socially sanctioned the act (e.g. atrocities against civilians in war versus killing in battle), the more severe the symptoms. PTSD is a common reaction even to situations when the victim is not seen, as in bombing.

A section on German officers’ reaction to guards shooting Jews standing before mass graves in the concentration camps has stayed vividly in my mind’s eye. Adolf Eichmann said, “Many . . . unable to endure wading through blood any longer, had committed suicide. Some had even gone mad.” After observing the shootings, Himmler was so badly shaken that he ordered the construction of gas chambers to place some distance between the soldiers and the murders.

At first it seemed odd to me that so very little had been written on the subject. But as I read the book, it became clearer. Society colludes to keep the subject cloaked in silence. Individuals do not talk of their reactions out of guilt and for fear of appearing crazy. Society objects to discussion; mention of PTSD in solders who have killed has been attacked for being anti-war propaganda, thus stigmatizing as unpatriotic those who would shed light on the issue.

The reason I found this book so powerful is that ritual abuse, by its vary nature, includes forced perpetration. It is a lot easier for most of us to accept that we were victims and that we wished we could have been saviors, helping other children, than to admit that we were also perpetrators, albeit unwilling perpetrators for the most part. And yet, unless we stop pushing that side of our experience out of consciousness, it is apt to erupt in one form or another and to shadow our present life with self-hatred and guilt.

I hoped that the publication of Perpetration-Induced Traumatic Stress would signal the start of sustained research and attention to the issues involved. When I searched in Google Books, I found precious little. Rachel McNair has written several books on related subjects, all of which look good. I did find On Killing: The Psychological Cost of Learning to Kill in War and Society by Lt. Col. Dave Grossman (2014)  First published in 1995 Little, Brown and Co, NY, NY. (Preview in Google Books.) Grossman also has a website; which contains information about other n=books, articles, audio visual material,and workshops.

However, I found nothing else, and I am afraid that the subject has faded back into the woodwork.