DEBRIEFINGS AND POST TRAUMATIC STRESS DISORDER
"Included in the service offered by the psychology service, Sector 10, are visits to outer-lying bases that have been subjected to stand off attacks, to assess and identify individuals who may be at risk of developing Post Traumatic Stress Disorder, and to offer them treatment as soon after the event and as close to the front line as possible."
- Extract from the report of my border duty
Each time there was an attack on one of our outer-lying bases, one of the two psychologists, (usually me) would go out and 'debrief' the soldiers who had been involved. The model which we followed for the debriefing of soldiers was that developed by the Israel Defence Force, which is described by Gabriel (1982). When I arrived on the border, Charl gave me a photocopy of that article. Some years later I wrote up the model as we actually applied it, and this model appears as Appendix 1 of this book.
Within a week of my arrival on the border I went to visit one of the small outer lying bases which had been mortared the night before (28-06-1987). Charl teased me about taking my rifle and bush hat "What are you going to do with that? This is lion country," he told me.
Aware that SWAPO could still be in the area and that my driver and I were travelling alone in a military bakkie, I loaded my rifle as we approached some stationary vehicles at the roadside - just in case it was an ambush. This probably earned me some strange sidelong glances from my driver, Rifleman Bullock. (This was well before we fell out!)
I felt nervous driving over any dirt roads, holding my breath as we went along sand tracks, which were so easy to mine. I waited for the bang!
No sign had been found of the SWAPO insurgents who had carried out the attack. The attack had come from an unexpected direction, and following a rev three weeks before. After the previous rev, the garrison had been told that all SWAPO forces had returned to Angola for retraining (known as 'Rehearsal').
In previous years, Ongongo had been subjected to a token annual rev, and this had become a familiar pattern. After the annual rev, the garrison knew it was over for another year, and they might have begun to relax. Now, suddenly, that comforting belief was shattered.
During the previous rev, one Grad-P surface to surface missile had hit the camp's gas depot, which had exploded gloriously.
In the three weeks since the anticipated rev there had been two separate land mine incidents. Those killed had been local Owambos, but soldiers from the garrison had been given the gruesome task of removing the bodies. This was the first encounter with death for some of them. This was a traumatic experience, and I had already seen one patient from this base showing traits of Post Traumatic Stress Disorder following that event.
On the night of the second rev, a party of left-wing visitors from Stellenbosch University (Afrikaans medium, but the most liberal) were in the camp. The visitors ignored the military personnel completely, and spoke only with the local Owambos.
The camp held a fire-plan at 22H30, and were scheduled to have a further fire-plan later on. At about 23H30 the SWAPO bombardment commenced. SWAPO fired about six mortars, most of which fell short of the camp. There was some confusion about the sounds. Some troops thought it was the scheduled fire-plan and stayed in the bar. The Dominee and the doctor also did not identify the sounds as a rev until the siren sounded. No missiles hit the camp; all fell about a kilometre short, and there were no casualties. (The visitors might have thought it was being put on for their benefit.)
Most of the troops were concerned about when the next attack would be, and why the fire-plan had not deferred the attackers.
DEBRIEFING REPORT - CAPTAIN FOWLER (29-06-1987)
MANAGEMENT: It was decided that I should pay a visit to Ongongo although the base had not been hit, as a 'dry run' for me to build up experience. I spoke first of all to the MO and the Dominee. The OC of the base was away. I spoke to the group of Officers and NCOs and then to the Troops. All debriefings were in groups.
From the NCOs, a NSM Corporal expressed confidence in their training; when they were attacked, they knew what to do because they had been trained well. There were no admissions of fear, and this idea was laughed at nervously.
The Corporal then went on to express frustration that the fire-plan was not effective in that it did not dissuade the attack. It may have scared them into attacking earlier, and from a distance too far to be effective, but they had been intent on attacking the base, and the fire-plan had not dissuaded them.
Some of the older SAKK NCOs said that they were tired of being in the army and being away from their wives and families for so long each year. Could this be a safe excuse to leave the operational area?
I gave a brief lecture on Post Traumatic Stress Disorder and asked them to look after themselves, and to be alert to these symptoms in their fellow NCOs and in their troops.
Next I gave a similar lecture to the 'other ranks', but during this I had less audience participation. I pointed out that it happens to 'good people', and that there is no shame attached to the disorder. It is more foolish to keep it to oneself than it is to ask for help for such a problem. I said that I would still be around the base for an hour or so, and anyone who wished to approach me individually during that time would be welcome to do so. (No one took me up on this.)
I spoke informally to the NSM Corporal, a mortarist, who had spoken up during the first lecture. His motivation seemed good. He said that the rev and other incidents justified their training and their presence in South West Africa. He said that what happened was important and it showed that 'SWAPO was not just a rumour', and that the war was real. After this I spoke informally to the MO and the Dominee again, partly about PTSD and its treatment. I seemed to be something of a novelty to them.
The visit was more a showing of face, or waiving the flag than a serious debriefing, but there were no traumatic experiences to be 'debriefed' or `defused'.
Soldiers at Ongongo base reported feeling bitter that Koevoet takes over the search and follow up operations. As soon as they arrive, the army are ordered to withdraw. They feel bitter that Koevoet will sell any 'heads' killed by the army the night before. The army gets revved, and Koevoet comes in and takes all the 'glory', and any financial rewards.
"DEATH IN THE AFTERNOON"
NOTE: The following material is taken directly from my official notes made at the time. To protect the privacy of those involved, I have changed the names and have omitted the date and other information which could be used to identify them. A passing reference is made to this incident in the official history of 1 SSB, `Pantser in Aksie' by Leo Barnard, p. 203. `Cav.' is the abbreviation of `Cavalier', the basic rank in armoured units, as `rifleman' is in the infantry, and `private' is in the SAMS and Air Force.
(Day 2) (B H Fowler - Capt) held debriefing with the following squadron of Ten Armour following a contact which occurred on (Day 1). The personnel involved; 3 crew members to each of 4 Eland armoured cars, were as follows:
(A)Lt. Malan - car commander
(C)Cav. W. De Villiers
(D)* (Cav. de Kock) - killed
(E)Cav. Wepener - car commander
(F)Cav. Hofmeyr - gunner
(G)Cav. Marais - driver
(H) Cav. Roussouw - car commander
(I)Cav. Roos - gunner (wounded)
(J)Cav. Cronje - Driver
(B)Cpl. Bredenkamp- car commander
(K) * (Cav. Van Zyl) - gunner - killed
(L)Cav. I. D. van Zyl - driver
INCIDENT: At about 16H00 on (Day 1) the squadron of four armoured cars was involved in COIN Ops. (Counter Insurgency Operations) and entered a kraal. There were no members of the local population in the kraal.
Cav. Roos bent down to pick up a pocket knife. At that moment shots rang out from a zinc hut. Cav. Van Zyl and Cav. de Kock were each hit in the head and fell. Cav. de Kock was still alive. Cav. Roos had a bullet crease his head. Troops reported that they were unsure of the positions of their fellow soldiers, and thus could not return fire. They dashed out of the kraal, and ran to the cars which were positioned 100m from the kraal. In their rush to escape, they left behind the bodies of Cav.s de Kock and Van Zyl.
Regrouping, they went in, fired shots into the hut and retrieved the bodies of Cav.s de Kock and Van Zyl. During this operation, the kraal was set alight.
Cav. Hofmeyr seemed to go out of control and appeared to be at risk of mutilating the bodies of the killed SWAPO terrorists. He was restrained by Lt. Malan.
Cav. de Kock was still alive when his body was retrieved, and Cpl. Bredenkamp worked hard trying to revive him, but was unsuccessful.
The operation was over, and the squadron was radioed the order to raze the kraal, which they did.
A helicopter arrived, and removed the bodies of Cav.s de Kock and Van Zyl, and the wounded Cav. Roos. Reinforcements arrived, as well as a senior officer to take charge of the situation.
The squadron returned to base and their OC reports that they were all 'crying like children'. They were addressed by the OC and the Dominee, who were supportive, and then allowed to return to their quarters.
The next day, a cache of 23 Grad-P rockets was found at the site of the incident - within effective firing range of Oshakati.
TIME TABLE OF THE DEBRIEFING
At 09H00 on (Day 2), I was requested to debrief the soldiers involved in the incident. The request was made by Major. Du Plessis (acting OC, 10 Pantser). I was unable to contact him to arrange a time table for my visit, so I reported to 10 Pantser's ops. room at 11H00.
By that time the Dominee had already held a memorial service for the two soldiers who had died. When I arrived, the OC of the squadron involved in the incident, Lt. Malan and Cpl. Bredenkamp had driven through to Ondangwa MBH to collect Cav. Roos who had spent the night in hospital, but was now ready to be discharged.
I was briefed by Lt. Swanepoel, who told me of the cache which had been found, and that Cav. Hofmeyr was considered to be most at risk for developing problems after what had happened.
Lt. Malan, Cpl. Bredenkamp and Cav. Roos were absent, but the rest of the squadron were gathered in the canteen, which was cleared for this purpose.
As soon as I had introduced myself, Lt. Malan, Cpl. Bredenkamp and Cav. Roos arrived, as well as the OC. The OC again briefed me, saying that he wanted to know how soon I felt him men could be operationally deployed again, because he was short staffed and needed them.
I saw Lt. Malan and Cpl. Bredenkamp together, to deal with them as the leader group. I told the troops that they could return to their quarters, but they elected rather to stay in the canteen.
Following the interview with the leader group, I gave feedback to Lt. Swanepoel to the effect that the squadron should be considered operational, possibly for deployment that night.
Following this, I held individual interviews with each of the troops, after which I gave feedback to the OC.
Premorbid functioning of the squadron:
Lt. Malan reported that the squadron was a particularly close unit, all of whom got on well with the other members, and there was a good co-operative relationship between the leaders and the men. It was mentioned that the group was entirely Afrikaans speaking, which was a binding factor. They had all been together for the year that they had been in the army. All the members who spoke on the subject confirmed the idea of the `closeness' of the squadron.
There appear to have been several sub-groups:
Cav. Van Zyl (Killed) was popular, and both Cav. Hofmeyr and Cav. I. D. van Zyl saw themselves as being particularly close to him. Cav. Hofmeyr reports that they were both 'farm boys', which built a bond between them. Cav. I.D. van Zyl shared a surname with Cav. Van Zyl (Killed) and worked with him as part of the same Eland crew. Both Cav. Hofmeyr and Cav. I.D. van Zyl reported having socialised with Cav. Van Zyl (Killed) on their passes (home leave).
Cav. de Kock (Killed) was new to the crew, having been with the crew for only ten days before he was killed. He replaced someone who had been away playing sport. He had volunteered for this border service, and his motivation for volunteering seems to have been his close relationship with Cav. Roos.
INITIAL: The Troops, when I saw them in the canteen were slow moving, red and glassy eyed. Most spoke very softly. They were still dressed in their smart uniforms from the memorial service. Most indicated that they had not slept the previous night.
Cav. Hofmeyr seemed most able to verbalise, and it was he who gave an account of what had happened.
Leader Group: Cpl. Bredenkamp seemed to have coped with the incident better that Lt. Malan. Cpl. Bredenkamp however reported an enuretic episode the previous night. He had not had any sleep. He had risen early and made coffee for his troops.
Discussion of operational deployment, with discussion of (1) they were needed, (2) they were functional, and (3) it would be better to keep them busy (a more humane reaction would be to give them a rest period, but psychological research, mostly anecdotal, would seem to contra-indicate this) (4) "Get back onto the horse that has thrown you as soon as possible before you start to doubt yourself." Both Lt. Malan and Cpl. Bredenkamp agreed, but with some reservation. Lt. Malan said it seemed inappropriate to go out again so soon - that night. Cpl. Bredenkamp said that the impression was of a service station (?production line) "Go out, lose two people, come back, get another two people, go out again." Both reported that they were (Reluctantly?) prepared to go out, but they had reservations about their troops' ability to do so.
(This interview, and the subsequent individual interviews with the troops were now held in the chaplain's coffee room.)
Note on management: I decided to see the troops in the order of their positions in the cars. A list was drawn up by Lt. Malan. This was done to:
(1) Adhere to the military structure - to support the discipline rather than to relax it out of apparent sympathy.
(2) So as not to focus further attention people identified as being at risk, like Cav. Hofmeyr. If he had been seen first, it would have confirmed what he already knew; that 'he was the one who had cracked'. This principle is adapted from Jay Haley's (1980) approach to start a family therapy session by focusing on the least involved parent/child.
ALSO: At first I would walk the soldier I had just interviewed back to his tent, where I would call for the next, and walk with him back to the chaplain's coffee room. By doing this we were walking through several rows of occupied tents, whose occupants could see our comings and goings.
I was aware that the squadron was already 'being watched' by the other soldiers; that my role / occupation must be known or guessed, and that by being seen with them, I might be drawing further unwanted attention and ? stigma to them, by each of them being seen individually by the psychologist. Would it not be better from this point of view to ask the person I had just finished with to call the next person on the list? This was less personal, but possibly reducing the risk of reinforcing them being seen (or perceiving themselves as being seen) as psychologically unstable, by virtue of the fact that they were seeing a psychologist. My maroon medics beret would have stood out like a sore thumb!
I discussed this candidly with one of the troops, who said that he felt the troops would prefer to be sent by the person who had just been interviewed.
INTERVIEWS WITH TROOPS
The structure was to ask each person what his role had been in the contact, his emotions at the time and afterwards, how he had slept, and how he felt now. (Of course using therapeutic skills of empathy and so on.)
I emphasised the normality of their experiences (emotional reactions), emphasised that they were heroes - they had done their job well, and the finding of the cache following the incident had most probably saved many lives - had Oshakati been revved.
I gave information on 'the mourning process', warning them of the time taken to accept a bereavement, as well as information on Post Traumatic Stress Disorder. I tried to be congruent by confirming that I had not been through what they had been through, so I could not say "I know how you feel". I reported the symptom associated with PTSD where sufferers report "I cannot relate to you because you have not been where (metaphorically) I have been. You cannot understand."
Following this I gave the four point explanation (above) of why they were likely to be deployed again that night, and asked for their comments and opinions.
I closed off by saying that I would be in contact again in the next couple of days. "Did they have anything they wanted to tell me, or ask me (or advise me?)?" We exchanged handshakes (at my insistence), I wished them `sterkte' (Strength). We exchanged salutes, and the next person would be sent for.
MATERIAL FROM INTERVIEWS WITH TROOPS: (Not in any order)
1. All requested that they be allowed to attend the funerals of their friends who had been killed.
2. Cav. Wepener reported that after having razed the kraal, the troops walked around destroying anything that was left, and killed the chickens that were still running around.
3. Some of the troops were aware that they were not as effected as some of the others. They asked why this was so, and seemed to feel some guilt at this.
4. Some reported that the helicopter took up to an hour to arrive, and expressed the feeling that if it had arrived sooner, their buddies' lives could have been saved.
5. Most said that they were confident at the way their leaders had handled the situation, and that they could not have handled it better. No one expressed doubt in the leadership.
6. Most reported that they were too busy following procedures to think during the incident. The realisation of what had happened only dawned on them (A) when the helicopter left with the dead and wounded, (B) when they were spoken to by the OC and the Dominee later that night.
7. Cav. W. De Villiers had not been centrally involved in the incident, and felt less affected than the others. He felt it was wrong to have left the bodies in the kraal during the initial flight.
8. Those who commented on it said that their attitude towards the local population was more negative than before; that they might be more inclined to shoot first next time. No overt aggression was shown during these comments. (I positively reframed their insight, emphasising the normality of such feelings, and expressing confidence, according to the evidence, that they would continue to act in a responsible manner.)
9. Cav. Cronje accepts what happened was 'God's will'.
10. Several people thought that they had learned the lesson that they would have to be more careful in future, and regretted not having been able to fire back immediately because of not knowing if their fellow soldiers would be in the crossfire.
11. Cav. Roos, in spite of having been wounded, and having lost his best friend, Cav. de Kock, seemed to be coping well. He reports having grown up mostly in the custody of Child Welfare and appears to have well practised and effective means of dealing with such problems. [sic!!! - What did he say to me to prompt me to write that?!]
12. Following the 4 point argument, all agreed to be operationally deployed again soon - that night if necessary. Towards the end of the set of interviews (after I had already had interviews with some of the troops), troops reported that they were discussing being deployed operationally that night, that they were anticipating an Op., and that they felt positive about it.
13. During the last couple of interviews, troops reported that they were talking about what had happened amongst themselves - a good sign!
14. Cav. Hofmeyr especially says it doesn't help that both terrorists were killed. It does not bring his friends back to life. Would he not feel worse if somehow the two terrorists had escaped, or (big joke!) been taken prisoner?
15. Cav. W. De Villiers stresses the importance of staying together as a squadron and not being farmed out to other squadrons.
16. (A while later) Troops feel positive about the replacement crew - they say they will know them anyway as they all trained together. The newcomers will not (emotionally) replace the people who were lost, but their presence is necessary for the squadron to be operational.
17. Lt. Malan made a comment about it appearing that the troops were more motivated than he was.
ALSO the possibility of guilt feelings in Roos because it was due to him that de Kock was in the operational area when he was killed - even if de Kock had volunteered.
PEOPLE APPEARING TO BE MOST AT RISK (In descending order)
1. Cav. Hofmeyr2. Cav. I.D. van Zyl3. Lt. Malan4. Cav. Roos
Follow up for all members to be made within the next few days.
REPORT BACK TO THE OFFICER COMMANDING
1. With reference to the literature, I recommended that the squadron be operationally deployed as soon as possible. Major du Plessis arranged for their inclusion in the operation that night - he had not intended this until now.
2. On request I told the OC I did not believe the squadron are especially high risk for committing atrocities against the local population.
3. Agreed to feedback on that night's operation - to follow up in a matter of days.
4. I thanked the OC for the opportunity of speaking to his troops. He thanked us for being an available resource.
Post Trauma Debriefing (Signed) B. H. Fowler (Capt.) SLKBHF
(Day 3) (B H FOWLER) I phoned Major Du Plessis to ask how Squadron # had functioned during last night's Op.. He reported that Hofmeyr had protested about going, but had reacted positively to a talk from the Major. The squadron had gone out, and their functioning was satisfactory. The Major was concerned about Cav. Hofmeyr and possibly Lt. Malan. I will interview each person again tomorrow.
(Day 5) Individual follow ups. All are in better shape. Cav. Hofmeyr and Cav. Van Zyl are taking longer than the others. The group expressed the feeling that it was not necessary to see a psychologist again. I will follow up again next week.
(Signed) B. H. Fowler (Capt.) SLKBHF
An issue which raised itself later to me; What if the soldiers had known that they had `blown' the rules? Would I be inducing guilt with the assumption that they had followed procedures correctly? They might be too ashamed to admit that they had made errors?
It was Major Kevin Holmes' task to conduct the autopsies of the two soldiers who had been killed. One of the SAMS medics had asked if he could attend, but he was seen as rather an idiot, and his request was not taken seriously. It did increase his reputation amongst his peers as being 'weird' or 'sick'. (I think it was the lad who was told that the `Flossie had crashed.')
Kevin told me about the autopsies for some reason - possibly knowing that I had been involved in debriefing the survivors. I presume that he managed to establish the cause of deaths without difficulty. I remember him commenting that there had seemed to be some minor fragments, like blackheads, in the face of one of the dead soldiers.
If I remember correctly, many years on, one of the two soldiers who was killed came from the same small Orange Free State town that Charl had grown up in. Knowing of Charl, some of the dead man's relatives phoned up requesting details of his death. Charl was away or unobtainable, so I was asked to deal with it. I knew that I could tell them nothing, and for me to have done so would have been a serious military offence. They had lost a son, who had died for his country and yet I, who knew all the details, could not tell them how he had died. I probably referred them to the chaplain service, who would have had more flexibility in such a matter than I did.
On the day I had originally been due to fly back to South Africa, I went to the Oshakati school to take photos, particularly of the armoured school busses. The convoy arrived from Ondangwa; an armoured car, an armoured bus, another armoured car, another bus, and a third armoured car. Quite a heavily armoured convoy to travel a thickly tarred road which could not be mined. There had also been no contacts along the road recently either. I recognised the driver of the first 'Noddy' (Eland/Panhard) car. He recognised me and waved. It was Cav. Hofmeyr, whom I had seen some months earlier when the squadron had been in the contact, and lost two of their crew members. And now here they were, escorting school children.
REMNANTS OF PREVIOUS ATTACKS
In 1986 a guard tower at Ruacana was attacked by a group of terrorists, and one of the guards was killed. The attack was beaten off and the mortar pipe which had killed the guard was mounted as a trophy outside the NCOs' mess. This served as a permanent reminder to the dead man's buddies of their loss, and they resented it.
A FURTHER NOTE ON POST TRAUMATIC STRESS DISORDER
In working with people who were suffering from Post Traumatic Stress Disorder I had a strong feeling that I could not be taken seriously by the people I was trying to debrief. There was almost something superior about people with this disorder; almost as if they were saying "You can't possibly know what it was like unless you've been 'there' yourself. Who are you to give advice? What are your qualifications to speak to me on this matter? If you had gone through what I've gone through, would you have coped as well as I?"
I always felt inadequate as a psychologist trying to help people suffering from PTSD. Psychologists, and everyone else feel that they must automatically say 'I know how you feel' when they plainly cannot.
In the film, 'The StarChamber'(1983), the lawyer character played by Michael Douglas says to the father of a little boy who was tortured and murdered; "I know how you feel!" then he thinks about it, and says; "No, I have no idea how you must feel!"
Thank God for honesty!
A female military psychologist, who worked at 1 Military Hospital, but whose gender exempted her from operational duty, saw 'Full Metal Jacket' (1987) and commented that she had just about got PTSD from watching the movie. Movies like that, and movies which claim to 'show how it really was' in Vietnam are probably destructive because they 'let people who are not involved become instant experts and judges'.
"I know how you feel! - I survived 'Full Metal Jacket'!
Published: 1 July 2000.
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