Fields of Combat

Understanding PTSD among today's veterans and how it is handled by the military and VA system.

Erin P. Finley is a medical anthropologist and Investigator at the Veterans Evidence-Based Research Dissemination and Implementation Center (VERDICT), Department of Veterans Affairs Medical Center, San Antonio, Texas, and an Adjunct Assistant Professor in the Division of Clinical Epidemiology, Department of Medicine, at the University of Texas Health Science Center, San Antonio.

Fields of Combat is highly recommended for leaders, persons providing direct care and ancillary services, and administrators involved in the care of active duty or retired service members, as well as for clinicians who work with veterans in community settings. It will be a valuable resource for family members to assist them in understanding and working with loved ones experiencing combat-related PTSD.

Matthew Gutmann, Brown Universitycoauthor,:

This is the first major ethnography of PTSD among veterans of America's most recent wars. In Fields of Combat, Erin P. Finley deftly weaves the experiences of these young men and women who have participated in the invasions and occupations of Iraq and Afghanistan into a larger fabric of the U.S. military enterprise, including the clinical responses to a health crisis in treatment and prevention of debilitating traumas of war. How Americans, civilian and military alike, respond to these veterans says as much about the mental health of U.S. society as about them.

Finley studies the process by which veterans of current conflicts define and seek treatment for combat-induced PTSD. Because she also seeks to illuminate military culture, she looks at how families cope with returning relatives who now seem like strangers; delves into the history of the Veterans Administration medical system, whose employees are struggling to treat a flood of new patients with limited resources; and chronicles how mental health professionals have defined the problems of veterans, from soldier's heart through combat fatigue to today’s struggles to define PTSD (and, hence, to decide who gets treatment).... A comprehensive look at the subject from many viewpoints.

Finley offers a well-researched and reasoned contribution that explores how the social environments veterans come from and return to when not deployed shape their PTSD experience. The book weaves together empirical research findings with lengthy case studies that show the experience of PTSD across time. This book's most important aspect is the understanding it conveys that PTSD is not only a psychiatric condition, but a socially mediated one as well, shaped by the ways in which the Veterans Affairs health system interacts with and compensates' veterans. Finley's richly textured ethnography demonstrates the many factors that influence the readjustment struggles of returning veterans. She closes the book with a helpful and practical set of suggestions that give it an edge on other works on the topic, many of which fail to treat the issues with Finley's depth and insight.... Summing Up: Highly recommended.

Kevin M. Bond:

Erin P. Finley creates a compelling account of how to understand PTSD and how to help treat those who suffer from it.... She mixes historical accounts of PTSD as a medical illness with the current understandings of its causes, signs, and evidence-based treatment.... Finley gives us hope and several well thought-out recommendations for preventing and minimizing combat PTSD.

Allan Young, McGill University:

Most of what we have learned about the personal costs of wartime trauma comes from veterans' experiences in post-Vietnam America. Things are different now. The wars in Iraq and Afghanistan are different, the injuries are often different, and the homeland's attitude to its veterans is different. Fields of Combat is an anthropologist's inquiry into the lives of a new generation of traumatized veterans and the people and institutions to which they have returned. Post-traumatic stress disorder is widely presumed to be a unitary and fully understood phenomenon. Erin P. Finley's engrossing ethnography corrects this profoundly mistaken view.

Dr. Devon E. Hinton, Massachusetts General Hospital and Harvard Medical School:

Fields of Combat documents the PTSD experience as it is lived by veterans of the Iraq War. In presenting the range of responses to PTSD, Erin P. Finley shows how they can be inflected by gender, ethnicity, and personal background. Anger, violence, and alcohol abuse emerge as major themes.