The materiality of virtual war: Post-Traumatic Stress Disorder and the disabling effects of imperialism

Virtual reality exposure therapy, individualization, and medicalization

“While some may say I’m broken, I call it a soldier’s heart.”

Jacob George, Soldier’s Heart (Democracy Now, 2014)

In addition to depoliticizing disability, the language deployed in Rizzo et al.’s (2011) study consequentially reinforces binary conceptions of individuals’ minds as able or disabled, healthy or unhealthy, normal or abnormal. While they assert that VRET “is perceived with less stigma” than traditional talk therapy (179), the authors frame their research as addressing “physiological dysfunction” and restoring “normal function” (183). By drawing on ableist conceptions of normalcy, the study reinforces an individualized, medical model of disability that necessarily stigmatizes and marginalizes both soldiers with PTSD and people with psychiatric disabilities more broadly. Alternatively, PTSD might be understood as a normal response to the ruthless violence of contemporary imperialist war. In a recent Democracy Now (2014) interview with members of Iraq Veterans Against the War, veteran Brock McIntosh relays the story of Jacob George, a fellow veteran, peace activist, and co-founder of the Afghan Veterans Against the War Committee, who took his own life in September of 2014. McIntosh explains that George “didn’t believe that he had PTSD; he believed that he had a moral injury, that it wasn’t a disorder to feel the way that he felt about war and that he was justified in being able to recognize that it wasn’t moral” (Democracy Now, 2014). While Rizzo et al. (2011) present their work as morally imperative and profess that “reducing human suffering in those wounded warriors who have sacrificed so much in their service to our nation” is their “core aim,” George refused the medical community’s pathologization of his mental condition (185). Rejecting a diagnosis that identified him as psychologically abnormal, George self-identified as the product of morally unjust social and political circumstances who, quite rightly and righteously, refused to accept these conditions. It was not George who was unhealthy or abnormal, but the conditions of which he was a product.

In stark contrast to George’s understanding of his own interpellation through the US military milieu, a Fox News article covering the use of virtual reality to treat PTSD favorably reported that “one soldier said that reliving his traumatic experiences in a virtual environment meant that he didn’t have to think about them when he was at home with his family” (Lewis, 2014). While I do not mean to condemn the medical treatment of this individual soldier, I want to emphasize that the discourse espoused in such media portrayals upholds the compartmentalization and shutting out of disturbing realities as healthy and, moreover, indicative of the successful treatment of the soldier’s alleged mental illness. Blocking out the violence intrinsic to war through VRET is valorized for enabling United States’ veterans to go on living their lives as usual, without questioning or challenging the continuous violence waged by the state. I want to suggest, further, that the celebratory tone of popular media depictions serves as a form of affective labor which both manipulates and produces particular affects within consumers (Hardt and Negri, 2004). Articles titled, for instance, “Virtual-reality videogames may be the best treatment for PTSD” (Mead, 2013), “Virtual-reality tech helps treat PTSD in soldiers” (Lewis, 2014), and “Study: Virtual-reality system helps treat PTSD in soldiers” (Study, 2014) all evoke a sense of comfort, reassuring readers of the promise that this new, individualized treatment holds for remedying veterans with PTSD while taking for granted the conditions under which disabling mental states are created. In line with Hardt and Negri’s (2004) assertion that “the media […] create affects and forms of life,” these portrayals serve to normalize a state of endless war and subdue insubordination and rebellion by conveying to the public that the consequential manifestations of war in individual soldiers’ minds and bodies are remediable through the wonders of modern medico-technologies (108).

Rizzo et al. (2011) go on to propose additional applications of virtual reality technology that extend beyond the treatment of PTSD. One such application is the Stress Resilience in Virtual Environments (STRIVE) project, which aims to foster “experiential learning of cognitive-behavioral emotional coping strategies in SMs [service members] prior to deployment to better prepare them for the types of emotional challenges inherent in the combat environment” (182). Premised on the contention that “internal thinking or appraisals about combat events can be ‘taught’ in a way that leads to more healthy and resilient reactions to stress,” this project “has created and disseminated training that aims to improve emotional coping skills and ultimate resilience across all Army SMs” (182). The STRIVE project, then, is advocated as a preventative measure for predicted future disability. The prevention of PTSD would be accomplished not by addressing the social and political conditions that give rise to psychological distress, but, rather, by altering the individuals in whom it is predicted such stress will manifest in the future. The authors propose the modification of individual soldiers’ cognition, intended to render them numb to the violent conditions of war, through the use of virtual reality technology. The application of virtual reality technology to members of the military through the STRIVE project represents a move to produce non-emotive cyborg soldiers. This project aims to transform individuals into detached and highly efficient war machines. The authors go on to explain that the “very success of STRIVE would in itself argue that individuals’ responses to stress can be altered” (184). In this way, military technologies are being employed to produce superior soldiers through the desensitization of emotions that naturally arise in the context of war, a practice designated “healthy” within this depoliticized, ahistorical, and individualized medical framing (182). Significantly, the authors also express their concern that failing to recognize when soldiers have reached their emotional limits puts service members “at risk for degraded performance” (184). This brings to mind Kafer's (2013) appeal to “examine the ways in which disabled people are positioned in terms of efficiency, productivity, and ability to work, or lack thereof” (119). The concern here seems less about soldiers’ health and more about their utility and efficacy as instruments of the military apparatus. In a twisted logic, then, the concern for the psychological health of the US soldiers arises out of an interest in maximizing their ability to psychologically (and physically) disable (and kill) others, namely, those resisting the imperialist violence waged by the United States.

The authors further suggest utilizing psychological testing measures, adapted from the same technology, in order to determine rank within the military hierarchy. As they explain, using “such information for recruitment decisions” would allow them “to predict what role is best suited to the unique characteristics and talent of a given recruit” based on their verbal, behavioral, and physiological reactions to virtual combat environments (183). Desensitization to violence, a highly masculinized trait, is equated with talent within the context of the military. Noting possible drawbacks of this application, the authors warn that this practice entails the risk of excluding some citizens from military participation, expounding that it is possible “that some future service members could be misidentified as high risk (false positives) and be denied access to joining the military” (184). Such statements render apparent their concern for the productivity and efficiency of the military apparatus. This application of virtual reality technology recalls Foucault’s (1977) description of the way in which disciplinary power “measures in quantitative terms and hierarchizes in terms of value the abilities, the level, the ‘nature’ of individuals” (183). This practice operates, moreover, “according to the use that [can] be made of [individuals]” (Foucault, 1977: 182).

Erevelles (2011) highlights the nuanced relationship between military technology and disability, stating that “one of the benefits of militarism is that advanced technologies developed in the battlefield trickle down to domestic markets […] to enhance the quality of (disabled) civilian life” (136–137). Erevelles’ consideration, which problematizes the condemnation of the use of virtual reality technology to treat veterans who seek alleviation from PTSD symptoms, cannot be overlooked. However, the use of advanced technologies to treat PTSD and simultaneously enhance soldiers’ effectiveness and efficiency demonstrates that while the trickling down of virtual reality technology can be interpreted as beneficial for some, these ‘benefits’ come at the expense of others and, further, serve to uphold and perpetuate the disabling conditions intrinsic to imperialism.

Challenging the individualization and medicalization of PTSD within military-funded research and perpetuated in media discourse extolling VRET, activists such as Jacob George, who self-identified with a moral injury and rejected the medical community’s classification of him as psychologically abnormal, can be usefully read through a critical disability studies lens. Reading PTSD in this way highlights that militarism is disabling not only for those occupied and oppressed by imperialist forces, but also for the individual soldiers employed to perpetuate US imperialism through the military apparatus. George’s actions demonstrate an awareness of the historical and political contexts that give rise to disability and highlight its social, political, and relational production and construction. In this sense, George seemed to understand his disablement as a process of social embodiment, or the way in which bodies are enmeshed in social and political dynamics on a world scale such that disability emerges through changing political structures and social processes over time (Connell, 2011). Activists such as Jacob George combat hegemonic perceptions of disability as weakness or abnormality located in individual minds and bodies that prevailing media discourse dictates can and should be remedied through individualized medical treatment.

Gaming and global capitalism

A medical model of disability, reinforced by Rizzo et al. (2011) and subsequent media depictions that similarly champion medico-technological treatments, renders soldiers labeled with PTSD unhealthy patients in need of individualized medical treatment. This framework obscures the way in which these psychologically disabling mental states are produced through a military apparatus employed to uphold the US state and secure global dominance through a “war-based economy” (Haraway, 1991: 167). Rizzo et al. (2011) explain that the “treatment environment was initially based on recycling virtual assets that were built for the commercially successful X-Box game and tactical training simulation scenario, Full Spectrum Warrior” (179). Without a hint of irony, then, they disclose that the technology utilized to treat returning soldiers struggling to psychologically cope following engagement in the senseless violence of imperialist war is the very same technology that serves to militarize subjects and normalize a state of perpetual war. As Dyer-Witheford and de Peuter (2009) point out, of “the many claimants of the title ‘inventors of the video game,’” all “were directly or indirectly employees of the US military-industrial complex” (4) also further, call attention to the conditions of global capitalism under which games are produced. They highlight the global division of labor that allows for programming to be outsourced for a fraction of the cost and, further, produces noxious e-waste in places like Nigeria and Delhi (3). The conditions of global capitalism under which virtual reality games are produced are left out of popular media accounts celebrating the promise these emerging medico-technologies hold. These exploitative conditions, importantly, serve to disable and further oppress historically marginalized peoples around the world (Meekosha, 2011).

Dyer-Witheford and de Peuter (2009) contend, moreover, that “digital games are systemically incorporated in the war-fighting apparatus of Empire” and that “what makes virtual play integral to ‘banal war’” is “the normalized state of perpetual conflict Empire’s global control demands” (5). They highlight the enmeshment of commercial gaming and military culture, recounting that “commercial game developers rushed to capitalize on market opportunities created by the invasion of Afghanistan and Iraq” (5). The authors’ compelling argument surrounding the centrality of virtual gaming for the normalization of violence necessary to perpetuate imperialist endeavors illuminates the twisted logic behind the use of such technology to treat PTSD. Within this framework, the perpetually disabling process of imperialism is rendered normal while the individuals produced through this process are labeled abnormal. Individual minds and bodies—and not the conditions through which they are interpellated—are perceived as requiring fixing. This supposed fixing is achieved, moreover, through treatment that utilizes the same virtual reality technology deployed to create and sustain these conditions. There is much need for disability studies work that unpacks the contradictory logics surrounding the relation of disability to the normalization of physical and psychological, material and virtual violence.

When psychiatric disability is created under conditions of imperialist war, romanticizing neurodiversity can dangerously depoliticize disability and hinder calls for political action. While disability studies scholars and activists should doubtless be concerned with reducing the marginalization of individuals labeled with PTSD, they should also be actively engaged in preventing the imperialist interventions that give rise to PTSD. As Erevelles (2011) concisely states, “war is one of the largest producers of disability in a world that is still inhospitable to disabled people” (132). Uncritical support and advocacy for a social model that does not account for global power imbalances risks invisibilizing instances wherein disability is created through imperialist violence and broader geopolitical injustices.

The invisibility of disability

In Missing Bodies: The Politics of Visibility, Casper and Moore (2009) argue that “the visible and invisible dimensions of human life, including representations of bodies, work together to create social order as we know it” (4). They assert that our “understandings of these bodies, our interpretations and explanations of bodily processes, give meaning to their materiality” (5). The hypervisibility of particular bodies and invisibility of others manifests in disparate concern for the differential treatment and inclusion of individuals with disabilities around the world. Such disparate concern is evident in the study conducted by Rizzo et al. (2011). Given the prevalence of repeated deployments and the “unlikely […] sudden end of the Global War on Terrorism,” Rizzo el al. (2011) argue that “a moral imperative exists to invest in finding new ways” to determine “when a [service member] has reached their limit” (184). While they frame their work as ethically imperative, it is essential to consider what bodies factor into moral considerations regarding the psychiatrically disabling effects of war. As Erevelles (2011) astutely notes, “Iraqis and Afghans who are killed or disabled in their ‘occupied’ countries are not thought of as ‘civilians’ resisting an imperialist force, but as ‘terrorists/insurgents’” (145). Subsequently, as Meekosha (2011) reveals in her work on the need to decolonize disability studies, “[we] know very little about numbers of Iraqi people disabled as a result of the war” (675). Mercy Corps’ estimates from 2011, however, put the number between three and five million (Meekosha, 2011). Not only do Iraqis and Afghans disabled by war not factor into ethical concerns regarding rehabilitation and support, but, moreover, these technologies rehabilitate and train soldiers for the very purpose of redeploying them as killing machines in the service of US imperialism.

Differential global access to the medico-technologies championed by Rizzo et al. (2011) and subsequent media coverage, in addition to the political-economic conditions under which such technology is produced, cannot be ignored. Discussing the differential access to technologies that support individuals with disabilities, for example, Meekosha (2011) points out that in Iraq “those who have lost limbs due to landmines cannot afford the prosthetics being marketed by the multinational suppliers” (677). The psychologically disabling impacts of war around the globe are equally troubling. As of 2012, there were 84 psychiatrists working in all of Iraq, which amounts to fewer than .05 for every 100,000 Iraqis (Crawford, 2013). Critical disability studies scholars cannot be silent about the disabling effects of imperialist wars (e.g. Erevelles, 2011).

Unequal access to technologies and services that have liberatory potential for disabled individuals raises broader questions about who counts as human in the War on Terror. While Rizzo et al. (2011) proclaim that “evidence-based clinical care could be made available that might reduce human suffering,” it is clear that only the suffering of particular humans factors into their moral considerations (184). The championing of medico-technological solutions in the study and subsequent media coverage renders apparent that the moral impetus to reduce human suffering and address the disabling effects of war extends only to (white) Americans. Indeed, in thinking about the differential valuation of life within the context of war, it is noteworthy that not only are the lives of American soldiers valued while the lives of racialized Iraqis and Aghans are rendered invisible, this disparate valuation of lives manifests domestically within the US military as well. In their intersectional analysis of the US military and the Iraq War, for example, Nagel and Feitz (2007) argue that disparities along lines of race, gender, class, and sexuality in society at large are perpetuated by military culture and practices. They point out that working class people are recruited for low-status, dangerous positions and soldiers of color are continually devalued within the military ranks. This analysis offers insight into the emphasis on enhancing the efficiency of soldiers through virtual reality technology. The concern with improving soldiers’ effectiveness is perhaps driven by rising concerns within the military regarding future enlistment, as military careers are increasingly viewed as an undesirable option among the American public (Serbu, 2014; Maze, 2013). Within this atmosphere, it is the economically exploited and oppressed who are further exploited to serve the imperialist interests of the United States. Heightened rates of homelessness among US veterans, further, suggest that the objectives of imperialism – more than a genuine concern for the well-being of US veterans – are driving funding for the research and development of these technologies. ² The disabling effects of military involvement, significantly, are differentially visible and disparately distributed such that already marginalized people are disproportionately affected by disabling conditions of imperialist war both around the world and within the US.

Creating cyborg soldiers

In her influential Cyborg Manifesto, Haraway (1991) explains that a cyborg is “a hybrid of machine and organism, a creature of social reality as well as a creature of fiction” (149). The use of virtual reality technology to alter the psychology and physiology of soldiers exemplifies the production of cyborg subjects. As Haraway contends, “biotechnologies are the crucial tools redrafting our bodies” (164). VRET, in line with this assertion, redrafts bodies by altering individuals’ psychological states, allegedly to return them to a normal/healthy condition. As discussed above, however, the very same VR technology is employed to render humans desensitized cyborg soldiers, instruments of the military apparatus that serves to uphold the economic interests of the capitalist state. Haraway describes modern medical practices as “rich exemplars of the privilege of coding and recognition systems as objects of knowledge, constructions of bodily reality” (164). Virtual reality technologies, as utilized by the US military and depicted through media discourse, are reconstructing bodily realities by redefining what it means to have a healthy/normal mind. Specifically, research and popular representations of VRET reconstitute desensitization to imperialist violence as psychiatric normalcy.

Drawing on both Haraway’s work and Masters’ (2005) theorization of the “cyborg soldier” of “contemporary military discourse,” Erevelles (2011) explains that the modern soldier “is in constant battle against the normal human male body” (136). This is because, as Masters (2005) contends,“[n]ew times seem to require new soldiers for the ‘job’ of defending the nation” (113). Extending the logic of a medical model that positions disabled bodies as problems in need of fixing, techno-scientific military discourse codes all “human bodies as problems in need of solutions” (Masters, 2005: 114). Masters (2005) considers the technological advancements that have allowed the cyborg soldier to materialize, explaining that “technological prostheses” enable the cyborg soldier to “[circumvent] human biological limitations: poor eyesight, hearing and discernment” (122) and render him “a much more resilient subject” (121). The military aims expounded by Rizzo et al. (2011) are illustrative of this phenomenon. Specifically, the report proclaims that the STRIVE project seeks to yield soldiers with “more healthy and resilient reactions to stress” (182). The use of virtual reality gaming by the US military represents a move to transform citizens into cyborg soldiers through technologies that, importantly, extend beyond the bolstering of humans’ physical limitations and into the realm of soldiers’ psyches. Projects such as STRIVE are directed at altering soldiers’ cognition by diminishing psychological responses to the violence of war. While Masters (2005) discussed “the mechanical [being] inserted into the biological,” virtual reality games, instead, serve to physiologically and psychologically alter the biological by transporting it to cyberspace (114). In this way, virtual reality technologies are employed to produce human-machine subjectivities that uphold the military apparatus. In line with Haraway’s (1991) proclamation, it is increasingly apparent that “modern war is a cyborg orgy” (150).

While the muddling of borders between human soldiers and war technologies is profoundly troubling, cyborg theory offers radical hope in addressing the atrocities brought about by contemporary imperialist wars. Specifically, the blurring of self-other boundaries in a war made possible by the devaluing and dehumanization of other/brown bodies holds liberatory potential and meaningful grounds for anti-war and anti-imperialist activism.

Cripping cyborg theory

While Erevelles' (2011) historical-materialist analysis enjoins disability studies scholars to attend to the disabling effects of imperialism and neocolonial violence, Kafer’s (2013) political-relational model of disability demands the transcendence of narrow inclusion politics in favor of radically transformative disability politics. Kafer’s conception of a “cripped cyborg theory” is particularly useful in thinking about the utilization of virtual reality technologies to alter the psyches of US soldiers. A cripped cyborg theory, she explains, cautions “against easy celebrations of the technological fix” and, rather, “[requires] a more complex and ambivalent relationship with technology” (119). Within this nuanced framework, technological fixes such as VRET cannot be wholly celebrated or condemned. “Cripping the cyborg,” Kafer explicates, “means recognizing that our bodies are not separate from our political practices; neither assistive technologies nor our uses of them are ahistorical or apolitical” (120). This reconceptualization of cyborg theory offers hope for inciting political engagement surrounding the use of virtual reality technology to treat individuals with PTSD. As Kafer explains:

The blurring of boundaries, the permeability of bodies, the porousness of skin—all take on different meanings depending on whether they are viewed through the prism of institutionalization or as part of a strategy for feminist analysis. Arguing for breakdown between self and other, body and machine, takes on a different hue in the context of coercive medical experimentation and confinement. The cyborg, in other words, can be used to map many futures, not all of them feminist, crip, or queer (128).

Concluding thoughts

While an important and emerging body of disability studies literature has shed light on the problematic Eurocentrism of disability studies scholarship that fails to consider disability created in oppressed nations consequent of global power imbalances (Connell, 2011; Erevelles, 2011; Meekosha, 2011; Meekosha and Soldatic, 2011; Soldatic, 2013), this paper sought to highlight the way in which imperialism and global capitalism materialize in racialized bodies in the Global North as well by focusing on widespread psychiatric disablement. Further, I have argued that celebratory narratives surrounding the use of virtual reality gaming to treat PTSD dehistoricize and depoliticize what is necessarily a social and political question. In their commendation of the potential for video games to rehabilitate minds deemed abnormal within a medical framework, these narratives are largely remiss about the role such technologies play in training soldiers for the violent engagements that produce these mental states. As Kafer (2013) astutely notes, however, “neither medical technologies nor diagnoses can be characterized as purely oppressive or politically neutral” (125). The intention of this paper was not to condemn the use of virtual reality as a treatment for PTSD but, rather, to reveal the contradictory logics in championing such technologies while simultaneously deploying them to produce further psychiatric disability, both among US soldiers and among the uncounted and invisibilized Iraqis and Afghans disabled in the so-called War on Terror. Moreover, it is crucial that disability studies scholars attend to the way in which the line between mental illness and mental health is being redrawn, not in liberatory and desirable ways but, rather, to propel and perpetuate an inherently disabling imperialist force.

It should be noted that questions of gender and sexuality are writ large within analyses of video games and perpetual imperialist violence. While the length of this paper does not allow for sufficient analysis, there is much future work to be done regarding intersections of gender, sexuality, and disability in the context of imperialism. Arguing for the need to develop understandings of disability that account for neocolonial violence, Connell (2011) notes that military violence “is gendered, involving as it does specific patterns of masculinity and the increasingly mechanized destruction of men’s bodies. War in the metropole has left a long trail not only of physical injury among men but also psychological disability, alcoholism and domestic violence” (1377). The reproduction of masculine norms, hypermasculinities, and gendered violence through the military has significant implications for disability studies. Importantly, the gendered violence of military culture carries over to the video games produced in collaboration with commercial video game manufacturers, rendering gendered and sexual violence abundant within both video games and the military.

This analysis sought to emphasize that disability is not apolitical or ahistorical and to challenge simplistic narratives of progress surrounding disability and medico-techologies. Media representations that celebrate the individualized, medical treatment of PTSD reify essentialized conceptions of normalcy and abnormality that hinder broader political activism surrounding disability. In the contemporary context of perpetual imperialist war, it is increasingly paramount that critical disability studies be proactively anti-imperialist. Given the disabling effects of imperialism, disability activism cannot rightly disentangle itself from anti-war, anti-imperialist efforts. International disability rights movements must be politically engaged and outspoken about the disabling effects of imperialist violence. Moreover, when the very same technological advances championed as a means to “fix” the supposedly abnormal, unhealthy minds of soldiers with PTSD are being deployed to recruit, train, hierarchize, and desensitize soldiers, critical disability studies scholars can critique and declare dissent surrounding the way in which health and normalcy are being reconstituted within today’s imperialist milieu. Such scholarship can shed light on how medical efforts to treat soldiers in the US are simultaneously physically and psychiatrically disabling othered, racialized subjects around the globe, revealing who is and is not recognized as human within hegemonic narratives.

By celebrating virtual reality video games for improving the lived realities of US soldiers and obscuring the material reality of the disabling impact of US imperialism for racialized bodies facilitated by the same technologies, scientific studies and media depictions of virtual reality treatment for PTSD blur the lines between virtual and reality in dangerous and undesirable ways. Haraway (1991) asked if there might “be ways of developing feminist science/technology politics in alliance with anti-military facility conversion action groups” (⁴169). Similarly, as imperialist violence is fundamentally antithetical to a liberatory disability movement, practical and undeniable affinities exist between disability and anti-imperialist research and activism. Disability studies scholarship and disability rights activism cannot be remiss about the corporeal manifestations of imperialism for oppressed peoples globally. Combating the physical and psychological disablement intrinsic to war necessitates the disablement of the United States’ imperialist power.