The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan. Adam Montgomery. Montreal & Kingston: McGill Queen’s University Press, 2017.

Is the warrior doomed to suffer psychologically because of the very nature of war? The apparent connection between the experience of combat and psychological injuries such as post-traumatic stress disorder (PTSD) among veterans of Iraq and Afghanistan has generated a sizeable clinical literature. This connection has also been documented anecdotally by scholars including Nancy Sherman and journalists such as David Wood and David Finkel, who paint a picture of a health care system straining to treat—let alone understand—large numbers of psychological injuries. So, it behooves society to ask if these mental wounds are particular to these wars and this type of warfare, or are they a universal outcome of all types of wars in all times and places?

While Jonathan Shay’s connections between Vietnam and Homer’s literature of war are one way of exploring the perennial risk of psychological injuries in war, the history of another country’s wars and experiences might offer a promising avenue of approach. Canadian historian Adam Montgomery’s book should thus be of interest to a wider audience than its subtitle alone might suggest. While students of Canadian military history will welcome it as a concise history of psychological injury and treatment in Canada’s wars since 1914, Montgomery usefully broadens the scope of the discussion. American readers, understandably preoccupied with the U.S. experience in Iraq and Afghanistan, will find the treatment of an allied and culturally similar military illuminating. Montgomery’s findings point to the startling ubiquity of psychological injuries in military operations of all types.

While Canada has its own unique military history, its understanding of what Montgomery calls invisible injuries draws on shared western notions of psychology, gender, and the moral obligations societies owe to their veterans, making it a useful case study in how modern militaries have come to understand and address the psychological costs of combat. His discussion of how ideas about these injuries have been shaped over time by cultural constructs such as gender and psychology is particularly illuminating.

The First World War occurred at the dawn of modern psychiatry. Canada, like its British ally, was unprepared for the mental cost of war in the trenches. By the end of the war, as many as 15,000 of the 600,000 soldiers in the Canadian Expeditionary Force were considered to have war-related psychological injuries, though the actual number may have been far higher.[1] Explanations for these injuries were elusive. In examining soldier’s letters and diaries, Montgomery finds a clear difference between those comrades who were genuinely incapacitated by psychological trauma and those who used the diagnosis of battlefield neuroses to cover perceived cowardice and malingering. While the popular term shell shock made it into the British medical journal The Lancet by 1915, the medical community, like the soldiers, was divided as to whether so-called war neuroses were a temporary response to traumatic experiences such as enduring bombardment, or the supposedly effeminate failings of cowards.

The memoirs and literature of veterans suggest the permanence of the mental trauma of that war. Canadian novelist Will Bird speaks of how the lives of the survivors were haunted by the “overshadowing visions and phantoms” of their war experience.[2] Nevertheless, the rudimentary care regime dedicated to veterans in the interwar years took a jaundiced and niggardly view of those whose symptoms persisted.

While the treatment of psychological injuries by the Canadian Army in the Second World War has been researched extensively, Montgomery advances our understanding by examining the values behind the diagnoses.[3] As he notes in his introduction, “historical eras shape their own symptoms of illness,” and by 1939, when Canada entered the Second World War, psychiatry was still dominated by cultural ideals of masculinity and manhood.[4] Reflecting the fluidity of terminology for psychiatric injuries, the category shell shock was replaced by a more blanket term designed to capture a variety of behaviours and breakdowns: battle exhaustion. As in the First World War, the goal was to return as many men to active duty as possible in the shortest possible time. The term itself—exhaustion—suggested a temporary condition, ameliorable by rest and the rebuilding of morale. Nevertheless, many of the Canadian frontline troops (20% in Italy, 30% in Normandy) diagnosed with battlefield exhaustion or neurosis were never returned to their units.[5] This suggests such cases were often persistent in nature.[6]

Any chronic psychological injury was attributed, in the language of the day, to inadequate character. G.B. Chisholm, a psychiatrist who became the Canadian Army’s Director General of Medical Services, attributed such character flaws to neuroses originating in the raising of boys by women, resulting, so he believed, in men with “excess femininity and mental weakness.”[7] Treatment of chronic psychological injuries employed psychotherapy to uncover these childhood flaws in the patient’s life story. While Canada after 1945 offered generous social programs to its veterans, for those with psychological injuries, as in the interwar period, the goal of treatment was to return men to successful masculinity as breadwinners and discourage reliance on unmanly pension seeking.

While it may seem a digression from a Canadian subject, the Vietnam War is an important part of Montgomery’s narrative, because it marks a sea change in the understanding of psychological injuries. As the U.S. entered the war in earnest, psychiatry downplayed stress injuries in favour of a Freudian emphasis on neuroses. Within a decade, however, the figure of the struggling, alienated veteran gave rise to the idea of the Vietnam Syndrome, a popular variation on the old term shell shock. A campaign by psychiatrists and advocates for veterans paved the way for a new term to appear, Post-Traumatic Stress Disorder. This new understanding of the persistent effects of stress was a significant development in psychiatry because it broke with the idea that psychological injuries must be rooted in a patient’s life history. Rather, such injuries could happen to anyone exposed to any stressful event, including but not limited to combat. At first seen as an American issue because of the Vietnam connection, this diagnosis was gradually accepted by other western militaries. For Canada, the road to recognition of Post-Traumatic Stress Disorder in the 1990s would run through very different kinds of conflicts, and often through operations that were officially described as peacekeeping rather than combat.

While the first two thirds of the book are situated in well-known conflicts, the latter third is focused minutely on Canadian defence issues and operations from the 1990s to the present, which may be unfamiliar to non-Canadian readers. Nevertheless, Montgomery’s discussion is instructive as a case study in both the ubiquitous nature of psychological injuries and the difficulties faced by militaries in adequately responding to them. Canada in the 1990s had a proud military heritage but did not see itself as a war-fighting nation. Despite a commitment to NATO, Canadian operations during the Cold War had been primarily low-risk, low-intensity efforts with the United Nations in locations such as Cyprus (1964-1993) and Golan (1974-2006), where there were stable ceasefires. These deployments changed radically in the unstable 1990s. Despite reductions of the Regular Army at the end of the Cold War, successive Canadian governments committed troops to missions in places such as Rwanda (1993-1996) and the former Yugoslavia (UNPROFOR 1992-1995) where there was little peace to keep. As soldiers cycled through these missions and witnessed violent ethnic cleansing—and even actual combat—they began to exhibit symptoms such as alcoholism, anxiety, panic attacks, anger, and suicide. After several false starts including suspected environmental causes, media investigations and medical reformers spurred the first diagnoses of post-traumatic stress.

For a country and a military grown self-satisfied and complacent with the virtuous ideal of peacekeeping, the reality of operations in places like Rwanda and former Yugoslavia came as a shock. This sense of bewilderment and even betrayal comes through strongly in Montgomery’s interviews with Canadian veterans of these operations. His subjects convey the impact and anguish of passively witnessing violence because their rules of engagement had reduced these soldiers to the role of spectators. As one described it, “Over there you’re staring at dead kids and starving people and little old ladies who ran beside your vehicle so they won’t get hit by snipers.”[8] These soldiers’ proximity to such suffering could itself be injurious. Because of the prevalent belief that peacekeeping operations were not war fighting, Canadian government and military officials were reluctant to acknowledge the prevalence of psychological injuries among veterans.

The most interesting and even admirable figures in Montgomery’s post-Cold War narrative are the Canadian military leaders who had the courage and persistence to name the problem. General Romeo Dallaire, commander of the United Nations mission to Rwanda, was candid with the press, after a public breakdown in 1998, about his own experience with the “anger, the rage, and the cold loneliness” of his psychological injuries.[9] Dallaire publicly and conspicuously sought out help at a time when Canadian soldiers with psychological injuries were often dismissed by their peers as emotional and weak.[10]

Montgomery also profiles Stephane Grenier, a veteran of Rwanda and himself diagnosed with psychological injury, who accelerated mental health reforms in the Canadian military around the treatment of psychological injuries. Grenier pushed to end the official use of Post-Traumatic Stress Disorder as a diagnostic and descriptive term, arguing that it stigmatized affected troops for having a disorder, causing them to be treated “like people who have the plague.”[11] Grenier invented the term Occupational Stress Injury (OSI), arguing the new term de-stigmatized psychological injuries and reframed them as being akin to physical injuries for which any soldier would naturally seek medical help.

This story illustrates Montgomery’s main theme of how terminology frames the perception and treatment of psychological illness. Occupational stress injury was a relatively neutral term that could be used to designate “injuries to the brain and psyche, caused by exposure to military-related trauma.”[12] For the Canadian soldier, an injury did not carry the scorn or shame associated with terms such as disorder.

Canada’s involvement in Afghanistan (2001-2014) saw the first officially designated combat roles for military personnel since Korea. During this period, the Canadian Armed Forces showed signs of learning from its experience of psychological injuries in the 1990s. It set up peer-to-peer support programs, increased pre-deployment screening of personnel, and implemented Third Line Decompression programs during redeployment to prepare soldiers better to reintegrate with family and society. By the end of the Afghan mission, over 40,000 personnel, roughly half of Canada’s military, had deployed to Afghanistan, and of some 30,000 who left the service by 2016, over 12,000 were receiving mental health care.[13] Throughout the post-Afghanistan years, a persistent debate has focused on the level of financial care provided to veterans. This debate has been fueled by prominent cases such as the murder-suicide of Lionel Desmond, a veteran of Afghanistan, which raised the question of which level of government has responsibility for such cases. Stories like the Desmond case illustrate another of Montgomery’s main themes, the real or perceived inadequacies of health care dedicated to veterans with psychological injuries. As Montgomery shows throughout his account, debates about responsibility for the mental health care of Canada’s veterans have occurred since the end of the Great War.

Thanks to the use of oral histories in the latter third of his book, I gained a clear sense of the emotional and mental impact of contemporary war but was left with questions I felt needed greater analysis. Montgomery’s term “psychological injury,” while usefully general, doesn’t distinguish between physiological injuries such as the effects of blast trauma on the brain, and psychic or moral injuries caused by witnessing suffering, which seem far more prevalent in Montgomery’s accounts. Can we distinguish between the kinds of injuries suffered by Canadians in Rwanda and the former Yugoslavia on the one hand, and those who served in combat roles in Afghanistan? How do these deployments compare with one another, or with the Canadian experience of peer-to-peer battlefields in the world wars? Is there something about the ambiguous, asymmetric character of contemporary military operations that is more psychologically injurious than previous more conventional conflicts?

Furthermore, for an author who focuses astutely on gender and ideas of masculinity in the definition of these injuries, I was surprised there were no voices of women veterans in the last chapters, since many Canadian women have served in a variety of roles in Afghanistan. While the clinical literature on psychological injuries among female military members is sparse and mixed, it is an interesting question given Montgomery’s focus on masculinity in the historical literature. Finally, while all histories must choose a cutoff point, the Canadian Armed Forces since Afghanistan have implemented programs dedicated to mental readiness and resilience. These programs would have made a useful epilogue for Montgomery’s account. The ideal of somehow making soldiers more physically, mentally, and even spiritually resilient has huge traction in the Canadian military today, and must have equivalent programs in other militaries. The success of such efforts may only be determined in the aftermath of future conflicts.

Adam Montgomery has written a fascinating and useful history. Reviews by prominent Canadian scholars such as Tim Cook have welcomed this book as a concise and much-needed work on a neglected and largely unexplored subject in Canadian military history. While books such as Carol Off’s Ghosts of the Medak Pocket have partially and provocatively addressed the mental costs of Canada’s recent deployments, a balanced and comprehensive account by an historian like Montgomery was overdue.

Montgomery’s book deserves a reading by non-Canadians for two important reasons. First, the story of Canadian veterans, who have suffered psychological injuries in combat (Afghanistan) and in traumatic non-combat situations (Rwanda, Yugoslavia) provides a useful case study for non-Canadian readers trying to assess the prevalence of such injuries. The experience of an allied military offers possible evidence of the ubiquity of such injuries in contemporary military operations. Second, and more importantly, this is a book that should command the attention of military leaders charged with the welfare of their personnel. Montgomery brings the reader to the edge of a haunting ethical question. If the small military of a middle power has faced such large problems of mental health in relatively modest operations, then what problems will all western militaries and governments face in caring for the veterans of a large conflict? The question is certainly one of the highest responsibility for militaries, and for political leaders who casually threaten to unleash them.

Michael Peterson: What got you interested in this subject, and why did you want to tell this story?

Adam Montgomery: My professional and personal interests in the subject have been linked for as long as I can remember. I’ve always been interested in how human beings deal with adversity, and, in particular, traumatic events. As a child I experienced a few near misses and I think that as I grew up it shaped how I viewed trauma and resiliency. I also had a grandfather who was a Second World War vet. Like many of his generation, my grandmother spoke about how the war changed him, and throughout his life there were nightmares and offhanded references to the war like, “It was either him or me.” He also, like many vets across time and place, struggled with alcoholism after the war. These experiences and family history dovetailed nicely with my love of history as a whole. When it came time to complete a PhD program, I knew I wanted to explore something to do with history and trauma, and since I’ve always enjoyed reading military history—which has adversity writ large into its very fabric—I chose to explore the history of trauma in the Canadian military. Over time, the project became both a professional passion and an homage to my grandfather, to whom the book is dedicated.

I wanted to tell this story, because, on top of the aforementioned experiences, I found it somewhat strange and, quite frankly, shameful that with all of the history of shell shock, battle exhaustion, and PTSD in the Canadian military no historian had tried to write an overarching story about it. I was especially concerned that modern veterans of the post-Cold War era should have their stories told, since so much of the literature still focuses on the First and Second World Wars.

What project(s) are you working on currently?

I always have several irons in the fire in various stages. Recently, I helped a retired Lieutenant Colonel [Stephane Grenier] write a memoir about his experiences during the Rwandan Genocide and attempt to change the military (and later civilian) mental health systems. I’m also working on a project that explores how Canadian soldiers have experienced war in a broader sense: what expectations they bring with them overseas, how ideas of home and away shape their tour, and what kind of coping mechanisms they use in theatre to understand what is going on around them. I also have a project in its infancy that will tell the story of VETS Canada, an organization that helps get homeless Canadian vets off the streets. It’s a very Canadian story and I can’t wait to write it. Outside of military history, I also have a few fun projects brewing, but I won’t get into those.

What do you like to read for pleasure?

If there’s one thing academia taught me, it’s that reading too much into one subject can cause a certain degree of unhealthy parochialism. For that reason, I’ve tried over the past several years to read a wide variety of books on a number of subjects in my off time. I joke with people that if they saw my bookshelf at home they’d think several different people owned it. I love gothic fiction because it explores the deep parts of the human psyche that we like to pretend don’t exist, and does so in an entertaining way. I’ve also rediscovered my love of historical biography. Reading about great figures across time really helps you to understand the human condition and how various people of different eras have both tried to shape their world and been shaped by it. One of my favourites of the past few years is The Places In Between by Rory Stewart, a book about his experiences walking across Afghanistan in 2002. The way he finds humanity in everything around him despite all the horrible things going on is inspiring, and I think it should be required reading for everyone.

One of the main ideas in your book is the constant reality of psychological injuries set against the changing terminology we use for them, from shell shock to Occupational Stress Injury. You use the term “psychological trauma.” I’m curious why you settled on that term?

That’s a tricky one. Throughout the book I was a bit loose with injury, trauma, and illness simply because it was referred to a lot and I didn’t want too much repetition for the reader. I settled on psychological trauma for the (sub)title because I believe that seeing it as psychological––that is in the mind—is crucial. We are learning a lot about brain science but the debate over what constitutes mind and what constitutes brain is still far from over. Psychological trauma affects a person’s mental state, and although one day we may discover the whole thing is physical, that doesn’t change the fact that it affects human beings. I think the human being has sometimes gotten lost in our desire to explore and explain everything in a cold, scientific, neuro-chemical way, and I didn’t want people losing sight of the fact that we are talking about people, not subjects.

What lessons do you think the Canadian military experience might offer for non-Canadian readers interested in the subject of psychological injuries?

First and foremost, I think the Canadian military’s experience with trauma, especially from peacekeeping, taught us trauma is as much a moral injury as a disorder. Peacekeepers who were trained like all soldiers to make a difference and get things done had to stand by and watch ethnic cleansing and genocide happen all around them. That inability to affect the events swirling around them felled many of them. Numerous vets had flashbacks and other signs of PTSD, but the constant references to how their experiences changed their worldview and morals were just as important. Psychiatrists have done some very important work, and the PTSD concept has helped us understand trauma and save a lot of people, but I think the Canadian military’s experience shows us that we can learn a lot and find a lot of interesting research avenues by simply listening—truly listening—to how those who have experienced trauma conceptualize it. When a veteran tells us, “I will never be the same after that tour,” we should believe them and try to understand that we might medically cure them, but they’re never going to be able to un-see the things they’ve seen. Our goal should be, in my opinion, to help them grow from those experiences. When you speak with veterans who have experienced the very worst in humanity and somehow turned things around to better themselves and others, it’s one of the most inspiring things you’ll ever come across; it’s what drove me to keep going with the research during the days when I felt like I couldn’t take listening to or reading anymore about death and destruction.

I also think that to a degree how we respond to trauma is universal. There are certainly cultural elements, but nightmares, for example, come up in most literature about war, even stretching back throughout history. The American Revolutionary War soldier Joseph Plumb Martin’s memoir, for example, discusses nightmares at one point. You can also find it in memoirs of Middle Eastern people who have come to the West and written about their experiences escaping oppression or genocide. I hope people will read The Invisible Injured and see it not just as a Canadian story, but as a case study that all of us can relate to in various ways.

Your historical account invites comparison of changing battlefield conditions from war to war. The Canadian combat soldier in Afghanistan was far less likely to be killed or physically injured than his counterpart in 1944-45 or 1914-18, and yet your last chapter suggests that a significant percentage of Canadian Armed Forces members released from 2011 to 2016 suffer some sort of psychological injury. How do you account for this? Is it even legitimate to compare the experiences of a soldier of Vimy or Normandy to those of a veteran of Haiti or Bosnia or Afghanistan? Have we as a culture become less inured to hardship and stress, or are we just more honest about the pervasive effects of stress?

This is one of the trickiest questions of all. I think to a degree that, yes, we have become less inured to stress and hardship. Death and injury were much closer to people a century ago when infant mortality rates were so high, workplaces were so dangerous, and so many things—ranging from syphilis to an infected tooth—could kill us. I remember reading in a British history of the First World War that miners in Wales had about the same chance of dying at work as soldiers on the Western Front. That really struck me, and it says a lot about how much death was a part of everyday life for communities. I think, again to a degree, you can say that yes, people a hundred years ago were more inured to pain and death, because they had to be and they experienced it often.

That being said, I think part of the answer is that up until recently most people didn’t talk about hardship or trauma with anyone except their priest or closest family and friends. I’ve heard literally hundreds of times now from families who have told me, “My father [or grandfather, uncle, brother, etc.] was very affected by the war, you could see it in him, but he almost never talked about it.” Many veterans only spoke about their experiences at the Legion with their comrades, and often only after they’d been loosened up by a few beers.[14] People dealt with the problems in their own head for the most part, and that ruined a lot of veterans and families. Talking about it more openly has allowed many people to get help of various kinds, from spiritual comfort, to psychiatric help, to peer support. That openness has saved a lot of lives. So, while I don’t want to sound like I’m fence sitting, I’d have to say it’s a combination of both factors.

One key theme in your book is gender, the construction of a supposedly healthy and positive masculinity from which chronic psychological injury is a deviation. You also note that ideas of masculinity are so embedded in the military ethos that they stigmatize those who need mental health care. Did you see any evidence of change in the last few decades as the Canadian Armed Force has tried to recruit more female members? Did you interview any female veterans, and, if so, is there a female experience of stress that is different than that of men?

Unfortunately, there just hasn’t been enough research done yet and not enough time has gone by to ascertain whether masculinity in the military has been affected by female recruitment and presence. I think there has been a small shift, but the fact that sexual harassment and assault have been perennial issues since the 1990s shows that in many ways that hard-edged masculinity is still there. Part of the challenge seems to be how can the military shape tough, stoic, and brave soldiers of both sexes without the use of a traditional macho masculinity that shuns weakness and so-called femininity? It’s often seen by many as an all-or-nothing issue, but so much of our idea of what constitutes manliness is cultural. In South Korea, for example, it’s not unusual to see young men—friends—holding hands in public or wearing colours we would consider feminine, like bright pink. To the Koreans, there is nothing feminine about it, since their culture has shaped different ideas about what constitutes masculinity. I think we need to look outside our own narrow view of traditional masculinity and understand that courage comes in many forms.

Unfortunately, my sample size of interviewees was limited to those who got in contact with me. (The methodology is explained better in the book’s introduction.) With trauma, one can’t simply cold call people and ask if they have PTSD. I was contacted by two women, one of whom backed out of the interview at the last minute, and the other, who completed the interview, is quoted near the end of the book. I tried to be constantly aware that I’m not a medically trained researcher, so the conversations were somewhat free-flowing, and that affected how much I was able to use from each interview. I think women will have a lot of important things to say on this subject, and we’ll learn a lot from them, so I’ll leave it to a keen graduate student to pick up the trail and write a dissertation or book on women’s experiences.

I noticed your discussion of recent Canadian Armed Forces history did not include the huge emphasis now placed on resilience. Early in your book you quoted Robert Manion, the First World War doctor, who wrote that stress is "a strain which [the nervous system] is unable to withstand, making it collapse instead of resiliently rebounding.” Does your research lead you to any thoughts on the possibility of making soldiers more resilient to stress and thus less susceptible to psychological injuries?

Resiliency is a key part of the equation, but I struggled with how to fit it into my overarching narrative. The literature on anything military is vast, and I had to be selective about what aspects of trauma I focused on. Again, I hope someone takes up the torch and explores resiliency in great depth, since it’s a crucial part of the equation.

My thoughts on resiliency have been shaped mainly by the subjects’ history. What you see when you look at wars and peacekeeping across time is that so much of soldiers’ resiliency seems to have come from how they were able to rationalize their experiences against a communal and national understanding of their service. Many Second World War vets struggled, but, because they were welcomed home as heroes, it seems many more of them were able to pick up and move on, even if they occasionally struggled with inner demons at home. Post-Cold War vets have a much tougher time in that regard because conflicts aren’t seen as a matter of national survival anymore, which affects the public’s engagement with them. With Afghanistan we see varying levels of support over time, and the war’s generally murky nature (and the negative outlook expressed by the media and even soldiers themselves) meant many soldiers came home feeling like they didn’t really make any difference “over there.” That inability to tie their experiences to a good versus evil or we won narrative seems to have affected some veterans’ ability to rationalize or cope with the traumatic side of service.

I think as time goes on we are going to see a discernible causal link between (historical) social support—be it communal or national—and resiliency or lack thereof. This leads us back to the idea of trauma being in many ways a kind of moral injury. Put simply, when our soldiers are supported at home they do better, and when they aren’t, it’s much tougher for them to see what they went through as something that was worth it.

Any final thoughts as to what you would you like readers to take away from your book?

I’ve gotten choked up by several emails I’ve received from veterans or their families who have read the book and said that it really spoke to them. Those letters are like gold to me. As a researcher, especially as an historian, it makes you feel great, since many people still question what the point of studying past events is and how they make any difference to the future. I’d like readers to finish the book and think, “Hmmm, history really does show us patterns that are worth exploring.” We live in a technological and scientific age, which in many ways is a good thing, but the anecdotal and narrative stories that history tells can really shed light on where we have been and where we might go from here.

Reading about trauma can tell us a lot about the human condition, and how human beings can go through the worst humanity has to offer and still come out the other side and carry on, even if they are forever changed by their experiences. I’d be most happy if readers finished and saw the very human story that is at the heart of the book. We all go through tough times of varying degrees; it’s part of being human. If we can help each other get through those times, we’ve done both them and ourselves a service. For those of us who haven’t put on a uniform, it’s a way for us to serve our country and fellow citizens in a different way.

Michael Peterson is a serving member of the Canadian Armed Forces. He teaches at the Canadian Armed Forces Chaplain School and Centre at Canadian Forces Base Borden in Ontario and is an Associate Editor for The Strategy Bridge. The views expressed in this article are those of the author alone and do not reflect those of the Canadian Armed Forces or the Canadian Government.

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Header Image: "Harvest of Battle" by Christopher Nevinson, 1918. (via Alex Browne via Made from History: The Art of World War One in 52 Paintings)

Notes:

[1] Montgomery, 34.

[2] Montgomery, 27. William Richard Bird (1891-1984) was a prolific Canadian novelist and writer. And We Go On, based on his service in World War One, was first published in 1930 and is still in print. https://www.amazon.com/We-Go-Memoir-Carleton-Library/dp/0773543961

[3] Terry Copp and Bill McAndrew, Battle Exhaustion: Soldiers and Psychiatrists in the Canadian Army, 1939-1945 (Montreal and Kingston: McGill-Queen’s University Press, 1990). https://smile.amazon.com/Battle-Exhaustion-Soldiers-Psychiatrists-1939-1945/dp/0773507744/ref=sr_1_1?s=books&ie=UTF8&qid=1526400305&sr=1-1&keywords=battle+exhaustion

[4] Montgomery, 15, 52.

[5] Montgomery, 64,67.

[6] Montgomery, 67.

[7] Montgomery, 60-61.

[8] Montgomery, 131.

[9] See also Dallaire’s 2016 book, Waiting for First Light: My Ongoing Battle With PTSD https://smile.amazon.com/Waiting-First-Light-Ongoing-Battle/dp/0345814436/ref=sr_1_1?s=books&ie=UTF8&qid=1526408231&sr=1-1&keywords=dallaire+waiting

[10] Montgomery, 139.

[11] Montgomery 177.

[12] Montgomery 178.

[13] Montgomery 209-210.

[14] The Canadian Legion is the equivalent of the American VFW.