Intended for healthcare professionals

Education And Debate

Effects of war: moral knowledge, revenge, reconciliation, and medicalised concepts of “recovery”

BMJ 2002; 325 doi: (Published 09 November 2002) Cite this as: BMJ 2002;325:1105
  1. Derek Summerfield, honorary senior lecturer (
  1. Institute of Psychiatry, London SE5 8AF
  • Accepted 1 August 2002

Western health professionals and the public have a misguided image of war and its aftermath that is often far removed from the actual experience of non-westernised societies. A British psychiatrist looks at the effects of war and at the belief that the emotional reactions of victims of war should be modified

In 1999, a survey of 600 households of Kosovo Albanians by the Centers for Disease Control and Prevention found that 86% of men and 89% of women had strong feelings of hatred towards the Serbs. Overall, 51% of men and 43% of women had a desire to seek revenge most or all of the time.1 Similar findings are seen, for example, with people from both sides of the Israeli-Palestinian conflict.2

The idea that feelings of revenge are bad for you comes from the quietist Judaeo-Christian traditions of confessing, forgiving, and turning the other cheek. The report of the Kosovan survey cast feelings of revenge as indicators of poor mental health, and it concluded by making recommendations for mental health programmes. In Croatia—a part of former Yugoslavia—a foreign led project told Croatian children affected by the war that not hating and mistrusting Serbs would help them recover from the trauma.3

In a recent study of victims of the apartheid era in South Africa—some of whom testified to the Truth and Reconciliation Commission—post-traumatic stress disorder and depression were significantly more common in those who were unforgiving towards the perpetrators than in those with high “forgiveness” scores.4 Such studies seek to give scientific weight to the notion that the mental health of victims is at risk if they do not forgive those who hurt them. The moral economy that operated during the hearings is indicated by the fact that commissioners were not uncomfortable if testifiers wept while giving …

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