Rambo and the Real-Life Struggle with PTSD: The portrayal of PTSD in fiction and the stigma attached to mental health


Even if you haven’t seen any of the films, the name Rambo will mean something. Rambo is a term that has become synonymous with gung-ho action, owing to the fictitious character’s capability of carrying out extreme violence either in war or because of war. Interestingly, First Blood, the movie that spawned the Rambo franchise, is based on the anti-war novel by David Morrell, a powerful study of how war can affect the mind and the sometimes longer-lasting effects.

Combat related stress is nothing new, diagnosed as ‘shell shock’ in the Great War and documented as far back as Ancient Greece in Homer’s epic poem, Odyssey, in the aftermath of the Trojan war. The term PTSD, however, didn’t exist when David Morrell started his novel in 1968. At the time, American psychiatrists were just beginning to get to grips with a combat related condition that they recognized was becoming more frequent and more acute in returning service personnel from Vietnam. The dynamic in Morrell’s book is altered for the film version to accommodate a wider audience. Fair enough, I suppose, but it’s just another example of how contemporary fiction, whether portrayed in books or on screen, uses PTSD for dramatic effect while ignoring the underlying issues. It’s visual and adds to the drama. Symptoms like violent outbursts can enhance a scene while a flashback serves as a valuable tool for plot development. But there’s usually little or no reference in the narrative to the condition itself. A useful prop bereft of any psychological analysis.

The oppressing effect war can have on the mind was captured in the poetry of Wilfred Owen. Owen suffered shell shock fighting in the Battle of the Somme and the nightmares that he experienced afterwards had a major influence in his writing. Owen found a way to articulate his war experience, not what happened but how he felt about it, like in the poem Strange Meeting, a haunting insight into the psychological impact of warfare. But many who suffer a traumatizing event, men in particular, find it difficult to express their feelings. There’s still a lot of stigma around PTSD, especially among veterans. It’s something rarely discussed in macho environments and it’s something Hollywood often glosses over. A common theme with mental health problems in fiction is that the drama is in the crisis and not in the treatment. PTSD symptoms are viewed almost like personality traits, advancing the plot but rarely explored. Rambo, on the big screen at least, is largely portrayed as an out-of-control killing machine, his psychological imbalance seen as just part of his character. But it’s important to point out that PTSD is very amenable to therapy. Focusing solely on the “sensational” lowlights comes at the expense of highlighting the whole PTSD journey including the treatment. Most veterans resolve their symptoms by seeking counselling. Just talking about it can help.

The Rambo franchise has been built on the effect war has had on one man.  But there are no Rambos in war, just human beings made of flesh and bone who can be destroyed by what they experience in combat as much as by the bullets and bombs they face on the battlefield. The road to recovery is just as important as the destruction and orgy of chaos that fiction often throws up.