Social Science & Medicine xxx (2010) 1e7

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Social Science & Medicine

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Suicide, social integration, and masculinity in the U.S. military

Harold Braswell a, *, Howard I. Kushner a, b
a
Graduate Institute of the Liberal Arts, Emory University, United States
b
Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE 5th floor E., Atlanta, GA 30322, United States

a r t i c l e i n f o a b s t r a c t

Article history: Reports indicate that suicide in the U.S. military has increased significantly in recent years. This increase has
Available online xxx been attributed to a number of factors, including more frequent deployments, more relaxed screening of
recruits, combat trauma, economic difficulty amongst soldiers, and the breakdown of interpersonal rela-
Keywords: tionships. In this article, we add an element that we believe is crucial to an understanding of military
Suicide suicide: the socio-cultural environment of the military itself. In particular, we examine the role that the
Military suicide
masculine ideologies governing military life play in the internalization of individual frustrations and in
Durkheim
suicidal behavior. Suicide investigators often have ignored the role of masculine ideologies in military
Social capital
Social integration
suicide because of the assumption that suicide results from social disintegration. In contrast, we argue that
Masculinity military suicide is driven largely by excessive social integration. From this perspective, current explanations
Positive psychology of military suicide are constrained by gender and etiological assumptions. Finally, this paper suggests the
Trauma implications of these findings for designing more effective prevention programs for military suicide.
USA Ó 2010 Elsevier Ltd. All rights reserved.

Introduction (Carden, 2010); this combat situation notwithstanding, suicide rates

In 2006, the U.S. Army suicide rate rose to 17.5 suicides per
100,000 active-duty soldiers (Jelinek, 2007). This figure surpassed
the previous record of 15.8 per 100,000 in 1985 (Associated Press,
2006) to become the highest annual suicide rate since the Army
began tabulating statistics in 1980 (Jelinek, 2007). This record-high
figure was not an aberration. Army suicides had risen steadily since
2002 (Associated Press, 2006; Martinez, 2003) and would continue
to rise after 2006, with each subsequent year establishing a new
record suicide rate: 18.1 per 100,000 in 2007 (Alvarez, 2008) and
20.2 per 100,000 in 2008 (Alvarez, 2009). In 2009, 160 soldiers took
their lives, bringing the suicide rate up to 21.7 per 100,000, another
record-high (Kovach, 2010; Thompson 2010).
The rise in the suicide rate among active-duty soldiers is not
limited to the Army. The Air Force suicide rate rose to 13.7 per
100,000 in 2009 from 12.5 in 2008 (Spoth, 2010). The Navy rate
increased from 11.6 per 100,000 in 2008 (Faram, 2009) to 14.5 per
100,000 last year (Spoth, 2010). The suicide rate among active-duty
Marines rose to 24 per 100,000 in 2009, up from 21.7 per 100,000 the
previous year (Kovach, 2010). The higher rates of suicide among the
Army and Marines have been attributed to these branches being
significantly more involved in combat in Iraq and Afghanistan
* Corresponding author. Tel.: þ1 404 727 9523; fax: þ1 404 727 1369.
E-mail addresses: hsbrasw@emory.edu (H. Braswell), hkushne@emory.edu (H.I.
Kushner).
have historically been highly comparable across branches (Eaton,
Messer, Wilson, & Hoge, 2006) and, indeed, have consistently risen
across all branches over the past four years (Carden, 2010). The
relative uniformity of these increases has led the military to view
suicide as a problem that affects all branches of the armed services. In
the words of Mike Mullen, the current Chairman of the Joint Chiefs of
Staff: “This isn’t just a ground-force problem” (Carden, 2010).
These increases in military suicide rates have been striking, even
given the notorious difficulties in determining accurate statistics for
military suicide. First, suicides among military personnel are
frequently misclassified as deaths from accidents or undetermined
causes; such classification errors may lead military suicide totals to be
as much as 21% higher than reported (Carr, Hoge, Gardner, & Potter,
2004, p. 233). Second, accurate civilian and military population
comparisons require adjusting statistics to account for the military’s
disproportionately large population of young adult males. Such
adjustment can strikingly lower the difference between military and
civilian populations: Eaton et al. (2006, p. 187) argue, using demo-
graphically adjusted statistics, that between 1990 and 2000, figures
for military suicide were 20% lower than civilian totals (approxi-
mately 12 per 100,000 for the civilian population, while under 10 for
all branches of the military). Such adjustments likewise lower the
difference between current military and civilian rates: Alvarez (2009)
reports that the adjusted rate of civilian suicide is 19.2 per 100,000,
a total that, while still notably lower than current Army and Marine
rates, would remain higher than rates in the Navy and Air Force.

0277-9536/$ e see front matter Ó 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.socscimed.2010.07.031

Please cite this article in press as: Braswell, H., Kushner, H. I., Suicide, social integration, and masculinity in the U.S. military, Social Science &
Medicine (2010), doi:10.1016/j.socscimed.2010.07.031
2 H. Braswell, H.I. Kushner / Social Science & Medicine xxx (2010) 1e7
However, regardless of these difficulties, rates of military suicide
have consistently and dramatically risen in recent years while
civilian totals have remained relatively stable at around 11 per
100,000 (McIntosh, 2009; Thompson, 2010). These increases in
military suicide rates have led a number of experts and commen-
tators to refer to military suicide as a “hidden epidemic” (Sklar,
2007). The origins of this epidemic have proven difficult to detect.
The tangled etiology of an epidemic
Investigators of military suicide have been cautious about
attributing this putative epidemic to a single cause (Stewart, 2009).
Increasing suicide rates have been connected with the stress of
longer deployments and increasing exposure to combat (Stewart,
2009). More urgent personnel needs have led the military to
loosen its recruitment standards and to enlist and, in many cases,
repeatedly deploy, individuals whose preexisting mental illnesses
and substance abuse problems may place them at a high risk for
suicidal behavior (Chedekel & Kauffman, 2006). Economic and
marital problems have also been shown to compound soldiers’
suicide risk (Goode, 2009). Finally, the military’s “warrior culture”
has been thought to discourage soldiers from speaking openly
about their psychological and emotional fragility (Alvarez, 2009;
Dinges & Mueller, 2009). This inhibits the ability of mental health
practitioners to recognize suicidal individuals and hinders the
healing process necessary to overcome suicidal ideation and post-
traumatic stress disorder (PTSD) (Alvarez, 2009; Dinges & Mueller,
2009). The lethality of all of these factors is significantly magnified
by the ready access to firearms characteristic of military life
(Mahon, Tobin, Cusack, Kelleher, & Malone, 2005; Martin,
Ghahramanlou-Holloway, Lou, & Tucciarone, 2009).
These approaches have addressed suicide as an individual
phenomenon that results from the manner in which particular
soldiers respond to understandably trying circumstances. In this
paper, in contrast, we will focus on the social/cultural framework in
which military suicide occurs. As sociologist of suicide Douglas
(1967) argued long ago, the impact of social events on individual
behavior is determined by the meaning that individuals give to those
events. This meaning is always mediated by a combination of indi-
vidual interpretations and the socio-cultural contexts in which they
take place. But while current explanations for military suicide have
studied how military culture may inhibit individuals from seeking
treatment for suicidal ideation, they have not studied how this
culture structures the meaning of suicide itself. Here, we provide
a starting point for understanding how the socio-cultural environ-
ment of the military might increase suicide among its members.
Part of the reason why current explanations of military suicide
have not examined the negative impact of military culture on
suicidal behavior is because they are implicitly framed by the
assumptions underlying contemporary theories of suicide more
generally. Most of these theories assume that integration into social
groups is protective against suicide. This assumption was first and
most famously enunciated in 1897 by Durkheim (1951), who argued
that declining social cohesion results in increased individual alien-
ation and egoism, which exacerbate the risk of self-destructive
behaviors. Durkheim’s theory of the protective nature of social
integration forms the foundation for what has become known as
social capital theory, about which we will have more to say later on.
As such theories take for granted the protective aspects of socio-
cultural groups, they never consider the possibility that social
integration could contribute to suicidal behavior.
Nevertheless, the history of suicide within Western military
populations provides evidence of the potential risks of social inte-
gration. While currently high rates of military suicide may seem
a historical anomaly, suicide rates among military populations were
Please cite this article in press as: Braswell, H., Kushner, H. I., Suicide, social integration, and masculinity in the U.S. military, Social Science &
Medicine (2010), doi:10.1016/j.socscimed.2010.07.031
relatively even higher in 19th century Europe. These high rates of
military suicide posed an important theoretical problem for 19th
century suicidologists: How could individuals integrated into one
of the most socially cohesive organizationsdthe militarydhave
such high rates of suicide if social integration was protective against
suicide?
We focus on how Durkheim addressed this problem. Durkheim
attempted to rationalize high rates of military suicide with his
theory of the protective nature of social integration by classifying
such suicide as “altruistic”. However, our interpretation of Dur-
kheim’s data suggests that most military suicides should have been
classified within Durkheim’s typology as “fatalistic”: that is, as
resulting from integration into constraining social groups. Drawing
on the findings of historian Lane (1979) and other more recent
suicidologists, we argue that fatalistic social integration has been
a crucial factor in suicide among population groups. This perspec-
tive provides a useful context for understanding military suicide.
Drawing on various studies of the military, we argue that Dur-
kheim’s conception of fatalism maps remarkably well onto the
rigidly disciplinary and emotionally constraining character of
military life. We link these controlling elements to the military’s
conception of gender, particularly the ideology of masculinity that
structures military culture. Understanding the role of masculine
fatalism in military suicide provides a valuable starting point for
rethinking current suicide prevention strategies.
Durkheim, fatalism, and the problem of military suicide
The problem of military suicide is not new. During the 19th
century official statistics from European countries consistently
reported that the highest rates of suicide were in the military. This
was well-known and often remarked on by suicide experts,
beginning with Esquirol (1838), leader of the French asylum
movement. By 1879 Morselli (1881, p. 256), professor of psycho-
logical medicine at the Royal University of Turin, noted that “in
almost all the statistics. the heaviest tribute to suicide is paid by
the military; in Italy, whilst on the total of the population they
constitute 5 per 1000, the suicides amount to 70 per 1000, that is to
say, to a ratio fourteen times larger”. The Czech academic Masaryk
(1970, p. 171) reported similar rates in the Austro-Hungarian mili-
tary. By the beginning of the 20th century the British commentator
Skelton (1900, p. 473) found that the rates of military suicide were
“truly appalling”. According to Skelton’s figures, from 1860 to 1888
the mean annual rates of military suicide per 1,000,000 were as
much as seven times that of their civilian counterparts in Italy,
three times as numerous in England and Prussia, and twice as high
in France (Skelton, 1900, p. 467, 474).
Nineteenth-century experts were divided on the causes of such
high suicide rates among military populations. Many commenta-
tors, such as Morselli (1881, p. 374) and Masaryk (1970, p. 171)
attributed these high rates to the encroachment of modern values
on traditional social structures like the military. But others, like
Esquirol (1976, p. 590) and Skelton (1900, p. 475), blamed military
culture for devaluing individualism and individual lives. As we
mentioned earlier, Durkheim endorsed the widely held view that
increasing suicide rates were due to modernity’s destruction of
traditional society. But he also recognized that military culture
might itself contribute to increased suicidal ideation among
soldiers. He resolved this contradiction by arguing that military
suicide resulted from the opposite social processes that he identi-
fied as responsible for the general increase in suicide rates. In order
to understand how Durkheim resolved this issue, it is necessary to
briefly explore his larger theory of suicide.
Consistent with many late 19th century medical and psychological
thinkers, Durkheim believed that psychiatric and physiological
 H. Braswell, H.I. Kushner / Social Science & Medicine xxx (2010) 1e7
disorders were bred and exacerbated by the “hypercivilization” of
urban society (Nye, 1982). Modernity, for Durkheim, destroyed
traditional social structures, such as the family. This destruction
resulted in increased levels of social pathology, including suicide,
homicide, and divorce. Consequently, Durkheim concluded that
integration into traditional social groups was protective against
suicide; this “integration” in Durkheim’s view entailed incorporation
into social norms on both an institutional and ideological level. Such
an explanation involved devising a typology that would not only
explain the putatively high rates of suicide among modern, urban
populations, but also could show that suicide among populations
well-integrated into more “traditional” social groups, such as the
family, the Church, and the military, were comparatively marginal
phenomena.
The purpose of Durkheim’s well-known suicide typology/clas-
sification system was to separate out those suicides which could be
attributed to the social disintegration of modern life from the forms
of suicide characteristic of traditional social systems. Durkheim
(1951) described four types of suicide: altruistic, egoistic, anomic,
and fatalistic. The rate of anomic suicide measured the alienation of
individuals isolated from the traditional social fabric. Egoistic
suicide was the product of individuals who acted without self-
restraint as a result of their no longer being checked by traditional
moral structures. Thus, as Durkheim defined them, both anomic
and egoistic suicide resulted from a lack of integration into tradi-
tional social orders. They cohered perfectly with his larger theory of
suicide’s origin in social disintegration.
Altruistic and fatalistic suicides, in contrast, were forms of suicide
characterized by a high level of social integration. Altruistic suicide
reflected heroic sacrifice that individuals made in order to preserve
and protect the communities of which they formed a part. Fatalistic
suicide, on the other hand, as Durkheim (1951, p. 276) explained in
a footnote, “derives from excessive regulation, that of persons with
futures pitilessly blocked and passions violently choked by
oppressive discipline”. Durkheim (1951, p. 276) declined to look in
detail at fatalistic suicide because he claimed that “it has so little
contemporary importance and examples are so hard to find. that it
seems useless to dwell upon it”. As a result, Durkheim considered
suicides caused by social integration to be extremely marginal. They
were either heroic and to be celebrated (in the case of altruistic
suicide) or rare anachronisms, foreign to the modern world (as in the
case of fatalistic suicide).
The high rates of military suicide posed a challenge to Dur-
kheim’s theory of suicide. The presence of suicide in the highly
structured environment of the military seemed to contradict Dur-
kheim’s insistence that increases in suicide resulted from the
alienation and egoism brought on by social disintegration. To
explain this contradiction, Durkheim classified military suicide as
“altruistic”. As a result, the high rates of military suicide could no
longer be attributed to oppressive social groups. Rather, they were
an index of the military’s success in encouraging the sacrifices
necessary for combat efficiency.
However compelling this explanation may seem, Durkheim’s
classification of military suicide as “altruistic” ignored the fact that
the deaths of soldiers who sacrificed their lives for their military
comrades in battle were never categorized as suicides in any official
statistics (Besnard, 1973; Kushner & Sterk, 2005). Indeed, to be
reported as a suicide, a military death would have to occur outside
a combat situation. Therefore, Durkheim’s classification of military
suicide as “altruistic” was a non sequitur which performed the task
of reconciling the contradiction between the high rates of military
suicide and the military’s cohesive social environment. Classifying
military suicides as altruistic allowed Durkheim to recognize the
high rates of military suicide without questioning his claim of the
protective nature of social integration.
Please cite this article in press as: Braswell, H., Kushner, H. I., Suicide, social integration, and masculinity in the U.S. military, Social Science &
Medicine (2010), doi:10.1016/j.socscimed.2010.07.031
3
The problem was that Durkheim’s description and discussions of
military suicide fit more comfortably into his category of fatalism
than altruism. Durkheim’s definition of fatalistic suicide as resulting
“from excessive regulation,” in which the individual’s “passions
[were] violently choked by oppressive discipline” (Durkheim, 1951,
p. 276) seemed to describe nineteenth-century military life
perfectly. Durkheim’s understanding of official statistics and his
own typological definitions could have led him to classify military
suicide as fatalistic (Besnard, 1973; Kushner, 2008). Given the
reported incidence of military suicide, Durkheim could have
concluded that fatalism was the most important type of suicide. But
had he done so, Durkheim would have called into question his wider
conceptual framework that assumed that traditional social envi-
ronments were protective. Classifying military suicide as “altruistic”
provided Durkheim with a way to acknowledge the high rates of
military suicide without compromising his larger theory. But, while
Durkheim was unwilling to link fatalistic social integration to mili-
tary suicide, others have done so.
Fatalism, social integration, and military suicide today
The work of historian Roger Lane is a particularly important
landmark in forming a theory of fatalistic suicide. Lane analyzed
19th century mortality data to conclude that, as AfricaneAmerican
Philadelphians became more socially integrated, their suicide rates
increased; therefore, homicide, not suicide, seemed to be related to
social disintegration (Lane, 1979). Lane interpreted these data by
highlighting the mediated nature of individual response to frus-
trating circumstances. In highly integrated environments, individ-
uals responded to adverse circumstances by internalizing their
anger. They did not lash out against the social order because they
shared its fundamental values. Instead, they understood failure to
be the result of personal shortcomings. As a result, their frustration
became self-directed, with suicide as the result. Homicide func-
tioned in precisely the opposite manner. It was a product of the
individual’s alienation from society. Rather than turning anger to
themselves, they externalized it, placing the blame on the society
from which they were excluded. The result of this alienation was
therefore homicide, not suicide. Suicide, according to Lane, was
characterized by a high level of integration into a constraining
environment, or what Durkheim had labeled fatalism.
Lane’s theory of the relationship between suicide and social
integration has been confirmed in recent studies of female suicide
rates. While Durkheim and his followers downplayed female suicide
due to their belief that the aforementioned family structures would
be protective, recent scholarship, including our own, has found that
women subsumed in traditional social groups are particularly at risk
(Canetto, 2008; Ji, Kleinman, & Becker, 2001; Johnson, 1979;
Kushner, 1995, 2008; Kushner & Sterk, 2005; Steinmetz, 1894). In
other population groups, social integration has also been found to
have damaging effects. Kunitz (2004) has recently concluded that
tight social relations within extended Navajo families in the U.S.
southwest often resulted in negative health outcomes, including
significantly higher rates of depression and self-destructive behav-
iors. Based on these studies, it is possible to conclude that social
integration can, in some cases, induce suicidal behavior.
The connection between fatalistic social integration and suicide
remains ignored because of its incompatibility with social capital
theory, the predominant theoretical model in contemporary public
health. Although social capital has a variety of contested definitions
(Durlauf, 2002; Whitehead & Diderichsen, 2001), there is a general
consensus that it encompasses community networks, civic
engagement, civic identity, reciprocity, and trust (Campbell, Wood,
& Kelly, 1999; Putnam, 2000). The accumulation of such “social
capital” is understood to be protective against a number of negative
4 H. Braswell, H.I. Kushner / Social Science & Medicine xxx (2010) 1e7
health effects, including suicide (McKenzie & Harpham, 2006;
Sartorius, 2003). This view is implicitly and often explicitly based
on Durkheim’s theory of the protective nature of social integration
(Berkman & Glass, 2000; Kawachi, Subramanian, & Kim, 2008;
Turner, 2003).
As a result of the hegemony of social capital theory, investigators
today continue to operate under the assumption that social integra-
tion is protective against suicide. Thus, the putatively low levels of
suicide among military populations have been ascribed to the mili-
tary’s cohesive social environment (Mahon et al., 2005; Martin et al.,
2009; Rothberg, Bartone, Holloway, & Marlowe, 1990). Similarly,
commentators have explained current rates of military suicide
through a theory of social disintegration, in which longer deploy-
ments have eroded traditional family structures and social connec-
tions (Stewart, 2009). As such, both the military’s previously low and
its currently high suicide rates can be attributed to a decline in social
integration.
Nevertheless, we believe that such an explanation ignores that
such a loss of connections outside of the military is accompanied
and, in part, caused by an increasing integration into the military
itself. As a result of the current wars, soldiers frequently have less
lag time between deployments and are redeployed multiple times
(Carden, 2010; Stewart, 2009). While the effects of these repeated
deployments on suicide have yet to be definitively determined
(Carden, 2010; McMichael, 2009), whatever decrease they provide
in integration into structures external to the military would be
proportional to their increase in soldiers’ integration into military
society itself; at war, the military functions much more like a “total
institution” (Goffman, 1961) than during peacetime and thus would
have a significantly higher level of social cohesion. Increasing rates
of suicide would be consequently correlated with increasing inte-
gration into the military.
Understanding the potentially detrimental effects of such inte-
gration involves turning contemporary theories about the benefits
of social integration on their head. Fortunately, even as Durkheim’s
account of suicide has provided the basis for such theories, his
description of fatalism provides a powerful tool to explain how social
integration can contribute to suicide. Nevertheless, before we can
apply this analysis to the military, we need to examine whether the
military can be described as a “fatalistic” social institution.
Masculine fatalism: the gender dynamics of military suicide
While it might seem difficult to speak about a unified military
culture, several scholars of the military argue that military
communities have similar basic social arrangements across cultures
and throughout modern history (Goldstein, 2001; Kovitz, 2003).
Military culture is consistently characterized by an extremely high
level of social cohesion. This cohesion is considered essential to
a unit’s operational efficiency. As Stewart (1991, p. 17) emphasizes
in her study of social cohesion in the Falklands War, “[r]esearch has
repeatedly shown that there is a strong relationship between
cohesion, soldiers’ level of morale, and combat efficiency”.
Military cohesion is created by socialization ritualsdmost
prominently, basic trainingdthat take “[d]isparate men from varied
socioeconomic backgrounds, of different ethnic origins and levels of
education [and make them into] not just a collection of individuals
but a unit in which an individual will sacrifice his life and die in order
to preserve the group” (Stewart, 1991, p. 17). The creation of social
cohesion thus entails an almost total subordination of the individual
to the group. Identity itself is rewritten through the “depersonal-
ization and deindividuation in which the military, in the form of
drills sergeants, must strip the individual of all previous self-defi-
nition” (Herbert, 1998, p. 9). Without such a subordination of the
Please cite this article in press as: Braswell, H., Kushner, H. I., Suicide, social integration, and masculinity in the U.S. military, Social Science &
Medicine (2010), doi:10.1016/j.socscimed.2010.07.031
individual to the group, the military’s culture of self-sacrifice might
not be able to function.
To build this social capital, the military submits individuals to an
extremely constraining environment that is ruled by a hierarchical
disciplinary structure (Ben-Ari, 1998; Goldstein, 2001). The foun-
dation of this structure is control: Recruits are taught to master the
external situation in which they find themselves through a process
of gaining control over their own emotions (Ben-Ari, 1998;
Goldstein, 2001; Harrison, 2003). As a result, any emotional or
situational flexibility is discouraged. This rigid, controlling char-
acter of military social organization identifies it as an institution
with a “fatalistic” character, even as it shows that this “fatalism”
may be more intertwined with the encouragement of “altruistic”
self-sacrifice than Durkheim’s initial typology would suggest.
Gender identity is central to the formation of social capital in the
military. Even Stewart (1991, p. 89), whose study does not employ
“gender” as a central analytic, describes the military as a “cult of
masculinity”. Melissa S. Herbert (1998, p. 7), in her study of female
soldiers, notes that the masculine nature of military society has been
so widely recognized that there is “little dispute” over the matter.
She argues that the specificity of the military is that it is “structured
along the lines of gender, not age, race, or physical fitness” (Herbert,
1998, p. 7). It is by emphasizing masculinitydand rigidly separating
the male from the femaledthat the military creates social capital
from a group of soldiers whose economic statuses, ethnicities, and
ideologies might otherwise place them in conflict with one another
(Herbert, 1998; Stewart, 1991). Masculine unity thus forms the
“cementing principle” of military life (Harrison, 2003, p. 75).
Ideals of masculinity are practically indistinguishable from the
most fatalistic aspects of military social organization. Herbert
(1998, p. 9) describes basic training as “the male equivalent of
‘finishing school’” whose stated goal is not only to transform
“civilians into soldiers,” but also “boys into men”. Ben-Ari (1998),
Goldstein (2001), and Hockey (2003) argue that the military ideal
of emotional control is inseparable from its notion of masculinity.
Citing Gilmore (1990), Ben-Ari also emphasizes the masculine
character of the military’s training of the individual to view his life
as expendable to the larger group:
[Gilmore’s] first proposal is that the core notion related to being
a warrior is the acceptance of men’s expendability. The idea is
that to be men, individuals must accept the fact that they are
dispensable.. From a social point of view, Gilmore goes on to
contend, ideals of ‘real manhood’ should be seen as inducements
to carry out collective goals because of the universal urge to flee
from danger (Ben-Ari, 1998, p. 112, citing Gilmore, 1990, p. 121).
Masculine ideals of expendability are thus fundamental to the
formation of socially cohesive groups in which individuals are
regularly willing to risk their lives. Fatalistic devaluation of indi-
vidual life dovetails with the meaning of manhood.
Whitworth (2008, p. 109) argues that the military’s masculine
ideology leads it to deny the prevalence of PTSD among its soldiers.
For Whitworth, to be traumatized subverts the emotional control
characteristic of military masculinity; thus, traumatized soldiers
are stigmatized and, indeed, feminized within their units and the
military as a whole has difficulty accepting the ubiquity of PTSD
among its ranks (Whitworth, 2008, p. 110). This link between the
military’s masculine culture and the denial of trauma and, more
generally, mental healthcare has, as we have noted, been openly
acknowledged by military personnel attempting to address the
current problem of military suicide. Nevertheless, here we suggest
that this argument could even be taken a step further: The mili-
tary’s ideology of masculine fatalism not only denies the damage
that soldiers suffer in combat, but also can itself take a significant
toll on the physical and psychological health of the troops.
 H. Braswell, H.I. Kushner / Social Science & Medicine xxx (2010) 1e7
Goldstein (2001, p. 269), in his extensive interdisciplinary
investigation of gender ideologies and practices in the military, has
linked masculine emotional control to the traumatic responses that
lead to suicidality:
Emotional shutting-down comes at a price. Biology endows us
with a range of emotional responses because they are useful in
a complex language-using social species whose members
depend on each other’s cooperation. To truncate this range of
responses e such as by losing the ability to cry e diminishes
a society.. [As a result of their suppression of emotions,] [y]
oung men then face a dilemma: pay the price of a warrior
mentality e anxiety, PTSD, emotional difficulties in relation-
ships e or pay the price in humiliation and shame that faces the
sissy as a failed man.
The masculine fatalism of the military thus places soldiers in
a particularly arduous double-bind: It traumatizes them and then,
by feminizing their trauma, reinforces its most damaging aspects.
This emotional shutdown, combined with the aggressive character
of military socialization, could lead to violent outbursts. Harrison
(2003) has linked the controlling aspects of military socialization
to the high rates of spousal abuse among current and former service
members in Canada. Combined with a culture that subordinates the
individual to the group, this aggression may be internalized,
leading individuals to castigate themselves for having failed the
community. The result could be higher suicide rates.
Finally, it has been argued that the relatively recent inclusion of
women in combat and the potential inclusion of openly gay and
lesbian soldiers may challenge the masculine model of social
integration that structures military life (Goldstein, 2001; Herbert,
1998; Kovitz, 2003). Certainly the considerable initial reluctance
that the military has shown toward including women and openly
lesbian and gay soldiers is frequently justified by the presumed
threat they pose to social cohesion (Hockey, 2003). And, as
Herbert’s (1998) careful study shows, the presence of females and
sexual minorities among the troops will, almost inevitably, be
perceived as a subversion of gender norms. Nevertheless, we
believe that such inclusion, by itself, will not be sufficient to change
the military’s culture of masculine fatalism.
First, though women have long served in the Army and currently
make up 15% of U.S. forces in Iraq and Afghanistan (Blank, 2008),
recent reports attest to their continued marginalization within
Army ranks (Bendict, 2009). Whitworth (2008, p. 119) has argued
that women in the military are marginalized because they violate
“one of the premises of military indoctrination: the myth of an
exclusively male-dominated world”. As a result of their trans-
gression, not only are women excluded from key aspects of military
life, but they are also subjected to violence with great frequency. As
Whitworth (2008, p. 119) notes “[r]ecent studies in the USA indicate
that between 43 and 60 percent of female enlisted personnel
experience some form of physical or sexual harassment or
violence”. This physical and sexual abuse attests to the exclusion of
women within the military.
This exclusion may be confirmed by differential suicide rates for
men and women in the U.S. military. Between 1980 and 1992, for
example, the suicide rate for men in the military was 2.5 times
greater than that for women (12.5e5.5 per 100,000 person-years);
during this period, however, the homicide rate for women was
slightly higher than that for men (6.5e5.5 per 100,000 person-
years) (Powell, Fingerhut, Branche, & Perrotta, 2000, p. 28). While
there has not been a more recent study of gender differences in
military suicide rates, last year’s Army suicide totals indicate that
a proportionately greater amount of men than women committed
suicide (97.5% of suicides were male, while women make up
approximately 15% of active-duty Army personnel) (Curphey, 2003;
Please cite this article in press as: Braswell, H., Kushner, H. I., Suicide, social integration, and masculinity in the U.S. military, Social Science &
Medicine (2010), doi:10.1016/j.socscimed.2010.07.031
5
US Army, 2010; Williams, 2005). Nevertheless, the putatatively
higher rates of suicide among male troops and homicide among
females would have to be confirmed in a more extensive study and,
in any case, are almost certainly influenced by the exclusion of
women from combat (Tyson, 2005). However, were these differ-
ential suicide and homicide rates confirmed, they could be read
through our account of fatalistic integration as evidence of the
impact of women’s exclusion from military social groups: As
a result of their exclusion, women in the military may be more
prone to externalize their frustration via homicide, rather than
internalizing it (as do men) via suicide.
We are also concerned with what might happen when women
successfully become incorporated into the military. Such integra-
tion will not, by itself, undo the most damaging aspects of military
masculinity. Biologically sexed women can perform masculine
gendered acts with equal proficiency to men. A disturbing example
of this potential for masculine performance is the participation of
female soldiers in the torturing of Iraqi prisoners in Abu Ghraib
prison. As feminist commentators have noted (McKelvey, 2007), the
female soldiers at Abu Ghraib joined their male comrades in
explicitly feminizing their Iraqi victims. Through this feminization,
they degraded their prisoners and affirmed their own identity as
masculine soldiers. While extreme and certainly atypical, the
example of Abu Ghraib should remind us that simply including
women in the military will not necessarily mitigate the most
damaging aspects of military masculinity. Tapering the effect of
masculine fatalism on suicidal behavior will thus entail addressing
military culture directly.
Conclusion
In this article, we have argued that social integration into the
military’s fatalistic masculinity is a key factor in the currently
high rates of military suicide. The components of this conclusion
are, by themselves, neither novel nor controversial. Suicidologists
have called for more attention to the socio-cultural dimensions of
self-killing (Canetto, 2008). Fatalistic social integration has been
linked to previously high rates of suicide in the military, as well
as other population groups. And scholars of the military have
emphasized the fatalistic aspects of military masculinity. This
paper goes further by explicitly connecting integration into the
military’s masculine social norms to suicide. We believe that this
gender analysis can contribute significantly to understanding
military suicide and designing more effective suicide prevention
interventions.
As we mentioned earlier, a number of explanations have been
offered for the currently high rates of military suicide, including:
longer and more frequent deployments, less rigorous screening of
incoming troops, economic difficulties, marital (and more generally
relational) problems, and combat trauma (Alvarez, 2009; Goode,
2009; Stewart, 2009). While these risk factors have been consid-
ered in relative isolation from one another, a gender analysis
reveals how they may be connected to the military’s masculine
culture. For example, the stigmatization of trauma and mental
health care in the military may be tied to a philosophy of masculine
self-reliance and emotional detachment (Whitworth, 2008). These
same values may impair the ability of soldiers to retain romantic
relationships, possibly even heightening their potential for abuse
(Harrison, 2003). Military masculinity could lead soldiers to inter-
nalize their frustration at their economic difficulties, even as it
discourages them from seeking potentially life-saving psycholog-
ical health. More frequent deployments might only worsen these
factors by heightening soldiers’ integration into the military’s
fatalistic gender identity. Our gender analysis of military suicide
thus complements and deepens other studies by illustrating how
6 H. Braswell, H.I. Kushner / Social Science & Medicine xxx (2010) 1e7
risk factors that previously had been considered in isolation are
connected to the military’s gendered socialization practices.
A gender approach also illuminates the social nature of indi-
vidual psychodynamics. In an insightful paper, Anestis, Bryan,
Cornette, and Joiner (2009) argue that suicidal ideation among
post-deployment soldiers is determined in large part by the indi-
vidual’s sense of thwarted belonging in communal life as well as his
or her impression of being a burden on others. In the case studies
they discuss, this “thwarted belongingness” (Anestis et al., 2009, p.
66) was related to difficulties that soldiers faced communicating
their emotionally-charged combat experiences to others. As such, it
may have been influenced not only by the experience of combat, but
also by the emotional detachment characteristic of military mas-
culinity (Ben-Ari, 1998; Goldstein, 2001; Harrison, 2003). Similarly,
the tendency to view oneself as a burden could be intensified by
integration into a social group that, as Ben-Ari (1998, p. 112) has
pointed out, is predicated on the subordination of the individual to
the community. Effective suicide prevention interventions should
be attuned to the social and gendered nature of the psychological
traits that place individuals at risk for suicide. Ignoring such social
and gender context could be disastrous.
We are particularly concerned with the Army’s recently adopted
program to curb its escalating suicide rate. In August 2009, the
Army announced that it planned to have all 1.1 million of its soldiers
take an intensive course designed to increase their mental and
emotional resilience (Carey, 2009). Named the “Comprehensive
Soldier Fitness Program,” the course is based on the research of
University of Pennsylvania psychologist Martin E.P. Seligman,
whose school of “Positive Psychology” teaches individuals to react
to negative stimuli in positive and empowering ways (Carey, 2009;
Dinges & Mueller, 2009). Seligman describes the program as an
attempt to change trauma from an experience that destroys the self
into one that fortifies it. “The idea here,” according to Seligman, “is
to give people a new vocabulary, to speak in terms of resilience.
Most people who experience trauma don’t end up with P.T.S.D.;
many experience post-traumatic growth” (Carey, 2009). By
teaching soldiers to have a positive response to trauma, the military
aims to reduce suicide rates. But such an approach may have
unintended consequences.
As Ehrenreich (2009) has recently noted, Positive Psychology is
predicated on two related understandings of “positive” emotions,
such as happiness. First, it argues that having a positive emotional
disposition will improve individual health and decrease the trau-
matic effects of life experiences. Second, it asserts that such positive
dispositions are within the individual’s control; therefore, trau-
matic reactions are not the product of circumstances, which “play
only a minor role in determining a person’s happiness” (Ehrenreich,
2009, p. 171), but rather of the individual’s own temperament. By
changing this temperament, trauma can be greatly reduced, inde-
pendent of life circumstances.
Our concern with the application of Positive Psychology to
a military population is that it may inadvertently reinforce the most
fatalistic aspects of military life. Like masculine fatalism, Positive
Psychology is predicated on the practice of rigid emotional control.
Rather than giving soldiers a richer vocabulary to explore their
trauma, Positive Psychology teaches traumatized individuals to deny
their trauma. The implication of this method is to pathologize not
only traumatic life circumstances, but also negative responses to these
circumstances. By pathologizing traumatic responses, Positive
Psychology may deny individuals the legitimate mourning process
that follows traumatic loss (Dobbs, 2009; Horwitz & Wakefield, 2007;
Kushner, 1991). Furthermore, through its view that emotional
response is not contingent on circumstance, but on individual
disposition, Positive Psychology may stigmatize those individuals
who are traumatized and are incapable of willing themselves out of
Please cite this article in press as: Braswell, H., Kushner, H. I., Suicide, social integration, and masculinity in the U.S. military, Social Science &
Medicine (2010), doi:10.1016/j.socscimed.2010.07.031
their trauma through optimistic self-fashioning. From this perspec-
tive Positive Psychology reinforces the very stigmatization of trauma
characteristic of military masculinity (Whitworth, 2008) and poten-
tially pathologizes those most in need of help.
It may also encourage them to pathologize themselves. Positive
Psychology teaches individuals that they, ultimately, are respon-
sible for their emotional response. But, as we have argued, the
fatalistic structure of military masculinity is itself predicated on this
same notion of emotional self-control. This ideology of self-control
may be what leads many soldiers to internalize their aggression
when faced with adverse circumstances. One such circumstance
may be the failure to respond to a therapy that suggests that
traumatic mourning is a result of the individual’s own failure at
emotional control. In a military population already prone to inter-
nalized rage, Positive Psychology may lead traumatized soldiers to
castigate themselves for what, in reality, may be the shortcomings
of the therapeutic technique. It could thus reinforce the emotional
control and internalization of frustration that are characteristic of
the masculine fatalism that informs military suicide. While the
Army’s suicide prevention program may aim to “build better
warriors” (Dinges & Mueller, 2009) by not taking a more critical
stance toward the warrior ethos itself, it may subvert its goal of
encouraging emotional resilience.
A reformulation of the warrior ethos is both possible and neces-
sary. The military has relied on masculine ideologies to generate
social cohesion, but social cohesion can be encouraged in other, less
risky ways. The fatalistic control characteristic of military masculinity
can easily produce the opposite effect: Teaching individuals to
suppress their emotions can lead to violent emotional outbursts. The
devaluation of individual life necessary to form a community based
on altruistic self-sacrifice can encourage suicidal behavior that
destroys social cohesion. Rethinking the fatalistic aspects of military
masculinity will require fundamental changes in the military, but
such changes will not be the end of the military. They are steps toward
a military that is stronger because of its sensitivity to those in its
ranks.
Acknowledgements
We thank Silvia Canetto, Anne Cleary, two anonymous
reviewers, the Social Science & Medicine editors for their sugges-
tions, and Carol R. Kushner and Nicole Karalekas for editorial
assistance.
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