The number of post-traumatic stress disorder cases among military personnel creates significant challenges to staffing and retaining qualified, combat-ready drone operations teams. Efforts to reduce PTSD include contextual, environmental, and procedural changes to remove stress and avoid burnout; still, trauma affects a person’s physical, mental, and spiritual health. Reassessing military strategy and deployment involving autonomous AI technology is one approach. Artificial intelligence and machine learning also are beneficial in detecting PTSD and customizing therapies. Another method is embedding qualified clinical psychologists on station who combine standard PTSD therapeutic methods with a holistic approach that includes religious rituals and mystical practices to assist AI-drone personnel in restoring their spiritual health and well-being.
6.1. Autonomous AI Drones
Interestingly, artificial intelligence applications provide solutions to mitigate remote warfare-induced PTSD from AI technology and other causes. As part of its long-term strategy, the military is developing and deploying fully autonomous, AI-directed drone systems to remove remote pilots entirely from the mission kill loop. At the present time, unmanned aerial vehicles are not totally autonomous. Remotely piloted drone operations are very labor-intensive and require special communication and technology skills along with quick decision-making abilities. Thus, human beings are in the killing loop, with complete control over mission implementation. Semiautonomous AI systems possess the sophistication to analyze, decide, and act during operations involving minimal risk. Yet, human beings remain on the killing loop, with veto power over mission execution.
Fully autonomous AI-directed aircraft require no remote pilots, so human beings are
out of the killing loop, which reduces their risk of PTSD and harm to their spiritual health. Employing massive amounts of data and advanced programming, these highly-complex AI systems rapidly analyze multiple combat scenarios, coordinate numerous tasks, and synchronize communications, which results in faster decisions and response times during missions. Nevertheless, the decision-making capabilities of completely independent AI algorithms do not possess moral agency. Lethal autonomous weapons systems (LAWS) make rational assessments but not necessarily moral ones. These systems require a “method of moral-scene assessment for intelligent systems, to give AI programs a ‘proto-conscience’ that allows them to identify in a scene the elements that have moral salience” (
Swett et al. 2019, p. 141). Identification involves encoding LAWS with agreed-upon human values, morals, and ethics without introducing societal bias and prejudice into the AI decision-making process.
Although tempting, the abdication of personal autonomy and responsibility to AI systems is unethical; it questions the notion of free will and underestimates or ignores the role and responsibility of human agents in the process. AI algorithms are computationally intelligent; however, they lack the emotional intelligence of human beings who “exercise leadership, inspire a team effort, persuade, empathize, and create human bonds between persons” (
Wood 2020, p. 88) while respecting everyone’s intrinsic dignity. In the future, general artificial intelligence systems may develop into independent, causal, moral agents. Until then, AI applications (especially lethal drones) are a means to help humanity in making ethical judgments on the battlefield and in remote combat situations. Even though AI systems are complex, soldiers should be able to understand their results and provide justification and accountability for the decision-making process.
Compared with RPA drone missions, fully autonomous AI systems reduce human involvement in decision-making, control, and responsibility for executing outcomes. Yet, AI-autonomous drones might create more stress for remote operators. As AI advances, “swarms of low-cost, autonomous air and space systems can provide adaptability, rapid upgradability, and the capacity to absorb losses that crewed systems cannot” (
Reding and Eaton 2020, p. 61). Instead of one remote pilot directing one drone system, each operator might control multiple AI-swarming drone systems. The increased machine speeds at which such weapons operate compress human decision-making and reaction times. Also, swarming systems require additional organizational complexity that includes intricate trajectory planning and collision avoidance strategies. Coordinating a mission involving hundreds of synchronized, highly-responsive drone swarms exacerbate RPA operator combat anxiety and PTSD symptoms.
6.2. AI Therapy for PTSD
Ironically artificial intelligence and machine learning techniques assist in detecting and managing post-traumatic stress disorder. Utilizing biosensors and nanotechnology, AI provides pre-symptomatic diagnosis and real-time monitoring for effective treatment of complicated combat injuries, especially for PTSD. Severe stress manifests in various ways and degrees during the first hours to days after the traumatic event. Because “there is evidence that timely intervention may reduce the risk of developing psychopathology after trauma” (
Malgaroli and Schultebraucks 2020, p. 275), rapid, accurate AI predictive evaluations are vital to medics dealing with battlefield trauma and clinical psychologists managing drone pilot post-traumatic stress and burnout. The prompt diagnosis and risk assessment, targeted treatment, and digital monitoring of the recovery process all prevent combat trauma from becoming a chronic, debilitating illness.
In determining a diagnosis, soldiers recount their traumatic combat experiences while AI applications passively observe then analyze speech patterns, facial expressions, and hand movements. Natural language processing (NLP) algorithms likewise determine predictive patterns of intonation, speed, and word frequency as well as content. Cameras concurrently capture posture, physical activities, as along with facial expressions and eye movements that artificial intelligence uses to evaluate a patient’s emotional and mental state. After diagnosis, mobile and AI wearable devices continuously collect a patient’s data and personal digital phenotypes by “assessing sleep quality and physiology… using GPS data to monitor avoidance and behavioral activation… [and] analyzing the speed and accuracy of keystrokes, taps, and swipes” (
Malgaroli and Schultebraucks 2020, p. 277) when patients use their smartphones. AI-driven diagnostic programs perform statistical analysis on this raw data then combine it with deep transfer learning to achieve a more accurate, nuanced PTSD diagnosis.
A one-size-fits-all therapeutic approach for PTSD frequently overlooks important distinctions among the various origins, responses, and symptoms associated with this psychiatric condition. AI applications and machine learning are well-suited to manage the massive amounts of diverse information necessary to detect indications of PTSD and to develop effective customized therapies that match an individual’s needs. Deep machine learning uses neural networks to identify then predict patterns or models from complex interactions between multiple variables within massive datasets. Algorithms analyze data from structured interviews describing combat experiences and causes such as genetics, neuroendocrinology, metabolomics, plus observed clinical symptoms (
Malgaroli and Schultebraucks 2020, p. 273). AI-personalized treatments, telehealth videoconferencing, and asynchronous multimedia messaging, provide effective, real-time PTSD therapy. AI applications collect and analyze digital data automatically for up-to-the-minute patient assessments, then notify therapists with suggested clinical and behavioral interventions or in some cases whether the patient is a potential suicide risk.
Utilizing AI in the diagnosis and treatment of PTSD offers therapeutic advantages, but it also entails some ethical challenges. Artificial intelligence is only as ethical as its data, algorithms, and human contributions to system functionality. Due to their novelty and technological complexity, artificial intelligence programs and machine learning are confidential or patented; thus, they are not very transparent. Without transparency, AI outcomes are difficult to reproduce, test, interpret, and critique. Developers are creating new interpretation techniques to explain predictive models, enhance reproducibility for independent testing, and create safeguards for statistical errors. Human-understandable AI algorithms and step-by-step simulations improve clarity and comprehension as well as instill confidence in the diagnosis and treatment of PTSD.
In addition to transparency, accountability and trustworthiness are necessary in the AI-assisted diagnosis and treatment of PTSD. Thus, accountability enhances confidence by explaining choices, identifying culpability, and determining ways to prevent future issues. Trust in AI system components essentially relies on the integrity and competency of analysts, designers, and developers. Training, experience, and prudent judgment are essential attributes for creating trustworthy applications. Trust also develops from using several historically-proven, dependable datasets and running multiple AI programs against them to reach a decision. Since deep transfer learning shares patient information between training models and multiple datasets, confidentiality and sensitive healthcare records must be protected. Each step in the process should comply with HIPPA rules and regulations and include human oversight and periodic audits. Employing cybersecurity technology likewise reduces unauthorized access and system manipulation. The ability to trace data back to original sources decreases the risk of unethical tampering and increases confidence in AI results.
6.3. Religious Rituals and Spiritual Development
Artificial intelligence applications provide sacred writings, devotional prayers, and interactive worship via the internet. Nevertheless, AI robots and interactive technologies currently lack sufficient empathic programming to make them effective at counseling and reestablishing spiritual health. The relationships people develop with or through these devices differ from conventional human interactions. Until AI technology significantly improves in the areas of mental and spiritual health, religious rituals and practices offer effective methods for coping with combat-induced PTSD and its subsequent harm to a person’s physical, mental, and spiritual well-being. In selecting beneficial treatments, mental health and pastoral care professionals should carefully evaluate whether PTSD affects a client’s religious and spiritual beliefs to avoid inappropriate theological or ethical topics during therapy. In appropriate cases, counselors encourage patients with PTSD to participate in spiritual and religious activities. Religious rites and spiritual practices foster connections with family and the community that help restore meaning, purpose, and hope lost during wartime trauma. Some suggested activities to improve spiritual health include attending religious functions, volunteer work, and practicing meditation, mindfulness, journaling, as well as enjoying nature.
The military is assessing a spiritual practice called mantram repetition, to improve a person’s focus and attention. Repeating sacred phrases such as
Ave Maria,
Om Mani Padme Hum, or
O Wakan Tanka throughout the day is a soothing mindfulness technique. It offers “significant reductions in perceived stress and anger and improvements in existential spiritual wellbeing and quality of life” (
Bormann et al. 2012, p. 497). Taking time each day to reconnect with one’s spirituality calms the mind while creating peace and clarity to cope with PTSD symptoms. Practicing mantram repetition while in a relaxed state teaches a person to regulate emotional responses in stress-triggering situations.
American Indian cultures demonstrate their deep respect for soldiers with special rites and spiritual traditions that prepare them for battle and help reintegrate them into society. The ritual contains two parts: “When soldiers go overseas, we give them warrior ceremonies to armor and protect them against the battle; when the soldier returns; we have to remove that armor, to help him reconnect with his home” (
Palmer 2015, p. 88). Adapting these traditional spiritual transition ceremonies to accommodate modern drone warfare helps RPA fighters cope with switching between their communities and remote combat conditions on a daily basis. Whether serving on site or on station, soldiers hold a special place of honor in American Indian communities. Spiritual rituals and communal dances celebrate soldier and veteran sacrifices, which are comparable to non-indigenous peoples’ parades, dinners, and welcome home receptions.
Faith-based organizations (FBOs) provide a variety of services to assist soldiers as they readjust to civilian life. Veterans’ most crucial needs are privacy, confidentiality, and a non-judgmental environment, especially when confronting the stigma of PTSD (
Werber et al. 2015, p. 8). Counselors must be sensitive to how religious and societal perspectives influence a warrior’s emotional interpretation of war trauma as glorified, sacrificial, or karmic. If the veteran is deeply spiritual or professes a strong religious faith, counselors and pastors should not discount, but gently affirm, notions of sin, right and wrong, and feelings of guilt so the person might seek comfort and healing from familiar rituals and personal, spiritual relationships with ultimate reality. After establishing a basis for trust as a “benevolent moral authority, [counselors offer] ‘psychospiritual’ or strictly spiritual support that enables veterans to open up, ‘reawaken,’ and regain a vision for their lives” (
Werber et al. 2015, p. 6). FBOs concentrate on spiritual assistance, but they also provide access to social, physical, and mental health services along with educational, vocational, financial, and legal support. This myriad of services reflects a holistic approach to healing PTSD and integrating veterans back into society.
Moreover, religious traditions provide specific rituals and prayer services that help heal and reconnect veterans with families, friends, and a faith community. Rituals provide significance, promote community participation, and transmit traditions and wisdom that enhance identity, meaning, and belonging. Religious rites also require self-awareness, and reflection. Veterans suffering from PTSD often are unable to accept self-forgiveness, the forgiveness of others, or a sense of divine forgiveness. The Catholic Church mediates God’s mercy and forgiveness through its communal rituals known as sacraments. Each sacrament communicates God’s healing grace to restore and strengthen one’s spirituality, self-esteem, and vital relationships with the divine and with the community. Baptism, for example, initiates a loving relationship with God and the Eucharist celebrates communion with God and each other. During Anointing of the sick, the physically, spiritually, and mentally ill share a special unifying experience with the entire Church community who is praying for them. Whether through healing, regeneration, or wellness, the person attains a wholeness and integrity of body, soul, and spirit.
The sacrament of Reconciliation (Penance) unites God’s mercy with a person’s faith. Nevertheless, the desire for “healing must come from within [and one] must be open to receiving help” (
Cooke 1994, p. 175) by admitting brokenness and dependence, then showing a willingness to trust the love of others. Acknowledging human transgressions and faults evokes healthy feelings of remorse and contrition through which God acts to forgive, heal, and restore damaged relationships with the divine, the community, and oneself. Reconciliation does not suppress the memory of violence; it does not mediate, but gently confronts lingering internal conflict. Hence, the healing process of reconciliation reestablishes psychological and spiritual health by recognizing a person’s dignity.
For veterans experiencing PTSD, sharing personal narratives contextualizes actions, feelings, and thoughts in broader patterns of life. Counselors and pastors create safe spaces for interaction and dialogue that enable narratives to neutralize the destructive effects of societal violence and wartime suffering. Adaptive Disclosure is a cognitive-based therapy treatment designed specifically for military personnel. Actively listening to RPA operators’ personal experiences and eyewitness accounts of violence and evil acknowledges the trauma causing mental and spiritual harm. These stories piece together the fragments of identity and memory that slowly reestablish trust and thus restore one’s humanity. Similar to the Sacrament of Reconciliation, narratives do not deny or forget the past; instead, they remember it in ways that heal spiritual, emotional, and psychological, wounds caused by PTSD. Such dialogue reconnects interpersonal relationships and achieves a sense of justice and dignity.