Aging & Mental Health, 2015 Vol. 19, No. 6, 493 499, http://dx.doi.org/10.1080/13607863.2014.954525

The lifelong struggle of Finnish World War II veterans Sirkka Nivalaa and Anneli Sarvim€akib* a

Department of Health Sciences, University of Jyv€ askyl€ a, Jyv€ askyl€ a, Finland; bThe Age Institute, Helsinki, Finland (Received 2 December 2013; accepted 5 August 2014)

Objectives: In many countries veterans from World War II are growing old. Research has shown that war experiences continue to impact those who have been involved in war for a long time. The present study targets old injured war veterans from World War II in Finland. The aim of this study was to produce knowledge of the impact of war experiences and injuries on the lifespan of Finnish war veterans. Method: The method used was grounded theory. Data were collected by interviewing 20 aged war veterans in their homes. Results: The analysis resulted in four categories, with also subcategories: (1) lost childhood and youth; (2) war traumas impacting life; (3) starting life from scratch; and (4) finding one’s own place. A substantive theory of war veterans’ lifelong struggle for freedom throughout the lifespan was outlined. Conclusion: The war overshadowed the whole lifespan of the veterans, but in old age they finally felt free. Since war experiences vary depending on historical context, a formal theory would require additional research. Keywords: lifespan; experiential ageing; PTSD; war traumas; grounded theory

Introduction Old age cannot be fully understood unless we consider the whole lifespan of the ageing person. Old age is constructed throughout life as interactions between the person’s own resources and external events (Giele & Elder, 1998). Being injured during war is a special kind of event that continues to influence the lives of many individuals as they grow old. Combat exposure has been called the hidden variable in the study of ageing men who served in the military forces in World War II (Spiro, Schnurr, & Aldwin, 1994). Many countries still have a large number of veterans from World War II, although their number is naturally diminishing. Finland is one of these countries. In World War II, 95,000 of Finland’s 600,000 army were permanently injured and the number of casualties was almost the same. About 5000 of the permanently injured are still alive and their mean age is 90 years. It has been estimated that in 2020 about 900 will still be alive; their mean age being 94 years (Kivim€aki, 2012; Sotainvalidien Veljesliitto, 2014). Exposure to combat and injury has been shown to have physical as well as psychological impacts. Elder, Shanahan, and Clipp (1997) studied World War II veterans in the United States and showed that exposure to combat predicted physical decline and death during a 15-year period after the war. Other studies on exposure to trauma over the lifespan suggest that traumatic events have an adverse effect on physical health, that people are most vulnerable during young and middle adulthood (Krause, Shaw, & Cairney, 2004) and that a history of trauma predisposes to burnout and lower cohesion in work relationships (Whealin et al., 2007).

*Corresponding author. Email: [email protected] Ó 2014 Taylor & Francis

One common impact of war is post-traumatic stress disorder (PTSD), a syndrome consisting of general anxiety, depression and psychosocial problems such as alcoholism (Seal, Bertenthal, Miner, Saunak, & Marmar, 2007; West & Weeks, 2006). Chatterjee, Spiro, King, King, and Davison (2009) have highlighted the fact that most research on the impact of military service and war focuses on short-term consequences. They called for a lifespan perspective in order to study the long-term consequences and effects of military service and wartime experiences on ageing. Studies conducted 20 years postconflict (Solomon, Helvitz, & Zerach, 2009) and 50 years post-conflict (Hunt & Robbins, 2001a; Ikin et al., 2007) have shown that war veterans suffer from PTSD for decades after war. Schnurr, Spiro, Vielhauer, Findler, and Hamblen (2002) concluded that trauma was highly prevalent among veterans from World War II and the Korean conflict but that few of them experienced lifetime PTSD. Studies have also shown positive outcomes of military service, such as mastery, self-esteem and coping skills (Aldwin, Levinson, & Spiro, 1994), as well as having achieved a broader perspective and appreciating peace (Chatterjee et al., 2009). Comradeship, veterans’ associations and family have been shown to be valuable resources for British World War II veterans (Hunt & Robbins, 2001b). In addition, research on post-traumatic growth (PTG) shows that traumatic events can also facilitate personal growth in terms of a reappraisal of life and priorities, existential re-evaluation and development of the self (Hefferon, Grealy, & Mutrie, 2009; Turner & Cox, 2004). Social support and finding a positive meaning in the distressing event are the factors that facilitate PTG (Caddell, Regehr, & Hemsworth, 2003; Morrill et al., 2008). These

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factors have been reported in research on war veterans, indicating the possibility of PTG (Chatterjee et al., 2009; Hautam€aki & Coleman, 2001; Hunt & Robbins, 2001b). Which experiences predominate may partly be understood in light of the historical context of the war. Being on the winning side makes it easier to feel proud and experience one’s sacrifices as worthwhile, while having lost a war must likely arouse feelings of failure. Finland’s involvement in World War II was triggered by an attack from the Soviet Union in 1939. The Soviet Union was concerned about cooperation between Finland and Germany and wanted to prevent Germany from using Finland as a base for invading the Soviet Union. Finland thus had to defend itself against a country with considerably larger military resources. In 1941, Finland became more deeply involved in the larger conflict between Germany, the Western Allies and the Soviet Union. Finland ended up as an ally to Germany, which fought its own war against the Soviet Union. Germany needed Finland to invade the Soviet Union and Finland needed Germany to fight off a stronger enemy. Finland managed to resist an invasion from the Soviet Union, but lost the war. The country had to pay considerable reparations for war-damage, while the Soviet Union annexed some Finnish territory. Finland, however, remained independent (Meinander, 1999). Given that Finland had lost the war alongside Germany, people wanted to forget the war as soon as possible and concentrate on re-building the country. The war veterans did not receive much recognition and their possible mental traumas were not understood. As Kivim€aki (2012) has shown, societal attitudes towards the war were split. On the one hand, the political influence of the Soviet Union over Finland created a culture of silence with respect to the war. On the other hand, fallen soldiers were buried in ‘Heroes Cemeteries’ and were regularly honored on commemoration days, and the war was remembered in literature, film and music. In the 1960s and 1970s the post-war generation in Finland was influenced by leftist movements in Europe. Left-wing youth organizations intensified their cooperation with the Soviet Union and expressed admiration of the communistic system. Although the left-wing radicals represented a minority of the youth, this did not make the climate easier for the war veterans. Many of them felt this was an insult to their fight for the country. At the end of the 1980s, there was a ‘neopatriotic’ turn, which, according to Kivim€aki, resulted in more patriotic versions of the war and stronger selfesteem among the veterans. Previous studies of Finnish war veterans have mainly focused on physical and mental injuries and rehabilitation. About 18,000 soldiers were treated for psychiatric diagnoses in the military hospitals during the World War II, while the number treated for physical injuries was 200,000 (Ponteva, 1993). In his research on mental problems among Finnish soldiers during the war, Kivim€aki (2013) concluded that these problems were poorly understood during and after the war. While soldiers who were physically injured could be seen as heroes, those who were mentally injured were considered weak. Kivim€aki

found that people suffering mental problems caused by the war were marginalized and effectively silenced, an effect that lasted even up to the present day. H€annik€ainen (1982) showed that the concept of war injury has changed since the war and Ranta-Knuuttila (1962) studied rehabilitation of injured war veterans. The goal for rehabilitation was to help the veterans return to a normal life as soon as possible. Not much attention has been paid to the lifespan and ageing of the veterans. One exception has been Hautam€aki and Coleman’s (2001) research, where they interviewed 30 older disabled veterans. The veterans spoke freely about the war and emphasized the fighting spirit and strong bonds of loyalty that they had experienced. They felt they had fulfilled an honorable task in defending their country. According to the researchers, this spirit was upheld by the Finnish veterans’ association in combination with the continuing esteem of society. The researchers also emphasized that the results have to be interpreted in a historical context. The fact that Finland was able to maintain its independence has made it possible for the war veterans to experience their contributions and injuries as meaningful. Studies carried out in Finland as well as other countries have provided knowledge on both the short-term and long-term impacts of war. We also have knowledge of how older war veterans look back on their war experiences (Hautam€aki & Coleman, 2001). What we do not know, however, is how war memories are reflected in their life and ageing experiences as a whole. The aim of this study was to produce knowledge of injured Finnish war veterans’ experiences over their lifespan and into old age. The research questions were as follows.  How do injured war veterans experience the impact of war over their lifespan?  How do they experience old age? Methods A qualitative method was chosen since the aim of this study was not to compare the study group with other noninjured veterans or other groups of older persons but rather to study experiences among the study group. Grounded theory (GT) (Glaser & Strauss, 1967) is a qualitative method especially suited to clarifying the basis of a less well-known area of study and to inductively formulate a new theory that is grounded in data. A substantive theory can be formulated on the basis of limited data, while a formal theory requires data from several studies. The purpose here was to listen to the injured war veterans themselves without intervening with theoretical concepts, that is, to make interpretations that remain close to the data and to outline a preliminary substantive theory. Data were collected by interviews carried out by the first author (S. Nivala), who is experienced in encountering older persons in her professional and voluntary work and has training in research methods and interviewing. In the first stage, four war veterans were interviewed at a nursing home for war invalids. The purpose was to obtain

Aging & Mental Health more experience at interviewing, to formulate a preliminary view of the area under study and to allow for revisions to the interview guide. In GT, it is important to proceed in stages so that new topics can be included during the process in order to cover the area of study as thoroughly as possible (Glaser & Strauss, 1967). In the second stage, 20 war veterans living in central Finland were included. They were recruited from a local association for war invalids. The time spent in the war varied from some three to six years. The veterans had all been physically injured in the war, suffering, inter alia, brain and head injuries, spinal injuries, amputated limbs, shrapnel injuries and sight and hearing problems. The degree of disability varied from 15 to 100 on a scale 0 100, where 0 stands for no disability and 100 for total disability. Four interviewees did not report their degree of disability. According to the War Injury Act, a veteran’s compensation is determined on the basis of the degree of disability. Their levels of PTSD were not measured. The interviewees were all men aged 77 87 years (mean age D 80.8 years). All of them were married or living with a female partner. All, except one, had children. After the war, half of them had earned their living as blue collar workers while the rest had been entrepreneurs or white collar workers. The interviews were carried out in the veterans’ own homes. The interview guide was not strictly followed but the interviews were open and allowed the participants to talk freely about their lives and experiences of ageing. The interviews took the form of life story interviews (Atkinson, 1998). The interviews lasted from one to three hours. All in all, the interviews resulted in 30 hours of audio-taped material and 305 pages of transcribed text. The interviews were transcribed by the first author (S. Nivala). A diary was kept by the interviewer with memo-notes from every contact with the interviewees. The diary included impressions from every interview situation. It worked as a memory tool for the researcher to recall in greater clarity each interview situation and to aid in analyzing the data. The analysis was performed in accordance with GT (Charmaz, 2006; Glaser & Strauss, 1967), starting with an open coding of relevant passages in the text. Since the purpose was to study the whole lifespan the codes were organized into four areas: childhood and youth, wartime, life after the war and old age. The next step was axial coding, where codes and passages within

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each area were compared and organized first into subcategories and then into overarching categories. Finally, as a summary, a preliminary substantive theory was outlined. The first author (S. Nivala) carried out the main analyses after which both authors reviewed the results, revised portions and outlined the preliminary substantive theory. No analytic software was used.

Results The analysis resulted in four categories: (1) lost childhood and youth; (2) war traumas impacting life; (3) starting life from scratch and (4) finding one’s own place. Each category had two or four subcategories (Table 1).

Lost childhood and youth The veterans’ childhood memories were related to work and having lost their youth. They experienced that their childhood and youth had lacked playfulness and peaceful maturing into adulthood, but they felt no bitterness about this. Rather, they felt that this was part of normal life during the time they were growing up. Having learned how to work was experienced as an asset later in life: As the oldest child I had to work a lot and there was no harm in that. One has to be taught how to work from early childhood onwards. (80 years, disability 20/100, manager)

Taking part in work life at an early age meant that school was sometimes interrupted. The son in the family had to follow the father to make a living for the family, or, if the father was absent, the son had to take the male responsibility for his childhood family. Their youth was finally cut short by the onset of war: It took away your youth, of course, it did that. That time when a person feels he is becoming an adult. (80 years, degree of disability not stated, manager)

They had been living in the shadow of war, expecting war and they went to war. As a rite of passage into adulthood, war changed everything. Going to war meant saying serious goodbyes, because you did not know whether you were coming back, or if the home would still be there after

Table 1. Overview of the results. Categories/ (1) Lost childhood and sub-categories youth 1 2 3 4

Childhood filled with work and lost youth War as a rite into adulthood

(2) War traumas impacting life The pain and misery of war Becoming injured The many faces of recovering from war War as part of the war veteran’s life to the very end

(3) Starting life from scratch

(4) Finding one’s own place

A difficult path back to From retirement to old work age: freedom The significance of Contentment despite family physical problems

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the war. Some of the veterans had enlisted voluntarily, since they were too young to be drafted: I wanted to go to war, since everybody else went and I thought that the men have to go. I was a skinny schoolboy, just a boy. I thought that now I have to be a man. (80 years, disability 30/100, blue collar worker)

War traumas impacting life The second category, war traumas impacting life, described the war and its effects on life. The pain and misery of war was mainly related to witnessing comrades die in awful circumstances. These situations had a strong impact on the veterans: I saw them burning next to me, one of ours, and that awful. . . The smell that comes from a body when it is scorched is awful. (86 years, degree of disability not stated, foreman) If 400,000 men went out [to war] 399,000 came back mad in one way or another. (84 years, disability 50/100, blue collar worker)

All the interviewees had been injured and described the situations vividly. In addition to the trauma of the situation, the stories were also about comradeship and belief in survival: I was injured by a grenade and lost consciousness. When I came to, I realized that I was on the Russians’ side and ours had disappeared. [. . .] Then one of our men was running by and I asked him to dress my head.[. . .] He said that he’s not going to leave me behind, having dressed the wound and all. He was a strong man and took me on his back. (80 years, disability 30/100, blue collar worker) When I was injured I sort of heard mother say ‘You will survive!’ When I told mother afterwards she said that maybe she was thinking of me at that moment. (77 years, disability 40/100, salesman)

Recovering from the war had as many stories as there were war veterans. Having survived almost always felt like a miracle. There were two kinds of coping: immediate coping and lifelong coping. In immediate coping, the interviewee had dealt with the war incidents and experiences immediately after the war. The experiences were still there but they no longer caused anxiety. When the veterans came home after the war, they were exhausted and some ways of immediate coping were sleeping and screaming: I slept for two days. I don’t remember anything for two days. But mum and dad said that now and then I let out terrible screams. It was probably a good thing that I screamed. I got it out that way, and then things moved on. (84 years, disability 50/100, blue collar worker)

In lifelong coping, the veterans still processed their war experiences. The war was an integral part of life to the very end: It [the war] changes you, there’s no denying that. It’s useless to say it doesn’t or that you’ll get over it. You don’t. (84 years, disability 50/100, blue collar worker)

In addition to the war experiences, the interviewees talked at length about stress reactions and traumas caused by the war. In addition to the immediate war injuries many health problems had occurred later in life as a consequence of the war: I got all kinds of damage in the war, heart problems and rheumatism and these dysenteries and scurvies. I’ve had to pay for teeth in the upper jaw and now I have to renew the lower jar too. (83 years, degree of disability not stated, entrepreneur)

It was easier to talk about physical traumas than psychological ones. The psychological traumas and stress reactions were experienced as nightmares. The nightmares had become fewer as time went on but they were not completely gone for the interviewees. Being absorbed in work had been an efficient way to keep the nightmares away. When the interviewees were younger they had sought comfort from alcohol and drugs. The most painful experiences after the war in addition to the injury were being despised and the object of ridicule. Comments like ‘what did you go there for’ were common up to the 1960s and they created much grief and mortification. The interviewees had no sympathy for the left-wing radicals of the 1960s. ‘I will never forgive the 1960s generation. Never!’ After the 1960s, the social climate changed and the war veterans felt they were recognized for their sacrifices.

Starting life from scratch Starting life from scratch refers to returning to life after the war, injured and without work or education, with no ready-made societal solutions to their problems: I had nothing in life when the war ended and when I got out from the war hospital. I had to think for a while, what the hell now? (80 years, degree of disability not stated, staff manager)

The path to work life was difficult. Some veterans were considered too injured to get a job and some had no proper clothes. One veteran thought he was fired because he had the wrong political background: So it just ended. I asked for a reason why. He said he didn’t know if he could tell me everything, he had been ordered to fire me. (80 years, disability 30/100, blue collar worker)

The war veterans felt hurt because people seemed to have forgotten their significance as builders of society. Marriage and family made life possible for the veterans after the war. The wives played a central role in helping the war veterans cope: When I think of my life companions, both my wives, [. . .], I have been very lucky. My life is based on that, that I have had a life companion which I have had! It is important for a man who has been a bit knocked about. (80 years, disability 30/100, blue collar worker)

Aging & Mental Health Finding one’s own place Having retired, the war veterans felt they had found their own place and lives. Although they talked vividly about their best working years, they felt that retirement had given them the opportunity to be themselves and rule their own lives: I felt so free. . . At the same time the hunting period began [. . .] it was like a celebration, going out on the snow on a beautiful afternoon, going freely to hunt moose. (78 years, disability 20/100, director)

The period of life from the early years of retirement to old age was in many ways an active period, which they remembered and described in a lively manner. At the time of the interviews, they were at a watershed, meaning that they were lingering in the past, reminiscing the early liberating years of retirement. Retirement was described as the best time of their lives. As they grew old, the veterans experienced more fatigue and different kinds of physical problems, but they thought that these were part of becoming old and did not try to analyze them: Now I start feeling that age is gradually becoming a burden. Most of all I feel. . .I become clumsy and such like. (80 years, degree of disability not stated, staff manager)

They talked about old age in the same way as retirement: old age had given them the opportunity to realize their own plans. Old age and realizing one’s own plans was associated with the experience of freedom to be oneself. They did not put demands on themselves anymore and neither did they accept demands from others. Characteristic of the subcategory of Finding one’s own place was reviewing the life lived and the clarity of life. Having had time to think about their lives, the war veterans had been able to find contentment despite all the previous hardships: I feel that it [ageing] is a relief. You never know how many years you are given, only a day or two. I am content. I have nothing to complain about, although all kinds of things have passed. (78 years, disability 100/100, entrepreneur)

Finding one’s place also meant being involved in the War Invalids’ Brotherhood Association, helping war brothers and taking pride in being a war veteran.

A lifelong struggle for personal freedom The lives of the Finnish war veterans had been a struggle from childhood on, and they had lived in the shadow of war their whole lives. Not until retirement had they found their own place and achieved a sense of freedom. The following preliminary substantive theory was outlined. The lives of the Finnish war invalids had been a lifelong struggle for personal freedom. It started as lost childhood and a youth spent under the threat of war and with many hardships. The war inflicted upon

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them physical as well as psychological traumas that they had to struggle with after the war, not always receiving the help and support they needed. On the contrary, they also had to fight demeaning attitudes in society. At the same time they had to start life from scratch. When they retired they felt they had found their own place in life and achieved freedom to rule their own lives. With old age came fatigue and mobility problems, but the war veterans still felt they had achieved personal freedom. Discussion The results of this study support previous research showing both short-term and long-term effects of war (Chatterjee et al., 2009; Hunt & Robbins, 2001a; Ikin et al., 2007; Seal et al., 2007; Solomon et al., 2009; West & Weeks, 2006). The interviewees’ PTSD was not measured but they expressed many feelings and thoughts that can be understood as stress and anxiety. It was easier for them to talk about their physical trauma, but they also mentioned recurrent nightmares as expressions of psychological trauma. Work had been an effective way to fight the nightmares but they still sometimes suffered from them. Despite hardship and trauma before, during and after the war the interviewees had been able to build a life, and, after retiring, achieve personal freedom and contentment. They seem to have managed to use their traumatic experiences in the service of PTG (Hefferon et al., 2009; Turner & Cox, 2004) and found their own place in life as they grew old. This was facilitated by social support from family and veterans’ organizations and the fact that they were able to see meaning in the traumatic experiences. This can also be understood in the light of previous research on the Finnish World War II veterans showing that rehabilitation after the war aimed at normalization (Ranta-Knuuttila, 1962). Hard work in childhood was seen as a preparation for life and work was later a way to escape nightmares. Growing societal recognition meant they had not suffered in vain. As in Hautam€aki and Coleman’s (2001) study, they felt companionship with other war veterans both during and after the war and appreciated the growing recognition from society. Interviewees had suffered negative attitudes in the 1960s and 1970s, but they had also experienced and appreciated the ‘neo-patriotic turn’ (Kivim€aki, 2012) at the end of the 1980s. These positive meanings did not save them from experiencing the physical decline of becoming old. They felt fatigue and had mobility problems, which affected their quality of life in a negative way. Such experiences are common in old age (e.g. Bowling, 2005; Sarvim€aki & Stenbock-Hult, 2000) which means that they were probably age-related rather than war-related. It is possible, of course, that the interviewees suffered more from physical problems than others at their age as a result of their war injuries. According to the lifespan perspective, a person’s life evolves through interactions between individual agency, social relations, history and culture, location in time and

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place, age and period and cohort (Giele & Elder, 1998). Features that were common to the war veterans interviewed in this study were cohort, age group, having been to war and having been injured. Similarities in their experiences of childhood and youth can thus to a certain extent be understood in terms of the historical and cultural conditions of society at the time that they were growing up; the conditions were mostly poor and harsh. The war was the common experience that the study focused on. They told individual stories about going to war and being at war, but they had all been injured and lived their lives as war veterans. There were similarities between the experiences and lives of the war veterans and other Finns belonging to the same generation, since World War II has had a great impact on the Finns who lived through that time. Poverty and hard work are common themes in interviews with older Finns and war-time experiences emerge in life-story interviews, even if they are not the object of study (e.g. Kulla, Sarvim€aki, & Ekman, 2010; Sarvim€aki, Kulla, Palo-Bengtsson, Heikkil€a, & Ekman, 2006). This study adds to previous research on war experiences in that it did not focus only on the war and war experiences but on the whole lifespan. While previous research on war veterans has focused on the impact of trauma on physical and mental health, e.g. PTSD, this study shows that it is possible to lead a satisfactory life in spite of war traumas. The substantive theory describes the Finnish war veterans’ lives as a life lived in the shadow of war and a lifelong struggle for personal freedom, which they finally achieve. The study also adds to our knowledge of the ageing of war veterans showing that the hardships associated with old age (physical problems, becoming a burden) as well as the assets (retirement, freedom) seem to be the same as for other older persons. Some methodological concerns have to be pointed out. First, the interviewees were recruited from an association for war invalids. This may have influenced the results, since they all had the opportunity of organizational support. Second, the fact that they were all married or cohabiting meant they had another dimension of social support. The importance of family as a support network has been pointed out as a resource in old age by gerontological research (e.g. Gabriel & Bowling, 2004; Sarvim€aki & Stenbock-Hult, 2000). Furthermore, the study did not follow the veterans throughout the lifespan but collected their life-stories in retrospect. The contentment and clarity they express in old age can thus be seen as a way of constructing a happy ending, a tendency that seems to be common in retrospective life interviews (Atkinson, 1998). The analysis of the interviews resulted in the outline of a substantive theory. The substantive theory means that it only applies to this group or similar groups. In order to construct a formal theory (Glaser & Strauss, 1967) on the life and ageing of war veterans, many more life experiences of veterans from different types of wars and with different backgrounds must be studied. The knowledge offered by such a theory could be used to support war veterans throughout their life cycle.

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The lifelong struggle of Finnish World War II veterans.

In many countries veterans from World War II are growing old. Research has shown that war experiences continue to impact those who have been involved ...
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