Operator Syndrome: Unseen Scars of the Elite Warfighter

Editor’s Note: This 4-part series was adapted by Chris Frueh, PhD, from his book titled Operator Syndrome (2024; Ballast Books). The pattern of injuries and impairments associated with the Operator Syndrome framework is often seen in soldiers from the combat arms, private defense contractors, intelligence agents, law enforcement officers, and firefighters. Read Part 1: Operator Syndrome: When the War Comes Home in Silence

The military special operations community is unlike any other. They undergo unique selection and training, undertake unique mission sets, sustain unique injuries, and require unique solutions. These American military heroes have spent more than twenty years fighting the Global War on Terror (GWOT) across the globe. Their individual and collective accomplishments are legendary—as they should be. Memoirs and histories have been written about them. Movies and television shows have celebrated their deeds.

The general public typically regards them as elite, brave, thrilling, even sexy. They are held in awe by many. People admire them and want to be associated with them, much like rock stars and athletes. This is completely understandable.

At the same time, however, relatively few people understand the massive “dose” of allostatic load they have shouldered on our behalf. Few comprehend the depth, complexity, and intensity—both physical and mental—of their sacrifices involving brain, body, and soul. Most cannot even imagine it.

Moreover, resentments have developed in some quarters. Some believe SOF personnel have been treated as “special” for too long and argue that they should now receive the same medical services as other soldiers and veterans. One prominent neurologist even told me it would be a “social injustice” to offer them specialty medical care targeted to their unique injuries. Other critics caution against their perceived “toxic masculinity” and raise concerns about potential war crimes.

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What Is a Military Special Operator and Why Are They Unique?

Military special operators are elite warriors, comprising less than 1 percent of the U.S. Armed Forces—a ratio mirrored by other NATO nations. Their selection and training are extraordinarily demanding. For most SOF units, fewer than 10 percent of candidates pass the selection courses. Contrary to the “knuckle-dragger” stereotype, operators are not only physically and mentally tough but also highly intelligent and creative problem solvers.

In the U.S., special operations are organized under Special Operations Command (SOCOM) and its subordinate, Joint Special Operations Command (JSOC). Approximately seventy thousand personnel—including operators, intelligence officers, aviators, civil affairs personnel, psychological operations specialists, technical enablers, EOD technicians, and officers—comprise SOCOM. Nearly all operators are male, though women serve throughout SOCOM and the intelligence community, including as Army Rangers.

Each branch of the U.S. military has its own SOF units, including but not limited to:

• Army: 75th Ranger Regiment, Special Forces (Green Berets), Special Operations Aviation Regiment (SOAR/Night Stalkers)
• Air Force: Pararescue (PJs), Combat Control, Special Reconnaissance, Tactical Air Control Party
• Marine Corps: Marine Forces Special Operations Command (MARSOC/Marine Raiders)
• Navy: SEALs, Special Warfare Combatant-Craft (SWCC), Explosive Ordnance Disposal (EOD)
• Coast Guard: Deployable Operations Group

Under JSOC, each branch typically has at least one Tier One unit, including the Navy’s DEVGRU (SEAL Team Six), the Army’s Delta Force, and the Air Force’s 24th Special Tactics Squadron.

Many U.S. intelligence and law enforcement agencies also contribute tactical paramilitary operators and specialists to JSOC operations. Beyond formally recognized SOF units, roles like Marine infantry, private contractors, aviators, snipers, paratroopers, and EOD personnel share similar injury risks.

An especially under-recognized group is the Cultural Support Teams—female combatants embedded with SOF in Afghanistan and Iraq to engage local women on missions. They faced the same dangers and exposures yet remain underserved.

Private defense contractors, often former military operators, frequently functioned like SOF in war zones. Not all were operators—many were interpreters, mechanics, logisticians, or administrators. They often served 5 to 15 years or longer in combat zones and receive no VA benefits or recognition due to their civilian status. Notably, about half of those supporting the U.S. military in Afghanistan and Iraq were contractors—yet they remain invisible to most Americans.

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The Unique Injury Profile of SOF Careers

Blast Exposures

Operators are intensively trained in demolitions and breaching, placing them in close proximity to blast overpressure. They are also exposed to blast waves from weapons systems like the Carl Gustaf and from firing tens of thousands of rounds. These exposures are cumulative—similar to concussions. Estimates suggest over 85% of operators sustain traumatic brain injuries from training alone, before deployment. Their blast exposure exceeds that of conventional forces by several orders of magnitude.

High Operational Tempo and Chronic Stress

SOF personnel have shouldered most of the combat during the GWOT—an estimated 95% over 20+ years. Many have completed 12 or more deployments, often with hundreds of missions each. Some reach over 1,000 missions in a career. Even when not deployed, operators endure rigorous training.

Violence of Action

Operators often experience nightly firefights and lethal engagements. Some have killed hundreds of enemy combatants in close-quarters combat. They also suffer tremendous loss—many have attended dozens of funerals and still keep the phone numbers of fallen teammates in their phones.

Training and Orthopedic Injuries

Operators are trained in rucking, diving, parachuting, rappelling, combat driving, and SERE. The injury and mortality risks in training alone are high. Most operators undergo multiple orthopedic surgeries over their careers and suffer chronic joint pain across their entire bodies.

Toxic Exposures

Beyond burn pits, operators face chronic exposure to heavy metals, gases, chemicals, smoke, and other toxins. Some have encountered contaminated sites (e.g., “neon green ponds”) from prior armies. One operator developed type 1 diabetes post-deployment and suspected toxic exposure as a cause.

Career Length and Family Separation

Unlike conventional soldiers who may serve four years, operators often stay in for 20+ years unless injuries force them out. With deployments and off-site training, many are away from home for about nine months annually, missing up to 80% of family milestones.

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Compartmentalizing Pain: The “Never Quit” Culture

SOF selection favors those willing to endure extreme stress and persevere. Operators volunteer for this life, enduring grueling selection courses that aim to make them quit. They learn to compartmentalize pain and ignore injury. Most non-acute injuries go untreated for years, accruing over time. Society often assumes they are invincible, failing to offer support when it’s most needed.

Operators embody the ethos: “never quit,” “never give up,” and “never be out of the fight.” Each unit has its own creed, yet all emphasize loyalty to comrades. Navy SEAL Bradley S. Cavner encapsulated this in his toast: “To those before us, to those amongst us, to those we’ll see on the other side. Lord, let me not prove unworthy of my brothers.”

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Implications for First Responders and Other High-Risk Professions

This whole systems approach may also apply to professions like firefighting. Firefighters frequently endure sleep disruption, danger, and loss, as well as chemical exposure from industrial, residential, and environmental sources. They often transition from traumatic shifts directly into family life—a jarring, repeated stressor.

These cumulative challenges affect the brain and body. My colleagues and I recently proposed a similar whole systems framework for “Firefighter Syndrome.”

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References

Christopher Frueh, et al. “‘Firefighter Syndrome’: A Proposed Whole Systems Framework,” CRACKYL Magazine, August 2023.

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About the Author

Christopher Frueh, Ph.D., is a novelist, clinical psychologist, and professor at the University of Hawaii. He has 30+ years of experience working with military and first responder communities, and has authored over 325 scientific publications. This series is adapted from his book, Operator Syndrome (2024; Ballast Books).

As the Voice of the Veteran Community, The Havok Journal seeks to publish a variety of perspectives on a number of sensitive subjects. Unless specifically noted otherwise, nothing we publish is an official point of view of The Havok Journal or any part of the U.S. government.