By Mitch Duque   

Remote-piloted drone technology has quickly become one of the most prominent staples in the modern landscape of large-scale combat operations. Given the prominence of this technology to current and future warfighters, members of the Research Special Interest Group (SIG) at the Consortium for Defense Psychology (CDP) decided to focus its monthly journal club on the mental health implications of drone warfare for remotely piloted aircraft (RPA) personnel. The article selected for review was a narrative review titled "Remote Warfare with Intimate Consequences: Psychological Stress in Service Member and Veteran Remotely-Piloted Aircraft (RPA) Personnel" by Norrholm and colleagues (2023). SIG members read the article and discussed the possible mental health implications of drone warfare for RPA crew members using this technology in their day-to-day lives.

The RPA career field has a variety of unique qualities that can potentially lead to adverse psychological effects. One of the most notable is the cognitive dissonance crew members can experience as a result of their geographical distance from their targets when conducting military operations. Despite being physically distant from their area of operation, RPA crew members experience disproportionate levels of intimacy with their targets based on the immersive nature of their weapon systems. This juxtaposition of physical distance and emotional proximity can lead warfighters serving in RPA crews to experience emotional turmoil regarding their role in conflict, particularly when executing lethal strikes on individuals that they’ve formed a remote bond with through days, months, or even years of surveillance. There can also be ‘psychological whiplash’ that occurs, with operations moving quickly from surveillance activities to kinetic action to after action-assessment, all in the span of minutes. This rapid shift is one of the central psychological challenges of RPA work.

Another dynamic worth noting in this population is the domestic nature of their work. Individuals working on RPA crews frequently execute their missions in garrison, meaning that they work in shifts and maintain personal lives when not on duty. This makes it uniquely possible for RPA crew members to play pivotal roles in potentially lethal operations akin to “mini-deployments,” mere hours before driving home from work to participate in their personal, family, and social lives. Per the article, it can be beneficial for conventionally deployed service members to have a period of decompression prior to returning home following combat operations. However, crews are not likely given adequate opportunities to decompress following this harrowing work. In other words, RPA personnel may be required to transition almost immediately from combat-related activities back to their everyday lives.

Additionally, the article identifies stigma surrounding RPA crews in the military, with crew members frequently viewed as “less than” or “inferior” for being assigned to remote aircraft instead of serving in a manned fighter or bomber aircraft. Coupled with long hours and shift work schedules that disrupt natural sleeping patterns, service members operating RPA are at a disproportionately high risk for adverse mental health outcomes and can experience symptoms of post-traumatic stress disorder and moral injury.

After learning about RPA crews and the unique challenges associated with their career field, the CDP research team discussed several important considerations for working with this population. The team was particularly interested in understanding the emotional dynamics within RPA units, especially those related to moral injury. Of particular interest was how traditional concepts of honor and military service may be difficult to reconcile for personnel who conduct remote warfare. Discussions surrounding responsibility for the deaths of enemy combatants were especially noteworthy, as many RPA crew members frequently report feeling guilt or shame for the way in which they conduct military operations, per the article.

The team discussed a handful of clinical considerations when treating these individuals. A clinical member of the team raised the possibility that psychotherapy could focus largely on stigma reduction and validation, given the isolating and invalidating nature of the environment surrounding this career field. The team also raised that cognitive-focused, evidence-based psychotherapy for PTSD, such as Cognitive Processing Therapy, may be effective in addressing experiences of guilt. Clinicians can assess and treat standard PTSD symptoms, but may also consider working with the client to target interventions toward acceptance and understanding given possible experiences of guilt, shame, stigma, and moral conflict unique to RPA service.

The unique operational environment of RPA personnel presents significant psychological challenges, characterized by a difficult juxtaposition of physical distance and emotional intimacy, compounded by the domestic setting of their work, irregular schedules, and persistent stigma. Future clinical approaches can address the prevalence of traumatic stress, moral injury, guilt, and shame in this population by prioritizing stigma reduction and employing therapies that aim to address guilt while promoting acceptance and self-understanding.

Ultimately, remote warfare may be physically distant, but it is not necessarily psychologically distant. RPA personnel may benefit from clinical approaches that recognize both the traumatic and moral dimensions of their work.

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Mitch Duque is a previous Research Assistant and HJF employee collaborating with the Consortium for Deployment Psychology, DoW and Uniformed Service Contractor