My own father, who was an artillery fire director who would go in with front line tanks during WW2 found the experience of fighting in the desert where there were just the armies involved, was quite different to the experience of urban warfare in Italy, where the civilians were constantly being caught between the combatants.

When he had to bring down artillery fire onto a German strongpoint in the middle of an Italian village, he knew that civilian property and lives would inevitably be lost. And when they took the village, the German casualties had been evacuated, but the Italians were there waiting for medical help. And he knew that he had caused most of them.

It was not a good feeling.

The Italians loathed the Germans and were on the whole happy to see the Allies get rid of them, no matter what the cost. On the other hand, with an insurgency, there is no clarity or sureness in anything. The conflict is many faceted and it is hard to know who the enemy is or what is being fought over. This puts enormous stress on soldiers, fighting an enemy that is at one moment a civilian and the next firing an RPG or triggering a IED.

During WW1, ‘shell shock’ was simply a function of being battered too much and for too long, under constant bombardment for months at time and suffering heavy casualties, without hope of an end to it.

Today, the casualties are minimal, as is the incoming fire. But what is much worse is urban/village cat and mouse fighting, where every car on the side of the road is potentially an IED. And a sniper fires at you from an adjacent house, but after you return fire and enter it, using grenades to clear it, you find that it isn’t insurgents lying on the floor, but a family….

That sort of stuff does men’s heads.