Detail from Saul and David, Ernst Josephson. 1878. Wikipedia Commons.
Did King Saul have PTSD?
Can we even ask that question?
The story of King Saul comes to us across the centuries, from roughly three thousand years ago, and the form we have it in was written down hundreds of years after that time, in what is called the Book of Samuel. The diagnosis of PTSD comes to us from 1980, and has already been revised several times, but the core of it is that certain extreme experiences change people in enduring ways. There are changes in how the body reacts, there are changes in how we see the world and other people, and there are changes in how we remember what we have been through. We don’t have all the possible answers from Saul’s story but we do have some.
We know from the story that King Saul had prolonged and extensive exposure to combat.
14:47 After Saul had secured his kingship over Israel, he waged war on every side against all his enemies; against the Moabites, Ammonites, Edomites, the Philistines and the kings of Zobah; and wherever he turned, he worsted [them].
14:52 There was bitter war against the Philistines all the days of Saul.
The people around the King observe that he has changed, and is deeply disturbed:
16:14 Now the spirit of the Lord had departed from Saul, and an evil spirit from the Lord began to terrify him.
Along with being terrified, it also appears that Saul had trouble sleeping. This is very common after trauma, perhaps even more so after combat trauma. Staying alert and on guard becomes very important. In addition, sleep can be disrupted by nightmares, either intrusive recollections of what has happened, or intense emotional re-experiencing of the fear, terror, and rage that are part of the memories. The people around Saul see this disturbance and try to help him find relief.
Saul’s courtiers said to him, “An evil spirit of God is terrifying you. Let our lord give the order [and] the courtiers in attendance on you will look for someone who is skilled at playing the lyre; whenever the evil spirit of God comes over you, he will play it and you will feel better.”
The lyre player, of course, is David.
16:23 Whenever the [evil] spirit of God came upon Saul, David would take the lyre and play it; Saul would find relief and feel better, and the evil spirit would leave him.
Anger and irritability are also often prominent. In addition, one’s beliefs about the world and one’s place in it may also be changed, with feelings that the world is always a dangerous place. Trust is frequently damaged. It’s not unusual for combat veterans to want to have weapons readily at hand, even – or especially—when they go to sleep.
18:10 The next day an evil spirit of God gripped Saul and he began to rave in the house, while David was playing [his lyre] as he did daily. Saul had a spear in his hand, and Saul threw the spear, thinking to pin David to the wall. But David eluded him twice. Saul was afraid of David, for the Lord was with him and had turned away from Saul.
Saul never does manage to trust David. He keeps trying to get him killed or kill him himself, and is not persuaded by repeated demonstrations by David that he means Saul no harm.
Saul has known constant war for years. In a way, it’s when he’s in his element, the place where he feels at home, the place where his suspiciousness and anger and lethal force make the most sense. Even though he believes that divine favor has deserted him, he once again leads his sons and his armies into battle against the Philistines, who this time, overcome him. Badly wounded, with his sons dead, King Saul asks his armor bearer to kill him, to spare him the humiliation of being captured. When his servant refuses, Saul runs on his own sword and takes his own life.
31:4 So he said to his armor-bearer, ‘Draw your sword and run me through, so that these uncircumcised brutes may not come and taunt me and make sport of me.’ But the armor-bearer refused, he dared not; whereupon Saul took his own sword and fell upon it.
Is that a suicide, as we know it in our culture? It’s not a clinical judgment we can make from here, but what we can say is that Saul has continued to place himself in harm’s way, and when the wounds from his enemies have not quite killed him, he does take his own life.
So did King Saul have PTSD? All we can say from here and now is that we hear the story of a man who goes to war over and over again, with sword and spear, hand to hand. We see him in troubled sleep, we see him in rage, we see him terrified in the night. We see him keep his weapons at hand. We see his relationships distorted, his trust broken, his life a constant succession of combat. And we see him go to battle one last time, where he dies. We don’t have the data to check all the boxes, to see whether he meets the criteria we now use. But we do have the shape of his character, and how it reflects the life he lived, the extreme events he went through and witnessed. King Saul may or may not have had what we now call PTSD, but the man in the story is someone who went to war and came back changed, with wounds and scars on his mind and soul as well as on his body.
Andrew Stone, MD
Hebrew 1 Samuel. Dead Sea Scroll, ca. 200 BCE.
Dead Sea Scroll Foundation.
1 Samuel. Itala Fragment. 4th-5th Century CE. Collegiate church of Quedlinburg.