San forager populations in nineteenth-century southern Africa were forced to adapt to greatly destructive aspects of the colonial project. Forging new societies from heterogeneous sources, they engaged in prolonged armed insurgency, recording their exploits, presence and beliefs in the rock-art archive of the Maloti-Drakensberg. These images reference conflict and trauma, conventionally interpreted as visions of spiritual warfare. However, viewed through the lens of post-traumatic stress disorder (PTSD), deeper dimensions emerge. PTSD is the culturally subjective experience of generalizable neuropathologies which develop following a traumatic event. Diagnosable in diverse communities worldwide, it nonetheless requires insider idioms to understand its local expressions. We explore how PTSD manifested in this historic and cultural context; how its symptomatic social dysfunctions would have been understood in forager aetiology, and how its intrusive flashbacks would have intruded on altered-state experiences induced to heal the consequences of violence. We find that the artists were not passive victims of trauma, but rather used art symbolically to reconsolidate individual and collective understandings of traumatic events.