31 May 2007

Wartime Reality

Filed under: Culture, Ktismata, Psychology — ktismatics @ 12:44 pm

When I was in grad school I helped start a counseling center for Vietnam veterans. This was around 1980 — 5 years after the last American troops pulled out of Vietnam, the same year that post-traumatic stress disorder was officially recognized as a diagnostic category by the American Psychiatric Association, two years before the Veterans Administration acknowledged that PTSD was a problem with the Vietnam vets. We started a group, and lots of vets started coming out of the hills looking for help. While we had some research findings and some psychoanalytic theory to work with, we were exploring mostly uncharted waters.

Our plan going in was to get the vets to relive their combat traumas, leading to catharsis and a resolution of symptoms. We soon discovered that catharsis didn’t have a lot of impact. The vets felt alienated from loved ones, paranoid, psychically numb, drawn to substance abuse and high-risk behaviors, prone to outbursts of anger, unable to hold down a job. There were occasional violent episodes and hallucinatory flashbacks (just like in the movies), but for the most part the problems were chronic.

Most of the vets in the group had never talked about their experiences with other vets; now they began to recognize that they shared with one another a similar orientation to civilian life. In getting to know their stories I realized that this orientation to life had begun while the were in Vietnam as survival strategies.

  • Alienation — when your friends are apt to be killed at any minute it doesn’t pay to get too closely attached.
  • Paranoia — the jungle and the village hold hidden terrors; a civilian may turn out to be a guerrilla.
  • Psychic numbing — when threat is imminent and continual, loss is frequent, and killing is part of your job description, then reacting emotionally just makes you less vigilant and more vulnerable.
  • Substance abuse — alcohol and drugs helped with the psychic numbing in Vietnam.
  • Risk-seeking — when life poses a constant threat, actively pursuing the enemy at least gives you the illusion of control.
  • Outbursts of anger — for a soldier, anger is part of the motivation.
  • Unemployability — when victory is not achievable, the only ways out of the war are death, injury, and the end of your tour of duty — i.e., losing your job.

Vietnam wasn’t just a different country; it was a different reality. What gave life meaning in America — home, family, success, competition, possessions, fun — had no place in Vietnam. War strips life back to the basics of survival — life and death, attack and defense, fear and anger and loss, hypervigilance and fatigue. After discharge, the survivors found it hard to return to the petty concerns of daily American life — it just didn’t seem serious. Though they had come home, they were still living inside a wartime reality.

My job was to help the vets to get over it, to re-adapt to civilian life, to lose their symptoms and regain psychological well-being. But as I came to a better understanding of their lives, catching glimses of life the way they saw it all the time, I began to have a change of heart. These guys knew things about life that I didn’t. Maybe they could sensitize me to strands of meaning that I ordinarily ignored.

At the time I wasn’t able to formulate these insights fully. My job was to serve as an ambassador of normal American reality. Welcome home; I’m here to help you resume your place in this reality. Knowing what I do now I’d go about it differently. Welcome home; teach us what you’ve learned.



  1. Yep, you were the right guy at the wrong time. The fellows that you worked with were hurting. It is poignant reminder of just how much pain can come when the reality that a person sees is not shared by those around him. It’s amazing that no one at the time (and few today) would think to say, teach us what you’ve learned, isn’t it?

    Wonder what a difference that could have made?

    Maybe you’ll get another chance to find out.

    Meilleurs voeux!!


    Comment by blueVicar — 31 May 2007 @ 1:29 pm

  2. I have much respect for veterans.


    Comment by Odile — 31 May 2007 @ 2:00 pm

  3. bluevicar –

    This is one direction to take: see the reality that the other person sees. It becomes possible also to disaggregate a reality into the component strands that give it its unique texture: danger, loss, death. Each of these strands links many different phenomena together; each strand also links the isolated individual to all the rest of us.


    Comment by ktismatics — 31 May 2007 @ 3:30 pm

  4. Odile –

    I too admire veterans. War is a terrible thing — governments are under obligation to place soldiers into wartime only when the war is just.


    Comment by ktismatics — 31 May 2007 @ 3:30 pm

  5. I started into college just as the Vietnam War was finally winding down and ran into quite a few vets on campus. It was a totally different type of experience talking to these guys and you are absolutely right that it moves you out of the comfort zone, sometimes shockingly.

    My next experience with PTSD was strictly vicarious, when doing medical transcription for a psych practice and seeing the reality from another standpoint, that of the general uselessness of the standard approaches to treating PTSD.

    The same guys would be back telling over and over their inability to switch back to ‘normality’. Dysfunctional in society, marriage and work. The psychiatrists doing their listening-prescribing jobs and feeling equally helpless in the face of combinations of symptoms that the cocktails prescribed barely had an impact on.

    It’s perhaps not so odd, but I was actually planning on commenting on Ktismatics about PTSD just a couple of days ago…


    Comment by samlcarr — 31 May 2007 @ 10:27 pm

  6. I don’t think a pill relieves the need for expression, telling the story. I’ve seen ballet, books, paintings inspired by war. I find that some find a drive to live that is impressive and inspires.


    Comment by Odile — 31 May 2007 @ 11:08 pm

  7. John,

    Were you successful in helping them for the most part?


    Comment by Ivan — 1 June 2007 @ 1:17 am

  8. Sam –

    You and I are contemporaries — I would have been drafted had I not been at university. The threat of the draft energized students to protest in a way that they haven’t about Iraq — not enough self-interest to stimulate the idealism. The returning vets who went to college were instrumental in legitimizing the protests. Given the personal toll it took, it’s understandable that a lot of the guys were reluctant to acknowledge that their efforts on behalf of the Vietnam war were unnecessary and futile, just as it will be for the Iraq veterans.


    Comment by ktismatics — 1 June 2007 @ 8:15 am

  9. Were we helpful? I’m not sure. I would get the sense at a certain point that I had nothing further to offer a particular vet, without knowing whether it had been of value. Vets expressed gratitude and said they were helped, so that’s something. I think it was helpful for them to know that someone else could see a little bit of what they saw and didn’t think they were nuts. Group was also helpful in this regard: I’m not the only person who’s having this experience. But one of our clients suicided; one of my clients took his family hostage at gunpoint and I had to go in with the police SWAT team at 3 am. Mostly, though, there remained a pervading sense of sadness and anxiety and resentment. To put this inside the vets’ heads rather than in American society was an injustice, an effort to treat these guys as individual psychological casualties rather than as indicators of something wrong in America.

    In his book about Unformulated Experience Stern cites Tim O’Brien’s novel The Things They Carried, which is the best Vietnam vet novel I’ve read. Stern’s point about the novel is that the vets didn’t just repress their memories of traumatic experiences; they never allowed these experiences to take meaningful shape in the first place. So telling their story means creating the story, embedding the past events into a current framework of meaning that allows them to make sense of it now.


    Comment by ktismatics — 1 June 2007 @ 8:26 am

  10. We humans often end up in senseless situations that we then struggle to ‘make sense’ of. I think the two world wars and the depression that was sandwiched in between were powerful drivers of existentialism, narcissistic as it was, it was also a necessary protest against the smug alliance of church and state that almost destroyed the world.

    I used to wonder, and still do, about how one can ‘make sense’ of something as horribly wrong as war. Certainly Odile’s comment on the war needing to be a just one is one part, but the reality of war is that it hurts civillians 10 times more than soldiers. Soldiers are forced to cause senseless and irreperable harm to noncombatants. Perhaps the most cynical words in today’s wars are “collateral damage”.

    The soldier is ‘just obeying orders’ and in situations like Iraq and Vietnam, also just trying to stay alive while seeming to ‘obey orders’ will be the hardest part. The continuous stress, fear, violence, hatred, rage, disgust… these just can’t be set right so easily.

    Even if we don’t try to turn them into heroes (and that was one older way of cordoning these folks off) acceptance is vital and it has to come from society at large. Families can also help-if only they know how. But all in all it’s a bad deal!

    Another fallout of having accepted that PTSD is real is that this diagnosis is now being used for all sorts of things. Recently i’ve seen domestic violence, rape and child abuse ‘victims’ all being assigned the PTSD tag, not that this then helps in terms of better treatment! it also makes me wonder whether soldiers should be thought of as war ‘victims’?


    Comment by samlcarr — 1 June 2007 @ 4:03 pm

  11. First of all…I am working on a response at your “Unclaimed Sorrows” post. Sorry its taking a while. Various reasons…will explain there when I post…I wanted to comment here on something really interesting.

    “didn’t just repress their memories of traumatic experiences; they never allowed these experiences to take meaningful shape in the first place. So telling their story means creating the story, embedding the past events into a current framework of meaning that allows them to make sense of it now.”

    I can TOTALLY relate to that, in terms of my childhood experiences. I feel like I’m trying now to figure them out rather than bring them into the light of consciousness.

    As for sam’s comments on how we “treat” veterans upon their return, I’ve been getting a wierd feeling in regard to some of the things he mentions, which are already happening with Iraq vets.


    Comment by Jaosn Hesiak — 1 June 2007 @ 7:51 pm

  12. Sam –

    Because Europe was the battlefield for the two world wars while America was not, existentialism and agnosticism took firmer root in Europe. America experienced these wars as foreign conquests, reinforcing the self-image. Europe, having seen itself as the torchbearers of modern civilization, found itself profoundly discouraged and pessimistic. Postmodern trends have taken very different shapes in America and Europe.

    I wonder whether Bush’s “war on terror” is a weirdly masochistic sort of envy of Europe and most of the rest of the world, where war has done so much to shape national identity. But what do we do? Instead of liberating Iraq we plunge it into a long war that shows no sign of resolution (unless Iran can do something constructive). We just don’t seem to do anything right militarily any more.

    As for following orders, Vietnam was a very decentralized operation. Most of the vets told me that their units routinely disregarded orders from central command and control, finding it both safer and more effective to improvise on the ground. Iraq I don’t think works that way, since the American presence is so isolated from the Iraqis. But I think both in Vietnam and Iraq there is a disregard for civilian casualties, kind of like they’re part of the scenery. This of course comes back to haunt the veteran after he’s left the combat zone. Collateral damage I suppose can be justified if you’re persuaded you’re preventing even worse carnage. Vietnam and Iraq don’t meet the criteria for justifiable collateral damage.

    I feel that the returning soldiers ought to bring their wartime perspectives to bear on their home countries. If the Vietnam vets had had more participation, not as heroes or as victims but as people with unique experiences and perspectives, then maybe America might have avoided this whole Iraq thing. The vets I knew were somewhat resentful of the antiwar crowd, but gradually came to acknowledge the futility of the effort. Then they got mad at the government. But mostly they remained profoundly ambivalent about the war, which is probably the most valuable thing we could have learned from them.


    Comment by ktismatics — 1 June 2007 @ 10:10 pm

  13. Oh, here’s something else regarding PTSD as a defense in criminal cases. My partner in the counseling center testified on behalf of one of her clients in a case. The prosecutor, himself a Vietnam combat vet, went after her hard, trying to get the jury to doubt her expertise. The prosecution won the case. Two weeks later the prosecutor committed suicide.


    Comment by ktismatics — 1 June 2007 @ 10:12 pm

  14. Jason –

    It’s good to hear validation of the idea that experiences can remain unformulated for a long time without being actively repressed. This is Stern’s argument: confronted with potentially troubling experience it’s easier and safer never to make the effort to make sense of it consciously.

    I have no doubt that the Iraq war returnees will experience a lot of what the Vietnam vets went through, probably for the rest of their lives. The war conditions were different, and a lot fewer Americans are getting killed in this war, but it’s got the same elements.


    Comment by ktismatics — 1 June 2007 @ 10:14 pm

  15. “a lot fewer Americans are getting killed” Is true but the continuous massing of troops and long tour duties, shortening of leaves and RR etc will mean that the lessons of Vietnam are ignored and in fact you are likely to have a lot more in the way of PTSD affected personnel.

    As you point out, what is worrying is that the ambivalence towards vets both in themselves and in society continues. There is no system for reintegrating soldiers back into society. It has always been a problem for institutionalised people to fit back in to society but now I think we are going to face a redoubled problem unless the realities of PTSD and returning vets is recognised and dealt with more effectively. This is especially true with the end of the Iraq ‘occupation’ in sight, though I doubt that anything like a complete pullout will happen.


    Comment by samlcarr — 2 June 2007 @ 6:31 am

  16. Sam –

    Part of the lesson the military thought they learned from Vietnam was to avoid the short, time-limited tour of duty. Soldiers in Vietnam saw themselves as “short-timers,” keeping their heads down until they’d finished putting in their time. In contrast to the soldiers in a “real” war, who knew they were there until they got the job done and returned victorious.

    The conservatives want to ignore the vets’ troubles. What I’m trying to get a grip on is the liberal way of territorializing the vets as a problem to be dealt with responsibly, a mess of our own making that we need to clean up. The liberal instinct is to embrace the vets as a clinical category deserving our sympathy and help, rehabbing them to become productive members of a society that continues on pretty much the way it did while the soldiers were gone. American externalizes its fears and violence to foreign enemies fought in foreign countries, then externalizes the returning soldiers by assigning them to caseworkers. It seems like something more radical is called for.


    Comment by ktismatics — 2 June 2007 @ 7:08 am

  17. One of the startling stats that I saw on PTSD is that 30% of those exposed to war situations go on to have PTSD, as distinguished from the more general, self-limiting, ‘stress reactions’.

    Certainly “something more radical” is called for. I’m just wondering what it is that you are proposing? Identifying with the victim’s experience and post experience perceptions is a good place to start but what then?

    I also think that starting with friends and family and going outward, there needs to be a heightened understanding and empathy for the sufferer of PTSD.

    I was surprised to see that though it is arguably the commonest after effect of being in a war zone, so little information is available on the adaptations that people who have not been in a war zone themselves will have to make in order not to exacerbate the problem.


    Comment by samlcarr — 2 June 2007 @ 8:18 am

  18. Sam –

    I agree that there are individual differences in feelings of threat and sensitivity to environmental danger, which is how I’m characterizing the central feature of war-based PTSD. Is this sensitivity a “disorder” or a gift? The majority of Americans seemed to perceive big threats emanating from Iraq — was this a widespread epidemic of PTSD, or a political position? This is part of what I’m thinking: that non-vets’ reactions to the vets is what turned their hyperattunement into an illness. If everybody had served in Vietnam, then this hyperattunement would have become part of mainstream culture. What I’m looking for is a way to validate the vets’ hyperattunement as something more like a gift than a problem, which can happen only if others recognize it as such.


    Comment by ktismatics — 2 June 2007 @ 12:53 pm

  19. In Sparta, every inhabitant was also a soldier. There are a few nations who still follow this policy, I think Switzerland is one.


    Comment by samlcarr — 2 June 2007 @ 3:15 pm

  20. So in Sparta would anyone who had never been a soldier be identified as flawed? Probably. In the Soviet Union anyone who criticized the state was regarded as psychologically disturbed. Anyone who has out-of-the-ordinary experiences, or who experiences the ordinary in an unusual way, is liable to be regarded as an outlier by the rest.

    By participating in a foreign war, a few hundred thousand Americans were apart from the rest. The rest responded to the vets’ newly-honed sensibilities and insights either by denying, shunning or pitying them. I don’t want to valorize the warrior or the military. I do want the uniqueness of the veterans’ perspective to be acknowledged as valid and as something valuable to the larger culture.

    We talked about sorrow before. Though war is a theater of mass collective sorrow, most of our sorrow-inducing experiences are individual. Those of us who have had these experiences are set apart from the rest, and our attunements to sorrow are often denied, shunned, pitied. This lack of resonance, lack of acknowledgment, can move someone from an experiencer of sorrow to a sufferer from depression. Now the person is categorized, pitied, cared for — absorbed into the mainstream culture via marginalization, leaving the mainstream untouched.

    In other words and in the extreme, instead of benefiting from the extraordinary among us we turn it into sickness, thereby letting us justify our inability to be affected by it.


    Comment by ktismatics — 2 June 2007 @ 4:09 pm

  21. Hey Doyle and sam,

    I just wanted to let you guys know that I’m really mowin’ what yer’ growin’ here. I think all three of us can probably identify with: “Anyone who has out-of-the-ordinary experiences, or who experiences the ordinary in an unusual way, is liable to be regarded as an outlier by the rest.” That’s not exactly comforting. Or, at least, it strikes a chord.



    Comment by Jason Hesiak — 2 June 2007 @ 7:33 pm

  22. “mowin’ what yer growin’” — dude, this sounds like Californiaspeak. I’m glad it’s striking a chord, even if it is a minor chord.


    Comment by ktismatics — 2 June 2007 @ 8:18 pm

  23. Certainly Neitsche and Foucault would appresiate “instead of benefiting from the extraordinary among us we turn it into sickness”. Paranoia is one of those things that we wish not to be a mainsream experience.

    It is destructive of relationship for trust is at the heart of relationships. Still, I remember some good friendships with some very paranoid people, even when I could not identify with their paranoia. Whether the friendships helped except temporarily to ameliorate the paranoia is another question but I do know that during conversations the fears were temporarily at bay. Sharing of common interests was an important ingredient in forming these friendships.

    The therapist, who is able to identify perhaps more than peripherally may be in a strong position to move the fearful back into some sort of context where it will still be meaningful without being destructive. This sounds entirely like a fantastic prospect, something certainly worth attempting!


    Comment by samlcarr — 2 June 2007 @ 8:28 pm

  24. Sam –

    I expect that your friendship did help your paranoid friends overcome obstacles they might not have been able to do otherwise. Your “affordances” of trustworthiness and openness would activate the relevant attunements in your friends, which presumably are blocked but not completely destroyed by the paranoiac orientation.

    I would hope to be able to understand someone’s paranoia without adopting it as my own orientation. We all enter into relationships with a degree of wariness, and other people really do subtly undermine our trust, even when we’re not consciously aware of it. So we can learn something about ourselves and other people from the paranoiacs among us. Maybe they can learn something from us too, some other motivations and affordances that can counterbalance the fear and mistrust. I’d rather enrich a reality by adding these other strands of meaning than impoverish it by taking strands away.


    Comment by ktismatics — 2 June 2007 @ 9:11 pm

  25. Dude,

    Its not exactly a minor chord. I’d say its pretty central to how my life is going these days. In the comment I just left on your Unclaimed Sorrows post, I mentioned my anger/apathy. I would very much also identify with the vet’s having two different combating allegiences in their soul. You used some phrase up there that I had to go look up…OH…I just remembered it…”a profound ambivalence.” I can strongly identify with that. The very word “ambivalence” seems to connote a certain passive silence. Why I feel “stuck” on my way to work every day.



    Comment by Jason Hesiak — 2 June 2007 @ 9:30 pm

  26. oh…and i did in fact learn “mowin’ what yer’ grown'” here in CA.


    Comment by Jason Hesiak — 2 June 2007 @ 9:31 pm

  27. Interestingly, I think there is a parallel in autism too. A lot of people feel (and i am one) that fear, especially fear of faces but also fear of involvement, or vulnerability, is certainly active in sustaining the ‘higher functioning’ autism and aspergers kids. Perhaps they are almost instinctively in a sort of permanently self protective mode.

    i had one friend as a young adult who was later diagnosed as having aspergers. I remember how our conversations were always driven by shared passions (cars, tennis and evolution) and never got ‘personal’, though underneath i do think we shared something more than just cammeraderie, and it was a good enough friendship that we still (after 20 years) trade occasional emails.


    Comment by samlcarr — 2 June 2007 @ 9:33 pm

  28. Jason –

    Profound ambivalence is something I wrestle with too, often on the anger/apathy axis. Ambivalence looks like passive silence, but it’s perhaps the equipoise of strong but competing vectors locked in a tense immobility.


    Comment by ktismatics — 2 June 2007 @ 9:51 pm

  29. I’ve not had personal experience with autism or asperge; most of what I know comes from reading. An inability to recognize the other as being like oneself emotionally and motivationally would probably make the other seem really alien and frightening. This basic inability to see oneself as another might be basic to the brain chemistry, but with patience they can overcome the fear and establish relationships with people they regard as very much unlike themselves. A real achievement for them. Or would you say that the autistic or especially asperge can, through friendships, come to see others as like themselves? By the way, did you read “The Curious Incident of the Dog in the Nighttime”?

    You seem to make friends with people who otherwise probably wouldn’t make friends with anyone. There’s something friendly about you, I’d say — a willingness to be involved, to make yourself vulnerable.


    Comment by ktismatics — 2 June 2007 @ 9:59 pm

  30. I don’t know, the same thing frightens me a bit, why do I make these connections, perhaps there’s somthing warped inside of me that’s reaching out?

    Yes, with autism, the alien is a good way to look at it. in aspergers one has good language ability so communication comes more naturally but some part of ‘inside’ is off limits and real connectedness remains very difficult.

    I’ve seen kids with severe autism improve but it’s hard work and needs trremendous consistency and patient. The turning away that comes so naturally to these kids is very very hurting to mothers in particular, reminds one of Stern’s example with the twins doesn’t it?


    Comment by samlcarr — 2 June 2007 @ 11:30 pm

  31. Doesm’t sound warped to me, Sam. You seem like the right sort of person to work with kids and their families who have difficulties sustaining human relationships. Having the requisite patience would be difficult for anyone. You’d have to see something in the other person that’s worth the effort to bring out. I’m not sure how many people have that vision. I’m not sure my own vision extends very far even with perfectly sociable people. I’ve become much more PTSD-ish, more asperge-ish, over the past few years — it’s partly why I’m able to think about a psychological practice again. Not because I’ve my vision has widened, but because it has narrowed — if that makes any sense.


    Comment by ktismatics — 3 June 2007 @ 4:15 am

  32. Perfect sense, though it’s unfortunate, but then the ‘vision’, i’ve found, is something that comes and goes. there are periods when you just don’t see the point, it’s all aggro, then something happens that helps to integrate it and take it all to the next level.

    Generally, it helps to find people, individuals, humanity, fascinating, and I think a lot of us do, so the interaction is good in its own self rather than necessarily having to achieve some goal. That may not always be possible in a therapy situation tho…


    Comment by samlcarr — 3 June 2007 @ 9:24 am

  33. I agree with what you say. I also am resistant to the idea of goal-directed therapy, looking for a process that’s good in its own right. So we’ll see.


    Comment by ktismatics — 3 June 2007 @ 1:56 pm

  34. Have a look at this from AP. With or without the VA, perhaps there’s hope that a few more of the soldiers will actually get some help.


    Comment by samlcarr — 25 May 2008 @ 8:54 am

  35. Your link doesn’t work Sam, but I suspect it’s about one of two things. First, the complaint that the VA is trying to downgrade diagnoses from PTSD to something less dramatic in order to save money on treatment. Two, the Democrats’ inclusion of $2 funding for vets’ mental health in the latest $130 billion war funding package. Both of those items rather disgusted me, so maybe there’s something else you’ve seen.


    Comment by ktismatics — 25 May 2008 @ 3:47 pm

  36. Sorry bout that, careless of me to not have checked. Here’s the link itself: http://news.yahoo.com/s/ap/20080525/ap_on_go_ca_st_pe/troops_mental_health;_ylt=Aj.aYv_puWGN7iYxIlasEMus0NUE
    and the original is hosted by AP at


    Comment by samlcarr — 26 May 2008 @ 8:13 am

  37. I’m a bit puzzled by this story Sam. Mental health professionals are volunteering their time, while at the same time the Defense Dept. is trying to hire (i.e. for pay) mental health pros because they’re understaffed. Why doesn’t the VA pay these volunteers for their time? Why does the VA say that maybe some of these volunteers will decide to become paid staffers? One possibility is simply that the VA will only pay counselors who work as salaried employees rather than on a per-case basis to non-employees. Another is that, while the VA recognizes the manpower shortage, they don’t have the budget to pay for more. Another is that the VA insists on specific criteria for offering services, and the volunteers feel constrained by these criteria.

    My personal experience stopping in at the VA mental health center here in town is that they claimed to be adequately staffed, that virtually all the vets they saw there were Vietnam-era and that they paid non-employee counselors only in a few isolated locations around the country. I also got in touch with the mental health volunteer network in the area, and they seemed to have run into difficulties finding Iraq vets. So there were volunteer counselors who had no clients. It’s possible to read that experience into the new story you sent: a thousand volunteers, but hardly any clients, vis-a-vis an understaffed VA that puts clients on waiting lists or gives them only cursory attention. Something’s messed up with this picture, but I can’t quite put my finger on it.


    Comment by ktismatics — 26 May 2008 @ 3:32 pm

  38. The article looked like a bit of PR work from someone who wants to get the message across that ‘something is being done by someone’. There seem to be multiple problems starting with getting the VA to actually admit that a soldier has a disability. For, once they admit it, they are committed to the care. Then there is the staffing problem that is acknowledged but as you point out, not really. I guess it depends on who’s asking?

    From all reports, the number and percentage of Vets with PTSD is much higher than in previous wars, so where have they all gone to? Perhaps they are all just sitting on waiting lists, and waiting…


    Comment by samlcarr — 26 May 2008 @ 7:15 pm

  39. Here’s the latest Iraq PTSD incidence counts. In this post I argued that the diagnostic category of combat-induced PTSD is misleading. I felt that the symptoms constituted not an unresolved trauma but a mismatch between warzone reality and civilian reality. During post-Vietnam this mismatch was typically characterized as a failure on the part of the American public to welcome the soldiers home. But why weren’t they welcomed? Largely it was because of the public’s ambivalence (at best) to the war itself. Obviously the same is true now about Iraq.

    But there’s also this sense of combat being a place where power and aggression are exercised wantonly, where adverse consequences more typically result from restraint than from overreaction. This aggressive posture coincides with the pose of the political hawks who run the war. So the soldier is thoroughly immersed in a physical space and a social hierarchy that encourages the open expression of violence and suppression, both individually and collectively. This is an authentic version of America as a political-military reality. Being brought back stateside, one at a time, where the domestic-tranquility reality prevails, is psychologically jarring. What I wish would happen is not that each of these guys would receive psychological services, restoring them to civilian mentality, but that they could find unified voice to express the profound and awful split between America the free and America the empire.


    Comment by ktismatics — 27 May 2008 @ 12:59 pm

  40. WWI-WWII veterans are considered heroes even today. Society found a place of honour for them to occupy where any strangeness is considered ‘normal’.

    I got your point. Certainly the scene changed with Vietnam or perhaps even Korea? Certainly the idea that America would only engage in ‘just’ wars came to be widely questioned. For the hungry mass media, the horrors of war became grist for the mill, and of course reporting became more objective, more cynical, and more critical. Heroes are now not taken for granted, as John Kerry found out the hard way.

    From what I can make out, public awareness of PTSD is about the best that one can do. Therapy itself seems rather of the hopeless sort-rapping & drugs! The emphasis now seems to be to just avoid the worst of the psychotic episodes and hope that with time the severity fades…

    So, the bottom line is, if the PTSD sufferer can’t adjust to society and society does not have the time or interest to spare to accommodate the veterans and their very real problems, what’s next? Society itself seems satisfied that it knows that there’s a catch 22 and that Ramboes may result.

    I guess the army is just hoping that the dilution factor will keep the lid on things. It certainly sounds as though you are looking for a different route to reality and perhaps a real denouement!


    Comment by samlcarr — 27 May 2008 @ 5:52 pm

  41. Combat-related PTSD is a normal response to a crazy situation. Treatment is helpful, just as it is with other stress-related problems. I suspect though that the existential sense of having invested the most intensely important time of your life in a futile and ill-advised undertaking would stay with you forever. I don’t see any route to help make it happen, but I’d like the Iraq vets — maybe the Vietnam vets too — to stand together against what the USA is doing over there, against the dehumanizing world of violence into which the US government immerses the American soldiers and especially the Iraqi people, and against the unnecessary suffering perpetrated for the sake of corrupt interests in the region. Would it make any difference? I don’t know, but I think the vets would have more of a sense of having done something worthwhile for the world, rather than just having to feel like they’ve been personally damaged and then given some help to forget their experiences.

    “Society itself seems satisfied that it knows that there’s a catch 22 and that Ramboes may result.”

    That’s what’s so terrible about the Congress voting for $100+ billion for another 6 months of war funding and tacking on a little bit for veterans’ mental health. It’s an acknowledgment of collateral damage perpetrated knowingly on Americans, but the big money goes toward inflicting much higher rates of collateral damage on the Iraqis. And the Democrats could pull the plug on the whole thing if they chose to do it. That they don’t, even when both candidate for the nomination of their own party say they’d wind the war down quickly, says a couple of things at least. One, the Dems don’t really want to end the occupation of Iraq and Afghanistan. Two, they’d rather take political advantage of a continued failure of the current administration’s policies even if it means squandering money and lives.


    Comment by ktismatics — 27 May 2008 @ 8:32 pm

  42. A sad and interesting statistic buried in a welter of inane ‘disinformation’ is this:
    “The true incidence of suicide among veterans is not known, according to a recent Congressional Research Service report. Based on numbers from the Centers for Disease Control and Prevention, the VA estimates that 18 veterans a day — or 6,500 a year — take their own lives, but that number includes vets from all wars.” from http://news.yahoo.com/s/ap/20080529/ap_on_go_ca_st_pe/military_suicides


    Comment by Sam L. Carr — 29 May 2008 @ 9:20 am

  43. I was just doing some quick calculations. The suicide rate for Iraq-Afghanistan vets is a little lower than the rate for the general US population, while the rate for veterans overall is more than twice the national average. So I think it’s still mostly Vietnam vets that are at risk — we’ll see how that changes over the years.

    Here’s a table of suicide rates by country. India and the US are about the same. I wonder what’s the story with Lithuania that it would have 4 times the incidence of suicide.


    Comment by ktismatics — 29 May 2008 @ 12:39 pm

  44. The army’s ‘suicide rate’ is a very very political issue right now. I simply find this figure to be hard to believe and my guess is that everything possible is done to avoid calling a death a suicide. The CDC figures are probably more telling, but no breakdowns are available. Back in Novrember ’07 I saw a CBS report on veteran suicides and it looks like they went state by state and extracted some useful info that was ‘unspun’.

    It’s an issue that bears closer inspection especially the question of whether these recent wars (Iraq, Afghanistan) are significantly better or worse than the older ones (Korea and Vietnam). The so called ‘gulf war’ in between was hardly a war but would be useful as a control (similar environment/conditions without the hard combat).


    Comment by Sam L. Carr — 29 May 2008 @ 7:48 pm

  45. The latest Time Mag article on the use of antidepressants (mainly about SSRIs) is particularly interesting in regards to this discussion.
    What’s your take on ‘helping’ soldiers to cope with the war zone in this way? It strikes me that the use of these drugs in this situation is ethically ridiculous given the fact that it is not based on any scientific studies, not even short term ones. Experimenting on the troops in the name of expediency is really the pits!


    Comment by samlcarr — 7 June 2008 @ 11:15 pm

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