The Ernest Becker Foundation
|The Thousand Yard Stare: Post Traumatic Stress Disorder, The Invisible Casualty of War|
|Written by John Lockman|
|Thursday, 07 April 2011 13:59|
The stench of tobacco fills the nostrils of those he passes, his brown stained fingers jotting down sparse and disjointed notes. He awaits anxiously the next break, when his fingers will hold a red-glowing Marlboro red to his lips, ushering the nicotine into his lungs. We listen to the words of the screenwriting instructor, but the electricity of the student's nervous anxiety distracts us like moths drawn to light. His feet bounce to a staccato beat beneath his desk.
We learn he is a gulf war veteran. His writing, raw and plagued with typographical errors, unveils a loose autobiographical account of a corporal's tour of duty; marine bravado punctuated with “jar head” expletives, narrating his horrific memories of combat. Depictions of reluctant sessions with “Wizards,” Marine Corp jargon for Military Psychiatrists, appear throughout. He repeats writing classes over and over, nibbling away at his GI Bill akin to maggots consuming a corpse. He recounts his story with the same nagging typos, and always in the same unwitting self plagiarism, immersed in compulsive self flagellation.
He is but one of the more than 300,000 “psychiatric casualties” trying to readjust to home life after service in Iraq. According to a 2007 study, the projected estimate of lifetime cost of treatment for these brave soldiers is some $660 billion. This is more than the $500 billion price tag of the war itself as of the time of that study (cf. Roehr).
Not all who return from the Gulf war display these symptoms immediately; some are in remission, and symptoms only surface under particularly stressful conditions. Others are apparently unaffected. Nonetheless, according to Mary Susan Littlepage, the level of this conflict disorder compared to others is nothing less than alarming (cf. Littlepage).
According to Peter J. Davidson, MD, a psychiatrist and Chief Medical Officer at the Blue Mountain Recovery Center in Pendleton, Oregon, PTSD is the psychological condition that results when soldiers or civilians experience death up close and personal. This experience shatters the cultural illusions that normally insulate us from the inevitability of our own death. The PTSD victim is profoundly shaken from the illusionary dream of perceived immortality, and lands far too remote from the buffers of religion, heroism and art that society cultivates to shield us from the realities that would make anyone's life unbearable–that is, ongoing and immediate realization of our own ultimate mortality.
Since humans waged war, PTSD-plagued warriors under such names as “railroad spine,” “traumatic war syndrome,” “shell shock,” “combat fatigue,” and “De Costa Syndrome,” as well as more colloquial terms that minimize the condition, such as “exhaustion.” Each conflict probably had its own pet name for it. Due to the modern technical capacity for inflicting mass destruction of savage proportions, PTSD is on the rise and is finally getting more attention. Only in 1980 was the term PTSD officially recognized by the Diagnostic Statistical Manual of Mental Disorders. This was a direct result of psychological research studies in universities across the nation in the wake of the Vietnam war. Paradoxically, as human beings become more destructive, we work harder also to explain, define and treat the ailments that accompany our progressive combative follies.
Before Vietnam, no single event contributed more to public awareness of PTSD than General Patton's infamous “slapping incident” on August 3, 1943. A weeping soldier, traumatized by combat, had taken refuge in a Sicilian hospital. Enraged by this young soldier’s alleged cowardice, Patton verbally assailed him with profane language, followed by a slap in the back of the head. Patton's behavior was reported by the press, thus leading to his suspension by General Eisenhower (cf. “Patton regrets”). Before this watershed event, vividly portrayed by George C. Scott in the film Patton, soldiers were ashamed of this “bloodless wound,” preferring to suffer in silence than to seek help. Thankfully, as the aura of the strong silent type dissolved from the collective psyche of American males through the fifties and the sixties, so did the shame of PTSD.
Only 10% of the U.S. veterans receive disability compensation, 71% of which through 1986 relate to PTSD claims (cf. Roche). The majority of claimants received only up to 30% disability. Prior to 1986, the Department of Veterans Affairs did not rate claims for PTSD at all, dismissing PTSD sufferers as crazy. If all PTSD-affected soldiers were to collect fully, it would represent a significant financial burden; hence the government's evasion of veteran claims is understandable. Roadblocks set for applicants, intended to cause claimant filing delays, forces victims to relive the horrors, and many eventually give up (cf. Roche, pp. 13-15). By minimizing the problem, society escapes the heavy tax burden in the short run. But we owe it to our veterans to provide the most effective, state of the art care possible. America has been engaged in war for twenty years since 1950 and constantly since 2001 (cf. Rubenstein & Livengston). Our economy seems to depend on our military infrastructure and industrial base; it is one of our most viable exports. We have lost over 100,000 men since 1950 to this merciless institution.
But a different war wages in the minds of veterans, resulting in a rate of suicide among combat veterans significantly greater than that of the civilian population. The suicide rate for soldiers in 2002 was 9.8 per 100,000. Now standing at 20.2 per 100,000 soldiers, the rate has more than doubled, despite efforts to screen recruits for preexisting mental illness (cf. Cogan). The number of suicide attempts is 10 times this number. Unfortunately, a past attempt is the greatest single factor determining an eventual successful suicide (cf. Jamison).
PTSD is a chronic condition. According to Annette Ernst, of the Vancouver Veterans Hospital, many PTSD sufferers go into remissions and not display any symptoms for years. But a sudden trigger, such as a helicopter flying overhead, may cause an immediate onset, rendering the person completely psychotic.
Not only do the returning veterans themselves suffer; their families also must endure the hardships of living with a sufferer of PTSD. Drug abuse, family discord, kidnapping, murder and many other crimes have been attributed to this disorder (cf. Sontag & Alvarez). These conditions potentially impact generations to come, compounded in some cases for youth deciding to enlist in order to escape abuse at the hands of their own parents, due largely to their own parents’ PTSD. Given our nation’s continuous wars, coupled with effective recruiting campaigns aimed at youth, a scenario like this is more common than we care to admit.
From a purely economic standpoint, the effects of PTSD are devastating. Given the stresses of employment, many PTSD sufferers are effectively closed out of any realistic vision of a career. The government is known to reject well documented cases of PTSD, and even if disability status is granted, it seeks to limit the coverage to only 30% (cf. Roche). One statement of combat duty by a Vietnam veteran in his declaration describes his 3rd day in the field, on March 3. 1970:
Lt. Deer was dead as his legs were shredded and forehead hinged open. His whole brain was lying on the ground ...Next I dug a hole and buried Lt Deer's brain. I wanted to fall down and cry but couldn't let my men see my weakness. I took over as Platoon Leader until another Lieutenant could be assigned.
Three months later, after documenting no less than six gruesome deaths, he describes the loss of his two best friends PFC Rash and Sgt Tango:
Rash had given me a Gouda Cheese in a red round wrapper he had received from home in a package that day... After dark I heard a short burst of AK-47 fire. Someone said “Boy that was a short fight” PFC had taken many bullets in his chest. He was dead before he hit the ground.
An RPG [Rocket Propelled Grenade] hit Sgt Tango and blew a big hole in his right side. He bled to death before they found him. My two best friends were dead in an instant. I cried and threw away the Gouda Cheese into the jungle. (cf. Roche pp. 30-33)
After a year in the jungle, this soldier was given an honorary discharge with a purple heart for a shrapnel wound to the head. His claim was filed in February 2001, but was rejected and delayed on many accounts. Finally in 2004, he was granted a 70% disability after consulting with John D. Roche, author of The PTSD Handbook. As of 2006, the soldier had not received full disability for PTSD. This is the thanks those who are young, naïve and “invincible” get for being misled into the glory of war.
Not all combat veterans believe PTSD exists. One very affable Vietnam POW survivor, who remains anonymous, was the Commanding Officer of an air squadron over Laos. He endured every bone in his body getting crushed in torture, enduring the sexually sadistic perversions of his captors, a criterion in itself for PTSD. He witnessed comrades starved and beaten to death, yet he denies the existence of PTSD. He and some of his fellow prisoners were repulsed by the behavior of some of their legion who, broke down and allegedly colluded with the enemy. When asked what got him through the ordeal, lasting five years, in which he was brought to the brink of death on a regular basis, he answered with a chuckle, “Martin Luther and his defiance of the dogma of the Catholic Church.” He also amused himself with memories of a lesson on survival at flight school, which warned downed fliers of the fatal consequence from consuming the toxic liver of Polar Bears.
But does the undoubted stoic resourcefulness of a small minority of combat veterans undermine the reality of PTSD? Using VA statistics, the vets’ advocacy group Veterans for Common Sense notes that over a million soldiers will contract PTSD, at a treatment cost of more than a trillion dollars and rising (cf. Littlepage) To put this figure in perspective, this is about 7% of our annual GNP, and about 75% of our U.S Federal Budget deficit! (cf. USDeptclock.org) These cost estimates are almost twice what was given in a 2007 study, which is astounding when we consider that PTSD is an “invisible ailment” the government barely admitted existed less than thirty years ago (cf. Roche).
There are preventative measures that limit the severity of PTSD; however each conflict greets a new generation with its own unique horrors, offering new challenges. Screening those who have a greater susceptibility would also help, but inevitably need for “a few (more) good men” takes priority over the testing results of unproven PTSD prognosticators (cf. Chang). Obviously, the military rarely considers this intangible toll when going to war. After Vietnam, Americans temporarily resisted the glorification of war. But seasoned politicians know only too well that people have short memory spans, and the youth can always be cajoled into serving once these old soldiers and their memories fade. Parade a few glamorous uniforms in front of them, or run a few television ads with a happy gang of combat soldiers smiling as they crawl on the ground sporting rifles, and they will line up at the recruitment booths.
Educators have a powerful arsenal for the eradication of the myths of war. After Vietnam, secondary English teachers were adamant about having students read books such as Heller's Catch 22 and Remarque’s All Quiet on the Western Front. Critical reading of these novels certainly counters the recruitment officers’ pictures of war’s glory and heroism. Another fine didactic work is Ernest Becker’s The Denial of Death, which exposes the psychology behind people’s desires to go to war. Becker’s book also teems with insights into the causes of PTSD, dissolving cultural illusions that serve to protect us against ongoing and immediate awareness of our mortality (cf. Elgee).
Military recruiters regularly visit high schools with the intention of influencing impressionable minds. Wouldn’t it be a worthwhile venture for a vets’ advocacy group to expose students to the words of veterans suffering from PTSD demonstrating the horrors of war? Let these young people take a look into the “thousand yard stare,” up close and personal. Sadly, many Veterans, even some of those who have sacrificed much of their own sanity in battle, feel it is the obligation of the young to put their own lives on the line, that we can perpetuate the American lifestyle and ideology of freedom. But unfortunately, sufferers from PTSD are anything but free. Students deserve to hear dark side of war myths and the dangers of PTSD.
One problem is that most young people are unconsciously convinced of their own invincibility–that death and PTSD happens of others, not to themselves. The reality of war is altogether different, and even if a soldier does escape death, experiencing death up close and personal can leave permanent psychological and emotional scars. Although many young viewers might resist the message of anti-war movies, one World War II Veteran confided that if he ever had seen the film Saving Private Ryan before going off to war, he probably would have become a conscientious objector.
So what can be done for the soldier with PTSD? According to Dr. Peter J. Davidson, whose practice was influenced by the ideas of Ernest Becker, they must be reoriented back into the buffering illusions of the culture (cf. Davidson). This may be facilitated through religion, as we saw in the case of the POW shot down over Laos, in which his identification with the stoic heroism of Martin Luther gave him sufficient internal resources to avoid PTSD. Religion generally provides answers to the unknown with the comfort of a promised peaceful life beyond death. Unfortunately, PTSD survivors know only too well the haunting truth that often counters the plausibility of these religious concepts. But even more than doctrines and ideas, religion also may offer fellowship. Twelve step quasi-religious organizations like Alcohol Anonymous and PTSD support groups foster a sense that sufferers are not alone in the world, and enable them to share their experiences without shame or judgment. Many soldiers have perpetrated horrible acts in war, and on the home front, and forgiveness may be sought through these fellowships and various religious rites.
Art is another way to reintegrate PTSD sufferers back into society. Picasso’s famously painted the masterpiece Guernica as a tribute to the lives lost in the first causalities of modern aerial warfare perpetrated by Franco in Spain. The canvas is chaotic and confusing, reflecting the nature of war. The Dada movement was also a backlash against conformity associated with war. Expressing one's emotions through an artistic venue, whether in written form through poetry and literature, or though other artistic forms, gives the creator a sense of timelessness in a peak flow experience, freeing them from their inner demons and thus slowly reuniting them with the wider society (cf. Csikszentmihalyi).
Finally, culture creates the buffering illusion of immortality through heroism. Through heroism, vets can to reintegrate back into society. An example of this is found in a military text, “Combat Stress: Resilience and Restoration,” which provides the foundational thesis for Sgt Brandi's book, The Warriors Guide to Insanity:
Treating veterans to ticker tape parades, celebrating their return, may relieve their struggles somewhat. However, care must be taken lest the objective get misdirected into hubris and arrogance. Often heroism is redirected back into the war movement. Creating monuments like The Iwo Jima Memorial in Washington, DC celebrates a comradeship, bonded in patriotism, urging youth to join the gang that planted the American flag on captured territory. I remember seeing it for the first time, as a young boy scout. It literally brought me to tears, anticipating for the day I could shave my head and enlist in the Marine Corps. But now I can only wonder, How many “invisible casualties” were inflicted in planting that flag on that piece of dirt? These invisible, bloodless wounds of war are difficult to memorialize. Andrew Jackson looks gallant on his rearing horse in DC’s Lafayette Park, but what does this monument of flashy General with his “Elvis” bouffant really tell us about the traumas of war?
However, we are making inroads. The Vietnam memorial wall was purposely erected as an understated tribute, without pomp and circumstance. More importantly, it is interactive, helping veterans experience cathartic release by tracing the names of fallen brethren from the etched engravings on the dark granite wall.
Coincidentally, as I was finishing this piece of journalism, a fellow student, always cheerful and well liked by his peers, came up to me. I confided to him that I was writing about his ordeal, his story, though one would hardly recognize him now from the description of him in the opening paragraphs. I asked if he was okay with it. “Ya good to go,” he replied. Let’s face it, once a marine always a marine! He is much calmer now. His gaze is no longer lost on the horizon. His self-prescribed literature therapy is been working–he has a few less typos and recently submitted a story that had nothing to do with the Corps. Who knows, at this rate, eventually he may even give up those cigarettes._________________________
Brandi, Andrew B., The Warriors’ Guide to Insanity: Traumatic Stress and Life. Self-published book, September 2007.
Chang, Alicia, “Military Experiment Seeks To Predict PTSD.” Military Connection.com 20 November 2009.
Csikszentmihalyi, Mihaly, Flow, The Psychology of Optimal Experience New York: Harper Collins, 1990.
Cogan, James, “US Military Suicide Rate at Record High.” World Socialist Website 4 Feb 2009
Davidson, Peter, MD. Personal communication June 5, 2010.
Elgee, Neil, MD. “Understanding Violence: Tools for Educators and Communities (UVTEC).” Ernest Becker Foundation, A report on the Fourth UVTEC Conference in October 2010 and a note on the background for the series.
Jamison, Kaye Redfield, Night Falls Fast, Understanding Suicide. New York: Vintage Books, 2001.
Littlepage, Mary Susan “PTSD Claims Rise Among Veterans Treated at VA, New Research to Study PTSD and TBI.” Truth-out 23 March 2010.
Lockman John S. Sr., US Navy, Lt Jg ,World War II, Retired. Personal communication, 17 November 2010.
Patton Regrets Slapping Soldier." San Antonio Light, 23 November 1943: 1
Roche, John D., The Veteran's PTSD Handbook. Washington, DC: Potomac Books, 2006.
Roehr, Bob, “High Rate of PTSD in Returning Iraq War Veterans.” Medscape Medical News 5 Nov 2007.
Rossi, Donald, “Combat Stress: Resilience and Restoration.” Department of the Army HQ Carl R.Darnall Army Medical Center. http://sgtbrandi.com
Rubenstein, Richard and David Livengston, “Why America Goes to War.” Washington Post 26 October 2010.
Sontag, Deborah and Lizette Alvarez, “Across America Deadly echoes foreign Battles” NY Times, 13 January 2008