Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War Reviewed by Ellen Nessuno
Let me say upfront that even if you do not read the whole book, you owe it to yourself as a veteran, relative or friend of a veteran, psychotherapist, social worker, or aware citizen of this nation, to read at least the foreword by Dr. Shay, the introduction by Penny Coleman, and most tellingly, the final chapter that makes it irrefutably clear that our collective “amnesia, numbness and denial” continue to cause pain and death to Vietnam vets and now to a new generation of combat veterans. Coleman’s fierce and clarion call to speak up for the humanitarian rights of soldiers engages the reader and, hopefully, spurs each of us to action. Coleman interleaves brief recountings, mostly by widows and a few children of Vietnam vets who killed themselves after returning home, with a history of the U.S. military’s refusal to acknowledge and treat the psychological damage of veterans. Some suicides occurred within a few years or less, others some time later. At first glance, some of the survivors’ first person accounts can sound self-pitying, but beneath that lies the complex knot of guilt –“ why didn’t I know?” “what could I have done?”; shame resulting from the stigma still attached to suicide and the consequent denial of support from family, friends and religious institutions; anger – at both the suicide himself for abandoning them and at the military and governmental agencies that denied help; and pain over the lack of support and acceptance that allows one to grieve and to heal. As one child of a suicide quite lucidly saw, “My dad actually killed people. He was trained to kill people. You’re trained to kill people, you get shot a lot, and then you come home to a regular family. How weird is that?” (page 44). The answer is that for more and more veterans then and now, it is weirder than they can handle. And while, at Ft. Carson, CO for example, vets returning from combat in Iraq are supposed to receive seven hours of counseling, no soldier interviewed by United Press International in May 2004 had received any counseling” (pages 164-5). And now, as in Vietnam, there is also no re-entry ritual. While parades and reunions may have limited purpose for veterans, they do provide some means of bridging the gap between there, then and here, now. Vietnam veterans have very few reunions compared to WW II vets, and it is likely that Iraq veterans will have fewer still, and feel even more isolated upon return and afterward. Coleman provides a very readable history of treatment, or rather lack thereof, for psychological maladies. Posttraumatic stress syndrome has been called many things in the history of warfare. In part because of the lack of definition and recognition of PTSD, there is no clarity about how many veterans were affected after World War II. What is clear, however, is that the average age of WW II vets was 26, Vietnam vets 19. The younger soldier has not yet matured to the point of being able to develop coping mechanisms. Also, through WW II, military training involved drilling; as of the Vietnam era, it started with psychologically breaking down the new soldier so that he/she was less an individual than a unit in a larger unit. Even when there was a draft, the demographic in the military was not the same as in the general population. That is true of even greater numbers now when the military often recruits the youngest, least educated, most economically disadvantaged, and most psychologically vulnerable members of the population. These soldiers may be more likely to suffer PTSD, and the military more than ever discourages them in every way from seeking help. It also uses the often delayed appearance of PTSD to avoid responsibility. A widow said, “I think Vietnam ripped his heart apart. The bullet [with which he shot himself] just finished what the war started” (page 124). A friend of mine who is the son of a military family, has a brother who is a career military person, and himself a West Point graduate who never was in combat points out that the military is the only profession which trains one to kill directly; all other professions either are geared to save life, sustain it, or at worst kill indirectly through socioeconomic systems and consequences. Coleman quotes from Dr. Jonathan Shay’s work, saying he uses the Greek word themis which he translates as “what’s right” to “describe the ‘trustworthy structure’ that should characterize a solder’s relationships within the military.” Shay believes that “Veterans can usually recover from horror, fear, and grief once they return to civilian life, so long as ‘what’s right’ has not been violated.” And what’s right is that soldiers be appropriately trained and equipped. It also helps to feel that one is fighting for a just and right cause. The military failed Vietnam combatants on all points, and is failing even more profoundly with Iraq and Afghanistan-era soldiers. Coleman documents in her book the military’s attempt to get a “quick fix” for soldiers suffering from the horrors of combat by giving them drugs and forcing them to return to combat. According to a military psychologist, “if drugs are given while the stressor is still being experienced…they will arrest…the development of effective coping mechanisms, resulting in an increase in the long-term trauma from the stress.” The military and the VA are creating the basis for even more PTSD cases and at the same time refusing to recognize them, particularly as some symptoms and suicides can occur several years after completion of military duty; they are called a “hidden death.” One of the unsubstantiated rumors of the Vietnam war is that there were more suicides than combat deaths. The rumor persists but independent, non-military studies are beginning to demonstrate the rumor is indeed true. And PTSD doesn’t just go away. At a recent symposium on PTSD, also attended by Penny Coleman, Michael Uhl, Ph.D., a Director on the board of Veterans For Peace, and a Vietnam vet, said in his opening comments, “…this mentally disordering thing weighing me down since my return from Vietnam…wasn’t just a mood swing or a bad day; it had threatened to become a state of being which seemed to literally drive my will toward choices that were irrational and self-defeating.” |
This well-written, informative book is the authentic voice of the widow of a Vietnam combat veteran. She combines compassion for the soldiers who survived combat but took their own lives, and for their parents, widows and children, with a clear-minded look at and recounting of what survivors, scientists, medical professionals, writers, and activists perceive as the lessons to be learned from Vietnam and our government’s and military’s devastating denial and maltreatment of veterans of Vietnam, and now, Iraq and Afghanistan.