An Uphill Battle: Post Traumatic Stress Disorder in War Veterans

When Ted Lavender is shot in the head in Tim O’Brien’s quintessential short story, “The Things They Carried,” his death is added to the multitude of other things that his friends and fellow soldiers must carry with them through the unforgiving landscape of the Vietnam War. The physical weight of what most of the lug on their backs through the jungle is enough to crush the spine; the psychological, emotional weight of the intangible—like Ted Lavender’s death—is enough to crush the spirit:

Kiowa, who saw it happen, said it was like watching a rockfall, or a big sandbag or something—just boom, then down—not like in the movies where the dead guy rolls around and does fancy spins and goes ass over teakettle—not like that, Kiowa said, the poor bastard just flat-fuck fell. Boom. Down. Nothing else (370).

The sights and sounds of war are not as glamorous as Hollywood makes them out to be. Just as Kiowa discovers this when he witnesses the unceremonious death of his friend Ted Lavender, so do a great many soldiers, in reality, discover the astonishing quickness of death, and the back-breaking weight of residual trauma.

After the Vietnam War, post-traumatic stress disorder (PTSD) was “conceptualized…as a relatively rare response to extraordinary and severe stressors such as war, violent acts, road traffic accidents or industrial accidents, sexual assault, and other disasters or events outside the range of normal human experience” (Horton n.p.). It is estimated that 30% of Vietnam War veterans are afflicted with PTSD and that up to 20% of soldiers returning from Afghanistan or Iraq also suffer from the condition (Robbins n.p.). However, PTSD is nothing new among veterans of war; Swiss Soldiers originally documented the symptoms in 1678 (Horton n.p.).

PTSD is categorized by three different sets of symptoms: emotions of distress brought on by flashbacks, nightmares, and other intrusive forms of revisiting a traumatic event; anti-social behavior as a strategy to avoid “symbols and cognitions associated with the event”; and those resembling deep depression including insomnia, “inability to have positive emotions such as happiness and loving feelings,” and an inability to “live in the present” (Horton n.p.). While today it is recognized that anyone can suffer from PTSD, it remains remarkably prevalent among war veterans—who are likely to experience post-traumatic stress in one form or another (Robbins n.p.). This is, of course, a result of the high amount of disturbing imagery and situations that soldiers are subjected to while at war. Horton quotes one soldier in particular, Lance Corporal Johnson Beharry, as saying, “Sometimes you just can’t get away from what you have seen, the minute I close my eyes I see my dead friends.”

Death, the regularity and familiarity of it in a war setting, has perhaps the biggest hand in soldiers’ development of PTSD. Horton, who served as a nurse in an Iraq field hospital, speaks of the idea of “war consciousness” in her article “Dealing with self-distress.” She describes it as an abrupt switch between participating appropriately in one’s everyday endeavors, to feeling and behaving as if he or she is back in the thick of combat. Her description of this switch in consciousness provides a good idea of the psychological state and stream of thought experienced by a soldier at war:

‘Feeling so hot, must prepare the nursing team for this horror, brief them, take care of them, protect them; so many last offices to perform. Still have patients in the ward, some for evacuation by road or Chinook, must decide.’ I walk to my office across the sandy floor, listening to the noise of war, smelling the death, my feelings and senses are numbed, frozen, I am watching a film of myself in my head but I can see, hear and smell the scenes.

A great number of returning soldiers will experience something like the sudden return to “war consciousness” that Horton describes here. Others may experience mental illness in other ways, but will not seek help because they are not familiar with PTSD or the myriad of resources available to aid veterans in returning to normalcy (Robbins n.p.). It is difficult for some to view PTSD as a legitimate service-related injury, and that developing the symptoms of this mental illness is not a sign of weakness but rather “a biological response to stress that cannot be processed in the brain” (Robbins n.p.). For one reason or another—and this is not necessarily specific to war veterans—there is a stigma associated with seeking help for psychological disorders. It is incredibly important, however, for returning soldiers (and even those preparing to go to war) to be informed of the symptoms of PTSD, as it can become a life-threatening condition for some.

Many veterans suffering from PTSD return from war feeling hopeless, guilty, depressed, and ashamed for both the inhumane things they were forced to do to survive and for their own perceived mental and emotional weakness preventing them from overcoming the symptoms of post-traumatic stress on their own (MacDonald n.p.; Horton n.p.). It is not uncommon for soldiers to lose their battle with PTSD—especially if they do not seek outside help—and “succumb to the effects of war” by committing suicide (Jones 376). A losing fight with PTSD can also manifest itself as a relative loss of sanity, such as what Horton describes during one of the most helpless points in her experience with the illness:

Over the next few years, I was to watch that film hundreds of times, unable to stop it or prevent its triggers. The ending of the film (sometimes after minutes, sometimes hours) always left me weeping and melancholy, an overwhelming sadness engulfing me, a frozen war consciousness holding me in the past, in Iraq… I developed rituals, began relationships with the dead men, speaking to them by name.

The hopelessness described here is characteristic of what many people with PTSD feel every single day. For one suffering from this kind of stress, seeking the right kind of help could be the difference between life and death. There are a number of options for returning soldiers who recognize and wish to alleviate themselves of the symptoms of PTSD. There are psychological and psychiatric treatments such as therapy, support groups, medication, and a form of psychotherapy detailed by Horton called eye movement desensitization and reprocessing (EDMR). After making a chance discovery of the close relationship between eye movement and emotional distress, Dr. Francine Shapiro developed EMDR therapy to considerable success:

When people are traumatized they may experience such powerful emotions the brain is overwhelmed: as a result the brain is then unable to cope with or process information as it does ordinarily. Distressing experiences become ‘frozen’ in time, stored in the brain in the original ‘raw’ form reoccurring as ‘action replay’ (flashbacks) or intrusive thoughts/memories… EDMR works by directly influencing the way the brain functions, helping it to restore normal function with psychological coping mechanisms (Horton n.p.).

Like traditional therapy, EDMR requires the patient to recount their painful memories of the war in order to overcome them (Horton n.p.). This can be a painful process for most but is one of the key healing factors in many forms of treatment for PTSD. In fact, many have found peace in recounting their stories with one another in support groups, or through spiritual congregations. MacDonald tells the story of Tim Pollack, a retired Army infantryman whose skull was severely damaged during his time in Iraq. Like many, Pollack developed a substance abuse problem and contemplated suicide as the final means of escaping the dark cloud that PTSD had hung over his life (MacDonald n.p.). Fortunately, though, Pollack found solace in religion, an institution that has made significant efforts in America to conduct positive outreach toward returning soldiers (MacDonald n.p.). Due to these efforts, Pollack joined a congregation and began leading support groups for fellow veterans (MacDonald n.p.).

Much like the outreach that is conducted by the church, the National Alliance on Mental Illness has also taken steps to engage veterans—as well as the general public—in educating themselves on the psychology of war and post-war life. This additional focus on civilians and not just veterans alone may be one of the critical missing pieces of aiding returning soldiers in their journey to recovery. As was mentioned earlier, many are under the impression that it is a sign of weakness to seek mental help. The more who understand that this is simply not true, the more who can provide support for their own friends and family, or even themselves.

Recognition and remembrance become particularly imperative in this context. On Veteran’s Day, for example, those who have served in the United States military are honored with pageantry and national appreciation. Those who died in service are also acknowledged, as they gave their lives for a noble cause from which the American people as a whole have benefited. The observance of fallen soldiers, however, should also extend to those who have fallen victim to the devastating effects of post-traumatic stress. An emphasis on the severity and high-occurrence rate of this disorder could raise public consciousness, and treating those who have died or suffered from PTSD with respect, honor, and care could raise the hopes of veterans in terms of finding the right help to get them through it.

War is traumatic for everyone, but those who choose to fight will garner experiences that many of their friends and family at home will only see in their most horrific nightmares. Even if the war is over, for many, a personal war begins as soon as they come back. The brutality and almost otherworldliness of what veterans see, hear and feel while at war is something that sticks with them long after it’s over. Horton likens the symptoms of PTSD to those experienced by people coping with the end of a long-term relationship. When death and suffering become commonplace in the lives of those fighting for their country, the abrupt switch back to civility must not be taken for granted. For those waiting with open arms to receive their loved ones returning home from this experience, it is important to lend support, sympathy, and a hand to help carry all of that extra weight.

Works Cited

Hilary, Horton. "Dealing with self-distress." Occupational Health 10 June 2011: n.p. Print.

Jones, E. "Book Review: Penny Coleman (2006) Flashback, Posttraumatic Stress Disorder, Suicide, And The Lessons Of War (Boston, MA: Beacon Press). Pp. Xiii + 223. 11.99. ISBN 978-0-8070-5041-5."History of Psychiatry 19.3 (2008): 376-377. Print.

MacDonald, Jeffrey G. "Fighting postwar stress; Groups, congregations pave a path of spirituality to help veterans."USATODAY.com. N.p., 5 Aug. 2009. Web. 7 Dec. 2013. <http://usatoday30.usatoday.com/printedition/life/20090805/ptsdchurch05_st.art.htm>.

Robbins, McLean. "Associations offer a helping hand to veterans with mental illness." Employee Benefit News. N.p., 15 Sept. 2008. Web. 7 Dec. 2013. <http://www.benefitnews.com/>.

Tim O'Brien. "The Things They Carried." The Vintage book of contemporary American short stories. Ed. Tobias Wolff. New York: Vintage Contemporaries, 1994. 366-384. Print.