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Trauma, Memory, and Evolving PTSD

Nearly thirty years ago, a crisis in the care for U.S. military personnel returning home from Vietnam, changed the way in which psychological diagnoses were defined. Ever heard of PTSD, of post-traumatic stress disorder? That diagnosis, which made it into the DSM after a protracted and highly political struggle, was created precisely to deal with the collection of symptoms presented by these veterans.

These veterans were experiencing flashbacks, depression, stress, constant anxiety, and too often, psychotic breaks. They were forced indoors much of the time, terrorized by the world and occasionally terrorizing the shrinking worlds around them, their families. Those who were not able to keep it together at even this level ended up in the streets, or dead.

They didn’t, at this early stage, end up in the hospitals, receiving quality care. Partly, this was because of the fact that there existed no diagnosis for these symptoms: they clearly shared a single experiential trigger of sorts – participation in the Vietnam War – but even at that level a great deal of diversity existed. There was the classic victim trauma, but also perpetrator trauma. The latter has received very little attention, perhaps because of the unpopular ethical questions that necessarily accompany its investigation. But the former has become enshrined in our medical, psychiatric, academic, literary, and popular cultures.

In thirty years.

Now, only six years into another great military conflict fought for reasons of imperial ambition, with America’s domestic political scene not only divided, but with one of those halves losing ideological unity and direction, the veterans of the current conflict are finally getting noticed for the problems they are presenting.

Gulf War One created Gulf War Syndrome – a wildly underattended and reported health crisis. Perhaps because we ‘won’ that conflict, it was somehow shameful to report on the costs? But it is increasingly clear that we have ‘lost’ this war, if indeed it was ever winnable.

Compared to these enormous, political, and social questions, the following consideration will necessarily seem trivial. However, this blog does not exist to stake out political positions, but to investigate and draw attention to a very specific range of issues, the most central of which cluster around the academic realm.

The cultural studies/psychological/popular trope of trauma, which plays out nightly on sitcoms, soap operas, radio shows, which makes its way into everyday conversation and spontaneous ‘pop psychological’ analyses of others, comes out of a specific lost war. The veterans and their supporters had to fight extremely hard to get the diagnosis added to the DSM, so that they could be treated.

PTSD is still in the DSM, though Gulf War Syndrome is not. And there are good reasons to want to avoid stuffing the DSM with syndromes, which are by necessity not the same thing as diseases in which we understand the cause of the symptoms. With syndromes, we are still guessing not only at the cause, but by definition, with whether diagnosis refers to a ‘really existing’ pathology, or is instead a collection of related and potentially overlapping problems.

So, while veterans of this current conflict may be able to receive care under the PTSD diagnosis, receiving treatment for Gulf War Syndrome is considerably more difficult. And even those who receive care receive it at places like the Walter Reed Medical Center, at the heart of so many outrageous scandals regarding the healthcare for military personnel

The following article is very worth reading: [link]

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4 thoughts on “Trauma, Memory, and Evolving PTSD

  1. erikwdavis says:

    I only checked the wikipedia article on PTSD this morning, long after posting the above. Turns out George Carlin expressed the same concerns and analysis more clearly and effectively (as is his wont, I am told).

    I don’t like words that hide the truth. I don’t like words that conceal reality. I don’t like euphemisms, or euphemistic language. And American English is loaded with euphemisms. Cause Americans have a lot of trouble dealing with reality. Americans have trouble facing the truth, so they invent the kind of a soft language to protect themselves from it, and it gets worse with every generation. For some reason, it just keeps getting worse. I’ll give you an example of that. There’s a condition in combat. Most people know about it. It’s when a fighting person’s nervous system has been stressed to it’s absolute peak and maximum. Can’t take anymore input. The nervous system has either (click) snapped or is about to snap. In the first world war, that condition was called shell shock. Simple, honest, direct language. Two syllables, shell shock. Almost sounds like the guns themselves. That was seventy years ago. Then a whole generation went by and the second world war came along and very same combat condition was called battle fatigue. Four syllables now. Takes a little longer to say. Doesn’t seem to hurt as much. Fatigue is a nicer word than shock. Shell shock! Battle fatigue. Then we had the war in Korea, 1950. Madison avenue was riding high by that time, and the very same combat condition was called operational exhaustion. Hey, we’re up to eight syllables now! And the humanity has been squeezed completely out of the phrase. It’s totally sterile now. Operational exhaustion. Sounds like something that might happen to your car. Then of course, came the war in Viet Nam, which has only been over for about sixteen or seventeen years, and thanks to the lies and deceits surrounding that war, I guess it’s no surprise that the very same condition was called post-traumatic stress disorder. Still eight syllables, but we’ve added a hyphen! And the pain is completely buried under jargon. Post-traumatic stress disorder. I’ll bet you if we’d have still been calling it shell shock, some of those Viet Nam veterans might have gotten the attention they needed at the time. I’ll betcha. I’ll betcha.

  2. erikwdavis says:

    Hi Bettye,

    I don’t have a link to the act offhand, but if you copy and paste parts of the speech into google, you’ll find a lot of links to various transcripts. I’m certain a video of the performance is online, and maybe another reader could help locate it. I believe it’s from a later version of his ‘7 Words you can’t say on television’ act….

    Good luck!

  3. Stephanie says:

    This is GREAT!!!
    I am a Psychology student who is focusing on treatment of PTSD, most of what is out there seems to be a way for the general public to feel good about what is being done for our combat vets, but not what they can do to help or what the vet has or is going through.

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