reluctance in initiating or maintaining intimate relationships, and sleep disturbances. These symptoms can in turn lead to serious difficulties in readjusting to civilian life, resulting in alcoholism, divorce, and unemployment. The symptoms persist for months or years after the trauma, often emerging after a long delay.
Estimates of the number of Vietnam veterans suffering from PTSD range from the Disabled American Veterans figure of 500,000 to Harris and Associates 1980 estimate of 1.5 million, or somewhere between 18 and 54 percent of the 2.8 million military personnel who served in Vietnam.
How Does PTSD Relate to Killing?
Societies which ask men to fight on their behalf should be aware of what the consequences of their actions may so easily be.
In 1988, a major study by Jeanne and Steven Stellman at Columbia University examined the relationship between PTSD manifestations and a soldier’s involvement in the killing process. This study of 6,810 randomly selected veterans is the first in which combat levels have been quantified. Stellman and Stellman found that the victims of PTSD are almost solely veterans who participated in high-intensity combat situations. These veterans suffer far higher incidence of divorce, marital problems, tranquilizer use, alcoholism, joblessness, heart disease, high blood pressure, and ulcers. As far as PTSD symptoms are concerned, soldiers who were in noncombat situations in Vietnam were found to be statistically indistinguishable from those who spent their entire enlistment in the United States.
During the Vietnam era millions of American adolescents were conditioned to engage in an act against which they had a powerful resistance. This conditioning is a necessary part of allowing a soldier to succeed and survive in the environment where society has placed him. Success in war and national survival may necessitate killing enemy soldiers in battle. If we accept that we need an army, then we must accept that it has to be as capable of surviving as we can make it. But if society prepares a soldier to overcome his resistance to killing and places him in an environment in which he will kill, then that society has an obligation to deal forthrightly, intelligently, and morally with the psychological event and its repercussions upon the soldier and the society. Largely through an ignorance of the processes and implications involved, this has not happened with the Vietnam veteran.
PTSD and Non-killers: Accessory to Murder?
After I had presented the essence of the hypotheses in this book to the leadership of a state Vietnam Veterans Coalition, one of the vets said to me, “Your premise [the trauma of killing, enabled by conditioning, and amplified by society’s “homecoming”] is valid not only for those who killed, but for those who supported the killing.”
This was the state’s Veteran of the Year, a lawyer named Dave, who was an articulate, dynamic leader within the organization. “The truck driver who drove the ammo up,” he explained, “also drove dead bodies back. There is no definitive distinction between the guy pulling the trigger, and the guy who supported him in Vietnam.”
“And,” said another veteran, almost whispering, “society didn’t make any distinction in who they spat on.”
“And,” continued Dave, “just like… if you came in this room and attacked one of us you would be attacking all of us… society, this nation, attacked every one of us.”
His point is valid. Everyone in that room understood that he was not talking about the veterans of noncombat situations in Vietnam who, according to Stellman and Stellman, were found to be statistically indistinguishable from those who spent their entire enlistment in the United States.
Dave was referring to the veterans who participated in high-intensity combat situations. They may not have killed, but they were there in the midst of the killing, and they were confronted daily with the results of their contributions to the war.
In study after study two factors show up again and again as critical to the magnitude of the post-traumatic response. First and most obvious is the intensity of the initial trauma. The second and less obvious but absolutely vital factor is the nature of the social support structure available to the traumatized individual. In rapes, we have come to understand the magnitude of the trauma inflicted upon the victim by the defense tactic of accusing the victim during trials and have taken legal steps to prevent and constrain such attacks upon the victim by a defendant’s attorneys. In combat, the relationship between the nature of the trauma and the nature of the social support structure is the same.
PTSD in the World War II Veteran
The degree of trauma and the degree of social support work together to amplify each other in a kind of multiplicative relationship. For instance, let us take two hypothetical World War II veterans. One of them was a twenty-three-year-old infantryman who saw extensive combat, killed enemy soldiers at close range, and held his buddy in his arms as he died from close-range enemy small-arms fire. The trauma he endured would probably rate at the very top of the degree-of-trauma scale.
Our other World War II veteran was a twenty-five-year-old truck driver (he might just as easily have been an artilleryman, an airplane mechanic, or a bos’n’s mate on a navy supply ship) who served honorably, but never really got up to the front lines. Although he was in an area that took some incoming artillery (or bombing or torpedoes) on a few occasions, he never was even in a situation where it was expected that he would have to shoot at anyone, and no one ever really shot at him. But he did have someone he knew killed by that artillery fire (or bombs or torpedoes), and he did see the constant remains of death and carnage as he moved along behind the advancing Allied lines. He would be placed very low on our degree-of-trauma scale.
When our hypothetical World War II veterans came home after the war they returned as a unit together with the same guys they had spent the whole war with, on board a ship, spending weeks joking, laughing, gambling, and telling tall tales as they cooled down and depressurized in what psychologists would call a very supportive group-therapy environment on the long voyage home. And if they had doubts about what they’d done, or fears about the future, they had a sympathetic group to talk to. Jim Goodwin notes in his book how resort hotels were taken over and made into redistribution stations to which these veterans brought their wives and devoted two weeks to reacquainting themselves with their family on the best possible terms, in an environment in which they were still surrounded by the company of their fellow veterans. Goodwin also observes that the civilian population they were returning to had been prepared to help and understand the returning veteran through movies such as
Our infantryman was one of the comparatively few World War II vets who participated in a ticker-tape parade in New York. Everyone griped about how what they really wanted to do was put all this “Army BS” behind them, but he would privately admit that marching in front of those tens of thousands of cheering civilians was one
