Do We All Suffer from PTSD?

The explosions wake me up at night. I'm back in the war. I almost roll off the bed to lie on the floor.The enemy is at it again. Mortar rounds. Then a shriek, a blast as the 75mm recoilless rifle round lands close. I'm caught in the open, in between waking and dreaming. It only lasts a moment. I wake up. I remember. It's the preliminaries for the 4th of July. Bottle rockets and the thick firecrackers that look like sticks of dynamite.  Fireworks, just fireworks. The neighborhood kids, ignoring city ordinances, defying the police, are having their fun. No fun for me. My nerves can't tolerate the homegrown artillery. It's part of what we call PTSD. And that is a complex subject, not easily explained in a short space like this.

The 4th of July is about war, the bloody one that won us our independence. We forget the Revolutionary War but there is a reminder. June 27 is PTSD Awareness Day. The U.S. Congress established that annual observance. Typically, the citizens for whom the soldiers fight ignore it. But the combat veterans never forget it. We know that every war has its crop of neurasthenia, "soldier's heart," as they used to say in the Civil War, the WWI shell shock, the WWII combat fatigue, the clinical DSM-IV Post Traumatic Stress Disorder, the bane of Vietnam veterans. And the signature wound of the recent wars, TBI, traumatic brain injury, from the liberally sown IEDs, all wrapped up in the tight bandages of "nostalgia." The early doctors recognized nostalgia long ago, the memories that don't quit. 

The American way of war creates a huge number of support troops supporting the 10% of the men who do the actual fighting. It's important to understand that there are veterans, and then there are combat veterans. But all are part of the war machine. I bring this up because too often the professionals who are supposed to help veterans "readjust" do not make the distinction, and this is not good. The focus on the combat veterans is lost. Of course, I'm focused on my own experience in my war, which allows insights into the experiences of many other combat veterans, young and old, going back to the Second World War. I have a very tender spot in my heart for the suicidal veterans, especially Iraq and Afghanistan veterans, with whom I have had long conversations, desperate young men whom I feel I have helped to see a way out of their despair. 

I believe that our entire society is suffering from PTSD. The eternal wars we have been fighting for the last 20-years are the reason for this. Killing should be the province of a small select group of professional soldiers, but constant war erases that boundary. You don't have to be a soldier in combat for the war to visit you. The truth is that there are no winners in war. It's been said many times but it bears repeating. Front line soldiers are trained to kill. Kill the enemy before he kills you. That's the simple logic of war, and in spite of our high-tech world, the man with the rifle continues to be the essential element in any army. Even pilots dropping lethal bombs from on high suffer the consequences of killing. But killing is not good for the soul. Killing is a violation of our humanity. Killing wounds the killer. The term for this is "moral injury" and it is a cause of PTSD, along with actual physical harm, even if that harm is just exposure to stress. The psychiatrist Jonathan Shay who has popularized the term "moral injury"defines it as a profound betrayal of "what's right," a violation of conscience by the individual soldier, or by his commanders. Moral injury is a psychic wound inflicted by acts that transgress deeply held moral beliefs and expectations. What does moral injury do to the soldier? And to the society that creates him and sends him off to war? Many combat veterans come home from war full of guilt, shame, depression, anxiety, rage, hopelessness, with vivid memories of bloody deeds, and above all a frightening loss of trust in themselves, in their families and communities, and a dark nihilistic rejection of God. From the individual level these symptoms migrate to the social level. We see that in the epidemic of mass murders and seemingly random and spontaneous acts of violence and killing that happen almost every day in this country. And most unsettling, in the readiness of our political leaders to resort to war as a solution to international problems.

Joe Barrera, Ph.D., is the former director of the Ethnic Studies Program at UCCS. He teaches Mexico/U.S. Border Studies and U.S. Military History. He is a combat veteran of the Vietnam War.