Add To Cart

Section 8
Veterans and PTSD

Question 8 | Test | Table of Contents

So you are either swept away by emotion and experience the self disintegrating, or you shut down entirely and feel nothing, the self hardened to stone. This latter is the most common response when faced with loss or with the ordinary demands that intimacy carries with it, as documented in the veterans’ stories. Yet there is never a resolution; there is always a tension between letting go and shutting down. George F.’s narrative is replete with indicators for this pull in these two directions: letting go by the healthy way of intimacy versus shutting down (or off), and now it seems that shutting down has won. George was one of two people among the veterans who told their stories here who did not take the project as an invitation to talk out their narratives with little or no interruption. Several of the veterans came to the tapings assuming that this would be like other research they had participated in, with me asking the questions and them responding. Most quickly sized up the situation and went ahead with an impromptu narrative. George’s tape is made up of patches of narrative, each one in response to an open-ended question. His story is, nevertheless, of a piece, coherent, in the way a mosaic is made up of bits and pieces of material that, viewed from a distance, merge into a whole. Although he never details just what happened there, George refers repeatedly to an event back in Nam on the side of some nameless hill. He assumed he was dead, he should have been, everyone else was, but he woke up in a hospital. This constitutes the core event of the story of his time in Vietnam. He spends four months in a hospital and thus finishes his first tour in the country; he can’t get rid of the urge to go back. His wife has another idea. George refers again to that hill and his “death” there.

“It was a transition, I knew I was mortal now. I still had a semblance of duty, God, and country, but it wasn’t as strong as it was before. They wouldn’t let me go back to Vietnam because I was on a permanent profile. . . . I realized I’d gone through the worst thing in my life—what the hell was anybody else going to do to me that would compare to that, it would be nothing to compare to that.. . . But like I said, I still had a semblance of God and country. The only thing I wanted to do was go back to Vietnam. I didn’t know why, people always asked me why. My first wife— we grew up together—got married between me getting out of high school and going in the army. She just told me she would not be able to take what she had gone through the first tour in Vietnam, and if I was serious about the second tour that she wouldn’t be there waiting for me. I acted like I didn’t give a shit and went anyway. I don’t know why I acted that way. Like I said, she was my girlfriend all three years of high school; we got married, even had a child while I was a drill sergeant. ... I had all the reasons to stay, but there was still something tugging at me to go back.”

And go back he does, intending not to make the same mistakes he made the first tour. First among these, he explains, was getting too close to too many people, people who got themselves wounded or killed or just shipped out never to be seen again.

“I just made too many friends the first tour. I didn’t want to repeat that mistake, but it’s kind of hard—you rely on each other so much that you get friendly with one or two or three or maybe all of them. It was hard. But I thought I managed that pretty well. I guess that was when I first started to shut down.”

George’s second tour lasts until his commanding officers can no longer tolerate his attitude and a few of his actions. These may be characterized (not his words) as “didn’t give a shit, didn’t give a shit who knew it.” Still the losses affected him deeply, he admits. Back in the U. S. A., George sets off down the random path of dealing alone with the aftermath, until, some months before beginning the advanced treatment program, he attempts suicide by shooting.

“I’ve been so screwed up these last six or seven years. I don’t know if I can really understand—I mean, I hear therapists telling me all the time, “You’re getting better, you’re improving.” I don’t feel like it. In fact, I feel strongly that once I get out of this program it’s just a matter of time before I become another statistic. And I battle that all the time. I mean, I don’t know why I shot myself last February, twice. I probably won’t know why next time. Fact is, I was in a blackout when I did it, felt no pain, heard no gunshot, woke up in intensive care. So now I’ve got that haunting me. If I go into another one of these deep depressions, I’ll end up blacking out and become just another Vietnam veteran combat statistic.”

At another point in his story, George reflects back on all the “bizarre things” he did. He also speaks about how he “pushed the envelope a couple of times, life-or-death type things.”

“I remember one time, I was tending bar, back in the early seventies. I had a DAV chapter, I was the bartender there. And I had a guy pull a gun on me one night. I just pressed him to the limit to pull the trigger on me ‘cause I didn’t really give a shit ii he did, because I probably would survive anyway.. . . In that same bar, I remember one night talking to another Vietnam veteran that was so full of shit, did all these courageous things in Vietnam, supposedly, with everybody in the Special Forces down to MACV to almost winning the Congressional Medal of Honor—I just knew he was full of shit. I used to carry a gun in those days. And I remember taking four rounds—it was a five-shot .32 Smith and Wesson —I took four rounds out of that thing. He was telling me how bad he was, and threw it up on the bar. I spun the barrel with that one round in it and threw it upon the bar and said, “Go ahead, pull the trigger.” Course, he had sense enough not to do it. And I picked it up and just to show him he didn’t have any balls to do it, put it to my head and pulled the trigger in front of the whole bar full of people. And gave it to him and said, “I went first, now you go.” Of course, he didn’t again. That was the best night I ever had for tips in that bar. I was thinking of doing it on a regular basis just to get more tips. I mean, that’s some of the stupid stuff I’ve done. And I’ve done that little game in private, too. Maybe that’s what I did that night, too. But that night there were six rounds in the chamber.. . . But the adrenalin pump, it was almost like being in Vietnam. It was getting addictive back then. It’s almost like life doesn’t have any meaning since Vietnam.”

Here is a primary example of the swing from all shut down to fully charged and ready. Moments like these bring you back to Nam and the heightened state of being that is endemic to the combat zone. It takes something like that time back in the bar in Florida to give meaning to life. This brings to mind Tim W.’s lament over the meaninglessness that he has experienced since his “time in the sun,” less than three months in and around Khe Sanh, now some twenty-six years later George seems haunted by his death experience on that hillside-he gives us the very date, February 6th, 1968. In ways that are surely lethal, he seems intent upon recreating that moment, beginning with the irresistible attraction that Vietnam held for him, leading to his signing on for another tour. For George this second period in Vietnam is something he recalls only in fragments. The hillside’s spell invades his dreams.
-Chalsma, H.W., “The Chambers of Memory: PTSD in the Life Stories of U.S. Vietnam Veterans”, Jason Aronson Inc.: New Jersey, 1998.

Personal Reflection Exercise #2
The preceding section contained information about a case of “shutting down” in a veteran with PTSD. Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
Screening for PTSD and TBI in Veterans using
Routine Clinical Laboratory Blood Tests

Xu, M., Lin, Z., Siegel, C. E., Laska, E. M., Abu-Amara, D., Genfi, A., Newman, J., Jeffers, M. K., Blessing, E. M., Flanagan, S. R., Fossati, S., Etkin, A., & Marmar, C. R. (2023). Screening for PTSD and TBI in Veterans using Routine Clinical Laboratory Blood Tests. Translational psychiatry, 13(1), 64. https://doi.org/10.1038/s41398-022-02298-x


Peer-Reviewed Journal Article References:
Held, P., Coleman, J. A., Petrey, K., Klassen, B. J., Pridgen, S., Bravo, K., Smith, D. L., & Van Horn, R. (2021). A case series examining PTSD and depression symptom reductions over the course of a 2-week virtual intensive PTSD treatment program for veterans. Psychological Trauma: Theory, Research, Practice, and Policy.

Perry, N. S., Goetz, D. B., & Shea, M. T. (2021). Longitudinal associations of PTSD and social support by support functions among returning veterans. Psychological Trauma: Theory, Research, Practice, and Policy.

Williston, S. K., & Vogt, D. S. (2021). Mental health literacy in veterans: What do U.S. military veterans know about PTSD and its treatment? Psychological Services.

QUESTION 8
What do Veterans with PTSD faced with loss or the ordinary demands of intimacy often experience? To select and enter your answer go to Test.

Test
Section 9
Table of Contents
Top