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Wednesday, June 11, 2008

Short History of PTSD

On Jun 11, 2008, at 12:32 AM, J N wrote:

Hi, I found your email linked on a site about PTSD. I have a question, and hopefully you can provide some insight. I am working with a production company to develop a parallel story between the lives of three brothers who served in Vietnam. Their struggle with PTSD and agent orange now, and then their experiences in Vietnam. What do you think is the reason that PTSD is only just starting to get more noticed now? Other vets tell me it's still a pain to get any help from the VA on PTSD. The PTSD information center on the VA's website didn't feel like anything centered towards military troops. What is the deal that causes PTSD to be hidden under the rug?
Any response would be appreciated.

My answer:
Before Vietnam, PTSD was called soldier's heart or nostalgia during the Civil War, shell shock or soldiers heart in WWI, combat fatigue by doctors in the war zones and combat neurosis by doctors at home during WWII.
In 1952, the American Psychiatric Association published the Diagnostic and Statistical Manual, an attempt to standardize psychiatric diagnoses. It included a category called "Gross stress reaction." If you had been through a big enough stress (gross=big), like a concentration camp or combat (this was in the Freudian denial and delusion period about incest) it could affect you.
In 1968, ironically during the TET offensive, DSM II was published. It dropped, with absolutely no scientific evidence, any reference to any stress reactions except a "transient situational disturbance" which lasted for six months or less. If it lasted for more than six months, you had a pre-existing condition, which meant, for Vietnam veterans, that the VA was not responsible because it wasn't service connected. This was absolute bullshit, propagated by who? No one knows. It is part of the cycle of acknowledgment and denial that PTSD goes through with every generation.
Anyhow a bunch of shrinks who had worked with WWII Combat vets and with battered wives and incest survivors and survivors of concentration and POW camps worked together to get it reinstated in the next edition, which it was in 1980 in DSM III. The APA was against it, because it would cost the government too much money. During the era of DSMII, people were told "Vietnam didn't change you. You were defective before you went." They were diagnosed wit schizophrenia or as sociopaths, narcissists, etc. They were overmedicated with thorazine. Since there was NO HELP, except for the very rare VA shrink, psychologist or social worker who would listen to them, many of them turned to alcohol and drugs to maintain. Psychiatrists who listened to the veterans were often called overly emotional and overly involved by other psychiatrists.
The first study of actual Vietnam vets with PTSD was done by John Wilson, PhD, with funding by the Disabled American Veterans because he couldn't get funding from any foundations or the government. Other studies of the time showed that only a few veterans had problems, but those studies didn't even ask them if they had been in Vietnam, never mind in combat.
My husband, Bob, (Robert Mason, author of Chickenhawk) came home in 1966 with PTSD. He was a helicopter pilot. In 1967 he was diagnosed with "combat fatigue," which at that time meant that he could never be sent to a war zone again. (And these new guys should NEVER be sent back.) But basically he thought he was a loser and I thought I was a bad wife or he would not be having problems. You can read more about that on my website as I use my experiences to help others
For a time after 1980, a lot of work was going on in the PTSD field, and if you could get diagnosed, you could get help, but most guys, having been turned away by the VA when they went for help, wouldn't go back. There was also the problem of the psychiatrist who knew the diagnosis had been made up for Vietnam vets, so they wouldn't diagnose it even when it was obvious.
For a while there did seem to be a lot of help out there if you could find it. But each VA Hospital is a feifdom, under the control of the Chief of Psychiatry, so if he doesn't believe or wants to do research on schizophrenia or whatever, the vets are fucked. Some VA's have great programs. Some have shitty ones. There is no standardization and no oversight that I can see. Plus when staff changes, the program can change. Did you read about the b*tch at Temple Texas who told the staff to stop diagnosing PTSD? That had been a really good VA, and maybe it still is, but probably not.
Up until 9-11, there was also a slow rise in denial and delusion among mental health professionals. This culminated in DSMIV which now describes traumatic stressors with a litany of latinate words punctuated by or's. It is a numbing ritual.
And now there is the bullshit of sending guys back on drugs, which is so EVIL, it can't even be believed. There have been no randomized clinical trials of how people do when the go back on drugs, but we do know from Israeli studies of guys who have been in multiple wars, that if they have PTSD in one war, they get it faster and worse in the next. Supposedly mental health professionals go by "First do no harm."
We also have the right-wing attacks on PTSD: it doesn't exist. Our men are brave and have no problems. It is a liberal attack, blah, blah,blah.
"What is the deal that causes PTSD to be hidden under the rug?"
The fucking government doesn't want to pay for treatment. Like the war, they had no plan.
This is what happens when REMF's (Rear Echelon M*ther F*ckers) run wars. They have no clue.
I could rant on, but this is probably more than you wanted.
Patience Mason, Editor and Publisher
Patience Press
P O Box 2757
High Springs, FL 32655


  1. Patience: Semper Fi, I am Six Time Wounded SSgt/0369 Vietnam 65-66 and 68-69. Your book and it's contents are helping my wife and myself understand what is going on with me.
    I worked for 35 years in the Law Enforcement Porfession and then retired in 2005. I moved to North Georgia Mountains and found myself in distress.

    I did stupide things like became angry with my spouse for no reason, and burned all her clothing in our front yard. I have always told her to call the Police if I became violent and she departed and did so.

    I secured the doors and windows and awaiting the enemy. the same people I worked with for 35 years. The shift commander having sense enough called me and by then I was calmed down. They left without even coming to the house. That morning I drove for hours and went to the VA where they wanted to lock me down for two weeks. First of all I cannot sleep with anyone in a room, except my wife or Marines I served with in Vietnam. Secondly, people there were driving me into a deeper rage by just seeing them walking around acting odd!

    At anyrate PTSD has grabbed me deeply and as usual the VA started me out at 50% with a 45 GAF score. MY last gaf score was 35, and I'm not sure what is next for me, I hope sincere help. The PTSD Center in Port St. Lucie is there for me, but I still very lost most of the time.
    Keep up the good work and I hope this will help other veterans reading your book.
    Tom Matteo

  2. I am a vet, and employed at the VA Medical Center, Louisville. I too, had a derogatory impression of the VA from the horror stories that I heard from my father, grandfather and uncles. It was not until 2004, that I went to the VA for my health care after loosing my job from becoming disabled with respiratory failure.
    At my first appointment at the VA Hospital, I found myself lost, looking for the ENT clinic. I ask a nurse where it was. She gave me directions, of which she could obviously see that I was confused. She said "That's alright, I'll show you".
    I told her that she didn't have to trouble herself.
    Her response was, "Honey, You’re the reason we are here!"
    I was so impressed with the compassion that I received, that I was compelled to go back to school, get an education in computer science and apply for a job at the VAMC, Louisville.
    I now work at the "New" Behavioral Health Lab, which is a linking service of Primary Care and Mental Health. We are proud to make the claim that our clinic answers most all referrals for PTSD, Depression, Substance Abuse and other Mental Health concerns within 24 hours.
    I am personally sorry for any lack of compassion, respect and service that any of our veterans have received from the VA. I vow that you shall never receive anything less than honor and respect from the BHL, Louisville.

  3. PTSD

    On false pretext they sent me off
    To murder and create,
    But there, ´twas hard to hold aloof
    Vacuity of hate,
    And now the matter rests with me
    But I don´t rest at all,
    And it may be PTSD
    But I´m not blessed at all.

    We are the men "that don´t fit in,"
    There´s no more fitting now,
    Because nobility struck tin
    With which men did endow
    Their fantasy, as left a mess
    All scrambled in my mind,
    So I was left with PTS
    And D not far behind.

    The army sez that my SD
    Existed pre post-trauma,
    So not a dime will give to me
    Except I have my Momma
    To tell me, hold my temper down
    But she has never been there,
    Where cognizance emerged full-blown
    Smack in the midst of sin there.

    I thought that I could be a hero,
    That I could go to school,
    But concentration nearly zero
    Has made me look the fool,
    And I may know the alphabet
    My teachers taught to me,
    But first, in their disorder, set
    Now PTS and D.

    I never knew the kind of rage
    As in my brain inhabits,
    But not a player on the stage
    It is not shooting rabbits
    That got me to an awful fix,
    Though you might find it funny,
    PTSD plays funny tricks,
    I wouldn´t hurt Bugs Bunny--

    And yet at minor provocation
    I´d take a schoolbus out--
    It´s all because I served a nation
    That didn´t have a doubt:
    Derangement by rage reinforced
    Has got me drinking liquor,
    But while I cauterize the worst
    Hostility grows thicker.

    So all young men who go to war,
    Although your cause be noble--
    They´ll show you that esprit de corps
    But leave you with the trouble,
    A peck of trouble, as with P
    Preceding T and S,
    And then at last a final D,
    To lodge at your address.

    Wherever you may go, and with
    Self-medication helping,
    There is no helping with the myth:
    Hostility keeps whelping
    Despite nobility pronounced
    On all the TV stations--
    PTSD, when they have pounced,
    One´s burden, not the nation´s.


  4. hi patience, I'm a psychologist and I have PTSD from a domestic violence upbringing, just wanted to say what a great blog you have and this post is one of the best (& most accurate!) that I've seen on the topic. Keep 'em coming!