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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