FLASHBACK: Posttraumatic Stress Disorder, Suicide, and the Lessons of War (Beacon Press 2006) --By Penny Coleman

Reviewed by Gerald Sorin                           

On Tuesday, July 4, 2006, in a speech marking Independence Day, George W. Bush, exuding confidence and still talking about “winning” the war, thanked American troops for their service in Iraq. Inches from this news item on the New York Times website was another story suggesting the vacuousness of the President’s appreciation: “Homelessness a threat to Iraq Vets,” the headline read. One 26-year old veteran quoted in the piece, who sleeps in his Jeep for want of an apartment, said he has continuous nightmares. In Iraq, he saw, among other horrors, “a baby decapitated when it was run over by a truck. I relived that every night,” he said. It seems as if our soldiers’ needs, often quite serious psychological and material needs, are even more ignored after the troops come home than they are while they are seeing action.

            That the neglect of veterans is an old story in American history is part of what Penny Coleman tells us so well in Flashback: Posttraumatic Stress Disorder [PTSD], Suicide, and the Lessons of War. Her central focus is the Vietnam War, in the wake of which her husband Daniel took his life. But she takes us from the American Civil War through the second Iraq War and from “irritable heart” to “shell shock” to “battle fatigue” to PTSD in an extensive analytical exploration of combat-related stress disorders. On the way, in passionate and painful, but careful prose, Coleman tells us about her own journey through darkness and shame; and she shares five years of her intensive research (and the research of other scholars and specialists) as well as pieces of her interviews with other women whose Vietnam veteran husbands, sons, brothers, or fathers were victims of self-inflicted death.

            “We can’t guard them twenty-four hours a day,” Judy James told Penny Coleman. “I want to tell survivors that all their “should haves” probably wouldn’t have changed a thing. [My husband] Ben had a privileged upbringing, a good job, a loving, happy, stable marriage…. [After Vietnam] he was under psychiatric care and on medication…. I thought we were doing everything right…. And still he killed himself.” Barbara Chism didn’t want to say that her husband Mack, a college-educated tough Marine who’d won five medals in Vietnam ruined her life by committing suicide, “but maybe if I’d had someone telling me I was good, that I could do it, it would have been different…. It’s like I still hear my mother’s voice in the back of my mind: ‘You’ve done something to get him to this point of killing himself. Maybe you don’t deserve to live.’ I try not to let that rule me, but it’s always in the back of my mind.”

            These voices and others quoted in the book are compelling and important. But Penny Coleman’s study involves much more than personal trauma. She also surveys, engagingly, the history of battlefield illnesses and examines the variety of proposed and attempted “cures.” In her review of the manifold techniques employed to keep armies in the combat zone and in line, Coleman looks long and hard at the political and cultural pressures, including “family, God, and country” that discourage soldiers from admitting fear or revulsion or loss of control, and that discourage society from recognizing or remembering the seriousness not only of front-line symptoms but of war-related psychological disorders that continue or recur long after the actual battles have ended.

            We seem to have learned about the reality of PTSD in WW I and Korea without yet having had a name for it. (See the extraordinarily revealing and disturbing novels of Pat Barker about WW I, especially Regeneration and The Eye in the Door. These works go unmentioned by Coleman, but they brilliantly render the conflict between duty, loyalty, and a sense of manhood on one side, and the futile and finally senseless brutality of the war on the other, a conflict raging not so much between groups or individuals, but within individuals). But as Coleman demonstrates so persuasively, we continue to fail to count PTSD as one of the more serious costs of military conflict. (Or for that matter as one of the most serious causes of the corrosion of the military itself through desertion, drunkenness, and drugs, and, in Vietnam especially, through “search and avoid” missions and “fragging” – the killing by soldiers of their superior officers).

            Penny Coleman doesn’t forget that four million Vietnamese civilians died as a result of American actions between 1964 and 1973. Or that 58,000 American soldiers gave their lives during these same years in Southeast Asia. But she also reminds us, or shocks us really, with the information that Vietnam veterans, in even higher numbers than the soldiers who died on the battlefield, committed suicide (as many as 100,000 say some studies) in the years following their homecoming. And what would the numbers be like if the living psychically wounded vets were counted as casualties? They are not, indeed they are virtually ignored by the Veterans Administration (V.A.) and by the public generally. As are the suicides in a culture that sees such behavior as personal weakness, as acts of cowardice, or even as products of mental illness unrelated to a war that ended in 1973. But as Maryallyn Fischer said when her husband killed himself sixteen years later, “This isn’t over, this isn’t over. It’s 1999, and my husband just died from the Vietnam War.”

            Societal and governmental ignorance and amnesia about PTSD, and worse, unconscionable neglect of its consequences, continue in the current and seemingly never-ending war in Iraq. Perhaps initial inattention was the result of the flagrantly unrealistic hope that there would be no PTSD in a country whose grateful citizens, freed from the tyranny of Saddam Hussein, would shower our soldiers with kisses and flowers instead of Improvised Explosive Devices; and that our soldiers, there for a mere quick fix, would escape what psychologist Jonathan Shay calls the betrayal of “themis,” that which is deeply ingrained in the mind of young warriors as “right.” Instead there were in Iraq, as in Vietnam, almost from the very beginning, three broad categories of institutional betrayal or failure: a lack of appropriate training and equipment, underdeveloped unit cohesion, and an absence, bordering on the criminal, of competent, ethical, properly supported and supportive leadership. These failures resulted in overly prolonged wars with their attendant rapes and murders and other violations of civilian populations, and with torture and other serious mistreatments of prisoners.

The cost to our soldiers of this betrayal of “themis,” the soldierly sense of what is right? Profound and widespread psychological damage. As early as August 2003, “a string of soldier suicides [at a rate three times greater than normal for the armed forces] and daunting psychiatric casualties provoked the army to send a team of mental health experts to Iraq.” It has, therefore, proven impossible to keep PTSD out of the current public debate entirely, but the Army and the Bush administration and its core of intellectual toadies have quickly fallen back on clichéd notions of masculinity and heroism, and already have prepared their own spin about  the “underdeveloped life coping skills” of individual soldiers and “over-diagnoses” of PTSD by liberal anti-war psychiatrists and doctors. This leap to denial is ghastly not only for the newly damaged veterans, but it has also driven the V.A. to revisit its earlier determinations to award maximum disability compensation for PTSD!

            One need not agree with all of Penny Coleman’s political positions [the death of millions of civilians in Vietnam was not “unintentional” or “incidental”] or with her quasi-pacifism [“no cure short of abstinence from war has proven to be reliable” in alleviating the symptoms of war-related trauma] to be convinced that PTSD is an inevitable, horrific part of all  wars, just or unjust, competently or incompetently pursued (but more pervasive in these second instances), and that the costs of PTSD ought to be part of the calculation in determining whether the good we might accomplish is worth the harm we will undoubtedly cause. If the past is a predictor, as Coleman insists, many Iraq War veterans will suffer from PTSD and “many will die in desperation by their own hands.” She began writing her book as history, but says plaintively, “Would that it remained so.”

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