John Liebert - Wounded Minds: Understanding and Solving the Growing Menace of Post-Traumatic Stress Disorder

John Liebert, MD, and
William J. Birnes, PhD, JD

Skyhorse Publishing

Copyright 2013 by John Liebert and William J. Birnes

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Library of Congress Cataloging-in-Publication Data is available on file.

ISBN: 978-1-62087-650-3

Printed in the United States of America

You may remember the character of James Bellamy from the PBS/ BBC television series Upstairs, Downstairs. He returns from the front at the end of World War I as a changed manafter being shot at and gassed in the trenches, he has begun to suffer from a mental condition called shell shock. Thats what medical professionals called the mental state in which many soldiers found themselves after the war. They were still disoriented and socially dysfunctional because of their experiences during the war. Freud himself was perplexed by patients returning without physical disability from World War I and changed his entire construct for psychoanalysis from The Pleasure Principle to the instinctual conflict within all humans to live and procreate while self-destructing in returning to dust. Because of recurrent nightmares, he conceptualized the enigmatic compulsion to repeat the traumaor repetition compulsion. For example, a woman raped at night in the park will feel compelled to revisit the park over and over again at night. This is certainly visible in victims of extreme psychological trauma and may be the seemingly futile effort to gain mastery over the unexpected and traumatic loss of control. Perhaps this is a fantasy, but perhaps, as with current practices of desensitization and implosion therapy for combat veterans, it can be natures way of healing from phobic avoidance of anything touching the senses from the original trauma, as in holding a weapon again.

In the motion picture Patton, General George S. Patton, Jr. (portrayed by George C. Scott), encounters a soldier in a military hospital in Italy. The man was trembling and crying that he couldnt take it anymore. Patton slapped him across the face, called him a coward, threatened to shoot him on the spot, and ordered that the soldier be taken out of a ward populated by other soldiers who had been wounded in battle. General Patton called him a coward, but the military doctors said he was suffering from a mental condition called battle fatigue.

Now flash forward to the Vietnam War. This was a very different war from the two world wars of the first half of the twentieth century. Vietnam was also different from the Korean Waralthough the allies were ostensibly fighting the same ideological enemy (the Communist forces) the Korean War was a classic invasion from the north into the south; countries divided after the close of World War II. In Vietnam, however, the circumstances were very different, as the war was more of an insurgency than a classic invasion of one country by another. In fact, when the north invaded the south on June 25, 1950, it looked as though the outnumbered and outgunned South Koreans would be completely overrun, and the Communist forces would eliminate the sovereignty of the south. In response to the invasion, American forces stationed in occupied Japan were airlifted to a small section of territory in the southeast corner of the Korean peninsula, known as Pusan, and from there pushed their way north towards the 38th parallel (the dividing line between the two Koreas). It was a classic land invasion to gain a toehold for the purposes of establishing a perimeter from which to expand, just like the Allied landing at Anzio and later at Normandy. Vietnam was different.

In Vietnama war that President John F. Kennedy was trying to avoid by pulling out U.S. military personnel before he was assassinatedAmerica and its allies were fighting an insurgent force backed by the North Vietnamese that had already defeated the French. In Vietnam, as many veterans of that war later told their doctors, you didnt know whom you were fighting until it was too late, because the very people you visited in villages said to be pacified by day turned into the enemy Viet Cong by night. It was challenging and frustrating, physically as well as psychologically, and for many, it caused mental derangement: Your friends, often guides known as Kit Carsons, who had been former enemy combatants re-educated in South Vietnamese POW camps, sometimes turned on you, and the rules of engagement forced you not to shoot at those you knew, but couldnt prove, were the enemy. Yet, there were free fire zones where anything that moved could be killedlike killing fields that could later haunt our soldiers with guilt for killing innocents. It was a war that couldnt be won, a war that couldnt be Vietnamized, a war that lost its mission, and a war that destroyed the presidencies of John F. Kennedy, Lyndon Johnson, Richard Nixon, and Gerald Ford while compromising Jimmy Carter and Ronald Reagan until Bill Clinton decided to call the whole thing off and diapatched John Kerry to strike a deal with North Vietnam to grant them most favored nations status. Unless one called Operation Phoenix, a clandestine operation that conducted kidnappings and assassinations of Viet Cong and North Vietnamese officials, a success, most American operations failed to blunt the North Vietnamese and Viet Cong war machine. American personnel listed as MIA or POW remained in Vietnam well after the war ostensibly ended in 1975 and probably still remain there today, just as American POWs remained in North Korea after that war and in the Soviet Union after World War I and II. They were soldiers left behind, according to James Sanders in Soldiers of Misfortune.

In fact, the Vietnam War was so different from previous conflicts in the twentieth century that during the Tet Offensive in 1968 40,000 North Vietnamese troops and, reportedly, NVA General Giap himself, disguised as a refugee, infiltrated Saigon. The American military units were caught without weapons because no soldiers were allowed to carry weapons inside Saigon except for the 716th Military Police Battalion. The infiltration of Saigon was a near rout and disaster, according to some of the soldiers in Saigon who believed they were about to be overwhelmed. President Johnson said privately that the North Vietnamese success at Tet demonstrated to him that the war was unwinnable, and that in the face of a looming military disaster, he would not run for a second full term in office. We now know from the release of the LBJ Oval Office audio tapes that Johnson believed he was on the verge of negotiating an end to the US involvement in Vietnam. However, because, LBJ said, FBI Director J. Edgar Hoover told him that the Bureau had wiretapped the South Vietmanese ambassador to the United States, Hoover had learned that Republican presidential candidate and former vice president Richard Nixon had gone around the White House to convince the South Vietnamese not to go along with LBJ and to hold out for a better deal with Nixon. In other words, the war could have ended in 1969 rather than in 1973. LBJ referred to Nixons behavior as treason on the tapes. President Johnson who pushed the Civil Rights Act, Voting Rights Act, and Medicare through an adversarial Congress, was driven from office by the Viet Cong and the North Vietnamese. It was that kind of wara war that ended with President Ford, Dick Cheney, and Donald Rumsfeld presiding over one of the most humiliating defeats and retreats of American military and diplomatic personnel in history, pulling frantic South Vietnamese clinging onto US Army helicopter landing skids for dear life, off the roof of the American embassy. When we think about who promulgated the war in Iraq, even before 9-11, it was Dick Cheney and Donald Rumsfeld, perhaps trying to restore what they lost as a result of the Vietnam debacle.