Reply #22: As one who suffered from mild PTSD, I certainly don't ignore it.

[TahitiNut]

It'd be very difficult for me to describe how almost totally clueless the professionals were at the time (1970-72). A diagnosis of "situational depression" and a prescription for Valium. (Whoopee.) The thing about PTSD that I learned is that it was typically precipitated by a somewhat covertly hostile life context. The reason I had nightmares and amplified startle reactions was that I'd been attuned to the hidden threat - the almost subliminal hostility of living in a combat zone. We humans are very adaptable - we survive by developing sensitivities ("sixth senses") that we don't even know we're developing. It's a lot like paranoia, I guess ... but the flashbacks had a verifiable reference: "traumatic" events.

So, what were those 'hidden threats' and subliminal hostilities that evoked combat trauma?
(1) The threat of being excluded from the 'group' - it's a very real threat in combat. One's survival is HUGELY dependent on the "buddy system" and the other guy "taking your six." The last thing any guy wanted was to be isolated and not supported by the guys around him. On returning to the "real world," guys that felt isolated or betrayed by their peers would experience the combat stress reaction to such a threat. That kind of isolation meant death. It's a threat.
(2) Hidden hostility and 'false flag' enemies. Charlie wasn't usually overt. Life in Nam was about surprises. The sudden night time rocket attack. The sappers. The ambushes. The occasional bomber. After returning to the "real world," guys were hypersensitive to back-stabbers and covert hostilities. It wasn't unusual. People in my office got their jollies for a while from making loud noises and watching me dive for cover - or start to. Folks would feign innocence (or ignorance) after dropping a big book or slamming a door, but that just added to the stress. Car backfires and firecrackers had me up a tree for years.
(3) Betrayals. Survival in Nam was largely based on trust. Officers that betrayed that trust could get fragged. In the "real world," such trust was vested in a spouse. Enough said.

Here's the thing about 'trauma' - it's an event or battery that's beyond the ability of the person to sustain resiliently. An emotional trauma results from some deficiency of coping skills vis-a-vis the perceived pain/threat. What may be traumatic for a child often ISN'T traumatic for an adult, due to the adult's more developed coping skills, learned over time. Furthermore, what might be traumatic to a person from one part of the world's population might not be traumatic to people from place where such events are more common. The way unaccustomed people cope with such events is to grab onto whatever behavior that "works" - often something primal or something that's recently indoctrinated. That's part of what military training is all about - developing a learned (unthinking) response. Then, after experiencing that event and grabbing onto a behavior that seems to ameliorate the stress/pain, the individual fixates on that response and tends not to develop more emotionally mature or contextually appropriate ones for similar events or events that evoke similar feelings. The later contextual dissonance of the fixated response often sets up a strong emotional conflict - a repressed reaction. That emotional conflict is seen as the 'disorder' - since the conflict is unresolvable given the person's 'learned' coping skills and framing.

This is the inherent problem in combat veteran reentry: there's no "basic UNtraining." The trained response, 'desired' in a combat context and fixated by it being 'successful' when activated, has analogs in non-combat stress situations. But the inclination ("survival mode") is to respond in similar ways. Repressing/suppressing such a response creates additional stress on top of the evocative stress. In other words, we choose to repress a trained response and, in so doing (in a "civilized" way), we add to our own feelings of stress rather than sublimate those feelings. Until we learn ways to cope with things that very, very few people know who've not had combat experience, that stress can be virtually unbearable.


This is a very clumsily-worded response - I'm not a trained psychologist or psychiatrist. (But I stayed at a Holiday Inn Express last night.)