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Authors: Jonathan Shay

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33
Personal communication, March 2002.

34
Vengeance is “payback,” taken by the avenger and involuntarily given by its target in compensation for the damage done to body, possessions, or honor (which in that world encompasses the first two). The thinking and ideology underlying the Homeric honor concepts of compensation, so clearly voiced here by Eupithes, are laid out in the Iliad. See Donna F. Wilson's brilliant University of Texas doctoral dissertation (1997), now reworked into
Ransom, Revenge, and Heroic Identity
(Cambridge: Cambridge University Press, 2002).

16. Introduction

1
Portions of this chapter and the next are reedited by permission from Shay and Munroe, “Group and Milieu Therapy for Veterans,” pp. 391-413, and from Shay, “Killing Rage,” pp. 31-56, available online at
www.belisarius.com/author_index.htm
.

2
See note 27 to the previous chapter for access to the full APA criteria for PTSD. The implicit idea of “normal” in the official diagnostic system of the American Psychiatric Association derives from the historically and cross-nationally
not
typical psychology of someone who has been spared—who has never been ridden down by any of the Horsemen of the Apocalypse. “Normal” means: never been in war, never in famine, never in pandemic, never been raped or tortured, never lived in a tyranny. Mr. American Normal may even mean that neither of Normal's parents were ever trampled either, nor even his grandparents! I do not praise the Apocalypse and say it's good for us to be trampled by its Horsemen. I want nothing more fervently than the elimination of famine, plague—and war.

3
J. Douglas Bremner, Steven M. Southwick, and Dennis S. Charney, “The Neurobiology of Posttraumatic Stress Disorder: An Integration of Animal and Human Research,” in Saigh and Bremner,
Posttraumatic Stress Disorder,
pp. 103-43. See also R. K. Pitman, L. M. Shin, and S. L. Rauch, “Investigating the Pathogenesis of Post-Traumatic Stress Disorder with Neuroimaging,”
Journal of Clinical Psychiatry
62S17:47-54 (2001), for the remarkable pace of scientific progress that the new, noninvasive,
in vivo
imaging methods permit. The two years between these two reviews showed palpable progress.

4
I believe that I am referring to the same phenomenon that Judith Herman described under this name in
Trauma and Recovery
and “Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma,”
Journal of Traumatic Stress,
5:377-92 (1992).

5
Odyssey
9:20f, Fitzgerald.

6
Bernard J. Verkamp,
The Moral Treatment of Returning Warriors in Early Medieval and Modern Times
(Cranbury, N.J.: Associated University Presses, 1993). Cf. Numbers 31:19ff.

7
See Leon Golden's excellent monograph,
Aristotle on Tragic and Comic Mimesis,
American Philological Association, American Classical Studies monograph No. 29, 1992.

8
Georges Dumézil,
The Destiny of the Warrior,
trans. Alf Hiltebeitel (Chicago: University of Chicago Press, 1970), p. 23f.

9
Every atrocity strengthens the enemy. There were not enough officers in the U.S. Army in Vietnam who saw this clearly at the time. Returning to the situation of young Lieutenant Kerrey, the way SEAL teams were employed in the Mekong Delta was an advantage to the enemy and a setup for harm to the SEALs. One officer who saw this was Colonel Carl Bernard, an Army infantry officer who fought in both Korea and Vietnam. During part of his time in Vietnam, Colonel Bernard was a province senior adviser in the Delta, working for John Paul Vann, the career Army officer and critic of the war who was the subject of Neil Sheehan's book about Vietnam, A
Bright Shining Lie.
A few days after the Kerrey story broke, Bernard wrote: This episode proves again the very old conclusion about how little Americans knew about the “people's war” that Kerrey and the rest of us were in. Simply stated, we did not know how to fight such a conflict at its beginning, and we learned very little during its course, in significant part because of the constant transfer of personnel [causing their knowledge and experience to be lost]. We were hurt even more by bringing the wrong lessons from Korea, and our dedicated, enduring refusal to learn anything at all from the French experience. We knew almost nothing of our enemy; we knew very little more of our supposed allies beyond our assumption of common goals. And we knew far too little of our own forces and those who manned them. The SEAL teams had no more capability to accomplish their so-called counterinsurgency missions one month (!) after they arrived in country than I have of doing brain surgery. The difference is that I know that I do not have these exotic skills, and I stay out of hospital operating rooms. I was damned unkind a couple of months after Than Phong in restricting the activities of the SEAL team in Vinh Binh, the province below the one in which [Kerrey was] operating. As I told them in some dudgeon, their activities were sustaining the Viet Cong's recruiting effort even better than the Air Forces activities. (Personal communication, e-mail, May 10, 2001.) In a “people's war,” the enemy recruits the uncommitted and unmotivated in the civilian population to its side when they can entice us to respond indiscriminately or massively against the civilian population. Second, every atrocity potentially disables the service member who commits it. When I speak here of atrocity disabling the service member, I am not pointing to that person's distant future as a guilt-ridden veteran, as important as that may be. I refer to the immediate question of whether he or she is lost to the force
today
because of the psychological injury incurred by committing atrocities. Sober and responsible troop leaders and trainers, who have personally “seen the elephant” and
cannot be painted as cravenly “PC,” are concerned about prevention of psychological injury as a readiness issue. An injured service member is lost to the force, whether the injury is physical or psychological.

10
R. Severo and L. Milford,
The Wages of War: When America's Soldiers Came Home—From Valley Forge to Vietnam
(New York: Simon & Schuster, 1989). See also the fascinating study by John P. Resch,
Suffering Soldiers: Revolutionary War Veterans, Moral Sentiment, and Political Culture in the Early Republic
(Amherst: University of Massachusetts Press, 1999).

11
An excellent summary of the Platonic view of this is found in Martha Nussbaum, “Tragedy and Self-Sufficiency: Plato and Aristotle on Fear and Pity,” in A. O. Rorty,
Essays on Aristotle's Poetics
(Princeton: Princeton University Press, 1992).

12
The numbers are somewhat distorted by one quite wealthy Continental Army vet who brought up the average at the beginning of the period, but then brought it down by his departure or death. Removing him from the analysis makes the decline less dramatic and the starting disparity in wealth more marked. But even with this one rich patriot removed, the decade-by-decade decline in wealth of the long-service veterans compared to the stability of the other two groups is still significant. See Resch,
Suffering Soldiers,
p. 210.

13
Personal communication. Swedish Sanskrit scholar Ernst Arbman probably offered the best German equivalent for
thumos
in 1927 as
“die Ichseele,”
the “I-soul,” which captures its narcissistic dimension. Conventionally, it is translated as
“das Gemüt,”
which is as opaque in German as the conventional English equivalent, “spirit.” While I like Arbman's coinage for
thumos
I do not subscribe to the rest of his critical approach.

14
Francis Fukuyama, author of
The End of History and the Last Man
(New York: Free Press, 1992), has tried to put
thumos
back into circulation, transliterating the word as
thymos.
See pp. 162ff and other places indexed under
thymos.

15
Phenomenology of Spirit
IV.A, and elsewhere. Transition from citizen to slave was the most salient image and vivid fear in the ancient Greek world. Loss of a battle or of a war could convert citizen to slave in a day.

16
A particularly useful overview of the psychoanalytic usage can be found in Sydney Pulver, “Narcissism: The Term and Concept,” in A. P. Morrison, ed.,
Essential Papers on Narcissism
(New York: New York University Press, 1986). Heinz Kohut's most influential work, and the source of my emphasis on ideals and ambitions as content for
thumos,
is
The Analysis of the Self: A Systematic Approach to the Psycho-analytic Treatment of Narcissistic Personality Disorders
(Madison: International Universities Press, 1971).

17
I discuss the biological significance of social trust and speculate on how war in the upper Paleolithic shaped human psychology in “Killing Rage.”

18
Or “another myself.” Quoted from
Nicomachean Ethics
IX.9.1170b6 (trans. Irwin). Aristotle's account of friendship is rich, complex, and laced with surprises. See particularly A. W. Price,
Love and Friendship in Plato and Aristotle
(Oxford: Oxford University Press, 1990), Chapter 4.

19
Martha C. Nussbaum,
The Fragility of Goodness
(Cambridge: Cambridge University Press, 1986), p. 354. Citations of the word
philos
and related words in the
Iliad
and
Odyssey
fill a whole page of R. J. Cunliffe's
A Lexicon of the Homeric Dialect
(Norman: University of Oklahoma Press, 1963; reprint of Blackie and Son, London, 1924), pp. 408-9.

20
Achilles in Vietnam,
pp. 35-37.

21
The first and second items on this list seem to me to connect to Circe's description of what she saw:
(10:502ff, Fagles) Now you are burnt-out husks, your spirits haggard, sere,
always brooding …
your hearts never lifting with any joy—

22
“Nostalgia” was the term going back to the seventeenth century that military medicine gave to the often fatal collapse of the will to live and of all self-care among soldiers. It was still in official use in the Union Army in the Civil War. Eric Dean gives an excellent account of this history in pp. 128-31 of
Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War
(Cambridge, Mass.: Harvard University Press, 1997). “Musselman” was concentration camp slang for this same phenomenon. Because the Nazis murdered inmates who could no longer work, it was
always
fatal.

23
Whether Hitler or bin Laden or both had awful traumatic backgrounds is not exculpatory. Despite many requests, I have never testified as an expert witness to get someone off on a PTSD defense. While it may seem contradictory, I have lobbied the governor of my state for better services to incarcerated veterans with PTSD.

24
There has been a burst of scholarship in this area, for example,
Understanding the Political Spint: Philosophical Investigations from Socrates to Nietzsche,
ed. Catherine H. Zuckert (New Haven: Yale University Press, 1988); James F. McGlew,
Tyranny and Political Culture in Ancient Greece
(Ithaca: Cornell University Press, 1993); Ober and Hedrick, eds.,
Dēmokratia;
Barbara Koziak,
Retrieving Political Emotion: Thumos, Anstotle and Gender
(University Park: Pennsylvania State University Press, 2000); Martha Nussbaum,
Upheavals of Thought: The Intelligence of Emotions
(Cambridge: Cambridge University Press, 2001)—inquiry into equal political respect is woven throughout this large book.

25
John Hesk,
Deception and Democracy
(Cambridge: Cambridge University Press, 2000). I thank Professor Josiah Ober for his patience in discussing Athenian legal restraints on
biē
and
mētis
with me.

26
It is possible that veterans who have remained stable in only
one
of these states in the above list (pages 160-61) would never come to our attention in a specialized combat PTSD program because they would be dead, incarcerated, hidden in the woods and not coming out, famous and powerful on a small or large scale, or diagnosed elsewhere as schizophrenic or physically ill. If complex PTSD after combat appears to be defined by repetitive cycling, that may be because the veterans themselves or the social system sends those who do
not
cycle somewhere else, rather than to us.

17. From the Clinic to the Wall

1
I was too busy trying to survive. Within the five years after the end of my psychiatry training, I had to take major responsibility in a family business with extremely serious problems, had a stroke (age forty!), my marriage disintegrated, and I was slandered by a senior colleague, derailing an attempt to get back on my feet at Harvard Medical School, where I had been on the faculty because of my research. I would not voluntarily undergo any of these experiences again, but I embrace them as my life, and as my second education.

2
Throughout this book I have used the word “patient” rather than “client.” The nonmedical disciplines in mental health have embraced the word “client,” apparently making the cultural connection to the client of a law, accounting, or business firm. Perhaps because of the suggestion that the client is free to take his business elsewhere, this appears to confer more dignity on the individual than “patient,” which is thought to confer a less powerful image, especially when contrasted to “the doctor.” No one
will be surprised that I have something to say about these usages based on the origins of the words in classical antiquity. A “patient” is one who suffers, the word being derived from Latin
patī,
to suffer. The “Passion” of Jesus on the Cross has the same etymology. “Client,” on the other hand, comes from Latin
cliens,
the dependent or hanger-on of a patron. A
cliens
hears the orders of his patron and jumps to please him. I ask you, which suggests greater dignity? I use the word “patient” not because I am a doctor and wish to assert my authority; instead I recommend it to
all
mental health professionals, psychologists, nurses, social workers, and counselors, because it reflects the ethical basis of what we do—the alleviation of suffering.

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