Odysseus in America (52 page)

³
Treatment outcome studies of the intensive inpatient VA specialized treatment units have shown a marked and persistent reduction of violence and an equally marked and persistent improvement in the veterans' quality of life. Not surprisingly, the symptoms of simple combat PTSD—the symptoms most measured by most studies, because of their official enunciation by the American Psychiatric Association—were little changed. They may represent irreversible brain changes, or at least irreversible with present knowledge.

⁴
Dr. Munroe recently received the Sarah Haley Award for Clinical Innovation of the International Society for Traumatic Stress Studies, the main professional organization in the trauma field. He and I have published a detailed description of the VIP treatment approach in “Group and Milieu Therapy of Veterans,” pp. 391-413.

⁵
Many of our professional colleagues—whom we love and respect—disagree vociferously with us, because they accept the cultural model of the scientist-professional laid out in its classic analysis by the great mid-century sociologist Talcott Parsons (who was my senior tutor in college). Readers familiar with Parsons's work will recognize the influence of the “pattern variables” in my critique. Explanation of the value pattern of the professional and how it leads to failure with complex PTSD is given in Shay and Munroe, “Group and Milieu Therapy of Veterans,” based on Parsons 's
The Social System
(New York: Free Press, 1951). I agree that treatment of simple PTSD may not require any more trust than is required to receive treatment for a ruptured appendix. Reliance on credentials and institutional position suffices and personal trust isn't needed. Functional specificity (division of labor among different occupational specialties) is deeply institutionalized in licensure, departmental organization of medical facilities, and career paths in the professions. For many combat veterans with complex PTSD, the careerism of officers and the career management systems of the military services (manifested then as six-month rotations in troop command positions) were the visible sources of their betrayals. Also, the division of labor is a key element in the processes that support state-authorized
atrocities and torture.
Veterans who had the misfortune of witnessing or participating in these were told, “none of your business” or “not my job” or “just do your job” if they raised objections. Many of those who crossed into the heart of darkness and executed those orders are now dead by their own hand. Herbert C. Kelman, “The Social Context of Torture,” in
The Politics of Pain: Torturers and their Masters,
ed. Ronald D. Crelinsten and Alex P. Schmid (Boulder: Westview Press, 1994).

⁶
James F. Munroe, “Therapist Traumatization from Exposure to Patients with Combat-Related Post-Traumatic Stress Disorder: Implications for Administration and Supervision” (Ann Arbor, Michigan: Dissertation Abstracts).

⁷
My own vanity has laid seductive traps. I got into trouble a couple times after the publication of
Achilles in Vietnam
from no longer listening to the particularity of a veteran's experience, but rather I fit his words into schemes of my own invention. This is just as bad as fitting it into schemes read in textbooks.

⁸
Herman,
Trauma and Recovery,
Chapter 8.

⁹
For further details of our Stage One approach, see Shay and Munroe, “Group and Milieu Therapy of Veterans.”

¹⁰
An educational pamphlet “On Medications for Combat PTSD” gives my philosophy and some specific experience on this subject. It is found on the Web at
www.drbob.org/tips/ptsd.html
.

¹¹
F. Kirkland, R. R. Halverson, and P. D. Bliese, “Stress and Psychological Readiness in Post-Cold-War Operations,”
Parameters
26:79-91 (1996), p. 86.

¹²
Kirkland et al.'s prescriptions are explicitly and implicitly incorporated in the Army's current doctrine on combat stress control,
FM 22-51: Leader's Manual for Combat Stress Control,
about which more in Part Three.

¹³
A vast and unexplored subject is the ways that trauma generates the human experience of the holy. I hasten to add that “holy” does not automatically mean good, or beneficent—it is “daunting awfulness and majesty” and “something uniquely attractive and fascinating,” according to Rudolf Otto's classic phenomenological exploration,
The Idea of the Holy,
trans. John W. Harvey (Oxford: Oxford University Press, 1923; 2nd ed., 1950). The sacred is—first and foremost—powerful.

¹⁴
As of May, 3,2001:
www.vietnamwall.org/news/namesadded.html
.

¹⁵
Inscribing the names of all the soldier-citizen dead was first practiced by the Athenians in their “
demosion sema,
or National Cemetery, in the Kerameikos district” of the city. Tritle,
From Melos to My Lai,
p. 166. A photo of fragments of these “casualty lists” is on p. 167 of Professor Tritle's book.

¹⁶
From Lydia Fish e-mail to VWAR-L, October 28, 1995. Copyright © Joan Duffy Newberry, May 1987. By permission.

¹⁷
“Mental Cases,” in
The Collected Poems of Wilfred Owen,
p. 69.

¹⁸
The comparison to Odysseus and his crew visiting the Underworld is inviting, but leads nowhere that I am able to see.

¹⁹
11:173ff, Fagles.

²⁰
M. R. Ancharoff, J. F. Munroe, and L. M. Fisher, “The Legacy of Combat Trauma: Clinical Implications of Intergenerational Transmission,” in Yael Danieli, ed.,
International Handbook of Multigenerational Legacies of Trauma
(New York: Plenum, 1998).

²¹
M. R. Harvey, “An Ecological View of Psychological Trauma and Trauma Recovery,”
Journal of Traumatic Stress
9:3-23 (1996). See also Shay and Munroe, “Group and Milieu Therapy for Veterans,” pp. 391-413.

²²
This should help justify the claim that considerations of social trust are human universals, and not purely an invention of the modern state or market economies. However, trust is dramatically more important in the modern setting than in small, face-to-face (“primitive”) societies. Paper money and banking rest almost entirely on trust.

²³
James Munroe prefers the term “basic trust” to “social trust.” He also refers to what we foster in VIP as a family of reorigin where the veteran can relearn social trust. He is drawn to metaphors drawn from the family; I am drawn to metaphors from the
polis.
J. F. Munroe, J. Shay, C. Makary, M. Clopper, and M. Wattenberg,
Creating a Family of Re-Origin: A Long-Term Outpatient PTSD Unit,
training “institute” at the Fifth Annual Meeting of the Society for Traumatic Stress Studies, San Francisco, 1989.

²⁴
Understanding and responding to these tests of trust is a huge subject beyond the scope of this chapter. It is, however, addressed in Shay and Munroe, “Group and Milieu Therapy for Veterans.”

²⁵
A key word in Aristotle's Rhetoric is
“pistis,”
to which scholars have given all sorts of tortured translations, e.g., “the available means of persuasion.” However, in the everyday language of Aristotle's time, the word simply meant “trust.” See Christopher Carey,
“Rhetorical Means of Persuasion,” in Amélie Oksenberg Rorty, ed.,
Essays on Aristotle's Rhetoric
(Berkeley: University of California Press, 1996), pp. 399-415.1 have summarized the Rhetoric for military use as a text on leadership in the handout to a visiting lecture in ethics at the U.S. Naval Academy. This handout is available online at
www.d-n-i.net/fcs/aristotle.htm
.

²⁶
I have pointed this out in my one small foray on the subject of Athenian tragic theater: “The Birth of Tragedy—Out of the Needs of Democracy.”

²⁷
Aristotle,
Rhetoric,
I.ii.3.

²⁸
Copyright © Michael Viehman, by permission. See biographical sketch on pages 184-85.

¹
“Lydia Fish Vita,”
The Vietnam Veterans Oral History and Folklore Project,
online at
faculty.buffalostate.edu/fishlm/folksongs/vita.htm
. VWAR-L was the subject of Richard R. Rohde, “Identity, Self, and Disorder Among Vietnam Veterans: PTSD and the Emergence of an Electronic Community,” Ph.D. dissertation (Anthropology), University of Hawaii, 1995. On p. 253, Dr. Rohde says, “My central criticism of the medical model of PTSD is that it locates the source of the problem within the individual, with little or no emphasis on the social-relational aspects of PTSD.” It should be evident to the reader that I heartily agree with this criticism as it applies to complex PTSD. I suspect that if we understood better how social recognition plays out in brain physiology, we would also see that he might be correct with regard to simple PTSD also.

²
I have pursued a two-stage permission process with the members of VWAR. In the first stage (mostly in 1997) I requested their permission to use the message at all. In the second, I sent them this complete chapter, so that they could see how I had edited their message and how I had contextualized it. In every case I received Stage One permission. No messages here are from members who
refused
Stage Two permission; their wishes are respected, of course. However, that leaves the members who gave Stage One permission, but whom I have been unable to reach. I have sent e-mail to their last known e-mail address in the VWAR directory, and called their last known telephone number from the same source. These few messages are identified only by their nickname or first name to protect their identities should they not wish to be associated with the words.

³
E-mail, December 21, 2001.

⁴
E-mail, December 8, 2001.

⁵
This information supplied by Tom Sykes at my request.

⁶
New York: Facts on File, 1985, pp. 144-45.

⁷
E-mail, December 11, 2001.

⁸
E-mail, December 10, 2001. My heart aches when I read this message.

⁹
E-mail, December 5, 2001.

¹⁰
Information provided by Jack Mallory at my request.

¹¹
A Jarai [“Montagnard”] with whom the author fought against the NVA. Mike McCombs's tribute to Weet is found in the story “Blood Brother” in the superb collection on the Web at
www.vietvet.org/namvet99.htm
.

¹²
A few additional pieces can be found at
www.vietvet.org/mcmike.htm
.

¹³
About five years later a flame war (an angry exchange of e-mail, with or without insults) flared briefly when Palmer Hall posted “A Valentine's Card for Those Who Were Not There: Ode for the Really-Cares.” After evoking the experience of privation, fear, and grief of combat, the poem ends with the following lines:
—Palmer Four words are all that count:
(1) YOU
(2) WERE
(3) NOT
(4) THERE!
It doesn't matter
that you reallycare. This brought an immediate and furiously obscene reply from a woman member who had been intensely connected to a veteran before, during, and after the Vietnam War. In a December 5, 2001, e-mail message to me, Palmer Hall called this poem “satire.” He was exploring and gently criticizing the stay-the-fuck-away-from-me mentality of some combat veterans. (See page 194 for more by and about Palmer Hall) A day after the “satire” was posted, it brought this quiet, more-in-sorrow response from Judee Strott: “R
EALLY
C
ARE”
[excerpts]
by Judee Strott
They say that it hurt them deeply,
that nobody wanted to hear
of the horrors of war they went through
when they came home from Vietnam, that year…. Well, there were many people who tried to help,
who just were pushed away,
many who have always cared
and will till their dying day. It just doesn't seem to matter to some
that we were always here,
they only want to hurt us,
when they call us “ReallyCares.” It seems they're intent on making us feel
just like they felt back then—
wounded in spirit and an object of scorn
unwanted by countrymen…. When the ReallyCares are gone my friends,
what will there be left?
Wets with the cynical mistrust they have,
alone again, bereft…. © 1994 by Judee Strott. All Rights Reserved. Used by permission of the author.

¹⁴
Online:
lists.village. virginia.edu/sixties/HTML_docs/Texts/Humor/Weptronics/ wep_product.html
.

¹⁵
E-mail, December 8, 2001.

¹⁶
E-mail, December 16, 2001.

¹⁷
Used by permission. Published previously in H. Palmer Hall,
From the Periphery: Poems and Essays
(San Antonio: Chili Verde Press, 1994).

¹⁸
E-mail, December 4, 2001. James Byrd, Jr., was an African-American who was murdered in Texas on June 7, 1998, by two white men who may or may not have cut his throat, but then chained him by the ankles to their pickup truck and dragged him to pieces while still alive. (Source: Roy Bragg, “Jasper Trial Defendant Says Byrd's Throat Was Cut,”
San Antonio Express-News,
Friday, September 17, 1999.)

¹⁹
Some material in Part III originated in the
Commandant of the Marine Corps Trust Study,
which can be found on the Web at
www.belisarius.com/modern_business_strategy/shay/cohesion.doc
. For a detailed refutation of the belief that emotion and reason are in all ways antithetical, see Antonio R. Damasio,
Decartes' Error: Emotion, Reason, and the Human Brain
(New York: Grosset/Putnam, 1994). The philosophic controversy, dating back to Plato's time, has been taken up with great cogency and power by philosopher Martha Nussbaum in
The Fragility of Goodness.
The footprints of Professor Nussbaum's philosophizing are all over my own work. In my view she has nailed the emotion-reason controversy once and for all in
Upheavals of Thought.