The Evil Hours (19 page)

Once, after interviewing an Iraq veteran on the phone for several hours, I heard the
maghrib
, the Muslim evening call to prayer, from my front porch in San Diego, even though there were no mosques in my neighborhood. My strongest associations with the
maghrib
pertain to Fallujah, a town known to some Iraqis as the “city of mosques,” and from Marine patrol bases within the city, you would hear the calls to prayer broadcast over loudspeakers throughout the day. (“God is great/I bear witness that there is no God except the one God.”) That many Marines were convinced that the mosques were insurgent sanctuaries that used their PA systems to coordinate attacks seemed almost irrelevant: hearing the
maghrib
never failed to send a chill up my spine. Spooky is just a word in your mouth until you have heard the sunset call to prayer in a half-rubbled city surrounded by Al Qaeda fighters.

The veteran and I had been talking about Diyala province, a mixed sect region east of Baghdad. The consensus among Marine officers was that the Sunni insurgents who had been driven out of Anbar in 2006 had largely relocated to Diyala, and I had been halfheartedly planning a reporting trip there before finally ending up in Dora. Somehow Diyala had come to represent a missed opportunity in my mind, a challenge unmet, and as we spoke I felt a certain disappointment in myself, along with a number of other complicated feelings about the war. Shortly after hanging up, I stepped out of my apartment to take a walk. When I returned, I heard a distant PA system turn on, followed by the strains of the
maghrib
. This went on for nearly a minute, continuing even after I went inside my apartment and shut the door.

Hearing the
maghrib
, sung in the distinctive Iraqi style, while in San Diego reminded me that, like many veterans, I have a number of disturbing, unresolved memories lurking in the depths that can be reactivated under certain conditions. Interestingly, the
maghrib
is not associated with any particular traumatic event for me but rather with the string of weeks I spent in Fallujah, beginning in May 2004. It is common within the clinical literature on trauma to focus on superlatives—on the singular moments of greatest terror and helplessness, such as the instant the IED went off or the moment the building collapsed during the earthquake—as if the process of traumatization must be reduced to a single point in time in order to be understood. In this vein, clinical descriptions of traumatic hallucinations are nearly always told as corresponding to a moment of maximum horror, a point of near-death. During my worst times post-Iraq, times when I felt the most alienated and angry at the world, it felt like my body was back in Dora and Ramadi, places where I lived on the knife-edge of fear for weeks at a time. It was, in short, a
cumulative
feeling of stress and fear that came back to me, not unresolved memories relating to a specific close call. Arabic music has always been evocative for me, and I wonder if hearing the
maghrib
in San Diego when I did wasn't a misperception that related to a broader stretch of time in Iraq, when I felt lost inside the war, like a fugitive from a regular, grounded life back in the States.

Post-traumatic hauntings require no such invitation from the senses, however.
John Bumgardner, a Union soldier in the Civil War who survived a near miss from an exploding shell, is one such case. After the war, he took up farming with his new wife, Charlotte. Several weeks after they were married, however, she noticed that something was amiss. John would be sitting quietly and then suddenly blurt out, “Don't speak to me; don't you hear them bombarding?” On one occasion, he came running in from the fields, yelling, “They are coming, they are coming. See the bombshell.” Soon after, he ran to an upstairs room, where his wife found him shivering in fear and saying, “Be still. Don't you hear them?”

Michael Ferrara, a veteran wilderness first responder in Aspen, Colorado, describes being overtaken out of the blue by what he called the “slide show,” a procession of mental images he couldn't control: eviscerated bodies, a father riding in the back of an ambulance with his dying skateboarder son, burned figures on a runway.
In a 2011 article in
Outside
magazine that recounted Ferrara's struggle, Hampton Sides wrote that “it was a horror show, crowded in his head like a Hieronymous Bosch scene, and the images wouldn't stop. He reacted to them with a surge of adrenaline, a stab of fear, a complex of real and present emotions. His eyes would drop, he'd lose visual contact with his surroundings. His blood pressure would spike and he'd find himself hyperventilating. He wasn't just remembering these traumas; he was reliving them.”

“The pictures were burned into my mind,” Ferrara said. “They were happening right here, right now. My subconscious didn't know it wasn't actually real.”

 

If the daytime is the occasional stalking ground of Freud's
daemons
, then the nighttime is their lair, an underworld of mystery and metamorphosis where they have free rein. Unsurprisingly, many trauma survivors report that it is at night that they feel the most vulnerable, both to their memories and the outside world. The daemonic night and its chief product, the nightmare, have always been a special hell for survivors. As we saw in the previous chapter, Siegfried Sassoon noted this soon after beginning treatment for shell shock in 1917, observing that there were in essence two hospitals at Craiglockhart, the “elaborately cheerful” hospital by day and the “sepulchral and oppressive” hospital at night, where he found himself submerged in the “underworld of dreams” and “memories of warfare.”
One Civil War veteran, after visiting the battlefield at Cold Harbor after the war, remarked that “skeletons and ghosts haunt us in our dreams.” An Indiana physician who treated Newell Gleason, a Civil War veteran who had recently been released from an asylum, observed that Gleason's sleep was “laborious” and “filled with dreams that seemed to make sleep exhaustive rather than refreshing.”

The dead seem most likely to visit us at night, as happened to Michael Herr, a reporter for
Esquire
in Vietnam. “During my first month back I woke up one night and knew that my living room was full of dead Marines. It actually happened three or four times, after a dream I was having those nights (the kind of dream one never had in Vietnam), and that first time it wasn't just some holding dread left by the dream, I knew they were there, so that after I'd turned on the light by my bed and smoked a cigarette I lay there for a moment thinking that I'd have to go out soon and cover them.”

In fact, it was the modern war nightmare that forced Freud to revise his theory of the unconscious in 1920.
Unable to explain their painful and repetitive “daemonic” character, Freud struggled to fit these nightmares into his theory of dreams as unconscious wish fulfillments. In time, this observation caused him to posit an entirely new facet of psychoanalysis, a counterweight to Eros that he called the death drive or
Todestriebe
. Noting that traumatic nightmares seemed to repeat themselves for years, Abraham Kardiner in 1939 described the repetitive traumatic dream as “one of the most characteristic and at the same time one of the most enigmatic phenomena we encounter in the disease” of combat neurosis. More recent research has confirmed Kardiner's thesis. Peretz Lavie, in an article in the
New England Journal of Medicine
a few months after 9/11, wrote that

 

trauma-related anxiety dreams appear to be the most consistent problem reported by patients with PTSD. Studies involving veterans of combat, survivors of Japanese imprisonment during World War II, and Holocaust survivors indicate such dreams persist, sometimes for more than 40 years after traumatic events.

 

One Vietnam veteran, “Mr. D.,” who was quoted in an early conceptual study of PTSD, continued to have dreams that repeated his wartime experiences. In the dream, he was on a hill being overrun by the Vietcong. The dream was dominated by images of death. Looking around and seeing his friends die, Mr. D. then kills a Vietcong fighter by smashing the man's forehead with his rifle. Another Vietnam veteran, who served on a U.S. Navy “swift boat,” still dreamed about his experiences in the Mekong Delta some twenty years later. The lone survivor of a boat that was destroyed by enemy fire, at night he revisited various scenes from the Mekong, picking up the wounded bodies of his buddies and the Vietnamese that they tortured. “In my nightmares I can't stand the screaming,” he said.

In many cases, the fear of these nightmares prevents the sufferer from falling asleep, or even trying to fall asleep, which leads to chronic insomnia. Over time, this lack of sleep can develop into a kind of ghoulish survivor lifestyle. One Vietnam veteran I met, who worked as a security guard at an office building in downtown Los Angeles, told me he hadn't slept more than two hours at a stretch since the 1970s. Numerous studies, dating back to the advent of the PTSD diagnosis, have confirmed what the spouses of veterans have known for millennia: survivors of trauma sleep differently than other people.
They have trouble getting to sleep, they wake up constantly, and they are more easily disturbed by noises. (My experience certainly bears out this thesis. Any sharp or unexplained noise when I am in bed will send my heart racing.) Interestingly, Richard Ross of the University of Pennsylvania has even suggested that PTSD nightmares might represent a new phenomenon called “REM sleep without atonia” or REM sleep without the usual low muscle tone experienced by most people.

The prevailing theory among researchers today is that traumatic nightmares are mostly “instant replays” of the original trauma, an idea that is surprisingly congruent with Freud's original “repetition-compulsion” theory, which says that survivors tend to reenact old traumas. “The bad stuff never stops happening: it lives in its own dimension, replaying itself over and over,” Tim O'Brien wrote in
The Things They Carried
.
Proponents of this belief look at these nightmares as being essentially sleeping flashbacks and even less significant than normal dreams because of their repetitiveness. For this reason, and the fact that nightmares are difficult to produce in sleep labs, little research is currently being done on nightmares.
The 2007
Handbook of PTSD
, edited by a group of leading VA researchers, contains but a single reference to nightmares in its 592 pages. (This holds true for similar heavily cited scientific anthologies on PTSD published in 1996, 2000, and 2009 as well.)

Why this seeming lack of interest in nightmares? The answer lies in the recent history of psychiatry. “Psychiatry,” says William Normand, a practicing psychoanalyst in New York, “has gone from being brainless to being mindless.” Clinicians who once neglected physiology in favor of emotionality now neglect the emotions in favor of brain chemistry. The study of dreams and nightmares, once the centerpieces of mainstream psychiatry when it was dominated by Freud and his many disciples, is now in decline. Today, researchers increasingly look to neuroscience to explain and manage PTSD symptoms. The most cited studies on traumatic nightmares today relate to the medications used to reduce them, principally Prazosin, a drug that blocks some of the effects of adrenaline, which the body releases during PTSD nightmares.

Nevertheless, interviews with survivors and historical accounts of post-traumatic nightmares give us a richer picture of this nocturnal world and can reveal aspects of trauma that may not necessarily have a neurological correlate. Further, because nightmares tend to be less transient than flashbacks and often have a narrative quality to them, studying them within the larger context of a PTSD sufferer's life can offer insights into the nature of the condition and how survivors really feel about what has happened to them.

One common theme in traumatic nightmares is that the horrific event has never ended, that it lives on and evolves, melding with the present, or, conversely, that it has come to encompass one's entire history: past, present, and future. Veterans of combat often describe dreams involving fallen comrades who have returned to judge them or to join seemingly non-war-related aspects of their past. In a study conducted by therapists at the West Los Angeles VA hospital, one Vietnam veteran, who claimed “his dreams were only about the war,” reported a dream in which he shot an attacking Vietcong soldier on a rooftop. When the Vietcong fell dead, the patient recognized the man as his brother.

Richard Fox, a therapist who worked with over one hundred Vietnam veterans in the 1970s, observed that the loss of a friend frequently led to the most powerful traumatic nightmares and other stress syndromes. He felt that these sorts of visitations were especially likely to occur if the deceased had been a close companion with whom the survivor had a “mirror relationship,” and that there was something intolerable about this because it represents such a close encounter with one's own extinction. This theory helps explain how Caleb Daniels, the Afghanistan veteran who lost his best friend in a 2005 helicopter crash, was so profoundly disturbed that he came to feel that he was being pursued by a buffalo-shaped “Destroyer” demon.

One Iraq veteran I interviewed, who now runs a successful printing company in Virginia, described his war-related dreams as happening on a “circuit.”
Mentioning how his nightmares seemed to correspond to his general stress level, he said, “Most of the time they involve being attacked, and my weapon misfires.” When I asked him if they were simply “instant replays” of traumas from Iraq, he responded, “[The] dynamics of the dream stay constant, the situation/environment changes. My takeaway is ‘You're not ready,' or ‘You're not prepared.'” Audie Murphy, the most decorated American soldier to emerge from World War II, had similar dreams. A line of Germans advancing toward him, “men running and shooting and hollering and then my gun would fall apart when I tried to pull the trigger.”