PTSD: Not so New, Just the Recognition of It

Translations of ancient documents, as old as from 1300 BCE, suggest battle scars which we now call PTSD.

“The sorts of symptoms after battle were very clearly what we would call now post-traumatic stress symptoms.

“They described hearing and seeing ghosts talking to them, who would be the ghosts of people they’d killed in battle – and that’s exactly the experience of modern-day soldiers who’ve been involved in close hand-to-hand combat.”



Torture: After it Stops, It’s Not Over

The obituary today for Helen Bamber, a long time healer to those who had been tortured, reminds us of the very best humans have to offer one another, and the worst.

Helen Bamber, whose volunteering to comfort broken survivors of a Nazi concentration camp when she was 19 inspired her to devote her next seven decades to helping more than 50,000 victims of torture in 90 countries, died on Aug. 21 in London. She was 89.

… Ms. Bamber said the worst toll of torture was psychic — “the act of killing a man without dying,” a survivor once told her. Torture, she wrote in an autobiography for her foundation, constitutes “a total perversion of all that is good in human relationships.”

“It is designed to destroy not only the physical and psychological integrity of one individual, but with every blow, with every electrode, his or her family and the next generation,” she continued. “The body betrays and is often discarded, a body to be hated for its scars and injuries, a body which is a constant reminder even if there are no scars or remaining injuries.”

Her approach was to treat the whole person, often in group therapy, which she saw as giving alienated victims a sense of community. She recruited dozens of professionals to treat more than 2,000 victims a year, and worked with many patients herself as a psychotherapist — which she became through experience, she said, rather than an academic degree.

Her method involved revisiting victims’ worst horrors and letting them “vomit” them out.

“You have to move into the torture chamber with them,” she told the British newspaper The Observer in 1999. “You almost have to be tortured with them.”

The next step, she told The Irish Times in 1995, is to work with the “noble and good” qualities that can enable a victim to survive. It was enough, she said, to take a victim’s story, hold it and say, “Yes, I believe you.”

Her theory, and practice, of immersion with the sufferer, back into the horror and repetitively talking it out, is much the same as that which has helped those gripped by traumatic stress (PTSD).  As Daniel Shay in his ground breaking book Achilles in Vietnam, says, “healing from trauma depends upon communication of the trauma–being able safely to tell the story to someone who is listening and who can be trusted to retell it truthfully to others in the community.”

The two faces of war trauma, both responsive to re-connecting with the human community that was lost.

Another teacher gone, but a legacy left of those who can carry on the work.

Cambodia, Misery Just below the Surface

With renewed understanding in the U.S. that one of the costs of war is enduring psychological damage not only to those who were in the theaters of war but to the families, first separated and then re-combined in combustible ways, one wonders about all those who have been so traumatized, not just Americans.

Cambodia Mental Illness

On a trip through Cambodia several years ago we were struck by the lack of everyday manifestation of war injuries.  It turns out, however, there is plenty — and as a poor country, not much help.

In 2012, in a first attempt to define the scope of Cambodia’s mental health crisis, the Royal University of Phnom Penh interviewed 2,600 people. More than 27 percent showed acute anxiety, and 16.7 percent suffered from depression.

The study estimated the suicide rate at 42.35 per 100,000 people. That would put Cambodia second only to Greenland in incidence of suicides.

Anxiety, depression, PTSD and suicide are estimated to be even higher among survivors of the Khmer Rouge — communist fanatics who took control over the country in 1975. More than 1.7 people, about one-fourth of the population, perished during their four-year rule.

The atrocities were appalling. Children saw their parents gutted, babies were smashed against trees and rice paddies became mass graves. Despite widespread hunger, simple suspicion of stealing food was punished by death.

While 2.7 percent of the overall population suffers from PTSD, the prevalence among survivors is 11.4 percent. Thirty percent of survivors suffer from depression and 36.8 from anxiety, according to a 2010 study by the Berlin Centre for the Treatment of Torture Victims. 

“When the participants were asked whether they seek help from professional mental health providers, 85.4 percent answered no,” the study found.

The country’s mental health burden also affects subsequent generations who did not have to live through the terror of the Khmer Rouge.

Studies found that children of mentally ill parents are more likely to develop syndromes as well.

Global Post and Asia Life

Post War Trauma — and Love

Terry Gross interviewed a quite incredible couple today on her Fresh Air show.

Kayla Williams and Brian McGough met in Iraq in 2003, when they were serving in the 101st Airborne Division. She was an Arabic linguist; he was a staff sergeant who had earned a bronze star. In October of that year, at a time when they were becoming close but not yet seeing each other, McGough was on a bus in a military convoy when an IED went off, blowing out the front door and window.

“Essentially a piece of shrapnel went through the back of my head, burrowed the skull from the back of my head past my ear, out through where my eye is and while doing this it also ripped some brain matter out,” McGough tells Fresh Air‘s Terry Gross.

Williams has written a memoir about their life together, titled Plenty of Time When We Get Home: Love and Recovery in the Aftermath of War,  surviving their sometimes reinforcing mutual PTSD, and now raising two kids.  It’s pretty amazing to hear them talk about what they have been through, and by talking perhaps giving others in similar situations the vocabulary and conceptual tools to advance further in their own struggles.

It’s worth the 40 minutes to hear them. Highly recommended.

Books -- Plenty of Time

For a related look at post-war trauma see Hidden Battles, a look at people affected by war in several times and countries — from the Nicaragua civil war to Palestine and Israel.  Victoria Mills has brought 5 veterans to the screen, some visiting the scenes of their old battles, and let them talk about what it has been like in the years after.  A very accessible way to widen the conversation about war injuries — they happen everywhere, not only to American soldiers in distant places.  Killing has consequences and not only for the dead.

PTSD and Domestic Violence

Actor Patrick Stewart of Star Trek fame, among other movies, has been a strong spokesperson against domestic violence.  Here he fields a question and links PTSD to much violence against women.


Originally found at

Sniper Down, Along With NRA Fantasy

Over the weekend it was reported that Chris Kyle, a US Navy SEAL and reputed ‘deadliest sniper in the world’ had been killed, along with another armed former soldier, by a third, while they were out for shooting practice.

It won’t penetrate the creative minds at the NRA that once again their argument about the defensive potential of automatic weapons, good guys over bad guys, has been buried with  a bloody bullet.  If a man with the best weapons training and deepest experience, with a weapon in his hand, can’t defend himself from a man with a gun, how on earth could anyone?  Whatever disagreement, or PTSD fueled anger had come up, had they not had such lethal weapons, the outcome would have been different — a black eye, a broken jaw, some knife wounds.  Two men would have had a chance to slow down the third. Not so with an automatic weapon.

Automatic weapons do not provide a means of self defense. They remove the possibility of self defense.

This is not to argue that Kyle and the others should not have gone out shooting, or not had weapons. Not at all.  Only to say that the argument that a good guy with a gun is the best protection against a bad guy with a gun doesn’t stand up to any real world experience.

His death is a sadness for his family and those he tried to help.  But in trying to help a man he knew to have PTSD  he missed the conclusion that a man who has a weapon and swirling ghosts from distant combat was a danger to others, and himself.

More at NYT

update: Eddie Ray Routh, the shooter, was definitely in the throes of PTSD.  He had threatened to kill himself and his family in September.

Former Congressman Ron Paul’s tweet, that ‘Treating PTSD at a firing range doesn’t make sense.” has been getting some nasty blowback.


The NRA of course, will not be impressed.  To add to the toxic carnival of deception and virulence Gayle Trotter, a fellow at the Independent Women’s Forum, a right-wing public policy group, testified before Diane Feinstein’s Senate Committee that banning assault weapons and high capacity magazines was discrimination against women, who,  armed with such a weapon, achieved ‘peace of  mind’ and ‘courage’.  The story she cherry picked as an example of female self defense with such a weapon did not, of course, prove her point.

Ms. Trotter related the story of Sarah McKinley, an 18-year-old Oklahoma woman who shot and killed an intruder on New Year’s Eve 2011, when she was home alone with her baby. The story was telling, but not in the way she intended, as Sheldon Whitehouse, a Rhode Island Democrat, pointed out. The woman was able to repel the intruder using an ordinary Remington 870 Express 12-gauge shotgun, which would not be banned under the proposed statute. She did not need a military-style weapon with a 30-round magazine.

And, in fact when you don’t just pick the cherry but eat the whole dish of experience, having a gun at home is very very dangerous.

The cost-benefit balance of having a gun in the home is especially negative for women, according to a 2011 review by David Hemenway, director of the Harvard Injury Control Research Center. Far from making women safer, a gun in the home is “a particularly strong risk factor” for female homicides and the intimidation of women.

In domestic violence situations, the risk of homicide for women increased eightfold when the abuser had access to firearms, according to a study published in The American Journal of Public Health in 2003. Further, there was “no clear evidence” that victims’ access to a gun reduced their risk of being killed. Another 2003 study, by Douglas Wiebe of the University of Pennsylvania, found that females living with a gun in the home were 2.7 times more likely to be murdered than females with no gun at home.

VA study: 22 vets commit suicide every day

There are a couple of ways of measuring the suicide rate in a group of people: one is suicides per day, the other is suicides in 100,000 per year.

The newest findings for US military veterans suicides is up from 18 per day to 22 per day in the last year or so, in the 34 states reporting.

Researchers found that the average age of a veteran who commits suicide is about 60. Analysts concluded that Vietnam and female veterans need particular focus.They also determined that a very intense period of risk for suicide is the first four weeks after someone leaves the military, and that this period requires strong monitoring and case management.

The analysis found that the actual number of estimated suicides per day among veterans has remained relatively stable, ranging from 20 per day in 2000 to 18 per day in 2007 and 22 per day in 2009 and 2010, the latest estimates available, according to a report on the study released Friday. The rate of suicide among veterans who use VA health care services has remained steady in recent years, at about 36 per 100,000

Of course, however bad it is that 22 commit suicide per day it doesn’t mean much until looked at against the background rate in non-veterans.  This is typically stated in the #/100,000/year form.  The latest findings, world wide, show the rate in the United States is at about 12.5/100,000  Presumably, that includes the veterans, so if their deaths were taken out, the non-veteran rate would be somewhat lower.

12.x vs 36 would put the veterans rate in the very terrible range.

Almost as terrible as the rate for all citizens in Korea or Lithuania

It is interesting that the rates being reported are higher among older, Vietnam vets.  No discussion of how that parses out to age on the one hand — and so we should expect a similar result as Iraq and Afghanistan vets age– or to the war itself.  Did the Vietnam war have a more ‘suicidal’ effect on those vets than might be expected for more recent vets.

Also interesting that the report says over half the deaths are by drug over dose or poisoning.  I wouldn’t have expected that.  What is the death by self-inflicted gun shot, or death by cop?

Don’t know.  Work is needed

The Externalities of War Costs


Iraq Vet Offers to Family He Destroyed — His Anguish

In a powerful article called Atonement in The New Yorker by the unparalleled Dexter Filkins we get a story that should be part of every recruiting package to anyone who thinks joining the armed forces is a good thing to do.

It tells of Lu Lobello, a hell-raising kid who joined the U.S. Marines and found himself in a fire-fight in Baghdad that nothing. nothing, nothing, had prepared him — or any of his squad– for.  Trained only for “when in doubt, light ’em up,” he was part of a massacre of an Armenian Christian family who were themselves trying to get out of harms way.  His memories of the afternoon have destroyed the rest of his life:  dishonorable discharge, heavy drinking,  continual insomnia.  Finally, in desperation, he decided to track down the young woman in the car they had shot at. And he found her — living in the United States, her shattered shoulder healed.  Filkins, who had written about the family after the incident, helped arrange a meeting between Lobello and Nora Kachadoorian.  And, out of uniform, away free fire zones and in the deepest wonder of human beings, he found forgiveness.

This is a story you will long remember.  It should be widely known, and read for all its lessons:

  • once in a war, you don’t get to chose what happens
  • what happens in 10 minutes may affect the rest of your life
  • bullets don’t know good guys from bad
  • no matter what you’ve prepared for, you haven’t prepared for this
  • no matter what your superiors tell you, they haven’t planned for this
  • some people, some times, find empathy beyond the imaginable

Some excerpts… but read it all..  New Yorker Oct 29 & Nov 5  [Sorry, no complete link.  You have to log in, or buy the issue, or go the library or a friend with a subscription, and of which will reward you] Read more of this post

Laos: A Moral Man at Work

Lee Thorn is a Vietnam War veteran, a bomb loader on the aircraft carriers that sent the likes of John McCain screaming over Vietnam and Laos to unleash the fires of hell on those b elow.  In both Vietnam and Laos most of the victims were not active combatants in the war.  Laos was not even party to the war. Yet the bombs fell.  When they didn’t fall to decapitate and burn they fell so the aircraft would not have to land with them; they were dumped.

For years Thorn had PTSD dreams of the hell he had been part of sending down on the villagers.  In 1998 he took a trip, as did other vets, to try to come to grips with their demons, and with what they had done.  Thorne fell in love with Laos, and returned, where he lives to this day.  Among other things. he helped set up, and is on the board of the Jhai Foundation.

This is is opinion piece in the SF Chronicle today:

Secretary of State Hillary Rodham Clinton visited Laos on Wednesday. Laos is a small, beautiful, landlocked country, which I first came to know when I served in the Navy during the Vietnam War and have since come to love.

I hope that the secretary will make a significant, long-term commitment to remove bombs that the United States dropped during the secret war in Laos and that are still killing people to this day. I hope that Americans can truly reconcile with the people of Laos and our own brutal past there.

This visit by Secretary Clinton was the first time a senior U.S. official acknowledged that we committed a secret crime against humanity in Laos. Of course, she did not put it this way. But that is what it was.

We never declared war on Laos, yet we carried out military operations there. In 1966, as an “emergency” bomb loader on the aircraft carrier Ranger, I loaded cluster bombs, napalm and high explosive bombs that fell mainly in the Plain of Jars. There was an “emergency” almost every day.

Bombing killed more than 30,000 non-combatants during the war. More than 20,000 people, a large percentage of them children, have been killed in Laos since then by unexploded ordnance, according to Legacies of War, a U.S. nonprofit. …

There is more in his piece, which you can read here.  I was particularly struck by his closing.

I try to work for peace on a daily basis now.

I must.

Sometimes it is just mentoring a younger person or holding my grandson. Other times I write or speak publicly.

I must do service or the dark memories of the bombing in Laos come back to haunt me.

But I also do service for Lao people because I have learned so much there. Lao people have something I think we all need: They know how to reconcile. They taught me how to reconcile.

Now we Americans need to reconcile with our history and the people we have harmed and to make amends. Our secretary of state’s visit is a start.

Other stories about Thorn can be found on-line.  Here are a couple:  from 2000;  about his coffee project, 2001;  in a geek blog ‘since 1968” about the Remote IT Village project; about growing coffee in Laos, in 2003;  he, and the rugged Jhai-PC  appears in a 2010 posting from the International Telecommunications Union.

Thorn is also on the advisory board of Legacies of War, a site to click on often.  Their release today, calls on SecState Clinton to honor her promise to address past legacies.

“It’s remarkable to see the highest ranking U.S. official to visit Laos since the end of the war come face to face with the devastating effects of unexploded ordnance (UXO). Now, she must keep her promise to Phongsavath and the people of Laos, who will otherwise live on dangerous land for generations to come,” remarked Channapha Khamvongsa, executive director of Legacies of War, further adding, “We agree wholeheartedly with Secretary Clinton that we can and should do more to end these past legacies.”

 Thorn is one of few in the world who have the moral imagination to grasp what has been done in his name, and in which he participated.  He found his road to healing by admitting: yes, I did this thing.  And then he had to courage to go to the land of the crime.  There was no reason to think this would turn out well.  His demons could erupt full force.  People could turn on him.  He could have walked  in shame and never emerged.  But he had the courage to put himself there.  He was rewarded.  As he says: The Laotian people “know how to reconcile. They taught me how to reconcile.”

His work there is small, in the big scheme of things.  In the big scheme of things, everything we all do is small.  Even big wars are small in the big scheme of things.  To Lee, and those he works with, what he does is large.  May it grow larger, and send many seeds.

What we need desperately in this world is an answer to the question of how to produce more Lee Thorns.  Ideally, before the fact of loading the bombs, but even after, to find a moral center and connection to others through the act of aggression come back in repentance and healing work is a wonderful thing. It wasn’t easy for him.  He didn’t let that stop him.

How do we encourage more to stand up and say no to the terror they are asked to participate in, the corruption they are players in, the cruelties they witness and walk away from? Way too many sit down, turn away, turn up the music and tell themselves it’s ok to ignore what they can’t change.  Lee Thorn changed, and so can we all.