Life After Wartime
Combating the veteran-as-victim narrative
Jun 2, 2014, Vol. 19, No. 36 • By MACKUBIN THOMAS OWENS
The press was complicit in perpetuating the negative stereotype of the Vietnam veteran. B.G. Burkett and Glenna Whitley’s incomparable 1998 book, Stolen Valor, explains how. Burkett used the Freedom of Information Act to check the actual records of the “image makers” used by reporters to flesh out their stories on homelessness, Agent Orange, suicide, drug abuse, criminality, and alcoholism. What he found was astounding. More often than not, the showcase “veterans” who cried on camera about their dead buddies, about committing or witnessing atrocities, or about some heroic action in combat that led them to their current dead end in life, were impostors. Many had never been in Vietnam, or even in the armed services. Burkett’s book stands as a rebuke to a generation of journalists who were so predisposed to believe the worst about the Vietnam veteran that they failed to do due diligence in checking the facts.
The “Vietnam vet goes berserk” angle became a staple of journalism. A watershed event in the evolution of this genre was the 1988 CBS documentary The Wall Within, which constituted a veritable caricature of Vietnam veterans: During the war, they routinely committed war crimes. They came home from an immoral war traumatized, vilified, then pitied. Jobless, homeless, addicted, suicidal, they remain afflicted by inner conflicts, stranded on the fringes of society.
It was during the Vietnam war that PTSD became a major issue. While PTSD was not officially recognized as a psychiatric syndrome by the American Psychiatric Association until 1980, its foundation was laid by such anti-Vietnam war psychiatrists as Robert Jay Lifton, who claimed that the psychiatric trauma suffered by Vietnam veterans was unique. In other words, since Vietnam was worse than earlier conflicts, returning soldiers were suffering severe psychological effects specific to the war.
Vietnam also marked a related change in military psychiatry. In World War I, the psychological stress of combat went under the name of “shell shock”; in World War II, it became “combat fatigue.” In both of these conflicts, the goal of military psychiatrists was to return the soldier to combat as quickly as possible. Approaches differed, but the idea was that the traumatized soldiers should be treated as close to the front as possible. Of course, not all could be returned to combat, and many who could be had to be treated farther to the rear.
The World War II approach was nicely captured by the 1963 movie Captain Newman, M.D., starring Gregory Peck, Angie Dickinson, Tony Curtis, and Bobby Darin, who received a best-supporting-actor Academy Award nomination for his role as a traumatized soldier. He is cured and returned to combat, only to be killed in action, illustrating the military psychiatrist’s dilemma.
Despite the recognition by the medical profession that psychological trauma was a reality, those suffering from such maladies were often seen as malingerers or even cowards. A case in point involved Lt. Gen. George Patton, who on two occasions slapped and berated soldiers who were patients at evacuation hospitals but without physical injuries during the Sicily campaign in 1943.
As Eric T. Dean noted in his fascinating book Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War, psychiatrists had traditionally seen their job as “salvaging” the agitated soldier and returning him to combat. But with Vietnam, psychiatry moved from a cooperative stance vis- à-vis the military to an adversarial one; the new goal was to keep soldiers from returning to combat. Dean quotes a psychiatrist who wrote:
As Dean wrote, “PTSD has formed a perfect bridge between the horrors of combat in Vietnam and the supposedly widespread readjustment problems of its veterans.” Today’s PTSD disease orientation, focused on an irreparably “broken” veteran, is directly traceable to Vietnam.
The ideological basis of PTSD as a disease caused by service in Vietnam gave opponents of that war an incentive to claim that the malady was very widespread, leading to soaring estimates of the disorder’s incidence among Vietnam veterans. Indeed, some have claimed that as many as half of those who served in Vietnam suffered from the malady. This seems implausible given the fact that only about 15 percent of those who served in Vietnam took part in combat.
But the ideological predisposition to over-diagnose PTSD soon became linked to a bureaucratic one. Just as PTSD was becoming an issue after Vietnam, the Veterans Administration was facing budget cuts due to the precipitous decline in the World War II veteran population. Thus the VA had an incentive to over-diagnose PTSD in order to protect its budget. Ideology and the self-interest of bureaucrats constitute a powerful combination.
In addition, there is a conceptual problem that helps to explain some of the recent travails of the VA. Most diagnoses of PTSD fail to distinguish between the stress that most combat veterans experience in the aftermath of combat—post-traumatic stress or PTS—and a more or less permanently disabling neuropsychiatric disease—PTSD properly understood. Just about anyone who has been exposed to combat has at one time or another exhibited symptoms of PTS: hypervigilance, flashbacks, insomnia, nightmares, depression, guilt—particularly survivor’s guilt—and psychic numbing.
But most veterans prevail over their demons and, like Odysseus, return “home.” Thus as Gen. Mattis observes, the crucible of combat can lead to post-traumatic growth.
The problem is that all too often, PTS and PTSD are conflated. This is probably one factor that has led to the current scandals afflicting the VA. Is that agency dragged down by bureaucratic inertia and incompetence, even criminal incompetence? The answer is most certainly yes (for more on this, see the excellent reporting by Mark Flatten in the Washington Examiner). But it is also the case that the VA is swamped by disability claims for PTSD, which—for bureaucratic and political reasons, as suggested before—is over-diagnosed.
In August 2013 President Obama acknowledged as much in a speech to disabled veterans:
Not all of these additional claims are valid, and in a bureaucratic version of Gresham’s Law, bad claims of PTSD often drive out good.
The veteran-as-victim narrative has hampered efforts by those who want to distinguish between valid and invalid claims of neuropsychiatric disorder resulting from combat. Attempts to draw the distinction have often been blocked by the assumption that to question any claim of a veteran is to deny him what is his by right, reinforcing the veteran’s status as a victim. The tragedy here is that unjustified claims of disability arising from the over-diagnosis of PTSD mean that less money is available to ensure that those truly suffering are receiving the care they need.
A milestone of sorts in the veteran-as-victim narrative occurred near the end of Bill Clinton’s presidency, when he signed legislation authorizing a plaque near the Vietnam Veterans Memorial to commemorate veterans who died after the Vietnam war of maladies attributed to Agent Orange and PTSD. According to the New York Times, “experts estimate that the number of veterans who died from these conditions is at least equal to the number inscribed on the wall, 58,220.” There is not an ounce of scientific evidence to support this breathtaking assertion.
Worse, the addition of the plaque to the memorial reinforces the stereotype of the Vietnam war veteran as victim. Indeed, the Times made the connection explicitly in its headline: “New Category of Victims at the Vietnam Memorial.”
But the veterans of the Vietnam war themselves have rejected this victim narrative. In response to a comprehensive VA survey taken in 1980, 91 percent of respondents who had seen combat in Vietnam reported that they were “glad they had served their country.” A healthy 80 percent disagreed with the statement that “the U.S. took advantage of me.” Nearly two out of three said that they would go to Vietnam again—even knowing how the war would end.
If Vietnam veterans have largely rejected the veteran-as-victim narrative, so have the veterans of Iraq and Afghanistan. Nonetheless, they also have had to make the journey of Odysseus, the return from war to peace. Iraq war veteran Danelo describes it this way:
This is what Gen. Mattis means by post-traumatic growth, and it, more than the disease orientation of PTSD, describes the journey home that most veterans successfully make.
There are two images that serve as metaphors for the veteran’s return from war. The first, which beautifully captures the duality of human life, is Homer’s description in The Iliad of the Shield of Achilles, which depicts, among other things, the city at war and the city at peace. Of course Achilles, unlike most veterans, will never get to enjoy the fruits of the city at peace.
The second is a passage from Wolfram von Eschenbach’s medieval epic Parzival, which illuminates the psychological split within the veteran engendered by war: “Shame and honor clash where the courage of a steadfast man is motley like the magpie. But such a man may yet make merry, for Heaven and Hell have equal part in him.”
Mackubin Thomas Owens, a Marine infantry veteran of Vietnam, is professor of national security affairs at the Naval War College and editor of Orbis, the quarterly journal of the Foreign Policy Research Institute in Philadelphia.
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