I have always thought she took too many risks and someday she would pay the price. Her mother had gone missing in an Alberta town in the 80s and was never found. Whenever I am with her I feel her mother’s eyes trying to see her daughter through mine. In some contorted fashion I cannot help but admire the way she lets herself follow her crazy instincts that compel her to park her flashy red sports car, get out and just sit down on the curb beside one of the 4000+ homeless people in Calgary just because she felt his “aura.” Her language is situated in some vague space between spoken word poetry and folk physics. And when she drops by unexpectedly I just automatically put on the teapot and take out the china. There’s always a story and I never know what is fiction and what is real but it all seems to matter somehow. When she leaves I feel exhausted.
While she sat there alongside the others a woman stopped and tried to give her money too. She didn’t feel insulted. She just felt she was supposed to hear this man’s story. He was a veteran from the war in Iraq and he was suffering from PTSD . It somehow made those stories we read about “out there” seem closer to “here and now” in Calgary.
Suicide prevention is a primary concern for Bostonian Jonathan Shay, M.D., Ph.D., staff psychiatrist for Veterans Affairs in Boston in his work with Viet Nam war veterans. The suicide statistics among Vietnam war veterans are higher than American soldiers who died in Vietnam (MHAT). While their names do not appear on the Memorial Wall, their faces are reflected on its surface.
The numbers of suicides among veteran-soldiers of the Irag OIF (Operation Iraqi Freedom) and Afghanistan theaters have reached epidemic proportions. In 2003 the US military engaged a team of mental health experts to investigate unprecedented numbers of psychiatric casualties.
“It is baffling, if not astonishing, that these military psychiatrists, supposed experts in combat-related stress, have so normalized war that it is overlooked as the source of the disease they have been sent to diagnose, that its horror can be thus discounted and its psychic effects rendered invisible (Shay 2006:2).”
Shay argues that wars have provided scientists and doctors with an ongoing supply of combat-traumatized soldiers including material to enhance understanding of the etiology of soldier-veteran suicides. He claims that war itself is a disease that kills and maims bodies, and ravages the minds of those who engage in it. In the 20th century US (and Canadian?) soldiers were at a much higher risk of becoming a psychiatric casualty (and death by their own hands) than death by enemy fire (Shay 2006:2). And the psychological ravages of war are not restricted to veteran-soldiers. The mental wounds are not restricted to those directly involved but also are inflicted upon civilians and society at large. In fact, Shay argues forcefully that Herman’s groundbreaking work on trauma and recovery (1992, 1997) can be applied to societies as well.
Shay claimed that the “structure, organization and fundamental culture” of 20th century US military ventures contributed to the trauma suffered by soldiers. He challenges distorted histories about why the Viet Nam war ended. He asked a question he cannot answer but felt compelled to raise:
“[Did] and in what ways, [US Vietnam War soldier’s] resistance or refusal in the face of moral outrage serve[…] to protect an individual psyche from the effects of an overwhelming traumatic experience[?] (Shay 2006:2).”
The human practice of war, a state-sponsored activity which causes lethal physical, emotional , spiritual and psychological trauma, can be ended. An end to war is an intergenerational project similar to ending the human practice of slavery. “It has been with us since time began.” “It is part of human nature.” “It is part of every culture and found in every part of the world (Shay 2006:xii).”
The end the human practice of war involves “creating trustworthy structures of collective security, within which citizens of every state would have a well-founded confidence in their security from attack by another country [or from within as in the case of genocide perpetrated on a targeted population within the borders of a nation-state]- backed up be reliable expectation of prompt, effective and massively multilateral armed intervention (Shay 2006:xii-xiii).”
Shay refers to Emmanuel Kant’s essay “Perpetual Peace: A Philosophical Sketch”  in which Kant argued that even in a peaceful world where ruinous wars have passed away, police-like soldiers, would be necessary. Shay is not calling for peace through war, but peace from ruinous wars (2006:xiii).
1. During the American Civil War the disorder was called “irritable heart;” in WWI it was called “shell shock,” in WWII it was “battle fatigue” and now it is called Post traumatic Stress Disorder (PTSD) (Shay 2006:2-3).
2. The suicide of her husband, a Vietnam veteran, provided the impetus for Penny Coleman to research the “why question” and the result is the book entitled Flashback.
3. Judith Herman (1992, 1997) described responses of intrusions or flashbacks as a reflex in which the mind attempts to integrate [explain, contextualize, make tolerable?] an intolerable memory. When the “intolerable memory” fails to be integrated, wounds remain open and healing cannot take place. This may provoke a contradictory reflex where the mind protects itself by numbing, “forgetting” or avoiding the intolerable memory. Intolerable memories can be triggered automatically and repeatedly. Defense mechanisms of avoidance and numbing create their own problems and make the sufferer even more vulnerable. Herman called this self-perpetuating cycle, an “oscillating rhythm” between two intolerable states of being (intrusion and constriction) where healing and equilibrium remain elusive, a dialectic of trauma.
“The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma. People who have survived atrocities often tell their stories in a highly emotional, contradictory, and fragmented manner that undermines their credibility and thereby serves the twin imperatives of truth-telling and secrecy. When the truth is finally recognized, survivors can begin their recovery. But far too often secrecy prevails, and the story of the traumatic event surfaces not as a verbal narrative but as a symptom (Herman 1997:Introduction).”
4. Kant also included notions of “hospitality” providing all with the freedom to emigrate with an anticipation of hospitality from the nation-state to which they were immigrating. He imagined a world of nation-states governed by republican governments and a global body of governance, a league of nations. His ‘conversation’ on world peace is ongoing.
Meanwhile, convoluted arguments are offered by political science professor, Erik Gartzke, who warns of the “possible pitfalls of a capitalist peace” (Perpetuating Peace forthcoming). Gartzke has used the Fraser Institute Economic Freedom Index to argue that ensuring economic freedom (including the freedom of the military industries) is more effective than forms of governance in the reduction of violent conflict.
US military professionals themselves are not militarists. Militarists who argue against an end to war include U.S. military industries and their most enthusiastic allies in politics and the media, many of whom seem to imagine that war exists to provide them with an income and/or an adrenalin rush (Shay 2006:xi).
Webliography and Bibliography
Coleman, Penny. 2006. Flashback: Post traumatic Stress Disorder: Suicide and the Lessons of War. Boston: Beacon Press.
Durkheim, Emile. Suicide.
Herman, Judith Lewis. 1992 . Trauma and Recovery: the aftermath of violence- from domestic abuse to political terror. New York: Basic Books.
Hopper, Jim. Excerpts from Trauma and Recovery.
Shay, Jonathan. 2006. “Foreword.” in Coleman, Penny. 2006. Flashback: Post traumatic Stress Disorder: Suicide and the Lessons of War. Boston: Beacon Press.
Mental Health Assessment Team (MHAT)
Filed under: at-risk populations | Tagged: dialectic of trauma, end of war, etiology of suicide, intrusion and constriction, Jonathan Shay, Judith Herman, mental health, perpetual peace vs perpetuating peace, post-traumatic stress disorder, psychiatric casualty, PTSD, suicide, Trauma and Recovery, veterans: mental health, war: psychological aspects of | 2 Comments »