Shell shock, combat fatigue, PTSD—the name changes, but the suffering is real.
“Bill, my husband came home addicted from service in Afghanistan. He says he is suffering PTSD. Is that really a medical condition or just an excuse to keep on drinking?”
I got the above email from one of my Fix readers. “Tony served in Afghanistan,” she went on, “and came home with a mild drug habit. When I told him I did not like it, he quit…or maybe merely turned to alcohol. Except for some violent flare-ups of bad temper, we had a good marriage for a long time. But in recent years, his drinking has steadily grown worse—his temper too.
“Last year, he checked himself into a rehab…stayed the 28 days…and began drinking again almost the day he got out.
“Bill, I Googled up Post Traumatic Stress Disorder, and found some Internet doctor who said yes, PTSD often does lead vets who’ve been in a war first into addiction and later into relapse. The talk frightened me. Does this mean there’s no hope for my husband?”
And she signed herself, “Emily.”
When the U.S. Army put me through the usual entry battery of mechanical aptitude tests, I did not do well. On a scale of zip to one hundred, I scored maybe an eleven, which is the category that says, don’t give this soldier so much as a pointed stick let alone a weapon with moving parts. So they lost me in what is laughingly called “military intelligence,” and the only stress I suffered in my army career was the Abandoned Dance Hall Bar in Hopkinsville, Kentucky, on a Saturday night.
But if I don’t know much about the stress of combat, I do know all I need about relapse—my own, which I have detailed in these pages—putting me through the worst two weeks of my life.
What’s in a name? In World War I, they called it “shell shock.” In World War II and Korea, “combat fatigue.” After Vietnam and the Gulf War, it was Post Traumatic Stress Disorder. Now, with our engagement in Afghanistan plus our new War on Terror, will the malady be given still another title?
No matter. The name changes but the suffering is real—the topic of PTSD, combined with addiction and relapse, is increasingly important. So I turned to my friend, mentor and an eminent practicing psychotherapist, Larry Bouchard—once an Air Force combat photographer in Vietnam, later assigned to the Army for clandestine missions about which he remains “vague” to this day.
“Right off the top,” said Larry, “let me give you a minority opinion. I think PTSD is maybe the most misdiagnosed or over-diagnosed disorder today. A guy comes in to see a psychiatrist or someone like me because he’s addicted, and can’t stop. Then, if he’s a combat vet, it’s easy to go right past his rocky marriage or oppressive childhood—both of which could be the unresolved issues that keep him drinking. He’s a combat vet and therefore, BINGO! We pin this red-hot diagnostic label on him. PTSD, tada…”
“You’re saying there’s no such thing?”
“I’m saying it’s misunderstood, and its symptoms falsely attributed. Whether it’s getting your new bicycle stolen the day after Christmas, or having your closest comrade shot through the eye while reading a letter from home, the grieving process is the same.
“There are seven distinct and equally vital stages,” said Larry, writing them down for me on a paper napkin.
“First, denial. It didn’t happen. When I look in the backyard again, the bike will be there, probably behind a tree. Or, he isn’t really dead, the medics will fix him.
“Second, anger. If I find the kid who stole it, I’ll stab him with a rusty spear, I’ll eat his liver. Or, I’ll blow away every nasty gook I can find and all his friends too.
“Third, bargaining. Please God, when I wake up, let the bike be there, I won’t ever tease my little sister again.
“Fourth, acceptance. No use moaning. It’s gone. Reality is beginning to set in.” Read more “the fix”…