The Evil Hours

by David J. Morris

  [>] psychiatric Esperanto: Ethan Watters, “Suffering Differently.” New York Times Magazine, August 12, 2007. This quote comes from Allan Young, a historian of PTSD and medical anthropologist at McGill University. On page 29 of Crazy Like Us, Watters writes: “In the spring of 1881 one popular French journalist wrote, ‘The illness of our age is hysteria. One encounters it everywhere. Everywhere one rubs elbows with it . . . Studying hysteria, Monsieur Lasegue, the illustrious master, and Monsieur Charcot have put their finger on the wound of the day . . . This singular neurosis with its astonishing effects . . . travels the streets and the world.’ Ethan Watters, “Suffering Differently.” New York Times Magazine, August 12, 2007. This quote comes from Allan Young, a historian of PTSD and medical anthropologist at McGill University. On page 29 of Crazy Like Us, Watters writes: “In the spring of 1881 one popular French journalist wrote, ‘The illness of our age is hysteria. One encounters it everywhere. Everywhere one rubs elbows with it . . . Studying hysteria, Monsieur Lasegue, the illustrious master, and Monsieur Charcot have put their finger on the wound of the day . . . This singular neurosis with its astonishing effects . . . travels the streets and the world.’”

  [>] the fourth most common psychiatric disorder: Rachel Yehuda, “Post-Traumatic Stress Disorder.” New England Journal of Medicine 346 (2002): 108–114, p. 108.

  [>] In 2012, the federal government spent: IOM (Institute of Medicine). Treatment of Posttraumatic Stress Disorder. See also Finley, Fields of Combat, 128. Finley provides an excellent insider account of the workings of VA San Antonio, which paralleled my experiences at VA San Diego. It is important to emphasize when discussing the VA what a vast system it is and how each site varies in the quality of care provided. The VA centers at San Diego and San Antonio are unusual and instructive because of the large military/veteran populations in both cities. In 2004, the VA reported that it spent 4.3 billion dollars on PTSD disability payments to veterans. This earlier figure is cited in Finley.

  [>] Since the attacks of 9/11: Watters, on page 71 of his book Crazy Like Us, describes the international response to the tsunami in Sri Lanka, saying, “By 2004 PTSD was on the cusp of becoming the international lingua franca of human suffering.”

  [>] Consumers who are so inclined: www.patchstop.com, SKU: P3216.

  [>] There remains a small but vocal cadre of researchers: Allan Young, in Harmony of Illusions, argues that the condition we know as PTSD was not discovered but was “glued together” by “the practices, technology and narratives with which it is diagnosed, studied, treated and represented.” Two leading historians of psychiatry, Edward Shorter at the University of Toronto and Ben Shephard, the author of War of Nerves, have both argued that the PTSD diagnosis and the science behind it are dubious. An illuminating collection of dissenting voices can be found in Posttraumatic Stress Disorder: Issues and Controversies, edited by Gerald Rosen.

  [>] Pierre Janet, a French neurologist writing in 1925: Herman, Trauma and Recovery, 35.

  [>] Over time, PTSD has changed not only: See Don DeLillo’s post-9/11 novel Falling Man (New York: Scribner, 2008), where a character says, “These are the days after. Everything now is measured by after.” Roger Luckhurst of the University of London makes a similar argument in his excellent scholarly work The Trauma Question.

  [>] both as a mental condition and as a metaphor: For a fascinating discussion of this, see Seeley, Therapy after Terror, 147–167. See also Susan Sontag’s classic Illness as Metaphor (New York: Vintage, 1979). In the chapter titled “Trauma as Metaphor,” Seeley argues, “Cultural conceptions of insanity, normality, morality, and reality are constantly in flux. Indeed Sontag’s claim that physical illnesses are metaphors, in that they stand for, call up, and play out dominant social themes, anxieties, and inequalities applies to mental disorders as well. Like labels for physical diseases, labels for mental disorders designate the ills and ill fortunes of others” (150).

  [>] The ancient Greeks staged plays: Jonathan Shay, in his pioneering Achilles in Vietnam, says, “The ancient Greeks had a distinctive therapy of purification, healing and reintegration that was undertaken as a community. We know it as Athenian theater . . . the distinctive character of Athenian theater came from the requirements of a democratic polity made up entirely of present or former soldiers to provide communalization for combat veterans . . . The Athenians communally reintegrated their returning warriors in recurring participation in rituals of the theater” (230).

  [>] Like Nick Carraway returning from: Fitzgerald, Great Gatsby, 2.

  [>] “The war itself was a mystery”: O’Brien, In the Lake of the Woods, 76.

  [>] One British World War I veteran: Eric Leed, “Fateful Memories: Industrialized War and Traumatic Neuroses.” Journal of Contemporary History 35 (2000): 87. Leed is quoting Charles Edmund Carrington, who said, “The 1916 fixation had caught me and stunted my mental growth, so that even ten years later I was retarded and adolescent. I could not escape from the comradeship of the trenches which had become a mental internment camp.”

  [>] Alice Sebold, in her bestselling: Sebold, Lucky, 27.

  [>] This palpable sense of not belonging: I owe a great debt to Karen Samuels at Memorial University of Newfoundland, who introduced me to the idea of PTSD as a state of liminality. Her article “Posttraumatic Stress Disorder as a State of Liminality,” published in the Spring 2006 issue of the Journal of Military and Strategic Studies, was extremely helpful and opened up a whole new way of thinking about the issue. Eric Leed’s discussion of liminality and war trauma in No Man’s Land is likewise excellent.

  [>] Arnold van Gennep coined the term: van Gennep, Rites of Passage, 11.

  [>] Yet as Victor Turner, an influential anthropologist: Turner, Betwixt and Between, 5.

  [>] Women have always played a pivotal role: Shay, Odysseus in America, 131–134. Mythology is filled with this theme of balance being achieved only through an interplay of the sexes. Paul Fussell, in The Great War and Modern Memory, wrote that “after considering the matter for centuries, the ancients concluded that one of the lovers of Venus is Mars. And Eros, some held, is their offspring. Since antiquity everyone who has experienced both war and love has known that there is a curious intercourse between them” (339). See also Campbell, Power of Myth, 64–65.

  [>] Looking back on this post-Iraq: Hemingway, Complete Short Stories, 109–117.

  [>] It reminded me of something a veteran: This comment is drawn from an interview I did with a Marine who fought at Observation Post 4 along the Saudi-Kuwait border in January 1991. See my 2004 book Storm on the Horizon (New York: Free Press, 2004), 73–79.

  [>] PTSD may well be the Esperanto: This impression of the literature being fragmented and “silo’d” was reinforced by my discussions with Jonathan Shay, whose groundbreaking work combined mythology, classical studies, and psychiatry. Shay, talking about his willingness to ignore the traditional boundaries between academic disciplines, at one point described himself as an “intellectual slut.” He gestures toward this in Odysseus in America, at one point arguing, “At best, the distinctions among brain, mind, society, and culture are throwaways—temporary guides to perception and communication, temporary artifacts of the philosophical, institutional, and methodological history of the West” (248).

  Other observers, such as Stossel in My Age of Anxiety (2013), have chalked this lack of coherence up to the longstanding intellectual discord in medicine and the sciences: “The conflicts between these different perspectives—and between the psychiatrists (MDs) and the psychologists (PhDs), between the drug proponents and the drug critics, between the cognitive-behaviorists and the psychoanalysts, between Freudians and Jungians, between the molecular neuroscientists and the holistic therapists—can sometimes be bitter. The stakes are high—the future stability of large professional infrastructures rides on one theory or another predominating” (53).

  [>] “trauma impacts the whole critter”: Interview with Jonathan Shay.

  [>] One leading V
A researcher: This extremely knowledgeable researcher had studied PTSD for over two decades and had published dozens of scientific papers on the subject. Curiously, her grasp of the nuts and bolts of military life and the basics of the Iraq War seemed almost nonexistent. This proved to be a common experience in my dealings with VA clinicians, which like the entire American medical establishment breeds an exceedingly narrow and parochial species of professionalism and does little to reward interdisciplinary learning. This overspecialization results in, among other things, a research literature that is virtually incoherent to anyone working in another field. As one British historian opined recently, “Researchers today no longer write in English.” At the risk of sounding shrill, virtually all of the leading minds on the subject of trauma have been committed generalists, thinkers well versed in philosophy, biology, sociology, history, psychology, and literature, W. H. R. Rivers, Robert Lifton, Chaim Shatan, and Jonathan Shay being but a few handy examples.

  [>] One British author of an influential: Ben Shephard, 15th Maudsley Debate, King’s College London, “Post-Traumatic Stress Disorder,” May 2002 (http://www.kcl.ac.uk/iop/news/debates/podcast-archive.aspx).

  [>] As Otto Fenichel, one of Freud’s: Seeley, Therapy after Terror, 150.

  [>] It would be foolish to diagnose: Faludi, Terror Dream, 2–15. Faludi writes “Virtually no film, television drama, play or novel on 9/11 had begun to plumb what the trauma meant for our national psyche. Slavishly literal reenactments of the physical attack—preapproved and presanitized by the new Production Code committee known as ‘The 9/11 Families’—or unrepresentative tales of triumphal rescue at ground zero seemed all the national imagination could handle. United 93, Paul Greengrass’s almost real-time chronology of the events on the last hijacked plane, released in April 2006, seemed to have no purpose other than to repeat what we already knew” (2). Over the course of the book, Faludi goes on to describe the various ways in which post-9/11 America has tended to celebrate “manly men,” while looking to recapture a kind of “Greatest Generation patriotism.” See also Andrew J. Bacevich’s superb The New American Militarism: How Americans Are Seduced by War (New York: Oxford University Press, 2013). While Bacevich, a retired army officer, focuses primarily on American foreign policy, he describes how American pop culture is suffused with a “romanticized view of soldiers” and “the fostering of (and nostalgia for) military ideals” (2).

  [>] Moreover, the ongoing militarization of American culture: One is reminded here of World War I veteran Robert Graves’s observation in Goodbye to All That (New York: Doubleday, 1957) when he returned home from the Western Front: “England looked strange to us returned soldiers. We could not understand the war madness that ran around everywhere looking for a pseudo-military outlet. The civilians talked a foreign language; and it was newspaper language.”

  [>] recent helicopter parenting phenomenon: Claire McCarthy, a physician and blogger, made this observation on www.intelihealth.com. See also Anita Bruzzese, “Self-Sufficiency Is Elusive to Young Adults of Hovering Parents.” USA Today, August 24, 2012. See also Katie Roiphe’s 2012 book In Praise of Messy Lives.

  [>] “These are the days after.”: DeLillo, Falling Man, 138.

  [>] If war is a kind of symbolic violence: The author and psychotherapist Gary Greenberg first suggested to me the idea that PTSD might serve a compensatory function for the civilian populace. The word he used was “mitzvah,” which is Hebrew for “good deed.” In No Man’s Land, Eric Leed writes, “The citizen-soldier has always been a central figure in what might be called an ‘economy of social guilt’ and public sacrifice. He is the holder of a blood-debt upon the society he has defended and can demand restitution for his ‘sacrifice of himself’ as well as for that of his comrades who have died . . . For this temporary loss of a private self, the soldier can demand restitution in the form of honor, prestige, or financial rewards” (204).

  [>] how modern therapeutic culture: For a fascinating conversation exploring the thesis that the PTSD “project” has pathologized normal human adversity, listen to the 15th Maudsley Debate from May 2002, “Post-Traumatic Stress Disorder” (http://www.kcl.ac.uk/iop/news/debates/podcast-archive.aspx).

  [>] literature has been the primary: The literature of trauma is rich indeed. The concept of PTSD is unimaginable without works such as The Odyssey, Wilfred Owen’s poetry, and Kurt Vonnegut’s Slaughterhouse-Five. Robert Jay Lifton, one of the architects of what became PTSD, seemed to sense this and wrote, in his 1973 book Home from the War (published seven years before the formalization of PTSD), that “I found echoes of many things I have heard Vietnam veterans say in J. Glenn Gray’s The Warriors and Guy Sajer’s The Forgotten Soldier, Erich Maria Remarque’s All Quiet on the Western Front and the poems of Wilfred Owen” (18).

  [>] “The experience of trauma is context-dependent”: Interview with Robert Stolorow.

  [>] “patients tell stories to describe illness”: Mukherjee, Emperor of All Maladies, 390. Earlier in the book, Mukherjee writes, “To name an illness is to describe a certain condition of suffering—a literary act before it becomes a medical one. A patient, long before he becomes the subject of medical scrutiny, is, at first, simply a storyteller, a narrator of suffering—a traveler who has visited the kingdom of the ill. To relieve an illness, one must begin, then, by unburdening its story” (46).

  [>] trauma’s corrosive power lies in its ability to destroy narrative: Shay, in Achilles in Vietnam, writes that “severe trauma explodes the cohesion of consciousness. When a survivor creates fully realized narrative that brings together the shattered knowledge of what happened, the emotions that were aroused by the meanings of the events, and the bodily sensations that the physical events created, the survivor pieces back together the fragmentation of consciousness that trauma has caused” (188).

  [>] “the central image of post-traumatic stress”: Interview with anonymous senior VA psychiatrist.

  [>] “PTSD” was referred to as “Post-Vietnam Syndrome”: Nicosia, Home to War, 159. Robert Lifton is usually credited with coining the term “Post-Vietnam Syndrome,” though he had an unhappy relationship with it, saying in his 1973 book Home from the War that “post-Vietnam syndrome is a dubious, easily-abused category, especially in its ready equation of effects of the war with a clinical condition (a ‘syndrome’)” (420).

  [>] This military connection continues into the present day: In Posttraumatic Growth: Research and Practice (New York: Lawrence Erlbaum Associates, 2006), Rita Rosner and Steve Powell say what is immediately apparent to anyone who has looked into the current state of PTSD research: “By far the best studied group of soldiers is the U.S. military, who are probably not typical for the rest of the world’s soldiers. At least in the case of U.S. soldiers in recent decades, joining the army is usually a deliberate choice, which indicates that there was some sense of control. Furthermore, U.S. soldiers have always fought abroad, which means that their families are safe and their home environment is comparably stable” (200).

  [>] a sort of global lingua franca: In Crazy Like Us, Watters writes that “it’s only been in the past twenty years that the diagnosis of PTSD has caught the world’s attention. It first gained critical momentum in the United States and then began leapfrogging the globe, being put to use after wars, genocides and natural disasters. By 2004 PTSD was on the cusp of becoming the international lingua franca of human suffering.” Watters quotes Allan Young, a medical anthropologist at McGill University: “We were spreading these ideas around the globe so effectively that PTSD was becoming the way the entire world conceived of psychological trauma . . . The spread of the PTSD diagnosis to every corner of the world may, in the end, be the greatest success story of globalization” (70–71). A number of skeptics, like Derek Summerfield and to a lesser extent Gaithri Fernando of CSU Los Angeles, have criticized this globalization of PTSD, saying among other things that the PTSD diagnosis, as applied today, is not culture-neutral and tends to deemphasize the powerful roles of family, comm
unity, and religion.

  1. Saydia

  [>] Through the small, thick Humvee window: This chapter is based on my recollections of my time as an embedded reporter in Iraq. The unit I embedded with in Saydia was 1-18 Infantry from Schweinfurt, Germany. I was on active duty in the U.S. Marine Corps from 1994 to 1998, and after completing my training as an infantry officer at Quantico, Virginia, was assigned to Kilo Company, 3rd Battalion, Fifth Marines at Camp Pendleton, California. I did one six-month deployment with 3/5 to Okinawa, where the battalion was part of the 31st Marine Expeditionary Unit (Special Operations Capable). My final year on active duty was spent as the assistant director of the First Marine Division Schools. I made three reporting trips to Iraq: April–June 2004, June–August 2006, and July–November 2007. While I was in Iraq, I reported for Salon, the Virginia Quarterly Review, and NPR.

  [>] “slow-motion ethnic cleansing”: I first heard this term from Damien Cave of the New York Times in August 2007.

  [>] I’d just spent a month in Dora: The unit I embedded with in Dora (sometimes spelled Doura) was 2-12 Infantry from Fort Carson, Colorado. 2-12 had recently been “reflagged,” meaning they had been changed from a paratrooper unit into a light infantry unit, a redesignation that no one in the unit liked. 2-12’s saga is documented in David Philipps’s book Lethal Warriors: When the New Band of Brothers Came Home (New York: Palgrave Macmillan, 2010). After they’d returned to Fort Carson, 2-12 was found to have a PTSD rate more than three times that of an equivalent U.S. Army unit that had been deployed to a less deadly part of Iraq (Philipps, 238). The dangers they lived with for months are impossible to describe with any justice. One image that stays with me is the thing I saw when I walked into 2-12’s command post for the first time: 16 framed photographs screwed onto a wall, one for each soldier killed in Dora.