[>] Could trauma—the nightmares, the daemons, the vanished hopes: McGaugh, Memory and Emotion, 122–125.
[>] “will clip an Angel’s wings/Conquer all mysteries by rule and line”: Quoted in Redfield Jamison, Touched with Fire, 259.
[>] While the number of research subjects involved: Brunet et al., “Effect of Post-Retrieval Propranolol,” 503–506.
[>] In January 2014, Pitman told me: Interview with Pitman.
[>] Society, it seems, is not ready for wholesale memory erasure: See Luckhurst, Trauma Question, 204–205.
[>] In October 2003, before the most promising experiments: President’s Council on Bioethics, Beyond Therapy: Biotechnology and the Pursuit of Happiness. Washington, D.C.: Government Printing Office, 2003.
[>] “Propranolol might be the most philosophically vexing”: Chuck Klosterman, “Amnesia Is the New Bliss: A Breakthrough Drug Can Erase Your Worst Memories—But Not Everyone Thinks You Have the Right to Take It.” Esquire, April 10, 2007.
[>] “To be denied a ‘normal psychopathology’”: Outka, “History, the Posthuman, and the End of Trauma,” 76–81.
[>] Trauma, when heard by society, is a form of testimony: See Herman, Trauma and Recovery, 1. See also Caruth, Trauma.
[>] Nevertheless, not everyone is convinced that propranolol: Adam Kolber, “Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening.” Vanderbilt Law Review 59 (2006): 1561–1626.
[>] “The original memory is indeed still there, deep inside the brain”: See Robin Marantz Henig, “The Quest to Forget.” New York Times Magazine, April 18, 2004.
[>] Prazosin, a drug first used to reduce high blood: M. A. Raskind et al., “Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study.” American Journal of Psychiatry 160 (2003): 371–373. See also Shiromani, Post-Traumatic Stress Disorder, 341–343; Friedman, Handbook of PTSD, 392.
[>] Some of the most experienced psychiatrists who treat PTSD: Comments made by Jonathan Shay during a presentation given at San Diego State University: “PTSD and Moral Injury: What’s the Difference and Does it Matter?” October 4, 2012.
[>] The most popular class of drugs prescribed for PTSD: See Friedman, Handbook of PTSD, 387. See also Shiromani, Post-Traumatic Stress Disorder, 348–352. Friedman asserts, “SSRIs are the treatment of choice for patients with PTSD, as attested by four independent clinical practice guidelines” (387).
[>] “Medication has really changed my life”: Interview with Jenny G., March 2013.
[>] Zoloft and other SSRIs have a decent track record with PTSD: Personal communication with Dewleen Baker, VA San Diego Healthcare System, February 2013. Interview with Jeffrey Matloff, VA San Diego Healthcare System, March 2013.
[>] “Prozac is a very forgiving drug”: Solomon, Noonday Demon, 115.
[>] One widely held belief among psychiatrists is: See Redfield Jamison, Touched with Fire, 247.
[>] But it wasn’t until 2002, some fifteen years after Prozac’s: K. Brady et al., “Efficacy and Safety of Sertraline Treatment of Posttraumatic Stress Disorder.” Journal of American Medical Association 283 (2002): 1837–1844.
[>] Despite these shortcomings, the trials published in 2002: Shiromani, Post-Traumatic Stress Disorder, 349.
[>] Seeming to recognize these inconsistencies, in 2008: See Institute of Medicine, Treatment of Posttraumatic Stress Disorder, 67–72. See also Shiromani, Post-Traumatic Stress Disorder, 338. The IOM’s assessment reads in part, “The committee concluded that the evidence is inadequate to determine the efficacy of SSRIs in the treatment of PTSD based on weaknesses in study designs and inconsistency of results. The committee also observed that SSRIs are widely prescribed, have a good safety profile, and might often find indications for use in veterans with PTSD because of comorbid major depression and anxiety disorders. The committee’s conclusion about the SSRI literature was difficult to reach” (71).
[>] As Dewleen Baker, one of the investigators on the original: Personal communication with Dewleen Baker, March 2013.
[>] This frustrating lack of progress with drug research: See Friedman, Handbook of PTSD, 545, where the author argues that “despite great advances in explicating biological alterations associated with PTSD, progress in developing pharmacotherapy has not kept pace . . . Our capacity to target key dysregulated pharmacological mechanisms would be greatly enhanced if it was predicated on a more comprehensive and fine-grained understanding of neurobiological abnormalities associated with PTSD.” See Rachel Yehuda et al., “Conflict between Current Knowledge about Posttraumatic Stress Disorder and Its Original Conceptual Basis.” American Journal of Psychiatry 152 (1995): 1705–1713. Also, interview with Gaithri Fernando, April 2013.
[>] The PTSD diagnosis, from its earliest days: Nicosia, Home to War, 178.
[>] The development of Prozac, for instance, reaches all the way back: See Kramer, Listening to Prozac, 60–64.
[>] Matthew Friedman, the first and longest-serving executive: See Friedman, Handbook of PTSD, 547.
[>] Is it truly a psychiatric disorder, as we understand them today: See Shay, Achilles in Vietnam; Brett Litz et al., “Moral Injury and Moral Repair in War Veterans: A Preliminary Model and Intervention Strategy.” Clinical Psychology Review 29 (2009): 695–706.
8. Alternatives
[>] Tall, blonde, and with a gait that makes her look: This section is based on my interview and personal communications with Elise Colton (not her real name) over the spring of 2013.
[>] “During the early days of the current era of PTSD treatment”: Shay, Achilles in Vietnam, 187.
[>] It is almost as if researchers have been talking to Elise: See David Emerson, Overcoming Trauma through Yoga: Reclaiming Your Body (Berkeley: North Atlantic Books, 2011).
[>] “after an episode of flow is over”: Csikszentmihalyi, Flow, 65.
[>] “To be identified with your mind is to be trapped in time”: Tolle, Power of Now, 40.
[>] “if many remedies are prescribed for an illness”: Quoted in Solomon, Noonday Demon, 135.
[>] “the most striking finding overall is the relative lack of empirical”: Strauss et al., “Complementary and Alternative Treatments for PTSD.” PTSD Research Quarterly 23 (2012): 1–7. See also Friedman, Handbook of PTSD, 545.
[>] One crowdsourced website I consulted: http://blog.23andme.com/23andme-research/what-works-for-ptsd/ (accessed August 2, 2014).
[>] “There are numerous new modalities of treatment”: Hoge, Once a Warrior, 202–204.
[>] “Each of us has his own rhythm of suffering”: Barthes, Mourning Diary (New York: Hill and Wang, 2009), 162.
[>] For example, the idea of training people with PTSD: For more on Todd Vance, see Tony Perry, “Veterans Fight Club.” Los Angeles Times, September 12, 2012.
[>] “no longer met the diagnostic criteria for PTSD”: Jill E. Bormann et al., “Meditation-Based Mantram Intervention for Veteran with Posttraumatic Stress Disorder: A Randomized Trial.” Psychological Trauma: Theory, Research, Practice, and Policy 5 (2013): 259–267.
[>] “The seed of EMDR sprouted one sunny afternoon in 1987”: Shapiro, EMDR, 9.
[>] “84 to 90 percent of the people using EMDR”: Ibid., 5.
[>] Despite these criticisms and complaints about how EMDR: See Foa et al., Effective Treatments, 333–334. See also Friedman, Handbook of PTSD, which discusses head-to-head comparisons between EMDR and PE, with EMDR coming out slightly ahead in some computer analyses of the data. “Several studies have compared EMDR to various combinations of CBT. Three of these studies report effect size advantages for EMDR in those who complete treatment. Ironson, Freund, Strauss and Williams (2002) compared EMDR to PE in a relatively small mixed sample and found no statistical differences between the two treatments” (344).
[>] “the therapist lets you control your thoughts”: See Van Winkle, Soft Spots, 206–207.
[>] Indeed, the technique was so well liked: Shephard, War of Nerve
s, 338. See also Michael M. Phillips’s excellent 2013 series of articles in the Wall Street Journal on the VA lobotomy program, “The Lobotomy Files.” Phillips found that the VA lobotomized at least two thousand veterans over the course of the 1940s.
[>] “My feeling is that therapy is for therapy and that writing”: This quote comes from a 2002 interview with Terry Gross that was included in a reading group guide at the back of the paperback edition of Lucky.
[>] “You may well ask why I write. And yet my reasons are quite many”: Ford Madox Ford, The Good Soldier: A Tale of Passion (Hertfordshire: Wordsworth Editions, 2010), 28.
[>] “EMDR helped a little bit but there was a phase”: Interview with Jenny G., Iraq veteran, March 2013.
[>] An ancient tradition within Polynesian cultures, the haka: See Australian Broadcasting Corporation News, “Giant Haka Honours Fallen NZ Soldiers,” August 27, 2012. See also the entry under “HAKA” in An Encyclopaedia of New Zealand, edited by A. H. McLintock, originally published in 1966.
[>] In the mid-nineties, a group of clinicians at the VA in West Haven: David Read Johnson et al., “The Therapeutic Use of Ritual and Ceremony in the Treatment of Post-Traumatic Stress Disorder.” Journal of Traumatic Stress 8 (1995): 283–298.
[>] One unusually thoughtful therapist I interviewed went so far: Interview with Gary Greenberg, April 2013.
9. Growth
[>] The passages about Steve House are largely derived from my conversations with him, my personal recollections, and his 2009 memoir Beyond the Mountain.
[>] “As I fell, I was relaxed at first. A flake had broken”: Steve Casimiro, “Steve House: What It Feels Like to Fall 80 Feet.” Adventure Journal, June 8, 2010.
[>] “My chest hurt like hell and I knew I didn’t have”: Interview with Steve House, February 2014.
[>] His junior year at Evergreen State: House, Beyond the Mountain, 27–36.
[>] House’s crowning achievement came in September 2005: Interview with Steve House, February 2014. See also House, Beyond the Mountain, 229–244.
[>] “The only thing I can compare it to is being on the moon”: Interview with Steve House, February 2014.
[>] A year later, he and Eva founded Alpine Mentors: See www.alpinementors.org.
[>] “All true wisdom is only to be learned far”: Halifax, Shamanic Voices, 6.
[>] “On the occasion of every accident that befalls you”: Quoted in Gonzales, Deep Survival, 149.
[>] “Some great men and women are fortified and redeemed”: Ha Jin, Crazed (New York: Pantheon, 2002), 319.
[>] “It feels to me as if the U.S. civilian population has pathologized”: Personal communication with the author.
[>] “There is a misperception of our veterans out there”: Jim Michaels, “Mattis: Veterans Are Not Victims.” USA Today, May 5, 2014.
[>] Perhaps the most radical of these reformulators is Richard Tedeschi: See Calhoun and Tedeschi, Handbook of Posttraumatic Growth (New York: Taylor & Francis, 2006) .
[>] “I thought, who do I want to know the most about, distressed”: Quoted in Jim Rendon, “Post-Traumatic Stress’s Surprisingly Positive Flip Side.” New York Times Magazine, March 22, 2012.
[>] “It is in the realm of existential and, for some persons”: Calhoun and Tedeschi, Handbook of Posttraumatic Growth, 6.
[>] “I have no doubt that there are people”: Quoted in Rendon, “Post-Traumatic Stress’s Surprisingly Positive Flip Side.”
[>] “PTSD and post-traumatic growth aren’t mutually exclusive”: Interview with Matt Friedman, March 2013.
[>] “Posttraumatic stress disorder is not necessarily indicative”: Zahava Solomon et al., “Posttraumatic Stress Disorder and Posttraumatic Growth among Israeli Ex-POWs.” Journal of Traumatic Stress 20 (2007): 303–312.
[>] “impressed by the number of prisoners of war of the Vietnam”: William H. Sledge et al., “Self-concept Changes Related to War Captivity.” Archives of General Psychiatry 37 (1980): 430.
[>] One study of Vietnam War ex-POWs even found: Segovia et al., “Optimism Predicts Resilience.” Journal of Traumatic Stress 25 (2012): 330–336. Interview with Francine Segovia, February 2013.
[>] Holocaust survivor Viktor Frankl, in his classic book: Frankl, Man’s Search for Meaning, 137, 155.
[>] “I remembered the basic truth of subjective consciousness”: See Kiland, Lessons from the Hanoi Hilton, 2013.
Epilogue: Counterfactuals
[>] “Justice in our minds is strife/We cannot help but see”: Haxton, trans., Fragments, 41.
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