Trauma, Memory, and Evolving PTSD

Nearly thirty years ago, a crisis in the care for U.S. military personnel returning home from Vietnam, changed the way in which psychological diagnoses were defined. Ever heard of PTSD, of post-traumatic stress disorder? That diagnosis, which made it into the DSM after a protracted and highly political struggle, was created precisely to deal with the collection of symptoms presented by these veterans.

These veterans were experiencing flashbacks, depression, stress, constant anxiety, and too often, psychotic breaks. They were forced indoors much of the time, terrorized by the world and occasionally terrorizing the shrinking worlds around them, their families. Those who were not able to keep it together at even this level ended up in the streets, or dead.

They didn’t, at this early stage, end up in the hospitals, receiving quality care. Partly, this was because of the fact that there existed no diagnosis for these symptoms: they clearly shared a single experiential trigger of sorts – participation in the Vietnam War – but even at that level a great deal of diversity existed. There was the classic victim trauma, but also perpetrator trauma. The latter has received very little attention, perhaps because of the unpopular ethical questions that necessarily accompany its investigation. But the former has become enshrined in our medical, psychiatric, academic, literary, and popular cultures.

In thirty years.

Now, only six years into another great military conflict fought for reasons of imperial ambition, with America’s domestic political scene not only divided, but with one of those halves losing ideological unity and direction, the veterans of the current conflict are finally getting noticed for the problems they are presenting.

Gulf War One created Gulf War Syndrome – a wildly underattended and reported health crisis. Perhaps because we ‘won’ that conflict, it was somehow shameful to report on the costs? But it is increasingly clear that we have ‘lost’ this war, if indeed it was ever winnable.

Compared to these enormous, political, and social questions, the following consideration will necessarily seem trivial. However, this blog does not exist to stake out political positions, but to investigate and draw attention to a very specific range of issues, the most central of which cluster around the academic realm.

The cultural studies/psychological/popular trope of trauma, which plays out nightly on sitcoms, soap operas, radio shows, which makes its way into everyday conversation and spontaneous ‘pop psychological’ analyses of others, comes out of a specific lost war. The veterans and their supporters had to fight extremely hard to get the diagnosis added to the DSM, so that they could be treated.

PTSD is still in the DSM, though Gulf War Syndrome is not. And there are good reasons to want to avoid stuffing the DSM with syndromes, which are by necessity not the same thing as diseases in which we understand the cause of the symptoms. With syndromes, we are still guessing not only at the cause, but by definition, with whether diagnosis refers to a ‘really existing’ pathology, or is instead a collection of related and potentially overlapping problems.

So, while veterans of this current conflict may be able to receive care under the PTSD diagnosis, receiving treatment for Gulf War Syndrome is considerably more difficult. And even those who receive care receive it at places like the Walter Reed Medical Center, at the heart of so many outrageous scandals regarding the healthcare for military personnel

The following article is very worth reading: [link]