Odysseus in America

by Jonathan Shay

  11 An excellent summary of the Platonic view of this is found in Martha Nussbaum, “Tragedy and Self-Sufficiency: Plato and Aristotle on Fear and Pity,” in A. O. Rorty, Essays on Aristotle’s Poetics (Princeton: Princeton University Press, 1992).

  12 The numbers are somewhat distorted by one quite wealthy Continental Army vet who brought up the average at the beginning of the period, but then brought it down by his departure or death. Removing him from the analysis makes the decline less dramatic and the starting disparity in wealth more marked. But even with this one rich patriot removed, the decade-by-decade decline in wealth of the long-service veterans compared to the stability of the other two groups is still significant. See Resch, Suffering Soldiers, p. 210.

  13 Personal communication. Swedish Sanskrit scholar Ernst Arbman probably offered the best German equivalent for thumos in 1927 as “die Ichseele,” the “I-soul,” which captures its narcissistic dimension. Conventionally, it is translated as “das Gemüt,” which is as opaque in German as the conventional English equivalent, “spirit.” While I like Arbman’s coinage for thumos I do not subscribe to the rest of his critical approach.

  14 Francis Fukuyama, author of The End of History and the Last Man (New York: Free Press, 1992), has tried to put thumos back into circulation, transliterating the word as thymos. See pp. 162ff and other places indexed under thymos.

  15 Phenomenology of Spirit IV.A, and elsewhere. Transition from citizen to slave was the most salient image and vivid fear in the ancient Greek world. Loss of a battle or of a war could convert citizen to slave in a day.

  16 A particularly useful overview of the psychoanalytic usage can be found in Sydney Pulver, “Narcissism: The Term and Concept,” in A. P. Morrison, ed., Essential Papers on Narcissism (New York: New York University Press, 1986). Heinz Kohut’s most influential work, and the source of my emphasis on ideals and ambitions as content for thumos, is The Analysis of the Self: A Systematic Approach to the Psycho-analytic Treatment of Narcissistic Personality Disorders (Madison: International Universities Press, 1971).

  17 I discuss the biological significance of social trust and speculate on how war in the upper Paleolithic shaped human psychology in “Killing Rage.”

  18 Or “another myself.” Quoted from Nicomachean Ethics IX.9.1170b6 (trans. Irwin). Aristotle’s account of friendship is rich, complex, and laced with surprises. See particularly A. W. Price, Love and Friendship in Plato and Aristotle (Oxford: Oxford University Press, 1990), Chapter 4.

  19 Martha C. Nussbaum, The Fragility of Goodness (Cambridge: Cambridge University Press, 1986), p. 354. Citations of the word philos and related words in the Iliad and Odyssey fill a whole page of R. J. Cunliffe’s A Lexicon of the Homeric Dialect (Norman: University of Oklahoma Press, 1963; reprint of Blackie and Son, London, 1924), pp. 408-9.

  20 Achilles in Vietnam, pp. 35-37.

  21 The first and second items on this list seem to me to connect to Circe’s description of what she saw: (10:502ff, Fagles) Now you are burnt-out husks, your spirits haggard, sere,

  always brooding …

  your hearts never lifting with any joy—

  22 “Nostalgia” was the term going back to the seventeenth century that military medicine gave to the often fatal collapse of the will to live and of all self-care among soldiers. It was still in official use in the Union Army in the Civil War. Eric Dean gives an excellent account of this history in pp. 128-31 of Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War (Cambridge, Mass.: Harvard University Press, 1997). “Musselman” was concentration camp slang for this same phenomenon. Because the Nazis murdered inmates who could no longer work, it was always fatal.

  23 Whether Hitler or bin Laden or both had awful traumatic backgrounds is not exculpatory. Despite many requests, I have never testified as an expert witness to get someone off on a PTSD defense. While it may seem contradictory, I have lobbied the governor of my state for better services to incarcerated veterans with PTSD.

  24 There has been a burst of scholarship in this area, for example, Understanding the Political Spint: Philosophical Investigations from Socrates to Nietzsche, ed. Catherine H. Zuckert (New Haven: Yale University Press, 1988); James F. McGlew, Tyranny and Political Culture in Ancient Greece (Ithaca: Cornell University Press, 1993); Ober and Hedrick, eds., Dēmokratia; Barbara Koziak, Retrieving Political Emotion: Thumos, Anstotle and Gender (University Park: Pennsylvania State University Press, 2000); Martha Nussbaum, Upheavals of Thought: The Intelligence of Emotions (Cambridge: Cambridge University Press, 2001)—inquiry into equal political respect is woven throughout this large book.

  25 John Hesk, Deception and Democracy (Cambridge: Cambridge University Press, 2000). I thank Professor Josiah Ober for his patience in discussing Athenian legal restraints on biē and mētis with me.

  26 It is possible that veterans who have remained stable in only one of these states in the above list (pages 160-61) would never come to our attention in a specialized combat PTSD program because they would be dead, incarcerated, hidden in the woods and not coming out, famous and powerful on a small or large scale, or diagnosed elsewhere as schizophrenic or physically ill. If complex PTSD after combat appears to be defined by repetitive cycling, that may be because the veterans themselves or the social system sends those who do not cycle somewhere else, rather than to us.

  17. From the Clinic to the Wall

  1 I was too busy trying to survive. Within the five years after the end of my psychiatry training, I had to take major responsibility in a family business with extremely serious problems, had a stroke (age forty!), my marriage disintegrated, and I was slandered by a senior colleague, derailing an attempt to get back on my feet at Harvard Medical School, where I had been on the faculty because of my research. I would not voluntarily undergo any of these experiences again, but I embrace them as my life, and as my second education.

  2 Throughout this book I have used the word “patient” rather than “client.” The nonmedical disciplines in mental health have embraced the word “client,” apparently making the cultural connection to the client of a law, accounting, or business firm. Perhaps because of the suggestion that the client is free to take his business elsewhere, this appears to confer more dignity on the individual than “patient,” which is thought to confer a less powerful image, especially when contrasted to “the doctor.” No one will be surprised that I have something to say about these usages based on the origins of the words in classical antiquity. A “patient” is one who suffers, the word being derived from Latin patī, to suffer. The “Passion” of Jesus on the Cross has the same etymology. “Client,” on the other hand, comes from Latin cliens, the dependent or hanger-on of a patron. A cliens hears the orders of his patron and jumps to please him. I ask you, which suggests greater dignity? I use the word “patient” not because I am a doctor and wish to assert my authority; instead I recommend it to all mental health professionals, psychologists, nurses, social workers, and counselors, because it reflects the ethical basis of what we do—the alleviation of suffering.

  3 Treatment outcome studies of the intensive inpatient VA specialized treatment units have shown a marked and persistent reduction of violence and an equally marked and persistent improvement in the veterans’ quality of life. Not surprisingly, the symptoms of simple combat PTSD—the symptoms most measured by most studies, because of their official enunciation by the American Psychiatric Association—were little changed. They may represent irreversible brain changes, or at least irreversible with present knowledge.

  4 Dr. Munroe recently received the Sarah Haley Award for Clinical Innovation of the International Society for Traumatic Stress Studies, the main professional organization in the trauma field. He and I have published a detailed description of the VIP treatment approach in “Group and Milieu Therapy of Veterans,” pp. 391-413.

  5 Many of our professional colleagues—whom we love and respect—disagree vociferously with us, because they accept the cultural model of the scientist-p
rofessional laid out in its classic analysis by the great mid-century sociologist Talcott Parsons (who was my senior tutor in college). Readers familiar with Parsons’s work will recognize the influence of the “pattern variables” in my critique. Explanation of the value pattern of the professional and how it leads to failure with complex PTSD is given in Shay and Munroe, “Group and Milieu Therapy of Veterans,” based on Parsons ’s The Social System (New York: Free Press, 1951). I agree that treatment of simple PTSD may not require any more trust than is required to receive treatment for a ruptured appendix. Reliance on credentials and institutional position suffices and personal trust isn’t needed. Functional specificity (division of labor among different occupational specialties) is deeply institutionalized in licensure, departmental organization of medical facilities, and career paths in the professions. For many combat veterans with complex PTSD, the careerism of officers and the career management systems of the military services (manifested then as six-month rotations in troop command positions) were the visible sources of their betrayals. Also, the division of labor is a key element in the processes that support state-authorized atrocities and torture. Veterans who had the misfortune of witnessing or participating in these were told, “none of your business” or “not my job” or “just do your job” if they raised objections. Many of those who crossed into the heart of darkness and executed those orders are now dead by their own hand. Herbert C. Kelman, “The Social Context of Torture,” in The Politics of Pain: Torturers and their Masters, ed. Ronald D. Crelinsten and Alex P. Schmid (Boulder: Westview Press, 1994).

  6 James F. Munroe, “Therapist Traumatization from Exposure to Patients with Combat-Related Post-Traumatic Stress Disorder: Implications for Administration and Supervision” (Ann Arbor, Michigan: Dissertation Abstracts).

  7 My own vanity has laid seductive traps. I got into trouble a couple times after the publication of Achilles in Vietnam from no longer listening to the particularity of a veteran’s experience, but rather I fit his words into schemes of my own invention. This is just as bad as fitting it into schemes read in textbooks.

  8 Herman, Trauma and Recovery, Chapter 8.

  9 For further details of our Stage One approach, see Shay and Munroe, “Group and Milieu Therapy of Veterans.”

  10 An educational pamphlet “On Medications for Combat PTSD” gives my philosophy and some specific experience on this subject. It is found on the Web at www.drbob.org/tips/ptsd.html.

  11 F. Kirkland, R. R. Halverson, and P. D. Bliese, “Stress and Psychological Readiness in Post-Cold-War Operations,” Parameters 26:79-91 (1996), p. 86.

  12 Kirkland et al.’s prescriptions are explicitly and implicitly incorporated in the Army’s current doctrine on combat stress control, FM 22-51: Leader’s Manual for Combat Stress Control, about which more in Part Three.

  13 A vast and unexplored subject is the ways that trauma generates the human experience of the holy. I hasten to add that “holy” does not automatically mean good, or beneficent—it is “daunting awfulness and majesty” and “something uniquely attractive and fascinating,” according to Rudolf Otto’s classic phenomenological exploration, The Idea of the Holy, trans. John W. Harvey (Oxford: Oxford University Press, 1923; 2nd ed., 1950). The sacred is—first and foremost—powerful.

  14 As of May, 3,2001: www.vietnamwall.org/news/namesadded.html.

  15 Inscribing the names of all the soldier-citizen dead was first practiced by the Athenians in their “demosion sema, or National Cemetery, in the Kerameikos district” of the city. Tritle, From Melos to My Lai, p. 166. A photo of fragments of these “casualty lists” is on p. 167 of Professor Tritle’s book.

  16 From Lydia Fish e-mail to VWAR-L, October 28, 1995. Copyright © Joan Duffy Newberry, May 1987. By permission.

  17 “Mental Cases,” in The Collected Poems of Wilfred Owen, p. 69.

  18 The comparison to Odysseus and his crew visiting the Underworld is inviting, but leads nowhere that I am able to see.

  19 11:173ff, Fagles.

  20 M. R. Ancharoff, J. F. Munroe, and L. M. Fisher, “The Legacy of Combat Trauma: Clinical Implications of Intergenerational Transmission,” in Yael Danieli, ed., International Handbook of Multigenerational Legacies of Trauma (New York: Plenum, 1998).

  21 M. R. Harvey, “An Ecological View of Psychological Trauma and Trauma Recovery,” Journal of Traumatic Stress 9:3-23 (1996). See also Shay and Munroe, “Group and Milieu Therapy for Veterans,” pp. 391-413.

  22 This should help justify the claim that considerations of social trust are human universals, and not purely an invention of the modern state or market economies. However, trust is dramatically more important in the modern setting than in small, face-to-face (“primitive”) societies. Paper money and banking rest almost entirely on trust.

  23 James Munroe prefers the term “basic trust” to “social trust.” He also refers to what we foster in VIP as a family of reorigin where the veteran can relearn social trust. He is drawn to metaphors drawn from the family; I am drawn to metaphors from the polis. J. F. Munroe, J. Shay, C. Makary, M. Clopper, and M. Wattenberg, Creating a Family of Re-Origin: A Long-Term Outpatient PTSD Unit, training “institute” at the Fifth Annual Meeting of the Society for Traumatic Stress Studies, San Francisco, 1989.

  24 Understanding and responding to these tests of trust is a huge subject beyond the scope of this chapter. It is, however, addressed in Shay and Munroe, “Group and Milieu Therapy for Veterans.”

  25 A key word in Aristotle’s Rhetoric is “pistis,” to which scholars have given all sorts of tortured translations, e.g., “the available means of persuasion.” However, in the everyday language of Aristotle’s time, the word simply meant “trust.” See Christopher Carey, “Rhetorical Means of Persuasion,” in Amélie Oksenberg Rorty, ed., Essays on Aristotle’s Rhetoric (Berkeley: University of California Press, 1996), pp. 399-415.1 have summarized the Rhetoric for military use as a text on leadership in the handout to a visiting lecture in ethics at the U.S. Naval Academy. This handout is available online at www.d-n-i.net/fcs/aristotle.htm.

  26 I have pointed this out in my one small foray on the subject of Athenian tragic theater: “The Birth of Tragedy—Out of the Needs of Democracy.”

  27 Aristotle, Rhetoric, I.ii.3.

  28 Copyright © Michael Viehman, by permission. See biographical sketch on pages 184-85.

  18. Lew Puller Ain’t on the Wall

  1 “Lydia Fish Vita,” The Vietnam Veterans Oral History and Folklore Project, online at faculty.buffalostate.edu/fishlm/folksongs/vita.htm. VWAR-L was the subject of Richard R. Rohde, “Identity, Self, and Disorder Among Vietnam Veterans: PTSD and the Emergence of an Electronic Community,” Ph.D. dissertation (Anthropology), University of Hawaii, 1995. On p. 253, Dr. Rohde says, “My central criticism of the medical model of PTSD is that it locates the source of the problem within the individual, with little or no emphasis on the social-relational aspects of PTSD.” It should be evident to the reader that I heartily agree with this criticism as it applies to complex PTSD. I suspect that if we understood better how social recognition plays out in brain physiology, we would also see that he might be correct with regard to simple PTSD also.

  2 I have pursued a two-stage permission process with the members of VWAR. In the first stage (mostly in 1997) I requested their permission to use the message at all. In the second, I sent them this complete chapter, so that they could see how I had edited their message and how I had contextualized it. In every case I received Stage One permission. No messages here are from members who refused Stage Two permission; their wishes are respected, of course. However, that leaves the members who gave Stage One permission, but whom I have been unable to reach. I have sent e-mail to their last known e-mail address in the VWAR directory, and called their last known telephone number from the same source. These few messages are identified only by their nickname or first name to protect their identities should they not wish to be associated with the words.

  3 E-mail, December 21,
2001.

  4 E-mail, December 8, 2001.

  5 This information supplied by Tom Sykes at my request.

  6 New York: Facts on File, 1985, pp. 144-45.

  7 E-mail, December 11, 2001.

  8 E-mail, December 10, 2001. My heart aches when I read this message.

  9 E-mail, December 5, 2001.

  10 Information provided by Jack Mallory at my request.

  11 A Jarai [“Montagnard”] with whom the author fought against the NVA. Mike McCombs’s tribute to Weet is found in the story “Blood Brother” in the superb collection on the Web at www.vietvet.org/namvet99.htm.

  12 A few additional pieces can be found at www.vietvet.org/mcmike.htm.

  13 About five years later a flame war (an angry exchange of e-mail, with or without insults) flared briefly when Palmer Hall posted “A Valentine’s Card for Those Who Were Not There: Ode for the Really-Cares.” After evoking the experience of privation, fear, and grief of combat, the poem ends with the following lines: —Palmer Four words are all that count:

  (1) YOU

  (2) WERE

  (3) NOT

  (4) THERE!

  It doesn’t matter

  that you reallycare. This brought an immediate and furiously obscene reply from a woman member who had been intensely connected to a veteran before, during, and after the Vietnam War. In a December 5, 2001, e-mail message to me, Palmer Hall called this poem “satire.” He was exploring and gently criticizing the stay-the-fuck-away-from-me mentality of some combat veterans. (See page 194 for more by and about Palmer Hall) A day after the “satire” was posted, it brought this quiet, more-in-sorrow response from Judee Strott: “REALLYCARE” [excerpts] by Judee Strott They say that it hurt them deeply,

  that nobody wanted to hear

  of the horrors of war they went through