As John McCain later wrote,
In the many years since I came home, I have managed to prevent the bad memories from intruding on my present happiness. I was thirty-six years old when I regained my freedom. When I was shot down, I had been prepared by training, as much as anyone can be prepared, for the experiences that lay ahead. I wasn’t a nineteen- or twenty-year-old kid who had been drafted into a strange and terrible experience and then returned unceremoniously to an unappreciative country.
The Hanoi Hilton experience is a unicorn in the literature of trauma, a case in which a perfect storm of circumstances converged to produce a group of people who defied the odds and, as such, would be exceedingly hard to duplicate. The episode does, however, highlight the myriad factors, both personal and cultural, that dictate who suffers post-traumatic stress and who does not, as well as the special role that reacculturation plays in the process. In most post-traumatic situations, survivors are viewed by “normals” with confusion, suspicion, and in some cases outright hostility. For a psychologically wounded person returning to the regular world, it is only natural to return this suspicion and hostility, virtually guaranteeing their own social isolation. One group of VA investigators, summarizing twenty-five years of research, wrote that “the major posttraumatic factor is whether the traumatized person received social support. Indeed, receipt of social support, which appears to be the most important factor of all, can protect trauma-exposed individuals from developing PTSD.”
Therapists like to talk about “small-t” traumas and “Big-T” traumas. Small-t traumas are not really traumatic in the formal sense of the word, but they are enough of a stressor to alter your perception of time and shake you up for a few days, like being woken by a bear rummaging through your campsite in the middle of the night. After your bear encounter, you may have trouble sleeping in your campsite, and the smallest sound, like a branch snapping, will send your heart racing. Small-t traumas, or danger for that matter, trip the guard-dog part of your brain known as the amygdala, a tiny almond-shaped piece of gray matter that deals with immediate threats (the Greek word for almond is amygdale).* Whenever you encounter a similar set of circumstances—a similar-looking or similar-smelling campsite—your amygdala will remember that first bear. These little details, many of which go unnoticed at the time, become what clinicians call a trigger, and you will probably not sleep well that night. Small-t traumas set up shop in the brain, altering your response to anything that reminds you of the bear, creating an emotional bookmark. Create enough bookmarks and you can begin to have a problem. During a small-t trigger, the amygdala initiates an incredibly complex series of chemical events that causes your heart rate to spike, your blood vessels to constrict, and your adrenal glands to secrete epinephrine and cortisol, two very powerful stress hormones. Outwardly, this process is often described by psychologists as one of “fight, flight or freeze.” During a small-t trauma, and the triggers that follow, your IQ is reduced to that of an ape and your body chooses one of those three outcomes before your conscious brain even has a chance to notice what’s going on. Time dilates, things happen on autopilot, and you notice things that were invisible before. You react, you don’t think.
Erich Maria Remarque, author of All Quiet on the Western Front, has written about this effect with amazing clarity, especially since, at the time of its publication, knowledge of the amygdala was limited to only a handful of scientists:
At the sound of the first droning of the shells we rush back in one part of our being, a thousand years. By the animal instinct that is awakened in us we are led and protected. It is not conscious; it is far quicker, much more sure, less fallible, than consciousness. One cannot explain it. A man is walking along without thought or heed—suddenly he throws himself down on the ground and a storm of fragments flies harmlessly over him—yet he cannot remember either to have heard the shell coming or to have thought of flinging himself down. But had he not abandoned himself to the impulse he would now be a heap of mangled flesh. It is this other, this second sight in us, that has thrown us to the ground and saved us, without our knowing how.
Of course, Remarque wasn’t exactly describing a “small-t” trauma in this instance. What he was describing was a mortar attack taken in isolation from all the other stressors one finds in war, one where everything went right and no one was killed or wounded or tripped and kicked in the face by his buddy hitting the deck right in front of him. But tallied over the course of months and years, such small-t events can add up and become something entirely different.
Big-T traumas can destroy the soul. Big-T traumas are the stuff of madness, permanent insomnia, and hallucination. Big-T traumas don’t merely trip the amygdala into a short-term survival response, they actually overload it, damaging its ability to respond in a predictable fashion, almost like a broken thermostat. If we imagine small-t traumas as setting up shop in the body, then Big-T traumas are like massively expanding multinational franchise chains, a series of big-box stores, each supported by a large invisible workforce that never sleeps. In time, this franchise can begin to crowd out other parts of the community. People with chronic, long-term PTSD are often described as having multiple personalities, as if the trauma hasn’t just fragmented their psyches but created separate identities within them. This is, in a manner of speaking, the franchise effect. Rape, physical assault, airplane crashes, extended military combat, natural disasters—hurricanes, earthquakes, tsunamis, and tornados—all qualify as Big-T traumatic events. The salient factor with these traumas is their ability to make you feel helpless and overwhelmed. When resistance and escape from terror are no longer possible, consciousness tends to become fragmented and disorganized, almost as if the mind, in order to effectively handle the spectacle of one’s own annihilation, has to slice or break up consciousness into smaller, more manageable pieces. This fragmentation, or in some cases dissociation, which happens in the moment of maximum terror, has big implications down the road.
Terror, like beauty, is in the eye of the beholder. If, when confronting a three-hundred-pound assailant, a potential rape victim recalls a jiujitsu class she took, she will likely feel less helpless than one of her peers who went to Pilates instead. In essence, one’s perceived sense of control dictates the likelihood that one will develop a harmful traumatic reaction. This highly subjective sense of one’s predicament creates some odd juxtapositions. On average, combat units suffer one psychiatric casualty for every physical one. During the 1973 Yom Kippur War, most frontline Israeli units conformed to this ratio. Yet, strangely, Israeli logistics units, who were exposed to far less danger, suffered three psychiatric casualties for every physical one.
Major traumas are both a death and a rebirth, the end of one kind of consciousness and the beginning of another. As practically any survivor will tell you, the day of their rape or “their” IED serves not merely as the end of a chapter in their lives, such as the end of puberty or bachelorhood, but the actual disappearance of their previous identity and the emergence of something altogether new and unknown. After trauma, your mind works differently, and your body has been altered to the extent that an entire new understanding of it must be negotiated. In time, as people enter therapy or simply reflect back upon the course of their lives, on the turning points in the stories of their time on earth, such days grow in power and take on a totemic quality, seeming to contain not only some portion of the mystery of their new being but also some key to the structure of the universe. Cormac McCarthy, describing one such haunted survivor in his classic novel The Crossing, wrote that
men spared their lives in great disasters often feel in their deliverance the workings of fate. The hand of Providence. This man saw in himself again what he’d perhaps forgot. That long ago he’d been elected out of the common lot of men. For what he was asked now to reckon with was that he’d been called forth twice out of ashes, out of dust and rubble. For what? You must not suppose such elections to be happy ones for they are not. In his sparing he found himself sev
ered from both antecedents and posterity alike. He was but some brevity of a being. His claims to the common life of men became tenuous, insubstantial. He was a trunk without root or branch.
Trauma exists in time even as it destroys it; the numerals of such dates can become like curses, and because they recur, both in the mind and on the calendar, they take on a timeless quality, as in 9/11 or 7/7, the date of the terrorist attacks in London in 2005. The language that Western survivors use in these instances is so consistent as to constitute a law of some kind, and it reveals, to a surprising degree, how religious images of rebirth and resurrection still govern the imagination. World War I veteran Max Plowman, describing his feelings when taken off the front lines, said, “It is marvelous to be out of the trenches: it is like being born again.” Reunited with his family at Clark Air Base in the Philippines, Hanoi Hilton survivor Dick Tangeman was moved by the “warmth and sincerity of all the wonderful people who welcomed us home and witnessed our rebirth.” Alice Sebold, writing of her return to her parents’ home after being raped, seems to echo a verse from First Corinthians: “My life was over; my life had just begun.” (Interestingly, this theme of rebirth takes on a slightly different tone when observed in non-Westerners. One Hindu survivor of the 2004 tsunami in Sri Lanka spoke of her joy in the aftermath of the disaster, for it surely meant that she would be rewarded in her next life.)
In the increasingly interconnected PTSD community, it is common to hear such days referred to as “Alive Days” or “second-birthdays.” On March 25, 2010, professional mountaineer Steve House was climbing Mount Temple, an 11,600-foot peak in Western Canada, when he fell eighty feet and broke his pelvis and six ribs, an event he would later describe to me as a “rebirth.” To this day, House and his wife Eva observe this day as a special event in their lives. House, who still climbs widely and is by temperament keenly attuned to the physical world, finds himself uniquely sensitive to the environment every March 25, as if he were being observed by the universe in some special way. On what he described as the “third anniversary of his second birthday,” he wrote on his blog, “On my way to Canada to celebrate my third year of life since my accident in the best way I know how: to climb and share experiences with the Alpine Mentors crew. [House founded a climbing training organization shortly after his fall.] The weather forecast seems to be a good omen that we’re doing the right thing.”
The death and rebirth that traumas constitute do not happen simultaneously, though the sequence is something familiar to us. One might catch a glimpse of death in an instant, but the process of emerging from that instant can take years, even decades. One friend of mine, who was raped as a young woman, speaks of having completely lost the five years after the rape; it was only after many years of wandering, taking odd jobs overseas, that she was able to return to the United States and regain a kind of consciousness. Nor is this rebirth a linear process. Robert Stolorow describes how for a survivor time often takes on an almost circular quality: life moves forward, but one reencounters memories of one’s loss over and over again, finding its fingerprints in situations seemingly unconnected to the past. In some instances, it is possible to imagine life not as a single rebirth but as a series of them, as a new aspect of the original event is unearthed.
The science bears out this idea of rebirth. After a traumatic experience, the body gets locked into a state of permanent alert, hypersensitive to any stimuli that might constitute a threat. In this state of chronic arousal, which is one of the principal symptoms of post-traumatic stress, the victim startles easily, is constantly irritable, and sleeps poorly. In fact, during World War I, some of the first psychiatrists who looked into the origins of war trauma believed the entire basis for postwar mental health disorders lay in this chronic mobilization of the autonomic nervous system, a system triggered by our watchdog, the amygdala (which you could almost imagine here as an aggressive pit bull barking wildly at every passerby). A number of recent studies examining the sleep patterns of combat veterans confirm this early impression. Simply put, people who have been exposed to traumatic events sleep differently than those who have not. As psychiatrist Judith Herman explains in Trauma and Recovery, “People with post-traumatic stress disorder take longer to fall asleep, are more sensitive to noise, and awaken more frequently during the night than ordinary people. Thus traumatic events appear to recondition the human nervous system.”
Traumatized people often feel fragmented, with their nervous systems living in the past, while other parts of their body continue to live in the present. This sense of temporal disorientation is strong enough that it is difficult to describe such feelings as merely memories. (When your heart starts to race and your eyes start scanning rooftops for snipers in downtown Phoenix, is this really the same as remembering your high school graduation?) Put another way, if on a chemical level your body is essentially still in Iraq, is that still memory? Isn’t it something more than a memory? Poet Robert Graves recounts how in civilian life he continued to behave as if he were in the trenches of World War I: “I was still mentally and nervously organized for War. Shells used to come bursting on my bed at midnight, even though Nancy shared it with me; strangers in the daytime would assume the faces of friends who had been killed.” In order to be happy, people have to be able to enjoy life as it happens, in the present. In its worst forms, trauma can almost completely destroy not only a person’s sense of time but also the very Western idea of time as a linear concept, of moving from one minute to the next and so on.
For some people, a traumatic event is so compelling that it takes on a hypnotic power. While the definition of what exactly qualifies as trauma is a discussion for another time, this hypnotic effect seems to apply to all kinds of powerful events. To some degree, what we call post-traumatic stress is merely an extension of a psychological principle that is obvious to anyone who reflects upon it: our bruises define us. Researchers at the University of California at Irvine, who interviewed survivors of the 1993 Laguna Beach wildfires, found that people who had been evacuated from their homes reported disturbances in their orientation in time: the past felt like the present. The future seemed disconnected from the present. People who reported a strong feeling of such temporal disorientation immediately after the firestorms were especially likely to continue ruminating on the past after six months. Here, we see one of the many paradoxes of trauma: damage occurs when you remember too much, and damage occurs when you remember too little.
Major trauma is a death and a rebirth; in some cases it kills the present, but it also gives rise to a second self, a doppelganger, a shadowperson with its own distinct body chemistry and sense of what is past and what is present. He was never the same after the war. This is the common refrain of the loved ones of the traumatized, followed closely by He came back a different person. Both of these sentiments are, it turns out, empirically accurate. Post-trauma, a person is essentially forced to begin all over again and retrain their body to deal with the stimuli the world throws at them. This overremembering makes sense from a survival standpoint. The parts of the brain dedicated to survival, such as the amygdala, store away as much information as possible for future reference. You might want that information to go away, but these deeply seated survival mechanisms, wired into the oldest regions of the brain, are simply not open to human reason. They are, as one researcher called them, “zombie subroutines of the brain.”
In my new post-Iraq life, I saw myself doing a kind of survivor shuffle, alternating between hating the past and missing it with an intensity that warped the present into a kind of extended flashforward. The past was always present, just like with Reaper, EVERYDAY IS DAY ONE, forever, or even worse, Tomorrow Is Day One. 2014 is 2004. Bodily, what I thought were two separate conditions I now know are one: withdrawing from the world and feeling like part of you is always on patrol in a sort of adrenalized present. Though I didn’t notice it until years later, I became irritable whenever someone walked behind me on the street, feeling their presence like heat on my ba
ck. On the street, I watched rooftops without even meaning to and searched the roadway for IEDs, taking note of potholes and irregularities in the asphalt. At times like this, I never felt like I was literally back in Iraq, but for a very long time I felt on edge, and I was not pleasant to be around. Average Americans, undisciplined and shambling through life without a care in the world, never failed to get on my nerves. My survival brain, trained and retrained by my years in the Marine Corps and Iraq, had wired a protective carapace of memories, many of which had outlived their usefulness.
The war is over, but it will live forever in the cipher of my brain. It is a part of me. To wage war against a memory is to fight against an old dream and, for me, an old way of looking at the world, the idea that “what does not kill me only makes me stronger.” Some ideas die the hard way: I can see now how foolish that notion is. Like many of my friends, I used to cherish my near-death experiences, collecting them like Boy Scout badges. A close call wasn’t simply a brush with mortality, it was an experience, a story, an episode from a novel in which I was featured as the hero. Now, when I think about getting shot or being vaporized by an IED or burned to death in the fiery crash of a helicopter, all the various ways of shuffling off this mortal coil, a certain melancholy settles in. The first time you see someone shot, it’s the most amazing day of your life; by the third time it begins to seem sad, sad and oddly boring, because you realize that there is nothing inherently meaningful or of metaphysical import in random enemy contact. As modern, technologically enhanced humans, we may live like gods, but we die like animals.
The Evil Hours Page 7
