[>] “All sorrows can be borne”: Hannah Arendt, The Human Condition (Chicago: University of Chicago Press, 1958).
[>] Sometimes, and particularly with respect to traumatic narratives: Aries, Hour of Our Death, 5–7.
[>] To scientists, these sorts of ideas: I first encountered the concept of apophenia in William Gibson’s novel Pattern Recognition. The term was coined by German neurologist Klaus Conrad in a 1958 book about schizophrenia. With respect to the “face” photographed by the Viking I spacecraft, see Carl Sagan’s The Demon-Haunted World: Science as a Candle in the Dark (New York: Random House, 1995).
[>] I felt like the German painter Otto Dix: Annette Becker, “The Avant-garde, Madness and the Great War.” Journal of Contemporary History 35 (2000): 72.
[>] Freud saw that sufferers of war neuroses: Freud, Beyond the Pleasure Principle, 32. Peter Gay, in Freud, writes that “Freud noticed one version of this monotonous, destructive replay of unpleasure in patients afflicted with a ‘fate neurosis,’ sufferers whose destiny it is to go through the same calamity more than once . . . Freud noted, patients who display this compulsion do their utmost to dwell on misery and injuries, and to force an interruption to the analysis before it is completed. They contrive to find evidence that they are despised . . . It is as though they have never learned that all these compulsive repetitions bring no pleasure. There is something ‘demonic’ about their activities. That word ‘demonic’ leaves no doubt about Freud’s strategy. He saw the compulsion to repeat as a most primitive mental activity, displaying an ‘instinctual’ character ‘to a high degree’” (400–401).
[>] One can see this sort of obligation: Fussell, Great War and Modern Memory, 411.
[>] This sense that the life-threatening experience: Interview with Robert Stolorow. See Stolorow, Trauma and Human Existence, 17–22. On page 17, he writes that “the patient explained to me that with the retelling of each traumatic episode, a piece of herself broke off and relocated at the time and place of the original trauma. By the time she reached my office, she said, she was completely dispersed along the time dimension of her crushing life history. Upon hearing this, I spoke just three words: ‘Trauma destroys time.’”
[>] In Slaughterhouse-Five, Kurt Vonnegut’s novel: Vonnegut, Slaughterhouse- Five, 23.
[>] “Our own death is indeed, unimaginable”: Freud, Collected Papers, 304–305.
[>] “time dilates, as if I’m dreaming”: Ralston, Between a Rock, 23.
[>] One study conducted by the U.S. Navy: Dimoulas et al., “Dissociation during Intense Military Stress,” 66–73.
[>] Michael Herr, in Dispatches, his classic work: Herr, Dispatches, 135.
[>] “the rapture of the deep”: Ibid., 31, 250, 256.
[>] As the popular neurologist and writer Oliver Sacks: Sacks, Hallucinations, 242.
[>] PTSD is often thought of as being a syndrome: See Caruth, Trauma.
[>] As Ben Helfgott, a concentration camp survivor: Sacks, Hallucinations, 243.
[>] As John le Carré observed: le Carré, Little Drummer Girl, 5.
[>] The year before, I’d interviewed a navy corpsman: See my essay “The Big Suck: Notes from the Jarhead Underground” in the Winter 2007 issue of Virginia Quarterly Review, where I tell the corpsman’s story in greater detail.
2. In Terror’s Shadow
[>] Once it enters the body, it stays there forever: Rachel Yehuda, in a 2002 article titled “Post-Traumatic Stress Disorder” in the New England Journal of Medicine, wrote that “studies of the biologic mechanisms of PTSD have delineated circumscribed alterations in brain regions, such as the amygdala and hippocampus, that are associated with fear and memory, as well as changes in the hormonal, neurochemical, and physiological systems involved in coordinating the body’s response to stress” (113). Yehuda, a professor of psychiatry at the Mount Sinai School of Medicine, in a September 2007 article titled “The Relevance of Epigenetics to PTSD” in the Archives of General Psychiatry (1040–1048), found that “offspring with parental PTSD displayed lower mean cortisol levels, reflected by the circadian mesor and reduced cortisol amplitude, compared with offspring without parental PTSD and children of nonexposed parents. This effect seemed to be specifically related to the presence of maternal PTSD.” While there is still some debate within the medical community about whether stress damages the brain (as Douglas Bremner of Emory University argued in his 2002 book), there is little doubt that major traumatic events change the human hormonal system and that these changes are passed along to the survivor’s offspring. See also Anke Karl et al., “A Meta-analysis of Structural Brain Abnormalities in PTSD.” Neuroscience and Biobehavioral Reviews 30 (2006): 1004–1031. See also Rachel Yehuda et al., “Transgenerational Effects of Posttraumatic Stress Disorder in Babies of Mothers Exposed to the World Trade Center Attacks during Pregnancy.” Journal of Clinical Endocrinology and Metabolism 90 (2005): 4115; J. J. Silverman et al., “Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps.” Journal of Child and Family Studies 8 (1999): 71–89.
Much of the evidence for the claim that the offspring of trauma survivors are biologically different from those with untraumatized forebears has come from studying the children and grandchildren of Holocaust survivors. Scott Stossel writes, in My Age of Anxiety, that “researchers have found analogous evidence in the descendants of trauma victims: the children and even grandchildren of Holocaust survivors exhibit greater psychophysiological evidence of stress and anxious arousal—such as elevated levels of various stress hormones—than do ethnically similar children and grandchildren of cohorts who were not exposed to the Holocaust. When these grandchildren are shown stressful images having nothing to do with the Holocaust—for instance, of violence in Somalia—they display more extreme responses, both in behavior and physiology than do their peers. As John Livingstone, a psychiatrist who specializes in treating trauma victims, told me, ‘It’s as though traumatic experiences get plastered into the tissues of the body and passed along to the next generation’” (255–256).
[>] as war correspondent Michael Herr testifies in Dispatches: Herr, Dispatches, 35.
[>] “Trauma is democratic”: Winter, “Shell-shock,” 11.
[>] the historian Will Durant calculated: Hedges, War Is a Force, 10.
[>] The numbers are staggering: a 2010 study: The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report. Atlanta: Centers for Disease Control and Prevention, 2011. “Nearly one in five women (18.3%) and 1 in 71 men (1.4%) have been raped at some point in their lives.” In Yehuda’s 2002 article on PTSD in the New England Journal of Medicine, she says, “PTSD developed in 55 percent of persons who reported being raped” (109).
[>] The most cited research study: R. C. Kessler et al., “Posttraumatic Stress Disorder in the National Comorbidity Survey.” Archives of General Psychiatry 52 (1995): 1048–1060.
[>] Alice Sebold, when asked why she chose to write: 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.
[>] Pulitzer Prize–winning novelist Cormac McCarthy: The Yuma Daily Sun article reads, “Clark, who led last year’s expedition to the Afar region of northern Ethiopia, and UC Berkeley colleague Tim D. White, also said that a re-examination of a 300,000-year-old fossil skull found in the same region earlier showed evidence of having been scalped.”
[>] Trauma defies description: In “Whereof We Can Speak, Thereof We Must Not Be Silent: Trauma, Political Solipsism and War,” Review of International Studies 30.4 (2004), 472, political scientist Karin Fierke defines trauma as “a ‘dislocation’ accompanied by an inability to mourn or speak of the trauma.” Interestingly, while trauma is thought to be nearly inexpressible by many scholars, it is thought to be more readily representable in the visual arts, which might help explain PTSD’s deep connection to film and television.
[>]
the “dose-response curve”: Herman, Trauma and Recovery, 57. Author interview with Matthew Friedman, 2013. Friedman, the longest-serving executive director of the National Center for PTSD, said, “One of the most interesting findings in all PTSD work is the dose-response curve. The greater the exposure to the trauma, the greater the likelihood of PTSD.” Friedman went on to say that researchers have observed the dose-response curve in a number of non-Western cultures.
[>] Was she extroverted?: I. V. E. Carlier et al., “Risk Factors for Posttraumatic Stress Symptomatology in Police Officers.” Journal of Nervous and Mental Disease, August 1997, 498–506. See also A. C. McFarlane et al., “The Etiology of Posttraumatic Morbidity: Predisposing, Precipitating, and Perpetuating Factors.” British Journal of Psychiatry 154: 221–228.
[>] Was she someone who was easily hypnotized?: Herman, Trauma and Recovery, 124. Moreover, a 1995 study by Daniel Weiss et al. titled “Predicting Symptomatic Distress in Emergency Services Personnel” and published in the Journal of Consulting and Clinical Psychology showed dissociative tendencies to be strongly predictive of PTSD symptoms in emergency response workers.
[>] How did she go about: Shay, Achilles in Vietnam, 191. See also Herman, Trauma and Recovery, 7–32.
[>] According to the Comprehensive Textbook of Psychiatry: H. I. Kaplan, ed., Comprehensive Textbook of Psychiatry. 4th ed. (Baltimore: Williams & Wilkins, 2009), 918–924.
[>] In the face of terror: See, for instance, van der Kolk et al., “Pierre Janet on Post-Traumatic Stress.” Journal of Traumatic Stress 2, no. 4 (1989): 365–378. See also Gray, The Warriors, 29. Gray writes, “War as a spectacle, as something to see, ought never to be underestimated . . . The eye is lustful because it requires the novel, the unusual, the spectacular.”
[>] It is almost as if certain types of events: See, for instance, LeDoux, Emotional Brain, 256. See also McGaugh, Memory and Emotion.
[>] “PTSD is a disease of time”: Young, Harmony of Illusions, 7.
[>] so-called acts of God: See Sacks, Hallucinations, 240. See also Yehuda’s January 2002 article, “Post-Traumatic Stress Disorder,” in the New England Journal of Medicine, which includes a very helpful table depicting PTSD prevalence rates on page 110.
[>] Sonali Deraniyagala, writing about the 2004 tsunami: On page 77 of Wave, Deraniyagala writes, “My journeys to Yala became less frequent after I began to harass the Dutch family. By that December, as the first anniversary of the wave approached, I had this new fixation. Strangers had moved into our home in Colombo. A Dutch family. When I was first told the house had been rented to them, I raged at Rajiv for doing it. I was desperate. I screamed. I explained: the house, it anchors me to my children. It tells me they were real. I need to curl up inside it, now and again.”
[>] Returning home from Iraq in October 2007: The fire in question, known as the Witch Creek Fire, was the second largest in California history and is described in “California Fire Siege 2007: An Overview,” a pamphlet produced by the California Department of Forestry and Fire Protection.
[>] an incident of so-called friendly fire: In an October 1998 article in the Journal of the Royal Society of Medicine, Martin Deahl cites an example from the Gulf War where a group of survivors of a friendly fire incident suffered a PTSD rate of 56 percent, the highest prevalence rate he cites. Researching my 2004 book Storm on the Horizon about the battle of Khafji, I found that the veterans most haunted by the war were those who’d had comrades killed by friendly fire.
[>] the “Hanoi Hilton” prisoner-of-war camp: Interviews with Taylor Kiland, Francine Segovia, and Richard Tangeman, April 2013. See Kiland, Lessons from the Hanoi Hilton. See also Dennis Charney, “The Psychobiology of Resilience to Extreme Stress: Implications for the Treatment and Prevention of Anxiety Disorders,” keynote address at ADAA conference, March 23, 2006; Francine Segovia et al., “Optimism Predicts Resilience in Repatriated Prisoners of War: A 37-Year Longitudinal Study.” Journal of Traumatic Stress 25 (2012), 1–7; William Sledge et al., “Self-concept Changes Related to War Captivity.” Archives of General Psychiatry 37 (1980): 430–443.
[>] Describing what he called his “transforming”: See McCain, Faith of My Fathers, 321.
[>] when the men of the Hanoi Hilton were finally released: Interviews with Taylor Kiland, Francine Segovia, and Richard Tangeman. See also Peter Davis’s excellent 1974 documentary on Vietnam, Hearts and Minds, which shows George Coker’s lavish homecoming to Linden, New Jersey.
[>] As John McCain later wrote: McCain, Faith of My Fathers, 323.
[>] One group of VA investigators: Friedman, Handbook of PTSD, 8. On page 13 of Post-Traumatic Stress Disorder, Shiromani says, “Very few studies actually include the assessment of post-trauma factors in terms of their contribution to the development and maintenance of PTSD. Social support is the one exception. Across 11 studies, Ozer et al. found that perceived social support following the trauma event was associated with PTSD symptoms.”
[>] Therapists like to talk about “small-t” traumas and “Big-T” traumas: I heard this expression used by three separate psychotherapists who treat people with PTSD. Two of them were with the VA in San Diego, while the other was in private practice in Denver.
[>] These little details, many of which go unnoticed: LeDoux, Emotional Brain, 142–148. See also Kandel, In Search of Memory, 342–345; for a more accessible discussion of conditioning, fear, and emotion, see Gonzales, Surviving Survival, 20–36. His chapter “The Crocodile Within” is very helpful.
[>] During a small-t trigger, the amygdala: See LeDoux, Emotional Brain, 256–258. See also Yehuda’s 2002 New England Journal of Medicine article, “Post-Traumatic Stress Disorder,” 110 –112.
[>] Outwardly, this process is often described: LeDoux, Emotional Brain, 45. See also Laurence Gonzales, Deep Survival, 35–36.
[>] “At the sound of the first droning”: Remarque, All Quiet, 56.
[>] Big-T traumas can destroy the soul: In Achilles in Vietnam, Jonathan Shay argues that “severe trauma explodes the cohesion of consciousness” (188).
[>] People with chronic, long-term PTSD: See Robert Scaer, Trauma Spectrum (New York: W. W. Norton, 2005). See also Herman, Trauma and Recovery, 118–122. For a brief discussion of the biological aspects of PTSD, see Yehuda’s 2002 New England Journal of Medicine article, “Post-Traumatic Stress Disorder,” 110–112.
[>] When resistance and escape from terror: Herman, Trauma and Recovery, 34–35.
[>] During the 1973 Yom Kippur War: Junger, War, 122.
[>] Major traumas are both a death and a rebirth: In her memoir Lucky, Alice Sebold writes, shortly after her rape, that “my life was over; my life had just begun” (33). On page 53, she writes that “it was an early nuance of a realization that would take years to face. I share my life not with the girls and boys I grew up with, or the students I went to Syracuse with, or even the friends and people I’ve known since. I share my life with my rapist. He is the husband to my fate.” On page 204, Sebold says, “I remember agreeing with my mother that I had gone through a death-and-rebirth phenomenon in the span of one year.” In We Came Home (Toluca Lake, CA: P.O.W. Publications, 1977), Richard Tangeman, a former Hanoi Hilton POW, says, “I was deeply moved by the warmth and sincerity of all the wonderful people who welcomed us home and witnessed our ‘rebirth.’”
[>] “men spared their lives in great disasters”: McCarthy, Crossing, 146–147.
[>] World War I veteran: Fussell, Great War and Modern Memory, 139.
[>] Reunited with his family: Tangeman, We Came Home.
[>] “My life was over”: Sebold, Lucky, 33.
[>] One Hindu survivor of the 2004 tsunami in Sri Lanka: Interview with Gaithri Fernando, 2013. In a 2012 article in Transcultural Psychiatry, Fernando writes, “Early in my Fulbright visit to Sri Lanka, I met Radha, a 34-year-old Tamil woman who had been severely tortured by the Sri Lankan military. During my assessment of her I was struck by her lack of distress when describing her current condition . . .
I asked her what her torture experience meant to her. ‘Well,’ she said, ‘I am really looking forward to my next life. I must have done some terrible things to have deserved this horrible suffering. I know that in my next birth, I will have the most wonderful life. This knowledge makes me very happy’” (396–397).
[>] In the increasingly interconnected PTSD community: See, for instance, the 2007 HBO documentary Alive Day Memories: Home from Iraq, produced by James Gandolfini.
[>] On March 25, 2010, professional mountaineer Steve House: Interview with Steve House, 2013.
[>] One friend of mine, who was raped: Interview with Elise Colton, 2013.
[>] Stolorow describes how for a survivor: Interview with Robert Stolorow, 2013.
[>] As psychiatrist Judith Herman explains: Herman, Trauma and Recovery, 36.
[>] Poet Robert Graves recounts how: This quotation can be found on page 288 of Graves’s 1929 memoir Goodbye to All That, a book he described as his “bitter leave-taking of England.” Here is the full quote, which describes his experience, one reminiscent of many Iraq veterans I have known: “Not only did I have no experience of independent civilian life, having gone straight from school into the army: 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 daytime would assume the faces of friends who had been killed. When strong enough to climb the hill behind Harlech and revisit my favourite country, I could not help seeing it as a prospective battlefield.
“I knew it would be years before I could face anything but a quiet country life. My disabilities were many: I could not use a telephone, I felt sick every time I travelled by train, and to see more than two new people in a single day prevented me from sleeping. I felt ashamed of myself as a drag on Nancy, but had sworn on the very day of my demobilisation never to be under anyone’s orders for the rest of my life.”
The Evil Hours Page 34
