[>] Researchers at the University of California at Irvine: Interview with Alison Holman. See Alison Holman et al., “Getting ‘Stuck’ in the Past: Temporal Orientation and Coping With Trauma.” Journal of Personality and Social Psychology 74, no. 5 (1998): 1146–1163. See also Schacter, Seven Sins of Memory, 175.
[>] “zombie subroutines of the brain”: Eagleman, Incognito, 131–132. Other neuroscientists have referred to this aspect of brain function as “alien subroutines,” “zombie agents,” “zombie systems,” and “System 1,” all of which emphasize our lack of conscious access to them.
3. Toward a Genealogy of Trauma
[>] Most people, when they first learn about PTSD: For an in-depth discussion of PTSD’s cultural construction, see Young, Harmony of Illusions; Shephard, War of Nerves, 385–399; Rosen, Posttraumatic Stress Disorder; and McNally, What Is Mental Illness?, 146–156. The idea that PTSD is not timeless and that the diagnosis has to a certain extent evolved in response to cultural conditions is controversial and upsetting to many veterans. One Afghanistan veteran reading about PTSD’s slippery conceptual basis on the National Geographic blog “The Frontal Cortex” wrote in the comments section, “Denying that 20–30% of all U.S. forces who have served in Iraq and Afghanistan are afflicted with PTSD is outlandish! This is like denying that the Holocaust ever occurred in Nazi Germany during WWII.” As McNally put it in an article in the 2003 Annual Review of Psychology, “Progress and Controversy in the Study of Posttraumatic Stress Disorder,” “There is never a dull moment in the field of traumatic stress studies. Discoveries are continually intermixed with explosive social controversies.”
[>] what Joan Didion called its “febrile rhythms”: Didion, We Tell Ourselves Stories, 589. See also Wheen, Strange Days Indeed.
[>] Commonly thought of as a signature symptom: Edward Jones et al., “Flashbacks and Post-traumatic Stress Disorder: The Genesis of a 20th-Century Disorder.” British Journal of Psychiatry 182 (2003): 158–163. Bartley Frueh of the University of Hawaii at Hilo made a similar point in a June 2012 article, “Suicide, Alcoholism, and Psychiatric Illness among Union Forces,” in the Journal of Anxiety Disorders which looked for psychiatric symptoms among American Civil War veterans: “It is interesting that descriptions of classic PTSD symptoms of reexperiencing, such as nightmares or ‘flashbacks’ were not found in that data reviewed.” Frueh’s findings with respect to nightmares are hard to understand, as the literature of the Civil War is rife with veterans who claimed to suffer from nightmares and supernatural visitations. See also Luckhurst, Trauma Question, 179–185. Luckhurst is very good in examining the role that cinema (and seventies cinema in particular) has played in the development of PTSD as a diagnostic concept. On page 177, Luckhurst argues that “cinema in fact helped constitute the PTSD subject in 1980, and . . . has continued to interact with and shape the psychological and general cultural discourse of trauma into the present day.”
[>] (Civil War veterans who suffered): See Dean, Shook over Hell, 101–114. See also Gilpin Faust, This Republic of Suffering, 161, 196.
[>] Adding to the confusion: See Luckhurst, Trauma Question, 61, 148, 183.
[>] Indeed, it is this historical slipperiness: Young, Harmony of Illusions, 5.
[>] The earliest appearance of the word: Ibid., 13.
[>] In 1866, a London surgeon: Ibid., 14. See also Shephard, War of Nerves, 16; Figley, Trauma and Its Wake, 5–14.
[>] Compared to depression, for instance: Solomon, Noonday Demon, 285–286.
[>] The never-ending ebb and flow of war: Shepard, War of Nerves, xxii. Interview with Bill Nash.
[>] With a mere three pages: American Psychiatric Association, Diagnostic and Statistical Manual, III, 219–221.
[>] As sociologist Georges Vigarello argued: Vigarello, History of Rape, 1. Joan Didion, writing about a rape case in New York in We Tell Ourselves Stories, in which the victim’s name was persistently left out of newspaper accounts, writes that “the convention [of leaving victims anonymous] assumes that this violation is of a nature best kept secret, that the rape victim feels, and would feel still more strongly were she identified, a shame and self-loathing unique to this form of assault, that a special contract exists between this one kind of victim and her assailant . . . that the act of male penetration involves such potent mysteries that the woman is permanently marked, ‘different’ . . . as in nineteenth-century stories featuring white women taken by Indians—‘ruined’” (690).
[>] Moreover, as Susan Brownmiller indicates: Brownmiller, Against Our Will, 11.
[>] The other reason for this dearth: Yehuda, “Post-Traumatic Stress Disorder,” 109–110.
[>] Despite the fact that rape is the most common: Ibid.
[>] Most of what we know about PTSD comes from studying men: See Finley’s excellent Fields of Combat, 73–89.
[>] “PTSD is a disease of time”: Young, Harmony of Illusions, 7.
[>] One possible beginning is: Much of the material in this section is drawn from Halifax, Shamanic Voices. There is evidence to indicate that certain PTSD symptoms are, in fact, timeless. Jared Diamond, in his book The World until Yesterday (2012), notes that postwar nightmares in the traditional, prescientific societies of New Guinea are common. “Men admitted having nightmares in which they became isolated from others in their group during a fight and could see no way back” (149). Many anthropologists consider the tribes of New Guinea to be a window into prehistoric man, and it is not unreasonable to conclude that postcombat nightmares are an essential aspect of human experience. Diamond also mentions that warriors in New Guinea often boast about the men they have killed, a practice in stark contrast to how warriors in the West conduct themselves today. He posits that this fact alone might account for the relatively high rates of PTSD in the modern world, a world where the spilling of blood is a (thankfully) rare occurrence to be done “off-stage,” for a limited period of time, by a distinct class of citizens.
[>] The shaman, a figure who emerged: Halifax, Shamanic Voices, 3–34.
[>] The secret suspicion that survivors are somehow tainted: In The Moral Treatment of Returning Warriors in Early Medieval and Modern Times, Bernard J. Verkamp of Vincennes University writes, “Among the most primitive and ancient peoples, including the Jews, the overriding sentiment behind the imposition of penances upon returning warriors had been a horror sanguinis. Any contact with blood, especially the shedding of blood, was deemed a source of contamination. By virtue of having killed in battle, therefore, the warrior came to be thought of as being unclean and in need of purification before he could return home or engage in any kind of cultic activity” (26).
[>] (Epilepsy was, in fact, often): Sacks, Hallucinations, 133.
[>] As one well-spoken Iraq veteran: Personal communication with Elliott Woods, 2012.
[>] The aftermath of this event is recorded: See Philippe J. Birmes et al., “Psychotraumatology in Antiquity.” Stress and Health 26 (2010): 21–31. See also Menachem Ben-Ezra, “Traumatic Reactions from Antiquity to the 16th Century: Was There a Common Denominator?” Stress and Health 27 (2011): 223–240; Menachem Ben-Ezra, “The Earliest Evidence of Post Traumatic Stress?” British Journal of Psychiatry 179 (2001): 467.
[>] As one VA psychologist: Comments by Abigail Angkaw, PhD, staff psychologist, VA San Diego, 2013. In his 2011 article in Stress and Health, Ben-Ezra asserts, “Some aspects of the reactions to traumatic events seem to have a common denominator. This set of symptoms basically includes sleep disturbances that have a salient somatic component. Sleep disturbances are at the core of psychological trauma and PTSD symptoms” (236). Jared Diamond’s anecdotal evidence from the tribes of New Guinea gives further weight to Ben-Ezra’s argument.
[>] The Greeks, by contrast, took a notably unclinical approach: Ben-Ezra, “Traumatic Reactions,” 228. Ben-Ezra argues that “Homer’s observations and experiences led him to understand the core human reactions to traumatic events. However, this understanding remained at the level of ep
os [i.e., that of an epic poem] rather than as part of the medical corpus, as we observed in Sumer and Babylon. This may explain why the concept of trauma was late to develop in the medical world in comparison to other mental disorders.”
[>] retired VA psychiatrist Jonathan Shay argues: Shay, Achilles in Vietnam, xiii.
[>] “As the legendary Oxford classicist C. M. Bowra put it”: Bowra, Classical Greece, 43. M. Bowra put it”: Bowra, Classical Greece, 43.
[>] The poet Heraclitus described: Haxton, trans., Fragments, 41.
[>] The ancient physician Empedocles: Solomon, The Noonday Demon, 286.
[>] We see this in the Roman poet Ovid’s Metamorphoses: Ben-Ezra, “Traumatic Reactions,” 229–230.
[>] His best friend, aide-de-camp, and comrade: Shay, Achilles in Vietnam, 39–54.
[>] Whenever I read lines like this from Homer: Interview with Kevin W., 2012.
[>] Perhaps unsurprisingly, Homer anticipates other ideas: See Ben-Ezra, “Traumatic Reactions,” 227. See also Birmes et al., “Psychotraumatology,” 25.
[>] As Odysseus faces a deadly storm: Ben-Ezra, “Traumatic Reactions,” 227.
[>] (In The Epic of Gilgamesh): Ibid., 226.
[>] Alice Sebold, describing her postrape roamings: Sebold, Lucky, 232.
[>] After the Civil War, the number of veterans: Dean notes, in Shook over Hell, that “sleepless and disturbed by memories of the war, some veterans simply left home and went off ‘tramping,’ walking or riding on railroad cars to wander the countryside” (168).
[>] Closer to home, a dear friend: Interview with Elise Colton, 2012; interview with Clint Van Winkle, 2012.
[>] The urge to reinvent one’s moral and physical universe: Gonzales, Surviving Survival, 149.
[>] Homer died some four hundred years before Hippocrates: The consensus among scholars is that “Homer” was not an actual historical person and that a conglomeration of bards is likely responsible for the composition of The Iliad and The Odyssey. However, following in the footsteps of a number of writers, I have used “Homer” to indicate these poets for simplicity’s sake.
[>] Some students of depression: Solomon, The Noonday Demon, 287.
[>] In Denis Johnson’s epic Vietnam novel: Johnson, Tree of Smoke, 61.
[>] If, as Siddhartha Mukherjee argues: Mukherjee, Emperor of All Maladies, 575.
[>] Keeping this in mind, leaders in the early Christian church assumed: Verkamp, Moral Treatment, 11.
[>] As Pope Gregory VII put it: Ibid., 33.
[>] Apart from the theological concerns with killing: On page 27 of Moral Treatment, Verkamp argues that “among ancient and more primitive peoples, the horror sanguinis at first reflected merely the primeval aversion for anything uncanny. By virtue of its association with the life forces, blood was viewed as being both holy and accursed, and therefore as something incalculably dangerous to both the individual and the community to which he belonged. The contaminated victim could spread a miasma to the whole community and sap it of its vital energies.” See also Shay, Odysseus in America, 152.
[>] The Archbishop of Canterbury: Shay, Odysseus in America, 18.
[>] Throughout the Middle Ages, religious authorities: Egendorf, Healing from the War, 133.
[>] These edicts, which came down: Verkamp, Moral Treatment, 20.
[>] One church document from the tenth century: Ibid., 20.
[>] Church records from the Middle Ages are rife: Ibid., 21. See also Egendorf, Healing from the War, 133.
[>] Studies of soldiers throughout history: Grossman, On Killing, xvii.
[>] As Ernest Hemingway wrote: Quoted in Egendorf, Healing from the War, 134.
[>] As one army sniper, who had killed dozens: Interview with navy psychiatrist, 2013.
[>] As Jonathan Shay argues at length: For more on the communalization of trauma, see Shay, Achilles in Vietnam, 188–192.
[>] Arthur Egendorf, a Vietnam veteran: Egendorf, Healing from the War, 133–134.
[>] In historical terms, technology is the great transformer of trauma: For a discussion of technology’s impact on history and warfare, see Marshall McLuhan, Understanding Media: The Extensions of Man (Boston: MIT Press, 1994), 338–345.
[>] As one South Carolinian declared in 1863: Gilpin Faust, This Republic of Suffering, 3.
[>] While visiting Union hospital ships moored: Ibid., xiii.
[>] The major technologies that made such a cataclysm: See McPherson, Battle Cry of Freedom, 287, 294, 474–477.
[>] As Arnold Toynbee observed: Gilpin Faust, This Republic of Suffering, xi.
[>] For many men, the shock of: McPherson, Battle Cry of Freedom, 409.
[>] The opening engagement of the battle of Shiloh: Dean, Shook over Hell, 130.
[>] One observer at Shiloh noted: Shelby Foote, The Civil War: A Narrative—Fort Sumter to Perryville (New York: Random House, 1958), 344.
[>] One historian, describing Sherman’s tortured recollections: Lewis, Sherman, 223.
[>] Noting this, one researcher writing in 2012: Frueh et al., “Suicide, Alcoholism, and Psychiatric Illness among Union Forces.” Journal of Anxiety 26 (2012): 769–775.
[>] Characterizing the state of medicine as a whole: Gilpin Faust, This Republic of Suffering, 4.
[>] A proper ambulance service was only established: See pages 118–123 in Eric Dean’s Shook over Hell for a description of the Union Army’s psychiatric casualty evacuation procedures and for a description of the Government Hospital for the Insane in Washington.
[>] In the mid-nineteenth century, before any formal: Ibid., 115–116.
[>] Another subgenre of these descriptors had a cardiac component: Friedman, ed., Handbook of PTSD, 20.
[>] In 1871, six years after Appomattox: DaCosta, “On Irritable Heart,” 2–52. See also Shephard, War of Nerves, 65, 123; Dean, Shook over Hell, 131; and Friedman, Handbook of PTSD, 20. Interestingly, some historians of psychiatry consider DaCosta’s article to be the first to describe the condition that today we would call PTSD. One of the patients DaCosta described—a “William Henry” of the Sixty-Eighth Pennsylvania Volunteers—complained of horrible stomach pains and diarrhea. As Scott Stossel writes in My Age of Anxiety (Knopf, 2014), “Deemed by his doctors to be in otherwise good health, Henry was the first person to be formally diagnosed with ‘soldier’s heart,’ a syndrome brought on by the stress of combat” (351).
[>] A word that has taken on different meanings: Dean, Shook over Hell, 116, 128–130.
[>] The Union Army recognized nostalgia: Ibid., 129.
[>] By war’s end, the Union’s surgical rolls: Ibid, 130, 284.
[>] Hundreds of thousands of soldiers from both sides: See Dora L. Costa et al., “Cowards and Heroes: Group Loyalty in the American Civil War.” Quarterly Journal of Economics 118 (2003): 528. Costa estimates that at least two hundred thousand troops deserted on the Union side over the course of the war. See also McPherson, Battle Cry of Freedom, 820–821.
[>] William Tecumseh Sherman, who later earned: Fellman, “Sherman’s Demons.”
[>] A number of states operated asylums, such as Indiana: Dean, Shook over Hell, 229–231.
[>] Stephen Crane, as an up-and-coming newspaper reporter: Crane, Red Badge of Courage.
[>] In fact, the violence loosed by the Civil War: On page 98 of Shook over Hell, Dean writes that “during the war, soldiers had been trained to kill and thereby threw off the restraints of civil society and accepted a life of violence; there was no immediate way to put an end to the habit of violence and reintroduce all of these men to the industrious and peaceful vocations of life. In both the North and the South a period of turmoil followed the end of the war.” Dean goes on to describe the startling numbers of Civil War veterans who turned to a life of crime. See also Gilpin Faust, This Republic of Suffering, 142.
[>] As researchers at the University of California, Santa Cruz: Archer et al., “Violent Acts,” 937.
[>] The U.S. Navy’s Health Research Center: Booth-K
ewley et al., “Factors Associated with Antisocial Behavior,” 330.
[>] In many ways, the catastrophe of the American Civil War: See Gilpin Faust, This Republic of Suffering, xi. See also Fussell, Great War and Modern Memory, 195.
[>] As Paul Fussell, one of the war’s: Fussell, Great War and Modern Memory, 7.
[>] Partly because of its catchiness as a phrase: Winter, “Shell-shock,” 7–11. On page 7, Winter asserts, “‘Shell-shock’ was a term which took on a notation which moved from the medical to the metaphysical . . . My central argument is that the term ‘shell-shock’ was a specifically Anglo-Saxon representation not solely of damaged soldiers, but more generally of central facets of the war itself.” Winter concludes his essay by saying that “the history of shell-shock, properly configured, is not the history of the officer corps, but the history of the war itself.”
[>] One of the primary means for wounded minds: Ibid., 10.
[>] As Pat Barker, the author of a Booker-winning: See John Ezard, “Warring Fictions.” The Guardian, September 11, 1993.
[>] Owen and, to a lesser extent, Sassoon: Lifton, Home from the War, 131. On page 19 of Home from the War, Lifton writes that “not surprisingly, World War I writings came closest [to the feelings of Vietnam veterans], especially battlefield recollections by Europeans of their responses to that war’s dreadful combination of slaughter and meaninglessness.”
[>] The first hints that the war was impacting soldiers’ minds: See Lerner, Hysterical Men, 1; Shephard, War of Nerves, 1–3.
[>] The German offensive, intended to take: See Fussell, Great War and Modern Memory, 43.
[>] “Watching, we hear the mad gusts tugging on the wire”: See Owen, Collected Poems, 34.
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