July 11, 2008 – One in five people returning from the Iraq war screen positive for post-traumatic stress disorder (PTSD), though less than half of those seek help. The reason? They fear that a diagnosis of PTSD will stigmatize them and hurt their careers. For a nation to have any claim to being a just society, it must take care of its war veterans’ wounds- both emotional and physical. For Iraq war veterans this demands that Americans address the fear, and its basis in reality, that admitting to emotional wounds carries stigma.
We like to believe we have come a long way from the attitudes of World War I when the claim of being “shell shocked” was considered a coward’s way out of fighting. We would like to believe we have moved beyond attitudes still vigorous in World War II, symbolized by General Patton’s slapping a hospitalized soldier at Anzio for being “yellow-livered.” During the Vietnam War we finally recognized PTSD but made little meaningful care available to the veterans.
Today the military screens soldiers for and educates them about the signs of psychological trauma. The U.S. Department of Veterans Affairs provides detailed information about the condition and how to access care. And perhaps most significant the U.S. government recently approved important revisions to its security clearance procedures by no longer requiring veterans to reveal whether they are seeking mental and emotional health counseling. “It’s time we made everyone in uniform aware that the act of reaching out for help is one of the most courageous acts — and one of the first steps — to reclaiming your career and future. All leaders must set an example by seeking help themselves and encouraging others to do so. Getting this question changed is a terrific first step,” Chairman of the Joint Chiefs of Staff Admiral Michael Mullen said in a May 2008 statement.
Why, then, do so few veterans seek help? What do we do with the claim of the parents of Marine Corporal Chad Oligshlaeger (as reported in the June 15 issue of the Austin American-Statesman) and others that the military tragically failed their children by not providing adequate services after they received diagnoses of PTSD? Reports still surface, all too frequently, from active duty soldiers that when they report symptoms of PTSD, their superiors tell them to “reconsider” and continue their duty. As recently as May 2008, a National Public Radio report revealed that a Veterans Administration psychologist had sent out an email to her staff directing them to “refrain from giving a (PTSD) diagnosis straight out” and to replace long term therapy groups with ones of three months duration to save money. (The VA refused interview requests about the incident.) Such a policy raises the question of how far the Government’s official change in attitude towards PTSD really goes.
It is a mistake to see the nation’s military as a creature that stands separate from the society it serves. As we read of our soldiers and their spouses and children and parents struggling with depression and rage, we must all reflect on our own attitudes towards mental health as being the “step-child” of our health care system. Why don’t health insurance plans cover visits to therapists to the same extent they cover visits to doctors of physical ailments? Why must families pay out of pocket if they want the services of expert psychiatrists? Why does the government agency responsible for caring for our veterans not take their emotional wounds as seriously as their physical ones?
My father, a World War II veteran, often repeated two lines to me: “Keep the flag flying” and “We lift ourselves up by our own bootstraps.” One doesn’t need to be a mind reader to know where he learned those words. But the accessibility of mental health care today reveals that those attitudes remain as ingrained in our society as they were in the 1940s.
It has taken me most of my 54 years to understand how much the horrors of World War II, through my father’s suppressed trauma, shaped my family and my values. I spent many years in therapy healing myself from the unintended transmission of his PTSD that followed his liberating a Nazi concentration camp. (Only after his death twenty years ago did I even learn he had witnessed a camp.)
Kurt Vonnegut, a veteran of World War II, described the emotional wounds of war as its “sad and beautiful countermelody of truth.” Its notes filter through all of our homes, no matter how far removed we believe we are from the front lines. When America sends its young off to war, we must respect and honor the vulnerability of the human heart and soul and understand that a wound to those often lasts for generations. We must fully acknowledge the emotional costs and repercussions war can have and embrace the same responsibility for healing those wounds as we do for the physical ones.
Only then may we claim to be a just society.
Leila Levinson, an Austin resident, is writing a memoir on the consequences for her family of her father’s World War II experiences.