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My father was a World War 2 veteran. I can’t remember a time he talked about his war experiences. What I do remember are times when something would trigger him, and he would withdraw into their bedroom for hours. My brother and I knew something was wrong, but not what.
Years later, while doing research on the topic in graduate school, I suddenly realized my father had post traumatic stress disorder, PTSD.
As I mentioned, my gentle, soft-spoken dad never spoke of his years in the war to his family. In fact, he likely would have taken those memories to his grave until my college-aged son asked him to tell him about it for a research project he had. Only then, in his mid-seventies, was my father willing to speak of some of the unspeakable horrors he witnessed during the war.
Ancient History of PTSD
Early attempts at diagnosing PTSD were made by an Austrian physician, Josef Leopold (1761), who called it nostalgia. He reported that soldiers exposed to military trauma, reported missing home, feeling sad, sleep problems, and anxiety. This list helped the U.S. military efforts in assessing soldiers for psychological injury during the Civil War.
A second model of this condition was called Soldier’s heart or irritable heart. This model suggested a physical injury as the cause of symptoms. These symptoms included a rapid pulse, anxiety, and trouble breathing. U.S. doctor Jacob Mendez Da Costa studied Civil War soldiers with these cardiac symptoms. He described it as overstimulation of the heart’s nervous system. It was also known as Da Costa’s Syndrome.
Unfortunately, soldiers were often returned to battle after receiving drugs to control symptoms.
WW I, WW II Treatment of Pre-PTSD
Later, during World War I, PTSD was thought to be caused by the loud explosions from the artillery shells. For this reason, the term shell shock was coined. Symptoms were much the same as earlier wars, with the addition of panic. Moreover, it was first thought to be the cause of hidden brain damage due to the impact of the large guns. However, that thinking had to change when auxiliary soldiers, not near the explosions, began presenting with the same symptoms.
This condition also came to be known as war neurosis.
During World War I, treatment was varied. Soldiers often received only a few days’ rest before returning to the war zone. For those with severe or chronic symptoms, treatments focused on daily activity to increase functioning, in hopes of returning them to productive civilian lives. In European hospitals, “hydrotherapy” (water) or “electrotherapy” (shock) were used along with hypnosis.
Unsurprisingly, World War II’s long surges of battle called for a new name for the symptoms the soldiers were showing. Therefore, shell shock was replaced by Combat Stress Reaction (CSR), or battle fatigue. Due to the long surges during this war, soldiers became battle weary and fatigued. Unfortunately, some American military leaders, such as Lieutenant Gen. George S. Patton, did not believe battle fatigue was a genuine problem.
On the contrary, up to half of World War II military discharges were reported to be the result of combat exhaustion.
PTSD in the 20th Century and Today
In 1980, after years of research involving Viet Nam veterans, Holocaust survivors, sexual trauma victims, and others exposed to traumatic situations, the American Psychological Association added PTSD to their diagnostic manual, the DSM-3. Finally, they had established a link between the trauma of war and post military life. Moreover, and to the researchers’ surprise, PTSD was more common than previously believed.
Each update of the diagnostic manual reflected the advancing research in this area of mystery regarding those exposed to trauma. Ultimately, in 2013, PTSD had earned it’s own category in the DSM-5, Trauma- and Stressor-Related Disorders. There were too many other moods and behaviors associated with PTSD, (depression, anger, reckless behavior, etc.) to keep it under the umbrella of another disorder.
PTSD includes four types of symptoms:
- reliving the traumatic event (also called re-experiencing or intrusion)
- avoiding situations that are reminders of the event
- negative changes in beliefs and feelings
- feeling keyed up (also called hyperarousal or over-reactive to situations)
Realistically, any of us could experience some of these symptoms immediately after a traumatic event. Therefore, all four types of symptoms must be present and last for at least a month before a PTSD diagnosis is made. In addition, they must cause significant distress and/or problems with daily functioning.
PTSD – The Discovery and Some of Its Effects
Fortunately, a few researchers and scientists like Bessel Van Der Kalk, M.D. and clinician, began studying posttraumatic stress in the 70’s. In the 1990’s, the introduction of brain scanning revolutionized their work. In his 2014 book, The Body Keeps The Score: Brain, Mind, and Body in the Treatment of Trauma, Van Der Kolk transformed the understanding of traumatic stress or PTSD. Their research uncovered the fact that trauma actually rewires the brain, specifically areas dedicated to pleasure, engagement, control, and trust, (The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma). (https://amzn.to/3gSijpA)
Van Der Kolk’s team’s ongoing research was also able to clearly establish PTSD symptoms in anyone who experienced trauma. In fact, there was a concurrent study in the 1990’s, instigated by Dr. Vincent Felitti, called Adverse Childhood Experiences, aka ACE. They interviewed over 17,000 people regarding carefully defined categories of abuse in their childhood homes, including physical and emotional neglect, and family dysfunction. The ACE study revealed that traumatic life experiences during early childhood and adolescence are far more common than expected, (The Body Keeps The Score: Brain, Mind, and Body in the Treatment of Trauma, Van Der Kolk.)
Two thirds of the group with mid-high ACE scores reported various effects from their childhood trauma/PTSD. More than half had learning disabilities or behavioral problems. Sixty-six percent suffered from chronic depression and/or chronic pain. Furthermore, there was a 30% increase in the risk of cancer Additionally, those with a high ACE score:
- dramatically increase the risk of suicide over their lifetime
- are 33% more likely to be raped in adulthood (women)
- have a 70% chance of being a substance abuser
- are more susceptible to ischemic heart disease, COPD, skeletal fractures, and liver disease
How Shall We Live After Trauma?
I became what I am today at the age of twelve, on a frigid overcast day in the winter of 1975…That was a long time ago, but it’s wrong what they say about the past…Looking back now, I realize I have been peeking into that deserted alley for the last twenty-six years.
Khalid Hosseini, The Kite Runner
I resonate with Hosseini’s statement. When the light in my brain finally clicked on to reveal the dysfunction in my childhood family, I felt like curious people going by a car accident. Even though they know it’s none of their business, and the police/EMS are rendering aid, they can’t tear their eyes away from the carnage.
I could not stop staring at the pain, poking at the damage which had been perpetrated. Moreover, I had been numb for so long that the anger surged over me like fire – I thought I would smother.
God whispered my name. He revealed to me anew that He had never neglected me or abused me.
And He never will.
He lifted my eyes away from what I perceived as my personal carnage and highlighted how He had carefully placed people around me all my life. These adults were supporters, encouragers, teachers, pastors, even neighbors.
They helped me be one of the resilient ones. I’m not an ACE statistic due to those whom God supplied.
That’s not to say I’m not headed that way a time or two or fifty! But God always pulls me back to Himself with His love and comfort, (Isaiah 41:10.)
There is help for you; there’s no need to keep peeking down the alley of your past.
To take the ACE test:
I highly recommend Van Der Kolk’s book, if you struggle with PTSD. He wrote it for the average person to be able to understand. In addition, he also offers ways to help yourself when you are triggered. ( (https://amzn.to/3gSijpA)