Tentacles of War The Truth Behind PTSD in US Combat Veterans and Their Families

‘What Happens in Vietnam Does Not Stay in Vietnam’: The Truth Behind PTSD in US Combat Veterans and Their Families

The Vietnam War is often described as one that left the greatest psychological impact on those who served. Combat veterans in particular developed far more severe trauma and PTSD than those who served elsewhere.1 Few discuss the impact of PTSD on veterans’ families. Affectionate spouses and parents returned from the Vietnam war as zombie-like beings.2 Vietnam combat veterans whose trauma symptoms were left untreated suffered internally, while also impacting the lives of spouses and children who lacked support as well. Scholars estimate that over one third of the two million Americans who returned home from the Vietnam war suffered PTSD.3 The DSM-IV explains that those with PTSD tend to be irritable, short-tempered, and hypervigilant while also being more prone to nightmares, anxiety, paranoia, depression, emotional numbing, distress, sporadic aggression, and withdrawal.4 One combat veteran, commenting on its severity, called it “Permanent Traumatic Stress Disorder,” something that has stuck with him for decades.5 He claims that “[a]nyone who tells you the Vietnam War ended on April 30th, 1975 is a liar … It came back with all of us. Buried deep in our psyche.”6 Considering the enduring effects of PTSD, he concludes, “[t]he Vietnam war will end only when the last veteran or the last family member of a veteran dies.”7

Soldiers Laying Down Covering Fire. W. Wolny. Wikimedia Commons.

The combat experience in Vietnam was unique. The nature of the war made postwar reintegration into society challenging. Consider the impact of jungle warfare, undercover enemies, and hidden dangers on the psyche of American soldiers: “Half the time you didn’t even see anything.... Until you’d find the bodies. They could booby-trap everything. A cigarette package – anything – and leave it around.”8 This unpredictability resulted in Vietnam veterans suffering psychological impairment at nearly double the rate compared to other wars.9 The psychological impairment could be severe enough to cloud veterans’ judgements once back in the United States. To make matters worse, Americans’ overall lack of support for the war exaggerated PTSD symptoms.

“Karl Marlantes explains that his psyche was so damaged that he could not differentiate between holding a weapon and holding his kids.”10

Marlantes recalls arriving home from war and being spat on when he was in uniform.11

Vietnam War Protestors at the March on the Pentagon. Frank Wolfe. Wikimedia Commons.

For many veterans, an immediate loss of identity and purpose was felt once back to the United States. The average age of Americans who served in Vietnam was nineteen, as opposed to twenty-six in WWII, making it difficult for veterans to find employment after the war.12 Furthermore, roughly twenty-six percent of veterans came back with drug addictions, a function of drugs being a cheap and accessible stress reliever in Vietnam.13 Back in the US, veterans self-medicated rather than seeking therapy to cope with PTSD.14 Unemployment, substance abuse, and a lack of treatment often led many veterans to homelessness or criminal activity.15 For some, the trauma resurfaced as assault, child abuse, divorce, rape, homicide, and suicide, hurting those closest to the veteran.16 For example, Marlantes awoke to his mother telling him that he had “reached out and tried to choke her,” though he had no recollection of this incident.17 Likewise, one woman commented that after her husband’s return from war, he nearly killed a stranger because the man had startled him.18 Vietnam veterans were not trained to address their heightened defensive responses, thus preventing them from being in control of behaviours that had become reflexive. Their psychological wounds were so deep, and their trauma was so raw, that their lives at home hardly felt different than their service in Vietnam.

The day’s battle ended, soldiers await the helicopter that will evacuate their comrade from the jungle covered hills in Long Khanh Province. Pfc. L. Paul Epley. Wikimedia Commons.

The impact of PTSD currently remains prevalent for many veterans and their families. It is estimated that roughly 500,000 Vietnam veterans had PTSD in 1990, though many undiagnosed veterans expressed similar PTSD symptoms.19 Bruce Taneski states, “there is not a day that goes by … that [I] am not reminded of the Nam.” forehead goodnight, and there is a stir, and a beautiful, trusting face has been transformed into the bubbled, flaking, disfigured black horror of the kid I once saw in the hospital.” have for killing innocent people particularly troubles them.22 Unfortunately, some view suicide as the easiest way to eliminate guilt. field on Tuesday … and arrive[d] back in ‘the world’ on Thursday.”24 Though some veterans received therapy through the National Center for PTSD, it was not beneficial if the psychologist was unfamiliar with combat fighting.25 Marlantes suggests several interventions that may have reduced the long-lasting effects of combat trauma. For instance, healing minds, bodies, and souls through religious meditation or special ceremonies could help veterans gain control of their emotions and behaviours.26 Moreover, prewar training explaining why combatants kill could reduce the psychological burden felt by veterans postwar.27 Finally, mandatory counseling funded by the Department of Veteran Affairs (VA) would limit the severity of PTSD symptoms for veterans and their families.

The lack of postwar support structures for veterans placed unreasonable pressure on their spouses. Veterans with a supportive spouse experienced greater success in the postwar healing process. challenging for spouses to contribute positively to healing if they are uneducated about PTSD. Some combat veterans were silent about their trauma and their spouses were not provided with resources to help. One wife did not realize her husband had PTSD until she read online about the disorder.30 She was later told that her husband would likely commit suicide within the next ten years yet was not provided with resources to aid him.31 Another wife was knocked down in a parking lot and thought to herself, “Oh my God, I’m going out with a crazy man” because she did not understand the effects of her husband’s PTSD. Family members must be familiar with PTSD in order to be an appropriate support for a veteran.

A barrier preventing spouses from supporting veterans is that they battle a trauma of their own. Marlantes calls them “veterans of a different war” due to the isolation, pain, and fear they endure after the veteran’s return. Avoidance and distrust are common symptoms of PTSD which often causes decreased intimacy or inexplicable behaviour.34 One wife describes her husband before and after Vietnam, “He was affectionate, considerate, kind. When he returned, he had a quick temper ... right now I do not like him.”35 A veteran recounts a time he was looking through photos: “I just flipped out … I beat my wife over the head with a full quart bottle of beer.”36 These behaviours lead to a lack of safety, increased stress levels, and greater parental and domestic responsibilities for the veteran’s spouse. One spouse claims that “[i]t’s hard to live with somebody who’s miserable… who’s broken on the inside.”37 An overabundance of stress may result in a separation between the veteran and his or her partner.38

Children of veterans with PTSD are also affected in numerous ways. Some veterans with untreated PTSD struggle to show emotions to their kids, thus fostering abandonment and a lack of self-worth.39 The absence of familial involvement from veterans with PTSD often causes children to feel emotional distressed, disappointed, or undervalued.40 As a result, children of veterans with PTSD may struggle to develop or maintain friendships. Furthermore, scholars determined that men with PTSD demonstrate greater parenting difficulties, triggering poorer behaviour amongst their children.42 Consequently, children of Vietnam veterans frequently experience more unease at home as a result of their parent’s behaviour. Regarding the severity of this disquiet, one wife explains that her husband with PTSD has had unhealthy thoughts about hurting his kids.43 Another wife recalls when her son startled her husband and suddenly “he had our son pinned on the floor.”44 The increased burden placed on spouses as a result of the veterans’ PTSD may alter their parental functioning as well.45 implications of this behaviour toward children are significant. One Vietnam veteran explains that for a long time “my children didn’t talk to me, [they] had nothing to do with me.”46

Nearly half a decade after the war, veterans and their families continue the search for effective supports that promote healing. One source states that roughly 2.3 million Vietnam vets received services from the Veterans Health Administrations (VA) between 2007 and 2009. significantly reduce the severity of PTSD, hence Marlantes’s claim that “[t]oo many veterans, from Vietnam … are still waiting to come home.” the VA assisted him by issuing pills that proved to be ineffectual.49 Other efforts such as the “Social Security disability and VA benefits” and the “Program of Comprehensive Assistance for Family Caregivers” financially support veterans who cannot work, though the long-term effects of such efforts are not always positive. resources. Additionally, it is estimated that thirty-five percent of American’s homeless population served in Vietnam which questions the validity and accessibility of the financial aids.

The impact of PTSD currently remains prevalent for many veterans and their families. It is estimated that roughly 500,000 Vietnam veterans had PTSD in 1990, though many undiagnosed veterans expressed Bruce Taneski states, “there is not a day that goes by … that [I] am not reminded of the Nam.”20 Another veteran explains a recurring nightmare: “I am leaning over the bed to kiss a forehead goodnight, and there is a stir, and a beautiful, trusting face has been transformed into the bubbled, flaking, disfigured black horror of the kid I once saw in the hospital.”21 The guilt combat veterans Unfortunately, some view suicide as the easiest way to eliminate guilt.23 Taneski explains, “all too often men were in combat on Monday, [left] the Though some veterans received therapy through the National Center for PTSD, it was not beneficial if the psychologist was unfamiliar Marlantes suggests several interventions that may have reduced the long-lasting effects of combat trauma. For instance, healing minds, bodies, and souls through religious meditation Moreover, prewar training explaining why combatants kill could reduce the psychological burden felt by veterans Finally, mandatory counseling funded by the Department of Veteran Affairs (VA) would limit the severity of PTSD symptoms for veterans and their families.28

The lack of postwar support structures for veterans placed unreasonable pressure on their spouses. Veterans with a supportive spouse experienced greater success in the postwar healing process.29 It is challenging for spouses to contribute positively to healing if they are uneducated about PTSD. Some combat veterans were silent about their trauma and their spouses were not provided with resources to She was later told that her husband would likely commit suicide within the next ten years yet was not provided Another wife was knocked down in a parking lot and thought to herself, “Oh my God, I’m going out with a crazy man” because she did not understand the effects of her husband’s PTSD.32

Nearly half a decade after the war, veterans and their families continue the search for effective supports that Spouses often bear the burden of coping with veterans’ PTSD alone. Photo by Kat Jayne on Pexels.com. promote healing. One source states that roughly 2.3 million Vietnam vets received services from the Veterans Health Administrations (VA) between 2007 and 2009.47 Many of these services, however, do not significantly reduce the severity of PTSD, hence Marlantes’s claim that “[t]oo many veterans, from Vietnam … are still waiting to come home.”48 For instance, after a Vietnam veteran was diagnosed with PTSD, Other efforts such as the “Social Security disability and VA benefits” and the “Program of Comprehensive Assistance for Family Caregivers” m effects of such efforts are not always positive.50 Veterans who receive financial support may be at risk of becoming dependent on the VA’s resources. Additionally, it is estimated that thirty-five percent of American’s homeless population served in Vietnam which questions the validity and accessibility of the financial aids.51

Solutions that have previously helped Vietnam veterans cope with PTSD are often inaccessible, and therefore, ineffectual to the general population. In the state of Washington, for example, a therapeutic helicopter program is offered to veterans to provide them with a sense of triumph in their PTSD recovery.52 Although this program has considerably improved veterans’ ability to cope with their trauma, it is only accessible to those who can travel to Washington. Other states should consider adopting a similar program to aid veterans. War memorials have also been labeled as a useful agent for decreasing the intensity of combat veterans’ PTSD symptoms.53

Vietnam veterans at the Vietnam War Memorial in Washington, DC. Wikimedia Commons.

The Vietnam Veterans Memorial facilitates the grieving process for Vietnam veterans as it forces them to confront their losses.54 Though war memorials may be an important element for reducing PTSD in veterans, they are not available to all Vietnam veterans in America. Therefore, efforts that are applicable to a minority of the population cannot be deemed a successful solution for reducing the severity of PTSD symptoms amongst veterans.

There are several evidence-based treatments (EBTs) that have significantly eased PTSD symptoms for Vietnam veterans. Cognitive behavioural therapy (CBT) programs remove the unrealistic perceptions associated with the veteran’s trauma, thus re-defining their experience in a more positive way.55 Exposure therapy is frequently recommended to those with PTSD as it reduces depression, anger, and guilt through the confrontation of traumatic memories

and feelings.56 Eye movement desensitization is designed to help veterans process unsettling memories or thoughts with the goal to relieve them of PTSD.57 Finally, selective serotonin reuptake inhibitors are commonly used to treat veterans battling depression.58 These evidencebased treatments all aid veterans in making sense of their experiences, which reduces the severity of their PTSD symptoms. Despite the efficacy of these methods, the cost associated with EBTs and the lack of clinician training prevents the widespread adoption of EBTs for veterans with PTSD.59

There are few efforts made to heal and support those married to or parented by a veteran with PTSD. Most programs offered to spouses and children of veterans are designed to help them mend the veteran rather than to reduce their secondary trauma. For instance, “Coping Skills for Loving your Veteran” is a course from the Associates of Vietnam Veterans of America which helps spouses develop empathy when caring for their partner.60 Likewise, the “Cognitive Behavioral Couples Therapy for PTSD” addresses communication issues and triggering incidents in relationships to prevent veterans from exhibiting aggressive outbursts.61 Veteran organizations must recognize the effects of trauma and PTSD on spouses and children. Pressuring family members to be healing agents undermines the severity of their own suffering. Additional efforts are needed to specifically assist the children and spouses of Vietnam veterans heal from secondary traumatization.

Effective and low-cost measures for aiding veterans and their families is the formation of adequate support systems and the commitment to open communication. Numerous VA centers have employed Vietnam veterans trained in counselling to work specifically with Vietnam veterans with PTSD.62 This creates a comfortable, safe, and trustful atmosphere. Forming support groups amongst veterans promotes healthy discussions and reduces the tendency for veterans to avoid or supress their experiences.63 Once veterans learn to gain control of their feelings, their understanding of their trauma is clarified, and healing can begin. Moreover, family counselling is encouraged to restore relations that were disrupted due to the veteran’s PTSD.64 Support groups have been deemed effective for many spouses of veterans with PTSD. One wife even deems her support group her “saving grace.”65 The most effective healing agent for children is communication with the PTSD victim. Intergenerational trauma often transfers to children when the PTSD victim becomes emotionally numbed, detached, and avoidant.66 Therefore, the communication of wartime experiences is necessary. The avoidance of sensitive subjects can cause children to form their own beliefs about a parent’s experience, though often “the made-up story may be even more frightening than the real one.”67 Therefore, if veterans openly discuss their trauma, they will likely help their children heal as well.

It is a misconception that the psychological trauma from the Vietnam war was eradicated once combatants returned to the United States. As one author writes,

“[m]any veterans are still fighting the war and desperately need our help.”68

The limited choice of post-war support systems for veterans and their families contribute to longlasting PTSD symptoms. With further research and interventions, victims of the Vietnam war will develop coping mechanisms which can lead to eventual peace and healing.

Kimberly Vandermeulen

Education major; History concentration; French minor