POSTTRAUMATIC STRESS DISORDER (PTSD) A VIETNAM VETERAN'S EXPERIENCE © Wayne J Scott 2001 - reproduced on this site with the kind permission of the author. All rights reserved.

• Running Scared 1986 Ost Rar Files

No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without prior permission in writing from the author. April 2001 ISBN: 0-642-73202-7 Iroquois helicopter from 9 Squadron RAAF hovers over a Centurion tank patrol, Image L71193 from National Archives of Australia Series A1200 Recorded by Australian News and Information Bureau Contents POSTTRAUMATIC STRESS DISORDER (PTSD) A VIETNAM VETERAN'S EXPERIENCE During ones life not many people will make a significant and lasting impression on you. In my life there have been only a few. One of these was Gary Martin. Gary was a career soldier, having joined the army at an early age and served in Korea, Malaya and with the 3rd Battalion Royal Australian Regiment (RAR) and the Training Team (AATTV) in Vietnam. He retired from the army as a Warrant Officer Class I and spent many years working in the Pacific region before settling in Dubbo with his lovely wife.

Gary died a few years ago from a liver problem, which he believed was caused by Agent Orange. Gary and I spent considerable time discussing the problems of Vietnam Veterans and how his Vietnam experience impacted on his life. I promised him I would share his views with other veterans one day in a way they could relate to his experience. Gary often said that too much had been written on Posttraumatic Stress Disorder (PTSD) which was overly scientific, medically orientated or just too complex for the average reader to understand. Similarly, numerous books have been written recently about Vietnam but I feel they do not capture the true sentiment or adequately cover the veteran's view of the PTSD experience and how the condition has impacted on their lives, families and children. In his latter years Gary's main aim was to help other veterans and their families, which he did unselfishly.

Running Scared 1986 Ost Rar Files

Gary knew so much about the condition of PTSD, in many ways more than the psychiatrists, psychologists and other allied health workers, because it touched him personally and those around him. Much of this article is in Gary's words and I have taken the liberty of sharing them with the reader as well as providing an insight into how the condition may have been influenced by what the veteran went through. Though Gary was an infanteer, his views are just as applicable to those who served in the other arms and services. The article is presented in several sections: a brief history of PTSD, the symptoms of PTSD related to real life circumstances, how the veteran's military training may have contributed to the condition of PTSD, the aftermath of the Vietnam conflict, problems facing veterans, a section devoted to organisations that provide help via various means and other information which may be of use to the veteran and his family. Stress has always been synonymous with soldiers involved in armed conflict and the carnage of war. Combat places tremendous psychological strain upon the individual and certain psychiatric conditions can prevent men and women from behaving as they are expected to behave. The attitudes of military commanders to individuals less brave than their fellows has varied greatly throughout history.

Brigadier P Abraham (1982) points out that as early as 480 BC historians noted that Herodotus Leonidas, King of Sparta dismissed troops he believed 'had no heart for the fight' and were unwilling to take their share of the danger during the defence of Thermopylae. Wellington of the Battle of Waterloo fame, a severe disciplinarian, observed that: '. All soldiers run away. The good ones return'.

As Gary Martin once said if, as we are advised by the psychiatric community that PTSD is a by-product of Modern War, then we should begin to look for evidence of the syndrome at the beginning of the century. This may give us an insight into how the Vietnam veteran may compare with those combatants of other wars. During the First World War more than 3000 British soldiers were sentenced to death for crimes committed in combat, mostly desertion and cowardice (about 10% of these sentences actually were carried out). Under the Australian Defence Act, Australian Forces in France were exempt from the death penalty, though 25 Canadian and 5 New Zealand allied soldiers were executed. Back home, few people knew of the executions and the proceedings of the courts martial were not publicly released. In France the death sentences were announced - and sometimes carried out - in front of troops on parade.

These harrowing ceremonies were supposed to deter potential offenders and keep the divisions fighting. Stanley Kubrick's 1955 classic film 'The Paths of Glory' which starred Kirk Douglas, clearly showed the hypocrisy of war. It tells how the French army dealt with a mutiny in World War I. The generals' approach to the handling of the situation would now be regarded as ludicrous.

When released in 1955 it was banned in France and her colonies (during the period of the Algerian conflict) and was only allowed to be played in French cinemas in the late eighties. Today, these men would have been treated as psychiatric battle casualties, rested a short distance behind the front line, given hot food, then returned to their comrades to continue fighting instead of being executed. Early diagnosis of battle stress (as opposed to cowardice in the face of the enemy or a lack of moral fibre) has centred on battle shock or war neurosis. Abraham (1982) highlights this shift in thought by citing the change in attitude of Military commanders in Northern France between July and September 1944.

He states that over 20 percent of all wounded in the British Second Army were battle shock victims and that the 6th US Marine Division suffered 2662 wounded in ten days of fighting and also 1287 psychiatric casualties. Overall, battle shock casualties accounted for one-third of all wounded. This was probably the first time in military history that the military hierarchy began to identify the psychological impact of combat on the soldier in earnest. In 1994 Gary Martin presented a paper to a group of health professionals in Dubbo.

In his paper he provided a brief Australian historical overview of war neurosis and attempted to parallel the symptoms displayed as that of PTSD. He argued that the psychological symptoms displayed by the famous 'Breaker' Morant, Witton and Hancock during the Boer war, in which Morant and Hancock were subsequently executed for the alleged murder of a missionary, were similar to symptoms of PTSD today. If one has the opportunity to view the 1979 Bruce Beresford's film Breaker Morant (as adapted from Kit Denton's book The Breaker) one can clearly see the symptoms of PTSD. When the Australian actor Jack Thompson summed up the defence for Breaker Morant, Witton and Hancock in the film what he was really describing were the symptoms of PTSD: War changes men's natures.

Abnormal men seldom commit the barbarities of war. The tragedy of war is that these horrors are committed by normal men in situations in which the ebb and flow of everyday life have departed and been replaced by a constant round of fear and anger and blood and death. Soldiers at war are not to be judged by civilian rules. I find it fascinating that the author of the book had such an incredible insight into man's reaction to combat. The book was written and the film made well before the 1980 introduction of the Diagnostic and Statistical Manual of Mental Disorders, Third edition (DSM-III) which at the time was the psychiatrist's main reference to the diagnosis of PTSD. In Gary's discussion of the First World War he cited the occurrence whereby in the month of July 1916 a single Field Ambulance unit recorded 22 per cent of casualties passing through were deemed to be 'shell-shocked'.

By 1931 over 7000 World War I veterans were in receipt of a disability pension for 'war neuroses'. Relative to those who served in combat from 1915 to 1919 this figure would indicate an undeclared or hidden number of 12,000 plus, not in receipt of a pension. He goes on to say that during 1944, 14 percent of casualties were judged to be suffering from war neuroses and that these figures did not reflect the final World War II figure nor the psychiatric disorders of prisoners of war. Gary's account of the Korean War and the Malayan Emergency (or Confrontation) was dealt with in a cursory manner, as he pointed out that very few accounts of war neuroses of these periods were written.

He did point out that after the Korean War the most severe cases of psychological impairment were found in the prisoner of war survivors. Other texts he had consulted indicated that there was a percentage increase in the number of evacuated neuroses cases which were marginally greater than the World War II figures cited previously. His account of Vietnam veterans' experiences is based on the statistics provided from the Australian National Audit Office (ANAO) Report presented to National Parliament in December 1992, which suggests that some 25 percent of Vietnam veterans are currently in receipt of a disability pension for either medical or psychological reasons.

To appreciate the psychological impact of battle on the individual we need to understand the extent of the trauma experienced. The DMSR III-R categorises PTSD as 'the development of characteristic symptoms following a psychologically distressing event that is outside the range of usual human experience' with the emphasis on 'usual human experience'.

All military medicos, psychologists, soldiers and historians would agree that battle experience is an event that is not what one could regard as ordinary. As McManners (1993) in his book The Scars of War succinctly describes the experience of war as ' going back to living the way the rest of the world lives gives combat veterans serious problems. Other people have not had their experience. In being blooded, the soldier has become a member of an exclusive club, which has high membership fees'.

It is very easy for non-Vietnam veterans to play down the combat experiences of Vietnam veterans. They often put forward the view that they experienced similar trauma in the Great War, Second World War and Korean War so why should Vietnam veterans be treated differently to other veterans? The critics often overlook the uniqueness of the Vietnam conflict. Vietnam was never a declared war; the tours of duty by soldiers were relatively short by comparison with those endured by their fathers and grandfathers.

The conditions suffered by veterans were peculiar to their cankered war. An Australian statistical study has shown that infantry soldiers in World War II in any theatre, endured and suffered up to a total of 60 days under combat-like conditions. An infantryman in Vietnam endured on a comparable scale 300+ days of combat-like conditions. Although logistics, medical services and rest places were superior to World War II, duration of stress induced conditions was considerably lengthened and became a point, that if making it through 'this patrols 5 week seek and kill' after a 10 - 14 day pause it would be repeated again and again for the rest of the tour. Even the 'luxury' of a FSPB 3 week encampment still required day patrols and night ambushes. Other Major Wars Vietnam Formal declaration of war Never a declared war.

Until recently Enemy and civilians clearly distinguishable Enemy and civilians were generally indistinguishable Conventional warfare Guerrilla warfare Clear boundaries were defined, operational areas, 'the front', and 'the rear' South Vietnam was the area of operations Spraying of defoliants Major campaigns and battles with periods of respite Constant irregular sequences of skirmishes with little or no respite Soldiers were patriotic, believed in what they were fighting for. Many soldiers came to doubt the cause of why they were sent to Vietnam Major wars ended with the allies as the victors Vietnam ended as a defeat Welcomed home as heroes by society Shunned by society. Never in Australia's military history have returned soldiers been attacked psychologically by their own people World War II soldiers experienced up to a total of 60 days under combat like conditions A Vietnam infantryman endured on a comparable basis 300+ days A tour of duty lasted for up to five years, committed until the war ended.

Tours were relatively short in comparison, usually 12 months. Conventional, mobile warfare. Highly mechanised, air mobility and massive firepower. WW II soldiers were rotated to their rear lines for a rest on a regular basis. This was due to the lessons learned in WWI. In Vietnam there were no rear lines to escape for a rest resulting in a continual psychological stress which continuously existed at the front. WWII and Korean War soldiers came into Units for the war's duration.

There were opportunities to become part of the Unit and to bond with your comrades in lifelong friendships. Vietnam soldiers did 12 month tours, a short time for any effective bonding to occur. Replacements came from Reinforcement Units and were only partly accepted unlike those who trained and embarked with their Battalion. Average age of WWII veteran was 26 years. Average age of a Vietnam veteran was 20 years. Table comparing the Vietnam War with other wars.

Vietnam soldiers fought an enemy that was generally indistinguishable from the village populations they were meant to protect. The enemy included women and children who might be implicated in setting lethal ambushes and maiming booby traps as well as landmines. Many soldiers had come to doubt the cause for which they had been sent to Vietnam, in a war which had never been declared and which ended in defeat. They remembered mates who were killed by accidents and 'friendly fire'. Their infantry war had mostly comprised tense, enervating patrols, clad in clothes and boots that were wet for days on end, with constant threats from foul water, unsafe local food, composite rations, skin eruptions, intestinal disorders, malarial infection and a well armed, elusive human enemy. Their campaign comprised an irregular sequence of skirmishes in which apparent successes were measured by ground half-secured and counts of enemy dead, which might again be innocent villagers. O'Keefe sums up their unique involvement by stating that it is a testimony to human resilience that in the outcome so few of the young men were mentally and physically broken.

I feel that the experiences of the Vietnam veteran may best be summed up by a joke, which I was recently told. Q: How many Vietnam vets does it take to change a light globe? A: How would you know. You weren't there. Throughout all of Australia's wars and conflicts there have always been disturbed and alienated survivors.

PTSD is a relatively new psychiatric diagnosis, which has recently been associated with combat and has been referred to by a multitude of names over many years.