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Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder, mental illness that some people develop after
experiencing traumatic or life-threatening events. Such events include warfare, rape
and other sexual assaults, violent physical attacks, torture, child abuse, natural
disasters such as earthquakes and floods, and automobile or airplane crashes. People
who witness traumatic events may also develop the disorder.
Memories of Vietnam A veteran of the Vietnam War (1959-1975) mourns the death of
friends killed in the war during a visit to the Vietnam Veterans Memorial in
Washington, D.C. Many Vietnam veterans, particularly those involved in combat,
suffer from post-traumatic stress disorder. Symptoms of this disorder may include
extreme anxiety, disturbing flashbacks and nightmares, emotional numbness, and
irritability.
Post-traumatic stress disorder in war veterans is sometimes called shell shock or
combat fatigue. In victims of sexual or physical abuse, the disorder has been called
rape trauma or battered woman syndrome. The American Psychiatric Association
(APA) adopted the current name of the disorder in 1980.
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HISTORIC DOCUMENTS
Vietnam Veterans Against the War
In the late 1960s and early 1970s, mass demonstrations erupted throughout the United
States protesting U.S. involvement in the Vietnam War (1959-1975). Thousands of
veterans joined together in a national organization, Vietnam Veterans Against the War,
that supported and influenced the antiwar movement. In this transcript from an April
22, 1971, hearing before the Senate Committee on Foreign Relations, committee
chairman Senator J. William Fulbright indicated his sympathy for the antiwar
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movement. Fulbright’s comments were followed by the testimony of Vietnam veteran
John Kerry, who called for an end to the war. Kerry also detailed what he believed to
be the war’s negative effects in both Vietnam and the United States. Kerry became a
Democratic senator from Massachusetts in 1985.
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SYMPTOMS
People with this disorder relive the traumatic event again and again through
nightmares and disturbing memories during the day. They sometimes have flashbacks,
in which they suddenly lose touch with reality and relive images, sounds, and other
sensations from the trauma. Because of their extreme anxiety and distress about the
event, they try to avoid anything that reminds them of it. They may seem emotionally
numb, detached, irritable, and easily startled. They may feel guilty about surviving a
traumatic event that killed other people. Other symptoms include trouble
concentrating, depression, and sleep difficulties. Symptoms of the disorder usually
begin shortly after the traumatic event, although some people may not show
symptoms for several years. If left untreated, the disorder can last for years.
Post-traumatic stress disorder can severely disrupt one’s life. Besides the emotional
pain of reliving the trauma, the symptoms of the disorder may cause a person to think
that he or she is “going crazy.” In addition, people with this disorder may have
unpredictable, angry outbursts at family members. At other times, they may seem to
have no affection for their loved ones. Some people try to mask their symptoms by
abusing alcohol or drugs (see Drug Dependence). Others work very long hours to
prevent any “down” periods when they might relive the trauma. Such actions may
delay the onset of the disorder until these individuals retire or become sober.
III
PREVALENCE
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Studies have found from 1 to 14 percent of people suffer from post-traumatic stress
disorder at some point during their lives. The findings vary widely due to differences
in the populations studied and the research methods used. Among people who have
survived traumatic events, the prevalence appears to be much higher. The disorder
may be particularly prevalent among people who have served in combat. For example,
one study of veterans of the Vietnam War (1959-1975) found that veterans exposed to
a high level of combat were nine times more likely to have post-traumatic stress
disorder than military personnel who did not serve in the war zone of Southeast Asia.
IV CAUSES
Post-traumatic stress disorder is an extreme reaction to extreme stress. In moments of
crisis, people respond in ways that allow them to endure and survive the trauma.
Afterward those responses, such as emotional numbing, may persist even though they
are no longer necessary.
Not everyone who experiences a traumatic event develops post-traumatic stress
disorder. Several factors influence whether people develop the disorder. Those who
experience severe and prolonged trauma are more likely to develop the disorder than
people who experience less severe trauma. Additionally, those who directly witness or
experience death, injury, or attack are more likely to develop symptoms.
People may also have existing biological and psychological vulnerabilities that make
them more likely to develop the disorder. Those with histories of anxiety disorders in
their families may have inherited a genetic predisposition to react more severely to
stress and trauma than other people. In addition, people’s life experiences, especially
in childhood, can affect their psychological vulnerability to the disorder. For example,
people whose early childhood experiences made them feel that events are
unpredictable and uncontrollable have a greater likelihood than others of developing
the disorder. Individuals with a strong, supportive social network of friends and
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family members seem somewhat protected from developing post-traumatic stress
disorder.
V TREATMENT
Treatment of post-traumatic stress disorder may involve psychotherapy, psychoactive
drugs, or both. Psychotherapists help individuals confront the traumatic experience,
work through their strong negative emotions, and overcome their symptoms. Many
people with post-traumatic stress disorder benefit from group therapy with other
individuals suffering from the disorder. Physicians may prescribe antidepressants or
anxiety-reducing drugs to treat the mood disturbances that sometimes accompany the
disorder.
The Vietnam War
I
INTRODUCTION
Vietnam War, military struggle fought in Vietnam from 1959 to 1975, involving the
North Vietnamese and the National Liberation Front (NLF) in conflict with United
States forces and the South Vietnamese army. From 1946 until 1954, the Vietnamese
had struggled for their independence from France during the First Indochina War. At
the end of this war, the country was temporarily divided into North and South
Vietnam. North Vietnam came under the control of the Vietnamese Communists who
had opposed France and who aimed for a unified Vietnam under Communist rule. The
South was controlled by Vietnamese who had collaborated with the French.
The United States became involved in Vietnam because it believed that if all of the
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country fell under a Communist government, Communism would spread throughout
Southeast Asia and beyond. This belief was known as the “domino theory.” The U.S.
government, therefore, supported the South Vietnamese government. This
government’s repressive policies led to rebellion in the South, and the NLF was
formed as an opposition group with close ties to North Vietnam.
In 1965 the United States sent in troops to prevent the South Vietnamese government
from collapsing. Ultimately, however, the United States failed to achieve its goal, and
in 1975 Vietnam was reunified under Communist control; in 1976 it officially became
the Socialist Republic of Vietnam. During the conflict, approximately 3 to 4 million
Vietnamese on both sides were killed, in addition to another 1.5 to 2 million Lao and
Cambodians who were drawn into the war. More than 58,000 Americans lost their
lives.
II THE BEGINNING OF THE WAR: 1959-1965
The repressive measures of the Diem government eventually led to increasingly
organized opposition within South Vietnam. Diem’s government represented a
minority of Vietnamese who were mostly businessmen, Roman Catholics, large
landowners, and others who had fought with the French against the Viet Minh. The
United States initially backed the South Vietnamese government with military
advisers and financial assistance, but more involvement was needed to keep it from
collapsing. The Gulf of Tonkin Resolution eventually gave President Lyndon B.
Johnson permission to escalate the war in Vietnam.
III ENDING THE WAR: 1969-1975
Promising an end to the war in Vietnam, Richard Nixon won a narrow victory in the
election of 1968. Slightly more than 30,000 young Americans had been killed in the
war when Nixon took office in January 1969. The new president retained his
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predecessor’s goal of a non-Communist South Vietnam, however, and this could not
be ensured without continuing the war. Nixon’s most pressing problem was how to
make peace and war at the same time. His answer was a policy called
“Vietnamization.” Under this policy, he would withdraw American troops and the
South Vietnamese army would take over the fighting.
During his campaign for the presidency, Nixon announced that he had a secret plan to
end the war. In July 1969, after he had become president, he issued what came to be
known as the Nixon doctrine, which stated that U.S. troops would no longer be
directly involved in Asian wars. He ordered the withdrawal of 25,000 troops, to be
followed by more, and he lowered draft calls. On the other hand, Nixon also stepped
up the Phoenix Program, a secret CIA operation that resulted in the assassination of
20,000 suspected NLF guerrillas, many of whom were innocent civilians. The
operation increased funding for the ARVN and intensified the bombing of North
Vietnam. Nixon reasoned that to keep the Communists at bay during the U.S.
withdrawal, it was also necessary to bomb their sanctuaries in Cambodia and to
increase air strikes against Laos.
The DRV leadership, however, remained committed to the expulsion of all U.S. troops
from Vietnam and to the overthrow of the Saigon government. As U.S. troop strength
diminished, Hanoi’s leaders planned their final offensive. While the ARVN had
increased in size and was better armed than it had been in 1965, it could not hold its
own without the help of heavy U.S. air power.
While many U.S. officials were convinced that Hanoi was bombed back to the
negotiating table, the final treaty changed nothing significant from what had already
been agreed to by Kissinger and Tho in October. Nixon’s Christmas Bombing was
intended to warn Hanoi that American air power remained a threat, and he secretly
promised Thieu that the United States would punish North Vietnam should they
violate the terms of the final settlement. Nixon’s political fortunes were about to
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decline, however. Although he had won reelection by a landslide in November 1972,
he was suffering from revelations about the Watergate scandal. The president’s
campaign officials had orchestrated a burglary at the Democratic National Committee
headquarters, and Nixon had attempted to cover it up by lying to the American people
about his role.
The president made new enemies when the secret bombing of Cambodia was revealed
at last. Congress was threatening a bill of impeachment and in early January 1973
indicated it would cut off all funding for operations in Indochina once U.S. forces had
withdrawn. In mid-January Nixon halted all military actions against North Vietnam.
On January 27, 1973, all four parties to the Vietnam conflict—the United States,
South Vietnam, the PRG, and North Vietnam—signed the Treaty of Paris. The final
terms provided for the release of all American prisoners of war from North Vietnam;
the withdrawal of all U.S. forces from South Vietnam; the end of all foreign military
operations in Laos and Cambodia; a cease-fire between North and South Vietnam; the
formation of a National Council of Reconciliation to help South Vietnam form a new
government; and continued U.S. military and economic aid to South Vietnam. In a
secret addition to the treaty Nixon also promised $3.25 billion in reparations for the
reconstruction of ravaged North Vietnam, an agreement that Congress ultimately
refused to uphold.
IV THE TROOPS
In the United States, military conscription, or the draft, had been in place virtually
without interruption since the end of World War II, but volunteers generally
predominated in combat units. When the first U.S. combat troops arrived in Vietnam
in 1965 they were composed mainly of volunteers. The Air Force, Navy, and Marines
were volunteer units. The escalating war, however, required more draftees. In 1965
about 20,000 men per month were inducted into the military, most into the Army; by
1968 about 40,000 young men were drafted each month to meet increased troop levels
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ordered for Vietnam. The conscript army was largely composed of teenagers; the
average age of a U.S. soldier in Vietnam was 19.
Those conscripted were mostly youths from the poorer section of American society,
who did not have access to the exemptions that were available to their more privileged
fellow citizens. Of the numerous exemptions from military service that Congress had
written into law, the most far-reaching were student deferments. The draft laws
effectively enabled most upper- and middle-class youngsters to avoid military service.
By 1968 it was increasingly evident that the draft system was deeply unfair and
discriminatory. Responding to popular pressures, the Selective Service, the agency
that administered the draft, instituted a lottery system, which might have produced an
army more representative of society at large. Student deferments were kept by Nixon
until 1971, however, so as not to alienate middle-class voters. By then his
Vietnamization policy had lowered monthly draft calls, and physical exemptions were
still easily obtained by the privileged, especially from draft boards in affluent
communities.
Both North and South Vietnam also conscripted troops. Revolutionary nationalist
ideology was quite strong in the north, and the DRV was able to create an army with
well-disciplined, highly motivated troops. It became the fourth-largest army in the
world and one of the most experienced. South Vietnam also drafted soldiers,
beginning in 1955 when the ARVN was created. Most ARVN conscripts, however,
had little personal motivation to fight other than a paycheck. In 1965, 113,000
deserted from the ARVN; by 1972, 20,000 per month were slipping away from the
war.
Although equipped with high-tech weaponry that far exceeded the fire power
available to its enemies, the ARVN was poorly led and failed most of the time to
check its opponents’ actions. United States troops came to dislike and mistrust many
ARVN units, accusing them of abandoning the battlefield. The ARVN also suffered
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from internal corruption. Numerous commanders would claim nonexistent troopers
and then pocket the pay intended for those troopers; this practice made some units
dangerously understaffed. Many ARVN soldiers were secretly working for the NLF,
providing information that undermined the U.S. effort. At various times, battles
verging on civil war broke out between troops within the ARVN. Internal disunity on
this scale was never an issue among the North Vietnamese troops or the NLF
guerrillas.
The armed forces of the United States serving in Vietnam began to suffer from
internal dissension and low morale as well. Racism against the Vietnamese troubled
many soldiers, particularly those who had experienced racism directed against
themselves in the United States. In Vietnam, Americans routinely referred to all
Vietnamese, both friend and foe, as “gooks.” This process of dehumanizing the
Vietnamese led to many atrocities, including the massacre at My Lai, and it provoked
profound misgivings among U.S. troops. The injustice of the Selective Service system
also turned soldiers against the war. By 1968 coffeehouses run by soldiers had sprung
up at 26 U.S. bases, serving as forums for antiwar activities. At least 250 underground
antiwar newspapers were published by active-duty soldiers.
Soldiers sometimes took out their frustrations and resentments on those officers who
put their lives at risk. The term “fragging” came to be used to describe soldiers
attacking their officers, often tossing fragmentation grenades into the officers’
sleeping quarters. According to one official account, 382 such fragging incidents
occurred between 1969 and 1971. Other sources estimate a higher number of
fraggings, since many went unreported.
By 1971, as Vietnamization proceeded with U.S. troop withdrawals, no soldier wished
to be the last one killed in Vietnam. Consequently, entire units refused to go out on
combat patrols, disobeying direct orders. The desertion rate in the Army peaked at
73.5 per 1000 soldiers in 1971, noticeably higher than the peak desertion rates
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reached during the Korean War and World War II. Another half million men received
less than honorable discharges. Vietnam Veterans Against the War was organized in
the United States in 1967. By the 1970s the participation of Vietnam veterans in
protests against the war in the United States had an important influence on the antiwar
movement.
V RESPONSE TO THE WAR IN THE UNITED STATES
Opposition to the war in the United States developed immediately after the Gulf of
Tonkin Resolution, chiefly among traditional pacifists, such as the American Friends
Service Committee and antinuclear activists. Early protests were organized around
questions about the morality of U.S. military involvement in Vietnam. Virtually every
key event of the war, including the Tet Offensive and the invasion of Cambodia,
contributed to a steady rise in antiwar sentiment. The revelation of the My Lai
Massacre in 1969 caused a dramatic turn against the war in national polls.
Students and professors began to organize “teach-ins” on the war in early 1965 at the
University of Michigan, the University of Wisconsin, and the University of California
at Berkeley. The teach-ins were large forums for discussion of the war between
students and faculty members. Eventually, virtually no college or university was
without an organized student movement, often spearheaded by Students for a
Democratic Society (SDS). The first major student-led demonstration against the war
was organized by SDS in April 1965 and stunned observers by mobilizing about
20,000 participants. Another important organization was the Student Non-Violent
Coordinating Committee (SNCC), which denounced the war as racist as early as 1965.
Students also joined The Resistance, an organization that urged its student members to
refuse to register for the draft, or if drafted to refuse to serve.
While law enforcement authorities usually blamed student radicals for the violence
that took place on campuses, often it was police themselves who initiated bloodshed
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as they cleared out students occupying campus buildings during “sit-ins” or street
demonstrations. As antiwar sentiment mounted in intensity from 1965 to 1970 so did
violence, culminating in the killings of four students at Kent State in Ohio and of two
at Jackson State College in Mississippi.
Stokely Carmichael, Malcolm X, and other black leaders denounced the U.S. presence
in Vietnam as evidence of American imperialism. Martin Luther King, Jr., had grown
increasingly concerned about the racist nature of the war, toward both the Vietnamese
and the disproportionately large numbers of young blacks who were sent to fight for
the United States in Vietnam. In 1967 King delivered a major address at New York’s
Riverside Church in which he condemned the war, calling the United States “the
world’s greatest purveyor of violence.”
On October 15, 1969, citizens across the United States participated in The
Moratorium, the largest one-day demonstration against the war. Millions of people
stayed home from work to mark their opposition to the war; college and high school
students demonstrated on hundreds of campuses. A Baltimore judge even interrupted
court proceedings for a moment of reflection on the war. In Vietnam, troops wore
black armbands in honor of the home-front protest. Nixon claimed there was a “great
silent majority” who supported the war and he called on them to back his policies.
Polls showed, however, that at that time half of all Americans felt that the war was
“morally indefensible,” while 60 percent admitted that it was a mistake. In November
1969 students from all over the country headed for Washington, D.C., for the
Mobilization Against the War. Over 40,000 participated in a March Against Death
from Arlington National Cemetery to the White House, each carrying a placard with
the name of a young person killed in Vietnam.
Opposition existed even among conservatives and business leaders, for primarily
economic reasons. The government was spending more than $2 billion per month on
the war by 1967. Some U.S. corporations, ranging from beer distributors to
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manufacturers of jet aircraft, benefited greatly from this money initially, but the high
expense of the war began to cause serious inflation and rising tax rates. Some
corporate critics warned of future costs to care for the wounded. Labor unions were
also becoming increasingly militant in opposition to the war, as they were forced to
respond to the concerns of their members that the draft was imposing an unfair burden
on working-class people.
Another factor that turned public opinion against the war was the publication of the
Pentagon Papers on June 13, 1971, by the New York Times. Compiled secretly by the
U.S. Department of Defense, the papers were a complete history of the involvement
of numerous government agencies in the Vietnam War. They showed a clear pattern of
deception toward the public. One of the senior analysts compiling this history, Daniel
Ellsberg, secretly photocopied key documents and gave them to the New York Times.
Subsequently, support for Nixon’s war policies plummeted, and polls showed that 60
percent of the public now considered the war “immoral,” while 70 percent demanded
an immediate withdrawal from Vietnam.
The Vietnam War cost the United States $130 billion directly, and at least that amount
in indirect costs, such as veterans’ and widows’ benefits and the search for Americans
Missing-in-Action (MIAs). The war also spurred serious inflation, contributing to a
substantially increased cost of living in the United States between 1965 and 1975,
with continued repercussions thereafter. More than 58,000 Americans lost their lives
in Vietnam. Over 300,000 U.S. soldiers were wounded, half of them very seriously.
No accurate accounting has ever been made of U.S civilians (U.S. government agents,
religious missionaries, Red Cross nurses) killed throughout Indochina.
After returning from the war, many Vietnam veterans suffered from Post-Traumatic
Stress Disorder, which is characterized by persistent emotional problems including
anxiety and depression. The Department of Veterans Affairs estimates that 20,000
Vietnam veterans have committed suicide in the war’s aftermath. Throughout the
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1970s and 1980s, unemployment and rates of prison incarceration for Vietnam
veterans, especially those having seen heavy combat, were significantly higher than in
the general population.
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