MAJOR FACTORS ASSOCIATED WITH PTSD

In their Vietnam Era Stress Inventory, Wilson and Krauss (1980, 1982) defined seven major factors associated with PTSD. They include:

1. Depression and Suidical Syndrome

The individual suffers from feelings of helplessness, depression, dejection, and severe grief with frequent thoughts of suicide. In 1986, a study published in the New England Journal of Medicine found that men who served in Vietnam were nearly twice as likely to commit suicide as men who did not serve. This study reveals that the number who died since returning home from Vietnam is close to the number who died in Vietnam itself--around 59,000. (Veteran, September, 1988)

Many veterans are enveloped in a death immersion; they remember it, they dream it, and the thoughts are ever present. It is not uncommon for them to possess and carry weapons.

In the veteran's mind, there was no resolution to the conflict in Vietnam, and with support lacking at home, there has been no resolution in their own lives; thus the accompanying depression and feelings of helplessness.

When pressed to discuss his war experiences and resulting feelings, the veteran invariably cries. There is an overwhelming feeling of sadness which accompanies the memories.

2. Isolation and Withdrawal

The veteran tends to withdraw from society, avoids groups of people, prefers to live alone, and sometimes retreats to remote or wooded areas typical of Vietnam. Traditionally he has few friends. Having lost buddies in combat, and harboring a deep-seated suspicion towards a populace who rejected him, he finds it easier to retreat.

The isolation is not limited to the veteran alone. His family is also subjected to frequent moves and/or alienation from other people. They are indeed expected to endure the lack of interaction with friends and extended families, creating an enormously stressful lifestyle.

3. Sensation Seeking Syndrome

There is a driving need for the veteran to be involved in high risk, thrilling, or dangerous activities in order to feel that he is truly "alive". It is not uncommon for those veterans seeking to bring some manner of order to their lives to seek careers as firemen or policemen, both high risk occupations.

According to Wayne Smith, (Veteran, October 1988) "some statistically small--but significant--number of PTSD sufferers relive their wartime experiences, suffering episodes of violence ... those who suffer from PTSD as a result of a wartime experience are subject to continual bouts of these symptoms that cannot, of themselves, be alleviated".

Smith continues, "A recent study indicated that fully 29,000 Vietnam veterans now reside in state and federal prisons; 37,500 have been paroled; 250,000 remain under probationary supervision; and 87,000 are awaiting trial. All told, 400,000 Vietnam veterans are in trouble with the law--a rate of some 20 percent of all Vietnam veterans, therefore, have failed to adjust to civilian life as a result of their experiences in Vietnam".

4. Paranoid State Syndrome

Explosive rage, anger, hostility, and suspicion, particularly toward authority figures, are also hallmarks of a PTSD sufferer. These emotions are often as frightening to the veteran as to those who come in contact with him. His family is not immune to his rage.

Often the outbursts are a result of flashbacks or fantasies in which he envisions himself confronted by the Vietnamese enemy. It is a frightening situation for anyone who tries to restrain him. Once again he finds himself in a struggle for survival. (Goodwin, Readjustment Problems Among Vietnam Veterans)

The veteran will often leave the scene when he feels his rage emerging. His fear of hurting someone is more overwhelming than the rage.

There are a myriad of reasons for the all encompassing rage, however, the primary ones appear to be leftover, violent impulses incurred in Vietnam, a general mistrust in the government which sent him there, and again in the society which rejected and often continues to reject him.

5. Profound Psychic Numbing

The veteran has lost all sense of self and feels completely hopeless; he may suffer extreme anxiety or show no expression at all; a loss of affect. It is not unusual for him to report that he feels dead inside. In the combat situation, numbing was an effective adaptive mechanism to avoid a breakdown. He would then be less susceptible to the feelings associated with loss. (S. Huppenbauer, November, 1982) He very effectively learned to hold back his feelings, and he continues to employ the same mechanisms today.

6. Alienation and Cynicism Syndrome

The veteran is extremely cynical about society in general, but particularly concerning the law and authority figures. Even though he may be highly moral, he thinks in terms of how to "get back at" the system, particularly in confrontations with police.

7. Problem of Intimacy Syndrome

Although the veteran longs for intimacy and strong relationships, he resists getting close for fear of losing those he loves (as in Vietnam).

Many veterans hold themselves accountable as individuals for combat killings. Their divorce and suicide rate exceeds that of their civilian peers and also that of non-combat Vietnam veterans. (S. Haley, 1979)

Upon his return home, the veteran was frequently rebuffed in his efforts to discuss his experiences with his wife or family. They, along with the rest of society, wanted to forget the war. The forgetting and the refusal to listen, only served to heighten his numbing process.

Another factor to consider once again is the guerrilla nature of the war, in which even women and children were the enemy. Consequently, veterans who have feared or killed women and children in combat may find it difficult to make the transition to the role of husband, protector and nurturing parent. (S. Haley, 1979)