From the time of Homer's ancient story of the battle between the
Trojans and the Greeks, and the times of the Bible and Shakespeare,
military personnel have been confronted by the trauma of war.
Recent books and movies have highlighted the impact of war trauma
on veterans of the Vietnam War and the Persian Gulf War. However,
the traumas faced by veterans of World War II and the Korean
conflict have been publicly acknowledged in the media less often
and less clearly. The recent movie, "Saving Private Ryan," showed
the reality of war trauma during World War II. World War II was
terrifying and shocking for hundreds of thousands of American
military personnel. For most World War II veterans, memories of the
war can still be upsetting more than 50 years later, even if the
memories arise only occasionally and for brief periods. For a
smaller number of World War II veterans, the war trauma memories
still cause severe problems, in the form of Posttraumatic Stress
Disorder, or PTSD.
How does war affect "normal," "healthy" military
personnel?
War is a life threatening experience that involves witnessing
and engaging in terrifying and gruesome acts of violence. Most
military personnel also feel that participating in war is their
patriotic duty, and they do so to protect and defend their country,
their loved ones, their values, and their way of life. The trauma
of war is the shocking confrontation with death, devastation, and
violence. It is normal for human beings to react to war's psychic
trauma with feelings of fear, anger, grief, and horror, as well as
with emotional numbness and disbelief.
Many studies have shown that the more prolonged, extensive, and
horrifying a soldier's or sailor's exposure to war trauma, the more
likely it is that she or he will become emotionally worn down and
exhausted. This happens to even the strongest and healthiest of
individuals, and often it is precisely these soldiers who are the
most psychologically disturbed by war because they endure so much
of the trauma. Most war heroes don't feel brave or heroic at the
time, but they do their duty, despite often feeling overwhelmed and
horrified, in order to protect others.
It is, therefore, no surprise that when military personnel have
had severe difficulty recovering from the trauma of war, their
psychological difficulties have been described as "soldier's heart"
(in the Civil War), "shell shock" (in World War I), or "combat
fatigue" (in World War II). After World War II, psychiatrists
realized that these problems usually were not an inborn mental
illness like schizophrenia or manic depressive illness but were a
different form of psychological dis-ease that resulted from too
much exposure to war trauma. This form of psychological dis-ease is
known as "traumatic war neurosis" or Posttraumatic Stress Disorder
(PTSD). Although most war veterans are troubled by war memories,
many were fortunate enough either to have not experienced an
overwhelming amount of trauma exposure or to have immediate and
lasting help from family, friends, and spiritual and psychological
counselors so that the memories have become manageable. A smaller
number, probably about one in twenty World War II veterans, had so
much war trauma and so many readjustment difficulties that they now
suffer from PTSD.
How is it possible to have PTSD 50 years after a war?
Because most World War II veterans received a hero's welcome and
a booming peacetime economy when they returned to the states, many
were able to make a successful readjustment to civilian life. They
coped, more or less successfully, with their memories of traumatic
events. Many had disturbing memories or nightmares, difficulty with
work pressure or close relationships, and problems with anger or
nervousness, but few sought treatment for their symptoms or
discussed the emotional effects of their wartime experiences.
Society expected them to put it all behind them, forget the war,
and get on with their lives. But as they grew older and went
through changes in the patterns of their lives-retirement, the
death of spouse and friends, deteriorating health, and declining
physical vigor-many experienced more difficulty with war memories
or stress reactions. Some had enough trouble to be diagnosed with a
delayed onset of PTSD symptoms, sometimes with other disorders like
depression and alcohol abuse. Such PTSD often occurs in subtle
ways. For example, a World War II veteran who had a long successful
career as an attorney and judge and a loving relationship with his
wife and family might find upon retiring and having a heart attack
that he suddenly felt panicky and trapped when going out in public.
Upon closer examination, with a sensitive helpful counselor, he
might find that the fear is worst when riding in his car, and this
may relate to trauma memories of deaths among his unit when he was
a tank commander in World War II.
How can I help an older military veteran who may have
PTSD?
First, if one feels emotional about past memories or experiences
some of the normal changes associated with growing older (such as
sleep disturbances, concentration problems, or memory impairment),
it does not necessarily mean that person has PTSD. If a World War
II or Korean conflict veteran finds it important, but emotionally
difficult, to remember and talk about war memories, help him or her
by being a good listener, or help find a friend or counselor who
can be a good listener.
Second, get information about war trauma and PTSD. The
Department of Veterans Affairs' Vet Centers and Medical Center PTSD
Teams offer education for veterans and families, and they can
provide an in-depth psychological assessment and specialized
therapy if a veteran has PTSD. Books such as Aphrodite Matsakis'
I Can't Get Over It (Oakland: New Harbinger, 1992) and
Patience Mason's
Home from the War (High Springs, Florida: Patience Press,
1998) describe PTSD for veterans of all ages and other trauma
survivors and PTSD's effect on the family.
Third, learn about the specialized therapies available at Vet
Centers and VA Medical Centers. These include medications to help
with sleep, bad memories, anxiety, and depression; stress and anger
management classes; counseling groups for PTSD and grief (some
particularly designed to bring together older war veterans to
support one another in healing from war trauma or prisoner of war
experiences); and individual counseling. It is important that
family members be involved in the veteran's care and in their own
individual care.
This fact sheet was based on:
Bonwick, R.J., & Morris, P.L.P. Post-Traumatic Stress
Disorder in elderly war veterans.
International Journal of Geriatric Psychiatry 11,
1071-1076.
Hyer, L., Summers, M.N., Braswell, L., & Boyd, S. (1995).
Posttraumatic Stress Disorder: Silent problem among older combat
veterans.
Psychotherapy 32(2), 348-364.
Schnurr, P.P. (1991).PTSD and Combat-Related
Psychiatric Symptoms in Older Veterans. PTSD Research Quarterly 2(1), 1-6.
Snell, F.I. & Padin-Rivera, E. (1997). Post-Traumatic Stress
Disorder and the elderly combat veteran.
Journal of Gerontological Nursing 23(10), 13-19.
