Henry Lang came to Downton Abbey to take over as the Valet to the Lord Grantham when the Lord’s previous valet had to leave suddenly. This fictional account of a household of the English aristocracy is originally set during the early days of World War 1. The writers of Downton Abbey researched how the war affected different individuals in England. Lang’s short time at the Abbey is one of the most sublime.
Lang had to leave the war because of a condition we now call PTSD. At the time, it had various names: Shell shock, soldier’s heart, war neurosis, and Combat Fatigue. The general population did not treat these soldiers well. They were often considered cowards and treated like lesser humans.
Lang came to the Abbey and at first everyone was impressed by his skill set as a valet. But quickly he showed signs of emotional deterioration. What made it difficult for Lang is the Abbey was being used to convalesce injured officers. Eventually Lang collapsed emotionally after seeing too many wounds and groaning soliders, and he left the Abbey in shame. Nothing more is said of him for the entire series.
This poignant portrayal of a character is accurately written. It is estimated as many as 100,000 British soldiers had this condition. If one adds the American, Canadian, French, Belgian, and soldiers of other allied nations, the number of soldiers suffering PTSD may have reached 1.5 million.
According to David J. Morris writing in The Evil Hours: A Biography of Post-Traumatic Stress Disorder.
“Over half a million men were permanently evacuated from the fighting for psychiatric reasons, enough to man fifty combat divisions.” And though many of them were sent to mental institutions, they were not treated with any compassion.
David J. Morris
Despite its prevalence, shell-shock was often attributed to moral failings and weaknesses, with some soldiers even being accused of cowardice.
Smithsonian Magazine also notes that they used horrific methods to wake up the soldiers from their internal nightmare:
Dr. Yealland asserted that his treatment cured all the most common “hysterical disorders of warfare”—the shaking and trembling and stammering, the paralysis and disorders of speech—sometimes in a single suspect half-hour session. Electric heat baths, milk diets, hypnotism, clamps and machines that mechanically forced stubborn limbs out of their frozen position were other strategies. As the war settled in, and shell shock—both commotional and emotional—became recognized as one of its primary afflictions, treatment became more sympathetic.
Even more tragic are some of the therapies adopted by American therapists. Many of them believed these soldiers needed to be shocked back to reality with a “hair of the dog” approach. Therapists kept these patients awake for days at a time. They re-enacted scenes of loud noises, flashing lights, and people falling down around them. The most heinous methods involved beating their bodies with sticks and hoses. One account says they used what we now call water-boarding to “wake up the dreary warriors.”
The WW1 soldiers drank heavily and commited domestic violence as they suffered through angst and depression. The roots for the American obsession with opiates trace their origin to the first world war and the untreated soldiers who came home with their PTSD pain untreated.
Why were these soldiers treated so starkly with so little empathic response? It was because not EVERY soldier returned with PTSD symptoms. Doctors and family members noticed that though most of the soldiers came home with the same stories about their experiences, only some of them showed the outward symptoms we associate with PTSD. Thus, people concluded that those soldiers with trauma symptoms had moral deficiencies.
Many of those with PTSD didn’t show the more notorious symptoms. They simply suffered in silence. But what is generally agreed is that whether each soldier had PTSD or not, most of them came back and medicated their pain. Whether through drugs or alcohol, whether with angry outbursts or isolation, the American society was shaken by a generation of men who were not the same as when they left.
This is the pattern we’re noting in this series of articles. War changes those who fight it. PTSD affects such a high percentage of them, even if they don’t show outward symptoms that others notice. And trauma sufferers affect their families in many negative ways. Thus, since we have four straight generations where war has affected the families of America, there are few family lines in our country not devastated by trauma.
We call this effect “Secondary Trauma”. Any individual who has had to live with someone suffering Primary trauma–which I contend is the majority of those who fight in war–will suffer some lesser forms of trauma themselves. If the primary trauma sufferer is violent, an alcoholic, or drug addict, many of their family members suffer Primary trauma themselves.
Since this has been occuring for four straight generations, it explains many of our societal ills. We will discuss that in a later article.
The trauma from the first world war went mostly untreated. And if it was treated, the treatments did not bring release and healing to those who suffered. But it didn’t stop there.
Just a dozen years after the end of World War 1, America experienced its worst recession in history. The impact on people recovering from the PTSD of WW1 was disheartening. In the first three years of the Great Depression, suicide rates jumped 20%. People were depressed, full of anxiety, given to violence, drinking, and drugs. In short, they experienced all the same symptoms of PTSD the soldiers did coming home from war.
At the end of the Depression, the US population was just eight years away from entering into the Second World War. I want the reader to consider what that must have been like. Millions of soldiers and their families had untreated PTSD from WW1. Then, just as the children of those soldiers reached teen years, they faced the PTSD as the result of the Great Depression. Before they even grew much older, these same teens were being sent to Europe and Asia to fight a war which was practically designed to create PTSD.
We call the ones who survived all of that trauma “The Greatest Generation”. As a whole, they were fortunate to survive at all. The ones who did not die or who were not institutionalized were still forever changed by what happened to them. Many of them were forced to serve in the second world war, or volunteered to do so. That started another round of PTSD and severe trauma.
As many as a million men may have returned from this war with PTSD. Almost all of them in combat situations suffered trauma. This is where the nation experienced a curious reaction to the soldiers. For the first time, the psychiatric/psychological community began to see these soldiers as emotionally damaged. And, for the first time, they were not shunned from society when they returned. They were hailed as heroes because of their service. And, since hospitals were no longer torturing them through treatment processes, some soldiers actually received help.
In 1952, a group of psychiatrists working for the APA developed a glossary of terms to describe psychological ailments and disorders. It was called the DSM. In that first volume, they identified a condition called “Gross Stress Reaction”. They recognized this as a disorder related to soldiers in particular. This is part of that diagnostical description:
This diagnosis is justified only in situations in which the individual has
Diagnostical and Statistical Manual, 1952
been exposed to severe physical demands or extreme emotional stress, such
as in combat or in civilian catastrophe (fire, earthquake, explosion, etc.).
In many instances this diagnosis applies to previously more or less “normal”
persons who have experienced intolerable stress
This “intolerable stress” was now definable and discernible by the medical community. But, because it was so new, very few soldiers benefited from treatment.
The television show MASH, set in the Korean War, highlights some of the changing attitudes toward PTSD. Several of their guest characters suffer this gross stress reaction and are sent home or treated in hospital. At the same time, some of the show’s recurring characters, such as Majors Frank Burns and Margaret Hoolihan, considered these men to be slackers and fakers.
Most military leaders were of the same opinion.
The soldiers who came home from WW2 gave birth to the baby boom generation. At the same time, they developed the largest alcoholic problem in history. More men suffered from alcohol addiction than at any other time before or since in America. With this alcohol dependency came violence, abuse, broken marriages, and broken bodies.
The women in these marriages were prescribed tranquilizers to help them cope. There are estimates that between 50-6o% of married women were consuming tranquilizers during the 1950s, most notably Miltown, Librium, and Valium. Together, these drugs were dubbed “Mommy’s Little Helpers”.
Unfortunately, the children of these gorked-out women and drunk, violent men could not be prescribed pills. Instead, they “medicated” with cannabis and alcohol themselves, creating a host of 1960s drug and alcohol addicts. Many of these young men were then sent to Vietnam where they were introduced to even harder drugs.
Though it is impossible to accurately count, between 1-1.5 million soldiers experienced some kind of battle conditions during the Vietnam War. Since it is virtually assured that anyone who undergoes combat situations endures some kind of trauma, these people brought this trauma back stateside when they returned home. If their numbers correlate to the numbers in other wars, perhaps 200,000-400,000 of these trauma sufferers returned home with PTSD.
Today, if you walk the streets of any major American city, you will find that a sizable minority of the homeless are vietnam veterans. Most of these have PTSD. You will also find these people populating VA psych centers, drug and alcohol rehab centers, and any other place where those with mental illness reside.
According to the National Vietnam Veterans Study, a government-led study of those who suffered trauma in the Vietnam War, a sizable minority of the soldiers still are affected by PTSD to this day. Here is their conclusion:
While NVVLS findings confirm that the majority of Vietnam theater Veterans are both mentally and physically healthy, a significant number are still suffering from PTSD symptoms and other chronic health issues related to their service.
National Vietnam Veterans Study
Over the years, how has the Military and the VA responded to this horrific toll on human life? They have sought to cover it up. As one psychiatrist at Fort Bragg told me “The Army has no use for those with mental illness. And we cannot afford to admit we caused it. That would cost too much.”
A study done by Yale University in 2018 concluded that there is significant evidence the Army has pressured non-governmental institutions to deny the effects of PTSD. Though the original DSM had a listing for war-induced PTSD, the second edition which came out during the Vietnam War removed it. According to the April 16, 2018 study published in the magazine “Chronic Stress“, the APA was ordered to eliminate all mention of combat-induced mental illnesses in the DSM-2. Recently released documents confirm the Army felt it would harm the morale of the troops.
A similar thing was done at the end of World War 2. Famous director John Huston created a documentary called “Let There Be Light” where he chronicled the almost 20% of soldiers who had PTSD from the war. The Army successfully blocked the release of this movie until 1981. At the time, they claimed it was to protect the privacy of the soldiers. But this has been shown to be completely false. It was to bolster the Military’s ability to recruit more soldiers.
Since the Vietnam war, we have experienced both Gulf Wars, wars in Afghanistan, Syria, the former Yugoslavia, and various peacekeeping flare-ups. One estimate is we have had another 2,000,000 soldiers coming home with some form of trauma.
One thing is clear from the overwhelming data and research: The U.S. Government and specifically the U.S. Military are quite aware of the psychological damage that war does to its soldiers. As I have read over 200 articles and 4 books on this subject, I come to a further conclusion: Because war PTSD has gone unrecognized and untreated for four consecutive generations, America has suffered completely from national PTSD, the likes of which few nations have ever faced.
In the next article, I want to show how this PTSD both affected and was treated by an institution which should have come to the aid of the wounded: The Church.
Instead of aiding the fight against the ravages of PTSD, the church has made it a lot worse.