The new “hot topic” – PTSD and the Civil War

Over the many years of my study of the Civil War, I’ve seen many “trends” emerge within the field.  Seems as every few years a “hot topic” will emerge promising new, fresh perspectives into some facet that has long been neglected.  On the whole, this is good.  Looking at things in a new light often adds to the general understanding.  Throw around a few questions, and things like the “three phases” at Antietam, or Ruggles’ Battery at Shiloh receive cross examination.  Or better still, areas such as southern unionism or the home front experience receive their proper due.  But the most interesting “hot topics,” which draw in the most attention, are somewhat abstract, at a higher level.  Subjects like “soldier studies” or “Civil War and Memory” for instance.

Let me mention what I sense is the “hot topic” of late – Post Traumatic Stress Disorder (PTSD) and the Civil War.  Several book-length treatments have touched the topic, along with journal articles… and not just one, but two posts over at the New York Times Opinionator.  In their post, Jeffrey Allen Smith and B. Christopher Frueh set an objective up front:

One would assume that the physical price paid by the men who fought in the war would have a rough equivalent in the mental price, that the experience of that terrible war would have left countless survivors with horrible psychological scars. But that may not actually be the case: according to official Union war records, adverse psychological reactions to combat across a variety of categories never matched, or even approached, the shocking physical losses from the war.

Sarah Handley-Cousins continued along that line of discussion in her more recent blog post:

There are no statistics that can tell us how many soldiers experienced moments of panic and helplessness, or how many feared they might be losing control. There is also nothing to teach us about the experiences of most of the soldiers after they were discharged.

The problem here is the inability to find set of “clean” numbers for to use when drawing a conclusion.  Even considering more recent wars, analogous numbers seem to escape any study of the subject.   We might point to treatment options in the Civil War, World War I, World War II, Korea, and Vietnam then mention increasingly progressive approaches to the problem.  But the statistics still fail us.  Why?  Well, for starters, as the PTSD Alliance points out, PTSD is very difficult to diagnose.

With that said, PTSD is a subject where the historian has to go beyond conclusions derived from raw statitics.  Unless the premise is something more than establishing PTSD existed, then the historian has to get some hands on the matter.  Otherwise, even with a lot of “pop” and “sing” the conclusion falls flat:

The men who fought in the Civil War participated in a brutal modern war, as soldiers’ letters, photographs and newspaper articles bear testament. Yet often obscured by the ghastly casualty figures and recounts of battles won and lost were the personal struggles that the troops fought on a daily basis – an internal conflict constantly waged against the self-evident, understandable mental and physiological pressures of military service and combat.

So… we don’t know the true measure of PTSD from the Civil War, but we do know it was bad.  I see that as externalizing the issue… and not considering the larger body of the subject.

What I find missing in the entire discussion (be it the two referenced posts above or other published works) is incorporation of the important work on PTSD in the psychological profession.  If we, as historians, are going to study PTSD in the historical sense, then we need to come to grips with what it is.  There is a tendency, given the contemporary coverage of the issue in regard to veterans, to focus narrowly on unpleasant behavior – violent actions, non-social behavior, or self-destructive acts – as the nature of PTSD.  Such coverage is like assessing the tiger by examining the teeth only.  And at the same time, we also should consider the difference between combat-related PTSD and other stimuli which create PTSD.

In his book “On Killing,” Dr. (Lieutenant-Colonel, Ret.) Dave Grossman offeed some historical context to the psychology of warfare.  Going beyond just expressing the nature of symptoms and proposing treatments, Grossman looked back to the roots of combat-related PTSD.  At its heart, combat-related PTSD involves calling a human being to perform actions which in any other setting would be immoral – killing – while that same individual is subjected to the threat of death.  And this has important implications to us, as historians, looking at the source materials:

Even the language of the men at war is full of denial of the enormity of what they have done.  Most soldiers do not “kill,” instead the enemy was knocked over, wasted, greased, taken out, and mopped up.  The enemy is hosed, zapped, probed, and fired on. The enemy’s humanity is denied, and he becomes a strange beast called a Kraut, Jap, Reb, Yank, dink, slant, slope, or raghead.  Even the weapons of war receive benign names – Puff the Magic Dragon, Walleye, TOW, Fat Boy, and Thin Man – and the killing weapons of the individual soldier becomes a piece or a hog, and a bullet becomes a round.

Consider that next time you read a first hand account of an action.  Then ask yourself if the choice of words is also a function of the writer’s reaction to the combat experience.  Those are, in no small way, symptoms of PTSD just as bad as self-destructive acts.  And with that in mind, can we not see the effects from PTSD in the way that we, generations removed, continue to interpret the Civil War?

I think, however, as we study PTSD and the Civil War, we do reach some common conclusions which do apply to our own times.  As Sarah Handley-Cousins said in her blog post:

One of the real tragedies of the conflict was not the sheer number of men who fought to win the Civil War, but the few who lost the war within.

Indeed.  PTSD is a survivable condition.

And for full disclosure, as I’ve mentioned before on this blog, several years ago I was diagnosed with PTSD.  I don’t think that gives me any advantage when writing on this issue.  All that does is give me a personal perspective – for better or worse.