Life After War: Perspectives on PTSD From Rhode Island Veterans

In 2003, having waited 15 years in the Rhode Island National Guard for the opportunity to deploy overseas, Vinnie Scirocco deployed for Iraq and trained at a base. Three months later, without seeing combat, Scirocco was physically injured and given honorable discharge. “I didn’t feel like I completed my mission,” said Scirocco, now the State Commander of the Veterans of Foreign Wars (VFW). “To the day I die I will probably always feel that way. No pill, no conversation with anyone at any educational level can change that.”

After six years of road rage and constant guilt Scirocco checked himself into the Veteran’s Affairs Hospital in Providence and was diagnosed with Post-Traumatic Stress Disorder (PTSD).

A childhood friend of Scirocco’s, who was deployed at the same time and remained in Iraq, developed Post-Traumatic Stress Disorder (PTSD) shortly after Vinnie’s discharge, after shooting and killing a baby girl. He was a gunner on a Humvee that patrolled the streets of Baghdad, where civilian vehicles are not allowed to pass military vehicles. A family desperately trying to get to the hospital chanced it and passed the Humvee. Scirocco explained the aftermath: “So he shot at the car. What you hope to do is shoot in between the husband and the wife. You didn’t want to shoot at anybody. Well, there was a little girl in the backseat who got shot and killed. This friend of mine, he’s a father. He’ll never be the same—no matter how many times I tell him, ‘It’s not your fault; you had to do that,’ he’ll always feel guilty for that—he can’t take that bullet back.”

Both Scirocco and his friend undergo therapy and take medication for PTSD. They’re both saddled with a heavy, inextinguishable guilt. But one of them never saw action, while the other did. The problem with diagnosing PTSD when no identifiable trauma has occurred is not necessarily that veterans will be getting benefits they don’t deserve, but that the misdiagnosis can lead to a dangerous reliance on prescription drugs, or an overestimation of one’s own mental health problems.

The condition’s implied emphasis on outside trauma rather than manufactured neurosis has done much to de-stigmatize mental illness among soldiers. And the more PTSD is destigmatized in the ranks of the armed services, the argument goes, the more active soldiers and veterans will feel comfortable seeking psychiatric help. And then the Army suicide rate—which this year surpassed the civilian one for the first time—might start decreasing. But PTSD diagnoses may overemphasize trauma and de-emphasize soldiers’ own understanding of duty, patriotism, and camaraderie. A study of four Rhode Island veterans reveals that guilt over not serving was equally responsible for fragile mental health as trauma sustained while in battle.

Dr. Tracie Shea, who works with PTSD patients at Veterans’ Affairs Medical Center in Providence, suggests there’s a fundamental difference between a veteran’s and a civilian’s PTSD.

“I’ve certainly seen cases in which people feel less bothered by the memories. They can manage it better, their quality of life is better,” Dr. Shea says. After administering group therapy with other veterans, Shea always asks what they found most helpful. “They always say ‘to be with people they can understand and connect with.’ But once they leave here, it’s back out in the cold world, the disconnected world.” The disconnect in question is not simply between PTSD and non-PTSD, but military and civilian.

Herein lies the harsh irony of the veteran PTSD case: the safe return to civilian life can be more debilitating than active duty. The pace of life is slow and unregimented; the concerns of others—a flat tire, a long line at the grocery store—seem absurd.

A fall 2010 study published in the journal Aggressive Behavior found that stressors related and unrelated to battle were equally responsible for anti-social, violent behavior among U.S. Marines. “Boredom or monotony” and “concerns or problems back home” were two of the leading complaints cited.

A college student enrolled in the Rhode Island ROTC program at Bryant College, who asked to remain anonymous for this article, says that when soldiers return home they often find it impossible to recreate the camaraderie they experienced in the course of duty. It’s also off-duty where they begin to confront their agency in battle. “It’s not ‘til afterwards that you realized that the person you shot down had a wife and a kid,“ Smith says. “You’re lookin’ through your scope, you get the order and you do it. I think that’s a big thing with it. You [come] back and you see somebody freaking out or really upset over something very, very trivial.”
 
Of the 8 million Vietnam veterans, about one million are thought to have had PTSD upon their return from duty, according to a 2006 RAND Corporation study. Many of these are among the estimated 600,000 veterans who killed themselves. By comparison, 58,000 US troops died in Vietnam. It’s thought that one of the reasons Vietnam veterans were so prone to suicide was that they had to cope with symptoms for 10 years before the PTSD diagnosis was even introduced into the DSM in 1980.

One local Vietnam vet with PTSD, 64-year-old North Providence resident Armand Briere, said the day he came home from war in July 1968 was the happiest of his life. Lacking any hope of a full-time career and unable to explain how he felt to anybody else, Briere self-medicated with hard drugs he picked up overseas, and overdosed several times. He can’t bring himself to talk about the details of his PTSD symptoms, particularly the flashbacks and nightmares. Though he reveals no desire to go back to war, he found himself re-engaging in a brutal, death-defying military consciousness, both inadvertently and on purpose. The heroin he took, he said, was like “dying and coming back.”

The only work he was ever capable of doing—until his body gave out on him—was physically exhausting, and he has chronic carpal tunnel syndrome to show for it. The flashbacks themselves have lodged themselves in his mind inexorably, and have had him revisiting scenes of death every day for 40 years.

Fellow Vietnam vet Roseanna Evans has the same diagnosis and experiences similar symptoms—like embarrassing duck-and-cover reactions to fireworks and periodic outbursts of public violence. But these symptoms materialized during the Gulf War, after she already had PTSD from Vietnam. Though no less serious, her initial PTSD was not suffered in combat, but on an army base in Oakland, California.

Evans, who is 60, grew up in a military family stationed in Newport, R.I. It had been her dream since childhood to serve in the Air Force. Deemed too light at 100 pounds, she instead took up with the Army and was sent to Oakland, California in 1969. In the politically-charged Bay Area, Evans was vilified.

“They asked the women to march in the parade. We got bombarded by bags of defecation, we got bottles of urine thrown on us, we got spit at, we had bricks thrown at us. And then we was called out—our names, we were told we were either gay or prostitutes. At the age of 18 that’s kind of hard to deal with.” Throughout the 70s, on reserve duty, Evans was periodically homeless in Oakland, sleeping on park benches. In 1970 she became pregnant from a rape by a fellow soldier on the base.

Evans developed a crippling guilt complex later that year. “I was supposed to go over to Vietnam and do the desertion forms—that was my job. [If you were] pregnant, they would not send you over. I had to train to this kid and he took my place. When Saigon got hit—he got blown.” After an explosion on a military base in Kuwait during her National Guard service in the Gulf War, images of Saigon—which she never actually saw—flooded back.

Neither of these traumas were sustained in battle, but they were a direct result of war-time circumstances. When Evans cries, it’s not about the rape, but about her pregnancy, which she holds responsible for another man’s death. Like Vinnie Scirocco, she was blocked from active duty and felt she hadn’t served her country. That’s why, two decades later, once her children were old enough to be on their own, Evans re-enlisted to serve in the Kuwait war with the National Guard. She didn’t know she had PTSD, and the symptoms were badly exacerbated upon her return.

Until recently, it was difficult for veterans like Evans to prove they had PTSD. As Evans puts it, “We wasn’t shot at, so we didn’t have PTSD.” In July 2009, General Peter Chiarelli, the Vice Chief of Staff of the US Army, and one of the foremost supporters of improved PTSD treatment, announced that the VA was repealing a policy which prohibited non-combat veterans from getting help.

While cases like Evans’ underscore why this policy is a good one, they raise the question: What exactly constitutes PTSD? If Scirocco got PTSD in Iraq, surrounded by war, but not because of a traumatic event, and Evans got it in America, but through a series of traumas, do they really have the same illness? Another study of PTSD incidence conducted in 2008 by the Rand Corporation identified 18 different criteria for PTSD and found that the percentages of afflicted veterans changed considerably when they applied different definitions to the same samples. The official DSM definition is vague, but emphasizes three main criteria: 1. The subject must be exposed to a traumatic stressor in which the subject or someone close to the subject is put in peril. 2. The subject’s reaction to this stressor must be fear. 3. The subject must reexperience the traumatic event and avoid stimuli associated with the event.

California-based researcher Dr. Paula Caplan argues that no veterans at all should be diagnosed with PTSD, suggesting more precise terms like “battle fatigue” and “shell shock” for dealing with mental battle scars. Caplan, who has a forthcoming book on the misdiagnosis of PTSD among veterans, argues that the PTSD label “pathologizes” and further stigmatizes veterans’ mental problems, which she says are a normal reaction to war. “We should never say that because somebody is traumatized by war [they have PTSD],” Caplan says. “We shouldn’t use that term. We should say they are traumatized by war.”

Caplan thinks the only way to rehabilitate veterans is through routine engagements with civilians, especially those willing to listen and talk. When “World War II veterans are going to the VFW halls or American Legions, are there guys and women talking about how traumatized they are? They’re just drunk out of their minds.”

Evans, Scirocco, and Briere are all unemployed or retired. Without their active involvement in the VFW, they say they’d lose hope completely. While Caplan’s vilification of VFW branches may be irresponsible, she’s on to something in seeking a better distinction between the psychological toll that occurs from war and that which occurs from trauma. Caplan argues that what we call PTSD is essentially a normal reaction to an extremely unnatural set of circumstances. This interpretation too has its flaws—for it would imply those who aren’t diagnosed with PTSD are somehow abnormal. And by extension, it might suggest that veterans like Scirocco and Evans, who are haunted by their inability to fight for their country, are the deranged ones, while those who wouldn’t dream of going back, like Briere, are better adjusted.

Couched in a veteran’s inability to readjust to civilian life are two primary impulses. One is to seek out those who understand their torment. The other is to perform a service for their country—a drive that impels so many to enlist in the first place. For many veterans, serving in battle carries with it infinitely more meaning than staying home and getting a part-time job, or even taking care of their own children.

Providence VA clinician Dr. William Unger notes two factors in particular that make some veterans want to go back to war—even those who know they have PTSD. “Guys leave with a snapshot of their life—but what happens when they’re gone? Babies are born, kids learn to drive, wife gets a new job, these are all good things, but they don’t fit the picture you had when you left,” Unger says. Second, many patients, numbed and unable to love their families again, yearn to reunite with their comrades. “They’re closer to [their comrades] than anyone else. Guys often talk about going back because they left their buddies.”

Others, like Evans, were desperate to return to war out of sense of national duty, even when it was an abject impossibility. “When 9/11 hit I wanted to go back to war, but because of my mental and physical state I was told I couldn’t,” Evans said.

Scirocco is still tormented by his discharge. “I was injured and I couldn’t go back. I guess that’s kind of why I volunteer with the VFW,” Scirocco said. “For me that’s a way of being able to give back. But I’ve realized I think the one thing that my comrades in the VFW share is that when we raised our hand for our country, that commitment didn’t end with our service.”

Other able veterans who want to re-enlist after being diagnosed with PTSD are not prevented from doing so. Dr. Shea says many veterans are extremely happy to return to combat for second deployment and often report better second experiences after clinical treatment in between deployments. Nevertheless, Shea adds that “there is evidence to suggest the effect of this stuff is cumulative, depending on the amount of exposure they get with subsequent deployments.”
 
Today’s soldiers returning from the Middle East are more frequently diagnosed upon discharge than any previous generation of American soldiers since PTSD was introduced to the DSM-III in 1980. Part of this increase is due to better reporting methods. All members of the military must check in with a VA specialist immediately upon return from duty. Members of the National Guard do the same, and then again at 30, 60, and 90 days after their tour of duty is complete. But as Rhode Island National Guard Press Liason Lt. Col. Denis Riel notes, “The issue is [what happens] once that process ends—a lot of PTSD symptoms don’t manifest for months, if not years.”

Another reason for high incidence of PTSD is that a higher number of citizen soldiers—National Guard and Army Reserves—is deploying than ever before. National Guard soldiers, who have much less training and are less equipped for battle, must return home two weekends a year and make a rapid readjustment rather than live on the army base. In January, the Army revealed that half of this year’s soldier suicides were committed by National Guard soldiers, though they make up only 20 percent of the total pool. Exactly 145 National Guard troops killed themselves in 2010, compared to 65 in 2009. In 2010, 156 full time soldiers committed suicide while on active duty; 162 did in 2009.

It’s impossible to gauge how many veterans commit suicide every year, since the army doesn’t keep track once soldiers are discharged, but a 2010 study by the California newspaper Bay Citizen found that the proportion of California suicides by veterans is about two to three times higher than that of non-veterans. As veterans get older, the likelihood of suicide increases. The study also notes that the incidence of fatal car crashes, motorcycle crashes, and “accidental poisonings” are all significantly higher among veterans than non-veterans.

It should come as no surprise that the National Guard doesn’t exactly tout PTSD statistics to potential recruits either. During the recruiting interview I underwent, the officer did not mention PTSD of his own accord. When I asked if it was something to worry about, he admitted it was, but that a lot of soldiers “faked it” in order to get medical leave.

Still, increased PTSD awareness does not seem to discourage soldiers from serving. The anonymous ROTC student told me, “When you raise your right hand and swear to defend the constitution of the United States against enemies foreign and domestic, PTSD isn’t really on your mind.” He also feels that his primary responsibility is to those who served, not himself.

“It’s really difficult to say ‘Hey Commander, I have PTSD, I need help, and I’m not going to deploy.’ Your buddy who you fought with six months earlier who might have saved your life and you might have saved his life—[he’s] going back. Your obligation and your affection and your love for those people is pretty much [more important than] some issues you might have.”

East Providence resident Amanda Octeau, 29, served in Iraq with the Army. After four years of treatment for PTSD, she is again ready to resume classes at the University of Rhode Island, where she double majors in psychology and biology. Despite having studied PTSD in her coursework before she enlisted, Octeau was not deterred from service. She recognized the symptoms of PTSD in herself, but she denied herself treatment, out of a desire to be a “superwoman” and a reluctance to stop her service.

Octeau adds that although the military leadership has made it easier and less embarrassing for veterans to seek mental health, an admission of PTSD can hurt one’s job prospects in the military.

“I think people are trying to impress their higher command,” Octeau says. “It is very competitive. Even if your commander seems nice, it might affect [your] job down the road.”

While many veterans are fast overcoming the stigma of talking about PTSD and seeking counseling, these Rhode Island veterans have lingering effects which they say no doctor or medication can cure. Drugs for anxiety and sleep, anger management counseling, cognitive behavioral therapy—all of these measures have proven effective at VA Medical Centers in correcting erratic behavioral patterns. Perhaps impossible to improve, however, is a marked inability upon discharge to re-adjust to the routines of civilian life, which leaves veterans treading a line between wanting to die and wanting to re-engage a military ethos through violence, a return to combat, or rigorously oppressive work ethics.

Briere said his daily ritual of housekeeping, bartending, and organizing parties at the VFW branch that’s 10 houses down from his own keeps him feeling busy and helpful. The same goes for Scirocco and Evans. Octeau, though she fills her time working hard in school, finds less and less time to talk out her problems, mostly because a vast majority of local VFW members are much older than she. The blanket definition of PTSD treats the veteran like any other trauma patient. Not only are many depressed and suicidal veterans being diagnosed with an illness they may not have; they’re being treated for it.

Late in his life, in a period when he psychoanalyzed World War I veterans, Sigmund Freud noted a reluctance among some patients to resist psychoanalysis altogether. He termed this destructive impulse the “death drive,” which resisted meaning and classifications altogether, as well as the possibility of improvement. This dangerous desire to repeat is especially pertinent among the veterans studied here. But it’s crucial that when a veteran says he or she wants to go back to battle, it’s not just out of a masochistic death-drive, but out of a longing for camaraderie and national service, and for that remarkable interplay between disciplined regimentation and adrenaline-rush that comes with battle.

Simon van Zuylen-Wood is a student at Brown University. This article originally appeared in The College Hill Independent, a student publication that receives funding and training as a member of Campus Progress' journalism network.

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