AS safe on the world.
Almost one million Americans saw active combat in Vietnam. Their experiences change them,
and many of them still suffer from the trauma of war. The depression and rage caused by
this is called post-traumatic stress disorder, or PTSD. But PTSD is not confined to people
coming out of war. The hallmark of PTSD is that a person has been exposed to a situation
in which they felt that they were in personal danger, that their own annihilation was a
real possibility, or that they witnessed awful things happening to other people. Today on
The Doctor Is In, a look at the extent of PTSD in our society. People caught in raging
fires or in natural disasters like an earthquake are being diagnosed with this condition. I
resolved myself that I was going to die, and in my mind I had died. I died under my desk
on October 17. Survivors of rape and childhood incest also suffer trauma and stress. Anxiety
attacks, depression. It seemed I was always depressed and always unhappy. Therapy that
grew out of Vietnam veterans' needs is now helping many others. Today, counselors are
teaching people how to deal with post-traumatic stress disorder, and helping them back to
healthy lives. That takes work. It's scary. There's a lot of crying. There's a lot of
reaching down inside yourself and seeing what's in there really. Hello, I'm Jamie Guth. Not
too long ago on a warm spring day, thawing ice came barreling down this river and broke
apart the bridge. People were driving on it at the time. One woman jumped out of her car
just in time to watch it float down the river. Can you imagine how terrifying that must feel?
Today that's what we're talking about. Situations that make us feel as if we have no control
whatsoever over our lives, that we may die at any time. War is like that. War isn't good
for people. Matthew Friedman is director of the Veterans Administration, National Center
for Post-Traumatic Stress Disorder, and a psychiatrist at the Dartmouth-Hitchcock Medical
Center. Furthermore, the greater the exposure to our own stress, the greater the likelihood
of having PTSD. World War II soldiers experienced more psychiatric casualties on the battlefield
than in any other recorded war. At one point, there were more men being discharged for psychiatric
reasons than there were men being drafted. Awareness of this led to immediate on-site
treatment for men in the Korean War. By the Vietnam War, breakdowns on the battlefield
were at an all-time low. But these statistics missed problems that did not start emerging
until a year and sometimes many years after the soldier had been sent home. Trauma had
still taken place. Researchers have documented physical changes that occur in the brain when
people are subjected to a crisis of this magnitude. These changes make the body more hyper-reactive
and alert for non-existent emergencies and blunt the feeling of pain. The more intense
the trauma and the longer it lasts, the more likely it results in post-traumatic stress.
Tim Beebe is a veteran and a counselor to veterans. The turning point for the Vietnam
Vet is, A, the mixture of a guerrilla war, never knowing who the enemy was. They could
be children, they could be women, because those folks were all considered warriors under
those conditions in their homeland. And the second turning point was the lack of a homecoming
for Vietnam Vets. Rick Lowes is a Vietnam Veteran. He lived for almost 20 years with
fear, rage, and depression before coming to this Vietnam Veteran Center in White River
Junction, Vermont. In 1968, Rick was 18 years old and a forward observer in the 101st Airborne
Brigade Infantry. He called in support fire for indirect fire weapons. When you're in
the jungle, there are no rules, and the only rule is survival. And the things you have
to do to survive leave you with a lot of guilt. Guilt is a major symptom of post-traumatic
stress disorder. So is alienation. People with PTSD feel different from others and pull
back. Rick felt isolated from his high school friends and family. At a time when he most
needed to deal with his guilt, he felt he had to keep quiet because of the strong reaction
in the states against the war. I had a lot of anger, lots of anger, and then I had a
lot of shame. But Rick had learned he could not express his feelings in the war. In combat,
the type of combat I was in, showing your expressions was giving up. You couldn't feel.
Why? Because there were a lot of cases that would kill you. You had to be alert. You had
to be tough. You had to be strong. There was no time for that. There was no time to feel.
So Rick numbed out. This is another symptom of post-traumatic stress disorder, trying
to ignore feelings. Often people do that with alcohol or other drugs. I remember when my
daughter was born and everybody made a fuss over it. I had to force myself to make a fuss.
I had to pretend that I cared. I felt empty inside. I didn't feel any emotions at all.
In 1979, legislation was enacted to set up Vietnam veteran centers across the country.
Students were finding themselves unable to keep jobs, marriages were failing, and many
were depressed and suicidal. I got real suicidal, super suicidal, where I'd sit in the basement
and stick a gun in my mouth and wait. Not really wanting to die, but not knowing what
to do. More confusion. I went to bed one Sunday morning and I started to cry, and I couldn't
stop crying. I hadn't cried, and nobody had ever seen me cry. That freaked my wife out
because she'd never seen me even. I'd always had this tough exterior, and I couldn't stop.
I was a kid on the outside, but inside I wasn't. Rick Lowe's had to deal with the rage and
guilt he'd felt all these years. He's been to alcohol treatment three times. He belongs
to an alcohol recovery group, and he's been in rap groups at the Vet Center. As veterans,
we probably did and saw, smelled, and touched things that most people don't. I think it
changed us. I couldn't believe that people actually opened up and told other people what
they were ashamed of. It was a place that I could admit what I didn't do in Vietnam.
These groups are extremely intense. They're scary to the veteran. Most have a fear of
going back to Vietnam. We do go back to Vietnam, but the caution is we're dealing with memories
now. Trauma victims, we've noticed here, have a time distortion in the sense that the traumatic
event that was so powerful to them seems to be occurring now, in the present. I didn't
want to be like this any longer. Cars backfired. It's not a backfire. It's a rifle shot. You
know it is. Your whole body just gears up, and it's just one big fight for survival.
That's not a human. It's not even an animal response. That's what you've been trained
to do as humans. You just lose your humanity. You just become a survival machine. I can
be back where I was 15 years ago, in a split second, with all the same reality, as much
emotion and fear. These same problems plague victims of other disasters. September 17th,
1989. It was just after five on a warm fall evening in California. Oh my God, he's done
one of the bridges. I can't say which one collapsed. The San Francisco area was hit
with an earthquake that registered 7.1 on the Richter scale. It broke apart two bridges,
tossed homes off their foundations, and opened up the earth, exposing broken gas and water
lines. Patty Schenck felt it from the 24th floor of her high-rise office. The building
is swaying back and forth and rolling, bouncing, rolling up and down. And I was not able to
stay under my desk. I was rolling out into the center area here. Leon Gregory was working
in a department store when the explosion started. I then saw our entire ceiling rip off. And
at that moment, when the ceiling just ripped open, a massive wall of brick avalanched in
on top of us all. And there were even bricks that went hurtling through the air, along
with large sections of roofing. Leon made it out alive, but he spent the rest of the
evening pulling others out of the wreckage. The noise that had taken place, along with
the tremendous vibration, the force that you had no control over, man seems so small in
relationship to these tremendous forces of nature that exist out there. Leon was able
to help others through the long night of the earthquake, but he started having his own
problems after the physical danger was gone. I, for example, went into a department store
not long ago that had an escalator that vibrated. And the very first thing I thought about was
what I went through during the time of the earthquake. Every time I hear the rumble of
a truck or car going by on the street where I live, I am more aware than ever of vibrations
and sounds, noises of any kind. Patty Schenck had trouble going back to her job as a legal
secretary. She'd expected to die here, 24 floors above the ground. She had said her
goodbyes to friends, family, and the things she would never see again and bowed her head.
But the vibrations ended and she was able to escape to her apartment, which had been
shaken but not destroyed. For a couple days after the earthquake, I was afraid to go anywhere.
I was afraid to go out of the house, to get in the car and drive somewhere. I was so afraid
the earth wasn't settled, nothing was settled, and I realized that I felt so vulnerable.
Patty's office reopened on a Friday, but she was too afraid to go in. Her boss asked
her to come in on Sunday for a special assignment and she went unwillingly. He wanted me to
go to the first Embarcadero No. 1 to pick up some legal documents from another law firm.
And I looked at him in the eyes and I said, I don't know where Embarcadero No. 1 is.
He said, yes, you do, Patty. I said, no, I don't. Right now, I don't know where it is.
And the other attorneys that were in the room who had flown in from another city and another
state, they were looking at me like, has she lost it? I had a hard time focusing. I couldn't
remember how to work my keyboard, my PC. I didn't know how to turn it on. I didn't know
what it was. I didn't remember the codes to make it work. And I thought, I've gone crazy.
I've gone off. The fear, the forgetting of everyday things, and the sensitivity to noise
and vibrations are all symptoms of post-traumatic stress disorder. Because of the Vietnam Veterans
Experience, therapists now know how important it is to get help as quickly as possible.
Both Patty and Leon got into group counseling. The therapist really helped us to understand
that we were not crazy. That how we felt from the moment the earthquake started, through
and including this very moment, was natural. It was normal.
Sometimes trauma is so severe and threatening, it actually gets blocked out of a person's
conscious memory. That's what happens to many victims of incest. Michelle Nappi had anxiety
attacks and deep depression for years and could never understand why.
I always felt, I joked about it, I felt like I was an alien and someone had dropped me
off from Mars or something and I just didn't fit anywhere.
At the age of 18, Michelle met her husband Dave in a bar. She had repeated a year at
school and was drinking heavily.
I wouldn't call a relationship a real healthy relationship. I think we both grew, our relationship
grew through the years into a healthy relationship.
Why wouldn't you call it healthy?
I was drinking quite a bit at the time we both met too and emotionally I don't feel
I was very stable in the sense of growth.
Incest victims often take the blame for the abuse. They assume that they are the bad person
because adults, especially parents, would not do something wrong to their child. So
the child loses respect for herself, which often leads to drug abuse, sexual deviance
and low performance in school.
Michelle and Dave married a year and a half after meeting in that bar. They had their
first child a year after that and Michelle became very depressed.
The doctors subscribed a valium and I felt like taking the whole bottle and Dave dumped
him down the sink. It was like I should be happy, but I wasn't.
Michelle had started having flashbacks of the abuse, but was afraid to acknowledge what
they were and afraid to tell Dave.
I would just say you're not going to love me. I was sure that he wasn't going to, like
I would have been tarnished somehow and I had always felt like I was dirty somehow and
different and if people found out that they would just not have anything to do with me
anymore, so I was sure that he wasn't going to love me.
I was having a very hard time believing in the memories she was having. It wasn't something
I wanted to believe. I wasn't supportive. I don't believe I was completely supportive
of her the way I wished I would have been.
Both Michelle and Dave went to counseling and as Michelle continued to remember, they
started putting together the pieces. This is what Michelle has remembered so far.
That I was sexually abused by five family members. My father, my grandmother, an aunt
and uncle and my brother. The first pregnancy was when I was nine years old and I miscarried
the child. It was a girl and she was about a five or six month fetus. I called my father
and we went into the bathroom and she was alive and she cried.
He killed her and wrapped her in a towel and he had me take her outside and put her in
the metal drum that we used to burn garbage. The next year when I was ten, I was pregnant
again and this time it went full term and I had my son in my grandmother's bed.
It's severe trauma like this that causes post-traumatic stress and when it's this
painful and goes on for this long, multifaceted therapy is needed. Counseling is a first step,
making the pain public can also heal. This is Michelle at age ten holding her son. He
was illegally given up for adoption and Michelle is now trying to find him.
I love him. It's very painful but also I'm looking for that part of me. It's true that
it happened twenty-six years ago but for me it's there with me all the time so it doesn't
feel twenty-six years old. Whether the problem is incest or rape or an
earthquake or a war, people with post-traumatic stress disorder experience the trauma as if
it happened yesterday. Michelle is angry but she's learning that it's okay to feel this
and not to be afraid of the feeling. She's using that energy to publish an incest survivor's
newsletter for people in the Vermont area. I think that also was a healing tool for me,
a voice and also a way for me to help other people and reach out to network other survivors
together. I was very angry and that was something that I did with my rage was use it constructively.
Both rape and incest survivors share the sense of being violated, of losing control over
their bodies but there are some important distinctions. For one, rape usually happens
only once as opposed to incest which can occur over a five or even ten year period and adults
have more opportunities to take control over their lives. For instance, women who've been
raped and who can move from their home soon after the crime can recover more quickly.
Meg Foster counsels crime victims. What happens if you're seven and you're being sexually
abused by a brother? Where are you going to go? Nowhere. That's why it hurts so much
to be sexually abused because there's an element of being trapped. Seven year old can't
go anywhere. Twelve year old can't go anywhere. But I can tell you by the time they get to
be about fifteen, they start to run. Almost all runaways are running from sexual abuse
at home. We have some research to show that. Large majority of street children are running
from sexual abuse at home. It's safer to live on the street than it is to live in their
own home. There are lots of other ways incest victims cope with this crime and in the past
these coping behaviors led them to being labeled as mentally ill. But now research into post
traumatic stress disorder has shown that these victims have just taken on some normal behaviors
under the circumstances. Let me give you an example. An eating disorder can be thought
of as a mental disorder, mental illness of some sort. But can you imagine if you were
being sexually abused by your dad say at four o'clock in the afternoon in the basement before
your mom got home from work that he would pick you up at school, bring you home, engage
you in sexual activity and then your mom would come home and cook dinner and you had to sit
down at the table and eat. It wouldn't be surprising at all that when you got some personal
power when you were maybe about fifteen years old you would say I'm not eating anymore and
someone would say this child has an eating disorder. It makes perfect sense to me why
that child when she finally got some personal power was going to have a very strong reaction
to her relationship to food. Another example is we find that women who have been sexually
abused say at night consistently can remember laying in their beds and watching the door
handle. They would lay awake as long as they could so they could be ready for when the
door handle turned and the aggressor entered, the benign aggressor by the way. This is not
a boogeyman, this is a kindly family member who is entering. It's not surprising that
later on in life that person will have a sleeping disorder, a sleep disorder. Yet we find many
women who accommodate to that terror, to those years of terror by simply taking employment
in areas where they don't have to sleep at night. So they work in emergency rooms and
they become police dispatchers and they take jobs on the night shift. People exposed to
trauma react in varying degrees. Some are so severely impaired they have to be hospitalized.
Others are able to keep jobs and on the outside at least appear stable and secure. Psychiatrist
Matt Friedman. Exactly that, that if you take a hundred people and expose them to some horrible
trauma, they're not all going to develop PTSD and what's the difference and can we even
determine in advance who is more vulnerable than others. These are the issues now under
research. I know now this will be ongoing for the rest of my life. At least I can recognize
the situation. Therapists do know that the earlier the person gets help dealing with
the crisis, the better the chances for making a healthy adjustment. Because of the length
of time that went by for many Vietnam veterans before being diagnosed, the problems have
become more complex. There's a notion now that's being explored, referred to as secondary
traumatization whereby other family members display the same symptoms as a traumatized
dad in that family. Public acknowledgement of the trauma has helped heal some wounds.
Public support is critical. This Memorial Day vigil begins every year at a Vietnam Memorial
constructed on a highway rest stop in Vermont. It continues through the night. What I did,
may not be morally wrong to everybody or right to everybody, but what I did was I survived.
That's basically what I'm trying to do now is survive day to day, you know, not drinking
one day at a time, not doing drugs one day at a time, learning to talk about all the
things that bothered me in the past that I never really had a chance to do. Today, I
love my children, you know, which is a big thing. I have feelings for them, I care about
them. In a real caring, it's not a pretend. You know, I have feelings for my wife, I have
respect for my wife, which I never had before. Early intervention is helping victims of natural
disasters avoid the years of trouble war veterans have had. When I do hear the windows creaking
and the building is swaying and I realize it's not an earthquake, it's the wind. Oh
yes, it's the wind. Okay, it's the wind. Fine. You're all right. The building's not going
to fall. And for those just remembering deep, early trauma like incest, education and patience
are cutting through the fear. And I learned that that happened a long time ago and I didn't
need to be afraid anymore. They took enough away from me and for me to hand over anything
else to them would be something I was doing to myself. I'm not going to hand them any
more of my life on a silver platter and say, here, take some more, you know. Recovering
from post-traumatic stress disorder is a process of moving from victim to survivor. It's hard
work but it can be done. I'd like to thank those survivors who are willing to share their
stories with us. That's our show for today. Thanks for joining us and keep informed when
the doctor is in.