The Evil Hours
Table of Contents
Title Page
Table of Contents
Copyright
Epigraph
Author’s Note
Prologue: The Warning
Introduction
Saydia
In Terror’s Shadow
Toward a Genealogy of Trauma
The Haunted Mind
Modern Trauma
Therapy
Drugs
Alternatives
Growth
Epilogue: Counterfactuals
Acknowledgments
Notes
Selected Bibliography
Index
About the Author
Footnotes
Copyright © 2015 by David J. Morris
All rights reserved
For information about permission to reproduce selections from this book, write to Permissions, Houghton Mifflin Harcourt Publishing Company, 215 Park Avenue South, New York, New York 10003.
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The Library of Congress has cataloged the print edition as follows:
Morris, David J., date.
The evil hours : a biography of posttraumatic stress disorder / David J. Morris.
pages cm
“An Eamon Dolan Book.”
ISBN 978-0-544-08661-6 (hardback)—ISBN 978-0-544-57032-0 (trade paper)—ISBN 978-0-544-08449-0 (ebook)
1. Post-traumatic stress disorder—United States. 2. Post-traumatic stress disorder—Patients—United States—Biography. 3. Morris, David J., date.—Mental health. I. Title.
RC552.P67M68 2015
616.85'21—dc23
2014034487
v1.0115
Heraclitus’s Fragment 62 is from Fragments: The Collected Wisdom of Heraclitus by Heraclitus, translated by Brooks Haxton, translation copyright © 2001 by Brooks Haxton. Used by permission of Viking Penguin, a division of Penguin Group (USA) LLC.
This book presents the research and ideas of its author. It is not intended to be a substitute for consultation with a mental health professional. The publisher and the author disclaim responsibility for any adverse effects resulting directly or indirectly from information contained in this book.
This book is not affiliated with or endorsed by the Department of Defense or other instrumentality of the United States.
How many a brief bombardment had its long-delayed after-effect in the minds of these survivors, many of whom had looked at their companions and laughed while inferno did its best to destroy them. Not then was their evil hour; but now; now, in the sweating suffocation of nightmare, in paralysis of limbs, in the stammering of dislocated speech. Worst of all, in the disintegration of those qualities through which they had been so gallant and selfless and uncomplaining—this, in the finer types of men, was the unspeakable tragedy of shell shock . . . In the name of civilization these soldiers had been martyred, and it remained for civilization to prove that their martyrdom wasn’t a dirty swindle.
—SIEGFRIED SASSOON
A modern disease, as it is comprehended in a laboratory, is explained to the laboratory technician, the student, and the layman as a phenomenon made up of its own pimples, rash, swelling and development. The disease is never presented as a creature—real or metaphorical—a creature that might have an existence separate from its description, even as you and I have an existence from the fact that we weigh so many pounds and stand so many inches tall.
—NORMAN MAILER
Author’s Note
Out of respect for their privacy, I have changed the names of some of the people who appear in these pages.
Prologue: The Warning
Have you ever been blown up before, sir?
Everything was fine until it wasn’t.
Apophenia: finding patterns where there shouldn’t be patterns.
These were the words I wrote in my journal on October 9, 2007, the day before I was almost killed by a roadside bomb in Baghdad. The last line I wrote in the days afterward. Later, I went back and underlined it in a different colored ink, as if to emphasize that I had come back to it in a different state of mind. As if I were leaving a clue for some future version of myself.
I was in Iraq for my third reporting trip and had gone out on a patrol with some soldiers from the First Infantry Division into Saydia, a neighborhood that seemed, at least on the surface, to be relatively peaceful. On our way back inside the wire, one of the soldiers asked nonchalantly if I’d ever been blown up before. I considered the question for a moment, and then, as the silence deepened, I sensed that something was amiss. The words came awkwardly as I explained that while I had spent the summer before in Ramadi, at that point the deadliest city in Iraq, I was still a virgin in that particular area.
It was like my fate had been spoken: I had never been blown up before, but everyone in the Humvee knew that was about to change.
According to the laws of grunt superstition, I was the injured party, but somehow I managed to feel bad for the kid who’d asked the question. As it happened, the soldiers in the Humvee were from all over Latin America—Peru, Mexico, Guatemala—and they began pummeling him in a variety of languages and accents for what he’d done.
At the time, I felt embarrassed more than anything else and just wanted the moment to end. I didn’t like being the topic of conversation, and it took everything I had to avoid thinking about being blown into tiny red pieces. This, in fact, was one of the first head tricks I’d learned in Iraq, to systematically ignore the obvious: you were always just about to die—get over it. I was wasted, too, and my mind wasn’t right. I had been in Iraq for a total of nine months by this point, and even though I had seen people killed by roadside bombs, I’d never been hit myself, and somehow I’d come to feel that I had my luck under control. But in posing the question, it was as if the soldier had stolen that control, thrown me over to the forces of chance that I had worked so hard to insulate myself from.
Later, I interviewed a prominent psychoanalyst, who told me that trauma destroys the fabric of time. In normal time, you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy, or bouncing about like a rubber ball from now to then and back again. August is June, June is December. What time is it? Guess again. In the traumatic universe, the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas.
Another odd feature of traumatic time is that it doesn’t just destroy the flow of the present into the future, it corrodes everything that came before, eating at moments and people from your previous life, until you can’t remember why any of them mattered.
What I previously found inconceivable is now inescapable: I have been blown up so many times in my mind that it is impossible to imagine a version of myself that has not been blown up. The man on the other side of the soldier’s question is not me. In fact, he never existed.
The war is gone now, but the event remains, the happening that nearly erased the life to come and thus erased the life that came before. The soldier’s question hangs in the air the way it always has. The way it always will.
Have you ever been blown up before, sir?
Introduction
Over the past four decades, post-traumatic stress disorder has permeated every corner of our culture. A condition that went unacknowledged for millennia, and began its public life with a handful of disgruntled Vietnam veterans “rapping” in the offices of an antiwar group in midtown Manhattan in December 1970, has spread to every nation on the globe, becoming in the words of one medical anthropologist a kind of “psychiatric Esperanto.” A species of pain that went unnamed for most of human history, PTSD is now the fourth most common psychiatric disorder in the Un
ited States. According to the latest estimates, nearly 8 percent of all Americans—twenty-eight million people—will suffer from post-traumatic stress at some point in their lives. According to the Veterans Administration, which spends more annually on PTSD research and treatment than any organization in the world, PTSD is the number one health concern of American military veterans, regardless of when they served. In 2012, the federal government spent three billion dollars on PTSD treatment for veterans, a figure that doesn’t include the billions in PTSD disability payments made every year to former servicemembers.
Since the attacks of 9/11, when public awareness of the disorder gained momentum, PTSD (a condition characterized by hyperarousal, emotional numbness, and recurring flashbacks) has, to the dismay of some international aid experts, supplanted hunger as the primary Western public health concern when a war or other humanitarian crisis hits the news. PTSD is one of the newest major psychiatric disorders to be recognized, and yet today it has entered the public lexicon to the degree that it is not uncommon to hear journalists describing entire countries as being stricken with it and writing lengthy articles debating whether or not Batman might be suffering from it. Consumers who are so inclined can now go online and purchase a commemorative patch for $5.99 that reads P.T.S.D.: NOT ALL WOUNDS ARE VISIBLE. As any trauma researcher will tell you, PTSD is everywhere today.
And yet, like many mental health disorders, there is broad disagreement about what exactly PTSD is, who gets it, and how best to treat it. There remains a small but vocal cadre of researchers who argue that PTSD is a social fiction, a relic of the Vietnam War era foisted upon the global community by well-meaning but misguided clinicians, and that by, in essence, encouraging people to be traumatized, we undermine their recovery. A condition born of strife, PTSD is dominated by conflict in its scientific life as well. There is, however, little disagreement that survivors of rape, war, natural disasters, and torture—the events that are generally recognized to lead to PTSD—experience profound, even existential, pain in the aftermath of such events. This brand of suffering has become so widely recognized that it has in fact permanently altered the moral compass of the Western world and changed our understanding of what it means to be human, what it means to feel pain.
Pierre Janet, a French neurologist writing in 1925, observed that emotional reactions to traumatic events can be so intense as to “have a disintegrating effect on the entire psychological system.” This book is about that effect and what it looks and feels like from the inside. Over time, PTSD has changed not only the way humans understand loss but also how humans understand themselves generally; I am interested in it both as a mental condition and as a metaphor. How people respond to horrific events has always been determined by a complex web of social, political, and technological forces. For most of human history, interpreting trauma has been the preserve of artists, poets, and shamans. The ways in which a nation deals with trauma are as revealing as its politics and language. The ancient Greeks staged plays that were written and performed by war veterans as a communal method for achieving catharsis. Today, for better or worse, we deal with trauma and horror almost exclusively through a complex, seemingly arbitrary cluster of symptoms known as post-traumatic stress disorder. In the classical world, the ancients in the wake of trauma might look for answers in epic poetry, such as The Iliad or The Odyssey. Today, we turn to the most current edition of the Diagnostic and Statistical Manual of Mental Disorders. This fact alone is worthy of further exploration: most of us no longer turn to poetry, our families, or the clergy for solace post-horror. Instead, we turn to psychiatrists. This is, historically speaking, an unusual state of affairs.
Before 2011, I had never seriously considered the question of post-traumatic stress, either in myself or as a general subject. I returned home in 2007, as I had returned from all of my reporting trips to Iraq, with a powerful feeling of alienation from my countrymen. Freshly deplaned from what I understood to be the defining event of my generation, I discovered to my great surprise that no one back home held this view or seemed to have given much thought to the war. Like Nick Carraway returning from the East in The Great Gatsby, I came home expecting to find the world “at a sort of moral attention.” When this didn’t happen, I was disappointed. The war had changed me, enlarged me in some way, made me feel as if history was a tangible force in my life, and seeing the workaday world, people with their looks of practiced oblivion, put me on edge. The writer in me secretly wished for something similar to what had happened before, perhaps something out of the Vietnam era: people marching in the streets, students debating the war’s meaning on college campuses, the war making itself felt at home in some visible way, the loss given some physical form.
The war had hurt me. I wanted the country to feel some of that hurt. Part of me needed to see that, to remind me that the war had been real, not just something I saw when I closed my eyes. I needed to know that the experience had meaning and that the death I had seen really mattered. What I saw instead was people commuting to work and going to the mall, the gym, and the health food store, making their bodies perfect, exactly as they had before. The yellow ribbons I saw seemed almost like a taunt, a challenge to all the horror I’d witnessed.
I learned very quickly that talking about the war wasn’t just pointless but actually damaging in its own right. I could barely begin to describe what I had seen before I would be interrupted by a racist comment about Arabs or by someone stopping me to explain how the war had just been about oil all along and that the important thing, really, was to develop alternative energies so that we could divest from the Middle East. After a while, I realized that the problem wasn’t just that they didn’t understand the war but that they didn’t want to understand it. What I had to say was not only inconvenient to their peace of mind but a tangible threat to it. Americans could no more cope with the reality of the war than they could with the reality of particle physics. Not only was it beyond their ken, but the fact that it might be beyond their ken was beyond their ken. Trying to cut through the various layers of incomprehension, I was confronted by further obscenities. If, by some chance, I could get someone to listen to me about what I had seen in Iraq, they would end up looking at me like I had a speech impediment. They’d meet my eyes, and I’d get The Look, a sort of mirror image of the famous Thousand Yard Stare from World War II, a look that told me more about American innocence than I ever wanted to know. More than once I was asked if I’d killed anyone over there. At times, my sense of alienation was so strong I seemed almost radiant with it, as if a stranger could look at me and tell that something was wrong.
Sometimes I would start to shake when I thought about the war—how wrong it was, how many childish mistakes had been made, how no one in power was held accountable, and how tens of thousands had died in the service of some Beltway egos—or the people who had died in the service of nothing at all, owing to the simplest accidents of space and time. One unit I was with north of Fallujah had lost a guy who was killed while using a Port-a-John in the middle of the night. He’d gone out to take a shit and, out of nowhere, a single mortar round came in and ended him. It was the only incoming they’d taken in days. How do you go about telling a guy who is alive only because he didn’t use the shitter at the wrong time that he ought to go back home, go to school, get married and mortgaged, have kids, and commit to the world when he knows for a fact that nothing in this world is real except chance? That his continued existence, his dreams, his plans, his hopes for the future are the product of invisible, ever-changing odds, odds that could shift and turn on him at any moment? What place did human reason have in this world really, after you’d seen what war could do to it? The lesson taught by the war was clear: to be human is to be small, powerless, and subject to the forces of randomness.
Every veteran knows this.
Knowing this is what makes it hard to step onto airplanes. Knowing this is what makes it hard to stand in large crowds. Knowing this is what makes it hard to drive a car.
Still, at other times, I found myself in pain, missing the field, missing the Marines and the excitement, the profane beauty of their words, the mid-patrol trance I’d slip into, the bump and grind of enemy contact, the feelings I’d had in a place where every second could either save you or kill you, where even the smallest gesture took on a certain weight because you knew it might be your last. Instead, people back home just looked at me as if there was something wrong with me, a look that cost me nothing to return.
That these two worlds, war and home, could be kept isolated, one living in almost perfect ignorance of the other, was an obscenity surpassed only by the obscenity of the war itself. The war had been difficult, but there seemed to be meaning in having survived it. Coming home and feeling the dullness of people, the pride they took in their ignorance, seemed to diminish that meaning, as if it had only been a bad backpacking trip overseas that I’d come back from. How could this be allowed to happen? Could a war really be called a war if nobody back home gave a shit about it? In time, I resolved to hate the country I’d once served: the fat, sheltered land with its surplus of riches, its helicopter moms and real estate agents—narrow-minded, smug, and only dimly aware of any lives other than their own.