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PTSD affects those who fight, even when they fight in ‘good wars’

PTSD has long been associated with unpopular wars and not noble causes — but history shows that any war can inflict mental trauma

6 min

The Department of Veterans Affairs, on behalf of the National Center for PTSD, recently released an advisory to veterans, especially to those who had served in Europe, on “coping with current events in Ukraine.” According to the warning, as they followed Ukraine’s struggle to survive, veterans might experience “an increase in mental health symptoms of PTSD or depression.”

VA deserves acclaim for being proactive on a serious mental health issue, particularly because post-traumatic stress disorder has long been associated with unpopular wars and not noble causes, such as Ukraine’s current war against Russian aggression.

To be sure, doctors long understood that war experiences could trouble veterans, estimating that 20 percent of battlefield casualties were of a psychiatric nature. But it took a controversial war, Vietnam, for the disease to finally be taken seriously, and now all combat veterans will benefit from an acknowledgment of the trauma caused by war, which may lead to more resources devoted to treating it.

In World War I, the common term was “shell shock,” and in World War II, the term was “battle fatigue.” The symptoms, such as nervousness and depression, were the same, but the medical and popular presumption was that the trauma of combat was short-lived or easily curable. As demonstrated in John Huston’s documentary, “Let There Be Light” (1946), U.S. Army doctors claimed a nearly 100 percent cure rate, usually with hypnosis. After all, the veterans helped the United States achieve its military goals, which had broad public support as “good wars.”

But the persistent official and popular emphasis on the noble cause of the war’s mission allowed PTSD to ravage the lives of those who fought in the world wars. Consider the case of 160 paratroopers, most from the 82nd Airborne Division, who landed hopelessly off-target near the French village of Graignes, Normandy, on D-Day. The villagers, about 900 citizens, asked the paratroopers to stay in Graignes to defend them from German occupiers. In turn, the men and women of Graignes served the paratroopers, finding their equipment in the surrounding marshes, conducting reconnaissance missions and organizing a cooking campaign that provided the paratroopers with two hot meals a day. On June 11 and 12, 1944, superior forces of the 17th Waffen-SS Panzergrenadier Division attacked the village. When they ran out of ammunition, the paratroopers withdrew from Graignes. They had suffered about 30 battlefield deaths. The battalion surgeon and medics stayed behind with wounded paratroopers. The Waffen-SS murdered wounded Americans, prisoners and medical personnel. The Nazis also slaughtered four villagers, including the parish priest, for the crime of ministering to wounded paratroopers.

Over the next 11 months, the surviving paratroopers fought in the Normandy campaign, participated in the wintertime Battle of the Bulge, jumped over the Rhine River on March 24, 1945, and liberated thousands of enslaved Eastern European laborers in the Rhineland area. Remarkably, most of the 110 veterans of Graignes made it to victory, although many suffered serious wounds. Some paratroopers also pulled occupation duty in postwar Berlin, and most carved out successful postwar lives for themselves and their families.

But they also endured PTSD. Excessive drinking characterized the lives of too many of them. Their friends and relatives thought the veterans drank in response to disturbing memories. One Silver Star winner ended his days running up and down the halls of an assisted-living facility, warning the staff that “the Germans are coming.” An officer, who won the Silver Star for inspired leadership at Graignes, declined to discuss the war or attend reunions and experienced recurring nightmares. The wife of a noncommissioned officer told her son that the man she married was not the same man who returned from Europe. She declined to elaborate. The children of an aging paratrooper took him to see “Saving Private Ryan” (1998), which has been lauded for realistically re-creating the sounds of war. The veteran audibly sobbed and cried during the movie.

In his 40s, S/Sgt. Rene E. Rabe, my father, who had been an avid swimmer, became afraid to put his head underwater after watching paratroopers drown in the marshes surrounding Graignes. He told his youngest son that, whenever he saw a body of water, a drowning paratrooper appeared in his mind’s eye. Reflecting sorrow and possibly guilt, Rabe also lamented seeing hungry German children scrounge through the paratroopers’ garbage. Soldiers were prohibited from befriending Germans during the war. In his 80s, Sgt. John Hinchliff built a log cabin near a pond in Webster, Wis., where he lived alone because he feared that he would hurt someone with his bouts of uncontrollable anger. Journalists who interviewed Hinchliff were “amazed and shocked” when he recounted the horrors of the battlefield.

But if World War II veterans suffered PTSD that went largely unseen and unacknowledged, the Vietnam War spawned both widespread PTSD and a new narrative to explain it. The United States did not accomplish its political and military objectives in South Vietnam, and veterans routinely expressed uncertainty and confusion about war aims. When Vietnam veterans returned home, political and military pundits characterized their mental struggles as “post-Vietnam syndrome.” Public narratives of Vietnam veterans’ struggle to reenter civilian life centered not on what they saw during the war, but rather on what they experienced coming home from an unpopular conflict. Vietnam veterans did not have a parade down New York City’s 5th Avenue; rather, they struggled with finding meaningful employment and being disdained as “baby-killers.” Travis Bickle (Robert De Niro) in “Taxi Driver” (1976) and Ron Kovic (Tom Cruise) in “Born on the Fourth of July” (1989) came to epitomize the distinctive struggles of Vietnam veterans.

In the aftermath of the Vietnam debacle, the medical profession recognized the depth of the mental trauma. In January 1980, the American Psychiatric Association defined PTSD as a legitimate disease or syndrome. People with the syndrome “have intense, disturbing thoughts and feelings related to their experiences that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they feel sadness, fear or anger; and they may feel detached or estranged from other people.” Whereas PTSD has been defined, it remains a challenge to persuade everyone — the federal government, the medical community and the public — to accept that the experience of combat exacts an inevitable mental toll.

Perhaps it would be best to be more clear-eyed about war and to invest in resources to support those that fight in them. To do so would be in the spirit of VA’s advisory on PTSD.