International Society for Traumatic Stress Studies

ISTSS News

Posted 1 January 1999 in StressPoints by Sandra L. Bloom, M.D., Immediate Past-President, ISTSS

This is the third in a series of articles that look at the origins and development of the ISTSS. It includes edited excerpts from Our Hearts and Our Hopes are Turned to Peace: Origins of the ISTSS to be published by Plenum in the new volume, International Handbook of Human Response to Trauma, edited by Sandy McFarlane, Arieh Shalev, and Rachel Yehuda.

There were direct consequences to the kind of advocacy that Chaim Shatan and Robert Lifton were pursuing. Beginning in 1970, Shatan came under government surveillance. Returning from a meeting at the Pentagon in June 1973, he found his phone had been tapped. After a visit to Washington to offer assistance to American prisoners of war returning from Hanoi, Vietnam, he discovered that someone had tampered with his mail. (Scott, 1993).

The FBI tried to infiltrate the group rap sessions by sending in informers posed as veterans seeking help (Lifton, 1978). Shatan found that plans were afoot to entrap him with blueprints of government munitions plants. A veteran who was suspected of being a part of the security apparatus of the time, sent blueprints and letters to Shatan, detailing how easy it was to get letters out of the Pentagon. Friends at the Center for Constitutional Rights urged Shatan to get the documents out of his office and lock them in their safe, rather than risk a raid, which they believed was imminent. But Shatan's response was to talk longer, louder, and more frequently in order to bring attention to the readjustment problems of the veterans and to make their cause more publicly visible and therefore less vulnerable to government sabotage (Shatan, 1987; 1998).

The Veterans Affairs central office attacked Lifton and Shatan in the press after the two psychiatrists estimated that 20 percent of men who had served in Vietnam were paying a heavy psychological price -- the VA claimed that only 5 percent had
combat-related psychological symptoms. Both were labeled as being hung up on the war and accused of dishonoring brave men (Shatan, 1985).

As Lifton recalls, "I believe that we always function within this dialectic between ethical involvement and intellectual rigor, and that bringing our advocacy 'out front' and articulating it makes us more, rather than less scientific . . . From the beginning, the therapeutic and political aspects of our work developed simultaneously"(Lifton, 1978, pp. 211­212).

Meanwhile on the West Coast, a schizophrenia expert, Philip May, was director of psychological services for the Brentwood Veterans Administration Hospital. In 1971, May recognized that Vietnam veterans were not getting the services they needed, so he hired Shad Meshad, a social worker and Vietnam veteran, to evaluate the situation. Meshad had already started one of the nation's first rap groups in the Los Angeles area and was highly critical of the VA services (Meshad, 1997; Scott, 1993).

So was William Mahedy, who had served as a chaplain in the Vietnam War and was working as a social worker at Brentwood, "Most Brentwood psychiatrists that I met during this period had not the slightest clue how to deal with Vietnam veterans . . . They didn't know how to treat combat-related stress. Nor could they provide any guidance to the kind of total reintegration into society that we knew was necessary." (Mahedy, 1986, p.56).

In response, Meshad created the highly unconventional Vietnam Veteran Resocialization Unit within Brentwood, with the support of the hospital director and set up storefront clinics where rap groups were held.

It was difficult for Vietnam veterans to get the services they needed from the VA for several reasons besides the existing, sometimes virulent, prejudice against them. First, there was no diagnostic code for combat stress in the Diagnostic and Statistic Manual for Mental Disorders-II. This latest edition of DSM had been published by the American Psychiatric Association in 1968. As Art Blank, points out, "As the return of troops from Vietnam was reaching a crescendo, the psychiatric profession's official diagnostic guide backed away from stress disorder even further, and the condition vanished into the interstices of 'adjustment reaction of adult life'" (Blank, 1985, p.73).

But even under DSM-I there had been no classification for delayed stress reactions. So, if the symptoms presented more than two years after discharge from active duty, the VA did not consider them to be service-related problems. If veterans presented systems of posttraumatic psychiatric symptoms, they were misdiagnosed as suffering from depression, paranoid schizophrenia, or character or behavior disorders (Blank, 1985; Wilson, 1988).

Senator Alan Cranston, a World War II veteran and a member of the Senate's Committee on Veterans Affairs, became convinced that the psychological needs of Vietnam veterans were different from those of older veterans. Starting in 1971, Cranston tried to bring about changes in the VA system by seeking better funding for the Vietnam veterans to obtain drug and alcohol rehabilitation as well as specialized readjustment counseling services. The bill he proposed passed the Senate in 1973 and 1975, but the House refused to pass it.

The House was dominated by World War II veterans who had an unwillingness to concede that the Vietnam War had produced different problems than had been previously recognized. In addition, the American Legion and the Veterans of Foreign Wars lobbied against the bill. Taking a more long-term approach, Cranston appointed Max Cleland as a member of his staff to review the VA hospitals. Cleland, a Vietnam veteran, had lost an arm and both legs in the war and had testified for Cranston at the Senate Committee on Veterans Affairs in 1971. In his new position, Cleland visited Meshad's storefront operations at Brentwood. Both Cleland and Meshad testified in 1975 before Senator Cranston's Subcommittee on Health and Hospitals, providing clear evidence that the VA hospitals were not meeting the needs of Vietnam veterans (Scott, 1993).

Besides the problems with the psychiatric diagnostic schemata, there was no organized Vietnam veterans' pressure group advocating for a change in benefits (Scott, 1993). The work of the National Vietnam Veterans Resource Project, created during the First National Conference on the Emotional Needs of Vietnam-Era Veterans, began immediately after the conference. By 1974, the NVRP had catalogued 2,700 diverse veterans' self-help programs, 2,000 of them on college campuses, some out in the community and others in prisons (Lifton, 1973; Shatan, 1974).

Jack Smith sought funding for an empirical study and called it the Vietnam Generation Study, because the intention was to study both veterans and draft resisters. He and a colleague obtained funding from the National Council of Churches, the Russell Sage Foundation, and the Edward F. Hazen Foundation to begin a pilot study (Scott, 1993). In 1975, the Senate Committee for Veterans Affairs initiated a bill, finally approved by Congress, mandating the VA to conduct a study to assess the needs of Vietnam veterans. As a result, the VA provided funds to Arthur Egendorf and the NVRP to complete the Vietnam Generation Study, which eventually culminated in Legacies of Vietnam (Egendorf et al., 1979; 1981; Laufer, 1985).

References

Blank, A. S. (1985). Irrational reactions to post-traumatic stress disorder and Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp.69­98). Washington, D.C.: American Psychiatric Press.

Egendorf, A., Kadushin, C., Rothbart, G., Sloan L. & Fine, M. (1979). Urban males of the Vietnam generation, a mental health perspective: preliminary findings of the Vietnam-era project. Paper presented at the American Psychological Association, San Francisco, August.

Egendorf, A., Kadushin, C., Laufer, R., Rothbart, G., Sloan, L. (1981). Legacies of Vietnam: comparative adjustment of veterans and their peers. Washington, D.C.: U. S. Government Printing Office.

Laufer, R. S. (1985). War trauma and human development: The Vietnam Nam Experience. In S. M. Sonnenberg, A. S. Blank, & J. A. Talbott (Eds.), The trauma of war: stress and recovery in Vietnam veterans (pp.31­55). Washington, D.C.: American
Psychiatric Press.

Lifton, R. J. (1973). Home from the war. New York: Basic Books

Lifton, R. J. (1978). Advocacy and corruption in the healing profession. In C. R. Figley (Ed.), Stress disorders among Vietnam veterans: Theory, research and treatment. Brunner/Mazel.

Mahedy, W. (1986). Out of the night: The spiritual journey of Vietnam vets. New York: Ballantine.

Meshad, S. (1997). Personal interview with the author, Oct. 28, 1997.

Scott, W. (1993). The politic of readjustment: Vietnam veterans since the war. Hawthorne, NY: Aldine de Gruyter.

Shatan, C. (1974). Through the membrane of reality: "Impacted grief" and perceptual dissonance in Vietnam combat veterans. Psychiatric Opinion 11(6), 6­15.

Shatan, C. (1985). Johnny, we don't want to know you: From DEROS and death camps to the diagnostic battlefield. Presented at the founding meeting of the Society for Traumatic Stress Studies, Atlanta, Georgia, Sept. 23.

Shatan, C. (1987). Johnny, we hardly know you: The grief of soldiers and the Vietnam veterans' self-help movement. Presented at the Third Annual Meeting of the Society for Traumatic Stress Studies, Baltimore, MD., Oct. 23.

Shatan, C. (1998). Personal interview with author, February 24, 1998.

Wilson, J. P. (1988). Understanding the Vietnam veteran. In F. Ochberg (Ed.), Post-traumatic therapy and victims of violence (pp. 227­253). New York: Brunner/Mazel.