Making Sense of PTSD

Post-Traumatic Stress Disorder (PTSD) has done more damage than most people (even veterans) realize. Thousands of Vietnam veterans have suffered for 40 years and more, without much help. Fighting PTSD in constructive ways isn’t easy, but it can be done.

By Mary Tendall and Jan Fishler

Making sense of PTSD.In 1968, three men were given orders for Vietnam. Nels* was born in the Midwest, grew up on a farm, and in high school participated in the church youth group and 4-H. After high school graduation, Nels went to work full-time on his dad’s farm. A year later he married his high school sweetheart and was drafted into the Army.

Joe grew up on the East Coast and “had it made.” He was the star quarterback on the varsity football team in high school, then attended an Ivy League college where he joined ROTC and graduated with honors. Following his military obligation and graduate school, Joe planned to become a college professor of English literature.

Louie was from a poor southern family, and spent much of his youth in trouble, even though he was easygoing, well-liked, and determined to turn things around. He hoped to escape from poverty and learn a trade, and his dream was to serve his country as his fathers and uncles had done, and to make the military his career. Anxious to remove himself from negative influences, Louie enlisted in the Army before finishing high school.

In Vietnam, Nels trained as a medic, Joe became a lieutenant in charge of a platoon, and Louie became an infantryman. Although these three young men never met one another, they shared similar experiences – they witnessed death, experienced near death, and didn’t think they would survive to be 30 years old. Even though they were not inclined to speak about Vietnam, they would all be able to describe horrendous and unbelievable aspects of the human experience.

Do you have PTSD? Check out these indicators.

The war ended, but for many, the trouble was just getting started

Nels is still haunted by the pleading eyes of severely injured soldiers. He says he had to play God and attend only to those who could be saved, yet many young men looked into his eyes as they took their last breath. He always wonders if he could have saved those who were left behind.

He relives the ambush daily and nightly, often wishing he hadn’t survived.

In spite of Joe’s excellent leadership skills, his platoon was ambushed and there was no possibility of air support. In addition to Joe, only two men from his platoon survived. According to Joe, there isn’t a day that goes by that he doesn’t think of “his” men and how he might have saved them. He relives the ambush daily and nightly, often wishing he hadn’t survived.

Trying to escape the triggers

Louie rarely speaks about the numerous firefights he endured, but he will never forget the sound just before a mortar exploded, the fear he felt not knowing where the mortar would land, or the smell of burning flesh following a hit. He says that the dead bodies he saw – especially the women and children – along with the stench – made him feel “as low as it gets.” Loud noises, children crying, smoke, the sight of anyone of Asian descent, or dark rainy nights are daily reminders of his past. Isolation has been his only escape.

While thoughts of his wife and parents gave him hope in Vietnam, Nels dreaded the reunion. By the time his parents and his wife, Cathy, greeted him, numbness had spread throughout his body and mind. His only thought was to get away, yet he knew that was not an option. So he drank, using the only escape possible. Nights were the worst, especially after scaring Cathy if she startled him. He decided to stay awake while she slept, making frequent checks of the farmhouse perimeter. By day he catnapped and dulled his memories with alcohol. Within a year, Nels was divorced. He moved to Oregon, where his cousin lived, and was able to make ends meet by taking odd jobs.

Plans for education, marriages, and futures destroyed

Joe landed in the U.S. only to be greeted by a group of protesters, projecting their views on the soldiers returning home. Even though he saw his father and brother waiting several yards away, he got into a fight with a heckler, was arrested, and spent his first night in jail. That led to a cool reception from his family. Joe requested time alone and his family allowed him to isolate “until he gets over it.” Joe never went to graduate school or became a teacher as he had planned. Instead, he became a caretaker for a rancher several hundred miles away from his home. Louie was greeted warmly by his family and was working as a carpenter within a month of his return. Although his use of alcohol and “whatever else I could get my hands on” increased, family and friends did not confront him. Louie was married within the year, and a year later he was a new father. The marriage lasted three years, and the substance abuse continued.

The country, which historically had greeted its soldiers as heroes, was now not only turning its back, but was betraying and demeaning the lives lost and the sacrifices made by those who survived.

Although their lives took different paths, these men could all say the same thing about their homecomings. After the initial sense of joy when the plane first left Vietnam, a dull silence ensued for the duration of the flight. Landing in the U.S. was a shock. The country, which historically had greeted its soldiers as heroes, was now not only turning its back, but was betraying and demeaning the lives lost and the sacrifices made by those who survived. Alcohol and drug use were rampant in the country, and these veterans shared a complete sense of not belonging. What a dilemma.

Escape became a way of life

Escape became a necessity, yet it was never complete. Whenever sleep took over, there were nightmares and night sweats, causing an adrenaline rush, headaches, and nausea. Vigilance was a way of life, and family expectations were painful. Crowds and social engagements were avoided with a variety of excuses and reactions, and fights or arguments were plentiful. Weapons were on hand or nearby at all times, and there was an overwhelming need to isolate. Due to lack of concentration, confinement, and authority issues, employment was a challenge. Emotionally intimate relationships were out of the question. Any shortcut for a temporary escape was embraced, including alcohol, drugs, sex, and compulsive physical work. For some, escape meant going deep into the mountains or the woods, or taking a long ride on a motorcycle. More than 30 years later they would say, “I had no idea all of that was a normal response to combat. I just thought I was an asshole!”

While Vietnam was not a subject of conversation, it continued in living color during sporadic sleep, and with ruminating thoughts during the day. Sounds, smells, faces, and even the weather could trigger an immediate reaction in the nervous system. The sound of a helicopter required immediate sighting, and an unexpected loud noise often resulted in hitting the floor. Now, more than three decades later, most of these symptoms, if untreated, still exist. They are locked in a kind of time warp deep in the limbic system, ready to trigger any time they are provoked. Families and loved ones, unaware that an experience so long ago could still be so pervasive, struggle to make sense of emotional outbursts, leaving these men filled with anger, guilt, and shame.

More than 30 years later they would say, “I had no idea all of that was a normal response to combat. I just thought I was an asshole!”

The good news is that many of the combat veterans have received help and are healing. Through psychotherapy, and for some the aid of medication, the debilitating symptoms have decreased, allowing for increased sleep and a feeling of well-being. It’s never too late to treat PTSD. Even World War II veterans are successfully experiencing the benefits of current treatment.


Do You Have PTSD?
If you suffer from some of the problems listed here, you could be suffering from PTSD and not even know it.

  • Desire to isolate.
  • Depression.
  • Self-medication (alcoholism, drug abuse).
  • Anger.
  • Irritability.
  • Difficulty concentrating.
  • Numbness.
  • Problems with authority, intimacy, and trust.
  • Hyper-vigilance.
  • Nightmares.
  • Flashbacks.
  • Ruminating about combat.
  • Avoidance of crowds, gatherings, and confined spaces.
  • Emotional distress upon exposure to situations that resemble the trauma.
  • Reenactment of the traumatic event.


*Names and some situations in this article have been changed. Some photos may include models who have no real-life relationship to the story or any PTSD issues.


Mary TendallMary Tendall, MA LMFT, has worked for over 20 years with combat veterans and their families, as a licensed psychotherapist, specializing in combat-related PTSD. She has consulted for the Gulf War Resource Center, National Public Radio, and Newsweek. She continues to work with combat veterans and their families, and is affiliated with several national non-profits whose goal is to help veterans, such as VietNow, Soldier’s Heart, Train Down, and America’s Heroes First. She can be reached by e-mail at


Jan FishlerJan Fishler is an author, writing coach, and creator/presenter of a series of writing workshops. Her memoir, Searching for Jane, Finding Myself, is available on Amazon. You can learn more about her at She is married to a Vietnam veteran.