There is a very high incidence of suicide in Vietnam veterans. Suicidal thinking has increased, as every week I hear from Vietnam veterans who feel suicidal, but are keeping their feelings to themselves.
By Mary Tendall
I was halfway through with my article when I received an e-mail from the wife of a Vietnam veteran. She had read one of the PTSD articles in VietNow, and after corresponding with me by e-mail, she pleaded with me to be a voice for her and her husband and family. Sheryl’s* husband, John, had shot and killed himself.
Although John was seeking medical help from the VA, he was not one to share his past with strangers.
She had noticed the escalated drinking, and that became the focus of her concern. After John died, Sheryl decided she would try to understand the intensity of what John had been holding inside for over 40 years. John did seek help from the VA, however the history of his time in Vietnam never surfaced between John and his care providers. He was treated for depression, and prescribed an antidepressant.
Although John was seeking medical help from the VA, he was not one to share his past with strangers. And the VA did not ask if he had been in combat, in spite of his Vietnam-era age. There was also no assessment of his alcohol use, which had escalated. (It should be noted that this would not have been omitted in many VA facilities, but it happens in many, and both veterans and spouses have to be aware of the information that is essential to share when seeking treatment for depression or any other ailments.)
As a wife, Sheryl sees the urgency of what many families and veterans are now experiencing. She received understanding through reading relevant books, such as the study done by John P. Wilson that appears in the book, Strangers at Home: Vietnam Veterans since the War, compiled by Figley and Leventman in 1980.
The traumatic impact of Vietnam will not go away without specialized treatment, which will help to reprogram the central nervous system, and effective emotional support such as a veterans group and/or spiritual group. PTSD treatment is best administered by someone who knows and understands the heart and soul of the war veteran. It’s not necessary that the health-care provider has experienced combat any more than it would be necessary that a physician has experienced the maladies he treats. But what is essential is that the treatment provider and the veteran have a trusting relationship.
I hear frequently from Vietnam veterans who are being flooded with war-time memories now that they are retired. It can be terrifying to have a nightmare show up after 40 years, or to relive the emotional roller coaster that was once a way of life soon after combat. In John’s case, he had a wonderful relationship with his wife and grown kids. He had even remarked in the past that he didn’t see how anyone could commit suicide because of what it would do to the family. He was known for his sense of humor and his intelligence. He had his daughter’s wedding coming up in the next year, and looked forward to walking her down the aisle.
It’s not necessary that the health-care provider has experienced combat any more than it would be necessary that a physician has experienced the maladies he treats.
I believe that John didn’t really want to die, but he must have believed that he was unable to cope with the flooding feelings and memories that were beginning to take over. He needed it all to stop.
What could have been done for John? Sheryl is now haunted by that question, and many others, as she and other family members of suicide try to replay what they could have done. Sheryl is convinced that if she had known just what John was dealing with, she would have been able to steer him to the right kind of help, and that he would be alive today. That may be true, but it is also very possible that at this stage in John’s life there was nothing she could have done. She will never know.
A wake-up call
So to honor Sheryl’s request, I offer this wake-up call to all Vietnam veterans and their families. Depression, isolation, and escalated use of alcohol can be a deadly combination. And combined with certain medications, there is a strong probability of tragic results for the veteran and family members.
Be sure to give all information when applying for and receiving physical and mental health care. Family members can accompany their loved ones to a physical, and offer information that might otherwise be omitted, in spite of objections from the veteran. Spouses are excellent reporters.
There’s a reason for the escalation of combat-related symptoms right now, so let’s look at why so many veterans are experiencing more intense memories of the war-time experience at this time of their lives.
Upon entering the military, soldiers start basic training with the underlying premise that the world is basically a safe place, most people are good, and that they are fundamentally good people. That is a foundation of their identities and the world around them.
Then comes the time when they leave the military and re-enter the world they once knew in a different way.
Then comes the military training, and they are asked to leave their old way of life, and their old identity behind. In war time, they are thrust into a reality that destroys the old premise – and later they realize that the world is not safe, many people are not good, and they have done things or been a part of things that go against their past ideas of being good people.
And patriotic attitudes cannot change that. Then comes the time when they leave the military and re-enter the world they once knew in a different way.
Assuming the identity of the ‘new box’
Jason, a veteran of the Iraqi War, describes it this way: “When I went into the Marine Corps, I was told to put my life as I knew it into a box and close the lid. From that time on, I opened a new box that defined my life as a soldier – and near the end of my tour, I was wounded.
As I stepped off the plane that brought me home, I felt like I didn’t belong.
“I didn’t want to return home, in spite of loving my wife and stepson, and in spite of missing them a lot. As I stepped off the plane that brought me home, I felt like I didn’t belong. My identity had changed dramatically since I’d been in combat, and except for my wife, everyone was like a stranger. I had assumed the identity of the ‘new box’ that was ingrained in my entire personality. But that didn’t really work back home – since I wasn’t in combat – and the old one didn’t work either.”
The dual identity upon homecoming, between trying to assume an old way of life (impossible), and reacting as if in combat, just didn’t work. Remember your feelings upon returning home after the war, and seeing lazy, irresponsible people whining about insignificant things? Remember thinking that you had no problem? Everyone else was the problem. Remember your reaction if someone didn’t follow through with an agreement or showed careless behavior? Is that still the case? (Ask your sweetheart.)
Although Vietnam was not a place most of you wanted to be, you didn’t fit in at home either. And the military didn’t give you another box after you left the military that would define your “life after combat.” It was up to you to figure it out.
Chuck Dean in his book, Nam Vet, says, “While in Nam, the ‘world’ became a revered and almost mythical place that filled our dreams. We counted the days, hours, minutes, and seconds until we climbed into our ‘freedom bird’ to return to that world, where all was safe, all was clean, all was happy. We knew that our war would end as soon as we got home.”
Although Vietnam was not a place most of you wanted to be, you didn’t fit in at home either.
Forty years later, is it too late?
Now it’s more than 40 years later for most of you, and you have coped with a great number of challenges and survived. And how many of your brothers do you know who are still with us? And how many losses have there been in terms of divorce, missed opportunities, and regrets? That is what plagues so many veterans as they reach their later years, and spend more time in reflection – wondering if it is too late to make a change – or deciding that it’s already too late.
Recently I phoned Cliff, a Vietnam veteran, to report the death of one of his combat brothers he had met at a support group many years ago. During our conversation Cliff and I shared many fond memories of a wonderful man who had found peace within himself two years before he died. We were happy about that, and then Cliff shared with me a synopsis of his own past 40 years.
He spoke of his many past mistakes, his determination in treatment, his willingness to get to an in-patient three-month program, and his many years in group and individual treatment. He later participated in many volunteer military activities, was a member of a color guard, and was on call to help other veterans as they struggled through the VA-claims process.
He recently found a VA Vietnam veterans group, and said that finally, after the preparation from all of his many years of searching for his sense of well being, he was able to open up to the fact that he needed to forgive himself and others.
His group facilitator was a woman who understood Vietnam veterans, and soon a trust developed between the veterans and the facilitator. After several sessions she asked each of them to write letters of forgiveness to those who needed it. Cliff said that he first had to forgive himself, and that was the hardest. He struggled with those letters a great deal, but when he read them in front of the group he felt a great relief.
Everyone read their letters out loud, and then ritually burned them. Cliff says that he held on to the belief that, “It never goes away,” and it is that fear that ultimately causes some to just want to end it all. He says that he has felt that way many times.
Family members and friends can make the difference
I’m happy to report that Cliff says his life is now better than he can ever remember. He has worked hard to get where he is, but whenever I see Cliff at some local event, I notice a new light in his eyes and a calmness that I hadn’t observed before. He has persevered with the help of family, therapy, and support groups – and has finally found a place within himself that feels good.
It’s too much work trying to maintain a normal life with all the old memories surfacing. So it’s important for family members to be mindful that as he ages, your veteran and loved one is increasingly more vulnerable to an increase in symptoms if there is no strong, knowledgeable support system.
As senior members of society many Vietnam veterans are now too tired to confront others as they used to.
If you are a war veteran, you can help other veterans by listening and understanding a combat brother who may be really hurting during this phase of life.
As senior members of society many Vietnam veterans are now too tired to confront others as they used to, too exhausted to take on the many projects they once had, and too resigned to just getting through the day.
One of them calls it “default mode.” And how do you move through that mode into a more meaningful existence? And how is the identity defined now in this stage of life? Many Vietnam veterans have simply resigned themselves to the “default mode,” only to repeat the same thing again and again.
This is an important time for veterans, family members, and friends to reach out to other Vietnam veterans who might be overlooked due to their increased isolation. A phone call, a short visit, or an invitation to an event of interest is a way to honor and value that person.
Many veterans are living alone, and with the public attention on those returning from the Middle East, many Vietnam veterans feel all the more isolated and lost. Their lives consist mainly of taking prescribed (or unprescribed) medications and watching television. Although we may not be able to change the course of someone’s life, we can improve the quality of it while they are with us. And that is always a good thing.
*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 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 firstname.lastname@example.org.