Even years later, the veteran often feels confused and left out.

What Does PTSD Do to Different People?

By Mary Tendall

Everything about PTSD is confusing, and in every case, the effects of PTSD are different. With some illnesses and conditions, doctors and other practitioners can see a patient, and can make a fairly good prediction on the course of that person’s illness. That’s not the case with PTSD. If you have PTSD, how do you think you fit in?

This is for the veterans who look at the often confusing (and confused) diagnosis of PTSD with disdain, feelings of avoidance and betrayal, and a long list of other sometimes unprintable descriptive adjectives. It’s a fact that everyone who was part of a war – the veterans, the families of the veterans, and their communities – all are affected by that war – and the traumatic effects of that war often remain long after the war. More simply put, there is disorder following trauma. I hope this article will help you decide for yourselves where you fit in.

Phase One: Community indoctrination

In the past, and in a few rare current-day communities, a warrior was born into a community where elders trained their future soldiers from an early age to protect the tribe or community. It often involved long preparation over many years, and included initiation and ceremony, along with the support of the community. The causes of the conflicts fought were clear, and the goals were understood by the warriors and the community. They were unified in their shared perspective regarding what their mission was. They were prepared mentally, physically, and spiritually. That entire first phase of the warrior’s journey has been all but eliminated in our modern times.

Carlos,* a Vietnam veteran, said he had no idea where the military was going to send him, and he felt separated from his past life. While waiting to find out where he was going, he felt nervous, and wondered just what his assignment would be. His family was also confused, and waited with many of the same feelings. When he was assigned to Vietnam, he knew it would be bad, but he says, “I looked forward to getting into something that I thought was important and meaningful. Some of my unit felt quite unlike me. No one seemed to be on the same page.” Many years later while he was seeing me, the unexpected trauma that surfaced was due to the POW training he had undergone. Because the training works on the subcortical level (lower levels of brain function), that part of his brain didn’t know the difference between the training and the real thing. His nightmares were from his pre-deployment experience.

Phase Two: Combat

In the distant past there was an intense motivation to protect the community and/or conquer land. Leaders making major decisions led their soldiers through the battles, and were participants in the conflict – in contrast to the modern wars whose leaders are often absent from combat. Soldiers from ancient times and modern-day soldiers have often written about the same kinds of trauma. What was experienced, lost, and seen was horrific, and symptoms of PTSD are written in many ancient texts, including the Bible.

Dave* said that he was never clear exactly why he was fighting, so his only goal became keeping himself and his fellow soldiers safe at all costs. (I have heard that same statement from hundreds of veterans.) He emphasized that there had been no preparation for what he saw and did in combat conditions. He remembered one of his men breaking down in the midst of an operation, and Dave feared that the same thing could happen to him if he didn’t really shut down his emotions in order to concentrate on the mission and the well being of his fellow soldiers. He also experienced racial strife within his unit, and was never able to relax during his down time. “Sometimes the conflict between the men in my unit was worse for me to witness than when I went after gooks, and I felt safer when we were on a mission.” Dave said he was unprepared to do what he had to do along with some of the things that he chose to do. “I still hold memories that make me think of how unprepared I was to face what I experienced, and I can re-experience many incidents in living color.”

Phase Three: Return from war

The next phase of a traditional warrior’s journey was to return to the community, and be received as someone who needed and deserved tending. Communities usually received their soldiers with the understanding that they were wounded physically, emotionally, and spiritually. That was looked at as a normal response to their combat experiences. They often experienced cleansing ceremonies that contained symbolic healing based on cultural beliefs, and the communities shared in the grieving for the losses of those soldiers who never returned or who were severely wounded.

It’s an understatement to say that Vietnam veterans came home to what many said was “as bad or worse than anything I experienced over there.” The betrayal all around was shocking. Instead of being a hero, many had to hide their uniforms, let their hair get long, and never talk about where they had been. The national betrayal at the time tore apart the very soul of many soldiers, leaving them with anger, undeserved shame, and numbness. Especially anger.

Donny* thought he would be welcomed back by his family, but found that certain family members blamed him and all soldiers for the decisions of the government. His sister blamed him for even being a soldier. “I was unable to face anything with the family, so I isolated and drank myself into numbness, but I couldn’t really get numb. I kept that up for seven years.” He reported that he has only recently made amends with his siblings. What a difference for Vietnam veterans returning home compared to soldiers of the past.

Toby,* a Native American, is proud to report that he returned to a tribe that had recently revived some of the ancient traditions offered to their returning soldiers. Toby says he resisted everything offered to him at first, but with a whole community showing up for him, he finally surrendered to a special ceremony. “It took a while for my resistance to wear down, but they didn’t give up on me. They all believed in me, and they were my tribe.” But Toby’s experience was an exception. Most veterans struggled at many levels to maintain their identity and just to survive. We all know the symptoms, and it makes a lot of sense that without the other supporting factors, many would end up with a clinical diagnosis, ineffective mental-health treatment, and prescriptive medications to try to quell the impact of what happened when they returned home.

John* was a veteran who proclaimed that he did not have PTSD. But eventually, he sought help as a condition to save his marriage. He worried that if he sought help, he would go on record as being “crazy.” Since he was a respected member of his community, he didn’t want his “other identity outed on paper.” John sought private counseling and therapy, and was able to recognize his unhealthy behaviors, and began to realize that they were indeed a product of a combat-ready nervous system that hadn’t changed much since he returned from the war. “I thought I could fake it in public, but within the family, that’s another matter.” His treatment included neuro-somatic treatment as well as the ability to use self-regulation tools to control his triggered reactivity. His wife says that now it’s like seeing the guy she first met. (John continues to say that he has never had PTSD.)

Janey* went to Vietnam as a nurse. Because she had never been in combat, she thought it wasn’t right for her to think of herself as having problems based on her Vietnam experience – even though she had seen soldiers with missing limbs, torn up by shrapnel, and much worse. “I was often the last person many of those guys saw before they died.” She says she felt safe most of the time in Vietnam, and it wasn’t until she returned home that she felt “my life was a disaster.” She thought she couldn’t ask for help because she didn’t really qualify as having suffered from combat. Her hyper-vigilance caused her to end many relationships, and she has remained single. Since she has just recently begun to get help I can’t report any further on her progress, but I’m pleased that she is now seeking to validate her experience and find help.

Phase Four: Elder wisdom and tending

Following years of healing and added wisdom, the ancient ways of the soldier entered into the final phase that then identified him as a true warrior. As a veteran healed within his community, and as an elder, he was ready to access the power and wisdom to pass on to new soldiers. While embodying the heart and compassion needed for their healing, he was able to complete the phase that declared him a true warrior.

Many veterans have found peace in helping other veterans. Through their support groups, they have created bonds, and have been able to share their stories with each other. Some have created their own groups within churches or on their own, and have shown up for those in need.

On the other hand, Jack* wanted a diagnosis so he could get a higher percentage of VA benefits. He appeared anxious when I first met him as he rattled off all of his PTSD symptoms very much as they appeared in the diagnostic manual. It took over a month for Jack to get real. He reported that he had been a door gunner – after reading his DD214 I learned that he had been presented with a Silver Star – and he finally began relating the parts of his life that he rarely talked about. Jack had become addicted to drugs during his time in Vietnam, and he was continuing to self-medicate with other substances. After three divorces and several jobs, he just wanted enough benefits to move to Mexico and not be bothered anymore. “Just get me to a warm place that’s cheap and I can pick up my check every month, and I’ll be happy.”

I’m pleased to report that after eight months of treatment, and with the support of a Narcotics Anonymous group, Jack is sober and has found sanctuary within his group and his church. Several years ago he began doing volunteer work that turned into a part-time job, and says that he is enjoying life like never before. And no, he didn’t go to Mexico. I smile when I remember him saying, “I was scamming you at the beginning, and I didn’t believe I needed help.” He now uses his PTSD diagnosis to understand himself and to help others. Jack’s spiritual community has provided significant support in his healing. It was within that special group of veterans that Jack was finally able to tell his story with the witnessing he needed. Initially, Jack had no idea that he really did have PTSD, but he is now happy in the role of helping others to heal based on what he has learned about himself.

Since there are now many gaps in the true warrior experience compared to ancient traditions, it stands to reason that we don’t have adequate replacements for those gaps. And until our military and civilian cultures can look at all phases of the true warrior experience, and find a way to lead our soldiers through the meaningful phases, we will continue to have a system that doesn’t really provide the necessary help for veterans or the entire community.

So, what do you think and how do you feel after hearing these brief stories? Did this wide variety of veterans all suffer? Did the combat experience impact their homecoming? (Correct answer is yes, by the way.)

We can call it a name like PTSD, but consider the complexity of what happens when a soldier goes to war and then comes home. The term PTSD doesn’t even begin to cover the complexity of returning from a war-time experience.


You are invited to contact Mary Tendall with comments and/or questions regarding PTSD. Her e-mail address is maryten@jps.net.

*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 twenty 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 maryten@jps.net.