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Original Essays

PTSD: A Normal Response to an Abnormal Experience

by Norman Bussel
 
  1. My Private War: Liberated Body, Captive Mind: A World War II POW
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    "It is hard to think of a better recent book on the POW experience from the inside, and it is also a notable addition to the PTSD literature for lay readers and helping professionals." Booklist

    "This is a strong narrative of a man who has been through much and has come through it not stronger but with greater self-knowledge. Simply and directly written; a fine candidate for any military collection." Library Journal

    "An honest account of matters once considered embarrassing — and much more common than civilians might realize, as a new generation of veterans is discovering." Kirkus Reviews


First, let me slap down the stigma that so many combat veterans apply to post-traumatic stress disorder (PTSD). The symptoms are not abnormal. PTSD is a normal reaction to an abnormally stressful situation. Although the term PTSD has been in use only 25 years, the effects are no different now than they were in my father's day, during World War I, when the term was "shell shock." Until I returned from World War II, I didn't connect my father's fits of anger to his combat experience, including being gassed by the Germans in the Argonne Forest.

The stressors that cause PTSD are generally the same for most combat veterans. The severity depends on the individual's experience. One of the most common symptoms is an exaggerated startle response, when an unexpected noise, low enough in decibel level that most people wouldn't even turn their heads, can cause someone who has been exposed to explosions in combat to come unglued.

Here is an example of my instant reaction to loud noise. It must have been an M-80 firecracker, because it exploded with the blast of a mortar. The sound reverberated up the stairwell of my fourth-floor walk-up with such force that I thought my door would fly off its hinges.

Instantly, I was a POW again, back in Germany during World War II, with my own United States 8th Air Force planes dropping bombs on the unmarked "40 and 8" boxcars we were locked into. We were in a marshalling yard near Berlin, and our guards ran for the air raid shelter, leaving eight boxcars of American POWs as targets for the bombs that rained down on us.

Then that mental image shattered, and I realized that I was in my own kitchen, and someone had tossed a firecracker into the foyer of my apartment building. In a flash, I lost it as my rage took over and I wanted only to destroy the culprit. Grabbing a carving knife, I flew down the stairs, left hand on the banister helping me to jump four steps at a time. Fortunately for the "celebrator," and for me, the foyer was empty. It was the fourth of July, 1970, and I was living on East 66th Street in Manhattan.

Although 25 years had passed since General George Patton's troops liberated my POW camp, the PTSD, part of the emotional baggage that I brought home from Germany, was still tenacious enough to trigger a violent reaction toward anyone setting off an explosion.

Today, 63 years after my liberation, would my reaction to such an incident still be as violent? I really don't know. I want to believe that I am now more controlled, but given the same circumstances, I can't be certain that my response would be any different.

Flying combat missions in a B-17; bailing out of my flaming plane over Berlin; being captured and beaten by German civilians and becoming a POW; I began a life of controlled rage. I raged at my enemy for his inhumanity. I raged that I was so helpless; that I was starving; that I was cold; that my wounds and illnesses went untreated; that I was constantly scratching at sores and lice. And sometimes... I even raged at God for allowing me to be captured in the first place. Sadly, after I was liberated, I wasn't able to leave my rage behind. I brought it home with me, along with other emotional baggage that I still struggle with today.

I stopped drinking almost 30 years ago, which was a helpful step in my improvement. At least when I lose my temper now, I'm not an angry drunk. For decades, the bottle had been my balm. Today, I take psychotropic medications sparingly because I fear I may become dependent. But the internal pressure cooker that contains my rage and allows me to let off steam in small, barely noticeable puffs is still not reliable when a situation pushes the gauge to: CAUTION! Then my reaction can be predictable only to the extent that it might be extreme and will be unreasoned.

I'm annoyed whenever I read a claim that PTSD can be cured. PTSD cannot be cured. It can be improved, often vastly. But we have yet to discover a treatment we can term a "cure." As a volunteer National Service Officer, accredited by the Department of Veterans Affairs to file compensation claims for veterans, I have never met a combat veteran who was totally without PTSD symptoms. It's simply a matter of degree. Some have all. All have some.

Most of the combat veterans who come to my office deny that they have PTSD symptoms. They don't want to disclose that they have problems because of the perceived stigma they feel such an admission would imply. This is the moment when I must bare my own bloodless "wounds" to convince them that I carry the same invisible scars. The procedure is painful for both of us. It is difficult to ask them to relive those harsh times, but it's the only way to prove service connection for their disabilities. Often, they end up reaching for the box of tissues I keep on my desk. Their candor tells me that I have their trust and I know that we can file a strong claim.

Perhaps the most unrelenting stressor is "survivor guilt." It is rare for a veteran to come through a combat tour without losing a buddy. I lost four crewmates when my B-17 bomber exploded over Berlin in April 1944. Since then, I have tortured myself with unanswerable questions: Why them and not me? Why was I spared?

When I returned home, I was already riddled with guilt over my survival. Then, just days before I planned to travel to my pilot's wedding in Atlanta, a letter arrived from the sister of my navigator, who was killed on the Berlin mission, asking how six of us could escape our burning plane and leave four others to perish. To me, the inference was that I had bailed out and left my wounded buddies behind. In truth, the only member of my crew I saw between takeoff and the moment my plane exploded in midair was my ball turret gunner, who came into the radio room for about five minutes while we were flying over the English Channel. I was devastated by her remarks, and I crawled into a bottle for two weeks. To my everlasting regret, I never made it to my pilot's wedding.

One of the greatest challenges in winning the battle against PTSD is convincing combat veterans to seek early counseling. With each passing day, the demons that haunt these veterans' minds gain more control.

If each of you who displays a "Support Our Troops" sticker on your car would persuade just one combat veteran to come to a VA Medical Center for an interview, you would be supporting our troops in the most effective way I know. They performed their duties well. Now, let's try together to make them well.

÷ ÷ ÷

Norman Bussel was a technical sergeant in the USAF. On April 29, 1944, he was shot down over Berlin and held prisoner at Stalag Luft. A year later, he was liberated by General Patton's tank corps, but would spend the next several decades battling the crippling effects of post-traumatic stress disorder (PTSD). He has testified before the House Committee on Veteran Affairs and is a leader in spreading awareness and promoting research on PTSD. Bussel lives in upstate New York. spacer
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