Patriotism as Pathology: Anti-Veteran Activism and the VA

By Dr. Phoebe S. Spinrad

Dr. Phoebe S. Spinrad, Capt., USAF (Ret), is associate professor of English at Ohio State University.

Is patriotism a mental disorder? According to the Department of Veterans Affairs, yes, it is—at least in Vietnam veterans. For more than 25 years, VA counseling services, in conjunction with the broader body of mental health professionals, have built their in- and outpatient treatment of Vietnam era veterans—and post-Vietnam veterans as well—on a model developed by antiwar activists of the 1960s and 1970s, a model that assumes the following:

*the proud veteran is a person in need of mental rehabilitation;
*families and friends who share a veteran's pride are codependents in the illness and must also be rehabilitated;
*the military in which the veteran served is a dehumanizing producer of atrocities;
*the war in which the Vietnam veteran fought is a disease still infecting the body politic.

To be sure, the segment of the Vietnam veteran population actually treated for this mental disorder at VA facilities is small; VA figures themselves place the proportion of Vietnam-era veterans (VEVs) suffering from posttraumatic stress disorder (PTSD) at 15% of the total VEV population, although some VA psychologists speculate that the actual percentage, allowing for those who don't report symptoms, may be as high as 36%. However, the treatment reaches far beyond the affected veteran population; it has spread out into the general public's perception of the Vietnam veteran and of the Vietnam conflict itself. And small wonder; the professionals who developed the definitions and treatment of PTSD were self-confessed antiwar advocates who used their professional status and their patients as tools to disseminate their political agendas to the general public.

The Myth of the Shattered Hulk

Before examining the treatment of Vietnam veterans in VA facilities, we may do well to ask whether Vietnam veterans do in fact need more help than other veterans, or, for that matter, than the general civilian population. As noted above, VA sources themselves posit the affected group at 15-36%, depending on variables such as degree of combat, time and duration of service, and, indeed, degree of speculation on the part of the statistics compilers. Complicating the statistical analysis is the fact that PTSD itself was not defined until 1980, and was then defined differently from the stress disorders defined for veterans of previous wars.

Furthermore, stress disorders themselves were not recognized officially between 1968, when they were removed from the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), and 1980. However, one conclusion we may reach is that the official 15% figure is surprisingly low for a veteran population viewed stereotypically as a group of people shattered by their war experiences. Fully 85% were not shattered.

Comparisons of emotional problems among VEVs, other veterans, and non-veterans yield similarly surprising results, in view of the stereotype. In a 1982 study done by Josefina J. Card, VEVs showed few significant differences from other groups (see Table 1);² in fact, in the area of enjoying free time and recreation, they reported slightly lower rates of problems than the non-veteran group. As for indicator symptoms of PTSD, according to Card, although 19% of Vietnam veterans tested positively on a majority of the indicators, so did 12% of non-veterans.³ The figures, then, may be somewhat misleading.

Despite the statistically insignificant differences, however, VEVs and non-veterans alike, according to a Louis J. Harris survey prepared for the VA in 1980, see Vietnam veterans as having more serious problems than other veterans, and of course far more serious problems than non-veterans (see Table 2).⁴

Table 1. Selected Indexes of Social Health, 1981, as compiled by J. Card, with statistical rates of significant difference across the three sample groups.

Of particular interest in Table 2 is the breakout of the general public into "educators" and "antiwar activists." These are primarily the people who influenced the VA in shaping treatment of Vietnam veterans, and who continue shaping that treatment, both inside and outside the official agencies, today.

Table 2. Perceptions of Veterans' Problems, extracted from Harris study for the VA, 1980.

In 1968, the American Psychiatric Association (APA) issued a new version of its Diagnostic and Statistical Manual, DSM-II. Unlike the previous version, this one made no mention of stress disorders or any other specifically combat-related symptomology, instead grouping the symptoms under such headings as "inability to adjust to adult life." The year was significant: 1968, the Tet Offensive, the shift in media reporting of the war, and the explosion of campus antiwar activities. Antiwar activism was making itself heard within the APA as well, with prominent members chairing antiwar sessions at its conferences and delivering the first of many papers on the role of the therapist as antiwar advocate.⁵

The APA and the War

By 1970, the year homosexual activists stormed the annual APA meeting and demanded (successfully) that the description of homosexuality as a disorder be removed from the DSM, the Board of Trustees was already formulating its official antiwar resolution, which was published the next year:

The Board of Trustees of the APA wishes to add its voice to that of the great masses of the American people who have so firmly expressed their agony concerning the war in Southeast Asia. Also, as psychiatrists we have specialized deep concern about its grave effects on morale and on the rise of alienation, dehumanization, and divisiveness among the American people. Therefore: The Board hereby expresses its conviction that the prompt halt to the hostilities in Southeast Asia and the prompt withdrawal of American forces will render it possible to reorder our national priorities to build a mentally healthier nation.⁶

Of special note in this resolution is the assumption that a mentally healthy nation (and thus each individual within the nation) is by definition opposed to the war, and that the war itself is a pathology, one that alienates, dehumanizes, and divides. It is hardly surprising, then, that Vietnam veterans cannot be described in terms developed for veterans of other wars. "Shell shock," "combat fatigue," "gross stress disorders"—all these earlier terms placed the veteran in the context of physically painful (rather than morally objectionable) activities, and assumed as part of the treatment that the veteran must extract some sense of purpose from the pain. Such definitions and treatments obviously could not be used for participants in a pathology rather than an activity.

With stress disorders no longer a possible diagnosis, veterans showing evidence of emotional problems had to be diagnosed in other ways. Between 62% and 77% of Vietnam veterans reporting stress problems in VA and other facilities were diagnosed as schizophrenics, alcoholics, and borderline personalities. The borderline personalities were turned away as social misfits, the alcoholics were thrown into drunk tanks, and—most reprehensibly of all—the schizophrenics were pumped full of antipsychotic medications such as thorazine, some of them developing lifelong drug dependencies from this treatment.⁷

Since these diagnoses and methods of treatment were also being used in the field, one can only speculate on how much damage was done to troops who were sent back into combat on the medication, which might interact in unknown and as yet untested ways with the troops' routinely prescribed antimalarial drugs.⁸

In addition, mental health professionals both inside and outside VA facilities tended to view their Vietnam veteran patients with what can only be called loathing. Veterans already traumatized by their combat experiences, as well as by their less than warm welcome home, found themselves being called the same names by clinicians as they had heard from antiwar protestors on the streets: murderers, losers, baby killers, and so on.⁹ But help was on the way from the more concerned of the mental health professionals—or so we have been led to believe. Even as veterans were being drugged and reviled in VA facilities, the APA antiwar activists were preparing to fill the vacuum left by their removal of stress disorders from the DSM; they were beginning their work on what was to become the standard method of psychological treatment for veterans throughout the VA.

The Early Experiments: Lifton, Shatan, and Jane Fonda

Among the antiwar psychiatrists attending the 1970 APA convention was perhaps the single most influential person in the development of both PTSD treatment and the Vietnam veteran stereotype: Robert Jay Lifton.

A New York psychiatrist with an interest in psychohistory, Lifton had previously studied victims of the Holocaust and prisoners returning from North Korean POW camps. Now he was active in the antiwar movement, publishing articles about the evils of the war—and of the military—and urging the necessity of political advocacy on other members of the mental health professions.

Although Lifton had not yet begun his experimental work with veterans, he had already decided what he would find: the same "psychic numbing" he had seen in Holocaust survivors, brutalization (Lifton's colleague Chaim Shatan had begun referring to this characteristic as "dehumanization" in his own work), and, of course, guilt.¹⁰ Guilt over what? Over becoming part of what he termed the "filth" of the war." As Lifton testified before a Senate committee chaired by Senator Alan Cranston in 1970, the war itself was an atrocity-producing situation, and all American troops had accordingly committed atrocities. "All killing," according to Lifton, "touches upon atrocity." [123]

Lifton had also begun working closely with Vietnam Veterans Against the War (VVAW), with whom he had testified before the Cranston committee, and in December 1970, he began his now famous series of "rap groups" with selected members of the New York chapter. He chose his sample carefully, as he acknowledges in Home from the War: "Almost all of them belong[ed] to the minority of Vietnam veterans who emerge with an articulate antiwar position . . .. I made no attempt to gather data from a `representative' group of veterans." [19] The articulacy was perhaps as important to him as was the antiwar position, since another of his stated goals was to make the men into public advocates:

Antiwar veterans generate a special kind of force, no less spiritual than political, as they publicly proclaim the endless series of criminal acts they have witnessed or participated in… The groups differed from street corner psychiatry in their second function, important from the beginning, of probing the destructive personal experiences of the Vietnam War for eventual dissemination to the American public.... For a number of them, and at varying intervals, political activities become inseparable from psychological need. [31, 69, 81]

The need was quickly met. In January 1971, Lifton and his VVAW contacts organized what came to be called the "Winter Soldier Investigation," a public media event staged in Detroit, at which 113 veterans—and Lifton—recited lists of atrocities the veterans had committed and claimed that these atrocities were being committed routinely by all American troops in Vietnam. As a way of horrifying the American public and increasing the pressure on the government to withdraw U.S. troops, such testimony could hardly be improved upon; as a way of destroying the good name of millions of American veterans, it has proved successful to this day. We should not be surprised, then, to learn that one of the primary sources of funding for the event was Jane Fonda.¹²

Later that year, Lifton organized yet another event around his VVAW subjects: Dewey Canyon III, the demonstration during which the veterans threw away their medals on the Capitol grounds. And as his subjects became more and more "articulate" through the rap group training sessions, he sent them to speak to veterans' organizations, civic groups, and even psychologists' meetings. For the most articulate, however, even better things were in store: opportunities to run their own counseling centers, instruct mental health professionals in what they had learned, and shape both the next version of the DSM and the new VA counseling system that was to begin in 1979.

The "Rap Groups": Models for the Future?

If Lifton's initial selection of a biased sample for his research was questionable—not to mention his deciding in advance what he would find—his selection of co-researchers and his means of keeping his sample biased were even more questionable. According to his own account again, he and Shatan collected a group of antiwar psychologists and psychiatrists in the New York City area, but if any of them during the course of the project objected to the "radical" politicization of the activities, they were simply invited to leave; or, as Lifton puts it, "those of us who held a more radical view of the groups tended to outlast the others in the general program." [83]

As for the veterans themselves, the same campaign of attrition applied. Those who could not be sufficiently politicized, or admit sufficient "guilt," were bullied until they left the group. Lifton's "findings," then—which, we must keep remembering, are still cited as authoritative on the subject of all Vietnam veterans—could be based solely on those who produced the desired results.

To cite just two cases of this attrition: "One former infantryman, though bitterly opposed to the war and increasingly committed to the rap groups, repeatedly insisted, `I just can't feel any guilt.^— [110] Members of the group bombarded him verbally until he burst into tears and acknowledged feeling guilt. His "crimes" had been killing some North Vietnamese troops, and having sent his men out on patrol, where they subsequently died. Such events are always traumatic experiences in any war, but in themselves they are not atrocities as most people understand the term, nor did the infantryman give any indication that he had sent out the patrol in error or with insufficient equipment or support.

No one has ever denied that killing, watching others being killed, and living in constant fear of death oneself are terrible experiences. Indeed, novelist John Del Vecchio maintains, in his foreword to a major psychological study of veterans with PTSD, that: "killing should hurt the killer—that, thank God, it does indeed cause lasting emotional scars—even if that killing is considered justified." However, Del Vecchio also points out that sometimes the killing is necessary, as horrible as it may be: "In the past several years I have spoken to thousands of veterans. Almost all have expressed a feeling that we . . . were not there to kill but were there to save lives .... If I killed someone in Vietnam, I believe that action saved the lives of other Americans and, more importantly, saved the lives of many South Vietnamese citizens.^"13

Whether or not one agrees with Del Vecchio about the purpose of the Vietnam war, his distinction between the evil of killing and the necessity of killing in a time of crisis is one that has been accepted even in our judicial system, where distinctions are made in cases of homicide, involuntary manslaughter, self-defense, necessary force on the part of police in stopping a crime, and other death-dealing actions. However, to Lifton every act committed in war is an atrocity and must bear the same kind of guilt, the guilt of having committed a criminal act. (By chapter three of Home from the War, the terms "war" and "war crimes" are used interchangeably.) The infantryman in this case, who by normal societal definitions had committed no crime, was congratulated on his new-found criminal guilt, but he never returned to the rap groups. [110-113]

In another case, "about four or five veterans joined in an angry condemnation of a former member" for "still being a first sergeant" and not going along with the program of the rest of the group. "The target of rage was a man from among them who held tenaciously to an identity element they had pointedly rejected, causing them to doubt their own capacity to rid themselves of that element and undergo change." [148-49] This man, too, was driven from their midst. The important point in this case, however, is the ominous note struck by Lifton's phrase, "causing them to doubt their own" new identities. The unrepentant veteran has become a personal danger to the others [emphasis added. SGS], and must be destroyed or driven away. We will look more closely at this problem later, in connection with current counseling methods in the VA.

Vet Centers and the DSM-III: The Major Players

After two years' work with the rap groups, Lifton published his landmark book, Home from the War, in 1973, to overwhelming applause and copious quotation in his own professional circle--and in the academic and media professions as well. The stereotype was now corroborated by a psychiatrist: all Vietnam veterans had committed atrocities, all were crawling with a guilt that caused "psychic numbing," and the only way to "animate" the guilt was to acknowledge their criminality and force others to acknowledge it as well. In fact, only those who had successfully animated their guilt were considered capable of helping others; those like the infantryman and the first sergeant were still hopelessly sick themselves. Again, this assumption was to have a serious impact on the setting up of counseling systems.

By 1975, the year of the fall of Saigon, hundreds of rap groups modeled on Lifton's and Shatan's work had spread across the country. The stereotypes were firmly in place, and so were the networks. It was time to join the lobbying effort for better counseling systems for veterans--and, of course, some guidelines in the DSM on how to diagnose and treat the veterans. Lifton and Shatan were in the forefront of both these lobbying efforts, and they headed the APA working group to write the new DSM-111.¹⁴

Lifton and Shatan had already done some groundwork on the VA project. In 1972, they sponsored the "First National Conference on the Emotional Needs of Vietnam-Era Veterans," held in St. Louis, Missouri. The conference was attended by ten people from the VA central office, who took copious notes and were introduced to the whole network of antiwar therapists from whom they would later draw their ideas for counseling systems.¹⁵ Some participating groups at this conference were:

* Flower of the Dragon - A veterans' counseling program in Sonoma County, California, which became one of the models for Vet Centers. The assumptions used in counseling were Lifton's and Shatan's, e.g., the military as dehumanizing agent, the war as a meaningless producer of atrocities, and "psychic numbing" and paranoia as universal characteristics of Vietnam veterans.¹⁶
* Twice-Born Men - A San Francisco group headed by Jack McCloskey, a VVAW member who later created yet another antiwar group, Swords Into Plowshares (see below).
* Veterans Service Project - A St. Louis-based organization run by members and former members of VVAW.
* Various other antiwar organizations which were using Lifton's assumptions and methods, and, of course, chapters of VVAW.

All these organizations later collaborated in setting up the new Vet Centers in 1979, staffing them with their now experienced "counselors" and advisors. In addition, a number of individuals connected with them became important voices in both the Vet Center movement and the writing of the DSM-III:

* John A. Talbott - An antiwar activist prominent at the 1970 APA convention, he lobbied both against the war and for the efforts of the Gay Liberation Front to remove homosexuality as a disorder from the DSM-11. With Arthur S. Blank, Jr., who is now director of the VA's Readjustment Counseling Services (RCS), he wrote and edited influential works on PTSD in the 1980s.

* Jack McCloskey - As noted above, McCloskey formed a number of rap groups in the early 1970s, and continued to counsel veterans for 23 years." In a 1984 interview with Myra MacPherson, McCloskey referred to all Vietnam veterans as being "haunted," and asked the following rhetorical question: "Now, if you^'re telling a nineteen-year-old kid it^'s okay to waste people and he will be rewarded for it, what do you think that does to his psyche?" Note the assumption that all the killing is "wasting," and that the main harm to the veteran lies in his being appreciated for what he has done.

* Arthur Egendorf, Jr. - An author and influential voice in concerns and treatment of Vietnam veterans, Egendorf said in 1972: "From the time I entered the military, it became increasingly obvious that the heroes of this war were those who fought it in the streets of American cities or in the courts or in the jails or by leaving the country rather than lend their support. . .. Whatever the personal cost, all of them —exiles, deserters, and resisters of every stripe—answered to the call to fight in a senseless war with the most appropriate response—an outright refusal."¹⁹ Here again, only those who opposed the war have something to be proud of; thus, a proud veteran is demoted to the status of coward or loser.
* John Wilson - Another extensive writer and editor on Vietnam veteran issues, he began working with Lifton and Shatan in 1976. Of his research, writing, and work in counseling, he said: "What I'm doing now is consistent with the [antiwar] commitment.^"20
* Charles R. Figley - Perhaps the most influential voice in published material on PTSD during the 1980s, editing a series of essay collections and himself writing many of the essays, Figley participated in Dewey Canyon III with Lifton's group of veterans, and later worked extensively with Lifton and Shatan in developing the DSM-III. In 1979, as the Vet Centers were being set up, Figley acknowledged that PTSD in Vietnam veterans was primarily a political issue among mental health professionals.²¹
* Jack Smith - A participant in Dewey Canyon III and instrumental both in the formation of Vet Centers and the writing of DSM-III, he acknowledged that most of the assumptions feeding into the definition of PTSD were based on Lifton's results in the rap groups. At the 1972 conference, he "launched into a tirade" (his own words) against a VA representative, a World War II veteran who had objected to the proceedings. In his interviews with MacPherson, he claimed that all veterans ^"want the country to say ^`God, it was a mess—but we can acknowledge that and then go on."' He also referred to the war as an "atrocity," and added, about his counseling of veterans as late as 1984, "What we're doing is questioning the fundamental assumption that war is just okay and noble.^{" 22}
* William Mahedy - Another major influence in formulating counseling methods, he said to MacPherson, "the Vietnam veteran participated in the historical experience that broke down the mythology of America's `right and might.'"²³
* Shad Meshad - One of the primary sources of Vet Centers as they exist today, Meshad was called in as a consultant by VA Director Max Cleland in 1977 because of his experience in setting up and running storefront counseling centers. His experimental system was already being used by the Brentwood VA in Los Angeles. Meshad had been a social work officer in Vietnam, and had conducted antiwar activities while he was still working with troops in the field. As he became more and more disgruntled, he finally decided—as he tells it—to "martyr" himself by taunting authorities. He was court-martialled for this taunting, and for refusing to trim his moustache.²⁴

Lifton, Shatan, and the others began work on the definition of PTSD in 1976, and in 1980 their definition was published in the new DSM-III.²⁵ It has since become almost a definition of the Vietnam veteran himself, not only in the mental health professions but in media portrayals of veterans, history textbooks, fiction, and even literary criticism. We will look more closely at some of these genre overlaps shortly.

The new definition coincided perfectly with the formation of the new counseling systems. In 1979, Congress approved and funded what were officially called VA Outreach Centers and became popularly known as Vet Centers, storefront facilities located physically outside VA medical centers (VAMCs) and administratively outside normal reporting chains. Part of the rationale for this separate status was that:

*veterans suspicious of the VA would be more likely to respond to a casual atmosphere with no trace of officialdom in evidence;
*the new expertise on veterans' problems could be tapped more readily, focused on more clearly, and networked more efficiently outside the stricter guidelines of VA recruiting and training procedures for counselors; and
*PTSD counseling could be combined more easily with other types of counseling, such as employment and retraining, in a structure not specifically medical.²⁶

A number of the previously organized storefront counseling centers were absorbed into the VA's new Readjustment Counseling Services (RCS), and others were set up around the country. Veterans^' organizations that had been seeking better services for Vietnam veterans rejoiced--but perhaps prematurely.²⁷

The Vet Centers in Action

Arthur S. Blank, Jr., who had objected strenuously to the anti-veteran attitudes of mental health professionals in the 1970s,²⁸ was enthusiastic about the new Vet Centers, and described them glowingly in a 1985 essay as an integrated team effort to help veterans, with the veterans themselves as part of the team. He was particularly pleased by the requirement that at least two members of each four-person Vet Center team be veterans themselves, so that clients could be assured of treatment by someone who was familiar with the war experience.²⁹ Ominously, however, he did not see any problems inherent in the groups he cited as having formed the basis of the treatment and the staffing of the early Vet Centers: VVAW, Veterans Service Project, Swords Into Plowshares, Twice Born Men, Project Return, Seattle Veterans Assistance Center, and Flower of the Dragon—all antiwar groups.³⁰

Even more ominously, Blank—already National Director of RCS as he wrote the 1985 essay—did not seem to recognize the danger inherent in what he cited approvingly as a requirement for counselors: a "full and effective working through of the staff member's personal history concerning the Viet Nam War" (235). As we have seen, the Lifton group had defined what constituted "effective working through" of the experiences: repudiation of the war, of one's service in it, and of the military in general.

Furthermore, in a 1984 interview with Myra MacPherson, Blank stated: "We scrupulously avoid letting political factors influence us in hiring. I'd say we are a mirror distribution of the attitudes of the 3.4 million Vietnam veterans—47 percent of whom feel we should have never gotten involved in Vietnam.^"31 In other words, almost half of RCS personnel, including Vet Center counselors, take it for granted that their clients (a) have participated in something wrong, and (b) agree that their own service was wrong.

MacPherson's narrative suggests that the percentage of antiwar Vet Center counselors and team leaders is actually much higher than 47 percent; in fact, she states that almost every Vet Center worker she talked to was antiwar, especially those who were veterans themselves. However, even the 47% figure may be faulty when applied to the full veteran population.

It is true that the 1980 Harris survey does give a 47% "should have stayed out" response among VEVs to the question, "Do you feel, in general, that we did the right thing in getting into the fighting in Vietnam, or should we have stayed out?^" However, responses to other questions in the survey suggest that the reasons for this response were not disapproval of the war or of the military (see Table 3).

Obviously, the way the question is asked determines the nature of the answer. "They shouldn't have sent us if they wouldn't let us fight" is quite different from "they shouldn't have sent us because the war was wrong." However, the problem with the counseling system goes beyond a mere statistical analysis; it lies in the very phrase Blank uses about Vet Center hiring procedures: no influence by "political factors." To assume that someone's attitude toward service in time of war must by definition be "political" immediately privileges only the already politicized.

Table 3. VEV responses to questions about the Vietnam War and attitudes toward serving. Numbers in parentheses are tables in the Harris study, Myths and Realities (1980).

The Neutrality Model

In a 1993 expansion and update of his original article, Arthur Blank expounded on the requirement that Vet Center personnel maintain political neutrality in their dealings with veterans:

Staff balance the advocacy-ombudsperson role with neutrality about political issues. For example, staff at all levels adhere to a nonpolitical stance about the Vietnam War out of respect for the widely differing values or attitudes about the war among the population which the Vet Centers are committed to serve and in order to be receptive to clients of all shades of opinion.³²

Charles Flora, National Associate Director of RCS, confirmed this model in an interview, further emphasizing the requirement of neutrality on the part ofcounselors. Because veterans represent "the entire spectrum of political opinion on the war," he says, "counselors should avoid imposing their own political views on the client. The veteran's perspective on the war and on the military, not the counselor's perspective, is the important factor in the client's postwar readjustment. The counselor's acceptance and understanding of the veteran's military experience is the foundation on which the therapeutic alliance is built."³³

That the neutrality is not often observed, we have noted before, in the citations from Vet Center counselors and team leaders given above. In fact, most of the professional literature on PTSD assumes the war to have been a meaningless bloodbath at best and an outright evil at worst. With such assumptions governing the field, counselor "neutrality" seems doomed at the outset.

Furthermore, VA counselors' willingness to articulate their antiwar and antimilitary positions in public indicates that they do not take very seriously the guidelines on neutrality.

Indeed, some counselors seem to feel so secure in imposing their antiwar stance that they annotate the imposition in their records of counseling. In one set of counseling records, written by the team leader of a statewide PTSD clinical team (PCT) under the jurisdiction of RCS, the following appears:

[Veteran X] is strongly pro-military and perhaps overly identified with military goals and roles …. Veteran is very much military identified, defensive when other point of view was brought up and feels that because of this [Veteran X] cannot continue in therapy with me. [Veteran X] cannot bear to think of the military in other than as a righteous organization and did not like comments made to the contrary. [Veteran X] has therefore decided to drop out of treatment. Discharged from PCT ³⁴

Despite Flora's insistence that any violation of neutrality should be reported to the VA and will be dealt with severely, when the veteran reported the antimilitary comments of this counselor, the counselor's local supervisors referred to the comments as"appropriate," and regional RCS managers did not respond to the veteran's complaint at all.

However, "neutrality" itself, even if it were observed, is a dubious term to use about a veteran's service. Prior to Vietnam, as we have noted, treatment of veterans assumed no such neutrality. Patriotism has never before been considered only one possible "political stance" out of many equally acceptable ones, a stance not to be interfered with where it exists but certainly not to be encouraged where it does not. By making patriotism optional, the VA declares it to be of no value.

Furthermore, as we have also noted, the methods of treatment adopted by the VA system were predicated upon building the veterans'—and therefore the veteran-counselors'—"identities" on their views of the war. The views, then, are not merely "opinions," but self-identifiers, indicators of mental health. To abandon a particular view becomes an acknowledgment that one's "cure" was invalid, that one is still sick. Now let us posit a series of events, assuming for the moment that the strict neutrality is being observed in each of the counseling situations:

1. Veteran A, who hates everything about the war and believes everything about it to have been evil, seeks counseling. He is encouraged to find his meaning in the fact that he recognizes the evil and will animate his guilt by educating others about the evil.
2. Veteran B, who served proudly but is still troubled by the deaths of his friends and his own reception on coming home, seeks counseling. He is encouraged to find his meaning in having fought in a good cause, in recognizing that his friends have heroically given their lives that others might live, and in carrying on their work of patriotism by showing renewed pride in his service.
3. Veteran A and Veteran B meet.

What will happen when the two veterans begin talking to each other? Will there be a spirited debate on "political issues"? Or will two people whose identities depend on their views of the war find each other a threat to their respective well-being? Before we attempt to answer this question, let us posit a different third event:

4. Veteran A becomes Veteran B^'s counselor.
Veteran A is now in a position of power, and Veteran B in a position of vulnerability—and yet Veteran B poses a threat to Veteran A. What we have here is a recipe for disaster, and because of the staffing history of Vet Centers, it is the recipe currently in use within the VA.

Of course, the question may be asked: What will happen if Veteran B becomes Veteran A's counselor instead; will there not be a similar disaster? Again, we must remember that Veteran B's position is one of pride in service, which has never before been considered a disaster. However, there may be a problem nevertheless; the scenario is predicated on a neutrality model that accepts any starting assumption without question or qualification. Even Veteran B has not learned to defend his position rationally. Both veterans have based their identities on emotion rather than reality, and at least one of them has based his identity on an untruth. Neither has been truly "cured."

And the Beating Goes On

Another question that may be asked is: Why need we concern ourselves with only 15% of an already small subset of our national population, especially after all this time, when it may be too late to do anything for the affected group anyway? The answer is that more than the 15% have been affected, and the people who began their work on Vietnam veterans have announced their intention of extending the attack to much broader categories of citizens, and finally to American culture itself. We may trace some of the steps even from the beginning:

1. Shift the focus from the troubled veteran to all veterans.

In most of the literature, the phrase "Vietnam veterans suffering from stress" quickly becomes simply ^"Vietnam veterans.^" Although often enough this may be nothing but verbal shorthand, the effect is to imply that all Vietnam veterans show characteristics of the 15% subset, or even of an individual patient. As we have seen, much of the shift in focus was done deliberately at the beginning: Lifton's VVAW patients publicly projecting their own ills onto others, the admittedly "unrepresentative group" being used as a representative model.

Two examples may indicate the lingering effects of this tactic: a handbook for clinicians published by the Disabled American Veterans, and a recent best-seller on trauma. In the first, chaplain Melvin R. Jacob describes "A Pastoral Response to the Troubled Vietnam Veteran,"³⁵ but by the second page of his description, the modifier "troubled" drops from his vocabulary, and he begins defining "the Vietnam veteran" solely in terms of PTSD: coldness, a sense of futility, loss and alienation, and so on. He then makes generalizations such as the following (page numbers are given in brackets):

The reality of Vietnam ate away at the spirit of many of its soldiers. The constant inconsistencies and incongruities, the gut-wrenching absurdities, and the endless emptiness left their indelible marks on the hearts of American warriors. [52; note that even in this passage, the word "many" disappears by the second sentence and the implication is that all warriors' hearts were marked by a "reality" that all warriors saw as dispiriting.]

The Vietnam veteran describes guilt and shame .... Like a heavy yoke carried on his shoulders, guilt burdens the veteran and diminishes creative energy and vitality. [61]

It should come as no surprise to find that most of Jacob's evidence for the above has been drawn from Lifton.

In the second example, psychiatrist Judith Lewis Herman's Trauma and Recovery, a 1992 best-seller, once again the Vietnam veteran is spoken of as a class having PTSD.³⁶ Like Jacob, Herman takes almost all her citations from Lifton; and she also agrees with Lifton on the political aspect of treatment for Vietnam veterans: "The study of war trauma becomes legitimate only in a context that challenges the sacrifice of young men in war.... The moral legitimacy of the antiwar movement and the national experience of defeat in a discredited war had made it possible to recognize psychological trauma as a lasting and inevitable legacy of war."³⁷

2. Shift the focus further from the veteran to the Vietnam War and then to all war and to the military in general.

As we can see from the two examples above—and indeed from Lifton's own early work in which he used the terms "war" and "war crimes" interchangeably—when the veteran's service is perceived as an evil, service itself becomes an evil, and the organization that shaped the veteran for service--the military--becomes the worst evil of all.

According to the Harris survey, fully 71% of VEVs say they enjoyed their time in service, and 90% say they are glad to have served their country (see Table 3). And yet, much of the PTSD literature, including Jacob's essay cited above, refers even to Stateside and peacetime service as "brutalizing" and "dehumanizing." Indeed, when Herman discusses the need to have a trauma sufferer repudiate the inflicter of harm, the harming agent for the Vietnam veteran is cited not as the enemy soldier but as the American military. Still other literature refers to all military service as "the cult of war" or "the warrior myth," and demands public rejection of such a cult.³⁸ From this point, supposed concern for the veteran often becomes a vehicle for attacking the military readiness of the United States, in that any expenditure on defense supports the "cult," and any training given to troops "brutalizes" and "dehumanizes" them.

3. Shift the focus, still further from the military to the culture that accepts the military in its midst.

Once the American military force has been demonized, the next target of attack becomes the traditional values associated with military service. Significantly, the latest villain in much of the current literature is John Wayne, whom one writer rejects scornfully as having "indoctrinated" young men with such outmoded notions as the "values of honor, courage, sacrifice over survival, and the resiliency of the human spirit.^"39

One need not be a John Wayne afficionado to note that what is being attacked here is not the actor or the oversimplifications in his films, but rather the values his films may have oversimplified. What terrible values to be "indoctrinated" with: honor, courage, and sacrifice; heaven forbid that any of our young men accept such things. And yet, this repudiation of ideals is the final step in the process that began in the 1960s and is being carried on in the VA today. Fortunately for our Nation, those who deplore such ideals are still worried about the ideals' tenacity. Surely, the writer quoted above sighs in the epilogue to his book, we should have learned better long ago, but national response to the Gulf War seems to indicate otherwise:

One wonders if a new generation of American men and women influenced by an updated John Wayne _.figure—John Rambo and his romantic battlefield exploits—or the deadly "Star Wars^" military hardware—dazzlingly displayed on television during the Gulf War—is ready to start the cycle over again and take its own heavy heart-of-darkness journey out of innocence.⁴⁰

Conclusion: Where Will It End?

The last passage quoted above is not from a psychological handbook but from a commentary on Vietnam War fiction. And here lies the greatest danger of all. The attack on patriotism begun in psychiatric circles and fostered by the VA has not been confined within the mental health professions any more than it has been confined to the 15% segment of the VEV population seeking counseling. Rather, the antiwar--and antimilitary, anti-America--message has been constantly reinforced by journalists who quote VA psychologists, VA psychologists who quote novelists and filmmakers,⁴¹ VA historians who quote the journalists who have quoted VA psychologists who have quoted novelists . . . and so on, ad infinitum. [Emphasis added. SGS] No matter where the American citizen looks, whether in popular or in specialized literature, the trail leads back to Lifton and from Lifton to the VA.

Small wonder, then, that Vietnam era veterans—even those not in the often cited 15%—have had so many problems with discrimination in the workforce and on campus. The image has become pervasive, and it now threatens to spread to other veterans besides those of the Vietnam era. Consider the spate of reissues since the Gulf War: Lifton, MacPherson, Gloria Emerson^'s Winners and Losers, Frances Fitzgerald's Fire in the Lake—all the original antiwar tracts attacking not just the war but the patriotism of American veterans have been reprinted with introductions urging the American public to view the veterans of Grenada, Panama, and the Gulf War as the Vietnam veteran must be viewed, and to treat them the same way as well.

Nor do I use the word "treat" lightly. The VA has opened the doors of its Vet Centers to post-Vietnam veterans, and is now considering offering the same treatment services to World War II and Korean War veterans 4² Soon all veterans will be afforded the chance to lose. their patriotism and sense of purpose under the auspices of the VA; and if the Lifton model continues, these veterans will then be sent forth to destroy the patriotism of their families and neighbors.

However, we have been alerted to the danger now. If there is any comfort for Vietnam veterans in all of this, it is that we are no longer alone; we are walking point for the rest of American society in the culture wars that continue in the corridors of the VA. And, as we once told the Harris survey interviewers, most of us are still proud to serve.

** Notes

¹These figures appear in most of the sources cited below, subject to variation according to individual surveys done by the authors. It is interesting to note that the 15% figure had become so universally known and accepted by 1992 that even a popular writer, Larry Chambers, cited it in the epilogue to his memoir, Recondo: LRRPs in the 101st Airborne (New York: Ivy, 1992, 237-38). See the end of this article for further comments onthe cross-disciplinary nature of discussions of PTSD.

²Josefina J. Card, Lives After Vietnam: The Personal Impact of Military Service (Lexington, MA: Heath, 1983), extracted from Table 5-2.

³Card, 113.

⁴VA, Myths and Realities: A Study of Attitudes Toward Vietnam Era Veterans Washington: U. S. Government Printing Office, 1980), extracted from Tables V-1 and V-2.

⁵See Wilbur J. Scott's description of the buildup of antiwar activism within the APA, particularly at the 1970 and 1971 conventions, in The Politics of Readjustment: Vietnam Veterans Since the War (New York: Aldine de Gruyter, 1993), 33-44.

⁶APA Official Actions, American Journal of Psychiatry 128 (1971):138-39.

⁷Joel Osier Brende and Erwin Randolph Parson, Vietnam Veterans: The Road to Recovery (New York: Plenum, 1985), 175.

⁸In 1976, long after the fact, D.M. Davis speculated that the combination of drugs might have caused excessive drowsiness—hardly a desirable effect on troops who had to be constantly alert for ambushes and booby traps. See Davis, "Special Problems of Psychiatric Patients Evacuated from Vietnam to a Backup Hospital," U.S. Army Vietnam Medical Bulletin (July/August 1976): 17-20.

⁹For a full discussion of such attitudes and behavior, see Arthur S. Blank, Jr., "Irrational Reactions to Post-Traumatic Stress Disorder and Viet Nam Veterans," in The Trauma of War: Stress and Recovery in Vietnam Veterans, ed. Stephen M. Sonnenberg, Arthur S. Blank, Jr., and John A. Talbott (Washington: American Psychiatric Press, 1985), 71-96. See also: Brende and Parson, Vietnam Veterans, 63, 74, 177-79, 205-207; Charles R. Figley and Seymour Leventman, introduction to Strangers at Home: Viet Nam Veterans Since The War, Ed. Figley and Leventman (New York: Praeger,1980), xxviii-xxix; Wilbur J. Scott, The Politics of Readjustment, 5; John R. Smith, "Individual Therapy with Vietnam Veterans," in The Trauma of War, 130-53. A particularly interesting (if horrifying) example of such attitudes is given unconsciously in Vietnam: A Casebook, ed. Jacob D. Lindy, et al. (New York: Brunner/Mazel, 1988), in which the anonymous therapists describing their case studies seem to take pride in feeling revulsion toward their patients. One therapist reports such antipathy in himself that he was on two occasions subject to migraine headaches and stomach upsets before returning a particular patient's phone call; he obviously expects to be admired for this revulsion.

¹⁰Robert Jay Lifton, Home from the War (1973; rpt. with a new introduction about the Gulf War, Boston: Beacon, 1992), ch. 1. Throughout this first chapter, Lifton openly describes his preconceived conclusions, his deliberate choice of a biased study sample, and his determination to politicize his subjects into public antiwar speakers who would give Lifton's agenda more credibility.

"Lifton, Home from the War, 159. All further references to this book will be given in brackets in the text.

¹²Scott, Politics of Readjustment, 18-19.

¹³Del Vecchio, Foreword to Brende and Parson, Vietnam Veterans, xii. The fact that a novelist was asked to write a foreword to a study by two psychologists is interesting in itself; we will look at further examples of cross-disciplinary collaboration later in this article.

¹⁴Scott, Politics of Readjustment, 60-62; Scott adds that the working group "drew [their] data primarily from the case histories of Vietnam veterans who had attended the New York City rap groups" (62).

¹⁵Scott, Politics of Readjustment, 44-45.(1977): 3-24.

¹⁶For a full description of Flower of the Dragon, see R. W. Eisenhart, "Flower of the Dragon: An Example of Applied Humanistic Psychology," Journal of Humanistic Psychology 17

¹⁷See Margaret Benshoof-Holler's interview with McCloskey in "Post Traumatic Stress Disorder," Vietnam (December 1993): 38-44.

¹⁸Myra MacPherson, Long Time Passing: Vietnam and the Haunted Generation (1984; rpt. with new introduction on Grenada, Panama, and the Gulf War, New York: Anchor Books, 1993), 51-52. Emphasis in the original.

¹⁹MacPherson, 168.

²⁰Scott, pp 55-57; MacPherson, 190

²¹Figley, "Confusing the Warrior with the War," APA Monitor (April 1979): 2. Note the phrasing of this title; it assumes that a soldier does not want to be associated with the war in which he has fought.

²²Scott, 46; MacPherson, 47, 170, 205.

²³MacPherson, 243.

²⁴See Scott, 35-37, 63-64. Meshad's in-country activities are described in his partially fictionalized account of them, Captain for Dark Mornings: A True Story (Playa Del Rey, CA: Creative Image Associates, 1982).

²⁵Since the 1980 publication of DSM-III, there have been two further revisions, DSM-III(R), and DSM-IV. In each version, the symptomology and indicators have been slightly refined or elaborated on, but the essential assumptions and definitions remain unchanged from the 1980 version.

²⁶Arthur S. Blank, Jr., describes the rationale at greater length in "The Veterans Administration's Viet Nam Outreach and Counseling Centers," in The Trauma of War, passim.

²⁷Although I concentrate on Vet Centers in the remainder of this discussion, we should note that most of the assumptions and methods used in the Vet Centers are used throughout the rest of the VA, including inpatient care in VAMCs. Brende and Parson describe phase-one treatment in VA Inpatient Specialized Treatment Units (ISTUs) as "using selected behavioral procedures, education about Vietnam and PTSD symptoms, and if needed, medication." (Vietnam Veterans, 237) We can only imagine what the "education about Vietnam" may consist of, given what we know about the background of the educators.

²⁸Blank, "Irrational Reactions," passim.

²⁹Blank, "The Veteran Administration's Viet Nam Veterans Outreach and Counseling Centers," in The Trauma of War, 227-38.

³⁰Blank, "VA Outreach," 233.

³¹MacPherson, Long Time Passing, 239.

³²Blank, "Vet Centers: A New Paradigm in Delivery of Services for Victims and Survivors of Traumatic Stress," International Handbook of Traumatic Stress Syndromes, ed. John P. Wilson and Beverley Raphael (New York: Plenum Press, 1993), 920.

³³Flora, personal interview, Washington, D.C., 10 November 1993.

³⁴Because of the confidential nature of these records, from which I quote with permission of the veteran, I cannot give any identifying citations.

³⁵Jacob, "A Pastoral Response to the Troubled Vietnam Veteran," in Post-Traumatic Stress Disorders: A Handbook for Clinicians (Cincinnati: DAV Press, 1987), 51-74.

³⁶Herman, Trauma and Recovery (New York: BasicBooks, 1992).

³⁷Herman, 9, 27.

³⁸This reference to cult and myth begins as early as Lifton's statement, in Home from the War, that the "transormation [of the veteran] depends directly upon exposing the filth beneath the warrior's claim to purity of mission, upon subverting much that is fundamental to American warrior mythology" (159); it continues in such recent works as Herman's Trauma and Recovery and the Herzog study cited below.

³⁹Tobey C. Herzog, Vietnam War Stories: Innocence Lost (New York: Routledge, 1992), 114.

⁴⁰Herzog, 215.

⁴¹See especially the Lindy study, as well as the studies by Jacob, MacPherson, and Herzog.

⁴²VA Mental Health: Improve It and They Will Come," DAV Magazine (September 1993): 2-3. The mental health of the VA, considering what we have seen of it in action, may indeed be in need of improvement.

This article originally appeared in the Journal of the Vietnam Veterans Institute, Volume 2, Number 1, 1993. Reprinted with Permission.

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