tag:theconversation.com,2011:/id/topics/combat-veterans-31977/articlesCombat veterans – The Conversation2020-07-01T12:18:48Ztag:theconversation.com,2011:article/1417312020-07-01T12:18:48Z2020-07-01T12:18:48ZFireworks can torment veterans and survivors of gun violence with PTSD – here’s how to celebrate with respect for those who served<figure><img src="https://images.theconversation.com/files/344904/original/file-20200630-103636-1k0hmq4.jpg?ixlib=rb-1.1.0&rect=0%2C7%2C4968%2C3282&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For those with PTSD, sounds from fireworks can trigger flashbacks.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/man-with-firework-display-standing-on-road-at-night-royalty-free-image/1146000103?adppopup=true">Getty Images / Josep Maria Gerardo / EyeEm </a></span></figcaption></figure><p>For some combat veterans, the Fourth of July is not a time to celebrate the independence of the country they love. Instead, the holiday is a terrifying ordeal. That’s because the noise of fireworks – loud, sudden, and reminiscent of war – rocks their nervous system. <a href="https://www.washingtonpost.com/lifestyle/style/who-will-solve-the-great-fireworks-mystery-and-will-we-ever-sleep-again/2020/06/22/f55c99d8-b431-11ea-a510-55bf26485c93_story.html">Daily fireworks in many U.S. cities</a> in recent weeks have no doubt been interfering with the sleep and peace of mind of thousands of veterans. </p>
<p>This reaction is not unique to veterans with post-traumatic stress disorder, or PTSD. Also affected are millions of others, including civilians, refugees, and first responders. <a href="https://www.starclab.org/members/arash-javanbakht">As a psychiatrist</a> who specializes in trauma and PTSD, I urge you not to overdo an act which causes so much suffering for so many of your fellow Americans.</p>
<h2>What is PTSD?</h2>
<p><a href="https://theconversation.com/veterans-refugees-and-victims-of-war-crimes-are-all-vulnerable-to-ptsd-130144">PTSD</a> can occur when someone is exposed to extreme exposure traumatic experience. Typically, the trauma involves a threat of death, serious injury, or sexual violence. Along with war veterans, it happens to refugees; to victims of gun violence, rape and other physical assaults; and to survivors of car accidents and natural disasters like earthquakes or tornadoes. </p>
<p>PTSD can also happen by witnessing trauma or its aftermath, often the case with <a href="https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd">first responders</a> and <a href="https://www.psychologytoday.com/us/blog/the-many-faces-anxiety-and-trauma/202006/invisible-wounds-the-frontline-heroes">front-line workers</a>.</p>
<p>All this adds up to tens of millions of Americans. Up to 30% of combat veterans and first responders, and 8% of civilians, <a href="https://www.ptsd.va.gov/professional/treat/essentials/epidemiology.asp">fulfill the diagnostic criteria for PTSD</a>. And that criteria is not easily met: symptoms of PTSD include nightmares, flashbacks, intrusive trauma memories, difficulty sleeping, avoidance of reminders of trauma, negative emotions, and what we call “hyperarousal symptoms.”</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/344905/original/file-20200630-103640-1x1gdjg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many war veterans suffer from PTSD. For some, the sounds of fireworks can be terrifying.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/depressed-vietnam-war-usa-military-veteran-covering-royalty-free-image/1132123415?adppopup=true">Getty Images / willowpix</a></span>
</figcaption>
</figure>
<h2>Fireworks can trigger flashbacks</h2>
<p>Hyperarousal, a core component of PTSD, occurs when a person is hyper-alert to any sign of threat – constantly on edge, easily startled and continuously screening the environment.</p>
<p>Imagine, for instance, stepping down the stairs in the dark after hearing a noise; you’re worried an intruder might be downstairs. Then a totally unpredictable loud sound explodes right outside your window. </p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<p>For people with PTSD, that sound – reminiscent of gunfire, a thunderstorm or a car crash – <a href="https://theconversation.com/veterans-refugees-and-victims-of-war-crimes-are-all-vulnerable-to-ptsd-130144">can cause</a> a panic attack or trigger flashbacks, a sensory experience that makes it seem as if the old trauma is happening here and now. Flashbacks can be so severe that combat veterans may suddenly drop to the ground, the same way they would when an explosion took place in combat. Later, the experience can trigger nightmares, insomnia or worsening of other PTSD symptoms. </p>
<p>Those of us who set off fireworks need to ask ourselves: Are those few minutes of fun worth the hours, days, or weeks of torment that will begin for some of our friends and neighbors – including many who put their lives on the line to protect us?</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=480&fit=crop&dpr=1 600w, https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=480&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=480&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=603&fit=crop&dpr=1 754w, https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=603&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/344907/original/file-20200630-103661-1to55nt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=603&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Instead of setting off fireworks on your own, consider going to a sponsored event.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/new-year-fireworks-royalty-free-image/1168128925?adppopup=true">Getty Images / www.JamesPhotography.com.au</a></span>
</figcaption>
</figure>
<h2>Who else is affected?</h2>
<p>Millions of others, though not diagnosed with PTSD, may similarly be affected by fireworks. <a href="https://adaa.org/about-adaa/press-room/facts-statistics">One in five Americans</a> have an anxiety disorder, many with symptoms of hyperarousal. Also impacted are those with autism or developmental disabilities; they find it difficult to cope with the noise, or just the drastic change from life routines. Then there are people who have to work, holiday or not: nurses, physicians and first responders, who have to be up at 4 a.m. for a 30-hour shift. </p>
<h2>How to reduce the negative impact</h2>
<p>There are ways to reduce how fireworks affect others:</p>
<ul>
<li><p>For those with PTSD, the unexpected nature of fireworks is probably the worst part. So at least make it as predictable as possible. Do it in designated areas during designated times. Don’t explode one, for instance, two hours after the designated time window. And avoid setting them off <a href="https://www.theguardian.com/society/2018/jul/04/fireworks-ptsd-fourth-of-july-veterans-shooting-survivors">on the 3rd</a>. People are less prepared then. </p></li>
<li><p>If you’re aware that a veteran or trauma survivor lives in the neighborhood, move the noise as far as possible from their home and give them prior warning. Consider putting a sign in your front yard noting the time you’ll set the fireworks.</p></li>
<li><p>Remember, it doesn’t have to be super loud to make it fun. Consider using <a href="https://thehill.com/opinion/energy-environment/504964-its-time-for-silent-fireworks">silent fireworks</a>. And you don’t have to be the one who lights the fireworks. Simply enjoy watching while your city or township does it safely.</p></li>
</ul>
<h2>Coping with the stress</h2>
<p>If you can’t stand fireworks, there are ways to reduce the stress:</p>
<ul>
<li><p>If the fireworks are a scheduled event, know the time they start and end.</p></li>
<li><p>Use earplugs or background sounds or music to reduce the intensity of the noise.</p></li>
<li><p>Be with loved ones who will support and help distract you.</p></li>
<li><p>Talk to your therapist, psychiatrist or primary care doctor for help in managing PTSD and anxiety symptoms. <a href="https://theconversation.com/veterans-refugees-and-victims-of-war-crimes-are-all-vulnerable-to-ptsd-130144">Effective treatments</a> are available. Your doctor may provide medication that helps during those difficult hours. But definitely do not get medications from others, as some may have <a href="https://theconversation.com/where-is-my-xanax-rx-why-your-doctor-may-be-concerned-about-prescribing-benzodiazepines-125346">serious consequences</a> if not used properly.</p></li>
</ul>
<p>And finally, don’t be shy. You can kindly talk with your fireworks-happy neighbors in advance.</p><img src="https://counter.theconversation.com/content/141731/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Arash Javanbakht does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Setting off fireworks may be fun for you, but for some of your neighbors it could be a traumatic experience.Arash Javanbakht, Associate Professor of Psychiatry, Wayne State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/871562017-11-10T00:22:01Z2017-11-10T00:22:01ZVeterans turned poets can help bridge divides<figure><img src="https://images.theconversation.com/files/194045/original/file-20171109-13317-u4wvaf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Vietnam Veterans Memorial in Washington.</span> <span class="attribution"><span class="source">AP Photo/Carolyn Kaster</span></span></figcaption></figure><p>Although Veterans Day is a national holiday, often filled with parades and celebrations, it brings with it ambiguity. </p>
<p>Howard Zinn, a World War II veteran, <a href="http://progressive.org/magazine/real-costs-war/">once wrote</a>, “I do not want the recognition of my service to be used as a glorification of war.”</p>
<p>Sometimes the cost of the service and sacrifice can temper any desire to celebrate. Just consider the fact that even on the original Armistice Day, almost 2,700 Allied and German soldiers <a href="https://www.penguinrandomhouse.com/books/129927/eleventh-month-eleventh-day-eleventh-hour-by-joseph-persico/9780375760457/">died in combat</a>.</p>
<p>Ambiguity is also the result of the growing gulf between those who have served and those who haven’t. At any given time, only .04 percent of the U.S. population is <a href="http://www.pewresearch.org/fact-tank/2017/04/13/6-facts-about-the-u-s-military-and-its-changing-demographics/">serving on active duty</a>. In The Economist, a <a href="https://www.economist.com/news/united-states/21730738-it-also-leads-lot-fuzzy-thinking-about-armed-forces-americas-love-affair">columnist</a> recently explained, “The gulf between America’s armed forces and its civilians has never been greater. In 1990, 40 percent of young Americans had a military veteran for a parent; in 2016, only 16 percent did.”</p>
<p>Sometimes the ambiguity lies within the veteran community, and sometimes within individual veterans. Veterans’ experiences are not uniform. Some have seen combat; many have not. The story of each veteran’s service is unique.</p>
<p>As WWII vet Frank Brookhauser <a href="https://books.google.com/books/about/This_Was_Your_War.html?id=TNbPngEACAAJ">once said</a>, “There was nothing right in one story. There is no such thing as one story if there are two people.” </p>
<p>Today, there are approximately <a href="https://www.va.gov/vetdata/Quick_Facts.asp">20.17 million veterans</a> – 7 percent of the U.S. population. That’s more than 20 million stories, along with the stories of their loved ones. Sometimes poetry is the most effective way to capture both the ambiguity and the story.</p>
<h2>Bridging divisions</h2>
<p>One poet who is aware of these divides is <a href="https://www.poets.org/poetsorg/poet/yusef-komunyakaa">Yusef Komunyakaa</a>, an Army veteran who served in Vietnam from 1969 to 1970 and earned a Bronze Star. He is now a professor at New York University. Either with his own poetry such as <a href="https://www.poetryfoundation.org/poems/47867/facing-it">“Facing It”</a> or by encouraging us to read other veterans’ poems, Komunyakaa explains that poetry has dual roles – to delight and to instruct, a concept traced back to Aristotle and Horace’s <a href="http://www.gutenberg.org/ebooks/9175">“Ars Poetica</a>.”</p>
<p>In “<a href="https://www.poetryfoundation.org/poetrymagazine/articles/60377/letter-to-the-editor-56d23f70602cf">A Letter to the Editor</a>,” Komunyakaa makes the case for such encounters with veterans’ poems, saying, “We need our young men and women, soldiers and civilians, to read good literature, to come across a voice like Yehuda Amichai’s in ‘What Did I Learn in the War.’” <a href="https://www.poetryfoundation.org/poets/yehuda-amichai">Amichai</a> is considered by many to be Israel’s <a href="https://www.enotes.com/topics/yehuda-amichai/critical-essays/amichai-yehuda">greatest poet</a>. His poem describes the soldier’s experience:</p>
<blockquote>
<p>“To march in a row and be alone in the middle,</p>
<p>To dig into pillows, featherbeds, the body of a beloved woman,</p>
<p>And to yell ‘Mama,’ when she cannot hear,</p>
<p>And to yell ‘God,’ when I don’t believe in Him”</p>
</blockquote>
<p>Komunyakaa and Amichai emphasize the need to encounter and learn from stories of those who served. Even though much about those stories is unremarkable or routine, some is not. Debs Myers, a WWII vet, describes his fellow soldiers in “<a href="https://books.google.com/books/about/This_Was_Your_War.html?id=TNbPngEACAAJ">The GI</a>”: </p>
<blockquote>
<p>“He learned how to sleep in the mud, tie a knot, kill a man. He learned the ache of loneliness, the ache of exhaustion, the kinship of misery. From the beginning he wanted to go home… He learned… that every man is alike and that each man is different, [but] if he was on the line it didn’t make much difference.”</p>
</blockquote>
<p>Myers’ soldiers longed for home. Veterans are home, and even if people read the stories about what is like to be “over there,” they may not always understand what it is like to be over here. Brian Turner, an Iraq combat vet, describes such thoughts in a “Ashbah,” a poem in “<a href="https://www.npr.org/templates/story/story.php?storyId=5126583">Here, Bullet</a>.” He is home, but he can’t help but think about:</p>
<blockquote>
<p>“The ghosts of American soldiers</p>
<p>Wander the streets of Balad by night,</p>
<p>Unsure of their way home, exhausted.”</p>
</blockquote>
<p>His poem helps us see that not just the ghosts are “unsure of their way home.” So, too, are those who survived and returned home, at least in the physical sense.</p>
<p>By being mindful, we might understand that on Veterans Day it is not simply enough to offer a free meal or host a parade. Honoring those who served means making an effort to connect with those who have served.</p>
<p>Eisenhower transformed Veterans Day from one that focused on WWI (it had been Armistice Day) to <a href="https://www.va.gov/opa/vetsday/vetdayhistory.asp">a celebration</a> of those who served in all wars. Congress added the <a href="https://www.congress.gov/bill/114th-congress/senate-bill/1004">Moment of Silence Act</a> in 2016, which asks for two minutes of silence “in honor of the service and sacrifice of veterans throughout the history of the nation.” </p>
<p>For the millions who have served – those who have not come home, those who have and those who have but who are caught in that space between here and there – celebration and silence are valued and appreciated. But are they sufficient to helping bridge the gap? </p>
<p>Service is integral to who veterans are, but it is transformational in ways that are not always easy to describe or celebrate. Listening to veterans’ stories and reading poems that attempt to capture the ambiguity and complexities of veterans’ experiences may offer another path to honor that service and sacrifice.</p><img src="https://counter.theconversation.com/content/87156/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Dubinsky received funding from the National Endowment for the Humanities. I was PI for a NEH Summer Institute on Veterans in American Society (2016). We brought 25 faculty from nine academic disciplines to Virginia Tech for three weeks in July 2016.</span></em></p>Civilians have become so far removed from the military and war, it can be hard to understand veterans. Their poetry can help us connect.James Dubinsky, Associate Professor of English, Virginia TechLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/777582017-05-25T03:31:44Z2017-05-25T03:31:44ZWhat veterans’ poems can teach us about healing on Memorial Day<figure><img src="https://images.theconversation.com/files/170872/original/file-20170524-31366-1wzk00u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A visitor pauses at the Vietnam War Memorial in Washington, D.C.</span> <span class="attribution"><span class="source">AP Photo/J. David Ake, File</span></span></figcaption></figure><p>Memorial Day, a national holiday to honor the <a href="http://www.va.gov/opa/publications/factsheets/fs_americas_wars.pdf">1.17 million men and women who have died</a> to create and maintain the freedoms outlined in our Constitution, is not the only Memorial Day.</p>
<p>The holiday <a href="http://www.hup.harvard.edu/catalog.php?isbn=9780674008199">emerged from the Civil War</a> as a celebration almost exclusively for veterans of the Union Army to remember those who had died. Veterans and their families from Confederate states held their own celebrations. Thus, it remains fraught with conflict and ambiguity.</p>
<p>In 2017, <a href="https://www.usnews.com/news/national-news/articles/2017-04-24/what-to-know-about-confederate-memorial-day">seven states</a> – Alabama, Florida, Georgia, Mississippi, South Carolina, Texas and Virginia – chose to also celebrate some form of Confederate Memorial Day. It’s usually celebrated on April 26 – the day associated with the surrender of <a href="https://rowman.com/ISBN/9780759116320/Memory-in-Black-and-White-Race-Commemoration-and-the-Post-Bellum-Landscape">General Joe Johnston</a>, nine days after General Robert E. Lee’s surrender at Appomattox at the end of the Civil War.</p>
<p>How can we overcome these deep divides? </p>
<p>Having served 28 years in the U.S. Army and as a teacher and <a href="http://veteransinsociety.wordpress.com">researcher who studies the roles veterans and their family play in society</a>, I believe poems written by veterans that focus on honoring those who have died may give us a clue.</p>
<h2>Bridging divisions</h2>
<p>Tension between North and South remains. We see it not only on days dedicated to remembrance. It surfaces daily as communities such as <a href="http://www.cbsnews.com/news/robert-e-lee-statue-removed-new-orleans/">New Orleans</a> wrestle with whether or not to keep memorial statues honoring Confederate leaders like Robert E. Lee.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/170875/original/file-20170524-31352-1euq0s6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Seaman Daniel Odoi of the Navy Operational Support Center of New York City presents the American flag on Memorial Day 2013.</span>
<span class="attribution"><span class="source">AP Photo/John Minchillo</span></span>
</figcaption>
</figure>
<p>One poet who does not ignore these divides is <a href="https://www.poets.org/poetsorg/poet/yusef-komunyakaa">Yusef Komunyakaa</a>, an Army veteran who served in Vietnam from 1969 to 1970 and earned a Bronze Star. He is now a professor at New York University.</p>
<p>In “<a href="https://www.poetryfoundation.org/resources/learning/core-poems/detail/47867">Facing It</a>,” a poem about visiting the Vietnam War Memorial, Komunyakaa, an African-American, confronts the wall and issues linked to war and race. He writes:</p>
<blockquote>
<p>“My black face fades / hiding inside the black granite.”</p>
</blockquote>
<p>But he is also a veteran honoring those who died; he is balancing the pain of loss with the guilt of not being a name on the wall: </p>
<blockquote>
<p>“I go down the 58,022 names, / half-expecting to find / my own in letters like smoke. / I touch the name Andrew Johnson; / I see the booby trap’s white flash.”</p>
</blockquote>
<p>The poem ends with two powerful images that offer a glimmer of hope: </p>
<blockquote>
<p>“A white vet’s image floats / closer to me, then his pale eyes / look through mine. I’m a window. / He’s lost his right arm / inside the stone. In the black mirror / a woman’s trying to erase names: / No, she’s brushing a boy’s hair.”</p>
</blockquote>
<p>The image of the speaker becoming a “window” addresses how two vets, one white and one black, bridge the racial divide and become linked through shared acts of sacrifice and remembrance. Yet even with such a positive affirming metaphor, the speaker’s mind and heart are not fully at ease.</p>
<p>The next image creates dissonance and worry: Will the names be erased? The concluding line relieves that worry – the names are not being erased. More importantly, the final image of a simple act of caring calls to mind the sacrifices made to protect women and children by those whose names are on the wall. As a result, their image in the stone becomes a living memorial.</p>
<h2>Memory and reflection</h2>
<p>We can also learn from Brock Jones, an Army veteran who served three tours of duty in Iraq and one in Afghanistan. He named his award-winning book “<a href="http://www.uapress.com/dd-product/cenotaph/">Cenotaph</a>,” the name for a tomb to honor those whose graves lie elsewhere. By using the name of a monument for those not present, a monument with historical ties to ancient Greece and Egypt as well as our own culture, Brock highlights how honoring the dead goes beyond culture and country. </p>
<p>Jones’ poems do not focus outward toward social strife, but inward. They address language’s inability to capture or express loss linked to memories of war. They also point to how those remaining alive, particularly those who have not served, might come to understand the depth of the sacrifice expressed by memorials and, by extension, Memorial Day.</p>
<p>In “Arkansas,” a poem that takes place at the Arkansas pillar, one of 56 pillars at the <a href="http://www.wwiimemorial.com/">National WWII Memorial</a> in Washington, D.C., the speaker remembers a journey with his grandfather:</p>
<blockquote>
<p>“dead eight years ago this summer / to the Atlantic pavilion engraved / with foreign names he never forgot. / Bastogne. / Yeah, we was there. / St. Marie Eglise. / We was near there.”</p>
</blockquote>
<p>The poem ends with the grandfather described as “a hunched figure, in front of ARKANSAS. Still, in front of ARKANSAS.” The grandfather is burdened by memories he carries, memories that render him “still” (motionless), memories that will remain with him “still.”</p>
<p>“Memorial from a Park Bench” offers a broader perspective, one that any visitor sitting on a bench in front of a memorial might experience. For the visitor, the memorial becomes “an opened book,” a place where “A word loses its ability to conjure / trapped inside a black mirror.” </p>
<p>The words are “names,” which “could be lines / of poems or a grocery list. / They could be just lines.” But they are not “just lines.”</p>
<p>At poem’s end, when all is contemplated, “Here are names and black stone / and your only reflection.”</p>
<p>Jones shifts the emotional and intellectual burden from the person on the bench to the poem’s readers, and thus to broader society. These words cannot be just lines or lists; they become, by being memorialized in a black stone, a “mirror,” the reader’s and thus society’s “reflection.” All on the bench are implicated; the names died for us, and, as a result, are us. </p>
<h2>Memorial Day and mindfulness</h2>
<p>Memorial Day may have “official” roots honoring Union dead, but veteran poets of recent wars serving a United States have found ways to honor all those who have died in battle.</p>
<p>Our country may be divided, but by taking a moment to pause and reflect on names etched on monument walls or gravestones, everyone on benches may see their own reflections, and in so doing further the task President Abraham Lincoln outlined in his 1865 <a href="http://www.bartleby.com/124/pres32.html">Second Inaugural Address</a> “to bind up the nation’s wounds…to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.”</p>
<p>By being mindful, we might understand what Robert Dana, a WWII vet wrote in “At the Vietnam War Memorial in Washington, D.C.”: that “These lives once theirs / are now ours.”</p><img src="https://counter.theconversation.com/content/77758/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Dubinsky received funding from the National Endowment for the Humanities to put on a three-week Summer Institute for faculty on Veterans in Society. He is affiliated with Virginia Tech Veterans Caucus. </span></em></p>An Army veteran and professor of rhetoric explores poetry written by veterans about a divisive holiday born of the Civil War.James Dubinsky, Associate Professor of English, Virginia TechLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/666182016-10-06T01:18:30Z2016-10-06T01:18:30ZDear Donald Trump: I treat combat veterans with PTSD, and they are not weak<p>Mr. Trump, there’s someone I’d like you to meet. </p>
<p>Well, not one person per se, but the thousands of veterans I’ve had the privilege to work with as a clinical psychologist over the past 20 years. They’ve served this country proudly – shouldering the responsibilities of the world while others went to college or into family business. They’ve served in war zones in Germany, Japan, Korea, Vietnam, Iraq, Afghanistan and places some probably couldn’t pronounce or find on a world map. </p>
<p>These men and women have seen direct combat and the aftermath of battle, and experienced extreme threats to personal safety. They’ve lived through the unthinkable – rocket-propelled grenade and artillery attacks, seeing friends’ bodies ripped in half or faces blown off, handled human remains, intentionally killed enemy combatants and had to live with the haunting consequences of <a href="https://www.ncbi.nlm.nih.gov/pubmed/18436857">accidentally taking the life of women and children</a>. </p>
<p>In the war zone, our brave men’s and women’s safety is often in danger. Alert around the clock, they are in constant fear of attack, have concern over encountering explosive devices and come within inches of their own death. Even in peacetime, our military face significant stressors – assisting in disaster relief and other humanitarian efforts, exposure to hazards and harmful substances and strenuous physical demands. </p>
<p>I not only have treated veterans with PTSD but have studied PTSD extensively too, at several of our country’s most elite research institutions. I’d like to lay out some evidence to explain why our combat veterans are not weak. They are the strongest people I have ever met. </p>
<p>And, they typically do not want to burden people with their pain. Most would never hold a grudge, go public on social media with their experiences or blame anyone else for their difficulties. Thus, I feel it is important, as a clinician and researcher, to defend these men and women who defended us.</p>
<h2>Lives never the same</h2>
<p>Combat trauma is a powerful predictor for a number of mental health problems. PTSD is, of course, the most notable consequence, but veterans who have served in war zones also suffer <a href="http://onlinelibrary.wiley.com/doi/10.1002/jts.20278/abstract">alarming rates of depression, anxiety and substance abuse</a>. And in recent years, the high suicide rates among U.S. service members have soared to an <a href="http://www.ptsd.va.gov/public/PTSD-overview/reintegration/overview-mental-health-effects.asp">estimated 22</a> dying by their own hand each day. </p>
<p>If knowing that isn’t enough to make most Americans – including you – hang their heads, pause in appreciation and potentially cry, I’m not sure what would.</p>
<p>Sadly, veterans with PTSD also have what health care professionals call a “<a href="https://www.ncbi.nlm.nih.gov/pubmed/17202557">reduced quality of life</a>.” They go to work less and use more health care services. </p>
<p>Unless treated, PTSD typically runs a chronic course and haunts a person for many years or decades. Thus, the substantial burden of PTSD is not just on a veteran’s back, but on their families, their communities and society as well. </p>
<p>And as for those who, as you <a href="https://www.washingtonpost.com/video/politics/heres-what-donald-trump-said-about-veterans-and-ptsd/2016/10/03/ea00d21c-8996-11e6-8cdc-4fbb1973b506_video.html">said</a>, “can’t handle” war, a large research literature exists on risk factors that make a person more susceptible to develop PTSD. The science on risk factors for PTSD does not support the idea that veterans are weak! <a href="https://www.ncbi.nlm.nih.gov/pubmed/18226287">Longer deployment time, more severe combat exposure,</a> <a href="https://www.ncbi.nlm.nih.gov/pubmed/17012689">more severe physical injury</a> and traumatic brain injury are some of the variables that pack the biggest punch in contributing to PTSD.</p>
<h2>Silent suffering adds to the burden</h2>
<p>Years ago, while I was running large psychotherapy groups for Vietnam veterans and those who served in the first Persian Gulf war, one of my veterans said to me, “Why do you do what you do?” Without missing a beat, and straight from my heart, I said, “Because there but for the grace of God go I.” </p>
<p>I have no doubt that had I directly experienced or witnessed the things that they did, that I would come home with intrusive, gruesome nightmares, daytime replays of faces who died recurring in my mind, continuing thoughts that I could have done something differently. These are not signs of being weak. These are signs of being human. Caring, loving, wonderful souls.</p>
<p>Many of our nation’s veterans <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa040603#t=article">don’t receive the services</a> they need and deserve or wait decades before seeking help. There’s a host of reasons for this, <a href="http://guilfordjournals.com/doi/abs/10.1521/psyc.2009.72.3.238">including denial or minimization of problems</a>, avoidance of trauma memories and reminders, stigma and wanting to solve problems on one’s own. </p>
<p>But the biggest barrier, in my clinician experience, and one that has been <a href="http://epirev.oxfordjournals.org/content/37/1/144.full">verified in research</a> is concern over being seen as weak. And so they suffer in silence. For way too long. </p>
<h2>‘All these years, I thought was crazy’</h2>
<p>About 10 years ago, one World War II veteran was referred to me by a primary care doc. Always dutiful, he came pleasantly to my office on his physician’s orders not really understanding why he was there. As I rattled off some signs and symptoms of trauma-related distress, his eyes widened as if to say, “How do you know what’s been happening to me?” He thought he had buried the horrors deep in his soul. He was shocked when he thought I could see it. This large, strong 80-plus year-old man openly sobbed and said, “All these years, I thought I was crazy, lazy, weak and bad.” </p>
<p>I wanted to cry too. This man suffered in silence for over 60 years. How sad is that?</p>
<p>In the line of duty and service to our country, men and women risk lasting impact on their mental and physical well-being, as well as on their families. They deserve respect, not shaming.</p><img src="https://counter.theconversation.com/content/66618/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joan M. Cook, Ph.D. receives funding from the National Institute of Mental Health (NIMH) and the Patient-Centered Outcomes Research Institute (PCORI).</span></em></p>The research is strong that the atrocities of war cause mental health issues. A clinical psychologist walks us through the research and tells of her personal experience treating those with PTSD.Joan M. Cook, Associate Professor of Psychiatry, Yale UniversityLicensed as Creative Commons – attribution, no derivatives.