"We Will All Be Lost And Destroyed": Post-Traumatic Stress Disorder and the Civil War

"We Will All Be Lost And Destroyed": Post-Traumatic Stress Disorder and the Civil War Eric T. Dean, Jr. Since the conclusion of the Vietnam War, psychiatrists, politicians, and the public at large have come to see the Vietnam veteran as beset by a wide variety of problems, from alcoholism, drug abuse, divorce, homelessness, and unemployment, to anxiety disorders and suicide. According to the prevailing view, the Vietnam veteran's problems relate primarily to Post-Traumatic Stress Disorder (PTSD), a psychological condition caused by exposure to warfare. Returning from Vietnam with jangled nerves, the veteran's PTSD was aggravated by an indifferent and even hostile reception by the civilian population. Even his own government tried to ignore him, refusing to recognize problems related either to PTSD or to Agent Orange, and private employers shunned him as maladapted and dangerous. PTSD is evidenced by symptoms of rage, guilt, flashbacks, nightmares, panic, depression, and emotional numbing, and violent manifestations of the disorder have seized the public's attention. Prompted in part by efforts of Vietnam veterans' organizations, the American Psychiatric Association has recognized PTSD as a mental disorder.' Psychologists estimate that approximately five hundred thousand to 1.5 million of the three million Vietnam veterans may suffer from symptoms of PTSD.2 Advocates such as Robert Jay Lifton have described Vietnam veterans as unique in being "alienated" and "different from veterans of other wars"3 who seemingly did not suffer from "delayed stress." 1 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders , 3d ed. (Washington, D.C: American Psychiatric Association, 1980), 236-38. 2 C. Peter Erlinder, "Paying the Price for Vietnam: Post-Traumatic Stress Disorder and Criminal Behavior," Boston College Law Review 25 (Mar. 1984): 305. 1 Robert Jay Lifton, Home From the War; Vietnam Veterans; Neither Victims nor Executioners (New York: Simon and Schuster, 1973), 35. Civil War History, Vol. XXXVII, No. 2, c 1991 by the Kent State University Press POST-TRAUMATIC STRESS DISORDER139 A corollary of this theory suggests that the problems of the Vietnam veterans would have been alleviated had the public welcomed them home as they did veterans of the First and Second World Wars.4 In sum, then, the theory holds that combatants in previous American wars usually were not subjected to the kind of stress that would result in permanent psychological damage, or, if they were, a warm homecoming ameliorated such problems. To anyone familiar with the American Civil War, the suggestion that Vietnam was unique in producing psychiatric casualties is suspect. Accounts of Civil War battles routinely refer to "dead bodies everywhere." The reaction of the soldier was often one of horror: "You must imagine the scene—I cannot describe it. The roar was unearthly; there is no better word for it. I shudder at the slaughter."5 If Civil War soldiers experienced combat trauma equal to, or more severe than, that of Vietnam, did these soldiers and veterans also suffer from something equivalent to PTSD? If such psychiatric casualties did occur, was the situation ameliorated after the war by a sympathetic civilian population? While the literature on the Civil War is voluminous, little or no attention has been paid to the phenomenon of psychiatric casualties in that conflict.6 This paper will investigate the ways in which psychiatric casualties were understood in the Civil War era, and it will further demonstrate that Civil War soldiers and veterans suffered both during and after the war from significant acute and delayed stress problems. Compared to more recent and expansive ideas of stress disorders and community mental health, the Civil War generation had a very narrow concept of insanity. Prior to the nineteenth century, in fact, the insane were usually lumped together with other socially dependent groups such as paupers, widows, or the physically disabled, and supported within the local community. Later, with the rise of the asylum, the insane were singled out and removed to the rapidly appearing insane asylums, 4 See "Psychiatric Problems of Vietnam Veterans," USA Today, Aug. 1981, 6; "The Forgotten Warriors; A Nation Begins to Understand, as the Viet Nam Vets Wait for Their Parade," Time, July 13, 1981, 18-25. ! Regis De Trobriand, Four Years with the...