Moments of Despair: Suicide, Divorce, and Debt in Civil War Era North Carolina

3. The Legacy of the War We Suppose: Suicide in Medical and Social Thought

Chapter three The Legacy of the War We Suppose Suicide in Medical & Social Thought A s the evidence in the preceding chapter has made clear, the Civil War fundamentally reoriented how white and black North Carolinians understood suicide. This evidence also suggests that the Civil War, at least at some level, effected some change in the frequency of suicide. The purpose of this chapter, therefore, is to present a series of hypotheses to account for the “suicide mania,” employing the tools of modern psychology. To be sure, we cannot place nineteenth-century suicide victims “on the couch,” and any analysis of a historical figure’s individual psychology is constrained significantly by the available sources. Nevertheless, modern suicide research should allow us to discern patterns in the data that would not necessarily be apparent to contemporaries. Given the complex nature of the war and its effects on the North Carolina political, economic, social, and cultural order, seeking a monocausal explanation is both unsatisfying and unproductive. Rather, these dramatic changes in attitudes and practices concerning suicide almost certainly were the product of a complex interaction of factors brought about by the Civil War. One possible explanation for the increased prominence of suicide among white North Carolinians is that many Confederateveterans of the Civil War suffered from post-traumatic stress disorder. Post-traumatic stress disorder, or PTSD, refers to a set of psychological consequences resulting from exposure to traumatic events, such as militarycombat, natural disasters, rape, or abuse. Originally defined in 1980 to describe symptoms displayed by Vietnam War veterans, PTSD has now been identified as the root cause behind what was known as “shell shock” in World War I and “combat fatigue” in World War II.1 suicide 54 PTSD can manifest itself in a variety of symptoms, including depression, irritability or fits of anger, nightmares, excessive anxiety, insomnia, emotional detachment, and flashbacks of the trauma.The severity and duration of these symptoms exhibit considerable variation among PTSD patients. While some PTSD victims manifest these symptoms almost immediately afterexperiencing or witnessing trauma, manyothers displaya “delayed onset ” of PTSD, going years or even decades before indications of the disorder manifest themselves. To be sure, not all victims of trauma develop PTSD; among Vietnam War veterans between 2 and 26 percent developed PTSD.2 The question of whether PTSD can result in higher suicide rates has vexed psychologists for decades, particularly in the case of Vietnam War veterans.The earliest studies indicated that the suicide rate amongVietnam War veterans was more than six times higher than in the civilian population . Indeed, some of these early estimates concluded that more soldiers killed themselves in the years after leaving Vietnam than died in combat.3 However, these results were rejected by a study conducted by the Centers for Disease Control (CDC) in 1990, which concluded that fewer than nine thousand Vietnam veterans had committed suicide through the early 1980s, a figure no higher than in a civilian control cohort.4 A more recent reevaluation of the CDC data, however, has indicated that veterans with PTSD displayed a statistically significant increase in the rate of suicide over veterans without PTSD. Moreover, many of these veterans did not display symptoms of PTSD or suicidal behavior until decades after leaving the combat theater.5 Regardless of the data, many Vietnam veterans maintain that PTSD has resulted in a significant increase in suicide among veterans.6 Some historians have argued that Confederate soldiers did not experience PTSD like their Vietnam era counterparts. They claim that although a Civil War soldier’s initial exposure to combat might be traumatic, after a period of “seasoning” he became largely immune to the psychological effects of witnessing and participating in the horrors of war. This line of argument concludes that Vietnam era soldiers experienced PTSD at such high rates because they never developed the “seasoning” that protected soldiers from an earlier generation.7 Other historians have argued that the development of the Lost Cause ideology during Reconstruction effectively protected Confederate veterans from the mental trauma so common among Vietnam era veterans. According to historian Gaines M. Foster, “Returning Confederates received such ritualistic welcome; the returning Vietnam vets at first did not—a difference that helps explain why so many more Suicide in Medical and Social Thought 55 Vietnam than Confederate veterans had a difficult time putting the war behind them.” The result, according to Foster, is that “little evidence of posttraumatic stress...