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Professional NewsFull Access

One Veteran's Perspective on PTSD

Published Online:https://doi.org/10.1176/pn.41.7.0013a

Robert O. Muller sat in his wheelchair through a full day of testimony in the Institute of Medicine's (IOM) inquiry into posttraumatic stress disorder (PTSD), waiting for the words of insight that never came.

Courtesy of Alliance for Security, Inc.

To Muller, the origins of PTSD have as much to do with a war's place in society as it does with a soldier's personal experience in combat.

He speaks with some authority. Muller took a bullet in the spine in 1969 while serving as a Marine lieutenant in Vietnam and spent over a year in a Veterans Administration hospital. He helped found and is now the chair of the Vietnam Veterans of America Foundation in Washington, D.C. Implied in the Department of Veterans Affairs' (VA) request to the IOM was a reminder that the distress of Vietnam War veterans was for so long not acknowledged by those charged with their care.

“Fighting the war was disturbing, but we got our arms around it,” he continued. “But later we understood that the war wasn't what we had been told it was. We were lied to. We felt a profound sense of betrayal, a cavalier abuse of trust.”

If there is some necessity, purpose, or meaning to trauma, soldiers can deal with it, he said. But if not, then problems arise. Once public support for the Vietnam War was lost, veterans had greater difficulty readjusting to their lives back in the United States. One result of that was PTSD.

“Posttraumatic stress disorder gave the VA a hook to hang the vets' dysfunctionality on,” said Muller in an interview after the IOM meeting.“ Until they got that hook, the problems of veterans weren't addressed. The VA initially medicalized and privatized a larger societal issue.”

The social and political dimensions of war and trauma never surfaced at the IOM meeting, said Muller. “PTSD has become fully medicalized, and psychologists, psychiatrists, and policymakers can't acknowledge that moral ambiguity will become part of the psychological difficulty in readjustment.

“The doctors [at the IOM meeting] are not going to touch the political question of whether the war was right or wrong,” he said. He fears similar issues will affect the current crop of veterans now fighting in Iraq as American society views that war as unnecessary. “When these vets come out of the military bubble, there will be a problem.”