Trust the JourneyA Study of Vietnam Veterans Healing from PTSD in Western North Carolina

Bailey Ethridge

Ethnographic Methods (ANTH 336)

Dr. John Wood

December 8th, 2016

To T.O.R.M.

May you always remember to be your own sunshine.

Foreword

My interest in studying Post Traumatic Stress Disorder as experienced by Vietnam War-

era veterans was spiked by my previous participation in an anthropology class at the University

of North Carolina at Asheville entitled “There and Back Again: The Anthropology of Witness.”

The class consisted of six students and six veterans who had previously participated in

alternative PTSD group-therapy classes led by Dr. Bruce Kelly, a physician at the Charles

George Veterans Affairs Medical Center in Asheville. Dr. Kelly’s class focused on creative

writing and the humanities as methods of addressing suppressed traumas of war. Our class was

intended to be somewhat of an extension on the healing progress made by the veterans in

previous therapies, as well as a way of documenting and preserving oral accounts of an important

era in the history of our country. The course structure was guided by “photovoice”

methodologies, in that we combined recorded interviews with photographs to create dynamic

accounts of these men’s lived experiences. As someone who had initial reservations about

participating in the class due to a lack of prior military experience or knowledge, I was

pleasantly surprised at the wealth of information I gained throughout the classr. Politics aside, I

was granted insight into how the war affected the morality, relationships, and self-image of those

who served. I grew particularly interested in the notion of “healing” from trauma and the actions,

people, and transformations that play a role in that process.

Upon the conclusion of the photovoice class I felt unsatisfied with my level of

understanding of these matters. The logical segue for the continuation of my inquiry seemed to

be a return to its origin: the creative writing class at the VA hospital. Unfortunately, the writing

class in its original form came to an end around the beginning of my project. I had the immense

privilege of attending the performance of “Brothers like These” at the Asheville Community

Theater, in which each writing class participant read a piece of their writing on stage in front of

an audience of over two hundred community members. However, aside from one atypical

meeting held for reflection on the performance, no writing classes were held during the duration

of my project. This led me to shift my intended ethnographic role from participant observer of a

preexisting community to a more active role that required me to establish individual relationships

and create opportunities for discourse. I moved from the questions I proposed initially: “What

role can creative writing play in the process of healing from war-related PTSD? Why is it an

effective tool?” As well as, “What does it mean to be a part of the ‘imagined community’ of

veterans? Is it easy to form relationships within it that expedite the healing process?” I had

envisioned myself writing a rave review of creative writing therapies and ultimately a universal

prescription for healing from trauma. Quickly, though, my research revealed that PTSD is far

more complex than a single solution. These changes also forced me to make peace with the idea

of a “roaming ethnography” confined by concepts rather than space or community.

As the semester comes to an end, I realize that the culmination of my research is far from

a complete portrait of the people I’ve studied, let alone a portrait of the topic. In a sense, it is as

much an account of my journey as an ethnographer as it is an ethnography of veterans. My hope

is that it will serve as a foundation for future inquiries and that its incompleteness may provide

the reader an understanding of how the proclivities of PTSD vary greatly between individuals. I

also hope that through witnessing the challenges and successes in my journey towards

understanding, concepts like war and trauma as well as the people who live them will seem more

accessible to those who want to learn but have reservations much like I did only months ago.

Part One: The Symptoms

I pull into a long gravel driveway next to a white, one-story home in Old Fort, NC. As I

scramble to pull together my notebooks and recorder, I look up to see an older man and two

skeptical white Yorkshire Terriers watching me from the front porch. The dogs cling tightly to

his ankles as we introduce ourselves, forgoing a handshake, and walk inside. Lester is a 70 year

old veteran who spent 30 months in Vietnam as a combat medic and also goes by the pseudonym

T.O.R.M. (tired old ranger medic). Although he quit the writing class before the final

performance, I was able to get his email address from the list of contact information of the

participants. When I emailed every address on the list to ask for an interview he responded only

an hour and sixteen minutes later, eagerly accepting my request for an interview. He was the

only veteran to respond.

Minutes after our introduction, I find myself seated across from Lester at his round, four-

seater wooden dining room table sipping the Pepsi he offered me and listening to the soft country

music playing in the next room. He’s telling me about wanting to end his life only months

before. He speaks of an inability to do anything, fueled by a drinking problem that controlled his

life. He speaks of neglected relationships, nightmares, and flashbacks that extinguished his will

to live. Never before has a person shared such intimate stories with me, but as my thoughts filled

with empathetic emotion I had no energy left to worry about finding an appropriate reaction or

response. I sat raptured, clinging to every word.

He explains that while he was fighting these battles he concurrently was fighting

numbness; he was “emotionally dead,” unable to feel anything. Even the death of his parents

elicited little emotion. It wasn’t until his oldest dog passed away less than a year ago that the

numbness began to fade:

“And I got to a point to where I had no feelings. And until recently I could look back and

I know that I didn’t have feelings. Nothing, uh, nothing really bothered me. Last

December when my little Yorkie female…I had to put her down. That just about killed

me. And that is- that’s the first time I really can remember having lots of feelings since

Vietnam.”

I look over towards the living room where Gizmo and Stubbie huddled on the couch and

understood how painful that had been.

~ ~ ~

The symptoms of Post-Traumatic Stress Disorder, like any other officially recognized

disorder, have been condensed into a general, standardized list that makes uniform diagnoses

possible. Upon entering a mental health clinic with suspicion of PTSD a patient will be

administered the PCL-5, a test which measures the severity of the 20 DSM-5 (the Diagnostic and

Statistical Manual of Mental Disorders, Fifth Edition) PTSD symptoms. Patients answer with

either “not at all” (0), “a little bit” (1), “moderately” (2), “quite a bit” (3), or “extremely” (4),

depending on how much they have been bothered by that symptom in the past month. A score of

33/80 or higher results in a PTSD diagnosis. The symptoms measured include: dreams/

memories/ flashbacks, trouble sleeping, trouble remembering the trauma, strong negative beliefs

about oneself, loss of interest in things previously enjoyed, avoiding external reminders of the

trauma, feeling distant or cut off from others, trouble experiencing positive emotions, irritable/

angry/ aggressive behavior, hypervigilance, and difficulty concentrating. What this sheet fails to

capture is what these symptoms look like when placed in the context of a real human life.

For Lester, “avoiding external reminders of the trauma” means getting laid off from the

job he held for 24 years at a plywood company for refusing to attend classes on “how to treat

women and minorities” because the cramped spaces triggered his PTSD. For Butch, “trouble

experiencing positive emotions” might mean not knowing how to express gratitude upon

receiving the gift of a quilt, made for him by an organization that supports veterans to thank him

for his service. In a moment of reflection he wrote:

“As result of our discussions, I was thinking of how un-prepared and un-skilled we are at

thanking people when we are recognized for our service and sacrifice. We have been

hiding out time and losses in Vietnam for 30 or 40 years, and only recently acknowledged

our service. I was presented a quilt that was made to recognize my service to the freedom

we enjoy as part of this great country. I could only say Thank-you, which didn’t seem

enough for the gratitude I had. Through the sessions we had downstairs I was able to

realize of how un-prepared we are to realize it is a different time and we are different

people. We don’t know how to show appreciation because we haven’t had to, we don’t

have practice.”

For Bob, these symptoms translated into him obsessively folding, smoothing, and unfolding a

holiday-themed dish towel that lay next to him on his dining room table as he recounted

traumatic events. For George, they appear as an aggressive response when he disagrees with a

discussion in Dr. Kelly’s writing class:

“’I’ll tell you what I think. I think this humanities stuff is bullshit.’ I said, ‘That man is

stating a fact. He killed him, because that guy was gonna kill him. And it was either you

or me and that’s just the bottom line.’ I said, ‘You don’t try to humanize it. You don’t try

to make sense of it. You don’t come back here and say that, you know, we’re humanizing

all that you’ve done.’ I said, ‘There’s no way in hell. That is not a humanized act that you

did.’ And- and I said ‘I ain’t accepting it. Nowhere near.’”

FIGURE 1. Butch’s “thank you” quilt

PTSD symptoms often go unaddressed. Certain tendencies of a paranoid, hypervigilant

veteran in the company of civilians might go undetected because of a lack of familiarity with the

disorder. Similar behavior in the company of other veterans might also remain undetected

because after 30 or 40 years of living with PTSD, its symptoms have been normalized to avoid

acknowledging their presence. As I began spending more time with the veterans I gained a

heightened etic awareness of the unique ways in which PTSD symptoms are triggered and

expressed within their own realities. The nature of my study, in that it only concerns veterans

who have made a conscious decision to begin actively healing, meant that my subjects were

simultaneously undergoing the emic process of getting to know their symptoms.

Part Two: The People

Healers

“They’re gluten-free!” Dr. Hillary Bolter exclaims proudly as she offers me a

Tupperware container of homemade oatmeal chocolate chip cookies. I take a bite as she settles

into the armchair facing the blue couch where I am seated. She asks me what my story is- what

brought me here- and I start to explain what I am studying and how PTSD came to interest me.

As I finish explaining the photovoice class, she suddenly remembers her boiling water and jumps

up to tend to it, asking me if I want tea. “Sorry,” she apologizes, “I’m a little spazzy.” She offers

me 6 different kinds of tea and I choose the Lady Earl Gray. As I wait for her to return I look

around her office, located in suite B of the first floor of a brick building on Merrimon Avenue. I

note the calming blue and white color scheme of the room, a bowl of toys on the coffee table

between us, and a sign hanging that says “trust the journey.” She returns promptly and hands me

a textured blue mug, kicks off her ballet flats, and scrunches back up in her chair.

~ ~ ~

Dr. Bolter is a clinical social worker who worked in the mental health department of the

VA hospital before leaving and opening a private practice. I came to her office through the

suggestion of Lester, who was one of her patients (and biggest fans) at the VA. Within the first

minutes of our initial interview, Lester told me:

“I quit [drinking] in early 2015 and by late March the nightmares and flashbacks and

depression and isolation and hypervigilance, I just, uh…I was at the end of my rope and I

knew that I either had to do something or…get out of my misery. And thank goodness I

had enough sense to, uh, give it one more chance and, uh, thank God for getting assigned

to Hillary Bolter. She, uh, she won’t admit it but she, uh, she probably saved my life.”

In my limited experience, veterans have had very strong opinions about therapy and the

VA’s mental health department. Some, like Lester, have raved about the benefits of seeking help

in that realm. Others, like George and Butch, have been turned off by their experiences and often

cite a heavy dependence on prescription drugs as a reason. This distaste for formal therapy

explains some of the veterans’ affection for the writing class: there were no mental health

specialists involved in the leadership and it took place in the basement of the VA proper rather

than the small gray “Building 70” where mental health resides. When asked why some veterans

prefer the writing class to other therapies, Dr. Kristen Barlow of the mental health department

responded:

“Oh, gosh, it’s the stigma. Yeah, there’s something, you know, it’s the whole walking

through the front door. I mean, it’s much easier to walk into the hospital than to walk into

a mental health clinic. And walking through that front door is like the hardest part for

some veterans to do. So, having Dr. Kelly who’s a physician or a poet laureate, you

know, are not as intimidating or confronting as ‘I have a PTSD therapist here.’”

George confirmed her assertion during the one writing class I attended. In the middle of a

discussion about the class itself he interjected, “This isn’t therapy or nothin’. We’re just talking

to each other.”

FIGURE 3. Charles George VA Building 70: Mental Health Clinic

Visiting the mental health building at the VA hospital provided some insight on why

certain veterans choose alternative locations for their healing journey.

~ ~ ~

I walk through the front door ten minutes before two- my scheduled meeting time with

Dr. Barlow- and immediately feel burdened by a feeling of hopelessness. Murmured speech and

slow movements contained in textured gray walls and beige floors make my animated demeanor

feel inappropriate. I stand in line at the check-in window behind a man in worn clothing carrying

a backpack. He is asking to be seen but does not have an appointment. The woman behind the

glass asks what brought him here today and he answers quietly, as if he does not want anyone

else to hear: “Depression…[pause] And, uh, deaths in my family.” I get called to the next

window, forcing me to abandon my eavesdropping and miss the outcome of the discussion.

I take a seat in the corner next to the soda machine, glancing at a poster of the Vietnam

memorial and a framed photo of Barack Obama while a Zoloft® clock ticks in the background.

The space seems to be reflective of the suffering that led the veterans to it, but lacks some

indication of the hope and healing it represents.

~ ~ ~

Even veterans who are fully receptive to the idea of therapy take risks in the process. It is

a delicate process that requires a careful balance of pushing patients to acknowledge traumas and

memories that they have been avoiding and knowing when to stop pushing to avoid them getting

“overloaded,” which means overwhelming the nervous system and potentially strengthening

those trauma neuropathways. Whenever I tried to ask how therapists know when different

measures are appropriate the answer included the phrase, “it depends.” No two veterans

experience PTSD the same way, and it is the job of the therapist to determine where they are

along their healing journey and to progress accordingly.

Another risk of therapy I encountered, albeit a more mild risk than getting “overloaded,”

is dependency. I witnessed this in the relationship between Lester and Dr. Bolter. During my first

interview with Lester he alluded to this briefly as he raved about the improvements she had made

in his life. He explained that he had openly expressed his gratitude to her multiple times, and that

she had responded with a firm warning: “You need to take care of yourself. You need to be your

own sunshine,” emphasizing the importance of accrediting his own role in the healing process.

She knew that she would not be able to continually provide the same level of support for Lester,

and did not want him leaning on an unpredictable external source of healing. When she recently

left her position at the VA hospital, Lester was forced to switch therapists. He told me that

despite much hesitation he has found himself beginning to trust the new clinician, but that he will

never be able to duplicate the relationship that he had found with Hillary.

My research was not extensive enough to determine the frequency with which this

occurs. During our meeting I commented to Hillary that Lester thought very highly of her, to

which she responded that he might give her too much credit. Her response led me to think that

Lester’s case was atypical, however, at one point she leaned over to the basket of toys on her

coffee table and picked up a pink fairy wand. “I have to tell some of my patients: I’m not

magical!” She says, eagerly waving the wand and sending pink ribbons into a frenzy. Naturally,

my discovery of this issue led to some reflection on my own relationship with Lester. The

following is an excerpt from a letter he wrote to me, which he gave me in a binder covered in

Vietnam War stickers containing: a presentation he is preparing for the VA that he asked me to

edit, a list of PTSD symptoms that he asked me to re-type in a large font, a couple pieces of his

writing titled, “Feelings” and “Todays V.A.,” a letter for me to take to my parents, and a t-shirt

which says “I [heart] MY VIETNAM VET:”

“My new friend Bailey has given me the desire to write again. Someone up above

decided I needed a unselfish friend that cared about what I think.

I have alot of tools in my tool box to deal with my P.T.S.D., but now I have another one.

Bailey did you ever think you would be called a tool in an old medics recovery. You have

added a new aspect to my recovery.”

Thus a new question arose, which remains unanswered in my inquiry: At one point does a

dependency on external relationships hinder the healing process? A large part of healing is

getting to a point where one is comfortable enough with their trauma to address it, as well as, I

think, to have it be addressed by others. I have tried to the best of my ability to act as validation-

as a witness to the trauma- by thanking the veterans for their stories and their friendships. To

consider healing as a purely individual act would largely ignore the human dependency on

intrapersonal interaction. I intend to continue organically with the relationships formed in this

study, being careful not to neglect my role as a witness and serve as a reminder for the men to

“be their own sunshine.”

Other Veterans

It’s a Tuesday afternoon at about 1 P.M. and I’m seated next to Lester on a wooden

bench at East Village Grill across from the VA hospital, waiting for a table to open. Lester is

wearing a Vietnam hat, a black Vietnam t-shirt with a long-sleeved maroon shirt underneath, and

a POW/ MIA rubber bracelet. As we chat we are approached by another man wearing Vietnam

attire who comes and shakes Lester’s hand. He says something brief but it’s mumbled, and I only

catch the last word: “brother.” After he walks away I ask Lester who he is and he replies that he

does not know.

A few minutes later we are seated at a table; Lester is washing down a BLT with sweet

tea and sharing snippets of his life with me when another man in Vietnam clothing approaches in

a motorized chair. They shake hands and the man asks, “Will you shake hands with a squid?” I

interpret this as meaning that he has a limp hand, but Lester informs me after he walks away that

this means he was in the navy. They converse about Veteran’s Day which is coming up on

Friday. The man in chair addresses it by saying, “You know we get a free meal on Friday,”

referring to a policy that certain restaurants have in place to honor the day. In an attempt to join

the conversation I say, “Do to-go orders count? You should stock up for the week!” The man

clearly disapproves of this, saying that if he’s going to eat in someone’s place he’s going to stay

and enjoy it, not take off with the food; it seems wrong to do otherwise. The men then tell me

that people will pretend to be veterans on that day in order to get free food and when I express

surprise and disgust they both laugh, joking with each other about how "sheltered and innocent”

I am. The conversation shifts to the upcoming election, which the man in the chair has many

strong negative feelings about. He is grappling with the fact that, out of three and a half million

people in this country, the two we have to choose from for president are a “bozo” and a “crook.”

His complaints continue for a few more minutes until the two say goodbye and the man rolls his

chair out the front door. Again, I ask Lester who he is. Again, he responds that he does not know.

~ ~ ~

This experience reinforced my understanding of why so many veterans dress themselves

in reminders of their trauma on a daily basis. By doing so they make themselves identifiable to

others who not only will acknowledge them, but will do so in solidarity. George addressed the

importance of identification in an interview, saying, “Unless you wear a hat that says ‘Vietnam

veteran’ or something like that you don’t know. And I’m not gonna ask you. And you’re not

gonna ask me. So, you know, we’ll talk about everything in the world and it might come up, you

know, if we were there long enough.” Once the veteran status is identified, there is a sort of

mutual understanding of what the other has gone through that initiates and guides the

conversation. The experience also reinforced a hypothesis that was initially one of the driving

forces of my inquiry: that membership to the “imagined community” of veterans is an integral

part of the healing process. While the conversation between the veterans at East Village Grill

remained politely trivial, it still allowed the men to play the role of veteran in a positive, non-

clinical space.

The friendship between George and Michael is an example of how intramilitary

relationships can fuel the healing process. Both men are Vietnam veterans who participated in

Dr. Kelly’s class as well as the photovoice class, and their relationship is strengthened by the fact

that both continued in the military after Vietnam for multiple deployments. Michael has fully

admitted to suffering from PTSD, albeit a somewhat recent admission, but despite his

participation in the aforementioned programs George is hesitant to accept the diagnosis. Michael

has maintained a tenacious assertion that George does, in fact, have PTSD and has continually

encouraged him to acknowledge it while providing patient emotional support. This relationship

can be understood through the last line of an email sent to me by Michael the day before I was

supposed to interview George. He wrote: “PS: Be gentle with George.”

The one occurrence of the writing class was the only chance I had to immerse myself in a

group setting of veterans. We met on Wednesday, October 5th at 4:30 PM in Classroom B in the

basement of the VA hospital.

~ ~ ~

As participants drift in they took seats at the plastic two-seater tables designed to look

like wood that are arranged in a circle around the room. Dr. Kelly passes around copies of a

group photo they had taken at the performance, and almost immediately the men begin cracking

jokes, calling themselves a “motley crew” and paying special attention to Butch, who is posing

almost comically seriously in the picture. Butch strolls in a few minutes past 4:40 and says to the

group, “Ok, now we can start.” He quickly realizes that the men had been joking at his expense

and defends himself, telling them, “You are looking way too into this.”

Dr. Kelly begins the class with a few introductions of the “important people” present,

including myself, and then prompts discourse by asking the veterans what they thought of the

performance. By this point in the class, the mood has grown more serious in nature and everyone

listens intently as the veterans share their feelings, moving around the circle of desks to the next

man. For almost the next hour, they talk. Some mention family, some mention therapists, some

mention strangers in the audience, and some just mention themselves. Each individual shared a

sliver of intimate emotion surrounding the performance, whether it was positive, negative, or a

mixed bag. As I sit and listen it is clear that these men are reflecting on something challenging

that they accomplished as a group, as a team, as a band of brothers.

~ ~ ~

Naturally, due to the complex and unpredictable nature of PTSD my hypothesis was

challenged even in the short duration of my study. I found that there can be tension between

veterans that arises in group therapy situations. The few men I talked to had opinions on who

“needed” therapy and who did not. A main source of disagreement came from the varying

experiences the veterans had during the war. Specifically, those who had not been in combat

trying to relate to those who had been and vice versa. I heard some cases of veterans enhancing

their stories with fictitious accounts, which I presume is an attempt to validate their suffering and

their “need” for the class. George told me the following story about an incident in Dr. Kelly’s

writing class:

“Well this ‘supposedly’ marine sniper in Vietnam said he- he says ‘I was, uh, there’ and

he says, ‘When I shot this four-year-old girl,’ and he says, you know, ‘I relive it.’ And I

think to myself, ‘How do you know she was four years old?’ And I said because it is- it’s

just like everywhere else. You wouldn’t go recover the body and you wouldn’t have been

able to talk to anybody. How would you know that to start with? And it would just mimic

that picture that- that one in that movie [American Sniper.] Now I said, ‘No, you’re lying

out yo’ teeth right now.’ And I don’t like that. I don’t like for a lot of these stories to get

so blown out of proportion. You know, that, I can’t handle it. I call ‘em out.”

Due to the lack of writing classes during this project, I was unable to witness this

competitive behavior between veterans materialize in a group setting. My awareness of it comes

only from indirect accounts. Its inclusion in this study is not meant to discredit the value of

intramilitary relationships in the healing process, but rather to demonstrate how PTSD symptoms

can influence and complicate even commonplace interactions.

Civilians

Excited chatter dulls to a hushed volume as the lights dim in the theater. I am seated in an

audience of over two hundred people at the Asheville Community Theater, awaiting the

performance of a piece titled “Brothers like These: A Staged Reading of Writings by Vietnam

Veterans.” The event was organized by Dr. Kelly as an opportunity for the veterans to showcase

the writings they had done during the class, and was being shown for the first time on

Wednesday, August 31st at 7:00 PM. I gather that the majority of attendees are friends and family

of the participants, and as I look around at the nicely dressed individuals I feel a sense of

solidarity and support among them. People seem both excited and honored to take part in the

evening.

The performance begins with initial introductions that establish the formality of the

event. Acknowledgements are given to distinguished men such as Joseph Bethanti (professor of

creative writing at Appalachian State University and North Carolina Poet Laureate 2012-2014),

who hosts the evening, and Bruce Weigl (Vietnam veteran, 2013 Pulitzer Prize finalist in poetry,

and ASU’s Rachel Rivers-Coffey Distinguished professor of creative writing for 2016-2017),

who receives ample applause. The eighteen writing class participants wait eagerly, seated in

chairs facing the audience along the back of the stage. With introductions underway, the veterans

take turns approaching one of two podiums located at either side of the stage to read a piece they

wrote, lasting only a few minutes, while a photo of them from their service is displayed on a

screen behind them. We are asked to hold our applause until the end.

After each emotion-ridden line is read, thanks and credits are given where due, each

veteran receives a challenge coin for their participation, and the audience releases the applause

they have suppressed for the past hour and a half, we file back into the lobby for the reception. A

row of tables draped in white tablecloths separate the room into two sides and boast platters of

cheese and crackers, vegetables and dip, and miniature sandwiches. The mood is jovial, with

everyone mingling and hugging one another. The enclosed space ensures that people interact. I

greet and congratulate the men I know from our photovoice class, however, their role in the

performance has landed them in the spotlight for the evening and we are constantly interrupted

by loved ones who have come to support them. The attendants seem to already know many

people present and, I assume from all the introductions that I witnessed, will leave with a further

expanded network. Throughout the evening the veterans maintain a formal yet warm and prideful

demeanor.

~ ~ ~

This evening was the conclusion of Dr. Kelly’s writing class, and it was intended as a

moment of closure for the veterans as well as an opportunity to connect veterans and civilians

through stories. For many, it was a big stride out of their comfort zone. During the discussion on

October 5th Charles, one of the participants, confessed that he had felt nervous beforehand and

“torn up inside” afterwards. Despite these feelings, he pushed himself to perform and follow the

advice of one of his psychiatrists: “make yourself do.” Butch expressed some uncertainty and

asked in search of validation, “Was it boring?” He also shared that it had not been a comfortable

experience and felt like “opening up a can of worms.” Ultimately, every man in the room said

that they were pleased with and proud of their decision to stretch beyond their comfort zone and

that it had changed their life in a positive way.

~ ~ ~

I walk up a short flight of stairs into “The Refinery,” a studio space near the South Slope

area of downtown Asheville. The space was recently taken over by the Asheville Arts Council

and tonight (Thursday, September 29th) is the grand opening. I am immediately greeted by a

woman who invites me to make a name tag for myself and sign-up to receive emails from the

organization. Wondering why I needed a nametag and feeling slightly out of place, I continue

past clustered displays of paintings and jewelry in search of familiar faces. The head of the

Asheville Arts Council had attended the “Brothers like These” performance a month prior and

said that it was the “most touching evening he has ever been a part of.” This impression led him

to reach out to Dr. Kelly and invite a portion of the veterans to do a second performance at his

grand opening event. Unlike the first performance, this event is not being held specifically for

the veterans. Their readings are scheduled from 7:00 PM until about 7:30 PM, taking up only a

fraction of the three-hour-long event. Their names are listed in the program among the other

“acts” of the evening, which include music, art exhibits, and guest speakers, and it seems to be

presented as “entertainment” rather than something serious, emotional, and political.

I soon run into Butch and his wife Cecile, who are passively observing the crowds as they

chat with one another. They greet me as though they are pleasantly surprised to see me. As it is

almost time for the veterans to perform, Cecile suggests we make our way to the main room and

asks that I carry her bag for her because it is too heavy. I agree and take the bag, realizing that it

must weigh at least ten pounds. When I ask what she is carrying that is making it so heavy she

laughs and replies, “Everything!”

We push past groups of formally dressed people sporting nametags and sipping Oskar

Blues beer and champagne out of plastic cups. In the main room a row of about ten chairs is

facing the front, all of which are occupied by older people who I presume to be family members

of the veterans. Behind the chairs is a crowd of people standing that consists of all ages (about

half look younger than 30). With the exception of one black man, everyone is white.

Dr. Kelly had given a quick speech about the project earlier in the evening. Although I

arrived after he had finished, I was told by the veterans that once he began to speak, “floods of

people left the room.” Unlike the first performance, the attendees of this event had come to

support the AAC and were not necessarily expecting to hear about the Vietnam War. The seven

veterans chosen to read line up, nervously clutching their papers. David asks me jokingly if I can

go up and read his piece for him. They begin taking turns standing in front of the microphone

and sharing the words that they spent so many months searching for, however, some attendees

continue to converse noisily. It is not until the third man begins to read that people stop flowing

in and out of the room and finally grow quiet, listening to the performance.

As the “act” comes to an end the frustration expressed by the veterans at the perceivably

disrespectful behavior of some attendees is replaced by celebration as they congratulate one

another. They thank me again and again for being there and even Dr. Kelly, who had not

addressed me at the first performance, shakes my hand and calls me by name as he thanks me.

Two women with praise for their work approach the veterans, one of whom says she works at the

VA, but that is the extent of their interactions with the crowd. They leave within five minutes of

the performance ending and go have dinner together at Tupelo Honey Café. Cecile makes sure to

invite me, but due to another obligation I have to regretfully decline. As I walk her and Butch to

their car she asks me what I plan to do for a career and encourages me to consider a job in

therapy.

~ ~ ~

The degree of reception of the veterans differed at the two events because of the different

crowds the spaces attracted. The performance at the community theater was advertised as being

about veterans, and commanded the attention of the audience through a set-up (dimmed lights, a

stage, and assigned seats) that established the roles of performers and witnesses. The positive

responses they received left the veterans feeling validated in their emotions and confident in their

work. The event at The Refinery yielded less rigidly defined roles- there was no stage, attendees

were not required to stop and listen, etc. - and thusly yielded slightly less validation. Even so, it

allowed the men the opportunity to interact with others as veterans, and required those others to

recognize their identities as veterans. Even a mixed bag of reactions can be beneficial in the

healing process in that it allows the veterans to position themselves somewhere in society. This

hypothesis is supported by a piece that Michael wrote on his experience performing:

“While waiting back stage, I couldn’t help but think how far we had come over the last

eighteen months as a group and as individuals to bring us to this moment in time and how

lucky we were to have been selected to participate in this program. As we lined up to go

on stage I think we were all a little apprehensive about what we were about to do and

then we were told to move on stage. Even though we had practiced what we were to do

we had not anticipated the audience’s reaction. As we walked on to the stage the

applause was a little unsettling and a new experience for us. Even though the audience

had come to share our current accomplishments their applause seeped into so many areas

that had not found closure in our lives. That applause validated that we mattered, that our

service to our country mattered and that we had not done anything wrong; it was in a

small way our country saying ‘Thank You’. Had the evening ended right then we would

have been satisfied. But it didn’t. We spent the next one and a half hours telling our

stories of what our lives had been before, during and after Vietnam. Later more heart felt

applause but this time we just reveled in it. Afterwards a reception which was pretty

much a blur with people we didn’t know coming up to us and thanking us and saying ‘I

didn’t know’ or ‘I didn’t understand’. I know I left there on a real high thinking life can

be good. The next day, reflecting back on the night before, I was at peace with myself.

Closure feels good.”

Although these interactions between veterans and their community did not occur organically,

they created the opportunity for the veterans to be recognized and understood by others and

consequently allowed them to better understand themselves.

Part Three: The Healing

At some point in my study I grew self-conscious of the frequency with which I used the

word “healing” and my limited understanding of what it actually means to “heal.” I began

looking for answers in my informants, asking them what they think it means to heal and whether

or not it is possible to ever truly heal from the wounds of war. One metaphor used by Lester to

explain healing was a spatial metaphor. He kept referring to a “place” where he needed to be able

to get to in order to “deal with it:” “You have to figure out how to get over it. It’s never a done

deal but, uh, you put it in a place to where you can- you can deal with it.” Confused by the

vagueness of his explanation I tried to prod him for something more concrete but my efforts

failed. Later on, when we were talking about what it means to “deal with it,” Lester told me he

had compiled an emergency plan for when he gets triggered. The following is an excerpt from an

interview in which he discusses the plan:

Lester: “Basically, I list what the triggers are. And the triggers are nightmares,

flashbacks, depression, smells, crowds, uh, sometimes news, TV, that triggers things to

happen. Uh, things that I do to overcome that is, uh, I have my dogs, I go for walks, I

have my great-grandkids that I go see, I cook, when I get on the wire I will cook, I will

clean, I will try my best to just, you know, let it pass. And my wife is a lot better now.

She, uh, I've actually confided in her in the last year and, uh, I can actually tell her, you

know, when I’m- when I’m going into depression and, uh, she knows to just leave me

alone and let me- let me work it out. Used to she could say ‘what’s wrong? What’s

wrong? What-what-‘ you know. All this. And there’s really nothing that anybody can do.

Now I have vets that I’m good friends with that, uh, you know, if it starts to get bad I will

call and talk to them but, uh, sometimes nothing works. And you just have to ride it out.

I’ve had instances when I got on the wire and I’d be on the wire for two or three days and

then I would- the bottom would fall out and I’d be in depression for two or three days

before I ever come out of it. But there’s a lot of things that I try to keep the…things from

happening. I know when things are starting to get bad. The depression will start and you

can feel it. And I’ve learned as soon as something starts to start dealing with it. It comes

from experience.”

Me: “What exactly does it feel like to be ‘on the wire’?”

Lester: “It’s like a natural high like you’ve never known. It’s higher than drinking, it is

higher than dope, it is, uh, it is, uh, like a…it’s like nothing you’ve ever experienced and,

uh, it’s something that Vietnam vets know because we stayed on the wire for days,

weeks, and months at a time. And, uh, and then when you finally come off of it it’s

usually, uh, not between the ditches it’s usually go from the top out the bottom. And then

you just have to work your way out of the rabbit hole and come back to life. And a lot of

people don’t when that happens it, uh, they don’t come out of the rabbit hole. They, uh,

choose to stay in the rabbit hole. But I’ve been- I’ve been able to come out of the rabbit

hole so far. “

Although Lester alluded to space when he says, “…not between the ditches it’s usually

go from the top out the bottom,” I did not make the connection between his spatial metaphor of a

healing place and the experience of going between being “on the wire” and “in the rabbit hole.”

It was not until my visit with Dr. Bolter that I realized Lester was talking about the space

between the highs and lows as the place he needed to be in order to heal. In response to the same

question, Dr. Bolter pulled out a small flip book of images and showed me a diagram of

something called the “Resilient Zone.” People without PTSD have no issue staying in their

“Resilient Zone,” which means that when something unexpected, upsetting, etc. happens they

have the capacity to process, adapt, and progress. In other words, they have the capacity to “deal

with it.” Contrastingly, such triggers will send victims of PTSD out of their “Resilient Zone,”

either into the “High Zone” or the “Low Zone.” The “High Zone” is characterized by symptoms

of irritability, anxiety, and hypervigilance and is what I believe Lester is making sense of when

he describes being “on the wire.” The “Low Zone” is characterized by depression, isolation, and

exhaustion- what Lester refers to as being “in the rabbit hole.”

FIGURE 3. The “Resilient Zone”

Another aspect of healing that both Dr. Bolter and Dr. Barlow mentioned is finding

meaning in life- reasons to live- and regaining parts of life that have been lost due to the PTSD.

A large part of this loss is due to feeling a lack of control. Certain alternative therapies are

offered to try and reestablish control and find meaning in the lives of veterans. For example,

Veterans Healing Farm in Hendersonville, North Carolina offers “meaningful activity” for

veterans to partake in. Similarly, Healing Waters Fly Fishing in La Plata, Maryland offers

veterans an opportunity to be in control. A quote from a retired SFC (sergeant first class) on their

brochure states, “It is through events such as a day on the river that fly fishing has allowed me to

regain some control over my life and limbs.” Practices like yoga and meditation that foster

control are also growing more popular as therapy options. After it was recommended to him by a

mental health professional, Butch tried practicing mindfulness and was able to gain control of the

present moment. In an interview he told me:

“…and I brought home the, uh- what is it called? Uh, when you clear your mind of

everything. Uh, the name for it. But you- the point is you clear your mind of everything. I

can remember going out by the pool here with the purpose of doing it, uh, mindfulness!

It’s called. And so, uh, your purpose is to clear your mind. Well, I cleared my mind

[mumbles] I noticed that the clouds at different levels are moving at different directions.

Well, I had never noticed that before in all my life. And here I am sixty-some years old. I

thought all clouds went from right to left! Well, they don’t. So I had some at one level

that were going right to left. Others, higher, were going a different direction. Maybe,

going from left to right. So, I thought, well that’s interesting. I never- now sixty-some

years of experience and this is something I’ve learned from that.”

Regaining control over one’s life requires a certain amount of acknowledgment of the

trauma. All of the veterans who I interviewed for this study have said that their PTSD went

largely ignored for 30 or 40 years. They would make excuses for their symptoms so that they

would not have to attribute them to the disorder. The most frequently occurring metaphor in

discourse surrounding PTSD is the metaphor of trauma as skeletons or boxes in a closet. In

talking about the writing class Michael confessed, “I guess earlier I had just unpacked all the

boxes and dusted things off and got rid of a few things and then apparently we packed ‘em all

back in that box and put it back in my head.” Based on my research, I believe that the boxes

containing Michael’s trauma will likely remain in that closet for a long time. Trauma does not go

away, rather, it becomes manageable. Dr. Bolter explained that through therapy one can get to a

point where “…these skeletons, you know them. And you’ve found ways to- it’s not making

peace with them necessarily, but it’s to learn how to live in relationship with them. Um, and

then- and then in that process they hopefully aren’t just popping out all over the place because

they kind of- you’ve settled with them in some way.”

Confrontation of trauma is not limited to one method, and writing about traumatic

experiences is only one of the methods I encountered. Lester confronted his “skeletons” in a

different constructive manner: he created a tombstone for Sergeant Benion at the VA hospital

that he visits regularly. Sergeant Benion was a man in Lester’s company who taught him about

“weapons, tactics, and how to be a good leader.” Benion was shot between the eyes not ten feet

away from Lester, and there was nothing he could do about it. The occurrence has haunted him

since, but he has finally found a release for some of his guilt through the erection of the

tombstone. For others, simply talking about the trauma might be far enough out of their comfort

zone to be productive in healing.

~ ~ ~

I walk into the Earwood home in Fairview and into a wall of heat. It feels like the way

people describe getting off of the plane after landing in a tropical country. I am greeted by Bob

Earwood, a friend of Lester’s from the writing class and a combat medic Vietnam Veteran who

was drafted at 20 years old. He is wearing a t-shirt with a large image of an eagle and the text

“They will soar on wings like eagles,” quoted from Isaiah 40:31, with fleece pajama pants

patterned with owls and moose. He leads me inside past stacks of pill bottles and packaged

snacks, saying, “Sorry for the mess. We live here.” I poke my head around the corner to find his

middle-daughter Stephanie approaching to assess the visitor. I introduce myself and giggle at her

shirt, which reads, “Who needs mistletoe with a face like this?”

We settle down at his kitchen table. I take the seat at the head of the table, Stephanie sits

to my left against the wall, and Bob takes the seat across from her where someone had left a

white plastic cup full of a dark pink liquid. Dr. Phil plays muted in the background. He talks for

45 minutes almost entirely uninterrupted, moving from the church he works at to his deployment

to getting attacked in Vietnam. He stops only to apologize once more, this time for forgetting to

put his teeth in. I assure him that I did not notice and he moves on. As the topic shifts to more

sensitive memories, Bob grabs the worn-out, Christmas-themed dish towel lying on the table and

starts to fold, smooth, and unfold it with an intensity to match his story. I sit tense with the

awareness that Bob is rife with emotion, yet I am unsure whether he is close to tears or laughter.

When we reach his homecoming he pauses and Stephanie cries out that she’s hungry,

letting me know that pork chops, fried cabbage, and macaroni and cheese are for dinner. I ask

how much more time he has. He sighs, looking defeated, then answers, “oh…I’m about out.” His

wife Lynn enters the room, remarking that “it’s awfully hot in here,” then heads to the front

porch to smoke a cigarette with her son next to the space heater.

~ ~ ~

The visible exhaustion Bob expressed after being interviewed indicated to me that the

content of his stories were skeletons that he might not be entirely comfortable with yet. In order

to avoid getting “overloaded,” it is important to keep confrontation at a level that feels

manageable. If Bob had continued to pull out boxes, he would have run the risk of harmful

emotional damage. For this reason, the VA mental health department offers programs requiring

different degrees of confrontation. Two of the most utilized programs are Prolonged Exposure

Therapy (PET) and Cognitive Processing Therapy (CPT), and they belong to a category of

therapies called Evidence Based Practices. CPT is the less intense of the two programs and

involves confronting and processing trauma through writing and completing exercises in a work

book. Participants generally complete the program in 12 sessions held once or twice a week. PET

requires a guided reliving of the trauma through the imagination as well as tackling real life

situations that PTSD had rendered inaccessible. This program has a duration similar to CPT,

lasting 8-15 sessions held once or twice a week. Dr. Barlow showed me an example of a list

made by one of her patients, ranking places in their life on a gradient of safety. I was surprised to

see activities I take for granted rated as troublesome- for example, the grocery store, the gas

station, and driving on the parkway.

~ ~ ~

I am seated by the front door of her minimally decorated and immaculately organized

office in building 70, listening as Dr. Barlow boasts about her department. Each time a new type

of therapy is brought up, she hops excitedly over to one of her filing cabinets or drawers and

pulls out a thick white binder, flipping through it to show me just how much information it

contains. She speaks with the fervor of someone who has a mastery over their profession but still

maintains reverence for it. She hands me pamphlets advertising the Evidence Based Therapies,

complete with photos of family members embracing and climbers reaching the top of a peak, and

explains that these options are the most effective. Specifically, that CPT is proven to be 50-60%

effective and that PET is proven to be 80-90% effective. I sit up, curious as to how such an

abstract process can be quantified. She replies by addressing the challenges in quantifying

progress, ”PTSD’s a tricky little monster because you’ll think that they’ve healed… It’s like

climbing a mountain. It’s real easy to climb up but you’ve been coming here every week. Don’t

let yourself slip back down that mountain. You have to keep on not avoiding but keep on

confronting these places.” She then explained what success in the healing process might look

like through an example:

“But it was when she came in and goes, ‘Desert Storm doesn’t bother me anymore.’

That- and when she first started the therapy she couldn’t even go to Desert Storm. She

was telling me about before they even deployed sitting in a gymnasium and all the buses

coming. But it got to the point where we wore it out so much that she’s like it’s not- it

doesn’t bother me. And she’d shared it- yeah she did share it with her partner. And, so to

me the habituation piece had worked when she was able to go and start doing these things

like driving on the parkway that she’s never done before. To me that was a signal that it

worked.”

Her answer reaffirmed my conjecture once more- that it is impossible to define PTSD, its

symptoms, and the healing from it in universal terms. It contorts itself to inhabit spaces in the

lives of its victims, coexisting with the other elements that make up individual reality.

Part Four: Moving Forward

Extensive research has been done on PTSD in the fields of psychology, psychiatry,

medicine, political science, history, and sociology. These fields have examined the neurological,

social, physical, and emotional implications of the disorder. I believe that an anthropological

approach to the topic can be useful in studying how these varying implications work together to

impact individual victims, and presenting these individual accounts to the general public in a

way that elicits more holistic understanding and compassion from those unaffected. The simple

addition of mental health experts in my informant group allowed me to make sense of the

veterans’ stories through an entirely new vocabulary and school of thought. One can imagine

how the addition of input from physicians, politicians, social workers, historians, etc. would

yield a similar volume of insight leading to a more comprehensive portrayal of the subject.

Perhaps most interesting are the people who work directly with veterans, because they play a

large role in shaping how the veteran understands their own PTSD.

The narrowly focused lens of the ethnographer allows for rigid comparison between

individuals. This creates opportunities to study the relationship of various factors such as

whether or not the veteran was drafted, their political views, race, sexuality, gender, social class,

and religion to the disorder. It also allows the ethnographer to capture the manifestation of the

disorder in the form of inponderabilia, “a series of phenomena of great importance which cannot

possibly be recorded by questioning or computing documents, but have to be observed in their

full actuality” (Malinowski 18). These are the details acquired not by interviewing or by reading

a manual on symptoms, but rather by spending time with the “subjects” of the inquiry. What

Lester does when he cannot fall asleep, the gifts Dr. Barlow receives from grateful patients, and

the way Michael always arrives 20 minutes early to our meeting all fall into the category of

inponderabilia. Through these slices of reality anthropology demonstrates the convoluted nature

of PTSD and reminds us of the importance of remembering the individual.

Afterword

At 9:13 PM on a Monday night I received the following email from Lester:

“BAILEY BAILEY BAILEY THE NATURAL HIGH OF COMBAT CANNOT BE

DUPLICATED VETS TRY I TRI ED THE WANT FOR THAT ADRENALIN FLOW

THE DRUGS THE ALCOHOL THE SPEEDING CARS THE GAMBLING THE 

EXCESSIVE SPENDING THE EXCESSIVE NEED FOR SEX AND YOU TIE ALL

THAT IN WITH NIGHT MARES FLASH BACKS AND DEPRESSION AND THAT

IS WHY WITHOUT HELP VETS TAKE THE EASY WAY OUT BAILEY YOU HELP

ME TO NOT TAKE THE EASY OUT YOUR ONE AND ONLY FOREVER TORM”

Misreading the last line as, “Bailey help me to not take the easy way out,” I immediately thought

Lester was having suicidal thoughts and began typing a response. I replied three minutes later

with: “Lester, Are you having nightmares and flashbacks? Do you feel like you’re “on the wire”

or “in the rabbit hole” or somewhere in between? Let me know how you’re doing. Love, Bailey,”

using terms he has used in interviews to try and gauge where he was emotionally. I quickly

realized my mistake after replying and felt a wave of relief, and did not check my email again

until the next day. What I received back was the following:

“BAILEY YOU HAVE BEEN LISTENING IT MAKES ME FEEL BETTER TO

SHARE IF I GET IN TROUBLE I WILL LET MY LITTLE CONFIDANT KNOW

YOU LEARN FAST AND DO NOT FORGET YOUR TORM”

Lester was acknowledging my use of his healing vocabulary. He realized that I had been paying

attention to what he divulged to me and valuing that information enough to remember it and

utilize it. In his essay “Remembering the Other,” Johannes Fabian discusses the distinction made

by the German language between three levels of recognizing. The first, erkennen, means to

recognize cognitively. Wiedererkennen means to recognize by memory, to remember. Finally,

anerkennen means to recognize by acknowledgment, a more active form of recognizing than the

previous terms. What Lester experienced through our relationship is the third type of recognition,

an acknowledgment of what he has been through and how that shapes who he is. Fabian warns of

the risk of recognition becoming appropriation, which happens due to the human tendency to

categorize people into “types” or to relate them to already familiar things in order to better

understand them. The word “veteran” elicits a variety of cognitive connections in non-military

individuals that lead to potentially harmful stereotypes. A civilian who comes in contact with a

veteran or active serviceman might make sense of that person by assumption, potentially

assuming the possession of negative traits like being uneducated or having a tendency to

violence.

By recognizing Lester and his behavior in the framework of his own terms, I was able to

both make him feel more understood and acquire for myself a more accurate idea of what he is

experiencing. I think that paying careful attention to language is especially important in

relationships that span generations, as disparities in meaning can occur and hinder

communication. Picking up on his vocabulary, however, was not purely a product of my role as

an ethnographer. I have witnessed this occurring in countless relationships, specifically

friendships and other relationships that involve repeated interactions. Lester’s reaction to my

email simply shows his appreciation for the authenticity of our relationship. Although it

originally formed out of my need for informants, it quickly developed into something genuine

and unbound by roles of authority (such as the relationship between therapist and patient). Our

relationship allowed Lester to be anerkennt as a veteran, as a victim of PTSD, and as a friend.

Works Cited

Fabian, Johannes. “Remembering the Other: Knowledge and Recognition in the Exploration of Central Africa.” Critical Inquiry 26.Autumn (1999) 49-69. Print. Malinowski, Bronislaw. “The

Subject, Method, and Scope of This Inquiry.” Introduction. Argonauts of the Western Pacific; an Account of Native Enterprise and Adventure in the Archipelagoes of Melanesian New Guinea.

London: G. Routledge & Sons, 1932. 1-25. Print.