"There is no cure for trauma. Once it enters the body, it stays there forever"

Survivors say the day of their trauma marks the end of a chapter in their lives. The IED attack in Iraq was mine

Published February 1, 2015 2:00PM (EST)

  (Reynaldo Leal)
(Reynaldo Leal)

Excerpted from "The Evil Hours: A Biography of Post-Traumatic Stress Disorder"

We are born in debt, owing the world a death. This is the shadow that darkens every cradle. Trauma is what happens when you catch a surprise glimpse of that darkness, the coming annihilation not only of the body and the mind but also, seemingly, of the world. Trauma is the savagery of the universe made manifest within us, and it destroys not only the integrity of consciousness, the myth of self-mastery, and the experience of time but also our ability to live peacefully with others, almost as if it were a virus, a pathogen content to do nothing besides replicate itself in the world, over and over, until only it remains. Trauma is the glimpse of truth that tells us a lie: the lie that love is impossible, that peace is an illusion. Therapy and medication can ease the pain but neither can suck the venom from the blood, make the survivor unsee the darkness and unknow the secret that lies beneath the surface of life. Despite the quixotic claims of modern neuroscience, there is no cure for trauma. Once it enters the body, it stays there forever, initiating a complex chemical chain of events that changes not only the physiology of the victims but also the physiology of their offspring. One cannot, as war correspondent Michael Herr testifies in "Dispatches," simply “run the film backwards out of consciousness.” Trauma is our special legacy as sentient beings, creatures burdened with the knowledge of our own impermanence; our symbolic experience with it is one of the things that separates us from the animal kingdom. As long as we exist, the universe will be scheming to wipe us out. The best we can do is work to contain the pain, draw a line around it, name it, domesticate it, and try to transform what lies on the other side of the line into a kind
of knowledge, a knowledge of the mechanics of loss that might be put to use for future generations.

* * *

Major traumas are both a death and a rebirth, the end of one kind of consciousness and the beginning of another. As practically any survivor will tell you, the day of their rape or “their” IED serves not merely as the end of a chapter in their lives, such as the end of
puberty or bachelorhood, but the actual disappearance of their previous identity and the emergence of something altogether new and unknown. After trauma, your mind works differently, and your body has been altered to the extent that an entire new understanding of it must be negotiated. In time, as people enter therapy or simply reflect back upon the course of their lives, on the turning points in the stories of their time on earth, such days grow in power and take on a totemic quality, seeming to contain not only some portion of the mystery of their new being but also some key to the structure of the universe. Cormac McCarthy, describing one such haunted survivor in his classic novel "The Crossing," wrote that

men spared their lives in great disasters often feel in their deliverance the workings of fate. The hand of Providence. This man saw in himself again what he’d perhaps forgot. That long ago he’d been elected out of the common lot of men. For what he was asked now to reckon with was that he’d been called forth twice out of ashes, out of dust and rubble. For what? You must not suppose such elections to be happy ones for they are not. In his sparing he found himself severed from both antecedents and posterity alike. He was but some brevity of a being. His claims to the common life of men became tenuous, insubstantial. He was a trunk without root or branch.

Trauma exists in time even as it destroys it; the numerals of such dates can become like curses, and because they recur, both in the mind and on the calendar, they take on a timeless quality, as in 9/11 or 7/7, the date of the terrorist attacks in London in 2005. The language that Western survivors use in these instances is so consistent as to constitute a law of some kind, and it reveals, to a surprising degree, how religious images of rebirth and resurrection still govern the imagination. World War I veteran Max Plowman, describing his feelings when taken off the front lines, said, “It is marvelous to be out of the trenches: it is like being born again.” Reunited with his family at Clark Air Base in the Philippines, Hanoi Hilton survivor Dick Tangeman was moved by the “warmth and sincerity of all the wonderful people who welcomed us home and witnessed our rebirth.” Alice Sebold, writing of her return to her parents’ home after being raped, seems to echo a verse from First Corinthians: “My life was over; my life had just begun.” (Interestingly, this theme of rebirth takes on a slightly different tone when observed in non-Westerners.
One Hindu survivor of the 2004 tsunami in Sri Lanka spoke of her joy in the aftermath of the disaster, for it surely meant that she would be rewarded in her next life.)

In the increasingly interconnected PTSD community, it is common to hear such days referred to as “Alive Days” or “second-birthdays.” On March 25, 2010, professional mountaineer Steve House was climbing Mount Temple, an 11,600-foot peak in Western Canada, when he fell eighty feet and broke his pelvis and six ribs, an event he would later describe to me as a “rebirth.” To this day, House and his wife Eva observe this day as a special event in their lives. House, who still climbs widely and is by temperament keenly attuned to the physical world, finds himself uniquely sensitive to the environment every March 25, as if he were being observed by the universe in some special way. On what he described as the “third anniversary of his second birthday,” he wrote on his blog, “On my
way to Canada to celebrate my third year of life since my accident in the best way I know how: to climb and share experiences with the Alpine Mentors crew. [House founded a climbing training organization shortly after his fall.] The weather forecast seems to be a good omen that we’re doing the right thing.”

The death and rebirth that traumas constitute do not happen simultaneously, though the sequence is something familiar to us. One might catch a glimpse of death in an instant, but the process of emerging from that instant can take years, even decades. One friend
of mine, who was raped as a young woman, speaks of having completely lost the five years after the rape; it was only after many years of wandering, taking odd jobs overseas, that she was able to return to the United States and regain a kind of consciousness. Nor is this rebirth a linear process. Robert Stolorow describes how for a survivor time often takes on an almost circular quality: life moves forward, but one reencounters memories of one’s loss over and over again, finding its fingerprints in situations seemingly unconnected to the past. In some instances, it is possible to imagine life not as a single rebirth but as a series of them, as a new aspect of the original event is unearthed.

The science bears out this idea of rebirth. After a traumatic experience, the body gets locked into a state of permanent alert, hypersensitive to any stimuli that might constitute a threat. In this state of chronic arousal, which is one of the principal symptoms of
post-traumatic stress, the victim startles easily, is constantly irritable, and sleeps poorly. In fact, during World War I, some of the first psychiatrists who looked into the origins of war trauma believed the entire basis for postwar mental health disorders lay in this chronic mobilization of the autonomic nervous system, a system triggered by our watchdog, the amygdala (which you could almost imagine here as an aggressive pit bull barking wildly at every passerby). A number of recent studies examining the sleep patterns of combat veterans confirm this early impression. Simply put, people who have been exposed to traumatic events sleep differently than those who have not. As psychiatrist Judith Herman explains in "Trauma and Recovery," “People with post-traumatic stress disorder take longer to fall asleep, are more sensitive to noise, and awaken more frequently during the night than ordinary people. Thus traumatic events appear to recondition the human nervous system.

Traumatized people often feel fragmented, with their nervous systems living in the past, while other parts of their body continue to live in the present. This sense of temporal disorientation is strong enough that it is difficult to describe such feelings as merely memories. (When your heart starts to race and your eyes start scanning rooftops for snipers in downtown Phoenix, is this really the same as remembering your high school graduation?) Put another way, if on a chemical level your body is essentially still in Iraq, is that still memory? Isn’t it something more than a memory? Poet Robert Graves recounts how in civilian life he continued to behave as if he were in the trenches of World War I: “I was still mentally and nervously organized for War. Shells used to come bursting on my bed at midnight, even though Nancy shared it with me; strangers in the daytime would assume the faces of friends who had been killed.” In order to be happy, people have to be able to enjoy life as it happens, in the present. In its worst forms, trauma can almost completely destroy not only a person’s sense of time but also the very Western idea of time as a linear concept, of moving from one minute to the next and so on.

For some people, a traumatic event is so compelling that it takes on a hypnotic power. While the definition of what exactly qualifies as trauma is a discussion for another time, this hypnotic effect seems to apply to all kinds of powerful events. To some degree, what we call post-traumatic stress is merely an extension of a psychological principle that is obvious to anyone who reflects upon it: our bruises define us. Researchers at the University of California at Irvine, who interviewed survivors of the 1993 Laguna Beach wildfires, found that people who had been evacuated from their homes reported disturbances in their orientation in time: the past felt like the present. The future seemed disconnected from the present. People who reported a strong feeling of such temporal disorientation immediately after the firestorms were especially likely to continue ruminating on the past after six months. Here, we see one of the many paradoxes of trauma: damage occurs when you remember too much, and damage occurs when you remember too little.

Major trauma is a death and a rebirth; in some cases it kills the present, but it also gives rise to a second self, a doppelganger, a shadowperson with its own distinct body chemistry and sense of what is past and what is present. He was never the same after the war. This is the common refrain of the loved ones of the traumatized, followed closely by He came back a different person. Both of these sentiments are, it turns out, empirically accurate. Post-trauma, a person is essentially forced to begin all over again and retrain their body to deal with the stimuli the world throws at them. This overremembering makes sense from a survival standpoint. The parts of the brain dedicated to survival, such as the amygdala, store away as much information as possible for future reference. You might want that information to go away, but these deeply seated survival mechanisms, wired into the oldest regions of the brain, are simply not open to human reason. They are, as one researcher called them, “zombie subroutines of the brain.”

In my new post-Iraq life, I saw myself doing a kind of survivor shuffle, alternating between hating the past and missing it with an intensity that warped the present into a kind of extended flashforward. The past was always present, just like with Reaper, EVERYDAY IS DAY ONE, forever, or even worse, Tomorrow Is Day One. 2014 is 2004. Bodily, what I thought were two separate conditions I now know are one: withdrawing from the world and feeling like part of you is always on patrol in a sort of adrenalized present. Though I didn’t notice it until years later, I became irritable whenever someone walked behind me on the street, feeling their presence like heat on my back. On the street, I watched rooftops without even meaning to and searched the roadway for IEDs, taking note of potholes and irregularities in the asphalt. At times like this, I never felt like I was literally back in Iraq, but for a very long time I felt on edge, and I was not pleasant to be around. Average Americans, undisciplined and shambling through life without a care in the world, never failed to get on my nerves. My survival brain, trained and retrained by my years in the Marine Corps and Iraq, had wired a protective carapace of memories, many of which had outlived their usefulness.

The war is over, but it will live forever in the cipher of my brain. It is a part of me. To wage war against a memory is to fight against an old dream and, for me, an old way of looking at the world, the idea that “what does not kill me only makes me stronger.” Some ideas die the hard way: I can see now how foolish that notion is. Like many of my friends, I used to cherish my near-death experiences, collecting them like Boy Scout badges. A close call wasn’t simply a brush with mortality, it was an experience, a story, an episode from a novel in which I was featured as the hero. Now, when I think about getting shot or being vaporized by an IED or burned to death in the fiery crash of a helicopter, all the various ways of shuffling off this mortal coil, a certain melancholy settles in. The first time you see someone shot, it’s the most amazing day of your life; by the third time it begins to seem sad, sad and oddly boring, because you realize that there is nothing inherently meaningful or of metaphysical import in random enemy contact. As modern, technologically enhanced humans, we may live like gods, but we die like animals.

It is easy when you are young to believe that you have a date with destiny and to assume that the universe is waiting to reveal its deepest secrets to you if you choose to put yourself in harm’s way. When I decided to go to Iraq, like many Americans, I was young and had mistaken my lust for danger as real insight into the nature of existence. I never supported the war, but I did believe that it would grant me a clarity and fix what was wrong with my life. In the end, Iraq did give me a certain clarity, it did force me to come to grips with my own human frailty and the frailty of others, but this insight, which has guided the writing of this book, didn’t happen simply because I went to Iraq. It happened because of what transpired afterward, in the years after I came home. Whatever knowledge or wisdom I might have achieved came in the aftermath as I began to read, to introspect, and to consider the choices I made in my life and how I fit into the larger world.

There are so many ways to think about PTSD. As a construct, it touches on so many things, but the most important of these might reside in the simple meaning of the first letter of its formal name, the P. The loss, the insight, the fragmentation, the moral vertigo, all of these things only happen post-, after The Event has come and gone and we discover to our shock and surprise that we are not who we used to be. It is perhaps a facile thing to say, but it seems to me that the first duty of every survivor is to simply acknowledge the existence of trauma, to accept that there are things in this world that can break us. Only then can we begin to make meaning out of everything that comes after.

Excerpted from "The Evil Hours: A Biography of Post-Traumatic Stress Disorder" by David J. Morris. Copyright © 2015 by David J. Morris. Used by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

By David J. Morris

David J. Morris is a former Marine officer and the author of "Storm on the Horizon: Khafji -- The Battle That Changed the Course of the Gulf War" (Free Press). He has embedded with Marines in Iraq for multiple tours since 2004.

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Books Iraq Post-traumatic Stress Disorder Ptsd The Evil Hours Trauma