Listen to the article
When the last American combat troops left Vietnam in January 1973, over 700,000 veterans needed psychological treatment for what no one knew how to diagnose. The VA couldn’t help them because officially, their condition didn’t exist.
Nightmares, flashbacks, rage, emotional numbness. Veterans knew something was wrong. VA psychiatrists called it depression or schizophrenia. Treatment rarely worked because doctors were treating the wrong things.
The psychiatric establishment had a term for combat trauma as early as 1952, when “gross stress reaction” appeared in the first Diagnostic and Statistical Manual of Mental Disorders. By 1968, when the DSM was revised during peak Vietnam combat operations, that diagnosis vanished without explanation. Veterans coming home had nowhere to turn.
Veterans Built Their Own System
Without official recognition or treatment, Vietnam veterans created their own support networks. Groups such as Twice-Born Men formed for veterans leaving prison. Others met informally, what psychiatrist Robert Lifton called “street corner psychiatry.” Veterans helped veterans because no one else would.
They demanded answers. Why were so many veterans homeless, unemployed or addicted? Why did symptoms that started in Vietnam follow them for years? The VA denied disability claims for psychological conditions because no combat-related diagnosis existed in the manual.
Advocates pushed back. Veterans testified before Congress. Researchers studied returning soldiers. Psychiatrists who worked with survivors of the Holocaust, rape victims and combat veterans saw the same patterns. Trauma didn’t discriminate by source.
The pressure mounted through the 1970s. Veterans organizations lobbied the American Psychiatric Association. Clinicians like Chaim Shatan wrote about “post-Vietnam syndrome” in The New York Times. The psychiatric community couldn’t ignore 2.7 million veterans anymore.
Read More: EMDR: The PTSD Treatment Many Veterans Don’t Know the VA Offers
In 1980, Changed Everything
Five years after the war ended, the American Psychiatric Association added post-traumatic stress disorder to DSM-III. The diagnosis finally gave veterans’ suffering a name and treatment pathway. More importantly, it shifted blame from individual weakness to external trauma.
PTSD was the first psychiatric diagnosis to identify the cause as outside the person rather than an inherent flaw. That distinction mattered. Veterans weren’t broken. They’d experienced events outside normal human experience and reacted normally to abnormal circumstances.
Congress ordered the VA to study PTSD prevalence in 1983. The National Vietnam Veterans Readjustment Study found that 15% of Vietnam veterans had PTSD. A follow-up study decades later showed 11% of male theater veterans and 7% of female theater veterans still struggled with PTSD 40 years after the war.
The PTSD diagnosis opened doors. The VA developed specialized treatment programs. Research into trauma-focused therapies began. Veterans could file disability claims for a condition the VA finally recognized. But recognition came too late for thousands who’d suffered without help for years.
Read More: December 1944: The Medics Who Saved Thousands at the Battle of the Bulge
The Legacy Lives On
Modern VA mental health treatment exists because Vietnam veterans refused to accept that their symptoms weren’t real. They organized, testified, demanded research and forced the psychiatric establishment to acknowledge combat trauma.
Today’s veterans benefit from that fight. PTSD treatment protocols, specialized VA programs, disability compensation for mental health conditions. None of it existed before Vietnam veterans created it.
The VA now offers evidence-based PTSD treatments such as cognitive processing therapy, prolonged exposure and EMDR. Vet Centers provide readjustment counseling. The Veterans Crisis Line operates 24/7. Mental health care is integrated into primary care.
But gaps remain. Veterans still wait weeks for mental health appointments. Some VA facilities lack trained PTSD specialists. The stigma around mental health persists in military culture.
Vietnam veterans fought a second war at home to get recognition and treatment. That fight created the modern VA mental health system. Every veteran who gets PTSD treatment today owes them a debt.
Stay on Top of Your Veteran Benefits
Military benefits are always changing. Keep up with everything from pay to health care by subscribing to Military.com, and get access to up-to-date pay charts and more with all latest benefits delivered straight to your inbox.
Story Continues
Read the full article here
18 Comments
The role of clinicians like Chaim Shatan in writing about ‘post-Vietnam syndrome’ in The New York Times was crucial in raising awareness and pushing for the recognition of PTSD as a legitimate diagnosis.
The perils of delayed recognition and treatment of PTSD, as seen in the experiences of Vietnam veterans, should inform our approach to supporting veterans and individuals affected by trauma today, emphasizing early intervention and comprehensive support.
The formation of support networks like Twice-Born Men for veterans leaving prison and the practice of ‘street corner psychiatry’ demonstrate the resourcefulness and resilience of veterans in the face of inadequate official support.
The statistic that 15% of Vietnam veterans had PTSD, as found by the National Vietnam Veterans Readjustment Study in 1983, is alarming and highlights the need for continued support and research into trauma-focused therapies.
This number is even more concerning when considering that a follow-up study showed 11% of male theater veterans and 7% of female theater veterans still struggled with PTSD 40 years after the war.
The number of veterans who were homeless, unemployed, or addicted due to lack of proper diagnosis and treatment is a stark reminder of the human cost of neglecting mental health support for those who have served.
The recognition of PTSD as a legitimate condition has opened doors not just for treatment but also for a broader understanding of trauma and its effects, which will benefit not just veterans but all individuals who have experienced trauma.
The comparison of patterns seen in survivors of the Holocaust, rape victims, and combat veterans by psychiatrists highlights the universal impact of trauma, regardless of its source.
It’s astonishing that it took until 1980 for post-traumatic stress disorder to be added to the DSM-III, finally giving veterans’ suffering a name and treatment pathway, and shifting the blame from individual weakness to external trauma.
The distinction that PTSD is the first psychiatric diagnosis to identify the cause as outside the person, rather than an inherent flaw, is significant in changing the perception of veterans’ experiences and reducing stigma.
This shift in understanding is vital for encouraging veterans to seek help without fear of being judged as weak.
The story of how Vietnam veterans fought for modern PTSD treatments serves as a powerful reminder of the importance of listening to and believing those who have experienced trauma, and of the need for a responsive and adaptive healthcare system.
The fact that veterans had to demand answers and push for recognition of their condition, including testifying before Congress, underscores the systemic failures in addressing their needs.
It’s heartening to see that the PTSD diagnosis has led to the development of specialized treatment programs by the VA and research into trauma-focused therapies, offering hope for veterans who have suffered for decades.
The development of treatments like EMDR, as mentioned, offers a glimmer of hope for veterans who have not found relief through traditional methods, and it’s crucial that the VA continues to offer and promote such therapies.
It’s also important for the VA to ensure that all veterans are aware of the treatments available to them, including EMDR.
The perseverance of veterans and their advocates in lobbying the American Psychiatric Association and pushing for the inclusion of PTSD in the DSM-III is a testament to the power of collective action in driving change.
The fact that the psychiatric establishment had a term for combat trauma as early as 1952, but it vanished by 1968, raises questions about the motivations behind removing ‘gross stress reaction’ from the Diagnostic and Statistical Manual of Mental Disorders.