The Corner

Subject: Contagious PTSD

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Hi.  I’m a psychologist at a VA hospital.  I’ve worked with vets with PTSD in the past, though these days I spend most of my time with head-injured vets.  The idea of “contagious PTSD” certainly doesn’t explain much if anything of what Hasan did, but it actually isn’t as strange as it sounds.

Vets with PTSD have, by definition, been through some absolutely horrendous experiences.  To be honest, “horrendous” is too gentle a word, but people so often misuse superlatives in everyday life that there aren’t any words left for things that are truly extreme.  I suppose I could give you some examples, but I don’t think I can do it without violating confidentiality, and anyway they’re not the sort of thing you’d want to publish on a family website.  If you want a sense of it…well, remember those pictures of people jumping from the towers on 9/11?  Remember how you felt about that?  Okay, now suppose you were actually standing there and watched the guy hit the ground.  Now suppose you made eye contact with the guy the moment before he hit–and you saw that he’s your best friend, and you’re there the moment he dies. 

It’s a nightmare.  For people with PTSD, though, it’s more than a nightmare.  Every time they send their kids out the door in the morning, every time there’s a quiet moment at work, every time they close their eyes at night, that nightmare comes back; it’s there again, more vivid than any other memory, and in some ways more vivid than anything real.

So if you’re the therapist of a guy with PTSD, you’re going to be taken on a tour of his personal nightmare.  You’re going to be taken on a tour of the next person’s nightmare, too, and the next and the next and the next, each more horrible than anything you’ve seen in movies or on TV. 

Listening to a string of horror stories has some pretty obvious consequences.  Some people can handle it–some people can shake it off and keep on going.  Some people can’t.  You can sometimes watch the interns and residents change as they start working with the PTSD patients.  Some of them get short-tempered and hostile; some of them start having crying episodes; some of them start having nightmares themselves; and they all feel guilty that they’re not able to do a better job.  Around here, we have an informal procedure in which someone taps them on the shoulder, sits them down, and suggests that they might be better off doing something else.  Someone did that for me, and it made an enormous difference; I’ve since done it for others.  For better or for worse, there are a lot of other things a psychologist can do here at the VA, and vets with PTSD need people who can actually help them. 

So yes, there’s something to the idea that PTSD is “contagious.”  The trouble is that that’s all irrelevant to the case at hand.  Yes, some of us have a tough time listening to all these stories, but we don’t go around gunning people down.  And…I don’t know if this makes sense…but even if we *were* going to gun people down, we damn sure wouldn’t gun down soldiers.  Serial killers kill the people whom they feel have wronged them–women, classmates, whoever.  We don’t feel that way about the vets.  If we did somehow flip out from the stress (in spite of the fact that we’re, you know, psychologists and psychiatrists who are trained to deal with this sort of thing), we wouldn’t hurt our soldiers.  We’d take our own lives first.