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November 15, 2018 by George Komaridis, PhD.


Because I began working with war veterans in the mid-1970s, I had contact with a number of World War II combat veterans between then and the 1980s. What I found most remarkable among many of these men was that despite the powerful emotional and psychological effects of their PTSD, many were able to carve out a civilian life in which they got married, had children, and worked to support their families. This was done because they had no options for treatment or support available to them from either the government or their communities, mainly because of our lack of understanding of the powerful and usually lifelong effects of war trauma on human beings. They basically learned to “bite the bullet” and make the best of the life they were dealt.

One such individual who stands out in my memory is an Army infantry man who was stationed on the European front with his unit. Their assignment was to give heavy artillery support to the men on the front lines and they were based by a river, living in tents. Their base was frequently attacked and strafed by Nazi Messerschmitts, and each time they took heavy casualties because they had nowhere to hide. Within months of this assignment, this veteran developed profound symptoms of combat stress based on his belief that he would die with every German attack. He forced himself to complete his work assignment and when he returned to Minnesota, he got married, became trained as an optician, and opened up his own small clinic in the town where he and his wife lived. He said that within a couple of years of starting his practice, he would experience frequent anxiety and panic attacks that disabled him from doing his work. Eventually he went to his local physician for help, but that did not help, and on one occasion he suggested to his physician that he should contact the Minneapolis VA to see if they could be of greater help. His physician discounted that idea, calling the VA a welfare system that robs people of their integrity. Because of this response, the veteran gave up the idea of contacting the VA and tried to live out his life by “biting the bullet”. He placed a cot in a back room of his office, and for the rest of his occupational life, he would take timeouts from his work with clients when overcome by his panic attacks or anxiety by retreating to the back room to rest and wait out those attacks. He said that his primary source of support was his wife, who was understanding and helpful to him in his hard times.

Unfortunately, his wife died when they were in their early 60’s and his psychological stability dissolved because he lost his primary support person. He was not able to continue his work and his panic attacks and other symptoms of PTSD became overwhelming and uncontrollable. Although we were able to give him some relief from the effects of his PTSD, it was in the twilight of his life and after too many years of “white knuckle” living. This was true of many other World War II veterans who also had to “tough out” their lives on their own because of the lack of understanding by our society of the effects of combat trauma on veterans and the lack of effective services and support for those veterans.

Probably the saddest examples of such veterans are the “town drunks” who quite often were homeless veterans who used alcohol for self-medication. Frequently, they were criticized and made fun of by other community members. Many of these men were war heroes who were honorably discharged from their service branches, but were so affected by their war traumas that they could not pull themselves together and function effectively as civilians.

Our country, and the world, did not learn well from the effects of war trauma on veterans in either of the first two world wars, and Korean and Vietnam war veterans who suffered from combat trauma and stress were also by and large ignored and inadequately treated by our country, including the VA hospitals. Not only did we not give serious concern to the effects of combat stress on veterans until the late 1970’s, but we also failed to recognize the adverse effect of sending soldiers into political wars where our objective was not to win and conquer the enemy. Wars became politically controlled, with our government’s concern being focused on not upsetting other world powers by restricting war zones and creating rules of war and conditions that restrained soldiers from engaging in full combat with enemy soldiers who were not restrained by the same rules.

The Korean War was our first politically controlled war. It was a civil war between North and South Korea, and the United Nations decided to intervene in defense of South Korea to stop the communist government of North Korea. The United States became involved as one of the United Nations countries that sent troops, but our troops made up 90% of the total number of soldiers sent to Korea by United Nations countries. Because of our country’s concerns about the two communist world powers who supported North Korea, China and Russia, we fought a war to stop the North Koreans from passing the 38th parallel of Korea rather than trying to defeat them. The North Koreans were eventually stopped at the 38th parallel, but at an enormous loss of soldier and civilian lives over a three-year period.

Because this was not an all-out war to defeat the enemy, our government called it the Korean Conflict rather than war and, along with our citizens, minimized and ignored the war after its conclusion, thus causing it to be called “the forgotten war” and, unfortunately for the men who fought in that war, they became the “forgotten soldiers”. Not only were our Korean War veterans deprived of the opportunity to win a war, they were also denigrated by our country’s reluctance to call it nothing more than a conflict. Understandably, most Korean vets came back to the country and retreated into their own communities and lives, becoming our country’s invisible soldiers. Most did not seek support from their communities or the VA systems mainly because of their desires to keep their war services to themselves in what became a highly ignorant and uncaring national environment. They, too, suffered all of the anguish of their war traumas, but they did it in silence.

During the late 1970’s and into the 1990’s, I had the opportunity to meet and provide services to a number of Korean War veterans. One that stands out was an Army infantryman who was in constant combat with North Korean and Chinese Army soldiers during most of his tour in the war zone. He was a unit machine gunner, carrying a Browning Automatic Rifle (BAR). As a result of his intensive contact with enemy, where on many occasions he and his unit would kill hundreds of Chinese soldiers who came at them in waves, but many without guns or weapons, he was constantly possessed by memories and images of combat situations. He also talked about getting frostbite in his feet that disabled him from being able to walk at the tail end of his tour, and having to be transported on the top of a tank to his home base. Following his combat experience in Korea, he returned to his army base in the US and became a drill sergeant, providing basic training to new recruits who were being prepared for the war zone. Because of his own experience and exposure in the war zone and the changes in his attitudes and views of life, he became very intense and harsh in his training of the new recruits and eventually was given the nickname of “Sarge”, which stuck with him for the rest of his life. His family jokingly described him as a tough disciplinarian who never left his army training and thinking. He had a tough and intimidating demeanor by which he interacted with virtually everyone.

I met Sarge when he was in his 60’s and on a disability status. He spent most of his time at home sitting at the kitchen coffee table and constantly ruminating about his war. His house was filled with war memorabilia and virtually every published war film. He would spend most of our sessions talking about various atrocities and incidents in which people were killed and maimed or tortured which he personally witnessed. He also talked about a significant number of kills that he made, particularly when Chinese attempted to overrun his unit’s outposts. He consistently complained about seeing a dark figure dart across his living room while sitting at the kitchen table and he was convinced that this was one of the Korean enemy soldiers. He knew better, but he constantly had this hallucination or vision which was accompanied by the very unsettling feeling that it was an enemy soldier. He attempted to deal with his PTSD and altered views of the world and life by keeping himself immersed in his military thinking and actions and war movie and books. Nonetheless, his intrusive memories, perceptual distortions, and nightmares constantly affected him until he died. He did not seek mental health help from the VA because of his disillusioned reactions to our government and governmental systems.

Another Korean veteran who stands out is a Marine Sargent who fought at the Chosen Reservoir. He was a very hardened individual who showed no emotions and was very serious in his interactive style. He spoke of constant direct contact with enemy on hill and mountain trails in their war zone and a number of hand-to-hand combat battles in which he engaged with enemy soldiers. He described the ongoing significant amount of killing on both sides as something that numbed him to the point that he was no longer affected by killing others or seeing death. He, like most of his fellow soldiers, returned home and blended in as a forgotten soldier, not seeking help from anywhere, including the VA system. Although his war experiences clearly changed him and his view of life and the world, and he was completely emotionless, he developed a style of survival that allowed him to have and keep a job and to have a family, but with a lot of interpersonal stress. By the time I met him, he decided that he could endure the lifestyle he developed and he did not want to open up any of the memories and pains of his war through therapy.

There were many other WWII and Korean veterans who I had the honor of meeting and giving some psychological assistance. Most were humble, responsible and caring persons who spent lifetimes of daily stresses working and providing for their families, as most Americans do, but, they also carried the added burdens of their war memories and scars until their final days. Despite the failures of our government and society to give them ongoing recognition for their sacrifices in their wars and for their war related adjustment problems, they all remained very patriotic and contributing citizens. This was true of the Korean veterans in spite of our country’s almost complete neglect of them.

This article was reprinted with permission by ASC Psychological Services.


If you have any related questions, please contact:


ASC Psychological Services

12 Civic Center Plaza, Suite 1615

Mankato, MN 5


www.ascpsychological.com


ASC Psychological Services is one of the first-of-its kind holistic mental health treatment providers in the Manakato, Minnesota region.

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November 15, 2018 by George Komaridis, PhD.



I have provided psychological services to war veterans for over 40 years, having started in my work with veterans in the mid-1970s. In this time, I have learned a lot about war and its effects on those involved in direct combat as well as those involved in other activities that are typically called support activities in the war zone.


Korean War crew members of a marine battery launcher hold their ears and crouch to the ground as rockets are fired into the night sky.


This unique opportunity to not only help veterans who are affected by their wars, but also to learn about the wars, has been something that I would not trade for anything and, as I have said on many occasions, if I had a chance to redo my life I would change many things but not my opportunity to work with war veterans.


The reason for this is simple. I am one of the few males in this world whose window of time for military duty fell during a peaceful period, between 1956 when I graduated high school and 1965 when I was already married, had a family, and was in graduate school. This was the period between the end of the Korean War and the beginning of the Vietnam War. After meeting real combat soldiers and coming to understand war through their eyes, I realized and became ever grateful for the fact that I was spared from such hardship and this gave me incentive to want to give whatever service I could to the men and women who went through the hell of war. In addition, I realized that war tends to clear people of many of the typical human foibles, such as the need to impress or to worry about the reactions of others or other insignificant things in life, as well as the various aspects of pride and self-aggrandizement. I find that war veterans are among the most genuine and honest people of this world and a pleasure to meet and work with.


So, what I have learned is this: soldiers of all wars throughout time who have engaged in direct combat and survived are always significantly affected by their wars and become changed persons. Some of the changes that soldiers undergo appeared to be universal and can be predicted, and some are different and unique to the soldier. Over the years, the effects of war on soldiers have been described in varying ways, but the one consistent factor is that it creates a powerful stress on the soldier to the extent that he becomes changed for some period of time or permanently.


In World War I, the stress reaction was labeled “shell shock” and was described as an injury to the nerves. The typical treatment was to remove the soldier from his combat position to a rear hospital where he was expected to rest up, after which he was encouraged to return to his combat duties. The general attitude at the time was that such “emotional breakdowns” were a sign of weakness and should be discouraged. Because of this, not much follow-up treatment or service was made available to combat veterans, although the British government did create disability pensions for what was called “soldier’s heart” because its symptoms were somewhat similar to the symptoms of heart disorders affected by acute anxiety. A World War I correspondent wrote the following observation of war veterans:


“Something was wrong. They put on civilian clothes again and looked to their mothers and wives very much like the young men who had gone to business in the peaceful days before August 1914. But they had not come back the same men. Something had altered in them. They were subject to sudden moods, and queer tempers, fits of profound depression alternating with a restless desire for pleasure. Many were easily moved to passion where they lost control of themselves, many were bitter in their speech, violent in opinion, frightening.” (From Shephard, Ben. A War of Nerves: Soldiers and Psychiatrists, 1914-1994. London, Jonathan Cape, 2000.)


In World War II, the same stress reaction was labeled “battle fatigue” or “war neurosis.” Medical doctors, including psychiatrist, associated with the armed services began noticing that soldier started showing symptoms of exhaustion and chronic fatigue after six months to a year in combat and this initiated the process of implementing time defined tours of duty in the war zone. However, the general attitude in most nations engaged in the war remained the same as it was during World War I and veterans still did not get proper services or encouragement to pursue them after the war.


In a comprehensive summary in Wikipedia, titled Combat Stress Reaction, several quotes reflecting national attitudes are given. American flight surgeons treating soldiers in South Pacific jungles noted:


Many have chronic dysentery or other disease, and almost all show chronic fatigue states. . . .They appear listless, unkempt, careless, and apathetic with almost mask-like facial expression. Speech is slow, thought content is poor, they complain of chronic headaches, insomnia, memory defect, feel forgotten, worry about themselves, are afraid of new assignments, have no sense of responsibility, and are hopeless about the future. (Mae Mills Link and Hubert A. Coleman, Medical support of the Army Air Forces in World War II (1955) p 851.)


In Contemporary Studies in Combat Psychiatry, (1987), a German medical doctor’s opinion of battle fatigue was described:


… he believed that there were no important problems due to stress breakdown since it was prevented by the high quality of leadership. But, he added, that if a soldier did break down and could not continue fighting, it was a leadership problem, not one for medical personnel or psychiatrists. Breakdown (he said) usually took the form of unwillingness to fight or cowardice.


Canada and Britain were more accepting of combat stress than other countries, as indicated in the quote from a Canadian historian:


“The infantry units engaged in the battle also experienced a rapid rise in the number of battle exhaustion cases with several hundred men evacuated due to the stress of combat. Regimental Medical Officers were learning that neither elaborate selection methods nor extensive training could prevent a considerable number of combat soldiers from breaking down.” (Copp, Terry “The Brigade” (Stackpole Books, 2007) p.47.)


But, the Finnish head of military medicine was not so forgiving, considering “…shell shock as a sign of weak character and lack of moral fibre. His treatment for war neurosis was simple: the patients were to be bullied and harassed until they returned to front line service.”


History clearly shows that the traumatic effects of war on soldiers were either discounted or not understood well enough to treat in any effective way. This lack of understanding and treatment continued with the Korean and post-Korean war era, and to some extent through the Vietnam and post-Vietnam war era.


Soldiers digging into bunkers atop Old Baldy in Korea in 1952


Not much changed in the treatment and care of Korean War veterans because their symptoms and ailments were still viewed in the same way that the symptoms of soldiers were reviewed during World War II, and they were treated similarly. Veterans with disabling PTSD symptoms either sought out help from their local physicians and were typically treated for anxiety or depression or they kept those problems private and buried, usually with the aid of alcohol, smoking cigarettes, and continuous activities by which to avoid letting their thoughts stray to war related memories. The trauma-based symptoms of Korean War veterans were still described as battle fatigue or war neurosis, and few of these veterans sought help from their VA medical centers.


It was not until the second half of the 1970s, after the 10 year long Vietnam War was formally ended, that new attention was given to the traumatic effects of war on soldiers. It took the efforts of an anti-war group of Vietnam veterans, Vietnam Veterans Against the War, and various antiwar activists to initially name the effects of war trauma on veterans as Post-Vietnam War Syndrome. These and other Vietnam veterans who felt alienated, discounted, and misunderstood by their countrymen after returning home, refused to simply be ignored or mistreated by the government and the country. They began their own protests against poor or unsuitable treatment by the VA systems and by other governmental agencies. And, their unstoppable defiance and indignation caught the attention of our government and their agencies.


With the release of the latest issue of the Diagnostic and Statistical Manual of Mental Disorders, version III, in 1980, PTSD was finally given formal recognition as a diagnostic mental disorder category. With this new and more enhanced description of the effects of trauma on soldiers came new and more concerned and informed awareness of the soldiers problems by medical, psychiatric and psychological professionals, and subsequently a greater emphasis on and improvement of treatment methods. The VA administration responded to the pressures of Vietnam veterans by developing a parallel system of storefront psychotherapeutic clinics for war veterans that were staffed by war veterans who were trained as mental health specialists and psychologists experienced in working with veterans, and set up as places where veterans can easily go to get direct services with minimal red tape or bureaucracy. These clinics were called Vet Centers, and they became effective in attracting disenchanted Vietnam veterans to seek services in their facilities.


ASC’s first formal contract with the VA system was through the Minneapolis Vet Center to provide psychotherapeutic services to Vietnam and other war veterans.

The Minneapolis Vet Center contracted with ASC because our clinic was already providing psychological services for some of the Vietnam veteran in the Mankato area and sending many of those veterans to the Minneapolis VA Medical Center (VAMC) for additional services.

Since the development of PTSD as a diagnosis and the introduction of the Vet Centers, services to war veterans have become much more available and more credibility has been given to the seriousness of war effects on veterans. But, since about 2000, increased pressures have been placed on the VAMC’s to see more and more veterans without an equal expansion of services and with a shift in philosophy that emphasized providing all services in-house and reducing reliance on outside professional providers. This has produced the inevitable breakdowns in the system, like the waitlist problems that resulted in deaths of some veterans while they waited for services, and the falsification of statistics and outright lying by VAMC administrators.


Measures have been taken by our legislators, like Tim Walz, who are committed to improving veteran services, but problems remain in the VA system, and many veterans remain disenchanted. At this point, it looks like the best solution to the existing problem of inadequate or inferior services that are available to veterans is to create a system similar to the medicare system where veterans would have a medical card that can be used with any licensed hospital, clinic or individual provider in addition to having access to the VAMC’s.

This article was reprinted with permission by ASC Psychological Services.


If you have any related questions, please contact:


ASC Psychological Services

12 Civic Center Plaza, Suite 1615

Mankato, MN 56001

www.ascpsychological.com


ASC Psychological Services is one of the first-of-its kind holistic mental health treatment providers in the Manakato, Minnesota region.

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September 12, 1950. South Korean WACs trained and ready to join their men in the battle against Chinese invaade through Pusan, main United Nations’ fort city in Korea



October of 1950. Paratroopers drop from U.S. Air Force C-119 transport planes during an operation over an undisclosed location in Korea.



December 21, 1950. Korean refugees board a vessel in Hungnam harbor, North Korea, as they flee the advancing Chinese Communists and North Koreans.



January 27, 1951. Yangji, Korea. A Korean civilian shot and left to die by retreating Communists during the Korean War. They bound his hands and left him a breathing hole

in the snow.


April 7, 1951, Korea. Tank and crew members stranded in river bed dip as they attempted to find a shallow crossing in the swollen Pukhan river. The tank was later towed to safety by a tank retriever.


1951. Wonsan, North Korea. Para-demolition bombs drop from the Fifth Air Force’s B-26 Invader light bombers and explode on supply warehouses and dock facilities at this east coast port.


January 16, 1952. Somewhere in Korea. Marines from the 1st Marine Tank Battalion fire a night mission at supply installations.


December 18, 1952. Korea. Pfc. Milton Reince of Green Bay, Wisconsin, adds a picture to his bunker wall of pinups.


June 18, 1953. GIs and Korean service corpsmen stack empty artillery and mortar shell casings at a collecting point near the front, revealing the huge amount of lead thrown at the enemy in four days of fighting for outpost Harry.


July 29, 1953. Returning from a combat mission over North Korea, three jubilant fliers of the 18th Fighter Bomber wing let the world know how they feel after learning of the armistice signing that day. Left to right are: 2nd Lt. John Putty, Dallas, Tex.; 1st Lt. James A. Boucek, Ottawa, Kansas,: and 1st Lt. Richard D. Westcott, Houston, Tex., waving from the back seat of the jeep.


South Korean women weep as they listen to President Syngman Rhee speak at a memorial service in Seoul, October 17, 1953. The service honored the 33,964 South Koreans killed in the last year of the war.

Photos courtesy of rarehistoricalphotos.com

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