In his recent guest editorial, Richard McNally voices skepticism about the National Vietnam Veteran’s Readjustment Study (NVVRS) data reporting that over one-half of those who served in the Vietnam War have posttraumatic stress disorder (PTSD) or subclinical PTSD. Dr McNally is particularly skeptical because only 15% of soldiers served in combat units (1). He writes, “the mystery behind the discrepancy in numbers of those with the disease and of those in combat remains unsolved today” (4, p 815). He talks about bizarre facts and implies many, if not most, cases of PTSD are malingered or iatrogenic. Dr McNally ignores the obvious reality that when people are deployed to a war zone, exposure to trauma is not limited to members of combat units (2,3). At the Operational Trauma and Stress Support Centre of the Canadian Forces in Ottawa, we have assessed over 100 Canadian soldiers, many of whom have never been in combat units, who have experienced a range of horrific traumas and threats in places like Rwanda, Somalia, Bosnia, and Afghanistan. We must inform Dr McNally that, in real world practice, even cooks and clerks are affected when faced with death, genocide, ethnic cleansing, bombs, landmines, snipers, and suicide bombers ...One theory suggests that there is a conscious decision on the part of some individuals to deny trauma and its impact. Another suggests that some individuals may use dissociation or repression to block from consciousness what is quite obvious to those who listen to real-life patients." Cameron, C., & Heber, A. (2006). Re: Troubles in Traumatology, and Debunking Myths about Trauma and Memory/Reply: Troubles in Traumatology and Debunking Myths about Trauma and Memory. Canadian journal of psychiatry, 51(6), 402.
The door suddenly jerks open. A wideeyedteenager bursts out. She stares at me in dazed horror. In a strangeway, I both know and don’t know what has just happened. As the fragmentsbegin to converge, they convey a horrible reality: I must havebeen hit by this car as I entered the crosswalk. In confused disbelief, I sinkback into a hazy twilight. I find that I am unable to think clearly or towill myself awake from this nightmare.A man rushes to my side and drops to his knees. He announces himselfas an off-duty paramedic. When I try to see where the voice is comingfrom, he sternly orders, “Don’t move your head.” The contradictionbetween his sharp command and what my body naturally wants—toturn toward his voice—frightens and stuns me into a sort of paralysis.My awareness strangely splits, and I experience an uncanny “dislocation.”It’s as if I’m floating above my body, looking down on the unfoldingscene.I am snapped back when he roughly grabs my wrist and takes mypulse. He then shifts his position, directly above me. Awkwardly, hegrasps my head with both of his hands, trapping it and keeping it frommoving. His abrupt actions and the stinging ring of his command panicme; they immobilize me further. Dread seeps into my dazed, foggy consciousness:Maybe I have a broken neck, I think. I have a compellingimpulse to find someone else to focus on. Simply, I need to have someone’scomforting gaze, a lifeline to hold onto. But I’m too terrified tomove and feel helplessly frozen.