Mary
Ellen was a nine-year-old girl from New York, who was being severally
abused and neglected by her foster parents. Mary Ellen might have died
if it wasn't for a social worker by the name of Etta Angell Wheeler, who
was working in her neighborhood. The reality of what happened is
frightening, Back in 1874 there were NO laws on the books to protect
children, yet there were laws on the books to protect animals.
The
social worker who knew Mary Ellen did every thing in her power to help.
If it wasn't for this nurses determination we might not have the laws
on our books that we have today. Etta Angell Wheeler did NOT sit back
and do nothing. She responded. She didn't take NO for an answer. The
solution to Mary Ellen's plight came because it was determined that she
was considered a member of the animal kingdom. The Society of Prevention
of Cruelty to Animal was then able to get involved and do something to
protect Mary Ellen from any more harm.
When
the Mary Ellen's story hit the news media there was a public outcry for
there to be change in the way children were treated. The Society for
the Prevention of Cruelty to Children was formed, by 1900 there were 161
such groups in the U.S.
It's
unbelieveable that it wasn't until 1968, when Dr. C. Henry Kempe and
Ray E. Helfer's book The Battered Child was published, that people began
to be aware of and believe that parents and caregivers truly could and
did physically abuse their children. Please note that it wasn't until
almost 20 years later that the world started to pay attention to the
whole issue of sexual abuse/assault of children (and adults).
Be
aware it wasn't until 1983-84, in Illinois the Confidentiality of
Statements Made to Rape Crisis Personnel granted absolute privilege to
sexual assault victims. This act was important because it meant that
anything a rape victim said to a Rape Crisis Counselor or Legal advocate
was absolutely confidential. This meant that no court could supena
records of victims.
In
1984 several very important acts were also implemented. In Illinois,
the Violent Crime Victims Assistance Act was signed into law. This
basically provided victims of all crimes, including survivors of sexual
violence free counseling and advocacy. This same year the federal
governement, signed into law the Victims of Crime Act (VOCA), it was at
that time states received notice of future funding for victims services.
It's
important to keep all of the relatively new history of how our society
has dealt with criminal sexual acts. It helps to understand why it is
so important for organizations like The Awareness Center to exsist.
We
all have to be thankful to social worker - Etta Angell Wheeler, who
cared enough to do something about Mary Ellen, back in 1874.
The Real Story of Mary Ellen Wilson
http://www.americanhumane.org/site/PageServer?pagename=wh_mission_maryellen
 |
| Mary Ellen Wilson |
The
sufferings of the little girl, Mary Ellen, led to the founding of the
New York Society for the Prevention of Cruelty to Children, the first
organization of its kind, in 1874. In 1877, the New York SPCC and
several Societies for the Prevention of Cruelty to Animals from
throughout the country joined together to form the American Humane
Association.
The
following is Mary Ellen's story, which marked the beginning of a
world-wide crusade to save children. It is extracted from American
Humane's Helping in Child Protective Services: A Competency-Based
Casework Handbook.
Over
the years, in the re-telling of Mary Ellen Wilson's story, myth has
often been confused with fact. Some of the inaccuracies stem from
colorful but erroneous journalism, others from simple misunderstanding
of the facts, and still others from the complex history of the child
protection movement in the United States and Great Britain and its link
to the animal welfare movement. While it is true that Henry Bergh,
president of the American Society of the Prevention of Cruelty to
Animals (ASPCA), was instrumental in ensuring Mary Ellen's removal from
an abusive home, it is not true that her attorney—who also worked for
the ASPCA—argued that she deserved help because she was "a member of the
animal kingdom."
The
real story—which can be pieced together from court documents, newspaper
articles, and personal accounts—is quite compelling, and it illustrates
the impact that a caring and committed individual can have on the life
of a child.
Mary
Ellen Wilson was born in 1864 to Francis and Thomas Wilson of New York
City. Soon thereafter, Thomas died, and his widow took a job. No longer
able to stay at home and care for her infant daughter, Francis boarded
Mary Ellen (a common practice at the time) with a woman named Mary
Score. As Francis's economic situation deteriorated, she slipped further
into poverty, falling behind in payments for and missing visits with
her daughter. As a result, Mary Score turned two-year-old Mary Ellen
over to the city's Department of Charities.
The
Department made a decision that would have grave consequences for
little Mary Ellen; it placed her illegally, without proper documentation
of the relationship, and with inadequate oversight in the home of Mary
and Thomas McCormack, who claimed to be the child's biological father.
In an eerie repetition of events, Thomas died shortly thereafter. His
widow married Francis Connolly, and the new family moved to a tenement
on West 41st Street.
Mary
McCormack Connolly badly mistreated Mary Ellen, and neighbors in the
apartment building were aware of the child's plight. The Connollys soon
moved to another tenement, but in 1874, one of their original neighbors
asked Etta Angell Wheeler,
a caring Methodist mission worker who visited the impoverished
residents of the tenements regularly, to check on the child. At the new
address, Etta encountered a chronically ill and homebound tenant, Mary
Smitt, who confirmed that she often heard the cries of a child across
the hall. Under the pretext of asking for help for Mrs. Smitt, Etta
Wheeler introduced herself to Mary Connolly. She saw Mary Ellen's
condition for herself. The 10-year-old appeared dirty and thin, was
dressed in threadbare clothing, and had bruises and scars along her bare
arms and legs. Ms. Wheeler began to explore how to seek legal redress
and protection for Mary Ellen. Click here to read Etta Wheeler's account of Mary Ellen.
At
that time, some jurisdictions in the United States had laws that
prohibited excessive physical discipline of children. New York, in fact,
had a law that permitted the state to remove children who were
neglected by their caregivers. Based on their interpretation of the laws
and Mary Ellen's circumstances, however, New York City authorities were
reluctant to intervene. Etta Wheeler continued her efforts to rescue
Mary Ellen and, after much deliberation, turned to Henry Bergh, a leader of the animal humane movement in the United States and founder of the American Society for the Prevention of Cruelty to Animals (ASPCA).
It was Ms. Wheeler's niece who convinced her to contact Mr. Bergh by
stating, "You are so troubled over that abused child, why not go to Mr.
Bergh? She is a little animal surely" (p. 3 Wheeler in Watkins).
Ms.
Wheeler located several neighbors who were willing to testify to the
mistreatment of the child and brought written documentation to Mr.
Bergh. At a subsequent court hearing, Mr. Bergh stated that his action
was "that of a human citizen," clarifying that he was not acting in his
official capacity as president of the NYSPCA. He emphasized that he was
"determined within the framework of the law to prevent the frequent
cruelties practiced on children" (Mary Ellen, April 10, 1976, p. 8 in
Watkins, 1990). After reviewing the documentation collected by Etta
Wheeler, Mr. Bergh sent an NYSPCA investigator (who posed as a census
worker to gain entrance to Mary Ellen's home) to verify the allegations.
Elbridge T. Gerry, an ASPCA attorney, prepared a petition to remove
Mary Ellen from her home so she could testify to her mistreatment before
a judge. Mr. Bergh took action as a private citizen who was concerned
about the humane treatment of a child. It was his role as president of
the NYSPCA and his ties to the legal system and the press, however, that
bring about Mary Ellen's rescue and the movement for a formalized child
protection system.
Recognizing
the value of public opinion and awareness in furthering the cause of
the humane movement, Henry Bergh contacted New York Times reporters who
took an interest in the case and attended the hearings. Thus, there were
detailed newspaper accounts that described Mary Ellen's appalling
physical condition. When she was taken before Judge Lawrence, she was
dressed in ragged clothing, was bruised all over her body and had a gash
over her left eye and on her cheek where Mary Connelly had struck her
with a pair of scissors. On April 10, 1874, Mary Ellen testified:
"My
father and mother are both dead. I don't know how old I am. I have no
recollection of a time when I did not live with the Connollys. ....
Mamma has been in the habit of whipping and beating me almost every day.
She used to whip me with a twisted whip—a raw hide. The whip always
left a black and blue mark on my body. I have now the black and blue
marks on my head which were made by mamma, and also a cut on the left
side of my forehead which was made by a pair of scissors. She struck me
with the scissors and cut me; I have no recollection of ever having been
kissed by any one—have never been kissed by mamma. I have never been
taken on my mamma's lap and caressed or petted. I never dared to speak
to anybody, because if I did I would get whipped.... I do not know for
what I was whipped—mamma never said anything to me when she whipped me. I
do not want to go back to live with mamma, because she beats me so. I
have no recollection ever being on the street in my life" Mary Ellen,
April 10, 1874 in Watkins, 1990).
In
response, Judge Lawrence immediately issued a writ de homine
replagiando, provided for by Section 65 of the Habeas Corpus Act, to
bring Mary Ellen under court control.
 |
| Mary Ellen Wilson |
The
newspapers also provided extensive coverage of the caregiver Mary
Connolly's trial, raising public awareness and helping to inspire
various agencies and organizations to advocate for the enforcement of
laws that would rescue and protect abused children (Watkins, 1990). On
April 21, 1874, Mary Connolly was found guilty of felonious assault and
was sentenced to one year of hard labor in the penitentiary (Watkins,
1990).
Less well known but as compelling as the details of her rescue, is the rest of Mary Ellen's story. Etta Wheeler continued
to play an important role in the child's life. Family correspondence
and other accounts reveal that the court placed Mary Ellen in an
institutional shelter for adolescent girls. Believing this to be an
inappropriate setting for the 10-year-old, Ms. Wheeler intervened. Judge
Lawrence gave her permission to place the child with her own mother,
Sally Angell, in northern New York. When Ms. Angell died, Etta Wheeler's
youngest sister, Elizabeth, and her husband Darius Spencer, raised Mary
Ellen. By all accounts, her life with the Spencer family was stable and
nurturing.
At
the age of 24, Mary Ellen married a widower and had two daughters—Etta,
named after Etta Wheeler, and Florence. Later, she became a foster
mother to a young girl named Eunice. Etta and Florence both became
teachers; Eunice was a businesswoman. Mary Ellen's children and
grandchildren described her as gentle and not much of a disciplinarian.
Reportedly, she lived in relative anonymity and rarely spoke with her
family about her early years of abuse. In 1913, however, she agreed to
attend the American Humane Association's national conference in
Rochester, NY, with Etta Wheeler, her long-time advocate. Ms. Wheeler
was a guest speaker at the conference. Her keynote address, "The Story
of Mary Ellen which started the Child Saving Crusade Throughout the
World" was published by the American Humane Association. Mary Ellen died
in 1956 at the age of 92.
History of the Illinois Coalition Against Sexual Assault (ICASA)100 North 16th Street, Springfield, IL 62703
(217) 753-4117
http://www.icasa.org/icasaHistory.asp
In
early 1977, women activists from nine community-based rape crisis
centers in Illinois gathered to "form a mutual support group...adding
strength to any issue such as legislative action, and giving our
strength to each other." Searching for a name that reflected the
profound social struggle necessary to end the degradation and rape of
women, these activists named their group the Illinois Coalition of Women
Against Rape (ICWAR).
As
early as 1972, rape crisis workers in Illinois had established 24-hour
crisis lines, conducted education and training programs, created
thousands of brochures, offered self defense classes, organized and
marched in "Take Back the Night" events and devoted thousands of hours
to helping victims heal from the devastation of rape.
By
linking their efforts through ICWAR, these early workers began their
long journey to change the society. Like their sisters across the
nation, coalition members advocated for legislative reform, insisted
that police increase their arrest rates, demanded privacy for rape
victims in emergency rooms and urged prosecutors to change plea
negotiation procedures.
This
monumental work, which forever changed the fundamental ways in which
men related to women, was done primarily by volunteers. Rape crisis
centers had very few resources other than dedicated activists. There was
no formal education or professional training regarding how to do
anti-rape work. However, once survivors broke the silence about the
terror of rape, women devoted their minds, hearts, time and money to
construct and sustain organizations that created the field of anti-rape
work. These organizations changed practices in hospitals, police
departments, the courts and within the field of psychiatry.
ICWAR
received much support as it began its efforts. YWCAs, churches,
synagogues, the National Organization for Women, women's studies
programs, the American Association of University Women, United Ways and
others pitched in with funds, space and staff time. Several state's
attorneys and legal aid lawyers helped advocates sharpen their advocacy
skills. And, the Illinois House Rape Study Committee forged political
alliances to pass legislative proposals responsive to the needs of
survivors.
Victims
and their advocates created rape crisis centers to fill a void – with a
definition and purpose different than traditional mental health or
social services. With the goals of social change, equality between men
and women, and the fundamental principle of victim-centered services,
the anti-rape movement offered a new model for institutional change and
individual healing. In Illinois, this model gained recognition and
credibility with each new accomplishment.
ICWAR
had multiple occasions to celebrate legislative victories. The Rape
Victims Emergency Treatment Act standardized the collection of medical
evidence. The Rape Shield Law made the victim's sexual history
irrelevant in a trial. The Illinois Criminal Sexual Assault Act
overhauled sex crime statutes. Federal and state statutes authorized new
categories of victim service funds.
The
first funding for sexual assault crisis centers, $148,889, was
distributed by ICWAR to 12 centers in 1982.Later that year, four more
centers were funded. Subsequent funds enabled centers to hire advocates,
counselors and educators. Since 1982, centers have developed
specialized services to meet the needs of children, adult survivors of
child sexual abuse, teens and male victims. They have standardized
volunteer training and developed curricula for conducting education and
training programs. They have implemented protocols with hospitals and
law enforcement agencies.
ICWAR
changed its name to the Illinois Coalition Against Sexual Assault
(ICASA) in 1984 and, with its many colleagues and supporters, continued
to change the way the state responded to rape. Also in 1984, passage of
the Illinois Violent Crime Victims Assistance Act made funds available
for increased counseling and advocacy with victims of sexual assault. On
the federal level, the Victims of Crime Act (VOCA) passed Congress,
promising future funding for victim services. In 1986, ICASA received
its first allocation of federal VOCA funds from the Illinois Criminal
Justice Information Authority. Rape crisis centers hired full-time
advocates and 16 centers established specialized counseling services for
children.
Victim
rights continued to receive a boost in 1994 when the Violence Against
Women Act was passed by Congress and signed into law. Two years later,
ICASA received its first VAWA funding from the Illinois Department of
Public Health and the Illinois Criminal Justice Authority.
ICASA's
funding increased from $6 million in 1996 to $13 million in 2000. The
increase in funding has allowed ICASA member centers to greatly expand
services to victims across the state. ICASA consists of 29 sexual
assault crisis centers, which operate 26 full-time satellite offices.
Member centers offer services in 73 of 102 counties in Illinois.
Throughthe
coalition, the centers adopted standards for local centers and created a
governance structure to allocate funds, track contract compliance, and
provide technical assistance to help centers maintain services in their
communities. ICASA continues to work on the cutting edge of legislative
reform and to advocate for social change and the elimination of the
oppressions that promote sexual violence.
- 1975 Rape Victims Emergency Treatment Act passes the Illinois General Assembly and is signed into law.
- 1977 Illinois Coalition of Women Against Rape (ICWAR) is formed.
- 1978 Rape Shield Act becomes law for sexual assault victims in Illinois.
- 1981
Federal Preventive Health and Health Services Block Grant is signed
into law. Illinois Department of Public Health receives allocation with
designation for Rape Crisis and Rape Prevention.
- 1982
ICWAR receives first Preventive Health and Health Services Block Grant
allocation of $148,889. ICWAR creates its first Contracts Review
Committee and allocates funds to twelve centers.
- 1983 Illinois Criminal Sexual Assault Act is signed into law, revising Illinois rape and incest statutes.
- 1983-84 Confidentiality of Statements Made to Rape Crisis Personnel grants absolute privilege to sexual assault victims.
- 1984 Illinois Violent Crime Victims Assistance Act is signed into law, making funds available for counseling and advocacy.
- 1984 ICWAR changes its name to the Illinois Coalition Against Sexual Assault (ICASA).
- 1984 Victims of Crime Act (VOCA) passes Congress; states receive notice of future funding for victim services.
- 1985 ICASA receives one-time grant from the Illinois Department of Public Aid for counseling services.
- 1985 ICASA granted its first allocation of state General Revenue Funds.
- 1986 ICASA receives its first allocation of federal VOCA funds from the Illinois Criminal Justice Information Authority.
- 1988 Law is passed prohibiting polygraph examination of sexual assault victims.
- 1988 Hearsay Exception is granted to child sexual assault victims under the age of 13.
- 1991 Civil Statute of Limitations for Adult Survivors of Child Sexual Abuse becomes law.
- 1992 Citizens vote "yes" for the Illinois Constitutional Amendment for Victims Rights.
- 1994 ICASA receives allocation for the SACY Project from the Illinois Department of Children and Family Services.
- 1994 The Violence Against Women Act is passed by Congress and signed into law.
- 1996
ICASA receives VAWA funding from the Illinois Department of Public
Health and the Illinois Criminal Justice Information Authority.
- 1997 Sex Offender Management Board created by Illinois General Assembly.
- 1997
Law is passed allowing a defendant's previous victims to testify about
defendant's "prior bad acts," whether reported or not.
- 1997 ICASA celebrates its 20th Anniversary with friends and colleagues.
- 1998
Law is passed which makes giving a person a "date rape drug" before
sexually assaulting her/him an aggravating factor to the crime.
- 1998
ICASA and DHS, using VAWA funds, develop a media campaign that includes
television and radio spots directed at male responsibility for rape.
- 1999 ICASA, with DHS, begins evaluation of its crisis intervention services.
- 1999
Law is passed to extend the criminal statue of limitations in sexual
assault cases of an adult victim to ten years past the time of the rape
and ten years past the age of 18 for minor victims.
- 1999 ICASA moves into a newly constructed administrative office building at 100 N. 16th Street in Springfield.
- 1999 Law is passed creating pilot Sexual Assault Nurse Examiner programs in four Illinois hospitals.
- 1999 ICASA, with VAWA funding, begins a two year evaluation of its prevention education programs in Illinois schools.
- 1999
Law is passed that allows a victim of sexual assault or sexual abuse to
request that the State's Attorney file a petition to have the court
records of the case sealed.
- 2000
Law is passed permitting minor sexual assault victims 13 through 17
years to consent to the release of her or his evidence collection kit to
be analyzed for evidence for prosecution.
History of the terms Post-traumatic Stress, Rape Trauma Syndrome and Dissocation
Our Hearts and Our Hopes are Turned to Peace
CommunityWorks - Philadelphia, Pa., USA
http://www.istss.org/What/history.htm
Published
in the International Handbook of Human Response to Trauma (2000), New
York: Kluwer Academic/Plenum Publishers. Edited by Arieh Y. Shalev,
Rachel Yehuda and Alexander C. McFarlane.
"Our
hearts and our hopes are turned to peace as we assemble here in the
East Room this morning", said President Johnson on the morning of
November 1968. "All our efforts are being bent in its pursuit. But in
this company we hear again, in our minds, the sound of distant battles".
President
Johnson was addressing these words to those gathered for the Medal of
Honor ceremony in honor of five heroes of the undeclared war in Vietnam.
One of those heroes was a young African-American man from Detroit, Sgt.
Dwight Johnson. Dwight, or "Skip" to his family and friends, had always
been a good kid, an Explorer Scout and an altar boy, who could only
recall losing control of his temper once in his life, when his little
brother was being beaten by older boys.
But
in Vietnam, when the men whose lives he had shared for eleven months,
were burned to death before his eyes, he suddenly became a savage
soldier, killing five to twenty enemy soldiers in the space of half an
hour.
At
one point, he came face to face with a Vietnamese soldier who squeezed
the trigger on his weapon aimed point blank at Skip. The gun misfired
and Skip killed him. But, according to the psychiatrist that saw him
several years later, it was this soldier's face that continued to haunt
him.
After
receiving the Medal of Honor, Skip who had been unable to even get a
job as a simple veteran, became a nationally celebrated hero. But his
body and mind started to give way.
In
September of 1970 he was sent to Valley Forge Army Hospital where the
psychiatrist there diagnosed him with depression caused by post-Vietnam
adjustment problems. "Since coming home from Vietnam the subject has had
bad dreams", read the psychiatric report, "He didn't confide in his
mother or wife, but entertained a lot of moral judgement as to what had
happened at Dakto. Why had he been ordered to switch tanks the night
before? Why was he spared and not the others? He experienced guilt about
his survival. He wondered if he was sane" (Nordheimer, 1971).
On
April 30, 1971, Dwight Johnson, now married and the father of a little
boy, was shot and killed while attempting an armed robbery of a Detroit
grocery store. The store owner told the police, "I first hit him with
two bullets but he just stood there, with the gun in his hand, and said,
'I'm going to kill you . . .' I kept pulling the trigger until my gun
was empty".
In
the exchange, Dwight Johnson, an experienced combat soldier, never
fired a shot. His mother's words echo down to us, twenty-seven years
later, "Sometimes I wonder if Skip tired of this life and needed someone
else to pull the trigger" (Nordheimer, 1971).
It
is with this dramatic behavioral reenactment of one young, despairing
African-American soldier that the curtain opens on the first act of the
story of the International Society for Traumatic Stress Studies. The
ISTSS is one organizational part of a late twentieth century social
movement aimed at raising consciousness about the roots of violence by
enacting and reacting to that violence everywhere.
The
ISTSS was born out of the clashing ideologies that became so well
articulated in the 1960's and 1970's. War crimes, war protests and war
babies; child abuse, incest and women's liberation; burning monks,
burning draft cards, and burning crosses; murdered college kids and show
trials of accused radicals; kidnappings, terrorism and bombings; a
citizenry betrayed by its government and mass protests in front of the
Capitol in Washington - all play a role in the backgrounds of the people
who founded the organization and in the evolution of the organization
itself.
If
I have learned anything from my contact with victims of violence, I
have learned that it is vitally important to remember - and honor - the
lessons of the past. We have to know where we came from if we are to
know who we are now.
But
it is extremely difficult to write history as history is being made.
Since this chapter can only serve as a marker along the way, I have
chosen to concentrate my attention on the origins of the Society, before
those roots become even more lost in the darkness that envelopes those
who move offstage. There are two fundamental aspects of the growth of
this group.
First,
there are the individuals who provided the action - both the victims
and their advocates. One remarkable aspect of our history is the extent
to which the founding mothers and fathers have had personal experience
with trauma, as pointed out by van der Kolk, Weisaeth, and Van der Hart
(1996).
It
may be that it was this close brush with the Angel of Death that has
given the growing field such a continuing sense of passion, devotion and
commitment. Whatever the case, there are a multitude of stories begging
to be told, severely limited here by time and space. The second aspect
of organizational growth is the group-as-a-whole growth that I hope will
emerge in the structure of the chapter.
The
origins can not be placed at the foot of one powerful individual and
did not derive from a clearly thought-out, hierarchical, managerial
demand. Instead, it has grown organically, from the grassroots, and has
remained multidisciplinary, multinational and multi-opinioned.
Dr.
Chaim Shatan was familiar with the symptoms of war. His father had
fought in three - the Russo-Japanese War, the Balkan Wars, and the First
World War before moving from Poland to Canada. His father wrote short
stories about his war experiences and the son translated them from
Yiddish to English.
Shatan
had gone to medical school during World War II, when physicians still
received training in combat-related disorders and had evaluated men
suffering from the traumatic neuroses of war (Scott, 1993). A New
Yorker, Shatan read the New York Times routinely and when he read the
story about Dwight Johnson, he felt compelled to respond. And, as
co-director of the postdoctoral psychoanalytic training clinic at New
York University, he could even harbor hope that it would get published.
His
op-ed piece to the New York Times was published in May, 1972 and
titled, Post-Vietnam Syndrome. In his editorial, Shatan described what
came to be called post-traumatic stress disorder, and told how he had
noticed these symptoms in the Vietnam veterans he and his colleagues had
been seeing in "group rap" sessions (Shatan, 1972; 1978a).
One
of these colleagues that Shatan referred to was Robert Lifton. Lifton
was an ardent antiwar activist who had served in Korea as a military
psychiatrist and had already studied and written about the survivors of
Hiroshima (Lifton, 1967). Lifton met Sarah Haley through the New York
and Boston chapters of the group, Vietnam Veterans Against the War
(V.V.A.W.).
Sarah
Haley was a social worker at the Boston Veterans Administration
Hospital. Unlike most of her colleagues at the time, Haley recognized
that many of her patients who had served in Vietnam, were being
misdiagnosed as paranoid schizophrenics or character disorders because
mental health professionals were failing to recognize the symptoms
related to combat. But she knew them.
She
had grown up with a father who was a veteran of World War II, a special
agent for the O.S.S. and an alcoholic. She had heard stories of trauma
and wartime atrocities from the time she was a little girl and she had
personally experienced the long-term impact of war on her father's
behavior. What other colleagues found unbelievable, she found entirely
realistic.
When
she met a Vietnam veteran who claimed to have been involved in the
massacre of a village called My Lai, she believed him. It was through
Haley that Lifton met and interviewed that soldier (Scott, 1993).
In
January 1970, Lifton testified to a Senate subcommittee about the
brutalization of GIs in Vietnam, a brutalization that he believed "made
massacres like My Lai inevitable" (Lifton, 1973, p.17). In April 1970,
the U.S. invaded Cambodia and students across the country rose up in
protest.
Within
days, the Ohio National Guard fired into a crowd at Kent State, killing
four students and wounding nine others. Chaim Shatan had previously
arranged for Lifton to speak at N.Y.U. but they decided to change the
topic to address the Cambodian invasion and the Kent State killings, and
advertised it widely around New York City.
Many
people came who were not students, including some Vietnam veterans who
were members of the V.V.A.W. (Scott, 1993). The rap groups in New York
evolved from this meeting and from correspondence and phone calls
between Jan Crumb, then president of the Vietnam Veterans Against the
War, and Lifton, beginning in November, 1970 (Lifton, 1973).
When
the clinicians sat down with Jan Crumb and several others from
V.V.A.W., the vets described the way the members "rapped" with each
other about the war, American society and their own lives and how they
felt they would like some people around with greater psychological
knowledge.
Lifton
suggested they form more regular rap groups with some professional
involvement. With the support of the chairman of the psychoanalytic
training program at N.Y.U., Shatan circulated over three hundred memos
asking for professional volunteers to join in their efforts. He urged
them to help, telling them that "this is an opportunity to apply our
professional expertise and anti-war sentiments to help some of those
Americans who have suffered most from the war (Shatan, 1971).
He
outlined for them three theoretical questions that he believed needed
to be answered. What are the differences between Vietnam veterans and
World War II veterans? Can we clarify the psychodynamics of war
atrocities and demonstrate how they grow organically out of modern
combat training? What is happening in the group process experience
between veterans and professionals?
The
enticements worked. Within five days, his memo had drawn forty
volunteers. A panel of professional psychological and psychiatric
colleagues in the New York area was formed. Most came from the New York
University Postdoctoral Psychoanalytic Program, others from prestigious
programs like the W. A. White Institute for Psychoanalysis and the New
York Psychoanalytic Institute.
These
clinicians participated in the groups until at least 1976 (Shatan,
1987). They called themselves "professionals" rather than "therapists"
because they "had a sense of groping toward, or perhaps being caught up
in, a new group form. Though far from clear about exactly what that form
would be, we found ourselves responding to the general atmosphere by
stressing informality and avoiding a medical model" (Lifton, 1973,
p.77).
Word
got out to the Vietnam vets through word of mouth, churches, and some
media coverage and they started to come. Jack Smith and Arthur Egendorf,
both veterans, were early members of the rap groups in New York.
In
1971, Shatan and Peter Bourne testified at the court martial of a
Marine POW who was being charged with desertion, though he clearly
suffered from traumatic stress. The papers written by Bourne and
published in 1969 and 1971 about war neurosis were ignored.
The
refusal to see the damage that had been done to these men motivated
Shatan even further. The response to Shatan's op-ed article was
overwhelming. He heard from over 1,250 rap groups from around the
country as well as student health and financial aid offices on many
campuses, and even veterans in prison.
Groups
had already been meeting informally with psychiatrists in Philadelphia,
Atlanta, and Boston (Shatan, 1987). All were functioning outside of the
established VA services either because they were past the two-year
limit for service-connected disabilities or because they found the
traditional service, geared to World War II veterans, hostile to them
and unwilling to meet their needs (Scott, 1993).
There
was at this time, tremendous hostility towards the returning Vietnam
veterans, particularly those who had become disillusioned with the war.
And the hostility came from the left and the right sides of the
political spectrum. John Kerry (now Senator John Kerry) was a founder of
the V.V.A.W. and holder of three Purple Hearts, a Bronze Star, and a
Silver Star for his service in Vietnam.
He
reported that a Minnesota American Legion post excluded Vietnam vets
because they had lost the war. Meanwhile, there were antiwar activists
and pacifists calling the veterans "baby-killers" (Shatan, 1987).
Even
the military victimized the vets as they were leaving the war through
the practice of giving "bad discharge numbers". According to a discreet
coding system, numbers were entered on discharge papers that identified
veterans who had been seen as "troublemakers" while in the service, and
then these codes were distributed to employers and personnel officers.
In
the media, especially television, the stigmatization was furthered by
the portrayal of Vietnam veterans as dangerous and psychotic freaks,
murderers and rapists (Leventman, 1978). In 1978, Leventman, citing an
earlier article of his own said, "nothing reflects so much of what is
wrong with American society as its treatment of Vietnam veterans . . .
one can only reiterate that the negative legacy of Vietnam lies more in
civilian society than in the psyches of veterans" (p. 295).
In
response to this discrimination, the veterans and their supporters
organized a counter-VA consisting of therapeutic communes, storefront
clinics, vet centers, and bars. They organized social and political
protests. They conducted street theater with mock pacification
operations in New Jersey villages.
In
January of 1971, they organized war crime hearings called the "Winter
Soldier Investigation" in Detroit, sponsored by Jane Fonda, among
others. One hundred and fifteen veterans, as well as Robert Lifton,
presented testimony about atrocities committed in Vietnam, while Fonda,
and antiwar activist, Mark Lane, filmed the testimony and arranged for
distribution.
Except
for Life magazine, however, the event got very little national media
coverage. In April 1971, the V.V.A.W. organized a march on Washington.
The military had called the invasion of Cambodia and Laos, "Operation
Dewey Canyon II, and the V.V.A.W. named their action "Operation Dewey
Canyon III", designating it as a "limited incursion into the country of
Congress". Their weeklong occupation of Washington culminated in a
ceremony on the Capitol steps, a "medal turn-in" ceremony.
Jack
Smith recalls, "I can still hear the dings of those medals, the Bronze
Stars and the Silver Stars bouncing off the statue of John Marshall, and
the Purple Hearts, behind the barricades" (Scott, 1993, p.23). They
published an anthology of war poems and used the money to help a Quaker
rehabilitation center in South Vietnam and to help rebuild Hanoi's
foremost hospital, destroyed in the carpet-bombing.
They
founded free clinics in poverty areas and staffed them with former
nurses and medics. They offered legal aid and regular visits to vets in
prison. And mental health professionals, moving beyond therapy and
detachment to advocacy participated, "we went, with the vets, wherever
we could be heard: to conventions, war crimes hearings, churches,
Congress, the media, and abroad. We, too, suffered insomnia and had
combat nightmares (Shatan, 1987, p.8).
Meanwhile,
out on the West Coast, Dr. Philip May, a schizophrenia expert, was
director of psychological services for the Brentwood Veterans
Administration Hospital. in 1971. He recognized that Vietnam veterans
were not getting the services they needed, so he hired Shad Meshad, a
social worker and Vietnam vet himself, to evaluate the situation.
Meshad
had already started one of the first rap groups in the country, in the
Los Angeles area and was highly critical of the VA services. He had been
a medic in Vietnam, was seriously wounded, and had endured several
painful operations in the States. He knew what veterans were contending
with from a first hand perspective (Meshad, 1997; Scott, 1993).
So
did William Mahedy, who had served as a chaplain in Vietnam and was
working as a social worker at Brentwood, "Most Brentwood psychiatrists
that I met during this period had not the slightest clue how to deal
with Vietnam veterans . . . they didn't know how to treat combat-related
stress. Nor could they provide any guidance to the kind of total
reintegration into society that we knew was necessary" (Mahedy, 1986,
p.56).
In
response, Meshad created the highly unconventional Vietnam Veteran
Resocialization Unit within the Brentwood VA hospital, with the support
of the director at Brentwood and set up storefront clinics where rap
groups were held.
By
1973, Robert Lifton's book Home from the War was published, the first
widely read book about the plight of the Vietnam veterans. He and Shatan
had made strong and supportive connections with the American
Orthopsychiatric Association and several universities. Both were
impressed by the growing grassroots movement and believed that it could
be strengthened even further.
In
1970, the National Council of Churches (NCC) had established an office
under Reverend Richard Kilmer, an ordained Presbyterian minister, in
order to help those hurt by the war in Vietnam. At first the NCC focused
efforts on draft resisters and antiwar protestors, but in 1973, at the
urging of Shatan and Lifton, the NCC began laying plans for the First
National Conference on the Emotional Needs of Vietnam-Era Veterans.
According
to Jack Smith, the veterans had pointed out to Reverend Kilmer that
they had an obligation to minister to people who were in the war as well
as out of it and the churches began to listen. The Missouri Synod of
the Lutheran Church put up $80,000 for expenses and agreed to host the
meeting at its seminary in St. Louis, appropriately situated right in
the middle of the country.
Arthur
Egendorf developed a list of veterans, psychiatrists and others who
were actively involved in helping Vietnam veterans around the country.
According to Shatan, about one hundred and thirty people attended the
conference, "60 vets, 30 shrinks, 30 chaplains, and 10 central office
people [VA] who came on at the last minute (Scott, 1993, p.45). At the
conference, Lifton and Shatan spent time with reporters talking about
the problems of Vietnam veterans.
The
conference lasted for three days, April 26-28, 1973, and out of the
conference the National Vietnam Veterans Resource project (N.V.R.P.) was
created with a governing council of 16 people co-directed by Chaim
Shatan and Jack Smith, with representatives from all three groups -
veterans, chaplains, and mental health professionals. The project was to
have several functions: to search and gather data on the effects of
combat stress and to help coordinate a self-help movement of veterans
groups (Shatan, 1987; 1997a).
There
were direct consequences for this kind of advocacy. Beginning in 1970,
Shatan came under government surveillance. Returning from a meeting at
the Pentagon in June of 1973, he found his phone had been tapped. After a
visit to Washington to offer assistance to American POW's returning
from Hanoi, he discovered that someone had tampered with his mail.
In
July of 1973, Shatan had been contacted by William Kunstler's Center
for Constitutional Rights for help in preparing a "post-Vietnam
syndrome" defense for the " Gainesville", eight veterans who had been
charged with planning to blow up the 1972 Democratic and Republican
conventions. After this, the interference with his mail was stepped up
so that if mail came from veterans' organizations, people who worked
with Vietnam vets, or Robert Lifton, it was bound to be searched (Scott,
1993).
The
FBI tried to infiltrate the rap groups by sending in informers posing
as veterans seeking help (Lifton, 1978). Through the Freedom of
Information act, Shatan found that plans were even afoot to entrap him
with blueprints of government munitions plants (Shatan, 1987). His
response was to talk longer, louder, and more frequently in order to
bring attention to the readjustment problems of the veterans and to make
their cause more publicly visible and therefore less vulnerable to
government sabotage.
The
VA Central Office attacked Lifton and Shatan in the press when they
made a guess that 20% of men who had served in Vietnam were paying a
heavy psychological price, when the VA claimed that only 5% of the men
had combat-related psychological symptoms. Both were labeled as being
"hung up on the war" and accused of "dishonoring brave men" (Shatan,
1985).
Both
Shatan and Lifton knew that it was impossible to separate the
professional work they were doing with these men from their political
activism. As Lifton recalls, "I believe that we always function within
this dialectic between ethical involvement and intellectual rigor, and
that bringing our advocacy "out front" and articulating it makes us
more, rather than less scientific . . . From the beginning the
therapeutic and political aspects of our work developed simultaneously"
(Lifton, 1978, pp. 211 & 212).
It
was difficult for Vietnam veterans to get the services they needed from
the VA for several reasons, besides the existing, sometimes virulent,
prejudice against the men who had fought in Vietnam and were suffering
from the delayed effects of combat stress. First, there was no
diagnostic code for combat stress in DSM-II. This latest edition of the
Diagnostic and Statistic Manual for Mental Disorders, published by the
American Psychiatric Association, had been published in 1968.
As
Art Blank, points out, "As the return of troops from Viet Nam was
reaching a crescendo, the psychiatric profession's official diagnostic
guide backed away from stress disorder even further, and the condition
vanished into the interstices of "adjustment reaction of adult life"
(Blank, 1985, p.73).
But
even under DSM-I there had been no classification for delayed stress
reactions. So, if the symptoms presented more than a year after
discharge from active duty, the VA did not consider them to be
service-related problems. If veterans presented with post-traumatic
psychiatric symptoms, they were misdiagnosed as suffering from
depression, paranoid schizophrenia, character disorders, or behavior
disorders (Blank, 1985; Wilson, 1988).
Senator
Alan Cranston, a World War II veteran and a member of the Senate's
Committee on Veterans Affairs, became convinced that the psychological
needs of Vietnam veterans were different from those of older veterans.
Starting in 1971 he tried to bring about changes in the VA system by
seeking better funding for the Vietnam veterans to obtain drug and
alcohol rehabilitation as well as the initiation of readjustment
counseling services.
The
bill he proposed passed the Senate in 1973 and 1975, but the House
refused to pass it. The House was dominated by World War II veterans,
who had an unwillingness to concede that the Vietnam War had produced
different problems than had been previously recognized. In addition, the
American Legion as well as the Veterans of Foreign Wars lobbied against
the bill. Taking a more long-term approach, Cranston appointed Max
Cleland as a member of his staff to review the VA hospitals.
Max
Cleland was a Vietnam veteran who had lost an arm and both legs in the
war and had testified for Cranston at the Senate Committee on Veterans
Affairs in 1971. In his new position, Cleland visited Shad Meshad's
storefront operations at Brentwood. Both Cleland and Meshad testified in
1975 before Senator Cranston's Subcommittee on Health and Hospitals,
providing clear evidence that the VA hospitals were not meeting the
needs of Vietnam veterans (Scott, 1993).
Besides
the problems with the psychiatric diagnostic schemas, there was no
organized Vietnam veterans' pressure group advocating for a change in
benefits (Scott, 1993). The work of the National Vietnam Veterans
Resource Project (N.V.R.P.), created during the First National
Conference on the Emotional Needs of Vietnam-Era Veterans, began
immediately after the conference. By 1974, the N.V.R.P. had catalogued
2,700 diverse veterans' self-help programs, 2,000 of them on college
campuses, some out in the community and others in prisons (Lifton, 1973;
Shatan, 1974).
Jack
Smith sought funding for an empirical study and called it the Vietnam
Generation Study, since the intention was to study both veterans and
draft resisters. He and a colleague obtained funding from the National
Council of Churches, the Russell Sage Foundation, and the Edward F.
Hazen Foundation to begin a pilot study (Scott, 1993). In 1975, the
Senate Committee for Veterans Affairs initiated a bill, approved by
Congress, mandating the VA to conduct a study to assess the needs of
Vietnam veterans. As a result, the VA provided funds to Arthur Egendorf
and the NVRP to complete the Vietnam Generation Study, which eventually
culminated in Legacies of Vietnam (Egendorf et al., 1979; 1981; Laufer,
1985).
The Mysterious Disappearance of Combat Stress
The
first version of the Diagnostic and Statistical Manual formulated by
the American Psychiatric Association was published in 1952, while
American psychiatrists were actively treating veterans of World War II
and Korea. "Gross stress reaction" was used to describe the aftereffects
of previously normal persons who began having symptoms related to
intolerable stress.
DSM-II
was published in 1968, at the height of the TET offensive in Vietnam
and "gross stress reaction" was replaced with "(transient) adjustment
disorder of adult life". The only mention of combat -- as "fear
associated with military combat and manifested by trembling, running,
and hiding" -- was put in the same category as an "unwanted pregnancy"
(Shatan, 1985).
As
Chaim Shatan wrote many years later, The disappearance of stress
reactions from DSM-II remains a mystery. Its causes have not been
established. I have not been able to find a soul who will say they know
how or why it happened . . . [but] we can say that the diagnostic lacuna
in DSM-II had great political value during the Vietnam war . . . every
diagnosis is a potential political act (1985, p.2-3).
For
Figley, the absence in DSM-II of a diagnostic category specific to
combat trauma can be attributed to the lack of American involvement in a
war during that period, as WWII and Korean veterans became integrated
into the community (Figley, 1978a). But Blank also believed that the
elimination of "gross stress reaction" had been politically motivated,
if not consciously, then unconsciously.
On looking back he concurs with Shatan, "These dramatic shifts from DSM-I to DSM-III suggest the
hypothesis
that - as part of a highly complex social and intellectual phenomenon -
irrational influences have deeply affected the recognition and
appreciation of accurate guidance by organized psychiatry" (Blank, 1985,
p. 74).
Wilson
has puzzled over this mystery as well, pointing out that after the
death of Freud the collective knowledge about psychological trauma
seemed to go underground and by the time of DMS-II had all but
evaporated. "What makes this so peculiar is that by 1968, the cumulative
historical events involving war, civil violence, nuclear warfare, etc.,
produced more trauma, killing, mass destruction, and death in a limited
time frame than at any prior time in recorded history" (Wilson, 1995,
p.15).
Blank
even now predicts that, for similar reasons, there will be a move to
exclude PTSD as a diagnostic category when the DSM-V is formulated in
the future (Blank, 1997a).
Whatever
the reasons - and there probably were many - as early as 1969, John
Talbott recommended that the future editors of DSM-III re-introduce the
gross stress reaction listing. Talbott, later to become President of the
American Psychiatric Association, had served in Vietnam as a
psychiatrist. He conducted some of the initial interviews for the
Vietnam Generation Study and was stunned by how much of this
"post-Vietnam syndrome" he had been failing to diagnose in part because
there was no way to make the diagnosis under DSM-II (Scott, 1990; 1993).
The Lost is Found: Post-traumatic Stress Disorder
CommunityWorks - Philadelphia, PA., USA
http://www.istss.org/what/history2.htm
Published
in the International Handbook of Human Response to Trauma (2000), New
York: Kluwer Academic/Plenum Publishers. Edited by Arieh Y. Shalev,
Rachel Yehuda and Alexander C. McFarlane.
Shatan
says that he first heard that traumatic war neurosis had disappeared in
1974 as a result of a phone call from an Asbury Park, New Jersey public
defender. A Vietnam veteran had been charged with violence against
property and had amnesia for his behavior.
The
public defender entered a plea of not guilty based on traumatic war
neurosis and the judge rejected the defense because there was no longer
such a diagnosis. Shatan recommended that the public defender contact
the DSM-III Task Force headed by Robert Spitzer. He did so and was told
that there were no plans to reinsert any form of traumatic war neurosis
in the DSM-III. A reporter from the Village Voice got this word back to
Shatan and he was shocked. He got together with Lifton to decide what to
do. They realized they had to mobilize, and mobilize quickly (Shatan,
1985).
Their
response was to form the Vietnam Veterans Working Group (V.V.W.G.),
supported, in part, by the American Orthopsychiatric Association and the
Emergency Ministry of the United Presbyterian Church (Shatan, Haley
& Smith, 1979).
The
National Council of Churches did any xeroxing that needed to be done.
Amitai Etzioni provided some office space for them at his Center for
Policy Research at Columbia University (Shatan, 1997a; Scott, 1993). In
1974, Sarah Haley published her landmark paper, "When the patient
reports atrocities" in the Archives of General Psychiatry, one of the
publications of the American Psychiatric Association, and it was widely
read.
John
Talbott had easy access to the American Psychiatric Association. He
sponsored meetings at the New York chapter of the APA, inviting Shatan,
Haley, Arthur Egendorf and others to present on "Post-Vietnam syndrome".
He also helped them get access to Robert Spitzer at the 1975 American
Psychiatric Association convention.
Jack
Smith developed a questionnaire as part of his doctoral thesis,
"American War Neurosis, 1860-1970" and Shatan sent the questionnaire to
35 members of the VVWG in 1975, many of whom had been working closely
with the veterans in rap groups and individual sessions, some as far
back as 1970 (Shatan, Haley & Smith, 1979). He asked them to go
through their caseload with the questionnaires.
Shatan
and Lifton, joined by Jack Smith and Sarah Haley, tabulated the results
on 724 veterans and arrived at a classification system very close to
the one Kardiner had proposed in 1941 (Shatan, 1997b, Shatan, Haley
& Smith, 1979; Van der Kolk, Herron & Hostetler, 1994).
While
this was going on in the psychiatric establishment, Charles Figley
organized panels in 1975 at the American Sociological Association and
the 1976 meeting of the American Orthopsychiatric Association. He met
with Chaim Shatan, Robert Lifton, and others, while beginning to work on
an edited volume which, in 1978, would become a landmark book on
Vietnam. Figley, a psychologist, had served in Vietnam in 1965 with the
Marines and was one of the first Vietnam veterans to return home.
He
completed graduate studies and participated in Dewey Canyon III. On
campus, he met other Vietnam veterans and became aware of the widespread
nature of their adjustment problems. After obtaining his degree, he
took a position at Purdue University where he founded and directed the
Consortium on Veteran Studies and started studying the post-Vietnam
effects intensively. He developed a bibliography about combat trauma and
began corresponding with other people interested in similar studies
(Scott, 1993).
Meanwhile,
John Wilson, a conscientious objector during the Vietnam War, began
working on the Forgotten Warrior project. Wilson had completed his Ph.D.
in 1973 and performed three years of alternative service in a crisis
intervention center. When two close friends returned from Vietnam as
radically changed people, a seed was planted in his mind. His first
academic position was in Cleveland where a student of his presented a
report on some Vietnam veterans he had interviewed on campus.
John
was intrigued. He sent out letters to the veterans on campus and more
than 100 responded. He and his student, Chris Doyle, recorded narratives
of their lives before, during and after Vietnam and the work became
consuming. His department chairman threatened to block his tenure or
promotion if he continued this work, but John was undeterred. He set up
rap groups at the university and requested funding from various
organizations for a study.
But
only in 1976 was he able, through the assistance of a disabled veteran,
to get the Disabled American Veterans to provided the money he needed
to complete the study (Scott, 1993). Out of over 450 interviews he and
an associate, Chris Doyle wrote The Forgotten Warrior Project (Wilson,
1977).
In
1977, Figley chaired a research symposium at the American Psychological
Association conference where he was able to arrange for the
presentation of three papers: Egendorf and his colleagues' first version
of what would ultimately become the Legacies of Vietnam study,
(Egendorf et al., 1977), his own work from the Consortium (Figley &
Southerly, 1977), and Wilson and Doyle's, Forgotten Warrior Project
(Wilson & Doyle, 1977).
Each
separate study supported and extended the other (Figley, 1978b) and
provided even more support for the efforts of the V.V.W.G. in their
attempt to change DSM-III.
Ironically,
the decision to alter the DSM-III in relation to homosexuality may have
had something to do with subsequent changes in the DSM allowing PTSD to
enter the lexicon. The argument over whether or not homosexuality was a
disease entity was so heated and politically loaded, that Spitzer
decided it should be put to a vote. This indicated that the DSM-II could
end up being completely redone, opening up negotiating room for those
who wanted to reintroduce stress reactions into the classification
schema.
In
the summer of 1975, the V.V.W.G. invited Spitzer to lunch at Columbia
Presbyterian in New York City. The group filled him on their activities
and he was willing to appoint a formal committee, the Committee on
Reactive Disorders, to proceed with the inquiry. He appointed himself,
Dr. Lyman Wynne and Dr. Nancy Andreason to be the representatives on the
committee with Andreason as chair.
She
had previously worked with burn victims and knew about the long-term
psychological as well as physical suffering that was involved in
recovery from severe trauma. Spitzer instructed Andreason to work with
Shatan, Lifton, and Smith. The appointment of Jack Smith, a non-M.D.,
was a highly unusual move. But the burden of proof still remained with
the V.V.W.G. (Scott, 1993).
Convincing
Andreason of the validity of the long-term reactions to overwhelming
stress was key to the success of the venture. The Working Group reckoned
that persuasion would be easier if they could show the similarities
between combat stress and other forms of traumatic experience. So they
recruited Harley Shands who had experience working with job-related
trauma, Mardi Horowitz who was working on the physiology of stress,
combined this with the research related to concentration camp victims
that Niederland and Krystal had been doing, and contacted researchers
working with other survivor groups to join in their mission.
Sarah
Haley pointed out to Andreason that in reviewing the charts of the
Vietnam veterans in the VA hospital, she had discovered that many of the
clinicians were treating the patients as if there was a diagnosis of
traumatic war neurosis available. This practical reality had a
particularly strong impact on the discussions (Scott, 1993; Shatan,
1997a). Shatan, Haley and Smith presented their position paper at the
1977 annual meeting of the American Psychiatric Association,
representing the accumulated work of the V.V.W.G. and making specific
recommendations to the DSM-III Task Force for changes in the
categorization system (Figley, 1978a; Shatan, Haley & Smith, 1977).
Early
in 1978, Spitzer called the Working Group together to present their
findings to the Committee of Reactive Disorders. Lifton, Smith and
Shatan presented their evidence in a meeting with Spitzer, Andreason,
and Wynne. They emphasized a wide circle of war zone victims, and the
similarity between them and other victim groups. Later that month, the
Committee released its decision, recommending a diagnosis of
"post-traumatic stress disorder".
The
DSM-III was completed and published two years later, having
incorporated most of the recommendations made by the V.V.W.G., which
were very similar to the observations made by Kardiner in the 1940's
(Kardiner, 1941; Scott, 1993; Shatan, 1978b). Interestingly, at the same
time as the V.V.W.G. were endeavoring to establish criteria for the
DMS-III, another group of mental health professionals were working on a
diagnostic system for dissociative disorders.
There
was no communication between them and the PTSD working group, largely
because very little academic conversation had yet occurred about the
relationship between dissociation and trauma. As a result, a separate
classification for the dissociative disorders was also entered into
DSM-III and separate organizations subsequently developed to study these
two related fields (Van der Kolk, Herron, & Hostetler, 1994).
In
the meantime, President Carter had appointed Max Cleland as Director of
the Veterans Administration and Alan Cranston assumed the chairmanship
of the Senate Committee on Veterans Affairs. Cleland called a meeting
with Art Blank, Charles Figley, Shad Meshad, John Wilson, William Mahedy
and others to make specific recommendations for a VA readjustment
counseling program.
Art
Blank, a psychiatrist, had been drafted to serve in Vietnam in 1965.
When he returned and got a position at Yale, one of his clinical
positions was at the West Haven VA Hospital treating Vietnam vets. As a
result of his own experience, he began diagnosing traumatic war neurosis
in 1972, long before his colleagues were willing to see the effects of
war on the returning veterans.
He
made contact with Sarah Haley after reading her 1974 paper and through
her, had met Figley and Shatan (Blank, 1998). Once the Vet Centers
became a reality, he became the VA's Chief of Psychiatric Services. As a
result of the changed political climate, at the same time as the APA
was changing the DSM-III, Congress directed the Veterans Administration
to create a nationwide system of specialized counseling centers (Vet
Centers) for a wide range of readjustment problems in Vietnam veterans,
including PTSD (Blank, 1985). The first Vet Center opened in 1979 and by
1990 there were almost two hundred around the country (Blank, 1993).
The
Legacies of Vietnam study was published in 1981. In that year, Robert
Laufer, the principle investigator of the study, testified before the
Senate Committee on Veterans Affairs. Senator Alan Simpson wrote the
Senate report summarizing the testimony and in it he said, "It does
appear clear from the report that there is a continuing need for the Vet
Center program and, as the findings of that study become more widely
known, that need may become greater as veterans and their families come
to realize that service during the Vietnam-era may have had an impact on
an individual's ability later in life to adjust satisfactorily to his
or her social environment" (United States Senate, 1981, p.16).
Convergence
Creates a Social Movement Although the Vietnam War provided the
"general tendency to change which is apparent in many spheres during
wartime" (Jones, 1953), other converging and significant social forces
played a role in bringing the recognition of the effects of trauma into
the public consciousness in the United States and around the world.
The
two most significant, and war-related events, of course, were the Nazi
Holocaust and Hiroshima-Nagasaki. Robert Lifton had published an
extensive study of Hiroshima victims (1967) a subject few people wanted
to address, no more than they really wanted to confront the problems of
Vietnam veterans or Holocaust survivors, all "politically incorrect
survivors of atrocities" (Milgram, 1998).
William
Niederland (1968) had already devoted twenty-five years to working with
concentration camp survivors, noting that the same delay preceded their
"survivor syndrome" as was being recognized in the work with Vietnam
veterans. (Shatan, 1974).
Niederland,
who Shatan had known for a long time, and Henry Krystal, who had also
studied concentration camp survivors (Krystal, 1968), organized a
conference on victimization at Yeshiva University in 1975 and joined the
V.V.W.G. (Scott, 1993). Shatan, Lifton, and others working with the
Vietnam veterans had already made international contacts as early as
1974 with other professionals working with veterans - in Canada,
Switzerland, and Australia as well as Israel (Shatan, 1974).
In
the early 70's, Shatan traveled to Israel and met with military
psychiatrists there (Scott, 1993). In a letter to the director of the
American Orthopsychiatric Association in 1978, Shatan reported that a
liaison had been established with the National Institute for Research in
the Behavioral Sciences of Israel (1978b). There, Dr. Rappaport and an
American consultant, Dr. Israel Charny, were working on a project called
the "Genocide Early Warning System", hoping to isolate and identify
features in a society which prefigure the later development of genocide
(1978b).
Studies
also began to be published and conferences held in Israel on the
effects of war stress there, a logical occurrence given the unremitting
nature of warfare in the region (Benyakar & Noy, 1975; Milgram,
1978; Moses et al., 1975; Noy, 1978; Sohlberg, 1975; Steiner &
Neumann, 1978). Noach Milgram organized the first of four international
conferences on psychological stress and coping in time of war and peace
in January, 1975 in Tel-Aviv, a year after the Yom Kippur War, and the
second in June, 1978 in Jerusalem.
Both
were attended by Israeli and U.S. participants (Milgram, 1998). Israel
was naturally the home for a large number of Holocaust survivors, yet
there was a "conspiracy of silence" in Israel about listening to their
stories (Danieli, 1981), similar to the phenomenon Neff had described in
reference to the Vietnam veterans with his observation that Vietnam
veterans were invisible patients with an invisible (nonexistent) illness
(1975).
Danieli
and Solomon have both provided a framework for understanding the
gradual transformation of Israeli society towards a willingness to
comprehend the magnitude of post-traumatic problems (Danieli, 1981;
Solomon, 1995a; b, c, d).
Yael
Danieli had served in the Israeli Defense Forces before emigrating to
the United States, where she founded the Group Project for Holocaust
Survivors and their Children. During this period she had already begun
her life work, exploring the intergenerational transmission of
victimization, styles of adaptation to victimization, survivor guilt,
and the attitudes and difficulties of mental health professionals
working with survivors and children of survivors of the Nazi Holocaust
(Ochberg, 1988b).
She
would later go on to establish strong connections with the United
Nations and become instrumental in bringing the concepts of traumatic
stress to a wider international audience (Danieli, Rodley, &
Weisaeth (1996). Ellen Frey-Wouters, a specialist in international law,
and originally from the Netherlands, co-authored, with her husband,
Robert Laufer, the third volume of the Legacies of Vietnam study while
also writing about survivors of the Nazi Holocaust and working on social
policy issues around the area of traumatic stress.
Many
studies of concentration camp survivors were being conducted in Europe
as well, including comprehensive long-term follow-up studies from
Denmark, the Netherlands, and Norway (Bastiaans, 1974; Eitinger 1961,
1964; Thygesen et al, 1970). Meanwhile, also in Norway, Askevold studied
the effects of prolonged stress on men who had served in the Merchant
Marine in World War II (1976).
For
the European community, Nazi occupations and the terrorism perpetrated
by the Gestapo played a significant role in sensitizing them to the
long-term consequences of excessive stress (Malt, Schnyder &
Weisaeth, 1996).
Another
effect of World War II was the vast movement of refugees. Eitinger
began studies of refugees in Norway as well as studying concentration
camp survivors (1960). The Vietnam War and the fall of Saigon in 1975
brought a flood of Vietnamese and Cambodian refugees to the United
States. As early as 1979 reports began to be published about the
adjustment problems they were having (Lin, Tozuma, & Masuda, 1979),
opening up a discourse on how Westerners could most effectively
intervene and help refugees from the East (Kinzie, 1978).
Independent
of the DSM-III process and the effects of war, a number of other
significant developments took place during the 1970s. One was Mardi
Horowitz' Stress Response Syndromes (1976), which, building on Selye's
earlier work (1956), began to provide a psychophysiological basis for
understanding the body's responses to overwhelming experience and how
that response connected to psychological processes.
Charles
Figley (1978), edited the first significant collaborative book on
Vietnam War veterans, and in doing so, introduced a new psychosocial
series for Brunner/Mazel that by 1990 would grow to eighteen volumes of
literature spanning every victimization category.
Crime
rates in the United States rose rapidly in the 1960's and attention was
also brought to bear on crime against women and children, probably for
the first time in history.
The
women's movement was instrumental in bringing attention to the
incidence of rape and domestic violence that was being perpetrated
against women. The first public speak-out on rape was organized by the
New York Radical Feminists in 1971 and the first International Tribunal
on Crimes Against Women was held in Brussels in 1976 (Herman, 1992).
In
1974, Ann Burgess and Linda Holstrom at Boston City Hospital described
the "rape trauma syndrome" noting that the terrifying flashbacks and
nightmares seen in these women resembled the traumatic neuroses of war.
Susan Brownmiller and other feminist writers and thinkers redefined rape
as an act of violence directed at maintaining dominance. In doing so,
they placed the act of rape squarely in a political framework of power
relationships, laying the groundwork for cross-fertilization with
colleagues working with other survivor groups (Herman, 1992).
The
feminist politicization of violence led to a deepening understanding of
the abuse of power within the family, leading to the "discovery" of
domestic battering and sexual abuse. As in the cases of delayed combat
stress and rape trauma, domestic violence and sexual abuse awareness
began at the grassroots, emerging out of feminist consciousness raising
groups.
Lenore
Walker published her landmark study on victims of domestic violence
(1979), while Gelles and Straus released the results of major studies on
family violence (Straus, 1977; Gelles and Straus, 1979). Around the
same time, Judith Herman and her colleagues in Boston began to document
the effects in adult women of having been sexually abused as children
(1981). Rape crisis centers and battered women's shelters began to
spring up in various communities around the country, outside of the
traditional mental health systems.
Finkelhor
has described the increasing professional concern about child abuse
over the last several decades as being the "result of a broad social
movement and a historic moral transformation" (1996, p.ix). C. Henry
Kempe, pediatrician at the University of Colorado first described the
"battered child syndrome" in 1962 (Kempe et al, 1962; Kempe, 1978). This
conceptualization of child abuse brought the medical profession into
this social movement with all the authority, prestige, and legitimacy
necessary to bring about legislative change.
At
first, clinicians and researchers like Green focused on the physical
abuse of children (1978a, b). The 1970's saw the establishment of
mandatory child abuse reporting laws and a widened system of child
protection that was furthered and supported by the growing feminist
movement (Finkelhor, 1996). But then Susan Sgroi (1975), David Finkelhor
(1979), and others began to document the widespread incidence of the
sexual abuse of children and the harm it was doing to them.
In
1973, the Children's Division of the American Humane Association
testified before a Senate Committee, estimating that 100,00 children
were sexually abused each year. Burgess and her colleagues noted in 1978
that "concern for the victims of sexual assault has become a national
priority only during the past five years. In that time, both public
awareness of and knowledge about sexual assault and its victims have
grown immeasurably" (Burgess et al., 1978, p.ix).
As
early as 1975, Shatan was studying the effects of other kinds of trauma
on children. In 1972, he chaired a roundtable discussion at the IV
International Psychoanalytic Forum in New York, comparing delayed
survivor reactions in two parent groups: Vietnam veterans and
concentration camp inmates, having noted significant symptoms of
unresolved mourning in young adults who were children of World War II
veterans from 1965-1970.
He
presented a paper at the 1975 meeting of the American Orthopsychiatric
Association (1975) looking at the delayed impact of war-making,
persecution and disaster on children. But there was a great deal of
professional resistance to recognizing that previously normal and
healthy children could be severely damaged by exposure to
psychologically traumatizing events. In 1979, Lenore Terr published the
first of her series of papers and a book on the children of the
Chowchilla, California kidnapping which introduced a developmental focus
on the effects of trauma.
Elissa
Benedek recalls hearing Terr present her data before a mocking and
hostile professional audience who were determined to deny the effects of
trauma and disaster on previously healthy children. As she puzzled over
this seemingly irrational response on the part of a professional group
she knew well, she concluded that 'this meeting was but another form or
manifestation of a long tradition of denying psychological and
psychiatric sequelae in the child victim of trauma.
The
audience's response of disbelief in the face of carefully collected
documentation, might have been so intense because it was difficult for
professionals to accept that traumatic events, caused by fellow humans,
in the lives of children might color and shape their lives for years to
come" (Benedek, 1985, p.4).
Crime
victimization surveys in the U.S. led to the development of the Law
Enforcement Assistance Administration, a federal agency designated to
provide victim service programs in the 1970's. While new services were
starting, researchers were gathering data about the consequences of
victimization to the individual and to the entire society.
In
1975, the National Organization of Victim Assistance (NOVA) was founded
and other victim-centered groups emerged, such as Mothers Against Drunk
Driving and Parents of Murdered Children (Young, 1988). Morton Bard
became involved in the crime victim movement in the 1970's when he
consulted with law enforcement agencies in New York City and later the
National Institute of Justice (Bard & Sangrey, 1979; Bard &
Shellow, 1976). He and Dawn Sangrey published a volume for crime victims
in Figley's psychosocial series for Brunner/Mazel in 1979.
Both
Robert Rich and Susan Salasin became involved in developing mental
health programs and social policies to meet the needs of victims (Rich,
1981; Salasin, 1981).
On
February 26, 1972, a dam burst in Buffalo Creek, West Virginia,
destroying houses, a community, and many lives. K. Erickson wrote a book
about the survivors of the Buffalo Creek disaster (1976) and other
researchers, including Bonnie Green, and later, Jacob Lindy, followed up
on the long-term effects of this disaster on the survivors (Gleser,
Green & Winget, 1981; Lifton & Olson, 1976; Titchner & Kapp,
1976).
On
March 28, 1979, a sizeable portion of the Unit 2 reactor at Three Mile
Island experienced a meltdown, outside of Harrisburg, Pennsylvania, in
the most serious U. S. commercial reactor accident to date. Some
gaseous, but inert material was released, and no serious health
consequences were expected. The population, however, had to be evacuated
and a Task Force was rapidly set up to evaluate the highly publicized
effects of this event on the affected populations (Dohrenwend, et al.,
1981).
Other
disaster studies began to emerge in the literature throughout this time
period as well (Boman, 1979; Quarantelli & Dynes, 1977; Parker,
1977), building on a knowledge base that dated back to Lindemann's
landmark paper on the Cocoanut Grove fire (Lindemann, 1944; Leopold
& Dillon, 1963). Manuals on helping disaster victims began to be
developed and published (Tierney & Baisden, 1979).
Beverly
Raphael from Australia, began publishing her work around disasters and
bereavement and she and John Wilson made early contacts with each other,
thereby establishing a firm connection with Australia (Raphael, 1977;
Raphael & Maddison, 1976; Wilson, 1997).
This
growing body of literature on the psychological effects of disaster
indicated that there could be long-term consequences of overwhelming
stress in populations generally considered by the public to be free from
any culpability in their experienced victimization. The high level of
publicity given to disasters helped to increase the general level of
consciousness about the consequences of trauma.
In
1974, a bank robber in Stockholm, Sweden took a bank teller hostage.
They fell in love and had sex during a long siege in the bank vault
(Ochberg, 1996). In the same year, the granddaughter of William Randolph
Hearst and heiress to the Hearst fortune, Patty Hearst, age 19, was
kidnapped by a terrorist group, while sitting at home with her
boyfriend.
Until
September of 1975, she was a captive of the group and was physically,
sexually, and emotionally tortured. She developed a new persona and a
new name, "Tanya" and was caught by the FBI while participating in a
bank robbery with the group. In 1976 she was convicted and sentenced to
seven years in jail, three of which she served (Hearst, 1981). This odd
form of bonding between kidnapper and victim was later recognized in
other types of captivity situations and came to be known as the
"Stockholm Syndrome" (Strenz, 1982).
Frank
Ochberg, a psychiatrist whose career decisions had been in part shaped
by the assassinations of Martin Luther King and Robert Kennedy,
co-authored a book on violence even as a psychiatric resident (Daniels,
Gilula and Ochberg, 1970). He went to work for the National Institute of
Mental Health and became the NIMH representative when the U.S.
Department of Justice commissioned an inquiry into terrorism in 1975. As
a result, he began to focus on victims of terrorism and hostage
negotiations.
He
served as Associate Director for Crisis Management at NIMH in the late
1970's, consulted to the U.S. Secret Service, and trained Air Force
personnel about terrorism and sabotage (Ochberg, 1988a). He published an
article on terrorism as early as 1978 in a new journal devoted to the
study of terrorism and in 1982 he co-edited one of the first books on
terrorism (Ochberg & Soskis, 1982).
In
England, an article came out with the seemingly surprising finding that
people not seriously harmed in a terrorist bombing were more
incapacitated than would have been expected and they termed this an
"aftermath neurosis" (Sims, White & Murphy, 1979) Across the nation
and around the world, the growing global communication network was
tuning us in to tragedy everyday. Trauma was in the air and a budding
awareness began to emerge that the various forms of traumatic experience
might be similar and even interconnected.
As
early as a 1979 paper, Shatan, Haley, and Smith were already comparing
the catastrophic stress of natural disasters, man-made disasters, combat
trauma, incarceration, Buffalo Creek, Hiroshima, and internment in the
death camps. The time was ripe for a convergence, for people to come
together and share their knowledge, experience, and sorrow.
Over
the past thirty years of being involved in the anti-rape movement, I’ve
worked with hundreds of survivors of clergy abuse from just about every
faith.
Every
time I received one of these announcements regarding the Pope, I can't
help but to thinking to myself that on some levels my Catholic friends
have it so much easier then us Jews. Within Judaism, there is not one
central person in charge of our faith. Meaning there’s not one person
to place the blame. Instead it feels as if we have zillions of
pontiffs. Within Judaism, there is no Pope. Instead each and every
rabbi is more or less like the rulers of their own kingdom.
by Betty Friedan was published
