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A Shakespearean view of PTSD

Filed by KOSU News in Public Insight Network.
May 31, 2013

In his book on Vietnam veterans, Dr. Jonathon Shay explores the question of what happens to veterans who return from war broken by combat by comparing modern day PTSD to Shakespeare's "Henry IV". (Beinecke Rare Book & Manuscript Library, Yale University)

Shakespeare’s “Henry IV” features a character traumatized by war and described in terms modern psychiatrists recognize all too well. (Beinecke Rare Book & Manuscript Library, Yale University)

Nearly 20 years ago, a psychiatrist working with the Department of Veterans Affairs published a book inspired by his work with Vietnam veterans struggling with PTSD. The book is “Achilles in Vietnam: Combat Trauma and the Undoing of Character” and its author is clinical psychiatrist Dr. Jonathan Shay, whom I’ve written about before.

Shay asks the question: “When a soldier is broken by combat, what breaks?” He answers it using words Shakespeare gave to Lady Percy, the wife of a combat veteran named Hotspur (Henry Percy) in “Henry IV”Lady Percy’s lines in Act 2, Scene 2, which comprise one contiguous passage, are in bold. Throughout, Shay has inserted the corresponding PTSD symptom.

O my good lord, why are you thus alone? Social withdrawal and isolation
For what offense have I this fortnight been
A banished woman from my Harry’s bed?
Random, unwarranted rage at family, sexual dysfunction, no capacity for intimacy
Tell me, sweet lord, what is ’t that takes from thee
Thy stomach, pleasure,
Somatic disturbances, loss of ability to experience pleasure
and thy golden sleep? Insomnia
Why dost thou bend thine eyes upon the earth Depression
And start so often when thou sit’st alone? Hyperactive startle reaction
Why hast thou lost the fresh blood in thy cheeks Peripheral vasoconstriction, autonomic hyper-activity
And given my treasures and my rights of thee
To thick-eyed musing and curst melancholy?
Sense of the dead being more real than the living, depression
In thy faint slumbers I by thee have watched, Fragmented, vigilant sleep
And heard thee murmur tales of iron wars,
Speak terms of manage to thy bounding steed,
Cry “Courage! To the field!” And though hast talk’d
Of sallies and retires, or trenches, tents,
Of palisadoes, frontiers, parapets,
Of basilisks, of cannon, culverin,
Of prisoners’ ransom and of soldiers slain,
And all the currents of a heady fight.
Thy spirit within thee hath been so at war,
And thus hath so bestirred thee in thy sleep,
Traumatic dreams, reliving episodes of combat, fragmented sleep
That beads of sweat have stood upon thy brow
Like bubbles in a late-disturbed stream …
Night sweats, automatic hyperactivity

As I read the passage and Shay’s interpretation, I felt cold. For each line or grouping of lines I thought of a veteran I’ve met or spoken with. War trauma is an old story, I know that — and it’s Shay’s point here. But reading this passage, the truth was visceral, not just intellectual.

If this kind of thing interests you, Shay has two books you should check out:

>> We’re doing our veterans coverage the Public Insight Network way, which means if you are a veteran, we’d love to hear from you on this and other veterans issues: Veterans: Help improve reporting on veterans.

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