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PTSD: Diagnosis and Identity in Post-Empire America

Lembcke, Jerry

Lexington Books, (2013)
ISBN: 9780739186244 (pb)

Reviewed by Richard Gehrmann, University of Southern Queensland

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Cover of PTSD: Diagnosis and Identity in Post-Empire America In this thoughtful account of post-war experience and ‘lost’ war experience, sociologist and Vietnam veteran Jerry Lembcke has built on his earlier critical work (The Spitting Image: Myth, Memory and the Legacy of Vietnam) to evaluate another American military-related issue, post-traumatic stress disorder (PTSD). War trauma is real, but there is clear evidence that individual trauma memories are appropriated by historians and can be manipulated to serve wider social functions (Lee 2014). Using a social constructivist approach, Lembcke examines military experiences from the World War One to Afghanistan and Iraq in PTSD: Diagnosis and Identity in Post-Empire America, tracing associations between PTSD and earlier culturally-based medical conditions including hysteria and ‘railway spine’. Of course, PTSD is not just an American issue, but it is culture-based - British veterans experience PTSD at a far lower rate than United States veterans (p. 157-8). In examining an American military culture where only 15% of deployed troops experience combat yet 30% suffer PTSD Lembcke presents case studies that alert readers to the uncomfortable reality that some veterans incorrectly claim past combat trauma as their defence for misogyny, violence and crime.

Lembcke addresses intersections between individual veterans suffering PTSD and American society’s acceptance of fantasy to process the complexity of a lost war. Mythology suggested many returned Vietnam veterans were spat on, but after a decade of research Lembcke still has only one verifiable first-person contemporary claim, and he debunks the Vietnam / Iraq fable of 19 being the average age of dead soldiers. Military victimhood myths are dissected with warnings that a cultural trope overemphasising loss, sacrifice and defeat can increase the probability of future wars. The author makes this point by emphasising how the often unrecognized and highly effective Allied campaign of August 1918 unequivocally routed a German Army whose humiliating defeat was redefined in German national mythology as a home-front ‘stab in the back’, with disastrous consequences.

Veterans often want to be perceived as authentic combat warriors, and can invent stories to achieve this. After World War Two (the ‘good’ war) some falsely claimed experiencing heroic events such as the liberation of Dachau. Conversely, the My Lai massacre became a defining image after Vietnam (the ‘lost’ war) and Lembcke provides evidence showing how some veterans bought into this antihero narrative with false atrocity stories. Veterans want to prove their participation, and Iraq War Abu Ghraib prison guards even stressed their ‘warrior’ credentials through deliberately staged photographs of abuse, an extreme form of self-incriminating narcissism. Lembcke examines the shifting definitions of combat and demonstrates how PTSD legitimizes veterans now defined as victims.

Many Americans accept such norms, as Lembcke shows by comparing two separate Iraq war bombing incidents involving high-profile American journalists whose combat injuries attracted widespread public interest in the United States at the time. The PTSD and minor physical wounds of Bob Woodruff are contrasted with Kimberly Dozier’s extensive physical wounds (p. 160-8), but Dozier’s refutation of victimhood and PTSD status resulted in her subsequent marginalisation by the US media.

Popular cultural renditions of veteran internalization of conflict reveal the scientific study of PTSD has been led by literature, film and media. Lembcke records how flashback became accepted in diagnoses after the film First Blood (1982), although his linkage between flashback, fiction and those seeking exculpation for their misdeeds will displease some.

PTSD can be a profoundly disturbing experience, an over-simplification of other conditions or a culture-based fantasy. While careful not to overstate fictitious PTSD cases, Lembcke is concerned about the rampant growth of PTSD and soldier victimhood that authenticates war service - by 2012, half of the 700,000 Gulf War veterans had disability claims filed, despite few having experienced combat (p. 127). Lembcke points out that most Vietnam veterans successfully reintegrated into their communities but a media-driven popular image represents them as disturbed victims and the image of the disturbed soldier has become part of American society. Ultimately, Lembcke believes one of the great tragedies of American PTSD is it caused “the displacement of the historically grounded image of the veteran empowered and politicised by his Vietnam experience, by the strung-out, dysfunctional, and dangerous victim-veteran who has brought the war home with him” (p. 129). Having served in the Australian Army Reserve in Iraq and Afghanistan, like Lembcke I am able to view PTSD as both academic and veteran, and from both perspectives I appreciate the contributions he makes towards a more critical approach to the socially constructed veteran experience. This very readable book will be of interest to sociologists, social historians, and analysts of war and society considering the Iraq and Afghanistan wars – and those considering future conflicts as yet unfought.


LEE, C. (2014). “‘But why should you people at home not know?’: Sacrifice as a social fact in the public memory of war”, in Goodall J and Lee C (Eds.), Trauma and Public Memory, New York: Palgrave Macmillan, pp. 17-36.