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The person’s response to the event must involve intense fear, helplessness, or horror. The characteristic symptoms resulting from the exposure to the extreme trauma include persistent re-experiencing of the traumatic event, persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness and persistent symptoms of increased arousal. The full symptom picture must be present for more than 1 month and the disturbance must cause clinically significant distress or impairments in social, occupational, or other important areas of functioning.
It is accepted that soldiers in combat will be exposed at some time to stressors that can lead to PTSD. It is not an automatic given that every soldier will be impaired with PTSD. It is not only those in the front line—the ‘bayonets’ of a military unit—that will be affected in war. What are referred to as ‘witnessed events’ can include, but are not limited to, observing the serious injury or unnatural death of another person owing to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. The disorder may be especially severe or long lasting when the stressor is of human design (e.g. torture, rape). The likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.
Recurring dreams and flashbacks
The traumatic event can be re-experienced in various ways. Commonly the person has recurrent and intrusive recollections of the event or recurrent or distressing dreams during which the event can be replayed or otherwise represented. In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment. These episodes, often referred to as ‘flashbacks’, are typically brief but can be associated with prolonged distress and heightened arousal.
Distress
Intense psychological distress or physiological reactivity [crying, over-reaction and non-reaction to events around them] often occurs when the person is exposed to triggering events that resemble or symbolise an aspect of the traumatic event [e.g. anniversaries of the traumatic event; hot, humid weather for combat veterans from Viet Nam; movies depicting events similar to those witnessed].
Avoidance of stimuli
Sufferers of PTSD will go to extremes to avoid the stimuli that has brought about their disorder and make efforts to persistently avoid thoughts, feelings, or conversations about the traumatic event and to avoid activities, situations, or people who arouse recollections of it. This avoidance of reminders may include amnesia for an important aspect of the traumatic event. This is often referred to as ‘psychic numbing’ or ‘emotional anaesthesia’ and usually begins soon after the traumatic event. Veterans may complain of having markedly diminished interest or participation in previously enjoyed activities, of feeling detached or estranged from other people, or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality). The individual may have a sense of a foreshortened future (e.g. not expecting to have a career, marriage, children, or a normal life span).
Symptoms
Those with PTSD have persistent symptoms of anxiety or increased arousal that were not present before the trauma. The symptoms may include difficulty falling or staying asleep that may be owing to recurrent nightmares during which the traumatic event is relived, hypervigilance (e.g. locking all the doors and windows in the house before retiring), and exaggerated startle response. Some individuals report irritability or outbursts of anger (e.g. road rage, overreacting to minor annoyances), or difficulty concentrating or completing tasks.
Specifiers or levels of PTSD
It is recognised that there are three levels or specifiers used to specify the onset and duration of the symptoms of PTSD:
1 Acute. This specifier should be used when the duration of the symptom is less than 3 months.
2 Chronic. This specifier should be used when the symptoms last 3 months or longer.
3 With Delayed Onset. This specifier indicates that at least 6 months have passed between the traumatic event and the onset of the symptoms.
Associated descriptive features and
mental disorders
Individuals with PTSD may describe painful guilt feelings about surviving when others did not survive or about the things they had to do to survive. Avoidance patterns may interfere with interpersonal relationships and lead to marital conflict, divorce or loss of job. Apart from self-destructive and anti-social or impulsive behaviour, some individuals feel shame, despair, or hopelessness, hostility and a change of previous personality characteristics. PTSD is associated with increased rates of Major Depressive Disorder, Substance-Related Disorders, Panic Disorder, Agoraphobia, Obsessive-Compulsive Disorder, Generalised Anxiety Disorder, Social Phobia, Specific Phobia and Bipolar Disorder. These disorders can either precede, follow, or emerge concurrently with the onset of PTSD.
Prevalence in combat veterans
Community-based studies in the United States of America reveal a lifetime prevalence for PTSD of approximately 8 per cent of the adult population. Studies of at-risk individuals (i.e. groups exposed to specific trauma incidents) yield variable findings, with highest rates (ranging between one-third and more than half of those exposed) found among groups such as combat veterans and those subjected to politically motivated internment and genocide.
When does it strike?
Post Traumatic Stress Disorder is not related to the age of the individual. Symptoms usually begin within the first 3 months after the trauma, although there may be a delay of months, or even years, before symptoms appear. Frequently, a person’s reaction to a trauma initially meets criteria for Acute Stress Disorder in the immediate aftermath of the trauma. Duration of the symptoms varies, with complete recovery occurring within 3 months in approximately half of the cases, with many others having persisting symptoms for longer than 12 months after the trauma. Symptom reactivation may occur in response to reminders of the original trauma, life stressors, or new traumatic events.
GLOSSARY
1 ALSG 1st Australian Logistic Support Group, based at Vung Tau
1 ARU 1st Australian Reinforcement Unit, based at Nui Dat
1 ATF 1st Australian Task Force, based at Nui Dat
2IC second-in-command
AATTV Australian Army Training Team Vietnam
AK-47 7.62-mm, automatic Kalishnikov assault rifle
Anzac Australian and New Zealand Army Corps
ARA Australian Regular Army
armoured personnel carrier the M113, a 10-tonne, tracked vehicle
ARVN Army of the Republic of Viet Nam, the South Vietnamese Regular army
ATF Australian Task Force, Nui Dat
avgas aviation gasoline
B-52 strategic US jet bomber
base wallah a soldier who works in a base or rear area
BHQ Battalion Headquarters
C-117 a Super DC-3, twin-engined, 24-seater transport aircraft
C-123 Provider, a twin-engined, short-range, tactical transport aircraft
C-130 Hercules, a four-engined, medium-range transport aircraft
Caribou twin-engined, De Haviland RAAF short-haul transport aircraft
Chinook CH-47, twin-rotor, medium-lift helicopter
Claymore mine M18A-1, Claymore, a directional anti-personnel mine that contained 1.25 pounds of HE (high explosive) and 500 steel ball bearings
CMF Citizen Military Forces, once called Militia, the forerunners to today’s Army Reserve
CO Commanding Officer, usually a lieutenant colonel in rank
CP Command Post
D 445 a Viet Cong Local Force battalion that operated in Phuoc Tuy Province
Dentcaps dental civil aid projects/programs conducted under the Army’s Civil Affairs program in Vietnamese outlying villages
DMZ demilitarised zone
Dustoff dedicated helicopter for casualty evacuation
FTD Full-time duty; reservist soldiers who served full time in the ARA
GPS Global Positioning System, a satellite-based navigation aid
grunt slang for infantryman
HMAS Her Majesty’s Australian Ship, Royal Australian Navy
HQ headquarters
J jungle
LZ landing zone
M-16 mine ‘Jumping Jack’, an anti-personnel mine that once tripped was blown into the air about a metre before detonating
M-16 rifle 5.56-mm American automatic and semiautomatic rifle
Medcap medical civil aid projects/programs conducted under the Army’s Civil Affairs program in outlying Vietnamese villages
Military Cross an officers’ decoration for gallantry
Military Medal a soldiers’ decoration for bravery
National Service two-year full-time service, usually in the Army
NCO Non-Commissioned Officer, soldiers above the rank of Private soldier and below the rank of commissioned officers
NVA North Vietnamese Army
OC Officer Commanding, usually a sub-unit commander and major in rank (Aust.) or captain (US) or lieutenant (ARVN)
OTU the Officer Training Unit at Scheyville, near Sydney: a National Service officer training institution
piastre the basic currency unit of Viet Nam during the war, now known as the Dong
PIR Pacific Islands Regiment, the army of Papua New Guinea when under Australia’s Protectorate
Pogo acronym (unsubstantiated) for ‘personnel on garrison operations’, see base wallah
Portsea the Officer Cadet School, Portsea, Victoria; a 12-month commissioning course
Post Exchange a duty-free store and commissary for soldiers
POW prisoner of war
Psyops psychological operations, designed to lower enemy morale, and gain support for the Allied forces
PTSD post traumatic stress disorder
R&C rest and convalescence leave, a short break from duties taken in Viet Nam
R&R rest and recuperation (but usually recreation) leave, taken for 5–7 days outside Viet Nam
RAA Royal Australian Artillery
RAAF Royal Australian Air Force
RAAMC Royal Australian Army Medical Corps
RAEME Royal Australian Electrical and Mechanical Engineers
RAN Royal Australian Navy
RAP Regimental Aid Post, a unit’s medical centre
RAR Royal Australian Regiment, straight leg infantry
reo a reinforcement soldier
RMC Royal Military College, Duntroon, Canberra
RMO Regimental Medical Officer, the unit doctor
RQR Royal Queensland Regiment
RSL Returned and Services League
SAS Special Air Service
SEAL US Navy Special Forces, acronym for Sea Air and Land forces
SLR 7.62-mm, semi-automatic self-loading rifle, also known as the FN
SO3 Staff Officer Grade 3, usually a captain-ranked staff position
SRV Socialist Republic of Vietnam
Stokes litter a wire-framed stretcher used to winch casualties into helicopters
TAOR Tactical Area of Responsibility, an area assigned to a unit or sub-unit to patrol
Tracker Platoon a group using Labrador dogs to track the Platoon enemy, formed out of the Anti-Tank, which had limited use in the jungles of South Viet Nam
uc dai loi the formal Vietnamese expression for Australia. Colloquially translated, it refers to the ‘Great Continent’ or ‘Great South Land’
USMC the United States Marine Corps, the forces from the Department of the US Navy designed to establish a bridgehead on a beach for later military operations by the Army
VC Viet Cong, a term invented by the Americans in the late 1950s to rename the Communist Viet Minh, which they considered too nationalistic
VD venereal disease
Viet Minh a contraction of Viet Nam Doc Lap Dong Minh Hoi, the term applied to the Vietnamese resistance fighters from the First Indochina (French) War
Wallaby Airlines a nickname given to the RAAF 35 Squadron and the Caribou short take-off and landing aircraft, owing to the squadron insignia on the tailplane
NOTES
Introduction
1 Elizabeth Stewart, ‘Return to Vietnam’, Paper, University of Newcastle, 2005
2 Ian McNeill, The Team: Australian Army Advisers in Vietnam 1962–1972, pp. 128–9
3 Elizabeth Stewart, op. cit.
4 Ibid
5 Ibid
6 ‘Vietnam is a densely-populated, developing country that in the last 30 years has had to recover from the ravages of war, the loss of financial support from the old Soviet Bloc, and the rigidities of a centrally-planned economy. Substantial progress was achieved from 1986 to 1997 in moving forward from an extremely low level of development and significantly reducing poverty. Growth averaged around 9 percent per year from 1993 to 1997.’ Source: The World Factbook 2007, www.cia.gov/cia/publications/factbook/geos/vm.html
7 Elizabeth Stewart, op. cit.
8 Ibid
9 Ibid
10 Bruce Davies and Gary McKay, The Men Who Persevered—The AATTV: The Most Decorated Australian Unit in the Viet Nam War, Allen & Unwin, Sydney, 2005
11 Gary McKay, Delta Four—Australian Riflemen in Vietnam, Allen & Unwin, Sydney, 1996
12 Interview with Garry Adams, Hoi An, SRV, 12 October 2005
Chapter 1 Great expectations
1 Interview with Garry Adams, Hoi An, SRV, 12 October 2005
2 Letter, Steve Campling, 24 December 2005
3 Letter, Derrill De Heer, 17 May 2006
4 Ibid
5 Letter, Bob Hann, 25 July 2006
6 Letter, Garry Heskett, 19 June 2006
7 Ibid
8 Letter, Suzanne Heskett, 16 June 2006
9 Interview with Bill Kromwyk, Mt Gravatt, Qld, 27 February 2006
10 Ibid
11 Ibid
12 Interview with Peter Rogers, Yaroomba, Qld, 12 December 2005
13 Ibid
14 Ibid
15 Ibid
16 Letter, Ian Ryan, 2 May 2006
17 Interview with Garry Adams, 12 October 2005
18 Ibid
19 Ibid
20 Letter, Bob Hann
21 Letter, Steve Campling
22 Letter, Derrill De Heer
23 Letter, Garry Heskett
24 Letter, Ian Ryan
25 Letter, Derrill De Heer
26 Interview with Bill Kromwyk, 27 February 2006
27 Ibid
28 Interview with Peter Rogers, 12 December 2005
29 Gary McKay, Delta Four—Australian Riflemen in Vietnam, Allen &Unwin, Sydney, 1996, p. 246
Chapter 2 The 5 RAR tour group
1 Interview with Paul Greenhalgh, Canberra, ACT, 20 February 2005
2 The HMAS Sydney was a converted ex-Royal Navy aircraft carrier. This ‘fast troop transport’ ship became known as the ‘Vung Tau Ferry’ or ‘The Steak and Kidney’.
3 Interview with Paul Greenhalgh, 20 February 2005. In the Second World War Chin Peng rose to prominence in the jungles of Malaya where many Chinese Malayans were waging a guerrilla war against the occupying Japanese. After the war he was elected Secretary General of the Communist Party of Malaya and gained notoriety for leading an armed insurgency that was responsible for the deaths of many civilians. He was exiled from Malaya but continued to lead the struggle against British rule.
4 Interview with Paul Greenhalgh, 20 February 2005
5 Citizen Military Forces (now known as the Army Reserve) soldiers and officers could be transferred to the Regular Army on what was called Full Time Duty status, abbreviated to FTD— usually for a minimum period of twelve months.
6 The Officer Training Unit at Scheyville just outside Sydney was established in 1965 to train selected national servicemen as officers for the Army. It was a 22-week course and based on the twelve-month Regular Army Of
ficer Cadet School (OCS) course conducted at Portsea in Victoria. The training is described in some detail in my first book, In Good Company, Allen & Unwin, Sydney, 1987.
7 Interview with Paul Greenhalgh, 20 February 2005
8 Ibid
9 Ibid
10 Ibid
11 Ibid
12 Ibid
13 Ibid
14 Interview with Paul and Wendy Greenhalgh, Hoi An, SRV, 12 October 2005
15 Ibid
16 Prospective medical officers were trained in an Army undergraduate medical program that required a return of service obligation after graduation of at least five years.
17 Interview with Ted and Joy Heffernan, Hoi An, SRV, 11 October 2005
18 Ibid
19 Ibid
20 Interview with Peter Isaacs, Hoi An, SRV, 11 October 2005
21 Ibid
22 Letter, Peter Isaacs, 7 September 2005
23 Ibid
24 Ibid
25 Interview with Ben Morris, Yaroomba, Qld, 8 March 2005
26 Ibid
27 Ibid
28 Ibid
29 Ibid
30 Ibid
31 Ibid
32 Ibid
33 Ibid
34 Ibid
35 Ibid
36 Interview with Ben Morris, Hoi An, SRV, 12 October 2005
37 Interview with Ben Morris, 8 March 2005
38 Interview with Fred Pfitzner, Royalla, NSW, 2 September 2005
39 Ibid
40 Ibid
41 Ibid
42 Ibid
43 The Army infantry battalions underwent several organisational changes after the Second World War as defence planners struggled to come to grips with a shift in alliances and a change in strategic outlook. These changes are discussed in a history of The Royal Australian Regiment, Duty First, by Dr David Horner, Allen & Unwin, Sydney, 1990, pp. 134–44.
44 Interview with Ron Shambrook, Brisbane, Qld, 14 July 2005
45 Ibid
46 Ibid
47 Ibid
48 Letter, John Taske, 13 September 2005
49 Interview with John Taske, Hoi An, SRV, 11 October 2005
50 Letter, John Taske
51 Ibid
52 Interview with Tina Taske, Ho Chi Minh City, SRV, 9 October 2005
53 Interview with Roger Wainwright, Canberra, ACT, 15 February 2005
54 Ibid
55 Ibid