A Focus on KP HealthConnect
••Fall 2004/Vol. 8, No. 4

Book Reviews

Odysseus in America: Combat trauma and the trials of homecoming | pdf >> By Jonathan Shay, MD, PhD; Foreword by Senator Max Cleland and Senator John McCain Book review by Helen A Williams, MS New York: Scribner; 2002. ISBN 0-7432-1156-1 352 pages. $25.00

Those moved by Jonathan Shay's first book, Achilles in Vietnam (1995)¹--an inquiry into Homer's Iliad as metaphor for the deforming effects of military combat on character--are in for another compelling read. This time, Shay examines The Odyssey and discovers that Odysseus' adventures look a lot like the symptoms of what we now call posttraumatic stress disorder, or PTSD. Shay's gift is to convey these symptoms as dramatis personae from The Odyssey cannibalizing the inner life of the Vietnam veteran.

Jonathan Shay is a psychiatrist in the US Department of Veteran Affairs Outpatient Clinic in Boston, where he began his career in 1987 working with Vietnam veterans suffering with PTSD. Based on Shay's work with these vets, his second book culminates in a plea for changing the way the US military organizes itself to fight a war--or, at least, for changing the way the military had organized itself through December 2001. The book went to press in 2002, before the war in Iraq began (in March 2003). After reading Shay's argument for strengthening the mental health of combat soldiers through policy change, readers might more than wonder about the military's response, if any, and what the outcome might be.

Structurally, the book is organized into three sections. Part 1 consists of veterans' narratives interwoven with the adventures of Odysseus; Part 2 presents a treatment plan for vets suffering with PTSD; and Part 3 puts forth an argument for preventing mental injury through policy change regarding deployment of US military personnel.

This is no ordinary book: it is full of poetry on several levels. What makes Part 1 so pleasurable to read is the way Shay links his amazing psychological insight into The Odyssey to present-day American military veterans. The writing is clear, colorful, and filled with memorable imagery, as shown in the following passage:

"Odysseus has no hope against the Cyclops [the one-eyed giant cannibal] in a force-on-force match-up. This is the way some veterans I work with feel when they face the government. They see themselves as powerless, liable to be eaten alive. Cunning, they believe, is their only defense. Like any one-eyed creature, government bureaucracies lack depth perception. They tend to see only the one thing they were set up for, and are blind to how things interconnect" [italics in original] (p 47).

One need not be a student of the classics or of Homer to be captivated by Shay's work or to marvel at his perceptiveness. Appendix I, titled A Pocket Guide to Homer's Odyssey, acquaints readers with enough information to follow the narrative. Those in the healing professions who have veterans as patients will find it an intriguing and helpful resource. And those who like stories and metaphor and who are curious about their own inner lives will enjoy the book for Homer's poetry and Shay's insight into it. That is not to say that case studies of contemporary vets with PTSD interwoven throughout are not painful to read. They are. And one gets it. Shay gives readers a reasoned appreciation for the horrors that color the inner landscapes of these walking wounded.

The clarity with which Shay articulates his vision is noteworthy. His words add new color and relevance to the timeless stories told by Homer. When Shay adds his own insights into Homer's words, they at once seem obvious. He brilliantly portrays the postcombat Odysseus as a life on the rocks, an outsider who, 20 years after the Trojan War, remains at a loss to return home to normal life. Shay relates this lost feeling of the outsider to the modern combat-battered vet struggling to return to normal life as a civilian.

Shay's fascination with Odysseus, his decisions, and his behaviors is so present on the page that the reader might feel like a fly on the wall inside the consulting room (pp 140, 142). Shay studies his would-be patient of 25 centuries ago as if he were here now. Shay contends, however, that Odysseus would not have sought treatment; otherwise, he would not have wasted 20 years going nowhere instead of home. Whatever one's point of view on that matter, if by some miracle Odysseus were to have found his way into treatment back then, Shay would have prescribed group therapy to foster a sense of community, the necessary mechanism for recovery. Group is where veterans who "have seen the elephant," ie, who have been in combat, can communicate their experiences without fear of disgusting others or driving them away in revulsion.

Part 2 is required reading for those wanting basic information on PTSD and its treatment. Shay's treatment program is based on Judith Hermann's² three-stage recovery model (p 168).

Part 3 is an impassioned plea to the military and all who might influence policymakers. Several arguments are made, but Shay's main point is that deploying soldiers into battle as military units--and not singly as replacements--would strengthen their mental health and thus their fighting effectiveness. It would seem plain common sense that soldiers who train together be deployed together, do battle together, and be discharged together. It makes sense that they would be stronger and better prepared to fight than soldiers rotated into battle as "replacement parts" along with strangers. One might wonder at the need to argue something so obvious. But that was the policy in effect during the Vietnam War--with disastrous results for the mental health of our combat veterans. The future effects of current military activity in Iraq remain to be seen.

For medical practitioners sensitive to the mind-body connection and the latent effects of violence on health, this book is a wonderful resource. The grounding that this book affords should serve as a valuable tool for the clinician. Additionally, Odysseus in America should be assigned reading in military schools and should be on the shelves of libraries that serve our soldiers, veterans, their families, and all those who provide them care.

References

1. Shay J. Achilles in Vietnam: combat trauma and the undoing of character. New York: Scribner; 1995.
2. Hermann J. Trauma and recovery. Revised ed. New York: Basic Books; 1997.

Helen A Williams, MS, is a retired Florida mental health counselor and psychotherapist. E-mail: Hapwjg@aol.com.

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