Best Defense
Thomas E. Ricks' daily take on national security.

David J. Morris’s ‘The Evil Hours’ could be the best book on combat PTSD ever

A former Marine officer, Morris left the Corps a few years before 9/11 and decided to work as a war correspondent. In 2007 he was in a Humvee that struck an IED while on a patrol in Saydia, Iraq. Though he’d witnessed several other traumatic events beforehand, he refers to this as his “trigger” incident. His account of that day sets the tone for the entire book.

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Best Defense is in summer re-runs. This item originally appeared on December 3, 2014.

Best Defense is in summer re-runs. This item originally appeared on December 3, 2014.

By Jim Gourley
Best Defense all-star team

The first thing I ever wrote to appear on this blog was a lengthy comment trying to explain, based on personal experience, what it’s like living with PTSD. Since then, I’ve written more extensively on the subject in terms of both commentary and research. Many people suggested that I write a book about it, using my own struggles as a basis to explain the landscape of people affected by PTSD today, but I never felt up to the task. The more I read, the more certain I became that there was an inherent, challenging paradox to write about it. A person who had never experienced it could only draw from the experience of hearing those who’d been afflicted by it, yielding only a second-hand account at best. But for a person who’d lived with it, the experience that lent a necessary credibility and access to the subject also hobbled the ability to articulate it. The book about PTSD we’ve been missing and sorely need is the writer’s equivalent of a gold medal in the all-round gymnastics. From survival and recovery, to contemplation and comprehension, to research and retelling, you need to be an expert (and a little lucky) in everything.

With every page of David J. Morris’s The Evil Hours, which comes out next month, I felt an increasing sense of relief that the subject had finally found that author. This is the book we’ve always needed. It is certainly the most relevant work for today’s combat veterans, families and clinicians struggling with the condition. It is likely the best book on the subject yet written.

A former Marine officer, Morris left the Corps a few years before 9/11 and decided to work as a war correspondent. In 2007 he was in a Humvee that struck an IED while on a patrol in Saydia, Iraq. Though he’d witnessed several other traumatic events beforehand, he refers to this as his “trigger” incident. His account of that day sets the tone for the entire book. Morris doesn’t dwell on gritty details or characterizations of Iraq’s urban landscape or the soldiers with which he traveled. There’s only enough there to make the events personal and to foster the necessary intimacy between the reader, the storyteller, and his pain.

It’s within this essential account, found in so many books about combat trauma, that Morris first demonstrates the agility that sets The Evil Hoursapart. Like others before him, he establishes his personal journey as the vehicle for his investigation of the history, nature, and treatments of PTSD. But Morris does not fall into the trap of indulging in his own story to the exclusion of a holistic view. As Morris himself observes, “Using writing as therapy is a tricky business because it can so easily turn into an orgy of self-pity and navel-gazing.” Like the host of a good documentary, he appears only when it serves to provide an essential humanistic context or segue. His success in discussing the subject lies in resisting the urge to talk about himself.

The discussion of PTSD that does result is expansive and engaging. From battlefields and cultural responses to traumatized warriors throughout world history to the internecine corridors of the San Diego V.A. hospital and the modern psychology establishment, Morris gives sight to the blind examining the PTSD elephant, offering up a clear understanding of what the beast is as well as the path it’s traveled across the landscape of warfare. He draws from a seemingly inexhaustible well of experience. Herding a cast that includes Hemingway, Klosterman, Sassoon, a host of anthropologists and neurologists, and the soldiers and veterans he met throughout his own odyssey, Morris accomplishes the necessary work of identifying all the necessary aspects of PTSD and still finds a way to magnify the nuances of how it affects individuals and societies.

The “out-of-body” experience and the recurring memory of traumatic events are familiar to those afflicted by PTSD. Many describe it as watching a movie on repeat from every possible angle. It’s the mind’s vain attempt to challenge trauma like a call in a football game, gathering the referees around a screen to watch the replay over and over until the past can be rewritten in favor of justice. Others who have attempted books about PTSD have floundered in this conceit. Morris avoids that and maintains his place at the commentators’ desk — close enough to call the play-by-play, but far enough away to keep perspective. Instead of raging at length about the process of enrolling in the V.A. care system (whose bureaucracy he declares forces veterans to run “a patience marathon”), he reflects on its problematic advocacy of “large, scalable, Evidence-Supported Treatments.” Morris unearths troubling aspects in the character of these treatments as he traces the history of PTSD therapy. He finds that they are highly impersonal, using worksheets and formatted responses that create barriers around therapists and make the afflicted feel more like they’re being treated as lab rats than patients. He observes that these methods are a profound departure from the type of treatments discovered and evolved by W.H.R. Rivers during WWI and, later, Vietnam veterans groups during the 1970s. Though Morris’s own experience with prolonged exposure treatment met with poor results and he expresses misgivings about similar therapeutic methods, he remains objective about their efficacy. Rather, he takes a more important and less scrutinized view of how treatments are vetted in the first place. Questioning the practice of excluding patients who drop out of test programs from data sets instead of listing them as showing no signs of improvement, Morris asks if reports inaccurately portray success rates. This leaves the V.A.’s dogmatic insistence on evidence-based methods particularly vulnerable to skewed numbers. He cites the widespread use of lobotomies as a post-traumatic intervention during the 1940s as a cause for skepticism. His exploration of the pharmaceutical approach to PTSD reaches similar conclusions. As Morris writes, “‘Evidence-supported’ and ‘evidence-based’ mostly means that a lot of doctors happen to like it, oftentimes for reasons that have less to do with the actual value of a therapeutic protocol than with trendiness.”

Of course, without evidence to support a treatment’s effectiveness, agencies like the V.A. are left with a litany of methods whose metrics for success are ambiguous at best. Morris explores these as well. He takes a yoga class with a rape survivor who struggled for years with her own PTSD before finding herself in the practice. He goes to a mixed martial arts gym that gives special classes to military veterans. He participates in a V.A. study on mantra repetition. Though he is unable to get into treatment himself, he does discuss eye movement desensitization and reprocessing (EMDR). The possibilities are limitless. He even confesses that, while not his original intention for penning this work, writing can be a form of therapy. He concludes his survey of the treatment landscape with the plainspoken wisdom of his Marine background: “If it’s stupid but it works, it isn’t stupid.”

Morris is as astute to resist the use of themes, either literary or clinical, in his examination of PTSD as he is his own life events. However, he does allow for the one recurring proposition that “PTSD is a disease of time.” An event that lasts less than a heartbeat can plague us for life. The past invades our present, forcing us to live a single moment over and over. The natural progression of growth is interrupted, replaced by a schism dividing the old self and the new, each one incomprehensible to the other. Morris is honest and correct in this assertion, as decades of introspection and study bear out.

This is the essence of a survivor’s dilemma when trying to write about the condition. PTSD is like a black hole. You can’t write about it unless you’ve seen it, but the closer you get, the more distorted your sense of self, and therefore, the narrative, becomes. Like Matthew McConaughey’s character in Interstellar, David Morris has emerged improbably from the chaos of the disease to give us the clearest understanding yet of its nature. Though he never presumes any great breakthrough or solution, Morris has achieved a work that empowers and connects people like never before.

Anyone who has been touched by PTSD would benefit greatly from this book. Clinicians, commanders, family members, friends, and comrades alike will certainly find new perspective of PTSD; possibly one that will allow them to make that crucial human connection that lets them offer or receive help. The first step to solving a problem is to admit you have one. Thanks to David Morris, we now have a book that articulates that problem in the way we’ve always needed.

I wish we’d had this ten years ago. I think it could have saved lives.

Jim Gourley is an author, journalist, and former military intelligence officer.

Brendan Smialowski/AFP/Getty Images

Thomas E. Ricks covered the U.S. military from 1991 to 2008 for the Wall Street Journal and then the Washington Post. He can be reached at ricksblogcomment@gmail.com. Twitter: @tomricks1

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