Are memorials built to honor, remember, heal or all three? War memorials, in particular, often spark controversy from their design, to their placement, and currently, if they should stand forever. Confederate civil war memorials, in particular are in the news these days. No matter your feelings on whether the monuments should remain or be removed, the following article provides another perspective and sheds light on a historic trauma still being experienced by soldiers today.
Empty Sleeves and Blank Stares
Where do you go to pay respects to Civil War veterans? Would it cross your mind to visit asylum cemeteries? Stories of mass casualties, crude amputations, POW camps, and longing for home dominate the narratives of soldiers’ suffering and sacrifice during the Civil War. Yet, accounts of the disturbing psychological baggage that many historic war veterans carried with them for the rest of their lives don’t take up much, if any, space in popular understanding of the 19th century. A look at this specific type of suffering among some Civil War veterans broadens our perspectives of historic wars and forces us to confront a stunning, timeless truth: for some, the war is never over.
It wasn’t until 1980 that the American Psychiatric Association added Posttraumatic Stress Disorder to its diagnostic manual, though other terms and diagnoses such as “soldier’s heart” during the Civil War, “shellshock” during World War I, and “combat fatigue” during the Second World War indicate early stages of acknowledging and treating the psychological ramifications of war. Fast forward to 2012, by which time the Department of Veterans Affairs had diagnosed 207,161 Iraq and Afghanistan veterans with PTSD. A think tank funded by the Pentagon asserted that an additional 14% of these veterans suffer from major depression and still a large number experience “headaches, sleeplessness, irritability, rage, and other symptoms of PTSD” but do not seek treatment and thus evade diagnosis.
Prevalence of combat-related posttraumatic stress during historic eras can be elusive. Diaries, letters, medical records, and physicians’ notes reveal that many Civil War veterans suffered from varying degrees of undiagnosed or mistreated psychiatric problems. Vague diagnoses such as “mania” riddled the medical records of veterans in asylums and mental breakdowns were blamed on everything from weak dispositions and character flaws to masturbation.
Though documents from the 19th century are useful, widespread illiteracy curbed the number of sufferers and loved ones who were able to leave such clues. Access to physicians and institutions that may have listed such symptoms also affected whether or not veterans’ experiences were recorded for modern study. These logistical barriers were in addition to gender expectations we still feel today.
Nineteenth-century society expected men to be stoic, unemotional leaders, fit for, and thus essentially unaffected by, war and fighting. As such, they were disinclined to acknowledge combat-related mental issues and seek what little help there was to be found. This intersection of gender roles, identity, and ego begs the question about whether or not memorializing (permanently, in public places) the unwavering heroism of war veterans acted as an extra layer of pressure on them to resume male life as usual, lives that left little room for nameless illnesses of the psyche. Some historians speculate that the development of the Lost Cause sentiment, among other things, “served to prevent the development of psychological and social problems” in Confederate veterans.
Similar to today’s veterans, particular circumstances of war, the support of loved ones, symptom expression and severity produced markedly individual experiences of posttraumatic stress. The financial ability and geographical proximity to receive some sort of treatment varied, making medical attention, as it is today, an issue of socioeconomic class. When families could no longer accommodate affected veterans, they took them to asylums, some of which did not have room for patients to stay for long periods of time, further reflecting the state of the mental health field and forcing many veterans to move from asylums to poor houses.
Despite advancements in technology, biology, medicine, armor, and warfare, the experiences reported by veterans of Iraq and Afghanistan are similar to the horrors witnessed by Civil War soldiers. Today’s veterans report being shot at, being attacked/ambushed, receiving rocket or mortar fire, seeing dead bodies, and knowing someone killed/seriously injured as “combat stressors,” or experiences that may contribute to posttraumatic stress. A look at firsthand accounts of modern-day veterans and their historic counterparts is eerie.
Today’s soldiers shield each other from attack and take cover in abandoned buildings in foreign countries, Civil War soldiers laid on their bellies in American cornfields as “stray shot and shell” fell around them. An Iraq veteran with PTSD recalled “casualty collecting…You pick them up and you put them in a body bag, pieces by pieces.” A Confederate veteran from North Carolina wrote that he spent the 4th of July burying the dead. Modern veterans recall close calls, “You’re talking and you’re driving, and then something blows up, and the next thing you know, two of your guys are missing their faces.” After a bomb burst over his head at Antietam, Christopher Niederer of the 20th New York Infantry described the relief he felt after realizing he had all his limbs before he felt something “damp” on his face and turned to see that the man next to him “lacked the upper part of his head, and almost all his brains had gone into the face of the man next to him.”
Clearly, combat trauma and posttraumatic stress isn’t new. It isn’t going anywhere quickly either. The RAND Center for Military Health Policy Research estimates that 20% of today’s veterans suffer from PTSD or major depression. What do we do with this information? Can today’s affected veterans help shed light on the broader implications of historic wars? What can we gain from looking at war through psychological lenses?
 Civil War soldiers can often be found listed in the directories of asylum cemeteries. In this particular directory, the records of 12 patients buried at the cemetery indicated military service during the Civil War. Athens Lunatic Asylum Cemeteries Directory. http://namiathensohio.org/wp-content/uploads/2015/04/AthensLunaticAsylumCemeteryDirectoryWeb.pdf. Accessed May 29, 2017.
 David Wood, “Iraq, Afghanistan War Veterans Struggle with Combat Trauma,” World Post, The Huffington Post (June 4, 2012). Accessed May 10, 2017. http://www.huffingtonpost.com/2012/07/04/iraq-afghanistan-war-veterans-combat-trauma_n_1645701.html.
 Tony Horwitz,
 Eric T. Dean, Shook Over Hell: Posttraumatic Stress, Vietnam, and the Civil War (Cambridge, MA: Harvard University Press, 1997), 8; PTSD: National Center for PTSD. https://www.ptsd.va.gov/professional/ptsd-overview/ptsd-overview.asp. Accessed May 2, 2017.
 “Analysis of VA Health Care Utilization among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn Veterans,” Veterans Health Administration, Department of Veterans Affairs (January 2015). Accessed May 9, 2017. https://www.publichealth.va.gov/docs/epidemiology/healthcare-utilization-report-fy2014-qtr4.pdf; “Mental Health Effects of Serving in Afghanistan and Iraq,” National Center for PTSD, Department of Veterans Affairs (August 2015). Accessed May 9, 2017. https://www.ptsd.va.gov/public/ptsd-overview/reintegration/overview-mental-health-effects.asp.
 Louis Leon, Diary of a Tar Heel Confederate Soldier, electronic edition, Documenting the American South digital project of the University of North Carolina. http://docsouth.unc.edu/fpn/leon/leon.html. Accessed May 23, 2017.
 Michael Goss quoted in Emily DePrang, “Iraq Comes Home: Soldiers Share the Devastating Tales of War,” http://www.alternet.org/story/55921/iraq_comes_home%3A_soldiers_share_the_devastating_tales_of_war.
Accessed May 23, 2017.
 Christopher Niederer, 20th New York Infantry, 6th Corps, Civil War Misc. Collection, USAMHI, “Antietam Eyewitness Accounts,” http://www.historynet.com/antietam-eyewitness-accounts.htm. Accessed May 23, 2017.