Q&A with author David J. Morris

David J. Morris is the author of the new book The Evil Hours: A Biography of Post-Traumatic Stress Disorder. A former Marine infantry officer, he was a reporter in Iraq from 2004-2007. His work has appeared in a variety of publications, including The New Yorker and Slate.

Q: Why did you decide to write about PTSD and your own experiences with it?

A: I had always been generally aware of the idea of PTSD. My dad was a Vietnam vet, and many of my neighbors were. I grew up near Miramar air base. I grew up with Vietnam being this fraught thing.

When I first went to Iraq as a reporter, I came back in 2004 and…I felt apart and different from the average American. [I felt] upset about the way the war was prosecuted...I didn’t feel that the deep moral violation in Iraq was appreciated in the United States.

In 2007…an IED blew up the rear half of the Humvee [I was riding in]. That was obviously a significant experience.

In 2009, I was in a movie theater watching an action film with my girlfriend—an…explosion was depicted, and it freaked me out. I blacked out, and when I came to, I was in the hallway of the Cineplex.

It was one of the hints I had that I was on the other side of something. I tried to understand it, and began researching about PTSD.

I wanted to find something like Paul Fussell’s The Great War and Modern Memory, or Kay Redfield Jamison’s [work], something vested in the literature that would give me a greater literary sense of what PTSD was, that would give me some of the history and situate it in the literature of post-traumatic stress.

Q: You write, “For better or worse, the popular image of PTSD is derived primarily from the image of the war-torn American veteran.” How complete is that image?

A: It’s really incomplete in a sense. The popular concept and the body of research relating to PTSD is heavily skewed to American veterans. It’s not a complete picture. PTSD emerged from the veterans’ experience in Vietnam, a group of [antiwar] veterans advocated for what became the PTSD concept.

For a very good reason, it’s associated with military service, but if you could line up every PTSD sufferer on the planet, you would see more female rape survivors. The PTSD diagnosis rape for rape survivors is [about] 50 percent. For American military veterans, it’s 12 to 15 percent….

Q: In the book, you review the experiences of servicemembers in wars before Vietnam, as well as more recent conflicts. How was post-traumatic stress viewed in the conflicts before PTSD was recognized?

A: Post-traumatic stress evolved over time. British researchers at King’s College went back and looked at accounts of British veterans who served prior to the era of film, and there was no evidence of the flashbacks associated with PTSD. American Civil War veterans were more likely to report visitations by spirits or demons. There are aspects that are immortal…but some aspects do evolve.

Q: What do you see as the most effective ways to help those dealing with PTSD?

A: It’s important to recognize that every survivor’s experience is different. There’s no magic bullet. Trauma can result from millions of different situations. You have to address the type of trauma, and the person in question needs to be addressed. You cannot really expect that one particular therapy is going to resolve all symptom areas.

To look at the VA’s number one therapeutic modality—people tend to take their cues from the VA…prolonged exposure. It works for about 60 percent of veterans. I was not among those 60 percent. It has pretty significant side effects.

The second one, even more popular in the civilian sector, is cognitive processing therapy, an outgrowth of cognitive behavioral therapy. It’s a nice go-to, a lot less risky…

One friend who is a rape survivor [found that] prolonged exposure did not work for her. She was not interested in reliving the event. She found yoga helpful for her. It’s one reason I wrote the book the way I did; it’s important to have a chapter on alternatives.

The VA will tell you something will work for you, but a survivor needs to have [his or her] own journey. It’s one of the deeper themes about PTSD…it’s helpful for survivors to make their own exploration and find what works for them…

Q: What worked for you?

A: The second therapy, cognitive processing therapy, was helpful. Additionally, on a non-therapeutic basis, I interviewed experts…the intellectual exploration, keeping a journal, coming to conclusions on a personal basis was helpful for me…

Q: You write that “many people do, in fact, grow from trauma and become better human beings as a result of almost dying.” Does that apply to your own experiences?

A: Yeah, particularly after having written this book. The number of discoveries I made…I did not want to put myself into in as many dangerous situations. I believed there was an almost mystical value to be gotten at by putting myself in harm’s way. I try to value normal life….

Winston Churchill said nothing is so exciting as being shot at without results. You take insights from that moment, to try to live life in that manner and understand how close you are to dying. It’s a powerful life philosophy that I came to see in my own life.

Q: Two of the writers whose work you cite frequently in the book are Tim O’Brien and Alice Sebold. What about their writing is especially compelling for you?

A: Tim O’Brien is the most influential war writer of our time, even apart from his obvious talent and the power of his work. [Writers about Iraq] like Phil Klay, Ben Fountain, Kevin Powers, particularly with Powers and Klay, there’s a sense of O’Brien’s work echoing for them.

My response is that I’ve always appreciated his ability to play with time. In The Things They Carried, you see veterans with a very dynamic experience with memory. In In the Lake of the Woods, there’s an iterative revisiting of traumas that mimics the actual experience, the aliveness of memory, the way it lives in all trauma survivors. It tends to evolve and shift and haunt us…

Alice Sebold’s work is impossible to ignore if you’re trying to understand a rape survivor’s experience. The literature of rape is very thin... There’s no peer to Alice Sebold’s Lucky as a memoir. There are millions of war memoirs, but almost no rape memoirs. It’s exquisitely well-written, and it allows you a window into the experience….

I was able to interview Sebold in the course of writing the book and trying to write about rape as a man. [Her work became] this guiding spirit for me.

Q: How was your book’s title chosen?

A: The title was taken from one of the other [guiding] spirits of the book, Siegfried Sassoon. In Sherston’s Progress, he was talking about shellshock and how evil lies not necessarily in the heat of combat but [in the suffering that comes later].

That was the first title I picked…I spoke with other trauma survivors, and they said it worked. I spent a lot of time on the issue of time in the book. The pain tends to come in waves. The idea of hours being evil, and living through an hour of intense suffering, is more reflective of the experience itself. The title seems apt.

Q: Are you working on another book?

A: I’ve started playing around with some ideas. I have a novel I want to write, and there’s another nonfiction book I’m toying with.

Q: Anything else we should know?

A: I originally thought of PTSD as a boring subject. Most of the coverage tends to be two things: a recapitulation of symptoms [or a portrait of] a sad soldier and his…wife. I discovered there’s a very rich literature relating to PTSD. There’s a lot of rich literary and emotional ground to cover.

If you step back from the issue, the really central question is, How do you live after you’ve almost died? No one had posed the question that way. The most central concern of all humans—we know we’re going to die…if you’re given the privilege [of an early look at it], what are you going to do with that knowledge?

For me, it’s far more than a soldier’s problem. It’s a very central human concern.

--Interview with Deborah Kalb. This Q&A also appears on deborahkalbbooks.blogspot.com.