Hour. I wondered if you could start out by telling me a little bit about yourself and why you wanted to write this book. Guest into some ways i had always lived in the shadow of ptsd roast of my adult life. My adult years were in uniform including the rotc. So i was vaguely aware of the idea of ptsd and that it was something soldiers were associated with and furthermore my dad was a vietnam veteran and i grew up in suburban san diego so all of my neighbors were either top gun instructors or marines and so i felt like i really grew up in the shadow of the vietnam. I was always part of the conversation and this lingering shadow. So i always have a general awareness of it and then i served in the military and was familiar with the idea in a general sense and then in 2004 i was out of the marine corps at this point and i did my first two are as a reporter in iraq and came back and noticed immediately getting off the plane in california feeling different, going to a bar and my best friend took me to this bar right near the airport we went to this club and i remember looking out over the people and there was i could tell everyone was drinking and talking and socializing and just as they had before as if nothing had changed and i remember there was no particular reason to feel angry or upset it really struck me that i had changed. And i remember oddly not being suddenly very bored and uninterested with what was going on and i left, stepped out and i think i went to use the atm at a local birth birth story at the interesting store at the interesting thing about san diego is all of them are run by iraqis and if so i went in and the owner of the store was from baghdad and so i ended up talking with him. So i was just off the plane not really fitting in and what do i do my walk i walk right next door and theres in iraq he we Start Talking about baghdad. It was a very strange feeling of apartness but i felt from my early days in 2004 and i was also angry about the war and how it had been prosecuted and i had been in the tail end of the battle in falluja and i have seen marines from my own regimen that were explained to me what they saw was gross mismanagement, poor leadership and completely irrational policymaking. They lost men as a result of this and then a few weeks later no wmd and then i was in iraq returning in july of 2004 and just a few months later in November George w. Bush was reelected so for me that was a very difficult process to understand that americans let in light of everything that happened all of the lies have been exposed so it was very difficult for me to accept that people voted in the face of knowledge of that information turn and reelect the person that had us there in the first place. And as i began researching and i began to develop symptoms of my own. There was a Movie Theater in 2009 fast forwarding briefly i was in a Movie Theater in an action film and there was an explosion that closely resembled one that i was in and it was shot from the point of view from where i would be in the humvee. So thats end of the cinematic experience was very overwhelming for me and i actually sort of blackout and when i regained full consciousness i was in the hallway. Snuck back into the theater, no one else was having this difficulty and i asked my girlfriend at the time what happened and she said there was an explosion in the movie and you ran out so i begin to sense began to sense on the personal level but not all was right upstairs and i didnt have full control of my memories. One marine i introduced in the book told me having ptsd was like having memories gone wild. So that was one of the incidents for me to begin examining ptsd not just in any personal level but also historical entity because i was curious like a lot of people. A lot of marines in veterans we thought of it as a copout as a shortcut not to having a authentic and honest emotional engagement with your service and postwar service. I thought that it was a way to dodge responsibility until i started looking into it and having these symptoms and what i discovered briefly is that the original people who thought for the diagnosis in the 1970s felt similar to how i felt and the founder of the group of Vietnam Veterans against the war which is the group that advocated for the diagnosis in the 70s, they saw the founder saw in his view there was no distinction to be made between the politics in vietnam and their own personal psychological struggle and out of that conversation and acknowledgment came to diagnosis that we have today. Host so you get a very ambitious synthesis of the personal historical, literary and scientific aspect. You touched on the history of its being kind of conceptualized in the modern era and given its current name. But what do you think is the most interesting thing that youve learned about what we now call the ptsd . Ptsd has been around since 1980 so about as long as Cable Television and it seems like a lot of people that if they were just recognized that it was a permanent thing that was always central to human condition it was always out there and what i found when i began researching is that is not exactly the case. And for instance Jared Diamond is a jogger for delete the geographer spent times in new guinea for the best preserved societies and he discovered talking to travelers that the postbattle with warriors often have nightmares and its something that you can find in the furthest reaches of Human History you find evidence of that. Host aerie common in the current suffering. Guest people consider it to be the symptom of ptsd the nightmare so there are parts of it that are theoretically a mortal comedian ever so and central, but there are other aspects of it but have evolved and thats one of the arguments i make in the book is that culture is more important in biology than ptsd. Host and how people experience it. Guest how we are to explain and benefits benefits sometimes. And its also considered to be one of the cardinal symptoms of ptsd. But in early 2008 group of british researchers at Kings College went back and examined the memoirs and accounts of the soldiers who have served before the age of cinema and discovered that the flashback wasnt really there and if you look at the account of the civil war veterans, they are far more likely to describe their symptoms, the visitations as spirits, ghosts and demons. And interestingly the civil war. Over the far more religious time than our own so there is a sense that you get that the time. Co. And the culture at the time influences how people manifest their symptoms and now in the flashback i looked at early here it was a term borrowed from the film to describe a break in the chronological blow in the story. So interestingly it appears as if the cinema and film have become so central to how we can conceive of human consciousness but its part of how ptsd works. So to answer your question there are historically aspects that appear to be universal and a mortal and other aspects that appear to be under the influence of the society they emerge from so its interesting mix of both immortality and a longstanding history and also in evolution and that was surprising to me. Did you think of it as a permanent thing that gets evolved. Host what you think modern veterans and other survivors can learn from reading literature lacks guest in the book i argue for instance that the elliott which is the foundation of western literature and you do see evidence johnson, his work a key reason the non and america kind of changed the conversation about ptsd. In the elliott eusebius keeley is feeling the survivor skills and crying over the death of his aid. Several of the veterans today the idea is that this super warrior, this alternative veteran and when a lot of ways with someone like that could suffer enduring psychological distress after war could become burning because its a very old thing. People have suffered for as long as human beings fought each other which is forever and so i think in the book i argue that literature is a very powerful medicine and something that the physicians and psychiatrists in particular dont think much about and certainly dont do well on the value of the work or you know literature has an extraordinarily powerful impact any measurable medical impact in terms of teaching you bringing you in closer touch with your own interstate and sense of emotions and naming them. A lot of veterans are unable to because the military sort of trains you to function and focus on the Mission Completion at the expense often times of the inner thoughts. The novels in particular and poetry offer people the experience number one as i alluded to to understand that they are not alone and their struggles are the struggles of immortality. And to secondarily get a greater sense of the emotional life and the way that a person can conceptualize their story and think about their own experience. And i personally learned a lot by reading the things they carry and getting a greater sense of how tim obrien in his other books as well, the memoir if i die in combat zones a combat zone me a lot about how what his homecoming experience was like. So there is this in many cases actual psychotherapy that you read about is the most impacting therapy used to treat across the board often focus on this idea of the narrative of discovering helping with your therapist helping you find your story and a way to conceptualize yourself as a person in the world and literature is basically a Training Session and public hopes us to understand how stories can be told. A lot of people if you grew up in television and film which is less emotionally rich in a lot of cases you dont get that emotional, you dont develop that and get a sense of how a story can be told. And for example, i think that its very useful to look at because after the trojan war he wonders for ten years and is literally homeless which in some ways is a metaphor for the homecoming experience in america and the idea of travel as a medicine and as this way of changing. So to understand and see how that works and how people can find themselves through wandering and how that plays out can be extraordinarily powerful and its measurable. This is a very High School English teacher thing to say but read a book. Psychologists have measured the impact and in particular they found that reading a book, reading a novel was one of the most effective ways to care for a job interview. So, you know for a variety of reasons there actually is a scientifically measurable impact models have on people. Host i would love if you would read a small excerpt from it if you dont mind. I pointed out earlier one that i would love for you to share with us. Guest this is from the Second Chapter and what i was trying to do here is after some brief memoir material sort of step back and examine the larger role and part of my idea for the book was to get as close to the idea of ptsd and the symptoms and the research and then at the same time step back and try to conceptualize it in the larger philosophical framework that ptsd exists. In the terrorist shadow. We are born into toeing the world. This is the shadow that darkens every cradle. Trauma is what happens when you catch a surprise glimpse of that darkness, becoming an violation not only of the body and the mind but also seemingly of the world. Trauma is the savagery of the universe made manifest within us and it destroys not only the integrity of consciousness but the myth of selfmastery and experience over time but also our ability to live peacefully with others almost as if it were a virus coming passage and content to do nothing besides replicate itself in the world over and over until only they remained. , is a glimpse of truth that tells us a lie that love is impossible and peace is an illusion. Therapy and medication can ease the pain but neither from the blood makes the survivor him see the darkness and unknow the secrets that lie beneath the surface of life. Host think you. One of the things that struck me in that passage was referring to trauma trying to replicate itself and i know in other spaces in the book you almost give agency to things. Talk about the universe scheming to wipe us out and the world is designed to hurt us and i wonder if you think that is an example of seeking patterns in things and if you belief and faith. Guest patterns that are not there. Yes i think with respect to the first question i think one of the reasons i wanted to that the book is a biography of the posttraumatic stress disorder and one of the problems when i originally began researching the topic as i found most of the journalism was related to ptsd and much of the science to simply recapitulate the symptoms and it gives us sort of general ideas about how it exists in the world by how it manifests to the emotional numbing. But i began the book with an excerpt from norman mailers book a time of our time where we talk about how the disease has a life of its own. And this applies to all. Cancer has a life and an intention. All the cds we look at the symptoms and the exterior parts of it and the resume of how it exists in the world in terms of how it manifests itself in the interior parts of the human being that has its own intentions and has its own way of being in the world. So i was interested to know if it is this being in the world that enters the body and expects its agenda and in particular i compare it to a virus and i want to be careful because i think that the over medical eyes. I dont look at it in terms of its treatment or its conceptualization. Host contagious . Guest in some ways depending on how you treat the metaphor it does have its contagious aspects to it and thats what is interesting when you talk about the cycle of violence and what they called the repetition. You find the war veterans are often even frequently waged to fix or to adjust or improve upon the legacy of what was thought. We invaded iraq because we didnt finish the gulf war in some peoples mind and there peoples mind and there is that relationship of one trauma exacting its toll and then on another level repeating itself and trying to recreate itself in another way and then people come from abusive families that were sexually traumatized by older leptons find themselves in situations where they receive the trauma and inadvertently unconsciously so there is a viable aspect that is fascinating and unnerving when you think about it because it continues to repeat itself and viruses, which i am not a cancer or aids researcher but speaking to some recently, there is this idea out there that viruses exist only to replicate. That is their major function in one of their main main main purposes in life and so the idea of wanting to replicate itself i think is something that is interesting because that is sort of situated in the medical literature. Additionally, one of the ideas one of the reasons i wanted to write the book was to make sense of my experience. I worked merely as a journalist overseas and one of the reasons i kept going back to iraq and served in the infantry in the mid1990s and had left before 9 11 we invaded iraq and everyone went to college with was there. Virtually as far as i was concerned michael universe had deployed to iraq. So i went for those reasons that additionally i went to iraq because i felt i had always been drawn to extreme experiences. I spend a lot of time in extreme environments and ive learned a lot about myself and i think living as a warrior in a war correspondent is a great way of being in the world because you see see the society pushed to its extreme and get insight into the nature of existence. So i kept going back to iraq because i thought there was some way i had a sort of mystical idea that the longer i stayed there and the closer i got to defend the longer i stayed in the mahdi the more spiritual insights i would get into the closer i get. One of the things i discovered was the longer you stay and more tired you get the more fatigue takes its way into your body and you notice connections that were invisible to you before. And i delved into this in a number of ways in the book that one of the most striking is the day before my worst ambush i was in a humvee with a bunch of soldiers who are all from latin america in the u. S. Army and born in guatemala and el salvador and one of them asked me have you ever been blown up before sir which as been talking about almost dying you dont do that from my perspective it was old and most like dont talk about them and how lucky youve been this week because you are tempting fate. So all of us when he asked that question we got angry because you cant ask that. Thats the last question you ask someone in a combat zone is have you ever been shot at, have you ever been wounded by because you are inviting you on your self and so in a way it didnt surprise me when i hit an ied the next day because the soldier had spoken in my way of thinking had spoken my faith so there is a sort of mystical connection this finding of connections where there shouldnt be connections and noticing patterns that were invisible to you before. These sort of things were a huge part of my war experience and why i kept going back because i thought i was learning. There was in a satiric knowledge, the spiritual insight about the nature of existence that was becoming available to me the longer i stayed there. So i reflect on that in the book it is an altered state of consciousness that be leaving those sort of things and that magical way of thinking is part of the dramatic universe and the idea of the supernatural trauma in the supernatural experience and visitations from the other side and for me even while i was there i felt there was this other side of the paranormal or the other world that was present in my experience. Host so when i talk about my war experience and homecoming i sometimes joke going on my first book tour was my own special version of prolonged social therapy because i got to talk about some of the most awful things i experienced with journalists asking me things like what is it like to watch someones death so i was really interested to read your discussion of your experience with formal prolonged exposure therapy at the va something that you called a sadistic virtually indistinguishable from torture, and punitive reconditioning. I was curious if you are at all concerned about using that type of language and might deter some people from thinking [inaudible] possibly. To go back prolonged exposure is the vas number one individual psychotherapy and its loosely based on the idea of pavlov and the idea of reconditioning a person. And the ideas of pavlov and others, classical psychological theory were updated by the university of pennsylvania researcher and its a therapist that asks you to recount. Very common in the world today. However i found it to the research does show that it works in the case is most veterans to get the benefits from it. But i found as i recounted the story of my ambush in baghdad on october 10 2007 i was asked to recount the story of dozen