Article: From Shiloh to Saigon: Treating the “Nonbeliever” – Thomas G. Shafer (Is.16)

Thomas G. Shafer, M.D.

Multiple sources have said that belief in past lives is not a prerequisite for successful regression therapy. But exactly how do we use past-life therapy with the “nonbeliever?” The author, the Journal’s new Associate Editor Thomas Shafer, presents a case of a man who improved after exploration of past-life type dreams even though his religious tradition prohibited any belief in reincarnation or any work in altered states of consciousness.

(Author’s note: This is a case from my psychiatry practice but names and identifying details have been altered to protect confidentiality.)

 George M. was a 49-year-old white male US Marine Corps Vietnam combat veteran who presented to my office at the US Veteran’s Administration on referral from his internist. He complained that he had adjusted well after the war until recently, but now “was going crazy” and “can’t deal with it.”

George had an unremarkable childhood history, growing up in a rural Alabama town with no family history of serious mental illness. He graduated from high school with a C+ average. After high school, he had worked for about a year in a paint shop, but had then enlisted in the US Marine Corps at age 19.

After about nine months of training and active duty, his unit had been sent to Vietnam. He had served a full 13-month tour there as a rifleman. He had spent most of this time “in the boonies” and had been in numerous firefights. His platoon had taken over 30% casualties during George’s tour, including two of his close friends. He estimated he had killed “over a hundred” enemy soldiers. He had not been wounded.

After his tour in Vietnam, but while he was still in the Marines, George married his high school girlfriend and they lived near where he was stationed, Camp Pendleton, California. He had some problems at first with nightmares, and with occasional weekend binge drinking and angry outbursts which sometimes led to fights. He said that when he had learned that his wife was pregnant, he “put that bottle down” and hadn’t used alcohol since. He denied any illicit drug use. He had received some low-level disciplinary actions from the Marines due to fighting but he said this ceased, along with the rages, after he stopped using alcohol. He was discharged as a Corporal at age 23. He said that his problems with flashbacks and nightmares ceased before his discharge.

George then moved to a somewhat larger city in Northern Alabama where he landed a “good factory job.” He described himself as “a hard worker,” working for the same company for the past 25 years and advancing from line assemblyman to foreman. He was respected by his peers and also had served as a union representative. He admitted he was “kind of a workaholic.”

When he came to see me, George and his wife were still married with two grown children who were doing well. He said he felt a bit distant from his family, but there were no major problems in their home or marriage. His family was active in a local Missionary Baptist Church. George said he felt he had made a pretty successful adjustment to his Vietnam experience. He admitted he had some occasional problems with intrusive thoughts and memories but he was able to deal with this by “getting busy.” He was proud of how well he and his family had done and also admitted pride about “not being like those other guys,” meaning veterans with severe Post Traumatic Stress Disorder (PTSD). He actually had a marked desire to isolate himself from other veterans and went out of his way to deny his combat service.

About two weeks before coming to my clinic, he had been reading a book about the Civil War a friend had given him for his birthday. He said he used to be very interested in this historical period during high school but hadn’t read much about it for many years. He saw a picture in the book showing dead soldiers after the Battle of Shiloh, and he immediately became very upset and anxious, “shaking and crying.”

Within days he had developed a severe full-blown case of Delayed PTSD with combat related nightmares, flashbacks, depression with suicidal thoughts, and withdrawal from friends and family. He was especially concerned about the flashbacks. He had several while driving to work. (In Vietnam, he was often driven into combat in trucks.) This situation had become so bad he was unable to go to work at all.

My first therapeutic intervention was pharmacologic. He was prescribed Paroxetine for depression and anxiety, and Clonazepam for sleep and nightmare suppression. He had a good initial response to the medication, in that the severe suicidal depression cleared and his sleep improved markedly. However, the flashbacks persisted and he was still unable to drive to work after the first two weeks.

George finally told me reluctantly that he had been having some “real crazy dreams” for about three weeks. They were combat-related, but in them he was no longer in Vietnam. Instead, he was a Confederate soldier lying wounded on the Shiloh battlefield. He said that in his dreams he lay there for hours with severe wounds he knew were mortal. He desperately wanted a drink of water and cried out many times but nobody came. He was all alone. All of the other soldiers around him were dead. Night fell and still nobody came. He became weaker and weaker and was terrified of being all alone in the dark. Then the dream ended. He said, “I guess I died.” He always woke up right before the death and therefore never seemed to get any sort of emotional closure from the dream experience.

He described this dream as being extremely vivid. “Like that was really me there.” He had begun having flashbacks in which he would briefly experience the same setting in the daytime, while awake.

Now here is where I had a problem. With my experience in past-life work, the explanation seemed obvious, the Civil War photos had triggered a past-life recall and the superimposition of that traumatic death and his present life’s Vietnam experiences had overwhelmed this man’s defenses. However, George’s strict fundamentalist background precluded any discussion of this idea since his church taught that reincarnation was an idolatrous concept. And doing any kind of hypnosis or other “altered state” work was out of the question since he had been taught that this would make him susceptible to demonic influence or possession. My only option at this point was to offer the interpretation that such experiences were not unusual and schedule a full therapy session for the following week.

By that time, the Shiloh dream was recurring every night. It was always the same: he found himself lying there alone, a wounded Confederate soldier, then the dream faded out just as he died. The dream experiences and flashbacks continued to feel very real, as if he had really been there.

At this point, I tried some didactic work, discussing past-life recall and therapy. As I expected, George was very uncomfortable with this, saying his church “preached against Eastern religions” and taught that “dabbling” with things like reincarnation could leave a person open to demonic influences. I explained to him that all the literature on PLT said a person did not have to believe in actual past lives to receive benefit from the therapy. I reassured him that, as a Federal employee, I had no agenda regarding changing his religious beliefs. He reluctantly agreed to discuss the dream further.

Then, I got an idea. I decided to try to model the experience in the terms of his own religious tradition. I reminded him of the Bible story of Joseph and how he had both had and interpreted dreams. This led George to quickly conclude that God had sent him these dreams to teach him something important, “just like those dreams Pharaoh had.” He was then a lot more comfortable with the whole experience and my proposed therapeutic game plan, and agreed to keep a dream journal and think about what the significance of the recurrent dream could possibly be.

The dreams were continuing 10 days later when I next saw him. George said, though, that his sleep had improved some and he was pleased that his daytime flashbacks had calmed down to the point that he had made it back to work. He clearly was no longer as frightened about the “Shiloh Dream,” as he had begun to call it.

We explored the significance of this dream and he said he thought he was reacting most strongly to the realization that the Confederate soldier had died all alone. He said he felt that soldier had been very angry at being abandoned after he was wounded. He said he now saw that the most terrifying part of his Vietnam experience was a constant fear of being wounded and abandoned. He said he had joined the Marines because “They never leave their wounded or their dead.” And he had had many experiences in Vietnam which confirmed this belief.

While he had consciously forgotten about it, he now remembered that while in Vietnam he had kept a hand grenade attached to his belt at all times. He recalled that he had promised himself if he was ever severely wounded and cut off from the others, he would “pull the pin and check out.” He said this was not a common practice in his unit, but he himself did it.

We discussed this fear of abandonment and the Confederate soldier’s sense of anger and betrayal at some length. I told him at the end of the session that his “homework” was to think about how this fear of being abandoned affected his life in Vietnam and the present.

The third and final individual session went well. George was sleeping better with only occasional nightmares. He said he had realized he had felt alone and distanced himself from other people in general, and other solders and veterans in particular, ever since he had arrived “in country” at the start of his Vietnam tour. We discussed this and he realized he had a real sense that Vietnam vets had received “a shitty deal.” He said he felt really torn because he had a sense that he needed to attend our Vietnam support group because he felt he would best be understood by other veterans, but he had a hard time “connecting” with them.

I offered the interpretation that the worse wartime experiences seemed to occur when people were all alone, and that feelings of abandonment were common. I told him that I felt one of the messages of his dream was that he needed to feel a sense of connection with those poor soldiers at Shiloh and soldiers who had fought and died in wars everywhere. He was almost tearful after this statement but said it was quite true. He then became quite emotional discussing how that poor Confederate soldier in his dreams “must have felt.” We then closed this session by discussing the possibility of his entering the Vietnam support group.

At the present time, one year later, George has made good progress. He is off the Paroxetine and has no further depression. He sleeps well most nights but uses the Clonazepam as needed. He still has an occasional dream about Vietnam but, interestingly, the “Shiloh Dream” and associated flashbacks ceased after his first two group sessions.

He is back at work and doing well. He attends the Vietnam support group at least twice a month and finds it helpful with dealing with the intrusive thoughts about Vietnam he sometimes still has. He has also joined a local veteran’s lodge.

Discussion

George presented me with a challenge. To me, his dream experience actually had “spontaneous past-life recall” written all over it. But he was totally resistant to discussing this idea even from the point of view of actively imagining or pretending he had been the soldier at Shiloh. Yet he definitely needed to process this past-life material to get at his present life problems. Furthermore, our Vietnam vets’ program relies heavily on peer support groups and George’s unresolved feelings about being abandoned to die on a nineteenth-century battlefield made it impossible for him to trust his twentieth-century peers, so he could not join the group.

Fortunately, I found a way to allow him to experience and assimilate his Shiloh experience within the framework of his own strongly held religious beliefs. I was able to reformulate his dream and ratify it in the light of his religious beliefs by discussing the Bible story of “Joseph the Dreamer.” This led him to concentrate on the underlying message of the dream, his sense of angry isolation and his fear of abandonment. Since then, he has resumed his previous successful adjustment with the help of a small amount of medication and some group sessions with his peers. So despite George’s total resistance to any concept of a past life, he was able to re-experience and move beyond a traumatic past-life experience. And, for me, our journey across time from Shiloh to Vietnam was quite a trip.

 

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