Norman M Camp, MD - Academia.edu (original) (raw)

Papers by Norman M Camp, MD

American Journal of Psychiatry, Jun 1, 1994

Rebuts several correspondence who responded to Camp, N.M. (1993) [The Vietnam War and the ethics ... more Rebuts several correspondence who responded to Camp, N.M. (1993) [The Vietnam War and the ethics of combat psychiatry. AJP, 150, 1000 1010] and sought to diminish awareness of the subject's (the military psychiatrist's unique ethical conflicts on the battlefield) importance, pervasiveness, complexity, and specificity.

Vietnam was America's most protracted and divisive war in modern times, however, evidently the US... more Vietnam was America's most protracted and divisive war in modern times, however, evidently the US Army did not retain psychiatric records and related materials that would serve as a data base for analysis and formulation of "lessons learned" regarding the dynamics of psychiatric attrition or prevention in the theater. Yet Vietnam introduced a rich variety of unique or changing circumstances altering both the ecology of the battlefield and the rear, as well as provided a new technology for treatment of psychiatric disorders, i.e., relatively non-sedating psychotropic drugs. This report provides an alternative rationale , survey instrument, and methodology for ascertaining a comprehensive description of the dominant patterns of psychiatric and psychosocial breakdown among U.S. Army troops in Vietnam and the forms of intervention provided through the accumulation of survey data from Army psychiatrists who served there. 15. SUBJECT TERMS military psychiatry, combat psychiatry, Vietnam 16. SECURITY CLASSIFICATION OF: 17. LIMITATION 18, NUMBER u n c lassifie d

The mental health challenges that arose in Vietnam over the course of the war were in many respec... more The mental health challenges that arose in Vietnam over the course of the war were in many respects both prodigious and unprecedented. An estimated 200 psychiatrists, including two women, served in Vietnam with the Army, Navy, and Air Force between 1964 and 1973.

Psychiatric Times, 35(11), 1, 4, 26., 2018

Describes the American Psychiatric Association's semi-Centennial commemoration ceremony, held on ... more Describes the American Psychiatric Association's semi-Centennial commemoration ceremony, held on November 1st, 2018 at the Vietnam Veterans Memorial in Washington, DC, honoring the approximately 200 psychiatrists who served in Vietnam during the war. As testimony to their distinguished legacy, the article also provides a synopsis of the prodigious and unprecedented psychiatric challenges that arose as the war lengthened and America underwent social upheaval, much of which centered on opposition to the war. The Action Paper passed by the APA Board of Trustees that resulted in the event culminates in the proclamation: "Despite the enormous personal and professional challenges and risks these psychiatrists faced, the extant record amply demonstrates their sustained devotion to providing the best care for the troops that they could, their willingness to overcome hardship pursuant of that end, and their record of capable and commendable service. The arrival of the war's 50th anniversary offers a unique opportunity to honor those who selflessly performed to the best of their ability their duty to their country."

. [I]t is important that the psychiatric experience of Vietnam and its aftermath be subjected to ... more . [I]t is important that the psychiatric experience of Vietnam and its aftermath be subjected to continuous re-evaluation utilizing new source material, operational concepts and conceptual procedures so that the important lessons in military psychiatry hidden within the heart of human tragedies like Vietnam be perceived and applied to the mitigation of human suffering in the practice of psychiatry and in future conflicts. 1(p19)

. [As Vietnam veterans, it] was easy for us to get ourselves accepted as long as we maintained, f... more . [As Vietnam veterans, it] was easy for us to get ourselves accepted as long as we maintained, for instance, that there was absolutely no excuse for American soldiers to be in any overseas theater, that military doctors were crude and inhuman, that poverty and misery in the U.S. was far more important and more horrible than such problems anywhere else in the world, that the Communists were not serious competitors of ours, and that the less we learned from Asia, Africa, and South America the better. For the home Americans seemed to "know" from the media that the Vietnam war was more immoral than the Civil War, the Spanish American War, or World War II. They explained how we soldiers should feel guilty for fighting such an immoral war. 1(p2) Colonel Matthew D Parrish, Medical Corps 3rd Neuropsychiatry Consultant to the Commanding General US Army, Republic of Vietnam (1972) P sychiatrists are specialized physicians who enter military service already committed to their profession's humanitarian ethical values, which emphasize care of the individual. However, like all soldiers, while serving in the military they also function in the ethical shadow of the institution's enormous and strict hierarchy, the central organizing principle of which is the subordination of individual values to those of the organization 2-presumably for the benefit of society. It follows that, in time of war, Army psychiatrists incur an obligation to support the US Army Medical Department's mission of contributing to the accomplishment of the combat mission, which means the clinical priority centers on the recovery of the individual soldier's

. [O]ne young warrant officer who was described by his flight surgeon as "one of the better all a... more . [O]ne young warrant officer who was described by his flight surgeon as "one of the better all around pilots in our unit". .. was discovered to be smoking marijuana 10 to 15 times per day while flying combat missions.. .. [When confronted, he replied,] "It didn't bother me being shot at for. .. every time I was stoned on marijuana. It was beautiful to me. The tracers were even pretty. I got to where I could fly pretty good on marijuana, but sometimes when I landed I could hardly walk." 1(p57) Lieutenant Colonel Norman Evans Army psychiatrist and flight surgeon 98th Psychiatric Detachment

The removal of the characterological is necessary to the functioning of the unit. From one standp... more The removal of the characterological is necessary to the functioning of the unit. From one standpoint the referral to the psychiatrist means a breakdown of group integrity. Sometimes it is not clear whether the patient does not feel a part of the group or whether he is not perceived as such. The passive aggressive, of course, was our stock in trade. With these referrals I had to consider whether the referral was honestly made. I think this is an important point because with time people's secret motives become apparent.. . .

Looking at the matter from a military point of view alone, one might ask whether it is not desira... more Looking at the matter from a military point of view alone, one might ask whether it is not desirable to send home all "shell-shock" cases-in whom so much effort results in so few recoveries. Such a decision would be as unfortunate from a military as from a humanitarian standpoint. Its immediate effect would be to increase enormously the prevalence of the war neuroses. In the unending conflict between duty, honor, and discipline, on the one hand, and homesickness, horror, and the urgings of self-preservation on the other, the neurosis-as a way out-is already accessible enough in most men without calling attention to it and enhancing its value by the adoption of such an administrative policy.

and even media support of an earlier day. .. dropped off precipitously once it was clear that the... more and even media support of an earlier day. .. dropped off precipitously once it was clear that the United States had opted out of the war. Societal problems of drug abuse, racial disharmony, and dissent,. .. reached epidemic proportions in the United States and, inevitably, spilled over to the forces in the field. Cumulatively, these differences constituted one of the most difficult challenges to leadership in the military history of the United States, and eventually their effects were felt throughout the forces in every theater. 1(p347)

What has been called a strategy of containment is designed to bring about peace and reconciliatio... more What has been called a strategy of containment is designed to bring about peace and reconciliation in Asia as well as in Europe. In the U.S. view, only if violence is opposed will peace and reconciliation become possible. If aggression succeeds [in Vietnam], the Asian Communists will have shown that [Chinese Communist Chairman] Mao [Tse-tung] is right: The world can only be reshaped by the gun. 1(p5) Why We Fight In Viet-Nam

elling the story of the Army's psychiatric problems in Vietnam requires that one start at the end... more elling the story of the Army's psychiatric problems in Vietnam requires that one start at the end so that the beginning and middle have context. As for the bitter end, the war in Vietnam came to a dramatic close 30 April 1975, when America's ally, the government of South Vietnam, surrendered to the overwhelming military force of North Vietnam. For the United States this represented a resounding strategic failure, if not a tactical one. Although American combat personnel had been completely withdrawn 2 years earlier, it must be acknowledged that this was in response to great opposition to the war at home, 1 widespread demoralization in the theater, which was often expressed in psychiatric conditions and behavioral problems (see Chapter 2, Figure 2-2 and Chapter 8, Figure 8-1), and a military leadership that was on its heels. This degradation of military order and discipline, as well as a general compromise of the mental health of the force, was unprecedented and mostly unanticipated because American troop strength had been dropping steadily since mid-prologue

Conversion [r]eactions and [m]alingering. .. are not of major importance to the civilian psychiat... more Conversion [r]eactions and [m]alingering. .. are not of major importance to the civilian psychiatrist whose patients exchange money, inconvenience, time, and in some cases an initial loss of self-esteem for the hope that the physician will relieve his discomfort. In the military, where cost is not a factor (and in fact illness could provide compensation), where time out of the field is a convenience (the longer the better), and where any medical procedure is preferable to the dangers and stress of combat, these topics become extremely important in the medical officer's daily workload. 1(ChapIX,pp5-6)

The peak incidence of our combat exhaustion cases occurred during [the battle of the Ia Drang Val... more The peak incidence of our combat exhaustion cases occurred during [the battle of the Ia Drang Valley].. .. [K]nowing what was going on [from the commanding general's briefing] was vital so that one could realistically perceive the difficulties that the troopers were confronting and give the individual trooper some feeling that his story was falling on knowledgeable ears. Perhaps this was just to alleviate my own anxiety, but I think this is a real thing, that as the troopers pass back [through the evacuation chain] nobody sits down and listens; and one of the major needs of distressed people of this sort is for someone to sit and listen. Often this was one of the prime functions of the corpsmen in dealing with the combat exhaustion patient. 1(p48) Captain Harold SR Byrdy, Medical Corps, US Army Division psychiatrist with the 1st Cavalry Division (Airmobile) August 1965 to June 1966 U S Army psychiatrists were deployed in Vietnam to provide specialized clinical services and leadership for allied medical and mental health personnel to aid in the conservation of the force in support of the military mission and to provide humanitarian care for the sick and wounded. The first Army psychiatrist in South Vietnam was Major Estes Copen. He was assigned to the 8th Field Hospital in Nha Trang for 5 months in 1962 to provide specialized care for the approximately 8,000 assigned US personnel. 2,3 In the decade that followed an estimated 135 to 140 psychiatrists served with the US Army in South Vietnam, typically for 1-year assignments. The last Army psychiatrist in Vietnam, Major Dennis Grant, left Vietnam in March 1973.

he need for clear and meaningful group missions. .. is simply another way in which good leaders c... more he need for clear and meaningful group missions. .. is simply another way in which good leaders can demonstrate to their units that they care-by seeing that their efforts and the risks (and losses) they incur are for something undeniably worthwhile. Certainly the discipline problems, wholesale drug abuse, and fraggings of the US Army in Vietnam came primarily in the latter years of the war, when it was clear that America had made the judgment that their task was not worth pursuing. Interpersonal bonding at the small unit level could not overcome the quite rational desire not to be the last one killed in an effort without glory or thanks 1(pp1-2) Frederick J Manning, PhD Military social psychologist C ombat-generated psychiatric conditions have traditionally been the most critical of the problems that military psychiatrists have faced; and, although a broad collection of stress-related factors have been determined to affect how well the soldier can withstand his combat ordeal, the predominant pathogenic one has obviously been its violent nature. However, there are additional challenges-deployment stress-that affect all who are sent to a theater of war, the majority of whom will not face combat directly. In fact history has shown that in a combat theater, commanders, medical personnel, and mental health specialists, as well as those in law enforcement and chaPter 8

A frequent source of contention between [division] psychiatrists and the KO team involves patient... more A frequent source of contention between [division] psychiatrists and the KO team involves patients who are seen as psychotic. .. in the division setting, but who present essentially characterologic problems [on] our ward. Problems potentially get worse because of the. .. fact that character disorders are not removed through medical channels in the Army.. .. [W]e are [thus] left with a man who we feel is character disordered and cannot evacuate [from Vietnam] through medical channels with good conscience, but on the other hand [he is] a man whom [you] feel is psychotic and cannot be returned to duty with good conscience.. .. So, what to do?? 1(pp1-2)

Camp N.M. US Army Psychiatry in the Vietnam War: New Challenges in Extended Counterinsurgency Warfare. Ft. Sam Houston Texas: Department of the Army, Office of the Surgeon General, Borden Institute; 2015. ISBN 978-0-16-092550-4, 2015

The Preface and Table of Content serve as the introduction to the author's study of the military ... more The Preface and Table of Content serve as the introduction to the author's study of the military psychiatric challenge in Vietnam--especially for the Army--the services provided, and results (1965-73). The study was necessitated by the rampant soldier mental and behavioral disturbances that arose in the second half of the war and the decades of institutional disregard for this unprecedented, dangerous, and damaging state of affairs. The methodology utilized was that of assembling and synthesizing information drawn from a wide variety of available sources documenting the successes and failures of the deployed Army psychiatrists and allied mental health and medical personnel, altho much is also said about parallel challenges faced by those caring for the deployed Marines. This approach was augmented by data from the author’s 1982 survey of the veteran psychiatrists who served with the Army in Vietnam. Whereas this review was intended to serve as a historical record, it is not the comprehensive history that should have been developed by the Army. Nonetheless, it does define many of the most salient “lessons learned” with respect to the variables that affected the morale, discipline, mental health, and performance of the troops deployed in Vietnam, as well as those bearing on the mental health specialists sent to support them.

American Journal of Psychiatry, Jun 1, 1994

Psychiatric Times, 35(11), 1, 4, 26., 2018

Over the course of the Vietnam ground war (1965-1973), especially during the second half, the dep... more Over the course of the Vietnam ground war (1965-1973), especially during the second half, the deployed US Army troops, along with the Marines, suffered a severe breakdown in troop morale and discipline -- matters that not only center on military leadership but also are necessary to accomplish the mission. This produced a wide array of psychological disturbances, psychosomatic symptoms and pathological behaviors, which thoroughly tested military leaders as well as the deployed mental health personnel.

Through assembling and synthesizing extant information from a wide variety of sources, including the deployed mental health personnel, this book provides a history of the developing military morale and mental health crisis in Vietnam that culminated in rampant heroin use, covert mutiny and assassination of military leaders, and unprecedented levels for medical evacuation. It furthermore documents the success and failure of Army psychiatry in responding to the psychiatric and behavioral problems that changed and expanded as the war became protracted and bitterly controversial.

Individual chapters can be found under "papers."

Choice Reviews Online, 1989

This bibliography collects and summarizes published observations, research findings, opinions, an... more This bibliography collects and summarizes published observations, research findings, opinions, and conclusions of mental health professionals, social scientists, and other trained observers regarding the effects of the Vietnam War on those Americans who fought in it. The 851 citations span the years from 1965, when large numbers of U.S. combat troops were first committed in Vietnam, through 1987. The authors have included primarily psychiatric, social, and behavioral science publications. These are augmented with personal narratives of those who served, descriptions by and reactions of war correspondents, and historical reviews of the war and the period, including observations and analyses of the war's effect on the combat soldier. Although selections were limited to materials in generally accessible sources--periodicals, journals, books, monographs, and government reports--articles from the popular press were included if they were written by behavioral science professionals or firsthand observations from Vietnam of an especially insightful nature. The volume is arranged topically and is divided into three major parts: service in Vietnam, veteran adaptation, and social and institutional context. Of particular value, the abstracts succinctly highlight each publication's critical findings, observations, and opinions.