Invisible Wounds: Veterans of the American Civil War
The United States expended a vast amount of blood and treasure to win the Civil War, to the tune of an estimated 750,000 lives and $3.2 billion dollars. More Americans died in the Civil War than died fighting under every general from George Washington to William Westmoreland, a fact well known among historians. Almost from the moment Robert E. Lee’s Confederate Army of Northern Virginia surrendered at Appomattox, the Civil War has arguably been the most written about war in American history. Because it destroyed the institution of slavery, a triumphalist narrative has dominated the telling and re-telling of the Civil War. This narrative has argued that the war was focused on emancipation and resulted in a collective national purging of the sins of slavery and a renewal of the country. This triumphalist narrative of emancipation continued—even as historians called readers attention to the experience of regular soldiers, and the contribution of African Americans—and culminated, arguably, with James M. McPherson’s Battle Cry of Freedom, and Ken Burns’ PBS documentary The Civil War. In the closing decades of the twentieth century, however, several historians made clarion calls to challenge this dominant interpretation of the war. Edward Ayers argued that a new “Civil War revisionism” was needed to set aside the “Olympian perspective” of the war, and instead, explore the “depth and scale” of the conflict in ways that would challenge the traditional narrative. Just a few years earlier, historian Maris A. Vinovskis published an article in The Journal of American History called “Have Social Historians Lost the Civil War?” Few events in American history had received as much attention as the American Civil War, yet for all we knew about how the war was fought and who led what charge, Vinovskis argued, historians knew very little about the personal lives of soldiers and civilians during the war, and almost nothing had been written about the postwar lives of veterans. Vinovskis speculated that the impact of the war did not end in 1865, but continued throughout the nineteenth and twentieth centuries. The conflict likely, he speculated, left scores of survivors physically disabled and “emotionally scarred.”
Historians have taken up with vigor Ayers' and Vinovskis' call to arms to complicate the traditional narrative of the war, in what collectively has come to be known as the "dark turn" in Civil War historiography. Drew Gilpin Faust explored how the war altered the culture of death in America, and argued that the war's destruction inaugurated an early wave of modernist writings and thoughts, which questioned romaniticism and traditional cultural values. Historians of Civil War guerrillas such as the late Michael Fellman, Daniel Sutherland, and Matthew Hulbert have emphasized that many Americans experienced the conflict as a brutal, hyper partisan guerrilla war, in which summary executions and tit for tat escalating violence was the norm not the exception. David Silkenat has asserted that postwar North Carolina experienced an exponential increase in suicides among its white population, particularly among Confederate veterans. Diane Miller Sommerville has gone further, and argued that Confederate veterans were inflicted with an epidemic of emotional and psychiatric trauma that reverberated throughout the Gilded Age. David Courtwright has argued that the war created a generation of drug addicts, mostly among Civil War veterans who were dosed with opium or morphine in wartime hospitals. Moreover, writing about the future of Civil War Era studies for The Journal of the Civil War Era, Stephen Berry predicted that current events would likely inspire more historians to complicate the traditional narrative of the war: "This experience of wars of occupation, insurgency and counterinsurgency, refugees, hearts and minds, atrocities, war contractors, ill-gotten fortunes, mission creep, terrorism, torture, and child soldiers will continue to be reproduced in our work, along with a darker understanding of how the sausage of war in a democracy gets made." Their work has begun to question, in a very potent way, the triumphalist narrative of the war.
As part of this new revisionist wave, historians have been debating how potentially damaging combat was to the mental and emotional health of Civil War veterans. The issue that has most animated historians on this question has been whether veterans suffered with Post-Traumatic Stress Disorder? Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder caused by a traumatic event such as war, rape or a natural disaster. Introduced into the third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1980, the diagnostic bible of the American Psychiatric Association, PTSD manifests as intrusive nightmares or flashbacks of the traumatic event, avoidance of stimuli that reminds one of the event, feelings of estrangement, and self-destructive irritability and anger. In 1997, Eric T. Dean, Jr., published Shook Over Hell, which compared veterans of Vietnam and the Civil War and argued that Post-Traumatic Stress Disorder did indeed affect veterans of the Civil War. Shook Over Hell was an important study, drawing scholarly attention to new arguments and archives. Dean, Jr.’s argument that combat had looming implications for the mental and emotional health of soldiers who fought the Civil War’s battles has had staying power. It has been highly influential on revisionist historians of the “dark turn” who have largely built upon Shook Over Hell’s conclusions. David Silkenat and Diane Miller Sommerville have suggested that PTSD may be a possible explanation for the increased number of suicides among veterans in the postwar South. James Marten, Jeffrey McClurken and Rusty Williams have pointed to PTSD as a possible explanation for the high rates of alcoholism and violence among veterans in the Soldier’s Homes.
Not every historian, however, has embraced the “dark turn” revisionism of the Civil War, and a counter-revisionism movement has been growing. Historians such as Paul Cimbala, Gary Gallagher, and Kathryn Shively Meier, argue that much of the “dark turn” revisionism ignores the ways in which nineteenth century Americans held radically different beliefs about war, death, the self and citizenship than their modern counterparts, and instead, imposes contemporary concerns and political agendas on nineteenth century peoples. In Veterans North and South, Paul Cimbala argues that Civil War veterans were remarkably successful in rebuilding their lives after they took off their uniforms. Most went to work immediately after securing the fruits of federal victory, or to regain control of their southern communities. Gary Gallagher and Kathryn Shively Meier have recently lamented the rash of studies that emphasize “atrocities, cowardice, needless bloodshed, physical maiming or mental breakdowns among soldiers and veterans.” Gallagher and Meier believe these could lead readers to think these experiences were normative, rather than atypical. Instead, they suggest that there is nothing to lead us to believe that many veterans suffered psychological breakdowns severe enough to prevent “their moving past military service to live productive postwar lives.”
These historians have also pushed back against the argument that Civil War veterans likely suffered with PTSD. Gaines Foster has argued that the “Lost Cause” ideology of the postwar South insulated Confederate veterans from Post-Traumatic Stress through ritual celebration and idolization. Allan Young has asserted that the idea of a traumatic memory, the foundation of PTSD, did not even exist until the late nineteen century. Frances Clark suggests that many historians have mistakenly seen Post-Traumatic Stress in what was in fact “nostalgia,” a separate medical diagnosis that reflected depression and extreme homesickness, but not PTSD. Finally, Wayne Hsieh has recently argued that historians who believe Civil War veterans suffered with PTSD often ignore “the importance of culture in shaping military phenomena in a specific time and place.”
My book, Invisible Wounds: Veterans of the American Civil War in the Gilded Age focuses on the inner lives of Civil War soldiers and veterans that previous historians have missed or ignored. Previous work, such as Shook Over Hell, has focused on a small set of Indiana soldiers, raising more questions than it answered. The ensuing debate has mostly focused on whether Civil War soldiers suffered with PTSD. Lost in this argument is how soldiers successfully coped with the trauma of war, how veterans and their families understood combat-related problems differently than asylum doctors, and how these new ideas and debates changed the psychological community and helped advance medicine.
Invisible Wounds focuses on the veterans of the Civil War, men who mentally and emotionally struggled with their experiences in Union blue or Confederate gray. This is an admittedly small set of soldiers. A minority of Yankees became patients in the nation’s asylums. Just over 1,500 members of the Union Army were admitted to the Government Hospital for the Insane (the Union’s main asylum for soldiers) during the war, while just under 2,000 veterans were admitted to the asylum from 1865-1890. Thousands more were likely admitted to state asylums throughout the country during and after the war, but even if they were all added up it would still be a minority of the three million soldiers who served. However, their stories, along with the stories of the physicians who treated them, as well as their families and communities are important and make up the pages of this study.
Invisible Wounds focuses on issues that historians have ignored or missed. Much of the debate about trauma and Civil War soldiers sees the men as victims, caught in the maelstrom of war and at the mercy of psychological processes they did not quite understand or could not control. Civil War soldiers, however, were not always mere victims, and many were active agents in their own recovery. I explore how Civil War soldiers successfully coped with the stresses of soldier life and returned to the ranks. To cope with the trauma of war, many soldiers turned to religion, camaraderie, or shirking.
I also show how soldiers sought new language to describe mental illness—such as “played out”—language that was separate from physicians and suggested that soldiers and their families understood that trauma in different ways. Physicians, meanwhile, turned to specific diagnostic nosology to define and categorize the patients coming into the wards of their asylums. “Played out” or “broken down” were terms soldiers used frequently to describe mental illness among themselves and their comrades, and was meant to holistically convey broad physical and psychological damage. They understood mental breakdown often as a collection of traumas that built up over time and could wear men out, like a broken machine or a lame horse.
This language is important because it is part of a forgotten debate over the relationship of war and mental illness that nineteenth century Americans were having. Traditionally, historians trace debates over the connection between combat and psychiatric breakdown as starting with the First World War. Psychiatrists in that war diagnosed mentally ill soldiers with shell shock, a strangely enduring diagnosis. Shell shock turned into combat exhaustion, which then gave way to Vietnam syndrome, which then became PTSD (or so the story goes). This linear categorization is flawed however, because it ignores the admittedly more narrow, but very real debate Americans were having about the relationship of war and mental illness in the late nineteenth century. During the Civil War, physicians viewed “insane” soldiers in specific diagnostic categories such as acute melancholia or chronic dementia. Doctors believed these conditions manifested due to physical causes—disease, exposure, or a blow to the head—or circumstantial moral causes—hereditary, intemperance, masturbation, and financial setbacks. Physicians did not believe, however, that exposure to the horrors of war could cause mental illness. During and immediately after the war, most Americans accepted the diagnostic and therapeutic theories of physicians as well. The war, though, created a small class of veterans who suffered with mental illness, who marched home as changed men. Some former soldiers, and their families, began to argue that fighting in the war—and all of the terrifying experiences that soldiering entailed—could cause “insanity.” The pension system obviously incentivized this belief, as soldiers who were federally recognized as becoming disabled from the war could receive annual allotments from the treasury. Over time, more veterans fetched up in insane asylums like the Government Hospital for the Insane (later known as St. Elizabeth’s). The growing numbers of mentally ill veterans, combined with pressure from their families, convinced some asylum superintendents to begin diagnosing “insanity” among some veterans as being caused by their experience in the war.
Becoming a patient in a nineteenth century insane asylum, however, was a development fraught with gendered social isolation. Many Americans believed that men who became inmates in an asylum were not truly men. In the eyes of their peers, sometimes their family, the loss of reason, and corresponding loss of independence deprived the patient of his manhood. Because of this, most Civil War veterans were understandably hesitant to admit the war had emotionally or psychologically affected them. But the experience of fighting did affect many of them. Invisible Wounds argues that the deeper psychological affects of fighting were more widespread than just the asylum. I also explore the emotional and mental affects of soldiering on veterans who never became patients in an asylum. This damage was apparent to many hospital nurses, and the soldier suffering frightening nightmares of battle made its way into the postwar fiction of Louisa May Alcott and poetry of Walt Whitman. Moreover, in the postwar memoirs of Civil War veterans, many admitted to suffering terrifying dreams of the picket post, the hospital ward, or the prison pen. While they did not think of themselves as victims, or as being mentally ill; in their many writings, veterans recognized the war did damage them in some fashion.
Did Civil War soldiers and later veterans suffer with PTSD? I believe that research such as Shook Over Hell that has suggested that Civil War veterans may have been afflicted with PTSD has been valuable in challenging the traditional narrative of the war, suggesting that combat could have an emotional price, and generating valuable debate and discussion among historians and the public. However, I also believe that historians such as Gary Gallagher are right to argue that PTSD is a modern phenomenon, contingent upon Vietnam, postwar activists, and the social and cultural landscape of the post-war United States. This is not to suggest that PTSD is not a real disease, I fervently believe that PTSD is a real disorder and that people legitimately suffer from it. However, medicine is not separated from society and culture. The very notion of a traumatic memory, the foundation of PTSD was not even an idea during the Civil War Era, and would not be an accepted theory of psychiatry until the 1890s. PTSD would have been a foreign concept to Civil War veterans and asylum superintendents. However, brain chemistry has not changed significantly since Appomattox. While the disorder itself is not universal, elements of it perhaps are. The signature symptom of PTSD is an invasive re-experiencing of a traumatic event (war, natural disaster, or rape) through nightmares, flashbacks or hallucinations. A look through asylum records, diaries, letters and postwar memoirs reveals a disturbing number of Civil War soldiers, and later, veterans, who confessed to suffering through frightening dreams of the hospital ward or picket post. While we cannot definitely say that Civil War soldiers suffered with PTSD because we cannot send a psychiatrist back in time, the evidence seems clear that some soldiers were traumatized by their experience in ways eerily reminiscent of PTSD.
I hope that Invisible Wounds will expand readers' knowledge and understanding of this understudied aspect of the Civil War Era. I also hope it will generate further discussion and debate about these very interesting and relevant issues.
 Edward Ayers in Karen Halttunen and Lewis Perry, eds., Moral Problems in American Life: New Perspectives on Cultural History (Ithaca: Cornell University Press, 1998), 165.
 Maris A. Vinovskis, “Have Social Historians Lost the Civil War? Some Preliminary Demographic Speculations,” The Journal of American History 76 (June 1989), 34.
 Ibid., 57.
 Drew Gilpin Faust, This Republic of Suffering: Death and the American Civil War (New York: Alfred A. Knopf, 2008), 3-9; Stephen Berry, “Forum: The Future of Civil War Era Studies,” (http://journalofthecivilwarera.org/forum-the-future-of-civil-war-era-studies/); Brian Craig Miller, Empty Sleeves: Amputation in the Civil War South (Athens: The University of Georgia Press, 2015), 3-9; Daniel E. Sutherland, A Savage Conflict: The Decisive Role of Guerillas in the American Civil War (Chapel Hill: The University of North Carolina Press, 2009), 117-140; David Silkenat, Moments of Despair: Suicide, Divorce, and Debt in Civil War Era North Carolina (Chapel Hill: The University of North Carolina Press, 2011), 2-11; Diane Miller Sommerville in Stephen Berry, ed., Weirding the War: Stories from the Civil War’s Ragged Edges (Athens: University of Georgia Press, 2011), 322; James Marten, “Nomads in Blue: Disabled Veterans and Alcohol at the National Home,” in David A. Gerber, ed., Disabled Veterans in History (Ann Arbor: The University of Michigan Press, 2000), 289; James Marten, Sing Not War: The Lives of Union and Confederate Veteran in Gilded Age America (Chapel Hill: The University of North Carolina, 2011), 30
 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (Washington, D.C.: American Psychiatric Association, 2000), 464-469.
 Eric T. Dean, Jr., Shook Over Hell: Post-Traumatic Stress, Vietnam, and the Civil War (Cambridge: Harvard University Press, 1997), 159.
 Silkenat, Moments of Despair, 53; Sommerville in Stephen Berry, ed., Weirding the War: Stories from the Civil War’s Ragged Edges (Athens: University of Georgia Press, 2011), 322.
 Rusty Williams, My Old Confederate Home: A Respectable Place for Civil War Veterans (Lexington: The University Press of Kentucky, 2010), 146; James Marten, Sing Not War: The Lives of Union and Confederate Veteran in Gilded Age America (Chapel Hill: The University of North Carolina, 2011), 30; Jeffrey M. McClurken, Take Care of the Living: Reconstructing Confederate Veteran Families in Virginia (Charlotte: University of Virginia Press, 2009), 51.
 Paul A. Cimbala, Veterans North and South: The Transition from Soldier to Civilian after the American Civil War (Denver: Praeger, 2015), xii-xvi.
 Gary W. Gallagher and Kathryn Shively Meier, “Coming to Terms with Civil War Military History,” Journal of the Civil War Era, 4 (December 2014): 492.
 Gaines M. Foster, “Coming to Terms with Defeat: Post-Vietnam and the Post-Civil War South,” Virginia Quarterly Review 66 (1990): 20-22.
 Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton: Princeton University Press, 1995), 5-9.
 Frances Clarke, “So Lonesome I Could Die: Nostalgia and Debates Over Emotional Control in the Civil War North,” Journal of Social History 41 (2007), 254.
 Wayne Wei-Siang Hsieh, “‘Go to Your Gawd like a Soldier’: Transnational Reflections on Veteranhood,” The Journal of the Civil War Era 5, no. 4 (December 2015), 554.
 Young, The Harmony of Illusions, 5-6.