The Research That Led to a Novel

Years before I started my Ph.D. in psychology, I found myself drawn to stories of resilience—stories of people who bounced back, even though atrocities had defined their lives. I read Victor Frankl’s book, Man’s Search for Meaning; I read about prisoners from previous wars; and even visited Dachau.

I was in the throes of divorce, nothing compared to a captivity situation, but one that caused me to experience a deep depression. When the worst of the depression had passed, I started my studies with the Fielding Graduate Institute with the topic of my dissertation already in mind. What will it take for me to bounce back from this horrible marriage? I decided to ask the experts.

 I contacted Paul Galanti, the then-president of NAM-POW, an organization of U.S. service members held as prisoners in North Vietnam. He put me in touch with navy Captain Robert Mitchell who invited me to join his research team in Pensacola in the spring of 1995 to work as a Red Cross volunteer for the Robert E. Mitchell Center for Prisoner of War Studies. This special program of the Naval Aerospace Medical Institute (NAMI) provides follow-up evaluations of repatriated prisoners of war (RPOWs) from Vietnam, Desert Storm, and Operation Iraqi Freedom to study the mental and physical effects of captivity and to address the findings’ applicability to current military operations. A unique institution, NAMI singularly holds the longitudinal database of the long-term effects of repatriated POWs. 

As part of the team, I learned that in captivity situations prior to the Vietnam War, evidence indicated there had been high incidences of PTSD (about 50-90%), or what psychologists once called “shell shock.” Because of these staggering numbers, in 1976 the Navy, under the leadership of Captain Mitchell, began a study of 138 repatriated Vietnam POWs, including John McCain, and a control group with equal numbers. 

 In 1996, the research team reached surprising conclusions about the data we had collected. This study revealed that fewer than 6% of the repatriated VPOWs had received a diagnosis of PTSD. We expected percentages of PTSD among the Vietnam group would be lower; we had no idea they would be that low. 

  These data astound when comparing the Vietnam group to other captivity situations, but they astonish when the implications become clear. To give a frame of reference, because of violent crimes, natural disasters, pandemics, and other kinds of trauma, at any time, about 5-10% of the population of any city experiences some symptoms of PTSD. In other words, this group of POWs, who had been imprisoned and brutalized for more than five years, had no higher incidence of PTSD than the people of any major city. How could that be? I wanted to know. My research, in conjunction with other data, uncovered the pivotal decisions each POW made to stay resilient—decisions about his beliefs, identity, and life’s purpose. In short, through their system of communication, they figured out how to do what hadn’t been done before.