• Nearly all of the characters in The Things They Carried experienced symptoms of Posttraumatic Stress Disorder. There was at least one character in the book that suffered from PTSD symptoms during the war and more that suffered the symptoms post-war. Of the characters developing PTSD during the war, Rat Kiley was clearly the more severe case. If not severe, then his case was still the most terrifying because of its sudden and seemingly out-of-nowhere emergence.
    The four main categories of symptoms of PTSD include: (1) repeated “reliving” of the event, (2) avoidance, (3) numbing, and (4) hyper arousal. It only takes a certain number of symptoms under two or three of the four categories to be diagnosed with PTSD and the symptoms vary from person to person. Rat Kiley did not have PTSD yet but was clearly progressing into a seriously unhealthy state of mind.
    As far as O’Brien’s book tells us, Kiley could not be determined to have suffered “reliving” the event. His mind did manage, though, to produce morbid hallucinations about his accumulated war experience. “Sometimes he’d stare at guys who were still okay, the alive guys, and he’d start to picture how they’d look dead. Without arms or legs – that sort of thing. It was ghoulish, he knew that, but he couldn’t shut off the pictures. He’d be sitting there talking to Bower or Dobbins or somebody, just marking time, and then out of nowhere he’d find himself wondering how much the guy’s head weighed, like how heavy it was, and what it would feel like to pick up the head and carry it over to the chopper and dump it in…‘at nigh the pictures get to be a b***h. I start seeing my own body. Chunks of myself. My own heart, my own kidneys…I can see the mongooses munching on my bones.’” After being sent back home, surely the sounds of mosquitoes buzzing past his left ear would be enough to force him under a table - or into the fetal position - and into a fit of rambling about meat and bug-food. The sound of the summer cicadas in Japan would have most definitely made it impossible to keep a window open for so much as a bit of fresh air, making him the hospital’s very own hermit.
    Kiley really did not avoid much. It was only briefly that he withdrew from the group to sink into himself. It was never truly stated in the book that he was in such a fear that he avoided anything. One can imagine, however, that he did his best to avoid the bugs. Most people developing PTSD tend to avoid talking about the trauma in order to keep from thinking about it. Rat Kiley spouted theories about the mutant, bone-munching mongooses but he never told anyone his fears until he broke down in front of Mitchell Sanders. Later, in Japan he may have avoided going anywhere near the emergency rooms. He would have more than likely avoided conversing with people who were missing arms or legs.
    Numb would not be the proper word for Kiley’s emotional condition. It’s not that he was hopeless to the point where all was lost. He was just hopelessly frustrated by the idea of not having a future. “‘This whole war,’ he said. ‘You know what it is? Just one big banquet. Meat, man. You and me. Everybody. Meat for the bugs.’” His words are tinted with inklings of intimations that his death is as certain as a pig’s sent to a slaughter house to be later severed on someone’s dinner table.
    The category from which Kiley suffers the most symptoms is from the last; hyper arousal. He suffered from insomnia, and nightmares must have been a problem. “He couldn’t sleep during the hot daylight hours; he couldn’t cope with the nights.” Many of the soldiers agreed that the whole country of Vietnam seemed to be of flesh and blood during the night and swore that it lived. “He claimed the bugs were personally after his a**…bastards homing in on him…they had him bracketed…Whispering his name…the night had its own voice…The monkeys chattered death-chatter.” Kiley was hyper vigilant…always on red alert. He was always over sensitive to all the sounds of the wild. It was bad enough for his comrades, but he must have taken it to a higher level to have combined his oversensitivity with paranoia and schizophrenia.
    Rat Kiley did not definitely have PTSD during his time spent at war but was it inevitably sure that he would come to develop it. He was already picking up habits of people living with PTSD such as self-destructive behavior; Rat never ceased his terrible habit of scratching the bug bites that marked his skin. “Constantly scratching himself. Clawing at the bug bites. He couldn’t quit digging at his skin, making big scabs and then ripping off the scabs and scratching the open sores.” A competent therapist would firstly subscribe Rat to some powerful meds to handle depression and insomnia. He would more than likely give him some SSRIs and the mental treatment would start of at some basic type of cognitive behavioral therapy then finally move on to exposure therapy to force Kiley to face his fears and get over them. Of course, he would have to be doing very well in the more basic type of cognitive therapy in order to proceed with the exposure therapy.

    Works Cited

    Diagnose Me.com. 07 Nov. 2008. The Analyst. 18 Jan. 2008. <http://www.diagnose-me.com/cond/C456835.html>

    O’Brien, Tim. The Things They Carried. New York: Broadway Books, 1990.

    U.S. Department of Veterans Affairs. National Center for PTSD. 16 Jan. 2009. <http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_what_is_ptsd.html>