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MacNair concedes that researchers know of numerous wartime triggers for PTSD, but her theory is that killing someone is the most severe.
Murtaugh calls MacNair's work "groundbreaking" and has asked her to help design a follow-up study. And her efforts lured a standing-room-only crowd at an American Psychiatric Association meeting in August 2000, where MacNair shared a conference-room stage with two other PTSD authorities, Lt. Col. David Grossman (a Vietnam veteran and West Point psychologist) and William Chamberlain (who runs anger-management sessions for the VA's PTSD unit in New York).
Grossman's 1995 book On Killing cites a study by World War II historian Samuel Lyman Atwood Marshall, who interviewed troops after battle and concluded that only 15 percent to 20 percent of the men on the front lines had fired their weapons and that those who did often aimed high to avoid killing. Marshall said the reason wasn't cowardice; the men had stood their ground and performed other battle duties unwaveringly.
Grossman's position was similar to MacNair's. "Looking another human being in the eye, making an independent decision to kill him, and watching as he dies due to your action combine to form the single most basic, important, primal, and potentially traumatic occurrence in war," he had written in his book.
By Vietnam, troops had been retrained to shell entire battle areas rather than just to fire at specific targets. Ninety percent of men discharged their weapons -- supposedly at a ratio of 50,000 bullets for every one enemy soldier killed. MacNair discussed that evolution in combat strategy in her own book, Perpetration Induced Traumatic Stress: The Psychological Consequences of Killing, put out by Praeger Publishers, a textbook publishing company, in 2002. Recapping her research, she noted that such traumas have existed everywhere, in every culture and time period, not just in war. There are other risk groups to consider, she writes -- police officers who kill in the line of duty, prison executioners, abortion practitioners, even bullfighters and veterinarians who practice euthanasia. She supported her argument with a loosely connected series of anecdotes, referring to an NBC Dateline story about a police officer who committed suicide and to historical notes about the mental deterioration of Nazis after they had slaughtered Jews in concentration camps. She cited PTSD allusions from Dostoevsky's Crime and Punishment, Poe's The Tell-Tale Heart, Shakespeare's Macbeth and an episode of Star Trek Voyager.
"It shows that it's not some modern idea. It's been there throughout history," she says of the PITS concept. That her theory presented the foundation for a wide-scale platform against violence was no surprise. Before enrolling at UMKC, MacNair had made a career of confrontational activism.
MacNair has other statistics -- on her rap sheet. She has been arrested for civil disobedience 17 times -- 7 for protesting nuclear armament, 5 for protesting nuclear power plants and 5 for protesting an abortion clinic.
She was raised on political doctrine. Her father was a preacher and theologian, as was her grandfather (who was arrested at a civil rights sit-in in Alabama) and her great-grandfather (who proselytized in Thailand). Her mother heard Martin Luther King Jr. give his "I Have a Dream" speech in Washington, D.C., in 1963. MacNair spent her early childhood bouncing throughout the Midwest as her father chased lectern and pulpit work; MacNair's parents divorced in the late '60s, and she and her mother moved to Kansas City, settling in a bungalow with a big front yard near the Nelson-Atkins Museum of Art. MacNair's mother told her she could be whatever religion she wished.
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