Echoes That Follow Us: Understanding ASR, Startle Reactions, and PTSD
By Del Albright
Introduction: The Holidays Aren’t Easy for Everyone
Most folks see the holidays as a time for family, lights, warm gatherings, and nostalgia.
But for many combat veterans—especially those of us from Vietnam—the season can also stir up memories, emotions, and echoes we carry inside. And sometimes these echoes grow louder when the world around us grows quieter. I share this in the spirit of compassion for many of my fellow vets
This isn’t a sad story. It’s an honest one. Because veterans deserve clarity, understanding, and compassion—not labels that confuse or dismiss what we’ve lived through. Families deserve to understand what is often not discussed around the family table.
Today I want to talk about three terms that have been used to describe what combat can leave behind:
Acute Situation Reaction (ASR) – heard in Vietnam-era military circles
Extreme Startle Reaction – something the VA still mentions
Post-Traumatic Stress Disorder (PTSD) – the modern clinical diagnosis many of us now carry
And I want to put them in plain language, from a soldier’s perspective—not a textbook.
1. What Was “Acute Situation Reaction”?
Back in the ’60s and ’70s, the military used a term many people today have never heard: Acute Situation Reaction (ASR).
It essentially meant a strong, immediate psychological reaction to overwhelming stress—combat, fear, chaos, loss. In plain English, it was the mind’s emergency flare going up.
ASR could include:
shaking
freezing
crying
confusion
emotional shutdown
withdrawal
or overwhelming panic after trauma
In Vietnam, this was often dismissed as temporary. Something a soldier was supposed to “shake off” before being sent right back into the field—just like the hard scene in the 1980s TV series, China Beach, that sparked this whole discussion. ASR wasn’t seen as a lasting wound. It should have been.
2. What the VA Often Calls “Extreme Startle Reaction”
Many veterans, including myself, have heard this phrase tossed around by medical docs and examiners.
Extreme Startle Reaction is usually described as:
snapping to attention at sudden noise
diving for cover
heart pounding from an unexpected sound
jumping at fireworks, slamming doors, helicopter blades, or even a dropped pan
Some VA clinicians treat this as a symptom rather than a diagnosis. Others treat it like something you “just learn to live with.”
But for many combat vets, it’s not a separate issue—it’s one of the lasting fingerprints of trauma. An echo from being wired for survival.
3. PTSD: What We Now Recognize as a Real Wound
Today, we have the term Post-Traumatic Stress Disorder, a far more accurate understanding of what war can leave behind.
PTSD acknowledges:
hypervigilance
nightmares
intrusive memories
mood changes
emotional numbness
difficulty sleeping
avoidance
and yes—extreme startle responses
PTSD encompasses what earlier generations called shell shock and what Vietnam vets called the shakes, nerves, or just “my baggage.”
It’s not weakness. It’s not failure. It’s a wound—just not one you can see on an X-ray. And it’s not confined to combat veterans or military personnel. Many of us suffer from one form or another of PTSD – and seldom talk about it.
4. Why the Definitions Matter
Because the label you’re given affects:
how society understands you
how family sees you
how the VA treats you
and how you treat yourself
Vietnam veterans especially endured decades of mislabeling, misunderstanding, and under-treatment. We carried things alone that should never have been carried alone.
ASR → Startle Reaction → PTSD. It’s the story of how a nation slowly learned to name what war takes from warriors.
5. Holiday Season: When Echoes Get Louder
During the holidays:
memories resurface
empty chairs are more noticeable
quiet moments are less quiet
the contrast between “joy” and “echoes” grows sharper
- lost ones are heavy on the mind
Even holiday music, decorations, or old TV reruns—like China Beach—can unlock memories you tucked away decades ago.
If this is you, you’re not broken. You’re human.
6. A Message to Veterans and Families: These Echoes Don’t Define Us
Let me speak directly to my brothers, sisters, and families:
**Combat changes a person.
It does not diminish them.**
Those echoes—whether they’re ASR, startle reactions, or full-blown PTSD—are reflections of the moments we survived, the people we loved, and the responsibilities we carried when we were young and far from home. They are not signs of weakness. They are signs that we lived through something real.
Many of us came home still wired for danger long after the danger ended. Some of us still are.
But we are more than those reactions.
We are fathers, mothers, husbands, wives, workers, leaders, mentors, storytellers, caretakers—
and we still have a place in this world.
If you’re struggling this holiday season, reach out to someone who gets it.
If you’re doing well, reach back and pull someone else forward.
If you’re a family member, offer patience and compassion—it makes more difference than you know.
Because healing doesn’t come from ignoring the echoes. It comes from understanding them…and from remembering we’re not alone with them.
Closing Thought
That old China Beach theme said something about reflections in the “mirror of my mind” —a perfect way to describe the memories that follow combat veterans through the decades.
We don’t erase those reflections. But we can learn to live with them with dignity, clarity, and strength.
And that, to me, is a message worthy of the holidays.