RSN August 14 Fundraising
FB Share
Email This Page
add comment
Print

Gregg Zoroya reports: "The idea of 'moral injury' as a cause of PTSD is new to psychiatry. The American Psychiatric Association is only now considering new diagnostic criteria for the disorder that would include feelings of shame and guilt, says David Spiegel, a member of the working group rewriting the PTSD section. Traditionally, PTSD symptoms such as nightmares or numbness to the world have been linked to combat violence, fear of being killed or loss of friends."

An anxious Marine waits to take psychological tests at the Marine Corps Air Ground Combat Center in Twentynine Palms, CA, 09/29/09. (photo: Jae C. Hong/AP)
An anxious Marine waits to take psychological tests at the Marine Corps Air Ground Combat Center in Twentynine Palms, CA, 09/29/09. (photo: Jae C. Hong/AP)



Feelings of Guilt May Be Top Factor in PTSD

By Gregg Zoroya, USA Today

26 November 11

 

leading cause of post-traumatic stress disorder is guilt that troops experience because of moral dilemmas faced in combat, according to preliminary findings of a study of active-duty Marines.

The conflicts that servicemembers feel may include "survivor's guilt," from living through an attack in which other servicemembers died, and witnessing or participating in the unintentional killing of women or children, researchers involved in the study say.

"How do they come to terms with that? They have to forgive themselves for pulling the trigger," says retired Navy captain Bill Nash, a psychiatrist and study co-author.

The idea of "moral injury" as a cause of PTSD is new to psychiatry. The American Psychiatric Association is only now considering new diagnostic criteria for the disorder that would include feelings of shame and guilt, says David Spiegel, a member of the working group rewriting the PTSD section.

Traditionally, PTSD symptoms such as nightmares or numbness to the world have been linked to combat violence, fear of being killed or loss of friends.

Half of all Iraq and Afghanistan veterans treated by the Department of Veterans Affairs have been diagnosed with mental health issues and the most common is PTSD, which is experienced by nearly 200,000 of these veterans, according to the VA.

PTSD caused by moral injury can lead to more severe reactions such as family violence or even suicide, says Jonathan Shay, a psychiatrist who has worked on military mental health policies.

The Marine Corps study helps expand the knowledge of the relationship between moral injury and PTSD, says Shira Maguen, a psychologist and VA researcher who has studied links between killing and the disorder among Vietnam War, Gulf War and Iraq War veterans.

"This (Marine Corps) study is important because so little work has been done to understand moral injury in a scientific context," Maguen says.

The ongoing research involves about 2,600 Marines and sailors examined before and after combat tours.

The preliminary findings on moral injury were gleaned from 208 Marines involved in severe combat in Afghanistan in 2009 and 2010. It showed that three months after coming home, 7% of the Marines likely had PTSD. Their condition was more closely linked to an inner conflict rather than threats to their lives, the sight of bodies or blood or family problems, the study said.

 

Comments   

We are concerned about a recent drift towards vitriol in the RSN Reader comments section. There is a fine line between moderation and censorship. No one likes a harsh or confrontational forum atmosphere. At the same time everyone wants to be able to express themselves freely. We'll start by encouraging good judgment. If that doesn't work we'll have to ramp up the moderation.

General guidelines: Avoid personal attacks on other forum members; Avoid remarks that are ethnically derogatory; Do not advocate violence, or any illegal activity.

Remember that making the world better begins with responsible action.

- The RSN Team

 
+22 # PAULA 2011-11-26 19:18
I am not military but I have PTSD Have been diagnosed as a chronci clinical depressive and diagnose with PTSD as a prisoner of war would have.
I promise you the inner conflict is WHY
 
 
+30 # pernsey 2011-11-26 19:29
Its very sad, these guys probably have to do things morally they would never do outside of military duty. God be with them and help them get through their issues.

More casualties of the Bush/Cheney war...I pray our leaders try to have some conscience, instead of just being puppets for their corporate masters, not to get us involved in any confrontation with Iran. ENOUGH IS ENOUGH!!!
 
 
+6 # Bluesguy 2011-11-27 01:17
Guilt is the part that...lasts.
PTSD is not curable, per se; it becomes a part of you.
How you deal with it is..problematic ; but there is hope, esp for the newer guys over there as Imperial troopers obtaining spice., I mean oil/gas, for "us."
VA Sec'y Shinseki-rememb er, the real vet Roomsveldt fired?-ordered that now the PTSD-originatin g incident does not nec have to witnessed, or proved, but there is the Cmp&Pension process.
There is new money allocated for this, finally;also, military suicides reached an all-time high just now.
We need the draft reinstated.
More about PTSD later, if poss. :)
 
 
+2 # uuzul 2011-11-27 04:09
Why isn't the word getting to the vets that they can use WREMS (www.wakingrem.com)? Someone who has experienced trauma can - inexpensively - use this process, on their own, to help undo the emotional damage sustained. All they need is the workbook and to follow instructions.
For years I've tried to bring this to veterans, and other victims of violence -- not only a safe way to change one's mind, but gain real understanding of emotions.
Here's hoping the word now gets out.
 
 
+9 # lydiablanchard@yahoo.com 2011-11-27 05:25
There is another level of guilt, which is when we direct guilt toward ourselves for having both betrayed ourselves and betrayed our deep knowledge of right and wrong in relation to all.

Powers-that-be may convince us to do moral injury to ourselves and others, leading some of us to feel guilty. This injury and guilt may occur when people hiding behind authoritarianis m lead us to believe that it is OK for us or our offspring to harm or kill others or be killed in the name of our country, religion, or other cause. Even self-preservati on is ironically an allowable reason for its being OK to be killed or to kill.

That dynamic may be seen as a giant betrayal of our selves, leading to guilt, because we allowed ourselves to buy into it under social pressure. When it is OK to acknowledge that "war is not the answer", no matter who tells us that it is the answer, we may stop killing others and ourselves and start trusting ourselves and our connection with morality and the Godness within.

This insight is borrowed from the poet Robert Bly in a talk heard in 1983.

From philosopher Martin Buber there is the suggestion that we treat our consciences as bowls filled by others, in part. We may benefit from examining the elements in our bowls and choosing whether each is worth keeping or modifying.
 
 
-1 # Nel 2011-11-27 05:56
"Moral Injury?" Still trying to smuggle medicine ("injury") into moral matter. Psychiatry/Psyc hology refuses to learn from Lady Macbeth.
 
 
+1 # helenschieffer@aol.com 2011-11-27 08:23
It would appear that PTSD is often what what was once known as a 'guilty conscience'. If so sufferers could obtain relief by acknowledging their crimes against humanity (sometimes called 'repentance') and engaging in some form of positive activity as expiation for their misdeeds.
 
 
+5 # Bluesguy 2011-11-27 19:00
Quoting helenschieffer@aol.com:
It would appear that PTSD is often what what was once known as a 'guilty conscience'. If so sufferers could obtain relief by acknowledging their crimes against humanity (sometimes called 'repentance') and engaging in some form of positive activity as expiation for their misdeeds.

I can tell your heart is in the right place; but your observation PTSD usually=guilty conscience is kinda like saying a brain tumor, or chain migraines is usually the same as a headache.
It goes much deeper than that-forgiving yourself is an important part of it-every vet i know has been punishing themselves for years; but, if I meet you, I will be sure to apologize.
Do some research, and thanks for your concern, if that what you are putting forth. The returning guys will need Tx for it; tha VA budget has been increased for this, and VA Sec plan to end vet homelessness within 5 years.
 
 
+7 # John Locke 2011-11-27 09:23
Humans are Not made to kill other humans except for those who are insane, to kill one of our own species i believe is enough to cause Post Tramatic stress
 
 
+2 # Marty 2011-11-27 09:43
There is an event scale where certain events are rated from a 1 to 10. In one year, 3 deaths a week apart. Next week father in hospital and next week he died. 4 months later a 15 ton truck, not knowing 5 cars were waiting on Southfield Freeway in Detroit for a person up front clearing debris off the roadway. I seen him coming over hill at Michigan Ave knowing he was helpless to stop I closed my eyes and he placed the truck between wall and me. Then before 9/11 I was laid off. All rated a 10 each. On 9/11 a mind numbed because my previous job involved travel weekly and Beamer, who was on the Shanksville flight, was also an employee at Oracle. PTSD you bet. But raising another factor could be added to the list of causes, after all we are all different even to experiences.
 

THE NEW STREAMLINED RSN LOGIN PROCESS: Register once, then login and you are ready to comment. All you need is a Username and a Password of your choosing and you are free to comment whenever you like! Welcome to the Reader Supported News community.

RSNRSN