PTSD Or Moral Injury


I’ve been in Veteran Caregiver support groups for a little over a year now. I see a lot of the same thought processes with our veterans, same issues, same emotions. While their experiences might not be identical, they are similar and carry on the same depressive patterns, the same thought patterns.

I’ve heard many veterans say something along the lines of, “It should have been me,” or “I deserve it all,” or “it’s my fault,” or even “God hates me.” A world of untruths swim through their brains and rarely escape their self-talk. When they do, their spouses/caregivers are left not knowing what to do or how to respond. No amount of “no” or “that’s not true”, or any variation, will sink in to their heart and let them believe that they don’t deserve this punishment, thus compounding their physical pain with emotional.

The things they’ve seen, the things they’ve done, all while in the danger zone could cause them to go against their core values of good and evil. Even though they may have seen some horrible things, or even possibly done some horrible things, it was all done to save lives. But in their heart, they know it’s wrong and it’s damaged their soul so deep that they can’t see any way to atone for that sin. They feel shame so great it consumes them. It’s like they are punishing themselves for everything they saw, everything they did or didn’t do. Punishment, or atoning for their sins. However you look at it, it’s a constant battle raging between logic and emotion. Logically, they know what they saw or did they had to do. Emotionally, they know it was wrong. And as I always say, the logical and the emotional brain never play nice with one another.

People call it Post Traumatic Stress Syndrome. But PTSD stems from life-threatening fear. And while there is plenty of fear associated with war, the military, with combat and hazardous zones, that fear can be addressed and become manageable and livable. What I’ve been seeing lately, though, is not necessarily fear, but more guilt and shame. It’s those things that the veteran has bore witness to, failed to prevent, or even committed that can tear their psyche apart.

David Wood says that “moral injury is a violation of what each of us considers right or wrong.”  PTSD has been recognized since the 1980s. Unfortunately, DoD has yet to recognize moral injury as a separate diagnosis. Doctors seem to always treat the wound, but never address the underlying cause, so it continually festers. The wound will sometimes scab over and things will look like they’ve gone back to a normal balance. Without addressing and finding ways to cope with that black spot, finding a way to accept it for what it is, thoughts will always chafe it and the wound begins to ooze, bringing the depression back to the forefront of everything once again.

It’s like putting a band-aide on a severed limb. If you’ve been in the military any length of time you’ll know what I’m talking about. Motrin, the wonder drug. That’s the go-to medication for any pain you go in to sick call or the hospital for. Military or civilian, it doesn’t matter. Motrin will fix it. If it doesn’t then you go back and go back and go back. We’ve been out now for almost 13 years and have been treated at both the VA and civilian doctors. We’ve only experienced one doctor who was baffled at the cause of his migraines. It wasn’t until about a year ago when he ordered a full head and neck MRI that he realized what was causing them. This doctor was the only one who wanted to get to the bottom of the why. Unfortunately, we are still at the same place with that. There’s no real way to fix it. We just try to manage the pain.

Not so easy for what they suffer alone in the darkness, though. It’s not something they want to talk about. It’s not pretty. It’s not politically correct. It makes the veteran uncomfortable. It makes the listener uncomfortable. If we never see or hear about it, it never happened, right? Wrong. Sweeping the undesirable under the rug doesn’t make it go away. It’s always there. For those living it, for those living with it. That truth is a lump under the carpet we try to avoid, but sometimes trip over. The truth is the truth, whether spoken or unspoken. The truth hurts. The truth is ugly. War is ugly. But it’s something that must be done at times and rather than ignore the problems that come from it, we should educated, understand, empathize, and help. Who are we to judge? Who are we to say what warrants this punishment or if it’s distorted? It is what it is and we must treat it. But the world always judges and that’s what keeps them in the dark.

This is going to take a long time to learn how to deal with. All we can do is be present. So, I’m here, always by his side. I am doing my best to help keep his hope alive, to help him see that what he did, or didn’t do, is not his fault, it’s not God punishing him, and that he doesn’t deserve it. I will offer my forgiveness, even though that’s not the forgiveness he needs. I will offer up that God forgives everything, all he has to do is ask. But it’s not enough. It’s never enough.

It hurts my heart deeply to see the torment TheHubs goes through. I know I will probably never know it all. What I do know is that I will forever be by his side, no matter what. He has to come to terms with it all and believe that he did what he had to do and did it well and honorably. He has to believe that what he couldn’t control is through no fault of his own, and his actions were always honorable even though someone else acted too late. He has to believe that he doesn’t deserve the punishment he’s putting himself through because of the situations he lived through. I cannot make him believe these things. I can only reinforce them and keep telling him, and hope that one day he will believe. Once this happens, he can be at peace, I think. Until then, I will continue my fight for him.

LadyJai

Related Articles you may like:
Present
You Are Not Alone
My poem about depression and hope, entitled Pieces
Moral Injury: The Grunts
Moral Injury: Healing

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