'Moral injury' as a wound of war

For years now I've been saying there are different types of PTSD just as there are different causes. Now it looks like "experts" are finally taking this seriously. Combat PTSD and PTSD in law enforcement should not be treated the same way a survivor of a natural disaster is treated. The cuts in veterans and police officers is deeper and different from the others. The simple reason is, others are simply survivors of the traumatic events but combat troops and cops are participants in them. Thank God they are willing to risk their lives for the rest of us and stop treating them as if they are like the rest of us.

MILITARY: 'Moral injury' as a wound of war
Conference to examine consequence of battlefield transgressions, exposure to carnage

Story Discussion By MARK WALKER - mlwalker@nctimes.com


A group of mental health experts is giving a name to the guilt and remorse troops feel when they see or do bad things during war: moral injury.

They say failure to recognize and acknowledge exposure to military or civilian carnage in Iraq and Afghanistan sets up troops for post-traumatic stress, a severe and often debilitating anxiety disorder that affects 1 in 5 combat troops.

The experts' findings on the emerging war wound will be discussed at a combat stress conference May 18-20 in San Diego. A study of the issue was first published in December in Clinical Psychology Review. Moral injury is not now officially recognized as a mental health malady.

The principal author of the moral injury paper, Dr. Brett Litz, said he and his colleagues are calling for wide-scale research into the issue to validate its existence and how it may lead to post-traumatic stress.

"Moral injury can occur from what you witness or what you do," said Litz, a clinical psychologist, professor and counselor for the Department of Veterans Affairs. "I've been seeing veterans for 24 years, and when people who seem well-adjusted and doing fine really talk about their war experiences, what often emerges is sadness about the loss and what they saw. That is moral injury."

Litz and his collaborators specifically define a moral injury experience as "perpetrating, failing to prevent, bearing witness to or learning about acts that transgress deeply held moral beliefs and expectations."

They argue that service members who don't talk to loved ones, clergy or some other confidant will become convinced what they did is unforgivable, leading to recognized symptoms of PTSD, such as withdrawal, self-condemnation and avoidance.

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Moral injury as a wound of war