Troops talk of how war assaults conscience

First, it was Vietnam veterans being studied that had researchers looking at the "moral wound" and what PTSD does to the men and women risking their lives in combat. Second, as this article points out the "largest group since Vietnam" it avoids mentioning the fact that Vietnam veterans are the forgotten generation in all of this.

If you want to read one of the best books on "moral injury" then read Achilles in Vietnam by Dr. Jonathan Shay published in 1995.

You can also watch this video

Achilles in Vietnam
from Charles Berkowitz
This documentary, developed as an undergraduate thesis film by director Charles Berkowitz, is based on the groundbreaking book, "Achilles in Vietnam : Combat Trauma and the Undoing of Character", by Dr. Jonathan Shay. In it, Shay examines the psychological devastation of war by comparing the soldiers of Homer's Iliad with Vietnam veterans suffering from post-traumatic stress disorder. Although the Iliad was written twenty-seven centuries ago it has much to teach about combat trauma, as do the more recent, compelling voices and experiences of Vietnam veterans.

Achilles in Vietnam from Charles Berkowitz on Vimeo.
They didn't take care of the veterans they already had and that is why things are as bad as they are now. None of this is new but it seems as if social media is rewriting history so that we forget how long they have had to get this all right for all veterans.

Moral injury: Troops talk of how war assaults conscience
Military.com
By Patricia Kime, Staff writer
November 19, 2015

“The largest group of veterans who have served our country since Vietnam are home," Sherman said. "And we need to help.”

Former Army Reserve Capt. Josh Grenard thought the anguish of losing men in combat would eventually wane in the years after a deployment to Iraq. But when soldiers from his unit began committing suicide, the wounds reopened — fresh, raw and painful.

“It’s almost two sets of injuries — but having your men kill themselves is wholly different,” Grenard said. “Was there something I could have done? Was there a way we could have gotten them help? Should I have seen it?”

He found himself slipping into isolation, going to his law office each day but questioning his very existence. He drank from 7 a.m. to 10 p.m. daily — “very metered, all day.”

“You don’t want to think about anything. You don’t want to answer those questions,” he said.

Grenard was not suffering from post-traumatic stress disorder, the psychiatric condition normally associated with combat.

Rather, his feelings, which included crippling helplessness, emotional pain, guilt and frustration, are often described as “moral injury,” a psychological condition related to having done something wrong, being wronged by others or even witnessing a wrongdoing, argues Georgetown University philosophy professor Nancy Sherman.
read more here

New to PTSD? You May Be But It Isn't.

It seems as if everyone is shocked to read how ancient people suffered from what we call PTSD but they suffered even without having any name to give it. Sure we changed the term given generation to generation but nothing about it has changed much. That really sucks when you consider there has never been more done to treat it yet we have more reports on bad outcomes.

Ancient Assyrian Soldiers Were Haunted by War, Too

A new study finds evidence of trauma experienced by soldiers returning home from combat over 3,000 years ago
Smithsonian
By Laura Clark
January 26, 2015

In his account of battle of Marathon in 490 B.C., the Greek historian Herodotus recorded the story of a man that went inexplicably blind after witnessing the death of one of his comrades. Until recently, this was believed to be earliest-known record of what modern medicine calls post-traumatic stress disorder.

But now, as BBC News reports, a team of researchers says they’ve found references to PTSD-related symptoms in much earlier writings, dating from the Assyrian Dynasty in Mesopotamia, between 1300 B.C. and 609 B.C. They published their findings in the journal Early Science and Medicine with an article poetically titled “Nothing New Under the Sun.”

Soldiers in ancient Assyria (located in present-day Iraq) were tied to a grueling three-year cycle, the BBC notes. They typically spent one year being “toughened up by building roads, bridges and other projects, before spending a year at war and then returning to their families for a year before starting the cycle again.”

By studying translations of known texts, the historians were able to see just how familiar symptoms of PTSD might have been to Assyrian soldiers. Co-author of the study and director of the Anglia Ruskin University’s Veterans and Families Institute, Professor Jamie Hacker Hughs told BBC News:
read more here

It is actually in the Bible too and many other ancient accounts of war.
King David

His life is conventionally dated to c. 1040–970 BC, his reign over Judah c. 1010–1002 BC, and his reign over the United Kingdoms of Israel c. 1002–970 BC.[1]

Goliath Challenges the Israelites

17 The Philistines now mustered their army for battle and camped between Socoh in Judah and Azekah at Ephes-dammim. 2 Saul countered by gathering his Israelite troops near the valley of Elah. 3 So the Philistines and Israelites faced each other on opposite hills, with the valley between them. 4 Then Goliath, a Philistine champion from Gath, came out of the Philistine ranks to face the forces of Israel. He was over nine feet[a] tall! 5 He wore a bronze helmet, and his bronze coat of mail weighed 125 pounds.[b] 6 He also wore bronze leg armor, and he carried a bronze javelin on his shoulder. 7 The shaft of his spear was as heavy and thick as a weaver’s beam, tipped with an iron spearhead that weighed 15 pounds.[c] His armor bearer walked ahead of him carrying a shield. 8 Goliath stood and shouted a taunt across to the Israelites. “Why are you all coming out to fight?” he called. “I am the Philistine champion, but you are only the servants of Saul. Choose one man to come down here and fight me! 9 If he kills me, then we will be your slaves. But if I kill him, you will be our slaves! 10 I defy the armies of Israel today! Send me a man who will fight me!” 11 When Saul and the Israelites heard this, they were terrified and deeply shaken.

Fighting and Military Career

And there was war again. And David went out and fought with the Philistines, and killed them with a great slaughter. And they fled from him. (1Samuel 19:8)

Psalm 144 Of David.

1 Praise be to the Lord my Rock, who trains my hands for war, my fingers for battle. 2 He is my loving God and my fortress, my stronghold and my deliverer, my shield, in whom I take refuge, who subdues peoples under me. 3 Lord, what are human beings that you care for them, mere mortals that you think of them? 4 They are like a breath; their days are like a fleeting shadow. 5 Part your heavens, Lord, and come down; touch the mountains, so that they smoke. 6 Send forth lightning and scatter the enemy; shoot your arrows and rout them. 7 Reach down your hand from on high; deliver me and rescue me from the mighty waters, from the hands of foreigners 8 whose mouths are full of lies, whose right hands are deceitful.

God the Sovereign Savior but there is also Psalm 23

A psalm of David. 1 The Lord is my shepherd, I lack nothing. 2 He makes me lie down in green pastures, he leads me beside quiet waters, 3 He refreshes my soul. He guides me along the right paths for his name’s sake. 4 Even though I walk through the darkest valley, I will fear no evil, for you are with me; your rod and your staff, they comfort me. 5 You prepare a table before me in the presence of my enemies. You anoint my head with oil; my cup overflows. 6 Surely your goodness and love will follow me all the days of my life, and I will dwell in the house of the Lord forever.

And there is the mighty Achilles.

How dare they use a Spartan for "resilience" training?
Veterans were suffering nonetheless when no one noticed other than their families.

Jonathan Shay continues "missionary work" for PTSD Veterans in Town Hall

Dozens gather to join forces in battle against PTSD
UpNorthLive
by Meghan Morelli
Posted: 08.28.2014

GRAND TRAVERSE CO. -- Post-traumatic stress disorder impacts 5.2 million adults every year. On Thursday, 7 and 4 News held a Your Voice, Your Future Town Hall on PTSD at Milliken Auditorium in Traverse City.

A panel of experts discussed the causes, symptoms, effects, and treatments of PTSD.

“It’s a widespread thing especially with a lot of the troops coming home nowadays and it’s something that more people need to be educated on,” said veteran, David Graves.

One of the experts was Doctor Jonathan Shay, a former staff psychiatrist at the Department of Veterans Affairs Outpatient Clinic, Boston, where his only patients were combat veterans with severe psychological injuries.

Dr. Jonathan Shay
For 20 years Jonathan Shay was a staff psychiatrist at the Department of Veterans Affairs Outpatient Clinic, Boston, where his only patients were combat veterans with severe psychological injuries. He retired from clinical work in May, 2008 to devote himself full time to preventive psychiatry in military organizations—what he calls his "missionary work." He is the author of Achilles in Vietnam: Combating Trauma and the Undoing of Character (1994) and of Odysseus in America: Combat Trauma and the Trials of Homecoming (2002). He has been a MacArthur Fellow since January. He has written and lectured on a variety of topics relating to veterans for decades and held a variety of positions with US military institutions.

Linda Fletcher was also on the panel. She is a retired Army Nurse (Lieutenant Colonel) with a Masters in Trauma Nursing who has been involved in an independent study of Post-Traumatic Stress Disorder (PTSD) for the last eight years.

Jacquelyn Kaschel, MLitt, CEIP-MH, PNH1 was another expert in attendance. She is the Executive Director of PEACE Ranch. PEACE Ranch is a center for experiential growth & learning where rescued, rehabilitated horses and licensed professionals help people dealing with a broad range of challenges including Addiction & Recovery, Behavioral & Emotional Issues, Marriage & Family Issues, Grief & Loss, PTSD & Trauma related issues.

Doctor Neil was the final panel expert at the event. He is a licensed clinical psychologist, has been in private practice for over 20 years. He has specialized in treating trauma for more than half of his career. Dr. O’Donnell uses Eye Movement Desensitization and Reprocessing (EMDR) and body based approaches to help those suffering from PTSD.
read more here

When it comes to Combat and PTSD, Jonathan Shay is the smartest guy in the room

When it comes to Combat and PTSD, Jonathan Shay is the smartest guy in the room
by Kathie Costos
Wounded Times Blog
April 2, 2013

Way back in 1999 I had Achilles in Vietnam in my hands and was crying soon after I started reading it.

I wrote about Shay in my upcoming book, THE WARRIOR SAW, SUICIDES AFTER WAR for several reasons. He has been talking about PTSD before reporters cared but families like mine were living with it. He talked about the spiritual connection and how important community support was. Had Shay been listened to when the over 900 suicide prevention programs were being developed, we wouldn't have seen suicides go up and I wouldn't be writing a book on military suicides because families asked me to after they had to bury someone they loved.

This is one of the quotes from my book.

Jonathan Shay wrote Achilles in Vietnam and addressed this connection in 1994.

“Moral-ruin” Achilles possessed a highly developed social morality. This was reflected in his care for the welfare of other Greek soldiers, respect for enemies, living and dead, and the reluctance to kill prisoners. Achilles moral unluckiness, his tragedy was that events-simply what happened, created the desire to do things that he himself regarded as bad.”

Shay wrote about a three tour Vietnam veteran and how as a kid growing up thinking how God would judge what he did and what he was thinking at the time. Little things he was sure God would forgive him for even if He didn’t approve of what he did but in combat all that changed.

“But evil didn’t enter it ‘til Vietnam. I mean real evil. I wasn’t prepared for it at all. Why I became like that? It was all evil. Where before, I wasn’t. I look back, I look back today and I am horrified at what I turned into. What I was. What I did. I just look at it like it was somebody else.

War changes you. Strips you of all your beliefs, your religion, takes your dignity away, you become an animal.”
(Achilles in Vietnam, Jonathan Shay)

Moral Wounds of War: Jonathan Shay Part 1
ReligionEthics PBS

"Recovery happens only in community. Peers are the key to recovery."

PTSD Expert Jonathan Shay to Hold Discussion with Veterans at UNC
Asheville
University of North Carolina
April 1, 2013

Dr. Jonathan Shay, a renowned psychiatrist who has specialized in treating veterans of war, will offer three public talks, April 9-11, at UNC Asheville. He also will meet with UNC Asheville's Student-Veteran Alliance as well as students and community members.

The following events take place on the UNC Asheville campus and are free and open to the public:

Tuesday, April 9 – "Moral Luck," an examination of philosophical experiences of soldiers in combat, from Homer's "The Iliad" to present day. 7:30 p.m., Sherrill Center, Mountain View Room.

Wednesday, April 10 – "Theatre of War," exploring the role of the arts in healing of the physically and psychologically wounded. 7.30 p.m.,Highsmith University Union, Alumni Hall.

Thursday, April 11 – "Open Discussion – Sleep, Community and other Hobby Horses." Dr. Shay will lead a discussion with veterans and members of the community encouraged to participate. 7.30 p.m., Sherrill Center, Mountain View Room.

A clinical psychiatrist and humanities scholar, Dr. Shay is the author of groundbreaking books on the nature and treatment of PTSD (post traumatic stress disorder), and he is a recipient of a MacArthur Fellowship.

His visit to UNC Asheville is sponsored by the university's NEH Distinguished Teaching Professor in Humanities, Sophie Mills, who champions the use of ancient classics to understand contemporary issues. "By using Homer to illuminate modern veterans' experiences, he has created a powerful body of work that has broadened and deepened the understanding of humanists, military leaders and psychologists concerning military combat and its effects on human beings," she says.

Dr. Shay views PTSD as a psychological injury of war, not a mental disorder. In a New York Times interview, Shay said that when soldiers return home, they often retain behaviors they adopted for their survival in combat. "Most of it really boils down to the valid adaptations in the mind and body to the real situation of other people trying to kill you,'' he said. read more here

Marine with Spartan blood

I love small media outlets because they do the best reporting on our troops and veterans. The national media, not so much and frankly, AWOL on the one issue we can all agree deserve our attention. I was reading this story about a young Greek-American U.S. Marine talking about his faith in God, the Greek Church and Spartan blood. That got me thinking about the "moral injury" a lot of reports want to pretend is some kind of new phenomenon that is behind Post Traumatic Stress Disorder in combat veterans.

What choice do they have since most reporters given the task of reporting on PTSD and military suicides were in grade school or not even born when real research on PTSD began? To them, this is all new even though they must have had at least one combat veteran as a relative. They just didn't pay attention to their WWII granddads and Vietnam veterans any more than they paid attention to Gulf War veterans. Just because they didn't pay attention that didn't mean it was not happening as it was going back to the beginning of "civilization" when nation sent men to fight against other nations.

This is my favorite book on combat and PTSD because it is honest, thoughtful and written by a real expert on PTSD before reporters knew about it.

Achilles in Vietnam: Combat Trauma and the Undoing of Character
October 1, 1995
In this strikingly original and groundbreaking book, Dr. Shay examines the psychological devastation of war by comparing the soldiers of Homer's Iliad with Vietnam veterans suffering from post-traumatic stress disorder. Although the Iliad was written twenty-seven centuries ago it has much to teach about combat trauma, as do the more recent, compelling voices and experiences of Vietnam vets.

In this new year we can have a new beginning in defeating PTSD but only if we go back to when real research was being done and stop pretending PTSD is new.

Dr. Jonathan Shay "Indeed Moral Injury is one of the primary if not the primary personal theme for the soldiers described in his books "Achilles in Vietnam" and "Odysseus in America" leading to lifelong psychological dysfunction from PTSD and other treatment-resistant deficiencies in prior or basic functioning."

ACHILLES IN VIETNAM
A DOCUMENTARY FILM

From War Front to Home Front with Dr. Jonathan Shay

If the DOD, VA and service organizations really want to help these veterans heal, there is no one better to ask.

Veterans discuss issues
By Emily Ayers
Posted on 08 October 2012

Dr. Jonathan Shay hosted an informal discussion called “From War Front to Home Front” with veterans and active duty soldiers following the workshop “PTSD and Moral Injury: What’s the Difference and Does it Matter?” on Oct. 4 in the Fowler Family Ballroom at the Parma Payne Goodall Alumni Center.

As a scholar in the humanities and a medical doctor who used his studies to contribute to issues facing the lives of Vietnam War veterans who have suffered from post-traumatic stress disorder, Shay created an atmosphere where veterans could address major issues.

Shay tried to make the discussion as comfortable as possible.

“I am here for the sole purpose of responding to what you guys want to talk about,” Shay said. “This is your time to ask and probe me about anything you want to know. I am hoping for you all to get some benefit out of this, so please, ask away.”
read more here

Dr. Jonathan Shay giving lecture

Dr. Jonathan Shay talks about not seeking help for PTSD

Dr. Shay is a hero to me. He knows more about PTSD than anyone I can think of and believe me, I've read just about everything on PTSD since 1982. I contacted Dr. Shay after reading Achilles in Vietnam. I wasn't past the third chapter when I emailed him. I had to. He managed to make me cry because it was the first book I read that addressed what I was going through living with my own Vietnam vet husband. The other books were clinical, distant, while they did help me to understand PTSD, they authors were detached from all of it. Dr. Shay took a different approach and made it personal.

I wrote my own book on PTSD to show what people go through telling the story of my husband's PTSD getting worse and what it did to my family. I also wrote about healing. Dr. Shay read it and supported me while I was trying to get it published. He was amazing. I couldn't believe someone this important would take that kind of time with someone like me, but he did it with grace.

Long story short, 9-11 attacks came and I knew I had to rush to book out because of what was coming. Dr. Shay agreed with what my fear was, that it was about to get a whole lot worse for the Vietnam veterans and the rest of the military. I self published, which was the biggest mistake I could have made because no publisher saw the need of a book like mine. It's been online for about 4 years now for free. For the Love of Jack, His War/My Battle is about us, but more it's about what we knew and when we knew it, long before anyone else was talking about it.

The last time I talked to Dr. Shay we were involved in a dispute with someone questioning him on tanks in Vietnam. The "person" basically called him a liar. I sent Dr. Shay a link to the site with tanks in Vietnam and a few pictures. I couldn't believe anyone was questioning his honesty or knowledge.

There is no way I would ever come close to the way Dr. Shay writes or what he knows. I strongly suggest you pick up a copy of this book and listen very carefully to what he has to say.

Fewer than half of returning Vets suffering PTSD seek help, VA Doc says.
Written by Sherwood Ross

Veterans returning from the fighting in Afghanistan and Iraq are displaying many of the same post-traumatic stress disorder symptoms of troops that fought in Viet Nam, yet most do not seek treatment.

“I’m not an alarmist but I think this is a serious problem,” Dr. Matthew Friedman, executive director of the Department of Veterans Affairs’ National Center for Post-Traumatic Stress Disorder(PTSD), wrote in The New England Journal of Medicine.

Referring to a 2004 study of 6,201 returned service members who had been on active duty in Afghanistan and Iraq, Friedman said most “apparently were afraid to seek assistance for fear that a scarlet P would doom their careers.”

Although one in eight veterans reported PTSD, the survey showed that “less than half of those with problems sought help, mostly out of fear of being stigmatized or hurting their careers,” the Associated Press reported.

“Once called shell shock or combat fatigue, PTSD can develop after witnessing or experiencing a traumatic event. Symptoms include flashbacks, nightmares, feelings of detachment, irritability, trouble concentrating and sleeplessness,” AP said.

Symptoms of major depression, anxiety or PTSD were reported by about 16 to 17 percent of though who served in Iraq.

Findings by the National Vietnam Veterans Readjustment Survey showed 35.8 percent of male Vietnam combat veterans in the late 1980s suffered from PTSD at the time, almost 20 years after their war experience, said Dr. Jonathan Shay, a psychiatrist at the Department of Veterans Affairs Outpatient Clinic, Boston.

In an article in The Long Term View, the magazine of the Massachusetts School of Law at Andover, Shay wrote that Vietnam combat veterans have been hospitalized for physical problems about six times more often than troops that did not fight in Vietnam and are three times more likely to have been “both homeless and vagrant” than their civilian counterparts.

Shay is a recipient of a John D. and Catherine T. MacArthur Foundation “genius” award for his work in this area.

“The supposedly traditional idea of honoring returning veterans ran afoul of deep divisions over the justice and wisdom of the war as a whole, making honor to the veterans seem an endorsement of the war policy,” Shay writes. Many veterans suffer from lingering doubts about the rightness of the war, causing some to feel deeply dishonored even as they accepted medals for bravery. Concern over the “rightness” of the wars in Iraq and Afghanistan may be producing similar doubts among veterans today.
read more here
Fewer than half of returning Vets suffering PTSD seek help

Jonathan Shay wins Genius Grant for PTSD

Hear Jonathan Shay talk about a scene in the Odyssey and how it relates to soldiers back from Iraq today.
Health Care
Psychiatrist Who Counsels Vets Wins Genius Grant
by Joseph Shapiro




Morning Edition, September 25, 2007 · Among this year's MacArthur fellowships — sometimes called the "genius grant" — is a half-million dollar award to a psychiatrist who helps heal combat veterans with post traumatic stress disorder by talking about the mythological Greek warriors Achilles and Odysseus.



Soldiers, and generals, too, listen to Dr. Jonathan Shay, of the Department of Veterans Affairs Outpatient Clinic in Boston. They listen especially when he talks about why it's crucial to soldiers' mental health to keep them together in the same unit over time, so they truly come to know and rely upon each other. This wasn't the practice in Vietnam. But it is again, today, thanks in part to Shay.



A lot of Shay's insight about how to prevent the mental health problems of war comes from reading the Iliad and the Odyssey. He first picked up the books while recovering from a stroke some 25 years ago. He was just 40.



As he slowly recovered, he took what he figured would be a temporary gig counseling Vietnam veterans at the Boston VA. He told them stories of Achilles and Odysseus — and those tales of betrayal by leaders and of guilt and loss among soldiers resonated with the Vietnam veterans.
"One of the things they appreciate," Shay says, "is the sense that they're part of a long historical context — that they are not personally deficient for having become injured in war."


go here for the rest


http://www.npr.org/templates/story/story.php?storyId=14682035

I read a lot of books about Vietnam and PTSD in a lot of years. This was the first one I read that made me want to contact the author. I was crying when I emailed Jonathan because this book was the first one that looked at PTSD as something personal. I didn't know very much about emailing or the web back then. I had the email blocking people not in my address book, without knowing it. Jonathan tried to email me back, but when he found it wouldn't go, he didn't give up. He searched until he found me. I was shocked. I didn't imagine him wanting to even email me back at all. I just wanted to let him know how much his book touched me.
Over the years, we emailed back and forth. He read my book when I was still working on it and helped me to keep pushing to have it published. It didn't work out and I went the self-publishing route but I will never forget his kindness. If anyone should be awarded for the work they do on PTSD and for our veterans, it's Jonathan Shay. He writes books so that everyone can understand and writes them from his heart.
If you want to read some of the best writing on PTSD and combat, go to the book store and find his name. He has several great ones but Achilles in Vietnam will always be my favorite.