“I realized I was hearing the story of Achilles over and over again." Dr. Jonathan Shay on PTSD

Open Focus: Shelburne’s Jonathan Shay increased awareness of PTSD, ‘moral injury’

Greenfield Recorder
By RICHIE DAVIS
For the Recorder
Published: 1/12/2020

Shay, who moved to Franklin County from Newton nearly a decade ago, is a Harvard-trained doctor with a doctorate from the University of Pennsylvania whose medical work shifted from neuropathology to treating combat veterans at the Veterans Affairs outpatient clinic in Boston. There, he says, “the veterans simply kidnapped me” with their compelling accounts of battle.

Shelburne resident Jonathan Shay holds a copy of his 1994 book, “Achilles in Vietnam.” For the Recorder/Richie Davis

It wasn’t until he was in his 40s that Jonathan Shay began reading ancient Greek author Homer’s landmark classics, “The Iliad” and “The Odyssey.”

Just a few years later, as a psychiatrist for the Veterans Administration in Boston, he heard the horrendous Vietnam War experiences of his clients as hauntingly similar to those of Homer’s characters Achilles and Odysseus.

“I realized I was hearing the story of Achilles over and over again,” the 78-year-old retired Shelburne psychiatrist recalls. “The Iliad is about the enduring themes of what really happens to soldiers in war.”

Even though Homer’s Greek tragedies were written 2,700 years ago, they reflect perfectly the moral and social world that today’s soldiers live through, Shay says

An audio version of Shay’s 1994 landmark book, “Achilles in Vietnam,” has been released, narrated by Academy Award nominee (“Good Night and Good Luck”) David Strathairn, while his 2002 sequel, “Odysseus in America: Combat Trauma and the Trials of Homecoming,” has already been recorded by Strathairn — both of them at Armadillo Audio Group Studio in Pelham.

Shay, who moved to Franklin County from Newton nearly a decade ago, is a Harvard-trained doctor with a doctorate from the University of Pennsylvania whose medical work shifted from neuropathology to treating combat veterans at the Veterans Affairs outpatient clinic in Boston. There, he says, “the veterans simply kidnapped me” with their compelling accounts of battle.

The 2010 recipient of the Salem Award for Human Rights and Social Justice, for building acceptance of post-traumatic stress disorder (PTSD) as a serious, bona fide war injury, the former psychiatrist disputes the label of PTSD as an illness, disease or sickness. Instead, he argues, saying those veterans have suffered a severe injury as serious as any physical wound from the battlefield.
read it here

Vietnam Veterans Forgotten Warriors Again?

Moral Injury inflicted by ignorant reporters
Combat PTSD Wounded Times
Kathie Costos
September 8, 2018

Reading many reports over more than three decades has left me stunned by some reporters failure to do basic research on the topics they write about. We are living with what they failed to do.

Vietnam Veterans have been forgotten over and over again!

Ryan Sanders, "contributor" to the Dallas Morning News, wrote "Some troops come home with wounded souls that need healing" leaving out the very veterans who caused all the wounds of war to be known!

There are so many things wrong with this article on "moral injury" that I am regretting being up this early! Moral Injury is not some new condition penetrating the souls of the veterans of today's wars, yet once again, older veterans have apparently been doing just fine and dandy in the mind of the author.

I got a kick out of this part!

Hyperconnectedness: In previous conflicts, especially in world wars but even as late as the Vietnam War, combatants engaged in battle after a long boat ride. They had limited contact with home, almost exclusively through letters. While no amount of separation can or should make war easy, these factors allowed fighters to sort their battlefield experiences, allowing many to leave that part of their lives "over there." In today's conflicts, an American soldier can be dodging improvised explosive devices in the morning and video chatting with his children in the afternoon. Separation becomes impossible, and the wounds can stick.

A long boat ride? Does he know they did have planes during the Vietnam war? Did he ever consider what it was like being the FNG coming into a unit when everyone wanted you to stay away from them especially the short timers counted down the days for DEROS instead of months?

Does he even understand that the term "moral injury" came from research on Vietnam veterans?

One of the best researchers and writers on the subject won numerous awards including the Genius Award, is Jonathan Shay who wrote about Achilles in Vietnam, among other books. This was all about the "moral injury" and it came out in 1994. It was one of the best things I read at the time while doing research on what was trying to kill my husband...PTSD.


Why do some people think they can eliminate the majority of veterans in this country, living with the same wounds of war, at higher rates...in higher numbers?

I have no idea if the subject of Sanders article gave him this wrong information or he figured it out all by himself, either way this is one more reason why the majority of veterans committing suicide remain the highest in veterans over the age of 50! This is pure BS! Wonder if he even had a clue that it was called Post Traumatic Stress Disorder back in 1978!

And yes, that is hanging on the wall behind my desk to remind me of why I do this and why my head explodes when the veterans, who pushed for all the research, keep being the Forgotten Warriors!

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.
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Life At Home After Combat Hardest Part

‘You feel so isolated’: Maine veteran talks about life at home after 2 tours 
Bangor Daily News
By Nok-Noi Ricker, BDN Staff
Posted May 15, 2015

“When you’re back, you feel so isolated. You’re suddenly tossed out of your element,” he said. “You have to come home and adjust. If you don’t have somebody there who understands all the time, it’s difficult to get by.”

Robin Aston
Army Reserve Spc. David Aston (center) returned home from Iraq
with the 94th Military Police Company, trained in Saco, in 2011.
In the photo with Aston are fellow reservists from southern Maine,
Branden Winkel (left) and Ben Johnson.

ORONO, Maine — When former Army Reserve Spc. David T. Aston II, a 2009 Bangor High School graduate, left on his second overseas tour, he thought coming home would be a breeze.

It wasn’t.

“I thought it would be easy,” he said Wednesday in the hallway of Wells Commons during the fifth annual conference of the Maine Military & Community Network. “It was much more difficult.”

He left Maine for the first time in 2010 with the 94th Military Police Company, an Army Reserve unit based in Londonderry, New Hampshire, and was deployed to Iraq to protect Outpost Muthana, a small post at the old Baghdad municipal airport.

Then he deployed again in 2013 with the 344th Military Police Company for a year in Afghanistan’s Parwan province, where he spent time training the Afghan army.

Both were dangerous jobs.

Serving overseas two times was difficult, but “the transition back is the hardest part,” recalled Aston, who received his discharge papers Thursday, completing his time in the service.

Living in constant danger takes its toll, he said.

Department of Veterans Affairs psychologist Dr. Jonathan Shay, who specializes in combat trauma, talked to veterans and other attendees about community reintegration after combat. Dr. Richard Lumb gave a presentation about ways to remain resilient after facing trauma. Pentagon Cmdr. Brent Embry talked about forging alliances between the military and community, and Joan Hunter, assistant surgeon general, talked about programs that support behavioral health.

There also were others on hand to talk about equine therapy for veterans, science-based natural therapies and other veteran resources.
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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

Defining The Deep Pain PTSD Doesn't Capture

It is ridiculous how some researchers think testing rats and killing them to study their brains will even come close to what PTSD does to humans. After all is said and done, they have no way of knowing what other emotions and memories will be altered. Above that, they ignore the human spirit. Some researchers have failed to begin to understand the complexities of Post Traumatic Stress Disorder. They lump all PTSD cases together. Great researchers understood a long time ago, PTSD varies from different causes, number of exposures and length of time they were in fear of dying. There is also the factor of doing a job. First responders, law enforcement, fire figting and combat.

Defining The Deep Pain PTSD Doesn't Capture
WBUR
By Martha Bebinger
June 24, 2013

BOSTON — An estimated 22 veterans kill themselves in the U.S. each day. And suicide among men and women on active duty hit a record high last year — 349. As veterans and researchers try to figure out why, there’s growing interest in a condition known as “moral injury,” or wounds to a veteran’s spirit or soul from events that “transgress deeply held moral beliefs and expectations.”

The concept has helped former Marine Corps Capt. Tyler Boudreau understand years of pain that medication and therapy for PTSD didn’t address. He tells his story, somewhat reluctantly, from the living room of his blue clapboard home in Northampton, Mass.

‘This Is What Occupation Looks Like’

Boudreau arrived in Iraq in the March of 2004 at the age of 33 shortly before four American contractors were killed in Fallujah. His unit moved into position for a planned assault on the city.

“We were always getting shelled, constant rocket and mortar attacks,” Boudreau explained. “An IED, the roadside bomb, blew up right next to my vehicle and I was involved in some firefight that was pretty, you know, pretty intense.”

The constant shelling wore on Boudreau. But the daily duties of war, what he did to Iraqis, also took a toll on him.

“It’s like this accumulation of presence and searching and patrolling and detaining people who, maybe they’re guilty, maybe they’re not,” Boudreau said, his voice building. “Bringing them back and putting them in locked rooms or in cages or putting bags over their heads and flex cuffs on the hands and all of these things that we do, day after day after day. This is what occupation looks like. Searching this house, searching that house, patrolling through the neighborhoods, questioning people.”

Boudreau has thought a lot about one evening when, as darkness fell, dozens of Marines pulled up to a farm house, ordered the family outside, swept their home and found nothing.
read more here

Wounded Times Blog • a few seconds ago This was understood back in 1984 when Point Man International Ministries began working with Vietnam Veterans. Bill Landreth, a Seattle police officer didn't want to keep arresting Vietnam veterans. He started Point Man and Chuck Dean, noted author and Vietnam veteran, took the idea further. Today Point Man is still taking care of the spiritual wound, or as Shay put it, the "moral injury" because that is exactly what this is. I am Coordinator for the State of Florida among other things because this works.

Jonathan Shay was not the first psychiatrist to talk about the connection between veterans and type of PTSD they suffer with but he is fact among the best.

Combat used to be hand-to-hand, face to face and it was brutal. While they did not have term for it back in Biblical times, it has been recored throughout the Bible. All one need do is read Psalms to discover how deeply they were changed by what they had to do.

Now there is not just the violence of bullets but the bombs planted in roads that causes a psychological wound as much as a physical one. These weapons have more than the purpose of killing, more than maiming, they are designed to cause fear that with every step there could be another one.

Soldiers see opponents die, but they also see civilians die along with their friends. They see them maimed. Then they take all that pain upon themselves. These people are unique because they were willing to die for the sake of someone else but they forget that when PTSD has invaded their soul. They believe they have become an evil creature failing to understand that had they been evil, they would not feel so much pain.

There is so much they do not understand but if they learn from people like Jonathan Shay and Point Man, they are much closer to the day when they are living better lives and healing from where they were sent.

When Soldiers Betray Their Sense Of Right And Wrong

‘Moral Injury’: When Soldiers Betray Their Sense Of Right And Wrong
WBUR
By Martha Bebinger, Samara Freemark and Jeff Severns Guntzel
Illustration and layout by Andy Warner
June 21, 2013

Veterans who have been a part of something that betrays their sense of right and wrong often find themselves grappling with what researchers are only now beginning to understand – something that PTSD doesn’t quite capture. They call it “moral injury.” It’s not a diagnosis, but an explanation for many veterans’ emotional responses to their experiences of war.
see the rest of this 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

Beyond PTSD to “moral injury”

Can I prove Dr. Jonathan Shay is right? Yes, because he proved it to me before this generation went to war. I contacted him back in 2000 after reading his book, Achilles in Vietnam.

After reading about a hundred clinical books on PTSD so that I could understand what made my husband so different from the rest of the veterans in my family and hearing my Dad say "shell shock" it was obvious to me that there was something missing in all of the books. The humanity in the inhumanity of war. In Shay's words, the "moral injury" of the people sent. Shay's book not only helped me to save my marriage, it helped me to save others.

Beyond PTSD to “moral injury”
Filed by KOSU News in Public Insight Network.
February 20, 2013

“I really don’t like the term ‘PTSD,’” Department of Veterans Affairs psychiatrist Dr. Jonathan Shay told PBS’ “Religion and Ethics Newsweekly” in 2010. “He says the diagnostic definition of “post-traumatic stress disorder” is a fine description of certain instinctual survival skills that persist into everyday life after a person has been in mortal danger — but the definition doesn’t address the entirety of a person’s injury after the trauma of war.” I view the persistence into civilian life after battle,” he says, “… as the simple or primary injury.”

Shay has his own name for the thing the clinical definition of PTSD leaves out. He calls it “moral injury” — and the term is catching on with both the VA and the Department of Defense.

We’re turning our attention to this idea of moral injury and the limits of the PTSD diagnosis to explore what happens to a person who has experienced combat.

There are no clean lines separating PTSD from moral injury (which is not a diagnosis) — there is no Venn Diagram, as with PTSD and traumatic brain injury – but Shay explains a fundamental difference by using a shrapnel wound as an analogy.

“Whether it breaks the bone or not,” he says, “that wound is the uncomplicated — or primary — injury. That doesn’t kill the soldier; what kills him are the complications — infection or hemorrhage.”

Post-traumatic stress disorder, Shay explains, is the primary injury, the “uncomplicated injury.” Moral injury is the infection; it’s the hemorrhaging.
read more here

I knew my husband was a good man but he started to believe he was evil because of all the things flooding his mind. While I understood the clinical aspects of PTSD, what I was living with was missing from thousands of pages in the 80's. I began to believe I was right about the spiritual aspect of PTSD when I discovered Point Man International Ministries was addressing it since 1984 but I was not aware of them until the 90's when I got online.

Shay's book reenforced the need to heal the soul/spirit first since that was where PTSD began.

It is not a matter of forgetting war but more a matter of making peace with it and all that came with it but first they had to know themselves. What was their original intent? Was it to defend this country? Was it to help the others already fighting the battles? Was it to save lives? All of this is forgotten when they see so much horror and evil during war. They forget that had the enemy surrendered, they would have been very happy to stop fighting. They didn't want to kill anyone but in war, that is what they have to do because other people are trying to kill them. The "moral injury" hits them harder than anyone else other than police officers, because they do not just witness the horror, they participate in it. That is the nature of war. It isn't pretty.

When I work with veterans, I walk them back so they can see the whole event as well as what they were feeling at the time and then help them make peace with it so they see themselves for who they really are inside and most of the time, they were the "givers" ready to help anyone in need. They see that while they endured some evil things, they did not become evil because of them. I help them discover that God was in fact there all along as long as within all the mayhem of war, someone cared about the suffering, reached out to help, cried, mourned for the loss of humanity.

If you ever want to understand what PTSD is, read Shay's book and know that this generation is just as human as all the generations that came before them. When it comes to their suffering, we know better than we did when Vietnam veterans came home but unfortunately, the lessons learned have been forgotten.

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

Jonathan Shay giving lecture at San Diego State University

This the smartest "man in class" when it comes to PTSD. Of all the experts I've read, he's the only one I ever sent fan mail to!

In 2000 he actually tried to help me get my book, FOR THE LOVE OF JACK, HIS WAR/MY BATTLE published. That's how great he is! I was even less known back then but he took the time to help me.

After 9-11, I called him and we talked about how Vietnam veterans would be shattered by the attack on this country on top of unaddressed PTSD. That's when I decided to self-publish it. (It is available again.)

When I was searching for information at the library and book stores, I came across his book Achilles in Vietnam. I read a couple of chapters when I ended up crying because he was the first one to write about what my life became.

If the DOD and the VA really want to do something to change what is not working, they need to get him involved!

Acclaimed PTSD Pioneer, Author, Johnathan Shay to Give Free Lecture at San Diego State University Friday
Posted on October 4, 2012
by The Military Suicide Report
Psychiatrist is Building Public Awareness About Post Traumatic Stress Disorder by Deb Welsh
KPBS, Oct. 4, 2012

Dr. Jonathan Shay, a clinical psychiatrist and author of several books, calls Post Traumatic Stress Disorder an invisible injury suffered by many of our war veterans.

“When somebody brings back from war the absolutely valid adaptation formed in war to survive other people trying to kill you and doing a damned good job of it,” he said.

According to Shay, PTSD consists of clusters of symptoms which include hyper-remembering, emotional numbing, withdrawal and finally the perpetual mobilization of the body and mind toward mortal danger.

Shay said when these three clusters persist into civilian life, the effects can be devastating.
read more here

Peer support is key according to Shay and he's been saying that all along!

Sleep loss is threat to vets with PTSD

This is why you may find an article on PTSD every other place online but not here.

Can sleep deprivation help prevent post-traumatic stress disorder?
A study suggests that a sleepless night can block the consolidation of traumatic memories

I don't jump on stories just because it may sound good or I think I can get more hits by posting something I know is false.

This article was all over websites for days after it was released. Now let's see how long it takes them to catch up to this piece of real news.

Sleep loss is threat to vets with PTSD
In Health
By Sharon Wittke, special to the Beacon
7:35 am on Wed, 09.19.12

The greatest danger to the veteran with post-traumatic stress disorder is loss of sleep.

“There is nothing more fundamental to the successful recovery of a combat veteran after war than the ability to get adequate, good quality sleep,” says Dr. Jonathan Shay, a psychiatrist.

He says sleep loss causes irritability and propensity to anger, which are classic symptoms of combat veterans suffering psychological injury.

Shay says Prazocin, a 50-year-old medicine for high blood pressure, has been shown to be very effective in tiny doses in alleviating combat nightmares.

“About half of the veterans who take it say that their nightmares are gone, and another quarter will say, ‘Well doc, I’m still having the dreams, but at least I can get back to sleep,’” he says.

The VA has begun conducting clinical trials of Prazocin at 13 of its medical centers and expects to complete its study sometime in 2012.

Shay says sleep is fuel for the frontal lobes of the brain, which is where the capacity for emotional and ethical self-restraint lies.

“Sleep is crucial. When you’re totally out of gas in your frontal lobes, you become a moral moron and a lot of the misconduct of combat veterans, I believe, is driven by this measure of frontal lobe function due to sleep loss,” he says.
read more here

You can find more about Dr. Shay right here

Guilt may be a top factor in PTSD

Guilt may be a top factor in PTSD
by
Chaplain Kathie
How many times have I said this over the last 30 years? It is impossible to come up with a number. One of the reasons is a man mentioned in this article. Jonathan Shay has been a hero of mine every since I read the first few chapters of his book Achilles in Vietnam and emailed him. It was the first book I read that completely addressed what I was living with. Shay not only knew the mind of the veteran, he knew his soul.

It was 1999. Back then I was doing what I could to help other veterans like my husband understand that PTSD was not their fault and they could heal but there was still so much more for me to learn. Shay's book helped me to understand it better. It is because of him that I was assured I was right on believing that PTSD hit the most compassionate the hardest.

Back then I had a messed up email that would only allow people I knew to send them, so Jonathan couldn't email back. He took the time to find me and sent a reply by mail. I called him and then we began to email. I told him about a book I was working on. He read it and tried to help me get it published. No one wanted it. September 11th came and I called him knowing there would be a flood of veterans with PTSD symptoms walking up. I told him I would self-publish the book. For the Love of Jack is available for free now by emailing me woundedtimes@aol.com.

This study on Marines is far behind what was already known but it is important to point out that it can manage to do some good if the researchers know what to do with it. So far most of them have failed. The programs they have come up with support the notion that there is some kind of weakness in their minds instead of addressing the strength of their character. This approach has done more harm than good but they have failed to acknowledge this. All they have managed to do is come up with sending troops back into combat with medications and programs like Battlemind telling them they can "train their brains" to prevent it and be resilient, leaving them with the impression if they end up with PTSD, it is their fault their minds were not strong enough to take it.

Study suggests feelings of guilt may be a top factor in PTSD
By Gregg Zoroya, USA TODAY

A 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.
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I tell the story often of a great example of this. A National Guardsman's Mom contacted me after her son tried to kill himself twice. He got divorced, lost his kids, his home and was sleeping on couches. I got his Mom to understand what PTSD was and why he acted the way he did. Soon her son called me. After enough phone calls to make him feel comfortable talking to me he was able to open up about the most haunting experience he had. All he could remember about it was the outcome. A family was killed in Iraq. He couldn't remember what happened before or what he tried to do to prevent it from happening. He forgot he screamed at the driver to stop the car. He threw rocks. He fired warning shots in the air. The car kept coming. In his mind it could have been one more suicide bomber out to blow up the Humvee and kill his team. His thoughts were about saving the men he was with. Once he was able to see everything that happened, he was able to forgive himself for what he had to do.

A nurse during the Gulf War was haunted by the lives of the men she couldn't save. She had forgotten how many lived on because she was there to help them on one horrible day of carnage.

Regrets can haunt anyone but for the men and women in the military, they have an abundance of events piled onto others. A soldier survived an attack but a buddy died and he thought it should have been him going home in a casket. A Marine recovering from an IED regrets he survived without his legs when his best friend died along with several others. Their stories are timeless and all too often, endless. They cannot heal unless they are helped to see the power already within them and be able to forgive themselves for whatever they believe they need forgiveness for.

Medications numb the pain but addressing the spiritual heals them. This is what has to happen. When they forgive others and themselves, they are able to feel the good feelings without regret. When families are able to forgive them for what they do under the control of PTSD, it heals the family relationships and helps the combat veteran to heal faster and deeper. What comes out on the other side of the darkness is a better person and a stronger family. I have not only seen this happen, I've lived it. My husband and I have been through all the hell possible but in the 27 years of our marriage I can honestly say I don't regret one day of it. Sure there are still some issues we have to adjust to but most of it has become "normal" for us. In my book I wrote about the "new normal" because for all the standards set by "experts" on marriage, our's is far from normal. However it is normal for a unique class of citizens we call veterans. Less than 10% of the population of America are veterans and less than 1% serve in the military today. Once we faced the fact that we are not a normal family by any measure, living a different type of life was easier to accept and thrive with.

Once a veteran sees why they joined and the fact they were willing to die for the sake of others, they begin to forgive themselves.

Greater love has no man than this, that a man lay down his life for his friends. John 15:13

This is also the reason I am with Point Man Ministries.

Jonathan Shay to receive Salem Award for work with veterans

DR. JONATHAN SHAY: RECIPIENT OF THE 19th ANNUAL SALEM AWARD FOR HUMAN RIGHTS AND SOCIAL JUSTICE

DR. JONATHAN SHAY: ADVOCATING FOR VETERANS



Dr. Jonathan Shay’s work has been instrumental in building public awareness and acceptance of post-traumatic stress disorder or PTSD as a serious and bona fide war injury, and his focus on how the military can reduce the incidence of such injury has been influential within the services.

From 1987 to 2008, he was a staff psychiatrist at the Department of Veterans Affairs Outpatient Clinic in Boston. Treating approximately 200 Vietnam veterans during that period, he became deeply knowledgeable about the psychological trauma that these men had experienced during the war and that they were still reliving.

In 1994 he published Achilles In Vietnam: Combat Trauma and the Undoing of Character, and in 2002, Odysseus In America: Combat Trauma and the Trials of Homecoming. The books form a comprehensive description of the specific nature of catastrophic war experiences, and how they combine with a number of other critical factors to produce PTSD in soldiers and veterans.

In particular, the books explore the effects on individual human character that disabling psychiatric wounds cause. PTSD can and does afflict anybody, including the strongest, bravest, and most capable among us.

Because of Shay’s work and the work of others, the more than six million troops who have served in combat since the beginning of the Vietnam War can now seek treatment for PTSD, though many continue to fear that the stigma will affect their careers.

Rigorous studies conducted in the late 1980’s showed that approximately 36 percent of male Vietnam combat veterans still suffered from PTSD. That translated to roughly 250,000 men with severe psychological injuries still alive in 1990.

Untreated PTSD results in on-going emotional pain and suffering, difficulty with families and jobs, self-destructive and criminal behavior, homelessness, and incarceration of veterans at rates disproportionate to their presence in the population.

Dr. Shay has worked closely with the military to implement reforms both in the training of soldiers and in the practices and policies used in actual deployment. He has collaborated with General James Jones, the past commandant of the Marines, and Major General James Mattis of the Marines.

In 1999 to 2000, he performed the Commandant of the Marine Corps Trust Study, and in 2001 he was Visiting Scholar-at-Large at the US Naval War College. From 2004 to 2005 he was Chair of Ethics, Leadership, and Personnel Policy in the Office of the US Army Deputy Chief of Staff for Personnel, and in the spring of 2009 he was the Omar Bradley Chair of Strategic Leadership at the US Army War College. In 2007 he was awarded a MacArthur Fellowship.

Like those who spoke out against the Witch Trials in 1692, it is Dr. Shay’s voice and the voice of others speaking out against injustice that have changed the way that both the public and the military treat a group of citizens, in this case American troops who suffer from PTSD, both while in active duty and after. Through his work, Dr. Shay has helped make it possible for those who serve in the military and others in the path of war with PTSD to be offered treatment so that they have an opportunity to lead a full life.
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Salem Award/

Dr. Jonathan Shay gets award for work with vets, PTSD

Doctor gets award for work with vets, PTSD
By Tom Dalton
Staff writer

SALEM — A Boston-area doctor who received a MacArthur Foundation "genius grant" for his groundbreaking work on the combat trauma suffered by Vietnam veterans has won the 2011 Salem Award for Human Rights and Social Justice.

Dr. Jonathan Shay, a former staff psychiatrist for the Department of Veterans Affairs in Boston, will be presented the award on Saturday, May 7.

He will be honored at a dinner and award ceremony at Salem High School.

Shay is the author or two books on post-traumatic stress disorder, "Achilles in Vietnam: Combat Trauma and the Undoing of Character" and "Odysseus in America: Combat Trauma and the Trials of Homecoming."

The committee for this year's award was researching post-traumatic stress disorder as it related to the thousands of combat veterans returning from Iraq and Afghanistan. Shay's name kept popping up.
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Doctor gets award for work with vets, PTSD

Acclaimed psychiatrist Jonathan Shay to discuss healing combat trauma

I don't know anyone who knows more about PTSD than Jonathan Shay. He should be the expert on TV and doing the interviews, but I doubt many reporters even know who he is.

Acclaimed psychiatrist Jonathan Shay to discuss healing combat trauma

Media contact: Margarita Bauza
E-mail: mbauza@med.umich.edu
Phone: 734-764-2220

ANN ARBOR, Mich. - Psychiatrist, author and MacArthur Foundation Genius Award recipient Jonathan Shay M.D., Ph.D., will hold two special lectures on combat trauma and the trials of homecoming at the University of Michigan on September 23.

Shay will give presentations 10:30 a.m. to noon at the Rachel Upjohn Building Auditorium, 4250 Plymouth Road, Ann Arbor, and at 5 p.m. at Rackham Auditorium, 915 E. Washington, Ann Arbor. Both lectures are free and open to the public. Shay will also sign books at the Rackham event.

Shay has devoted his career to treating Vietnam veterans. In his two books, Achilles in Vietnam: Combat Trauma and the Undoing of Character, and Odysseus in America: Combat Trauma and the Trials of Homecoming, he examines the experiences of combat veterans through the lens of the classical texts, The Iliad, The Odyssey and The Aeneid.

“His work clarifies how military trauma can be conceptualized and understood, drawing on both ancient literature and the experiences of Vietnam veterans,” said Marcia Valenstein, M.D., M.S., associate professor in the U-M Department of Psychiatry and Research Scientist for VA Health Services Research and Development. “His work has been immensely helpful to Vietnam veterans attempting to understand their reactions to combat stress and their symptoms once they return home, and to clinicians charged with helping veterans in picking up their lives. His work has renewed relevance as soldiers return from the long conflicts in Iraq and Afghanistan.”

Shay's lectures will honor the work of Don Behm and Tom Devine, two Vietnam veterans who have experienced Post Traumatic Stress Disorder (PTSD), and who have spent the last decade helping returning Iraq and Afghanistan soldiers get care.

The lectures are sponsored by the U-M Depression Center and Department of Psychiatry, the Department of Veterans Affairs VISN 11, the U-M Student Veterans Assistance Program, and the Welcome Back Veterans project. Several military generals and officers will join Shay at the University talks, including Major General Thomas Cutler, the Adjutant General for the Army and Air Force; Brigadier General James Anderson, the Assistant Adjutant General for the Army; and Brigadier General Carol Ann Fausone, Assistant for Mobilization and Reserve Affairs, Department of Military and Veterans Affairs.

Shay received a B.A. from Harvard University in 1963 and an M.D. in 1971 and Ph.D. in 1972 from the University of Pennsylvania. Since 1987, he has been a staff psychiatrist at the Department of Veteran Affairs Outpatient Clinic in Boston, Massachusetts. In 2001, Shay served as Visiting Scholar-at-Large at the U.S. Naval War College, and from 2004 to 2005, he was chair of Ethics, Leadership, and Personnel Policy in the Office of the U.S. Army Deputy Chief of Staff for Personnel.

Local author recognizes that pain of war spans the centuries

Local author recognizes that pain of war spans the centuries
By Chris Bergeron/Daily News staff
The MetroWest Daily News
Posted Aug 31, 2009 @ 12:03 AM
After he began working with Vietnam veterans, Dr. Jonathan Shay heard in their stories the same feelings of grief and betrayal that triggered "the rage of Achilles" in Homer's ancient epic, the "Iliad."

At the Veterans Affairs Outpatient Clinic in Boston in 1987, former grunts spoke to him of the betrayal of "what's right" by officers and politicians. They revealed lingering sorrow over lost comrades and simmering rage that made their homecomings so difficult.

A Harvard-educated psychiatrist who'd never been in the military, Shay made powerful connections with them by writing stories about Homer's heros, Achilles and Odysseus, warriors like them scarred in body and soul.

"From the beginning, I had an interest in the idea that war could damage good character. War hasn't changed in 3,000 years," he said. "The Iliad is about what war has always done to people. Everyone is changed by combat but not everyone is injured."

Looking back, Shay remembers the veterans in that first program as "very rough men who'd experienced severe combat trauma and were given to rages."

"Everyone was an outpatient. There were no locked doors, no court orders. Almost all were from Vietnam," he said. Later, there were a few from World War II and Korea, he said.

Now retired, Shay credits "dumb luck" for helping him reach troubled veterans through stories from Homer's 2,700-year-old poems about the Trojan War and its aftermath.
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Local author recognizes that pain of war spans the centuries

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.
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Fewer than half of returning Vets suffering PTSD seek help

Healing PTSD and "the ultimate spiritual crisis"

I have not been posting as much lately because I've been researching more material for a new book about combat trauma and faith. One of my friends, who is an ordained pastor, and I have begun to work on this after many conversations about faith after trauma. I came across this and thought it was worth re-posting from last year. It is right on the mark when it comes to the spiritual connection and healing PTSD.

If you want to share your story about faith and healing for this book, just email me at namguardianangel@aol.com.

As for this article, after you read it, you may want to watch my video on PTSD Not God's Judgment. It may help you understand that God did not abandon you.

EXCLUSIVE:Healing the Wounds of War

November 30, 2007

Healing the Wounds of War
by Benedicta Cipolla

Photos by Suzanne Opton

War is, in some ways, the ultimate spiritual crisis.

By its very nature, it requires participants to perform acts that would be considered legally and morally wrong in civilian life. "Your whole life, regardless of religion, you're told, 'Don't kill, don't kill, don't kill.' Then all of a sudden it's, 'Here's a gun.' It's hard to reconcile that," says Linda McClenahan, a Dominican nun, trauma counselor, and former Vietnam Army sergeant who lives in Racine, Wisconsin.

In a 1995 study, 51 percent of veterans in residential post-traumatic stress disorder (PTSD) treatment in a Veterans Affairs facility said they had abandoned their religious faith during the war in which they fought. In the same study, 74 percent of respondents said they had difficulty reconciling their religious beliefs with traumatic war-zone events. Battle creates moral confusion, and it can leave a soldier spiritually as well as physically wounded.

Unlike many other traumatic experiences, combat can cause "moral pain" arising from "the realization that one has committed acts with real and terrible consequences," according to a seminal 1981 article in PSYCHOLOGY TODAY by Peter Marin. He was writing about Vietnam, but his overarching thesis could be applied to any military conflict. Profound moral distress is the "real horror" of war, yet its effect on those who fight is rarely discussed.

The difficulty of talking about the spiritual wounds of war was apparent in October when the Episcopal Society of St. John the Evangelist in Cambridge, Mass., announced a four-day retreat at its monastery called "Binding Up Our Wounds," for men and women returning from places of war. Nobody showed up.

A November report published in the Journal of the American Medical Association underscores the magnitude of the problem. After they return from combat in Iraq, one-in-five active-duty soldiers need mental health care. For reservists, the numbers were even higher: Two out of five need treatment. And one 2004 study concluded that veterans who avail themselves of mental health services appear to be driven more by guilt and the weakening of their religious faith than by the severity of their PTSD symptoms.

"In a war, in a firefight, you're both victim and perpetrator at the same time," says the Rev. Alan Cutter, general presbyter of southern Louisiana for the Presbyterian Church (USA) and a former Navy officer who served in Vietnam. "At its heart, a trauma, and especially a war trauma, leaves a wound to the human spirit. When I came back, my spirit was pretty well shredded and ripped."

Marin wrote that moral pain or guilt erroneously remained a form of psychological neurosis or pathological symptom, "something to escape rather than learn from," and he alleged that therapy failed to take moral experience into account. More than a quarter-century later, many experts feel little has changed.

"Once the category of PTSD was established in the early '80s, that swallowed the veteran whole," says William Mahedy, an Episcopal priest and former Army chaplain who has spent 33 years working with veterans in southern California. "Combat creates far more wide-ranging problems than stress."

It's not just the act of taking a life that raises the kinds of questions Mahedy says can only be addressed spiritually and philosophically. Witnessing death and suffering also goes to the heart of life's meaning: Why did God, if there is a God, allow this? Why is killing the enemy not a sin? How can I be forgiven? Why couldn't I save my comrade? Why am I alive when I don't deserve to be? Psychology isn't always equipped to answer such questions.

"Trauma can be characterized as a sense of betrayal of one's experiences: life wasn't supposed to be this way," says the Rev. Jackson Day, an Army chaplain in the central highlands of Vietnam from 1968 to 1969 and now the pastor of Grace United Methodist Church in Upperco, Maryland. "The faith parallel to that would be the statement, 'God has let me down. I did my part, and God didn't do his.'"

In his book ACHILLES IN VIETNAM (1995), clinical psychiatrist Jonathan Shay explored combat trauma through a close reading of the ancient text of the Iliad and his own experiences treating Vietnam veterans with chronic PTSD. Those with lifelong psychological injury, he argued, had suffered a betrayal of "what's right" -- of leadership, trust, the dead, the social and moral order -- above and beyond war's "usual" horror and grief. Those whose belief in God's love was shattered by war suffered another betrayal: their worldview and sense of virtue were obliterated.
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http://www.pbs.org/wnet/religionandethics/week1113/exclusive.html