Commentary

Moral injury and suicide in warriors


 

The current administration’s use of drones and the disturbing impact of these weapons can be a source of pain for warriors. In a recent speech at the National Defense University in Washington, President Obama said that the many civilians and children killed by these drone attacks will "haunt us as long as we live." He might have talking about those veterans with PTSD who have nightmares/flashbacks of dead children chasing them.

But think what the phrase "as long as we live" might mean to the anguished veteran who is back home struggling with these memories. Such a phrase might suggest a false solution to the person contemplating suicide: If they "do not live," they cannot be haunted by these images.

Treating patients

Those of us who are treating these patients can take several steps that will help increase their chances of healing. Here are a few suggestions:

• Never ask a veteran if he or she killed anyone. Enemies are "dehumanized" and degraded into nonhumans and are considered monsters.

• Never tell a veteran that it was God’s wish that he or she survive enemy fire. This will give the impression that a comrade’s death was God’s wish.

• Make sure that the veteran understands that he or she followed orders as required while in theater. In other words, responsibility for the war rests not with the patient, but on the shoulders of the commander in chief.

• Do not minimize a veteran’s guilt, as this is a normal reaction. Only a psychopath would not feel guilty.

• Differentiate between guilt and shame. Tell the patient that it is possible to repent and compensate for guilt. Guilt means "I am a good person, but I made a mistake"; shame means "I am the mistake."

Dr. Marvasti, a psychiatrist in Manchester, Conn., has edited several books, including War Trauma in Veterans and Their Families (Springfield, Ill., Charles C. Thomas, 2012) and Psycho-Political Aspects of Suicide Bombers, Terrorism, and Martyrdom: A Critical View From "Both Sides" in Regard to Cause and Cure (Springfield, Ill., Charles C. Thomas, 2008).

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