Post-Traumatic Stress and the Military

Linked is an interesting discussion on the Kojo Nnamdi program on NPR radio aired on March 12, 2012, with Nancy Sherman, Ph. D., member of the Washington Center for Psychoanalysis and Professor of Philosophy at Georgetown University, Col. Charles Engel, MD, Director of the Deployment Health Clinical Center and Associate Professor of Psychiatry, Uniformed Services University of the Health Sciences, and Johnathan Shay, MD, Ph. D., former Staff Psychiatrist, Boston VA Outpatient Clinic. They discussed various topics related to treating returning soldiers and civilians coping with post-traumatic Stress. Of particular interest were comments about the moral implications of combat service and internal conflicts related to shame and guilt. The concept of survivor guilt is frequently brought up when considering the internal conflicts of returning soldiers and civilians who served with those who have died or been seriously injured. Survivor guilt is thought of as a more irrational or neurotic guilt where a person may unreasonably feel guilt in the place of mourning painful losses that have occurred. Guilt and shame, however, are frequently legitimately experienced and cause significant internal conflict. One may have been required to act in a manner that violated their own standards of moral behavior, despite firmly believing to be involved in a just cause. These internal conflicts require thoughtful consideration and empathic understanding in order be resolved.