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Many veterans feel guilty because they lived while others died. Some feel ashamed because they didn’t bring all their men home and wonder what they could have done differently to save them. When they get home they wonder if there’s something wrong with them because they find war repugnant but also thrilling. They hate it and miss it.Many of their self-judgments go to extremes. A comrade died because he stepped on an improvised explosive device and his commander feels unrelenting guilt because he didn’t go down a different street. Insurgents used women and children as shields, and soldiers and Marines feel a totalistic black stain on themselves because of an innocent child’s face, killed in the firefight. The self-condemnation can be crippling.
The Moral Injury, New York Times. Feb 17, 2015

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Most people coming out of a war feel lost and resentful. What had been a minute-to-minute confrontation with yourself, your struggle with what courage you have against discomfort, at the least, and death at the other end, ties you to the people you have known in the war and makes, for a time, all others seem alien and frivolous. Friends are glad to see you again, but you know immediately that most of them have put you to one side, and while it is easy enough to say that you should have known that before, most of us don't, and it is painful. You are face to face with what will happen to you after death.

When we apologize for something we’ve done, make amends, or change a behavior that doesn’t align with our values, guilt — not shame — is most often the driving force. We feel guilty when we hold up something we’ve done or failed to do against our values and find they don’t match up. It’s an uncomfortable feeling, but one that’s helpful. The psychological discomfort, something similar to cognitive dissonance, is what motivates meaningful change. Guilt is just as powerful as shame, but its influence is positive, while shame’s is destructive. In fact, in my research I found that shame corrodes the very part of us that believes we can change and do better.

The victims of PTSD often feel morally tainted by their experiences, unable to recover confidence in their own goodness, trapped in a sort of spiritual solitary confinement, looking back at the rest of the world from beyond the barrier of what happened. They find themselves unable to communicate their condition to those who remained at home, resenting civilians for their blind innocence.
The Moral Injury, New York Times. Feb 17, 2015

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It was the shame we knew so well, the shame that drowned us after the selections, and every time we had to watch, or submit to, some outrage: the shame that the Germans did not know, that the just man experiences at another man's crime; the feeling of guilt that such a crime should exist, that it should have been introduced irrevocably into the world of things that exist, and that his will for good should have proved too weak or null, and should not have availed in defense.

People generally don’t suffer high rates of PTSD after natural disasters. Instead, people suffer from PTSD after moral atrocities. Soldiers who’ve endured the depraved world of combat experience their own symptoms. Trauma is an expulsive cataclysm of the soul.

The Moral Injury, New York Times. Feb 17, 2015

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