Combat Veterans: Impressions of an Analytic Observer in a Non-Analytic Setting

Abstract

The hallmark presentation of combat trauma-nightmares, waking hallucinations, intrusive traumatic memories, and extreme affective reactions to environmental triggers-may best be conceptualized as part of an adaptive mechanism intended to protect the individual against a repetition of trauma. Combat veterans continuously must cope with the extreme affects that combat induced. Fear, rage, guilt, and grief predominate. Their mental and emotional life is complicated by a conscience split between war zone and civilian morality and by the special group dynamics of combat. Optimal clinical understanding of combat-related trauma, whether in a psychoanalytic or general mental health setting, requires an awareness of the interaction of the personal dynamics of each individual with the specific characteristics of their combat situation.

J.D. Salinger and the moral wounds of war

“…Service members who have killed, or who believe they have killed, are more susceptible to PTSD…" (Stern, 2014, p. 258). Stein (2007) a psychoanalyst "who spent more than 20 years working with combat veterans in a clinic focused on their care" described clinically the psychological impact of combat: "For many combat veterans, an intrinsic part of the trauma has to do with violence against others. That violence may not bring up guilt in the combat zone, where the soldier may well be living up to some necessary morality of protecting himself and his fellow soldiers.…”

Role of Combat Exposure and Insomnia in Student Veterans’ Adaptation to College

“…Other possible explanations could involve service members having greater self-awareness regarding sleep habits than other psychological symptoms. However, it is possible that sleep difficulties may be a common response to stress, even in the absence of mental health symptoms (Stein, 2007). Despite studies finding insomnia to be one of the most reported symptoms of veterans, Hermes and Rosenheck (2013) found that only 3.4% of patients receiving care from Veterans Health Administration (VHA) services (N = 5,531,379) were diagnosed with insomnia.…”

Life of Pi and the Moral Wound

“…Many servicemen returning from war zones have been exposed to the kind of complex trauma we see portrayed in Life of Pi. Stein (2007), a psychoanalyst who "spent more than 20 years working with combat veterans in a clinic focused on their care" writes: "For many combat veterans, an intrinsic part of the trauma has to do with violence against others. That violence may not bring up guilt in the combat zone, where the soldier may well be living up to some necessary morality of protecting himself and his fellow soldiers.…”

“…As part of psychological development, this becomes a personal value as well as a value of civil society. "Combat veterans," Stein (2007) writes, "frequently develop a split in superego functioning. They come to the combat zone with some variant of a 'civilian' conscience and ego ideal.…”

“…Those moral values are cherished sufficiently to cause pain when part of our self disapproves of something we have done that violates them. Stein (2007) captures the dilemma of the returning combat solider: "In order to adapt to civilian life, the veteran must attempt to regain some form of civilian morality; but by the terms of that morality, he may experience extraordinary guilt over what he has done in the war zone. The returning veteran has a number of unconscious choices: (1) he can maintain the war morality and be antisocial in the eyes of the civilian world; (2) he can embrace his original morality at the cost of enormous self-hatred and loathing; (3) he may attempt to embrace both, essentially shifting back and forth from one to the other" (p. 581).…”