The Hidden Wounds of War: Helping Veterans Heal from Childhood Trauma
Veterans face mental health challenges from childhood trauma.
Much has been written about moral injury in veterans. In this post it’s tied to childhood trauma to emphasize a key vulnerability veterans face. “More than 80% of veterans reported experiencing at least one childhood trauma or adversity. About 40% of study participants endorsed four or more childhood traumas or adversities.”
https:www.ncbi.him.nih.ov/pmc/articles/ PMC5385349/
When people who have suffered childhood trauma have not had the tools to recover from it’s effects and are placed under a great deal of stress, such as military service and/or combat, the effects of those emotional and psychological wounds may leak out in confusion, rage, and terror.
Complex trauma develops with a series of traumatic events in your life. Childhood trauma worsens post-service struggles.
“The presence of a moral injury does not mean someone lacks resilience, it points to a soul shattering disintegration of the core of one’s belief about the world and the individual’s ethic, religious, and spiritual beliefs.”
https://www.themoralinjuryinstitute.com/2023/10/21/657/
Understanding childhood trauma.
Childhood trauma has a unique component to it. Whether it’s trauma during that event in your lifespan depends on your age and perception. Certain things that are traumatic as a child are not so much trauma as an adult. Falling out of a bunkbed as a five year old is more frightening than for a college age student. On a more intense level, the impact of physical, verbal or emotional abuse on a child is usually more profound than on an adult. Younger children tend to feel overly-responsibile for what’s happening in their world and are often trapped in their circumstances. They are not developed enough to cope well.
Military experience and tough times.
“During World War II, 504,000 men were lost from America’s combat forces due to psychiatric collapse. “
Grossman, D. L., & Siddle, B. K. (2010). Psychological effects of combat, Stress of war, conflict, and disaster (2nd ed., Academic Press, Sydney, Australia)
How many people have had nightmares about their loved ones joining the military? What happens when a teen leaves the shelter of home and is awakened at random hours, has orders barked at them, is stretched physically to their limits and endures psychological games to toughen them for combat or being captured. All of this constitutes military training. It is key to have the presence of mind to understand the context and that you have to learn to survive both individually and as a group.
Childhood abuse breaks the capacity to trust and bond. Developing trust for authority and for fellow soldiers makes military service easier. What if your commanding officer or the system makes it hard to trust? The dilemma is when you’ve been hurt yourself, you may want to hurt someone/anyone in close range. Think of it, what was acceptable in your family, becomes a way of venting your anger towards authority or people that are closest to you.
Childhood trauma from abuse can put veterans in a double bind during combat. Combat is a place where violence is sanctioned. Acting out your trauma pain is easier to hide. When you’ve got someone’s back as a Marine, it’s your job to kill the enemy who killed your own. What’s different is the intensity level of rage and revenge compounded by childhood trauma may clash with rules of engagement. What can result is a hidden wound called a moral wound. Moral wounds result in living against your ethical, moral and faith beliefs.
Barriers to Help
People with moral injury often feel guilt, shame, disgust and/or anger. It is hard to forgive yourself or you may feel a need to punish yourself. You may end a relationship because you do not believe you are worthy of love and/or are too ashamed. You may miss therapy appointments because you do not believe you deserve to feel better.
“We have ceremonies and sacred rites for those killed in battle, but unlike the Navajo people, we lack the needed rituals (in society) to contain the full impact of the experiences of these surviving warriors. The returning warrior is often left to “resume his or her pre-war life as quickly as possible, devoid of the ravages of combat, loss, and brutality he or she remembers all too well.”
https://www.themoralinjuryinstitute.com/2023/10/24/community-involvement-in-healing-the-morally-injured/
Many choose to self-medicate with alcohol or substances. The military culture has sanctioned coping with alcohol and in the past has overlooked substance use, ie the Vietnam War.
Early intervention and creating safe environments
The good news is that the military is screening people before allowing them to serve. A history of anxiety disorders, including panic disorder, agoraphobia, social phobia, simple phobias, obsessive-compulsive disorder, acute reactions to stress, and posttraumatic disorder are disqualifying conditions. The military has collaborated with the National Academies of Science, Mathematics and Engineering medicine which provide independent and objective advice. The Academies https://www.nationalacademies.org/about# has suggested policy changes and helped confront challenging issues for the benefit of society.
The military used to encourage veterans to get treatment before being discharged. Many veterans denied or repressed their needs in order to expedite going home. Now disqualifying conditions allow veterans to be discharged and go home to their families for their care.
Making Things Better
Veterans and their loved ones need to know what’s being done on their behalf. It’s important to know that a pill is not a long term solution. An Army psychologist named John Rigg stated, “Medication doesn’t fix this stuff.” https://www.theheraldtimes.com/moral-injury-why-it-matters-and-what-we-can-do/meeker/
The VA coordinates physical and mental health care for veterans, has emergency services for mental health issues, offers individual and group therapy and a mental health hotline for veterans.
For VA crisis help:
Dial 988 then Press 1.
Start a confidential chat.
Text 838255.
If you have hearing loss, call TTY: 800-799-4889.
The VA sets the Gold Standard for PTSD treatment in the country with many informative online trainings for mental health care providers which veterans can access. For further resources for veterans and mental health care providers see https://www.ptsd.va.gov/understand/related/moral_injury_ptsd.asp and https://www.mentalhealth.va.gov.
Disability for mental health issues is available for veterans. The more your mental illness affects your ability to support yourself and execute activities of daily living, the higher your rating. For mental illnesses, possible VA disability ratings are 0, 10, 30, 50, 70, or 100 percent.
In conclusion, civilians need to develop understanding and empathic support for veterans. Saying “Thank you for your service” is not enough.
