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A New Theory of PTSD and Veterans: Moral Injury

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PTSD and guiltThey called themselves the Saints and the Sinners, a company of Marine reservists from the Mormon land of Salt Lake City and the casino shadows of Las Vegas. They arrived in Baghdad a day before Iraqis danced on a fallen statue of Saddam Hussein, and as they walked deeper into the city, they accepted flowers from women and patted children on the crown. Then their radio operator fell backward, shot in the head.

Perhaps 5,000 rounds followed in an undulating crosscurrent of gunfire and rocket-propelled grenades. At a five-point intersection near the headquarters of the Republican Guard and Defense Ministry, the men of Fox Company—Second Battalion, 23rd Marine Regiment—dug in. They aimed at everything, because everything seemed to be aiming at them.

From second-story windows and around corners, they fired into the road. Their bullets broke windshields, pierced soft flesh, and exited into seat cushions. At least three enemy vehicles broke through the American barricade. The company’s radio failed, cutting them off from reinforcements, and a grenade bounced behind their line—a dud, or the casualties might have been even worse.

Although all the men in the unit came home alive, many came home changed. Within five years, one in four had been diagnosed with posttraumatic stress disorder. Today one in two of them carries debilitating psychic wounds, according to an estimate by the men. They are jobless, homeless, disposed to drugs and alcohol, divorced from their spouses, and cut off from their former selves. One made love to his girlfriend, the mother of his twin daughters, then immediately drowned her in a warm bath. I

f you ask the military and mental-health establishment what happened to the men of Fox Company, the answer is simple: they lived through “events that involved actual or threatened death,” felt “intense fear,” and like the 300,000 other service members who share this narrow official path to PTSD, they were badly shaken by it.


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