Moral Injury: Two Perspectives

Abstract

There is a growing awareness that the diagnosis and treatment of post-traumatic stress disorder (PTSD) in military service members has not been an effective means of dealing with the psychological trauma of war. Mental health professionals who treat soldiers returning from Iraq and Afghanistan have perceived a disparity between soldiers’ psychological responses to combat and the officially identified cause of PTSD), which is fear. William Nash, who in 2004 served in Iraq as a combat psychiatrist, notes that after the Battle of Fallujah, not fear, but “survivor’s guilt, moral injury, [and] feeling betrayed by leaders” were the predominant reactions among soldiers.¹