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The Trauma of War: PTSD and Moral Injury

War inflicts psychological damage on the innocent.

Source: Clker-Free-Vector-Images

There is a war in Europe. This statement seems out of place in the 21st century, but the war in Ukraine is, unfortunately, very real. Tales of heroism and resistance fill the television bulletins. We see housewives preparing Molotov cocktails, which they plan to use against the invaders. We also see determined men, many of whom had never touched a gun before in their lives, holding AK-47s and telling Western journalists that they are willing to shoot at the enemy in order to defend their homeland. We see, too, scenes of destruction, injured children and countless refugees desperately seeking asylum in neighboring countries, overwhelmed with fear and sadness. Young conscripts and bombed and displaced civilians are the inevitable, often forgotten, and anonymous victims of war, particularly since "total war" was invented in the last century. I can’t help feeling that there is a painful dissonance between the grandiloquent rhetoric of war and the pain of the powerless caught up in the horrors of an armed conflict.

War generates untold amounts of psychological trauma, in addition to all the other losses and injuries associated with it. The pain of post-traumatic stress may linger long after the event, particularly if the violence is sustained and ongoing. The aggressor’s propaganda dehumanizes the victims in order to facilitate and justify the bloodshed inflicted on them.

Good and Bad Wars, PTSD, and Moral Injury

History has divided recent conflicts into “good” and “bad” wars. The First World War is seen as a “bad” war because, according to popular perception, it was fought by the common man in order to satisfy the ambitions of their rulers, and didn’t achieve anything. Vietnam is also seen as a “bad” war, for similar reasons. In contrast, the Second World War is often seen as a “good” war, in which good triumphed against evil, even though it was also the single most horrible, cruel, and catastrophic event in the history of our species. Curiously, we associate PTSD (Post-Traumatic Stress Disorder) much more strongly with “bad” wars, like the First World War (at the time they called it "shell shock") and with Vietnam, than with the Second World War. It is as if the perceived moral dimension of a given war should determine whether a soldier, or a civilian for that matter, should be traumatized by it or not. This does actually happen, and the phenomenon has been termed "moral injury." A soldier asked to exert violence against an innocent civilian, for instance, may experience moral injury in the form of painful traumatic emotions and equally painful memories after the event.

However, I very much doubt that fewer people are traumatized in “good” wars, or that their trauma is significantly less severe, even when they have the desired outcome for the morally good side in the conflict. In all wars, including the current one in Ukraine, we all wish the victims of aggression to fare well and the invading aggressor to fail. Above all, however, we need to be very clear that war is essentially a very bad thing. It is crucial never to forget the suffering of the innocents and to ask our leaders to do all they can to avoid future wars. Too often, they haven’t.