Post-traumatic Stress Disorder (PTSD) is “an anxiety disorder that some people

develop after seeing or living through an event that caused or threatened serious harm or

death” ("Post-Traumatic”). Symptoms of PTSD often show as strong memories of that event,

guilt, worry, outbursts, “emotional numbness”, and avoiding reminders of the event

("Post-Traumatic”). The treatment for PTSD is often talk therapy, cognitive behavior

therapy, exposure therapy, and medication. It was first recognized as a real disorder and

included in the American Psychiatric Association’s Diagnostic and Statistical Manual of

Mental Disorders in 1980 ("Post-Traumatic”). Before this, it was doubted to be a real

disorder and was thought of as a condition in which veterans were just “unable to face their

experiences on the battlefield” ("Post-Traumatic”). They were thought of as weak and were

taken out of combat or discharged from the military. Oftentimes, these veterans were

shunned by those around them and feared by their communities and society

("Post-Traumatic”). When it was finally accepted, it opened the doors for research into what

was going on with these veterans.

In 1983, the National Vietnam Veterans Readjustment Study (NVVRS) began to see

how many veterans from Vietnam were suffering from PTSD. It found that 15% of Vietnam

veterans still suffered from PTSD. A more recent study built off of that one called the

National Vietnam Veterans Longitudinal Study (NVVLS) in December 2013 (“PTSD and

Vietnam”). Within the pool of 1,450 veterans who participated in the second study, 7.6%

had “significant decreases” in symptoms, but 16% had “significantly worse” symptoms

(Handwerk). PTSD was still present in 7% of women and 11% of men within theater
veterans. Within those theater veterans, “37% also met the criteria for major depression”

(“PTSD and Vietnam”).

A more recent discovery of veterans coming back from combat is moral injury. Moral

injury is often mistaken for PTSD because it has many of the same symptoms, but what it is

mostly based off of is “the loss of trust - in oneself, in others, in the military, and sometimes

in the nation as a whole” (Puniewska). It is defined as “a sense that their fundamental

understanding of right and wrong has been violated, and the grief, numbness or guilt that

often ensues” (Wood, “A Warrior’s”). The treatment for moral injury is difficult because it

isn’t fear-based like PTSD is. Treatments often focus on acceptance of the past. Adaptive

disclosure is one of the options for treatments that help veterans accept what they did

during the war instead of erasing the memories, and helps them explain experiences with

other people without feeling guilty or shameful. Treatments focus on forgiving oneself and

accepting what happened in order to move on with life. Since the loss of trust is a large part

of moral injury, being able to trust oneself and others is another form of therapy. “Peter

Yeomans, a psychologist at the Philadelphia V.A. Medical Center who runs a moral injury

group therapy for Vietnam veterans, asks them to perform several random acts of kindness

each week” to build up trust in themselves again (Puniewska). Each of these treatments

would help those with moral injury understand their guilt, forgive themselves for their

actions, and learn to trust themselves again.