Page 59 - Total War on PTSD

Veterans can black out and have for longer periods of time and have no recollection of their actions. The Veteran is unaware this is happening at the time and often only recognizes this has occurred due to missing chunks of time or when other people inform them of behavior they do not remember doing. This is the brain’s way of protecting them from intolerable emotional states or triggers. Many Veterans will dissociate while discussing their trauma in my office and will need assistance grounding back to their current environment. Trauma congruent visual, auditory and sensory hallucinations are not uncommon with PTSD and individuals who have been in war may experience hearing people screaming, gunfire, mortars, etc. They may also see images of people who they have lost or harmed. It is not unusual for sensory experiences to occur when memories replay, such as physical pain when a memory of a personal injury replays or smelling blood when a scene where someone is hurt replays.
Altered Sense of Self:
Combat Veterans are often placed in situations where they are forced to be aggressive as a means for survival either for themselves or their peers. They may have taken the lives of individuals, including women and children, in order to save the lives. The combat zone often leads to numbness and their actions, which are certainly warranted, are often not looked at through an emotional scope until they return home and start viewing their actions outside of the context they occurred. The combat Veteran will often struggle with their own sense of violating their core values and beliefs, especially the belief “thou shall not kill,” leading to moral injury. They keep their actions secret from their family and those around them, suffering silently and often believing those they love would judge them or look at them like a “monster” if they knew what they had done. They often have a fear of destroying their family members’ sense of innocence or naiveté should they learn of the realities of war and what has actually happened. Combat Veterans often shoulder a crushing sense of guilt over not being able to prevent negative events from occurring, especially if they involve the injury or loss of one of their peers. Their helplessness and sense of vulnerability over these events is commonly replaced with self-blame, guilt, and self-loathing.
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