Page 64 - Total War on PTSD

the Veteran to reintegrate their emotions and learn to be comfortable with them. Over time, this helps breaks numbing, reduce dissociative symptoms, helps them feel more connected to their world and people, as well as reduces their anxiety and anger. Until combat Veterans reintegrate their emotions, they will convey that they feel like they are just “going through the motions” day-to-day and they do not actually enjoy their lives or feel connected to them.
It is human nature for a combat Veteran to harbor guilt over their peers being injured or killed, even if events were unpredictable or not within their control. Throughout their military career, the combat Veteran has been inculcated with the belief that if they follow their training, they can overcome any obstacle and defeat their enemy. Although this mentality and training certainly helps them persevere in aversive situations, no one can ever have complete control over events in a combat zone no matter how great of a warrior they may be. Inevitably, individuals will at times get hurt and be killed. This leaves the combat Veteran with the sense that in some way them must have failed or done something wrong. Consistently the combat Veteran will hold onto their belief they should have been able to change the situation to prevent the trauma from occurring. By carefully processing events as they actually occurred, the combat Veteran can gain clarity that choices were made in a reasonable manner with the information they had at the time of the incident. It is helpful to remind combat Veterans that they cannot control what they cannot predict.
Combat Veterans also struggle with violating their core values and beliefs. An unavoidable truth is that war always involves killing and the taking of lives. Although the Veteran cognitively understands this going into combat, actually being placed in a situation where killing is necessary, especially if it involves women or children, can be devastating for the Veteran. In treatment, we discussed the difference between murder and killing; one which occurs out of lust and the other out of necessity. The combat Veteran will need to come to terms with their actions in the context they occurred, as well as work through aspects of self-forgiveness. It is always important for them to recognize that children can be lethal in a combat zone and are often used to stop convoys for ambushes, as vested suicide bombers, and often carry guns and throw grenades. The combat Veteran may be conflicted over believing the child did not fully understand what they were doing and will see the minor as innocent and/or forced to engage in the behavior they
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