Page 51 - Total War on PTSD

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 are doing. The combat Veteran may struggle with guilt over having their own children when returning home and the crying of their own children can then become a significant trigger for them stateside.
Over the course of a deployment, combat Veterans often become more numb and aggressive. They will dehumanize people and see them as objects, targets, or “Haji,” the slang and derogatory term given to Middle Eastern individuals in the combat zone. The combat Veteran often will use morbid humor to cope with aversive events, as well as may feel empowered or even elated during the kill cycle and the taking of lives due to adrenaline highs. All of these reactions to the combat zone can be considered adaptive and a way to minimize the emotional impact on the Veteran at the time of the trauma. As one can well imagine, the combat Veteran will often come home and in hindsight start to question their morals and values that they could act in such a cold and callous manner, often labeling themselves “monsters.” Again, these adaptive behaviors must be looked at in the context they occurred and viewed as necessary to function. Often these numbing and chemically driven reactions are not driving the Veterans behavior. The situation and context, typically the need to survive and protect their peers, almost
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