For years, I’ve argued that PTSD is really two very different disorders, improperly lumped together as one by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders (DSM).
The first, of course, is the fear of being killed which manifests itself in hypervigilance, vivid nightmares and flashbacks. It’s about what others have tried to do to you.
But the second, which I’ve come to call the Wounded Soul Syndrome, is based in the guilt of what you have done to others. It’s about violating your own moral code, about trying to reconcile your actions to your beliefs.
I saw a classic example of the Wounded Soul Syndrome recently in a guest column published in the Washington Post. Authored by retired Marine Capt. Timothy Kudo, it said that military suicides reflect the moral conflicts of war.
“I held two seemingly contradictory beliefs: Killing is always wrong, but in war, it is necessary. How could something be both immoral and necessary? I didn’t have time to resolve this question before deploying,” wrote Kudo, who had deployed to Iraq in 2009 and to Afghanistan in 2010-11. “And in the first few months, I fell right into killing without thinking twice. We were simply too busy to worry about the morality of what we were doing. But one day on patrol in Afghanistan in 2010, my patrol got into a firefight and ended up killing two people on a motorcycle we thought were about to attack us. They ignored or didn’t understand our warnings to stop, and according to the military’s ‘escalation of force’ guidelines, we were authorized to shoot them in self-defense. Although we thought they were armed, they turned out to be civilians. One looked no older than 16.”