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This is perhaps the most difficult question yet put forward by SpokaneFAVS, both for personal and professional reasons, however I am at a loss as to how to answer it. Rather than attempt to respond, and perhaps either prove myself ignorant or worse, provide an answer harmful to veterans, I will only provide these snippets of information I found while researching this topic.

“The situation is alarmingly large”

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This is perhaps the most difficult question yet put forward by SpokaneFAVS, both for personal and professional reasons, however I am at a loss as to how to answer it. Rather than attempt to respond, and perhaps either prove myself ignorant or worse, provide an answer harmful to veterans, I will only provide these snippets of information I found while researching this topic.  Whether or not they are definitive, I do not know, but seeing that the Veterans Administration is at least looking into the problem gives me some hope for a long-term treatment.  The situation is alarmingly large and seemingly without end in that we are still at war and, based on history, probably always will be.

Here’s what I found:

‘We conclude that veterans’ pursuit of mental health services appears to be driven more by their guilt and the weakening of their religious faith than by the severity of their PTSD symptoms or their deficits in social functioning. The specificity of these effects on service use suggests that a primary motivation of veterans’ continuing pursuit of treatment may be their search for a meaning and purpose to their traumatic experiences. This possibility raises the broader issue of whether spirituality should be more central to the treatment of PTSD, either in the form of a greater role for pastoral counseling or of a wider inclusion of spiritual issues in traditional psychotherapy for PTSD.”

– Fontana, A., & Rosenheck, R. (2004). Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD. Journal of Nervous and Mental Disease, 192, 579-584. doi: 10.1097/01.nmd.0000138224.17375.55.

“There is also a series of articles that point to important potential mediators within the context of moral injury. Beckham and colleagues (1998) highlighted the role of cognitions related to hindsight bias and wrongdoing among those endorsing atrocities. Witvliet et al. (2004) examined forgiveness of self and others and found that difficulty with any kind of forgiveness was associated with PTSD and depression and that difficulty with self-forgiveness was associated with anxiety. Religious coping seemed to be associated with PTSD symptoms but the authors cautioned that this relationship should be explored in greater detail. Indeed, this and other studies have highlighted that the religious and spiritual causes and consequences of moral injury are complex and need to be explored. For example, many of the pre-existing morals and values that are transgressed in war stem from religious beliefs and faith practices. Religion and spirituality are critical components of moral injury. More research is needed to better understand how these factors shape beliefs, attributions, and coping in the aftermath of a moral injury.”

– Witvliet, C. V. O., Phillips, K. A., Feldman, M. E., & Beckham, J. C. (2004). Posttraumatic mental and physical health correlates of forgiveness and religious coping in military veterans. Journal of Traumatic Stress, 17, 269-273. doi: 10.1023/B:JOTS.0000029270.47848.e5

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