In late 2015, IDI Fellow Dr. Jerry Fromm participated in a conference on war trauma. From his report:
In December, the University of Pennsylvania Law School’s Center for Ethics and the Rule of Law hosted a conference called “Preventing and Treating the Invisible Wounds of War: Combat Trauma and Psychological Injury.” It was an unusual conference in at least two ways. First, it brought together people from the military, law, philosophy, psychology and other fields; in that sense, it was a fully interdisciplinary conference. And secondly, it was a working conference; no papers were presented, only themes for discussion among the forty or so invited participants. The form of the conference is noteworthy because the complex problems of our time require this sort of inter-disciplinarity and openness to discovery. The fact that so many different professions were involved promoted genuine learning across disciplines but it also required a sustained effort to grapple with different languages and basic assumptions.
In terms of the conference content, one theme stood out: “moral injury” as a powerful if less considered component of war trauma. Moral injury is a term coined by Jonathan Shay, a conference participant, and broadened by Brett Lidz, both speakers at the 2012 Erikson Institute conference on “Untold Stories, Hidden Wounds: War Trauma and its Treatment.” (The Erikson Institute at Austen Riggs is an Affiliate of IDI. The psychoanalyst Erik Erikson actually wrote about war trauma in Childhood and Society.) It refers to a deep sense of betrayal about “what is right,” committed by someone in legitimate authority or by oneself, in a high-stakes situation, a devastating emotional legacy of witnessing or participating in something that fundamentally violates one’s most basic sense of moral order. This form of war-related trauma is not as responsive to the “exposure therapies” that are somewhat effective with the symptom triad of flashbacks, dissociation and hyper-arousal.
Many questions emerged from the conference. One had to do with the relational underpinning that seemed implicit in some of the tragic stories of how these troubles were lived out. Fathers and mothers, buddies and girlfriends were central to these stories, including the context for some suicides, but how they figured into the veteran’s psychology and into their self-destructive actions was left to be spelled out. Another set of questions had to do with how moral injury could also be described as what some psychoanalysts call “traumatic disillusionment” with its disastrous consequences for self-esteem and workable idealization. Finally, within the U.S. military system, the organizational structures designed to help with these troubles seem so fragmented as to risk replicating the sense of betrayal and abandonment within the initial injury. How might this dilemma be addressed at the systems level?
Both in its form and content, this conference relates directly to IDI concerns: in particular, to leadership’s role in making sense of massive disillusionment following societal trauma, restoring areas for the self-esteem of citizenry, and building the organizational structures to facilitate these processes.
Interested readers are invited to contact Dr. Fromm via this website for more information.
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