A Balm for Psyches Scarred by War

Two months into his deployment, Mr. McCourry was caught in a firefight. Amid a hail of bullets and mortar rounds, he spotted a white truck approaching from the opposite direction. Despite signaling the truck to stop and firing a warning shot, it kept approaching.

Mr. McCourry began shooting at it. Later, he learned that the people in the truck were a father and his two daughters. The father survived, but the girls did not. “The death of those girls, it haunted me,” Mr. McCourry said.

In 2005, between tours of duty, Mr. McCourry sought help from a battalion medical officer for his sleep and anxiety issues. When the doctor dismissed his concerns, “I kind of lost my mind and started yelling at him,” Mr. McCourry said. Shortly after, he was honorably discharged on the basis of a personality disorder — a diagnosis that was not legitimate grounds for discharge and that Mr. McCourry vehemently disputed.

At first, Mr. McCourry felt overjoyed to be home, but he soon noticed that something felt off. He was tense around friends and family. He was easily offended by any hint of perceived disrespect and found it increasingly difficult to control his anger. When he learned that nearly his entire former squad had been killed by a roadside bomb, he felt an unsettling mixture of numbness and guilt. “At that point, things spiraled,” he said.

Veterans frequently struggle with the readjustment process after returning from war, but they often do so quietly. “By and large, soldiers don’t like to reveal that they have any problems, so they tend to minimize their symptoms,” said Dr. Elspeth Cameron Ritchie, the chair of psychiatry at MedStar Washington Hospital Center and a specialist in military and veterans’ issues. “Many don’t like to talk about their feelings.”

Some veterans, including Mr. McCourry, also experience a phenomenon called moral injury, which frequently occurs alongside PTSD and can complicate treatment. According to Dr. Robert Koffman, a psychiatrist and retired U.S. Navy captain, moral injury develops in service members who feel responsible for perpetrating or for failing to prevent an act that violates their deeply held beliefs. The result is often intense feelings of shame and guilt.

For years, vivid nightmares and paranoia prevented Mr. McCourry from sleeping properly, and he began having suicidal thoughts. Eventually, he sought help at a Veterans Affairs clinic. He received a diagnosis of severe PTSD, and the doctors recommended conventional treatments including therapy and medications.

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