PSTD and Religious Faith
Combat PSTD and Religious Faith
According to Dr. Nelson-Pechota (2004), every war has been virtually fought with a religious foundation. Faith in the divine powers has helped soldiers to confidently stride to a battle. Their religious faith has strengthened their courage and convictions. They also believe that they are favored or empowered by God when they meet with success in the battlefield. However, wars also create a moral confusion due to the combatants’ religious influences. As such, they find it conflicting to perform an act of violence which might be a sacred duty in another instance.
For combatants, intrusive thoughts and flashbacks often include the following: anger, atrocities, anxiety and nervousness, depression, denial, drug abuse, emotional constriction and numbing, family pressure, guilt, and isolation (Whealin, DeCarvalho & Vega, 2008). Important beliefs such as religious faith can be lost when a traumatic event happens. They started to feel that the world is bad and unsafe (Whealin, DeCarvalho & Vega, 2008). Real war veterans revealed that they suffered great guilt and judged themselves on their actual or perceived mistakes, errors and shortcomings. They felt too much grief and sadness and recollect the fears from their field experiences (Clark, 2010).
They experience some symptoms wholly or in part and the lingering effects rob them of their joy of life. Maguen & Litz (2010) termed it as “moral injury.” This is an act of serious transgression which leads to serious inner conflict as the previous war experiences are contradictory to a person’s core and ethical beliefs and values. It may be their acts of commission or omission, others’ behavior/s or bearing witness to great human suffering and grotesque aftermath of a battle. In the midst of the battle, combatants may do things out of the ordinary and their savage response may lead to guilt feelings later on. This guilt may linger till death. In most instances, the combatants tended to believe that they have sinned (Maguen & Litz, 2010). Then, they must come to terms with their perceived sins.
Traumatic events often lead to life changing world views among combatants and their fundamental assumptions about goodness, safety and meaning negatively shifts. For those individuals who base their core values on religion, such traumatic events make them question the basic nature of God’s relationship with humankind. They lose faith in their long held belief that God is loving, kind and powerful has been shaken by the experience of witnessing innocent people being victimized or killed.
According to Dr. Nelson-Pechota (2004), the traumatic combat experiences usually lead to a personal and a collective sense for a search for life’s meaning and purpose. Hence, PSTD patients seek answers to several questions about the painful realities of warfare, the meaning of their lives, and the general value of the human race. Individuals who are not able to address the moral and spiritual challenges and make them spiritually alienated. Hence, they lose their faith in God and they feel abandoned by God. They also reject the notion of God or feel that God was powerless when they need Him. They also feel that the pains they have accumulated were God’s punishment. Spiritual alienation is closely linked with traumatic stress. Patients feel they are separated from God or any divine being. This problematic relationship with God also leads to difficulty with interpersonal relationships. This includes estrangement from other people. Hence, the combatants’ feelings are compounded by the negative feelings about their God or their faith and their unmet needs.
What Religious Leaders Can Do
Among mental health professioanls, there is an increased recognition that spirituality and/or restoring the combatants’ faith is an initial human dimension approach to restore the combat PSTD patients’ mental health. Presently, spiritual beliefs and practices have also evolved in the coping strategies along with other cognitive, emotional, physical, and social aspects as crucial coping resources (Drescher & Foy, 1995). The military has a strong tradition of supporting the spiritual needs of its men through Chaplains of various religious denominations (i.e. Jewish, Catholic and Protestant religions). Studies have shown the general, positive relationships between religion and mental and physical health. Specifically, regular religious practices, against particular beliefs, like church attendance, prayer and scripture readings have evidenced positive effects to mental and physical health (Drescher & Foy, 1995).
In the discussion of key existential issues, pastors can explore issues which are relevant for the combatants. They must be able to inform the group how several traditions have resolved these issues but they must have their own path to solve this question on their own. Pastors can explore topics like reconciling God’s existence with the presence of evil and suffering in the world. They may also process the combatants’ feelings of anger at their perceived abandonment and/or betrayal by God. Pastors can also explain issues such as forgiveness, guilt, self-blame, and shame. In this session, combatants can reflect about their own religious culture and what views they held about these issues since childhood.
Pastors can also lead various spiritual exercises such as those involving guided imagery, meditation, and silent prayer. These exercises must also feature a relaxation component which will be founded on the existing stress management skills already learned and applied by PSTD patients. These exercises are drawn from various religious traditions. Pastors should also encourage patients to draw on external practice of prayer and meditation exercises.
Pastors and facilitators can also compile their patients’ collection of suggested readings. These readings are assigned as homework and each patient is asked to keep a journal to record their thoughts about the readings and other group activities. These sessions emphasize the significance of religious rituals. This is a very effective way by which religious rituals are used to communicate meaning by way of imagery and metaphor. Pastors can encourage group members to realize meaningful rituals in churches they visit. They may also initiate new and unique ritual among group members which might express something of the issues discussed during the group activities. Pastors can ask the group to enact the ritual at some point, usually at the end of the group meetings.
In spiritual autobiography, PSTD patients are asked to write a description of their spiritual journey since they were young. This emphasizes major life experiences and decisions which were made on their religious faith and shows the real context in which they happened. Spiritual autobiography allows patients to clarify their present religious beliefs and practices and reflect on their new directions. During sessions, the PSTD patients present their autobiographies and initiate discussions of relevant issues and themes.
Pastors must encourage PSTD patients to read the bible on a regular basis. Ex veterans who have found spiritual help affirmed the Holy Bible as a source of comfort and direction for them (Brende & McDonald, 1989). Among the bible stories, patients can find comfort in the books of the New Testament, Genesis and in Psalms. The New Testament contains the related themes: Jesus healing the sick (Matt. 4:24; Luke 3; John 5; and Mark 5), the positive power of believing in Jesus (Mark 9: 17-29), the outcomes of not believing (Luke 1: 18-23), forgiveness of sins (John 21; Mark 15:69-72), assistance for loneliness and despair (Matt. 27:46; Mark 15:34; Luke, 22:39-47), and Jesus' mission of forgiveness and healing (Mark 11:24-25; Luke 23:32-35, 42-43; Matt 5:17-26, 6:17-20) (Brende & McDonald, 1989). The story of the Adam’s fall highlights the description of the aftermath of seeking power for personal gains rather than obedience to God. This is very applicable to the combat PSTD patients’ experience of being alienated from God and taking the power to take his own life (Brende & McDonald, 1989). Most of the verses in Psalms address the feelings of veterans in terms of fear, isolation, death-related imagery, and tremors. To illustrate, the feelings of alienation from God are perfectly contained in Psalm 60:
O God, you have cast us off. You have broken us down: you have been displeased; Oh restore us again!
The feelings of guilt and forgiveness are also taken up by Psalm 55:4-8:
My heart is severely pained within me and the terrors of death have fallen upon me, and horror has overwhelmed me Oh, that I had wings like a dove. For then I would fly away and be at rest. Indeed, I would wander far off and remain in the wilderness.
An ex veteran has suggested that patients should seek spiritual transformation to gain "freedom from the violence of the soul which is a residue from the violence of war" (Brende & McDonald, 1989). He believed that combat PSTD patients feel desolated and the scripture can be a good source of being reminded that God alone is the light in times of darkness. Most patients avoid spiritual help or maintain their isolation mainly because they are very angry with God. Religious leaders must encourage these patients to honestly express their anger to God and wait for God’s healing. Recovery is only possible when veterans are willing to "walk away from the anger, rage, and hatred that are the war's continuing residue” (Brende & McDonald, 1989). The pastors must encourage veterans to seek God in a personal way, even when it seems obscure or when there is resistance.
Religious leaders must ensure the voluntary participation of PSTD patients. This is because these patients' views of spirituality can be very personal and emotionally intense. They have come to view spirituality as unimportant. Hence, the pastors must support the discussion of sensitive and delicate issues in a more liberal environment. They have to maintain a tone of interest and mutual respect for the patients’ different views. The pastors should emphasize the religious aspects which attract cohesion rather than those which promote separation. The most important thing is for the pastors to maintain a safe environment to express emotions and disclose their true selves.
Brende, J. & Elmer McDonald. (Winter, 1989). Spirituality Today, 41 (3), p. 319 – 340.
Clark, A. (2010). “PTSD From All America’s Wars.” Combat Faith Website. Retrieved on January 7, 2013 from, http://www.combatfaith.com/AttnCombatVets.html.
Drescher, Kent D. & David W. Foy, Ph.D. (1995). Spirituality and Trauma Treatment: Suggestions for Including Spirituality as a Coping Resource. NCP Clinical Quarterly 5 (1).
Maguen, S. & Litz, B. (2012). Moral Injury in Veterans of War. PSTD Research Quarterly.
Nelson-Pechota, M. (2004). Spirituality and PTSDin Vietnam Combat Veterans. Retrieved on January 7, 2013 from, http://www.vietnamveteranministers.org/spirituality_intro.htm.
Whealin, J. M., De Carvalho, L. T., & Vega, E. M. (2008). Strategies for Managing Stress after War: Veteran’s Workbook and Guide to Wellness. John Wiley & Sons.