Thursday, July 28, 2005

Systems thinking and preventing/treating PTSD

I'm reading Redesigning Society by Ackhof and Rovin (2003), and something occurred to me.

They describe four ways to address a problem:
  • absolve it--ignore it and hope it will go away.
  • resolve it--employ behavior previously used in similar situations to get a good-enough outcome.
  • solve it--discover or create a new behavior that yields a best-possible outcome.
  • dissolve it--redesign the system or environment to eliminate the causes of the problem.
Accordingly, IF moral guilt caused by killing in war is a cause of PTSD, then even unlimited post-combat medical screening and VA access will not take care of the problem for those afflicted. Those actions (currently being taken, with the best of intentions) treat the symptoms of PTSD, not the cause. DoD is setting itself up for long-term, resource-intensive care if it addresses only symptoms, not root causes.

We as a military profession need to "redesign" the way we think about killing. We need to recognize that it's an upsetting experience--if not initially then later upon reflection--and empower our Soldiers to understand that what they did was morally right. Or, if they killed unjustly, call a spade a spade and help the Soldier come to terms with that. We can't forgive ourselves if we haven't first come to terms with the offense. As LTC Grossman says, we are only as sick as our secrets.

What would a redesign look like? Here are some initial ideas:
  • FMs would use the words kill, killed, and killing (vice "targets destroyed").
  • EMs at BCT would be assured that there is a moral justification for killing in war.
  • NCOs and officers would talk about the moral justification of killing as part of OES and NCOES.
  • Leaders would talk with their Soldiers about the moral justifications of killing.
  • Chaplains would be fluent in religious and secular justifications for killing.
  • Chaplains would assist justifiably guilt-ridden Soldiers to gain forgiveness.
  • All Soldiers would know that feelings of guilt about killing do not necessarily indicate a moral wrongdoing. Doing a necessary, morally permissible evil can still feel wrong, even when it's right.
  • Guilt would be talked about the way fear is among Soldiers. It's part of the harsh reality of war that it's really hard to prepare ourselves for, but being informed is nonelessless a good start.

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