Complex psychosocial distress postdeployment in veterans: Reintegration identity disruption and challenged moral integrity.

Abstract

How individuals experience reintegration post-combat and subsequent military discharge is a poorly explored phenomenon though for many service personnel it is fraught with complex psychosocial hurdles. Therefore, seeking both positive and negative interpretations of this phenomenon, semi-structured interviews explored the 'lived' experience of five former military personnel. Using Interpretative Phenomenological Analysis one superordinate theme emerged: Shaping and Breaking: Who am I now? and overarched five subordinate themes. Four themes encapsulated the search for post war identity in these former military personnel. As such, narratives revealed that each participant grappled to understand a destabilising sense of betrayal beyond leadership malpractice. This was interpreted as an enduring organisational failure that was cumulative on core morality changes from exposure to war. Psychological injuries remained fresh and raw despite years since discharge. Memories of feeling discarded, lost, and alone rekindled the self-doubt, distrust, and depleted confidence that fostered an inability to readily re-engage with civility, with loved ones and society. Turning on self, intrinsic blame fuelled either self-loathing or retreat into silence or rage. A fifth theme revealed tenuous insights where minimal acceptance, some redefining of altruistic identity, and hope could emerge. Findings are discussed in light of these results particularly the role of organisations in providing immediate supportive validation of deployment experience where validation of moral distress and identity disruption are included in reintegration programs nurturing recovery and psychological wellbeing.

Moral Injury: An Integrative Review

“…Again, measures of morally injurious outcomes (Currier et al., ; Koenig et al., ) appear more strongly associated with depression than measures of exposure to PMIEs (Currier, Holland, Drescher et al., ; Nash et al., ). Authors of qualitative evaluations have also suggested that morally injurious outcomes and depressive psychopathology co‐occur (McCormack & Ell, ; Purcell, Koenig, Bosch, & Maguen, ); for example, Vargas, Hanson, Kraus, Drescher, and Foy () observed that veterans involved in civilian deaths reported self‐deprecation and social isolation, which are putative signs of internalizing problems.…”

“…The findings of qualitative studies have suggested a range of potential interpersonal conflicts and social problems associated with exposure to PMIEs. For example, some active‐duty military personnel have described perceived or actual rejection by family or friends (Vargas et al., ); resentment due to feeling misunderstood by civilians (Ferrajão & Oliveira, , , ; Worthen & Ahren, ); and loss of trust in military command, romantic partners, government, or society in general (McCormack & Ell, ). Healthcare providers have also cited alienation from fellow providers and occupational guilds after exposure to work‐related PMIEs (Gibbons et al., ; Haight et al, ).…”

Rebuilding Lives: Psychological Trauma and Growth in the Aftermath of a Catastrophic Australian Bushfire

“…Similar to recent studies with veterans and [8], [22], and humanitarian personnel [14], a personal renaissance occurred for these participants through a cognitive struggle to engage differently with the world and self. As such, the participants experienced a re-emergence of empathy and love for moving forward positively.…”

Violation and hope: Refugee survival in childhood and beyond

“…Furthermore, internal coping mechanisms including spiritual and religious beliefs can offer hope, solace and a sense of protection for some refugees (Goodman, Vesely, Letiecq, & Cleaveland, 2017;Pittaway et al, 2009). These findings contribute to the growing evidence of positive psychological consequences possible despite extreme distress following catastrophic and complex trauma, that is, in Afghanistan veterans (McCormack & Ell, 2016), humanitarian aid workers (McCormack & Joseph, 2013) and in healthcare workers exposed to the Ebola crisis (McCormack & Bamforth, 2018). However, making sense of refugee experiences in childhood, and the potential for post-traumatic growth from these experiences, has not been explored.…”