Open Focus: Shelburne’s Jonathan Shay increased awareness of PTSD, ‘moral injury’

  • Shelburne resident Jonathan Shay holds a copy of his 1994 book, “Achilles in Vietnam.” For the Recorder/Richie Davis

  • DAVIS

For the Recorder
Published: 1/12/2020 4:18:55 PM
Modified: 1/12/2020 4:18:11 PM

It wasn’t until he was in his 40s that Jonathan Shay began reading ancient Greek author Homer’s landmark classics, “The Iliad” and “The Odyssey.”

Just a few years later, as a psychiatrist for the Veterans Administration in Boston, he heard the horrendous Vietnam War experiences of his clients as hauntingly similar to those of Homer’s characters Achilles and Odysseus.

“I realized I was hearing the story of Achilles over and over again,” the 78-year-old retired Shelburne psychiatrist recalls. “The Iliad is about the enduring themes of what really happens to soldiers in war.”

Even though Homer’s Greek tragedies were written 2,700 years ago, they reflect perfectly the moral and social world that today’s soldiers live through, Shay says.

With violent conflicts heating up recently between the U.S. and Iran, the former clinician best known for his work with veterans traumatized by combat says he hopes that an all-out war can be averted.

“God forbid there actually is a bigger war in the Mideast,” Shay says. “War is the most hideous activity that humans engage in.”

An audio version of Shay’s 1994 landmark book, “Achilles in Vietnam,” has been released, narrated by Academy Award nominee (“Good Night and Good Luck”) David Strathairn, while his 2002 sequel, “Odysseus in America: Combat Trauma and the Trials of Homecoming,” has already been recorded by Strathairn — both of them at Armadillo Audio Group Studio in Pelham.

Shay, who moved to Franklin County from Newton nearly a decade ago, is a Harvard-trained doctor with a doctorate from the University of Pennsylvania whose medical work shifted from neuropathology to treating combat veterans at the Veterans Affairs outpatient clinic in Boston. There, he says, “the veterans simply kidnapped me” with their compelling accounts of battle.

The 2010 recipient of the Salem Award for Human Rights and Social Justice, for building acceptance of post-traumatic stress disorder (PTSD) as a serious, bona fide war injury, the former psychiatrist disputes the label of PTSD as an illness, disease or sickness. Instead, he argues, saying those veterans have suffered a severe injury as serious as any physical wound from the battlefield.

PTSD represents, he says, the same “enduring response to overwhelming mortal danger the combatants experienced, just as any other species would exhibit.”

Although Shay has had no direct military experience, and in fact was a conscientious objector, he says that status was never held against him by clients because of his profound respect and empathy for what they had experienced and his passion for learning from them. If anything, he adds, they told him they admired him for taking a stand for what he believes in.

“I treasured the opportunity to be useful to these men,” he says. In their therapeutic work, the clinicians provide the arena, but “the vets do the heavy lifting.”

“They know that they’re not crazy, that they did actually go through this insane situation, where other human beings really are trying to kill you, and they’re doing a damned good job of it.”

But in 20 years of working at the VA clinic, Shay says, he related stories from Homer no more than five or 10 times, and only when there was a “zinger of a parallel” to what they were relating from their own stories.

“There was a special kind of a hush,” Shay recalls. “They were really pleased, and usually responded, ‘Tell us more, Doc.’”

In 2018, Shay had named in his honor a Volunteers of America center on “moral injury” to research and promote understanding of the syndrome he helped identify.

Moral injury is characterized by “a betrayal of what’s right by someone who holds legitimate authority in a high-stakes situation, so that there can be personality changes and complications in treating the post-trauma injury.”

In the case of the Vietnam vets in his groups, there were frequent complaints of being issued M-16 rifles that malfunctioned, or being sent out on patrols where they felt like sitting ducks in difficult, unfamiliar terrain by a commissioned officer corps that Shay describes as incompetent.

Shay went on to teach at the U.S. Naval War College, Army War College and Dickinson College. He later received a MacArthur “Genius Grant” fellowship, and he conducted a Marine Corps study in trust that is the basis of a book he’s co-authoring.

The breakdown of trust following moral injury, Shay says, is at the root of dramatic societal problems many veterans brought home because the military didn’t provide sufficient transition services: homelessness, domestic violence, substance abuse and even crimes.

Although Shay says he has “profound respect” for people who serve in the military, he says the experience “is perfect training for criminal activity, and perfect training for knowing how to survive on a prison tier, which is horrifying to contemplate.”

Shay’s “Odysseus in America” book contains the author’s prescription for preventing psychological and moral injury in the military: training troops together, deploying them into danger together and bringing them home with time to digest what they’ve all been through.

Because it destroys a person’s capacity to trust, moral injury, combined with psychological injury, becomes “the poison chalice,” Shay says.

“If you look at the number of combat veterans who become pathologically suspicious of their wife’s fidelity, who are constantly hearing or believing that they are being ‘dissed’ at work. It’s an awful way to live. To have one’s capacity for trust devastated is damaging to society big time. To live with moral injury is to live in a state of chronic pain. It’s awful and can be incredibly scary, because there aren’t a lot of choices. You can run and hide … or you adopt a false identity.”

The problems faced by many — although certainly not all — returning veterans have been compounded by the stresses of multiple tours of duty in Iraq and Afghanistan, Shay notes.

“Nobody in their right mind should doubt that exposure to danger is cumulative,” he says. “The empirical data indicates that very clearly. It’s hideous. ... There’s no safe place.”

Recently retired, Richie Davis was a writer and editor for more than 40 years at the Greenfield Recorder. His email is richie@richiedavis.net.




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