Captain Nicolas Phillips of Carmel. Credit: Ashley Conti

Dr. Jonathan Shay, a psychiatrist and combat trauma expert, spoke at the University of Maine Wednesday night to a crowd of more than 250 people. Here are five takeaways from his keynote address:

— Let veterans sleep.
“Whatever your role in the world of a returning veteran, as a family member, as an employer, as a friend, as a neighbor, the job [number] 1 of everybody, including every health care professional, is to help a returning combat veteran get adequate, good, quality sleep. Isn’t that a let down? You wanted something much more dramatic,” Shay said. “But there is nothing more critical to the successful return to civilian life than getting adequate, good quality sleep.”

Sleep is fuel for the frontal lobe, the part of the brain that controls self-restraint. Loss of sleep — a common experience for veterans — diminishes the frontal lobe’s functioning, making it harder to control a temper.

— “Learn and care about the boring stuff, the not-dramatic stuff.”
Personnel policies, leadership approaches and training determine the health of the military’s forces.

“I desperately want the public to learn about and care about these things and to demand of our legislators, of our responsible military leaders, that we get these right because these are the factors that will protect the mind and spirit of these good young people,” Shay said.

— Understand moral injury.
Post-traumatic stress is only part of the psychological harm that veterans may carry with them after combat. This other part, moral injury, comes from a sense of abandonment of morality.

“Moral injury is where there’s been a betrayal by someone holding legitimate authority,” Shay said.

A superior might betray what’s right in the veterans’ culture, or the veterans themselves might feel like they betrayed their own sense of virtue.

“It blights the capacity for a flourishing human life,” Shay said. For veterans, it can create a long-lasting expectation that they will be harmed, exploited and humiliated, leading to despair.

— You can do something to help.
“The good news is that people can recover from these kinds of terrible psychological and moral injuries. And while plain vanilla PTSD that is not complicated by moral injury has several successful treatments today that are available from various health disciplines … most of the veterans who drive us crazy, who drive themselves crazy, drive their families crazy, often with fear and grief, and so often end up dead, often by their own hands, this to my mind requires a community,” Shay said.

Often the community contains the veteran’s peers — people who know what the person is enduring. But at a minimum, a community requires several people who are always going to support the veteran.

“The moment a combat veteran is able to know in their gut that they are not forgotten, that they are not targets by even a small number of people, they have begun to heal from moral injury,” Shay said.

— Healing happens by having one’s story told and understood, often through the arts.
“There is an enormous healing power to know one’s story is understood by another person and that then that person retells the story in a way that has the authenticity, the truth content, that the trauma survivor can say, ‘Yeah, somebody listened. Somebody cared,’” Shay said.

Narrative, drama and visual arts can all be vehicles for sharing that trauma.

Veterans don’t have to be good at the arts to benefit from them. “You just have to do it,” Shay said.

Above, you’ll find three videos of Maine veterans describing their experience overseas, their return home, and how their perception of home changed.

Erin Rhoda

Erin Rhoda

Erin Rhoda is editor of Maine Focus, a journalism and community engagement initiative by the Bangor Daily News.