A distinction between the psychological and physical wounds of war may seem obvious at first consideration.

It would appear easy to separate the wounds of war into the physical and the psychological. Most people have an initial sense of distinctions between them. But when we view them more carefully, these distinctions blur and even become problematic.

Myth 1- Physical wounds are visible and psychological wounds are not.

Indeed, we can’t help but notice and react when we see a veteran with visible war wounds. When we see a disfigured or dismembered wounded warrior, we may cringe, take a breath, and then feel great empathy. Yet, most of the so-called physical battle wounds are invisible to the outside observer. Traumatic brain injury, embedded shrapnel, the internal biological effects resulting from chemical exposure, muscle impairment, tinnitus, and a multitude of chronic and intermittent pain challenges remain invisible to others. In fact, this invisibility can lead those suffering feeling out of sight as well and that their difficulties are not as real as the amputee. Meanwhile, to the thoughtful observer, psychological wounds are quite visible. That is, PTSD is highly correlated with substance abuse, anger/violence issues and a range of behavioral indicators outlined in The Wounds Within.

Myth 2- Psychological wounds are just in one’s head.

Well, that’s partly correct. In fact, that’s exactly correct. But generally that notion means that psychological loans are somehow fabricated in the Ethernet of a person’s psyche. The truth is there are clear physiological changes that happen as a person copes with psychological trauma. The human brain is incredibly adaptive and under high stress or in life threatening circumstances such as combat, the brain goes through complex gymnastics to keep functioning with a primary focus on immediate survival. In the aftermath, however, the traumatic memories of the experience can stay frozen in the brain creating emotional and perceptual difficulties until they have been reprocessed. PTSD is a brain miswired in the neurological sense and though brain scans cannot yet fully map those exact linkages, evidence is clear that the brain is changed by psychological trauma. For instance, the memory-related hippocampus organ actually shrinks in the brain as a result of PTSD. The good news is that trauma-recovery treatments like EMDR can restore the effective functioning of the brain. Effective therapy allows the brain to recover more adaptive functioning.

One of the important reasons to clarify that psychological trauma is physical is to reduce the stigma that still exists. PTSD sufferers should have all the appropriate treatment they need available. They also need support to feel that they can aggressively pursue their own recovery. A person with psychological pain is just as worthy of services as someone with physical pain. In fact, these distinctions also blur because physical pain generally creates psychological pain and psychological pain often manifests itself in enhanced physical pain.

Myth 3- Physical wounds of war are more heroic than psychological wounds.

Why? Do we value our bodies more than our brains? Seems ridiculous, doesn’t it?


Mark Nickerson     January 17, 2015