Understanding PTSD beyond Good and Evil: a (Lacanian) Reflection on Jonathan Shay.

achielleMy encounter with Jonathan Shay’s Achilles In Vietnam was almost accidental. I had never heard before of Moral Injury and, perhaps, not many people outside the circle of professionals have heard or read about it. One day my wife, who works with the veteran community, mentioned that a training/presentation on the idea of moral injury would take place at the VA. I am not an expert on PTSD or trauma studies in general. Nevertheless, my almost two decades long interest in psychoanalysis, and my life long training in literature and philosophy, naturally induced me to explore further this fascinating idea. My first exploration of his research took place online. I found a video in two parts where Dr. Shay summarizes his idea of moral injury. Since my wife has worked for the VA, my knowledge of the veteran community has grown deeper and stronger, and my overall understanding of the toll paid by soldiers and their families has increased accordingly. There is, however, an insurmountable gap of knowledge between those who read about veterans with PTSD and those who work close with them in any capacity:  this is not just a difference in the degree of comprehension, but a profound demarcation between what is visible and what is invisible to the common eye. Psychiatrists, social workers, and health professionals who work with veterans with PTSD handle the consequences of invisible wounds.

There is no fixed symptomatology to decipher PTSD. Most of the time, professionals deal with maladaptive behaviors that make it extremely difficult to discern signals, motifs, and symptoms. We can not observe the traumatic wound like any other wound because we see no visible scar. The invisible wound lurks in the shadows, hiding behind a demeanor that, to most, appears exclusively as an irreducible death wish. It is with regard to the peculiar nature of the soldiers’ invisible wound that the compassionate and unwavering voice of  Achilles in Vietnam stands out. The main idea underscoring the text can be summarized in the following quotation from the last chapter of the book:

The essential injuries in combat PTSD are moral and social, and so the central treatment must be moral and social. The best treatment restores control to survivor and actively encourages communalization of the trauma. Healing is done by survivors, not to survivors.

In order to clarify such a statement, we need to approach the problem of PTSD from the point of view of the social context in which the veteran is reintroduced. Veterans are not the only demographic to carry the silent wounds of a traumatic experience. Yet, veterans are victims of an ambiguous morality. On one hand, the traumatic wound is recognized as the trace of an unordinary experience transcending common knowledge. On the other hand, the wound is relegated to a voiceless space that prevents its bearer from finding its locus, its space in the commonality of social experience. Besides being a scholarly inquiry into the limits of PTSD diagnosis, Achilles in Vietnam is a melting account of voiceless wounds struggling to find their narrative and their place in our social chain of signification.  The ambiguous moral stance toward veterans has a strong rhetorical connotation. While the general public feels compelled at any given occasion to “thank” a veteran for his/her “service,” the level of empathy and understanding does not go further than a charitable compassion.

Most of the time, whenever we “thank” a veteran for his/her service, we reopen the traumatic wound and we silence it even further. We often lack the perception of the overall rhetorical significance of our gesture. While we may experience it as a due sign of respect and recognition, we usually overlook the conflicting attitude and reluctance with which our thanks is received. In fact, when we say “thank you for your service,” we hardly know what exactly we are thanking that person for and we forget that a thank you, usually, would imply also a “you are welcome.” However, we never hear a veteran answer back to us “you are welcome.” Usually, a veteran would answer by thanking us back. As a matter of fact, this exchange of courtesies obliterates the very object of the conversation. Our recognition bounces back to us. The rhetorical conundrum consists of this misfire of communication. The object of the service is glossed over, unspoken, removed from language as well as from understanding.  As John Austin would say, thanking someone is a performative expression as it enacts what it states. The paradox is thus that the rhetoric of the “thank you for your service” performs an action without a definite object, it is a sort of intransitive utterance that hitherto only indirectly addresses its target. The lack of recognition of the act of thanking (the absence of a “you are welcome”) determines a failure in the communication process as it hinders the necessary reciprocity any speech needs to effectively carry out its function. To use a linguistic distinction, the veteran’s utterance of the returned “thank you” determines a misrecognition of the speaking subject. In obliterating the object of the service, the veteran enunciates something that our ears are not trained to capture. What we hear is not what is being said. The service that we civilians believe is worthy of praise and gratefulness hides, in fact, a much larger deconstructing narrative that does not only yield to be heard but, above all, necessitates a proper space in the social chain of signification. In order to better grasp the importance of this necessary reciprocity we can start by analyzing a passage from the end of the book:

Unhealed combat trauma -and I suspect unhealed severe trauma from any source- destroys the unnoticed substructure of democracy, the cognitive and social capacities that enable a group of people to freely construct a cohesive narrative of their own future (pp. 181)

How can combat trauma undermine the substructure of democracy? What is a cohesive narrative? Shay uses the story of Achilles as told in the Iliad as a master plot to understand the process of the undoing of the character. A character is always a social construction. Its undoing is parallel to the undoing of established moral and social coordinates. According to Shay, our collective understanding of character and trauma is negatively biased. Our bourgeois culture instilled in us the belief that a good upbringing, associated with a good social context, always forges a strong character capable of withstanding obstacles and to defy traumatic events. Shay strongly refuses this cultural assumption. The good upbringing can be negated by a betrayal of what is socially understood as good. As Lacan reminds us in his seminar on The Ethics of Psychoanalysis, what is socially good is what is acceptable and permitted by the law: “the domain of the good is the birth of power.” As a consequence, we should thus consider that a good and strong character is also sustained by a good law. It is important to understand that, from a psychoanalytical point of view, there is always a conflicting dialectic between what a subject seeks for pleasure and what the socially accepted good allows as pleasure. The good standing of a character depends on the precarious balance between personal drive and demand of the law (the Lacanian other). In real life, the demand of the law and that of the drive rarely coincide. In a military context, the power that is the depository of the good is also the power immediately responsible for the very survival of the individual. This is the dramatic difference: in a normal social context, the betrayal of what is right may cause an unbalance between personal pleasure and demand of the law, while in a combat context the same betrayal may determine the life or death of an individual. The cohesive narrative that PTSD destroys is a cloth woven by both a personal and social thread. The texture of combat trauma must be dispelled within the framework of the overall social narrative. The social discourse about what is good must be reintegrated into the discourse of the survivor who has seen the good betrayed by the law that demanded it in the first place. Shay defines moral injury as

the betrayal of ‘what’s right’ in a high-stakes situation by someone who holds power.

The concept of “what is right” is thus mingled with the fear of death. The idea of what is fair, in a high stake situation, is radically associated with deprivation and destruction. As Lacan also points out:

The true nature of the good, its profound duplicity, has to do with the fact that it isn’t purely and simply a natural good, the response to a need, but possible power, the power to satisfy. As a result, the whole relation of man to the real of goods is organized relative to the power of the other […] to deprive him of it.

When someone holding power betrays “what is right,” he/she is breaking the very balance between a person and her/his sense of precarity in relation to what can be lost. In order to restore trust in the social order, a survivor suffering from PTSD should first have his/her faith in power restored and, inconsequently, in the overall social rhetoric that expresses the common notion of what is good and what is bad. According to Shay, to make this possible, we need to operate a shift in the way we collectively think of post-traumatic stress disorder. I felt compelled to refer to Lacan to stress the importance played by discourse and social chain of signification in Shay’s argument. Despite not being a psychoanalytical study, Achilles in Vietnam can also be regarded as an inquiry into the need of building socially cohesive narratives and their limits.

The idea of describing the undoing of the character by following the master plot of Achilles reflects this understanding of trauma as a collective, social, and cultural experience. At the beginning of the Iliad, when Agamemnon seizes Achilles’ spoil/prize (Briseis) as compensation for giving up his own spoil/prize Chryseis to appease Apollo’s wrath, we do not simply witness an injustice toward Achilles, but to a misuse of power and authority. Agamemnon’s reluctance, at first, to give up his spoils of war causes a plague in the Achaean army. When confronted with the disastrous consequences of his blindness, he reluctantly returns Chryseis to her father who had previously tried to ransom her to no avail. The king is guilty two times: first toward his entire army for disrespecting the Gods by mistreating one of Apollon’s priests and, second, toward Achilles for unfairly claiming for himself what rightfully belonged to the son of Peleus. The traits that characterize Agamemnon’s behavior are duplex. On one hand, the king’s action was about to jeopardize the entire military campaign. On the other hand, his unwillingness to recognize his mistake led to a second offense against an individual soldier (Achilles). Agamemnon’s action disrupts the cohesive narrative of the Acheans. The irresponsibility and prevarication of the king undermine the self-representation of the soldiers. Achilles can no longer mirror himself in the higher structure of authority. His war becomes only his. The loss of trust in the authority holding power, and thus defining what is good, results in a progressive lack of trust and respect toward any social bond.

The master-plot of Achilles shows how the betrayal of “what is right” (themis) by someone who holds power in a life threatening situation unsettles the shared norms, expectations, and values of an army. War is always presented as a just war. Soldiers assume to be fighting the good fight, to be on the right side of the battlefield. The betrayal of trust into the responsibility of power and its notion of good debunks the very belief into a just war. Achilles in Vietnam collects several stories of Vietnam veterans who progressively question the fairness of authority and, thus, the fairness of the war itself. If I am fighting for the right cause, why am I ordered to kill women and children? If my service is valued by my country, why is my rifle defective? If my superior cares about my life, why am I being left behind?  The nature of the modern warfare machine hinders the possibility for a soldier to recognize who is responsible for what. The betrayal of what is right produces a moral injury because the categories of good and evil are irremediably suspended. While Achilles can blame the misfortune of the Acheans straight onto Agamemnon, the modern soldier faces a more mystifying and complex hierarchy of power. The moral injury should be intended as well as an injury of the moral. The loss of meaning of categories such as just, fair, and good is accompanied by a parallel eradication of the categories of wrong, evil, and unfair.

The lack of distinction between good and evil does not mean a confusion of the two. What happens is that under a constant life threat, good and evil cease to matter. As Lacan writes,  good and evil belong to the category of representation (Vorstellung): they are not objective entities, but figures of identification and regulation of the social apparatus. A cohesive narrative, at the individual and social level, is made possible by the binary opposition of the two representations as they are imbued with historically determined meanings.  The suspension of good and evil precludes the possibility for the subject to find that thing (das Ding) that makes someone happy within the accepted social boundaries. Lacan stresses the importance of this thing to remind us that pleasure and individual happiness are not defined by the moral principles of society but by the ethics through which an individual finds his/her own way to pleasure and happiness between the confining and limiting structure of morality. The moral injury injures morality. The absence of the law (of the good law) determines a void, an absence that dehumanizes the subject. How does this apply to the condition of veterans with PTSD?

Jonathan Shay argues that the breaking of the social order through the betrayal of what is right reduces the subject to an emotional state that is either above or below of what we normally consider “human.” Shay shares as examples stories of soldiers who either went berserk (experiencing the rush of super-powers) or began to perceive themselves as animals rather than humans. In either case, the subject places him/herself above or belove the human level. The lack of faith into any authority holding the cipher to what is good prevents the veteran from restoring his/her faith in the social apparatus as a whole. The narrative of the veteran speaks a language that our moral order, culturally constructed, does not understand. When we thank a veteran for his/her “service,” we believe to be giving recognition for something good. At the same time, however, the veteran can no longer receive such a recognition because the notion of good is gone along with the faith in the possibility, for a social order, to maintain and sustain such a notion. The veteran who carries a moral injury is not able to find anymore the thing that would make him/her happy, that would give him/her pleasure, since the system of representation, within which happiness is allowed, has faded. The thing we believe can give the veteran some pleasure when we say “thank you” is not the thing the veteran is seeking.

When Shay claims that healing should be made by survivors and not to survivors, he emphasizes the gap between our language and that of the veteran. Our language still belongs to a cohesive narrative, while that of the veteran does not. In a cohesive narrative, we are able to distinguish what matters. A survivor who carries the wound of a moral injury has lost the notion of what matters because any notion of good has been suspended. According to Shay, we should create the condition for a veteran to piece “back together the fragmentation of consciousness” by refining our listening skills.

To use a Lacanian framework, if the subject has discovered that his/her demand for meaning can no longer be satisfied, and his/her voice is “barred” by the lack of a fulfilling chain of signification, the quest for the thing that would give pleasure is also abolished. We need to redefine our listening strategy by suspending our cohesive narrative of good and evil. We need to understand that the social bond that ties us to a veteran is fragmented and so is his/her consciousness. Listening beyond good and evil means to momentarily dissolve our belief in the interpretative and normalizing power of words. We need to participate in the lack of the veteran, enacting a sort of transfer where the void of meaning is not mechanically replaced with our meaning. According to Shay

What a returning soldier needs most when leaving war is not a mental health professional but a living community to whom his experience matters.

In order for us to see the story of the veteran as something that matters, we need to assume that the story has something to tell us that we do not know. We need to desire the story of the survivor as much as the survivor needs to desire to tell it. Something can matter only if it expands our horizon. If we assume that our social cohesive narrative, where good and evil are solidly defined, is always capable of understanding a story and validating it, we are doomed to fail. A story matters only if we listen to it as something new, as something that has the potential to shift the structure of our own story. To reestablish faith in something good, we need to share the lack of the thing. Only by seeking reciprocal meaning, our stories and the survivors’ stories can be communalized.

The “Big Other,” as Lacan calls it, is a necessary representation to sustain our belief in an authority granting meaning to our lives. As a matter of fact, there are only partial “others,” small individual stories that weave the texture of our existence. In listening beyond good and evil, we should perhaps consider that what matters is to share the feeling of the lack(ing), to reciprocally acknowledge the absence of certainty in our social order, and to traverse our demands with the awareness of being all doomed to return to the same fantasy: to retrieve what we believe we lost, that thing inside that has been stolen and hidden from us. Yet, even this thing beyond good and evil may be only another necessary illusion of our representation of life. For something then to really matter, we need to look at ourselves as all “barred” and, as Lacan says in his seminar on anxiety:

“let the other be the other, the place of all signifiers where we become histories.” 

Let a survivor be the other who reveals to us something that matters, and let us be the other who listens without trying to bring back what is definitely lost. The undoing of character should be intended as something that can not mechanically be re-done. There is no formula to rebuild a character as well as there is no formula to build a character able to withstand any traumatic experience. The undoing of the character is the open-ended narrative of a story that has crossed the boundaries of morality. Healing the injury is writing a book without knowing how it will end, without assuming for the other the existence we would like for ourselves, and accepting the possibility for that story of un-do ing our own character and reshape our own narrative. Let the other be the other….

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