On "moral injury': Psychic fringes and war violence
On "moral injury': Psychic fringes and war violence
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DOI：
10.1177/0952695117750342
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发表时间：
2018-04-01
影响因子：
0.9
通讯作者：
MacLeish, Kenneth
中科院分区：
文献类型：
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作者：
MacLeish, Kenneth
本文关注的是将创伤后战斗压力解释为在不确定的战场条件下实施致命暴力的冲击所产生的精神伤害的理论和治疗实践。虽然精神伤害据说与创伤后应激障碍（PTSD）有许多共同的症状，但它的支持者-军事和退伍军人健康管理局临床心理学家，牧师和一些精神病学家-担心PTSD无法解释伊拉克和阿富汗的反叛乱战场据称特别容易在美国士兵中产生的基于意义的道德和伦理困扰。精神伤害理论家似乎想描述一种比创伤后应激障碍更深刻的现象，但正如临床心理学家希拉·马古恩和布雷特·利兹所说，这种现象本身并不是一种精神障碍。在这篇文章中，我研究了精神伤害理论的边缘诊断状态和它所理解的对士兵心理造成独特伤害的暴力类型的边缘状态之间的联系。道德伤害使战争和军事文化价值化，同时将战争视为几乎不可避免的精神病理学的来源。我认为，精神伤害理论代表了一种努力，开拓出一个独特的领域的心理学专业知识，但也谈判的紧张局势之间的战争暴力的正常的实践和过度或道德上危险的表现-这两者都直接链接到政治的精神疾病的战争暴力和战后护理。
This article is concerned with theories and therapeutic practices that interpret post-traumatic combat stress as a moral injury' produced by the shock of carrying out lethal violence in uncertain battlefield conditions. While moral injury is said to share many symptoms with post-traumatic stress disorder (PTSD), its proponents - military and Veterans Health Administration clinical psychologists, chaplains, and some psychiatrists - are concerned by PTSD's inability to account for the meaning-based moral and ethical distress that counterinsurgency battlefields in Iraq and Afghanistan are allegedly especially prone to produce in US soldiers. Moral injury theorists seem to want to describe a phenomenon that is both more profound than PTSD but which, as clinical psychologists Shira Maguen and Brett Litz state, is not itself a mental disorder. In this article, I examine the links between moral injury theory's fringe diagnostic status and the fringe status of the kinds of violence it understands as uniquely injurious to soldiers' psyches. Moral injury valorizes war-fighting and military culture while casting war as a source of almost inevitable psychopathology. I argue that moral injury theory represents an effort to carve out a distinct domain of psychological expertise but also a negotiation of the tension between war violence's normal' practice and its excessive or morally hazardous manifestations - both of which link mental illness directly to the politics of war violence and post-war care.