1. Lynne McCormack, Stephen Joseph School of Sociology and Social Policy University of Nottingham August, 2010

3. The Experience of War is Complex  Impact tends to be interpreted through a medical model - i.e. PTSD Lynne McCormack, June, 2010

4. War Trauma “more complex than simply PTSD.......... depression, anxiety, substance abuse...” (Hunt, 2010, p38)

5. Research Rationale There is a paucity of research into the ‘lived’ experiences of war and individual meaning making. Processes used by individuals to redefine their lives following war Sense making when society is antagonistic and scapegoating e.g. Vietnam Lynne McCormack, August, 2010

6. Research Questions? To understanding:  How individuals make meaning of the ‘lived’ experiences of war and homecoming  What processes are used by individuals to following war to redefine their lives both positively and negatively  How does the social narrative influence reintegration and psychological adjustment from war over time. Lynne McCormack, July, 2010

7. Literature informing this study Modern Warfare  Fiala (2008) – Just war theory  Freyd (1996) – caretaker betrayal  Shay (1994) – the berserk state – ?betrayal and grief Lynne McCormack, June, 2010

8. Modern Warfare Morally problematic for young soldiers – no immunity for civilians.  genocide  sexual violence  displacement  psychological trauma  environmental - poverty and disease

9. Research informing this study OVP of growth following adversity (Joseph & Linley, 2005):  Person-centred theory (Rogers, 1959)  Self-determination theory (Deci & Ryan, 1985)  Combines 5 PTSD theories

10. OVP of growth following adversity Joseph and Linley (2005) - integrated model  Completion tendency  Assimilation versus accommodation  Meaning as comprehensibility versus meaning as significance  Hedonic and eudaimonic wellbeing  Social Support believed integral

11. Social support What if: Absent Antagonistic Disinterested How to: Reintegrate Intimacy Narrate Make sense of/comprehensibity

12. Can people grow when social narratives are: absent, negative, antagonistic scapegoating

13. If Social support negative Reintegrate Engage in intimacy Narrate their story Make sense of....

14. Alternate Discourse of Trauma  Interpretative  Subjective  Data driven  Understanding  Generalisable  Objective  Theory driven  Explanation QualitativeQuantitative

15. Participants Nine Vietnam veterans 40 years post war Lynne McCormack, June, 2010

16. Narrative of individual pathology DSM IV criteria for combat related traumatic event All had a diagnosis of PTSD Disability pensions Co-morbid categories: e.g. anxiety, depression, Long term counselling

17. Interpretative Phenomenological Analysis (Smith, 1996)  Semi-structured interviews  Double hermeneutic  Interpretative  Seeking meaning  Unique subject matter Lynne McCormack, June, 2010

18. Strengths of Qualitative Methods such as IPA  Context and meaning  Richer understandings of phenomena  Good in complex situations  New areas of exploration  Subjective meanings, attitudes and values  Distinct epistemological underpinnings Lynne McCormack, June, 2010

19. IPA “.. me making sense of you making sense...” Lynne McCormack, July, 2010

20. Negative and Positive themes Lynne McCormack, July, 2010 Overarching superordinate theme: Moral authenticity: a lone journey out of war

21. Five subordinate themes: Betrayal in youth Betrayal in meaning Betrayal in belonging Betrayal in understanding Reparation with self Negative themes Positive theme Lynne McCormack, July, 2010

22. Betrayal in Youth The beginning of doubt and bewildering grief: Lynne McCormack, July, 2010

23. Doubt: “It was a nasty kick off in life... I didn’t really understand what had happened in Vietnam to get us there in there first place... We were just sent there ‘off you go boys’ ”

24. Bewildering grief: “We grew that close – that’s probably what hurt me the most about the death and destruction – plenty of ours cut to pieces and when you don’t see them anymore and you’ve trained with them, and been through this, then someone comes in and replaces them and – and they are – so that – that – that hurt the most”.

25. Betrayal in meaning: Erosion of trust in others with shameful threat to moral integrity

26. Externalised Shame: “The straw that broke the camel’s back: (Third incident)... so by the time we got this Vietnamese wounded soldier off one helicopter and waiting for another, I’m already sort of starting to get a bit of head – I’m getting a head of steam up cause this bloke’s such an idiot. … of course the guy died and it ended up that I lost it completely – I just – just went crazy and pulled my rifle on him and threatened to blow his head off … - quite out of control, because – because of all this other stuff … we could have done better”.

27. Internalised Shame: Sean: “I thought I was a failure there because I went out and got drunk and got beaten up by the White Mice (South Vietnamese police) and the Yanks and um – … and while I was in hospital, 9 of my own mates got killed … I’d have been with them … so I’d have probably been one of the KIO’s (killed in action)… How do you get your head around it. I don’t know. … I had a vendetta to fulfill – definitely anger ar – probably towards myself you know … Shame is the question I ask myself lots of times over and over …”

28. Betrayal in Belonging Shameful rejection and scapegoating

29. Rejection: “You know, they didn’t even want us back here... I couldn’t pick up where I left off … I just didn’t fit in … I felt alienated from them”.

30. Scapegoated: “People around me just wouldn’t talk about Vietnam because OK it was a war we lost … so the Vietnam veterans probably got the blame for that”.

31. Betrayal in Understanding Shame and misunderstanding in a lone therapeutic narrative

32. Narrative of misunderstanding: “They thought you were mad. You were on your way to the mad house”.

33. Shameful diagnosis: “When I was diagnosed with posttraumatic stress disorder … I felt guilt that I – that I had posttraumatic stress and yet I wasn’t in the field … It seems to have a stigma of we’re nuts or leapers”.

34. Reparation with self Lone growth out of shame, humility and self valuing

35. Growth: “If I was to draw any positives from Vietnam, I know I’d be a stronger person … I can confront tragedy in front of me … emotionally I’ll be strong enough to cope with it … I can confront the demons … and I don’t mind shedding a few tears”.

36. Self-valuing: “You were basically thrown in the deep end and made to think, made command decisions … and we used to do things that took initiative”.

37. Humility: “The word humility comes to mind, only that I am older now and wiser, or wiser after the events. I am thankful for what I have and for what I have had …yes, humility is a big word for me … after all I only did the best job I could under the circumstances”.

38. Betrayal, stigma and scapegoating Shame Other blame Self blame Rage/berserk stateRestraint Humility and Self-valuing Self reparative growth and psychological wellbeing Lone Pathways out of betrayal/shame and personal moral doubt to psychological growth

39. Lynne McCormack, Stephen Joseph School of Sociology and Social Policy University of Nottingham August, 2010