By Brett T. Litz PhD, Leslie Lebowitz PhD, Matt J. Gray PhD, William P. Nash M.D.
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Extra info for Adaptive Disclosure: A New Treatment for Military Trauma, Loss, and Moral Injury
2014) there is some content about how intentional perpetration should be “contextualized” or “processed” but there are no explicit exercises or developed dialogue to illustrate how that might be done. Without the latter, it is doubtful that therapists will know with confidence what to do when confronted by moral injury or whether their approach is replicable based on some operationalized standard. Other content acknowledges that self-forgiveness and separation of a past act from present totality of self are valued therapeutic goals, but detailed techniques to advance such possibilities are largely lacking.
Consequently, after each emotional disclosure and processing experience, the therapist ensures that there is time for a dialogue about the meaning and implication of the military trauma, and takes a very active role in addressing and influencing these emerging meanings. ” In some instances, self-blame may not be altogether inaccurate. In these instances, the therapist may spend less time challenging the accuracy of the belief relative to conventional cognitive therapies and comparatively more time promoting more adaptive future possibilities.
Moral emotions can be evoked by accurate appraisals of culpability even without malicious intent. For a therapist who is unfamiliar with the military culture to assume otherwise is problematic in our view. PE also purports to relieve guilt through contextualizing. . , 2007, pp. 28–29). 16 ADAPTIVE DISCLOSURE More recently, Smith et al. (2013) suggested that PE is appropriate for treating guilt associated with perceived perpetration, or harm enacted “as a consequence of the trauma context” (p. 462), which can include intentional killing while enraged.
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