PTSD – Living With Guilt and Shame

PTSD - Living with guilt and shame.

By Mary Tendall and Jan Fishler

Part One: The Combat Veteran’s Perspective

Combat experiences create many unresolved memories that can lead to feelings of guilt and shame. What one sees, hears, and does – and even what one thinks and feels during and following combat – can contribute to conscious and unconscious guilt and shame. The mere act of having survived leaves many veterans remembering those who were “more worthy to live than me.” Other veterans confide that they live in the hidden world of shame, where their memories are as devastating as actual combat experiences.

Intrusive homicidal thoughts following an altercation, fear of spiritual rejection, guilt following an overreaction to family and friends, severe judgment of self and others, guilt over excessive isolation, and the feeling of being completely unique with this burden are some of the ways memories manifest for combat survivors. Because each combat experience is unique, it would be inaccurate to make generalizations. However, it is safe to say that combat veterans share certain beliefs and perceptions that lead to the emotions of guilt and shame. These include:

Failure of self and others to meet specific ideals and standards of competence.

Bob described working on projects in his shop and constantly trying to “get it right.” He frequently blamed himself and others in the process, and showed up irritable and withdrawn when joining family members later in the evening. Alcohol was his way of numbing those feelings and avoiding conversation. He described having no tolerance for what he perceived as carelessness or incompetence, which he saw everywhere. He now realizes that his feelings were due to the fact that, in combat, incompetence could be life threatening.

Decreased value of self and others

After several therapy sessions, Jim said he was certain he would be going to hell when he died. He said that he went to church to please his wife, but he saw others as hypocrites. He explained that what he did “over there” could not be forgiven. He refused to allow others to compliment him or offer him verbal or physical affection (except his dog!). His fear of hell actually saved him from suicide on numerous occasions. Now he is working hard to find ways to accept and trust the love of his family, and finally to accept himself as a devoted husband.

Defensive responses to shameful memories

These responses might include increased self-medication with alcohol and drugs, withdrawal and isolation, criticism of “everyone else,” pre-occupation with watching TV, hours on the computer, or excessive physical activity.

He explained that what he did “over there” could not be forgiven.

Wendell drank alcohol to numb his feelings and memories. When his doctor told him his body couldn’t take it anymore, he turned to all-nighters on the computer. Gradually, with therapeutic help and support from his family, he substituted some of his computer time for gardening with his wife and playing senior softball with his friends.

Anger and disgust toward self and others

Paul is a gifted and talented artist who would not let anyone outside of his immediate family see his work. In his mind, his effort was never good enough, yet when he went to exhibitions, he called the work of other artists garbage, and left within minutes, feeling angry and disgusted. Although prior to combat, he was encouraged by his parents to pursue a career in art, he says that he has never really enjoyed painting since combat. At the same time, he feels compelled to continue. Paul has shown me photos of his work, which is exceptional enough to be exhibited in galleries.

Lack of emotional intimacy and sense of joy and happiness

Although his current wife loves Michael dearly, he believes that if she knew his “horrific thoughts,” she wouldn’t be with him. “When she is happy and affectionate with me, I feel like a fraud.” Because Michael believes he is unworthy of his wife’s loving nature, he withdraws and looks for faults “in everything.” He has stated that he doesn’t deserve to feel joy. “I’ve seen too much.”


In each of the cases described above, the veteran has worked on his trauma symptoms using neurosomatic treatment along with cognitive behavioral work. Creating new neuro pathways to process sensitive input as well as having an understanding of the process, helps the veteran to be in charge of his reactivity and decrease it on a continual basis. This gives him the tools he needs to regulate his reactive behavior before his symptoms become a problem. Other veterans have joined support groups (available at Veteran Hospitals and Vet Centers), openly shared their feelings, and found great relief in discovering they are not alone. By learning how to self-regulate their symptoms, veterans are able to decrease the attack/avoidance syndrome and integrate the separation of thoughts and feelings.

Part Two: Jan’s Perspective

It has been 14 years since my husband was diagnosed with PTSD, and our family continues to work on healing from the impact of war. Initially, understanding the behavior associated with PTSD and mastering the intellectual aspects of war trauma dominated our efforts. It was not difficult to understand that the reactive behaviors resulting from PTSD are a normal response to a combat experience.

This was a big first step in developing compassion. The next hurdle was realizing that various behaviors like shouting and reactivity were not personal attacks, but a need for combat-ready order. Finally, our family learned techniques and strategies for avoiding confrontation and keeping the peace.

Awareness of the guilt-shame cycle is the initial step for integrating these emotions.

In essence, over the years, we found and employed tools to manage the symptoms, but beneath the surface, our family’s emotional pain lingered. The terror, rage, anguish, guilt, and shame my husband brought back from combat was like a cold – eventually, everyone in the household caught it and passed it on. Awareness of the guilt-shame cycle is the initial step for integrating these emotions, and can go a long way in promoting understanding and compassion within the family.

The Cycle of Guilt and Shame

On a very simplistic level, the cycle of guilt and shame occurs like this: A man comes back from war carrying guilt and shame, the raw emotions of combat, and feeling unworthy, disgusted, and unlovable. To cope with these negative feelings, he tries various methods of sedation, such as drugs, alcohol, sports, television, work, and sex. When he is not sedated, he is outraged and angry. Friends and family quickly learn this, and try to avoid setting him off, but in spite of their efforts, situations in daily life occur which propel (trigger) him into action. Programmed to win at all cost, he reacts. Those around him – especially family members – feel the impact of his emotional reactivity. As a result, they become hooked and also react: They fight (argue, call him names, even hit him); take flight (they move away, run away); or freeze (become emotionally numb and detached).

As each side tries to “win,” the cycle of victor-victim begins, and in time, everyone is walking on eggshells. Eventually, this dis-harmony turns into anger and resentment, and both parties end up with feelings of guilt and shame.

Wives and Family Members

During a support group for veterans’ wives, the women were asked to talk about their own feelings of guilt and shame. Below are some of the stories they shared.

Linda’s Story

My family has a lodge at Lake Tahoe. My grandfather and his brothers built it, and it’s large enough to accommodate our entire family, plus friends, any time we want to use it. When Sam and I got married a few years ago, I brought him there for the weekend to go fishing – something I know he loves to do. My brothers took Sam out on the boat, and when the guys came back, everyone had caught their limit. That night, we cooked up the fish and sat around the table drinking beer and wine and telling “fish tales.” I thought Sam had a good time, but whenever I suggest going back, he makes up some lame excuse. His unwillingness to go – especially when he knows how important it is for me to spend time with my brothers and their families – makes me furious. I’ve gone by myself, but when I do, I feel guilty about leaving Sam behind. And I have to make up some story about why Sam couldn’t come with me. When I get back, I’m so angry with Sam, I can barely tolerate him.

Susan’s Story

I’ve been with my husband, Jesse, for 30 years. When we first got married, he would have an occasional beer, but now he has at least a six pack each day, and last year, he got a prescription for marijuana “to help him with back pain.” Every morning he goes out to his shop to “take a puff.” I’m sure the pot helps, but I hate how he acts when he’s stoned. He talks in circles, is even more forgetful than usual, and spends the day doing something that should take only an hour or so. I was looking forward to our retirement years, but now I don’t want to spend time with him. I feel guilty about the excuses I come up with to avoid being with him, but I don’t know any other way to cope. I wish we could talk, but his altered state makes reasonable conversation next to impossible.

June’s Story

This incident occurred several years ago, when our son Randy was about 8 years old. At the time, I thought my husband, Tom, was simply impatient and demanding – always expecting too much from the boys, but if I look at the incident again, knowing what I know now, I see it differently.

Tom wanted Randy to learn how to mow the lawn, but Randy was anxious about using the mower, and was reluctant to try. After a five-minute demonstration, Tom passed the mower to Randy and told him to go ahead. Tom then left Randy, who was barely able to reach the handles, alone to do the task. From the kitchen window, I could see Randy struggling with the mower. Although I wanted to go out and help, experience told me not to intervene, as Tom had often accused me of pampering the boys, especially Randy, our youngest. Ten minutes into the task, Randy was crying in frustration.

Wondering where Tom was and why he wasn’t providing our son with more instruction and moral support, I went out to help. That’s when Tom appeared, looking angry. We reached Randy at about the same time. Tom spoke first and demanded, “Why aren’t you working?” Randy tried to cough up an explanation, but Tom didn’t have the patience to listen.

Instead, he grabbed the mower from Randy’s hands and muttered, “If I want something done right, I guess I have to do it myself.” Randy, who wanted to please his dad, was devastated, and I was furious at Tom for both his lack of compassion and for setting Randy up to fail. I sent Randy into the house to wash his face, and then approached Tom, who could tell I wasn’t happy. He turned off the mower and stood with his hands on his hips, a posture I had come to recognize as “the battle stance.” Tom was quick to defend his position. An argument ensued where he accused Randy of being a mama’s boy and me of babying him. This wasn’t the only scenario like this, but it stood out because it seemed so unfair.

At the time, I remember thinking that Tom should be ashamed of himself for treating his 8-year-old son this way. Of course I didn’t take Tom’s military training into account, and it didn’t occur to me that learning a task quickly and doing it accurately was the driving force behind Tom’s actions, the difference between life and death. While Tom’s military programming might have worked in the battlefield, it became emotional abuse when directed toward his young son.

What I didn’t realize until now was how bad my husband must have felt about himself.

How do guilt and shame fit in? To this day, Randy doesn’t like to help his dad. Now 30, Randy has expressed guilt about not doing more for his father, but those old wounds are deep. At the time, I felt guilty about allowing Randy to be set up for failure, and I was ashamed of myself for putting up with my husband’s accusations and verbal attacks. I used to argue with my husband, but at some point I surrendered and withdrew. What I didn’t realize until now was how bad my husband must have felt about himself – must still feel about himself – and how guilty and ashamed he must have been for causing Randy and me so much pain. (At this point in her story, June had tears in her eyes, and then she said, “For years, under my breath, I’ve been calling Tom an asshole. Now, I realize he was just a victim, too.”)

Maria’s Story

To avoid his anger and reactivity, I’ve been lying to Juan for as long as I can remember – mostly about money, but other things, too. Juan grew up poor, and he watches every penny and is always afraid I’m going to spend too much money. We’re on a fixed income now, and he’s worse than ever. At the grocery store, I’m always careful to buy food that is reduced or “on special.” But if I go shopping with my sister or my mom – to buy clothes or household items I want, but don’t really need – I sneak the bag into the house when he’s not looking. I’m ashamed of myself for behaving this way, but at this point, I’ll do anything to avoid confrontations with him.

Barbara’s Story

I don’t know if I’m ashamed of myself for the affair I had, but I definitely felt guilty about it at the time. My husband’s lack of affection drove me to it. I wasn’t looking for someone else – I loved my husband and didn’t want to leave him – but a co-worker and I hit it off, and one thing led to another.

I don’t think my husband ever suspected anything, and I never told him. While I don’t feel guilty about having the affair any more, I do feel guilty about keeping it from him; although at this point, I think honesty would probably do more harm than good. Because he has so many issues with trust, this would just add fuel to he fire.


Guilt and shame create a vicious, no-win cycle that carves out a path of emotional pain that both veterans and family members carry for years. The resulting deception, blame, and unhappiness breaks down communication, establishes a pattern of unhealthy behaviors, and creates years of unnecessary stress and tension.

Compassion and understanding can begin the healing process, but the ultimate goal for all parties should be clear, honest communication, mutual understanding, and self respect.
*Names and some situations in this article have been changed. Some photos may include models who have no real-life relationship to the story or any PTSD issues.


Mary TendallMary Tendall, MA LMFT, has worked for over 20 years with combat veterans and their families, as a licensed psychotherapist, specializing in combat-related PTSD. She has consulted for the Gulf War Resource Center, National Public Radio, and Newsweek. She continues to work with combat veterans and their families, and is affiliated with several national non-profits whose goal is to help veterans, such as VietNow, Soldier’s Heart, Train Down, and America’s Heroes First. She can be reached by e-mail at


Jan FishlerJan Fishler is an author, writing coach, and creator/presenter of a series of writing workshops. Her memoir, Searching for Jane, Finding Myself, is available on Amazon. You can learn more about her at She is married to a Vietnam veteran.