Larry Dewey

Moral injury

in Moral injury

American psychiatrist (MD), Chief of Psychiatry at the Boise, Idaho Veterans Affairs Medical Center for over twenty years. Practised psychiatrist with combat veterans rather than an academic researcher; came to the moral-injury conversation through clinical experience with a single VA caseload over a long career.

Stake§

Dewey writes from the position of a working VA clinician with both a Christian theological vocabulary and twenty years of combat-veteran clinical practice. The stake is that the diagnostic category PTSD does not capture what most of his patients are actually wrestling with, that the categories required are explicitly moral and spiritual (sin, confession, mercy, forgiveness, redemption), and that omitting them from the treatment frame produces care that fails its patients.

Dewey's 2004 book War and Redemption: Treatment and Recovery in Combat-Related Post-Traumatic Stress Disorder (Ashgate) sits between Shay's 1994/2002 books and the Litz et al. 2009 paper that redefined the field. The book uses case material from sixty-five veterans across multiple wars and is structured in three parts; the third part is the explicitly theological argument for sin, confession, and redemption as treatment categories.

Dewey's name does not appear in most of the post-2009 clinical literature, partly because his theological framing fell outside the Clinical Psychology Review register and partly because Ashgate's reach was smaller than the journal's. The book remains the most thorough early articulation of what would later be called the moral injury programme inside VA psychiatry, and is worth recovering for that reason.

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excerpts

The moral, spiritual and existential pain that soldiers experience as a consequence of war.
War and Redemption — Treatment and Recovery in Combat-Related Post-Traumatic Stress Disorder (2004)

[[entity:larry-dewey|Dewey]]'s naming of the missing dimension in the standard PTSD treatment frame, written five years before [[entity:brett-litz|Litz]]'s 2009 reformulation gave it a clinical-research vocabulary. The book uses the case material of sixty-five veterans across multiple wars to make the argument.

on Moral injury