Shame, Guilt, Self-Hatred and Remorse in the Psychotherapy of Vietnam Combat Veterans Who Committed Atrocities

A subgroup of Vietnam veterans suffering from combat-related Post Traumatic Stress Disorder (PTSD), committed atrocities while serving in Vietnam. Years after their service in Vietnam ended, certain veterans continue to exhibit shame, guilt, self-hatred and a sense of being interminably unforgivable, all feelings related to the atrocities they committed. In this paper, the inability of these veterans to express remorse is seen as a key dynamic in their treatment. Therapists eager to “get the patient over his guilt,” and particularly his sense of being unforgivable, may short-circuit the patient’s attempts to express remorse. The working through of a patient’s shame, guilt, and self-hatred are fundamental to the expression of remorse. This process is examined and treatment recommendations are made.