Perpetrator trauma

Therapies that have shown some effectiveness in the treatment of perpetrator trauma include group therapy, eye movement desensitization and reprocessing,[10] Time Perspective Therapy[11] and understanding how common the problem is.[12] Those who suffer, many of whom participated in violence as a matter of social expectation, find it beneficial to know that they are having a normal reaction to an abnormal situation, and are not uniquely cowardly or crazy. Traditional remedies of atonement, forgiveness, and bearing witness have also stood the test of time as being helpful.[13] More vigorous studies are needed for all these suggestions, as well as common PTSD therapies that have not yet been thoroughly explored with the distinction of perpetration versus victimization in mind.

Other proposed treatments have been proven to be ineffective. The “flooding” technique, technically called Prolonged Exposure, which desensitizes the sufferer of trauma by repeated exposure to reminders of it in controlled settings, appears to be a bad idea, counter-indicated when the trauma involved being active in inflicting harm.[14] It may be that expressive writing, which most people find helpful in working through their traumas, instead increases anger in soldiers.[15] Differences in what physiological mechanisms in what pharmaceutical drugs might be useful in therapy are not yet known.

Several of the symptoms are capable of causing or allowing for renewed acts of violence.[1][16] The outbursts of anger can have an impact in domestic violence and street crime. The sense of emotional numbing, detachment and estrangement from other people can also contribute to these, along with contributing to participation in further battle activities or to apathetic reactions when violence is done by others. Associated substance abuse may also have connections to acts of violence.

Perpetrator trauma has been documented among the perpetrators of the Holocaust,[17] the Indonesian Communist Purges,[18] the Cambodian genocide,[19] the South African apartheid,[20] and among slaughterhouse workers.[21][22] In writing about the experiences of American soldiers during the Iraq War, the psychiatrist R. J. Lifton claims in the aftermath of the Haditha massacre:

The alleged crimes in Iraq, like My Lai, are examples of what I call an atrocity-producing situation—one so structured, psychologically and militarily, that ordinary people, men or women no better or worse than you or I, can commit atrocities. A major factor in all of these events was the emotional state of US soldiers as they struggled with angry grief over buddies killed by invisible adversaries, with a desperate need to identify an 'enemy.'[23]

Referring to the definition of "atrocity-producing situation", Morag (2013) was one of the first scholars to theorize perpetrator trauma and delineate the victim-perpetrator distinction in the context of the twenty-first century new war on terror.[24] According to Morag's theorization, perpetrator trauma as an ethical trauma has been documented among Israeli soldiers during the Intifada as well US soldiers in Iraq and Afghanistan.[25] Authors from the PTSD Journal have documented perpetrator trauma among slaughterhouse workers, stating that "these employees are hired to kill animals, such as pigs and cows that are largely gentle creatures. Carrying out this action requires workers to disconnect from what they are doing and from the creature standing before them. This emotional dissonance can lead to consequences such as domestic violence, social withdrawal, anxiety, drug and alcohol abuse, and PTSD."[26]

• Moral injury