TBI is PTSD and moral torture

I have read that a traumatic brain injury (TBI) is now closely associated with Post Traumatic Stress Disorder (PTSD). I have also read PTSD is associated with a moral injury. These words are weak for me, as it is more like a brain injury is moral torture. I say this because when my mental connections are going haywire and the madman is attacking within I have grandiose delusions. These delusions have a life of their own. Then, as a result of this, I will project my fear and aggression onto others. My projecting my fear and anger onto others does not happen near so much now, and yet for some reason my mind is finding nothing true or valuable to believe in. It seems senseless and useless.

Because of the senselessness and uselessness I still experience my aggression and anger against myself or others. It is no simple on-off switch. It is like my TBI and PTSD are deep states of reactivity, deep states of self-alienation, suffering, and self-destructiveness ---- and everything in between. I feel caught in a web of illusions and the torture is more reactivity, self-destructiveness and compulsivity. The extreme torture is being “told” who I am not, even by my own brain, and then the madman attacks.

Maybe my flaws and irrationalities, even within my burning rage, are not merely incidental to who I am. It is just seems this raw material makes my brain unable to filter this TBI and PTSD into a accepting my powerlessness. I say this because my rage is pointing directly at the powerlessness and nothingness. The real powerlessness is teaching this madman to not impose patterns and projecting an enormous idea onto every circumstance. So within my mental torture I just needed to write so I could let go. It is my way of finding space within my torture.

Thank you for allowing me to be direct, no matter how unseemly and unflattering I may be, as this helps to find courage to accept.

Syd, Just reading your first few sentences here, and its kind of like a light bulb as turned on. I have wondered for quite a while now if I didn’t have some kind of ptsd, but wasn’t sure how I would have gotten it. Well, duh. It makes perfect sense that tbi and ptsd would be associated with one another. Thank you for posting that. How could one have a tbi and not have a bit of ptsd?
I am not sure what “moral injury” means to be honest. And I’m sorry you are having a hard time. Sometimes, I feel rage too, I guess we all do. Its just that some days with these tbi’s are more difficult than others and I am not sure how to express it myself, quite frankly. Or my feelings in general. I try to say one thing, it comes out wrong, someone gets mad or feelings hurt. God forbid anyone think about the fact that we have TBIs and may not say or do everything just right.
For what its worth, I still wish I had your sense of language and writing.

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The ptsd side of things is natural. 'Post TRAUMATIC…" Of course its traumatic, our world, as we knew it, has been turned up-side-down, how much more traumatic can you get??? I believe it’s how we deal/manage/cope with it all that makes the difference.
Aly, I know for me it’s how I deal with it all mentally that has a huge impact. Get me on a bad day and I have a chronic case of “foot IN mouth” disease where I’m honest, too honest and I offend people without even trying. I often think “Hell, can you image how bad they’d be offended if I’d tried”. But then I tell myself I can’t control their emotional reaction to my statements. I can, at times, be a little insensitive, but then often so are their statements ie “Ohh just get over it”, jeez, if I could I would.

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Merl I agree, a lot of it is how we deal with it. And if I’ve gotten enough sleep and am feeling ok, usually all is well, I can look over and ignore. If not, I have noticed I just don’t have the patience for certain family members anymore. I think maybe I have kept quiet for so long, they just think I will continue to be walked on, but I am getting tired of that.

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You are talking about the book “Achilles in Vietnam” where the author talks of moral injury. But, he is saying the moral injury CAUSED the PTSD, not the other way around. It is a very good book, based on the Iliad.

Jonathan Shay is the author. He predicates his work on the Iliad and several words in the text, such as Θέμις (themis), which is doing what is right.

The Iliad more frequently uses the Greek work " θυμός" (Thumos) which I believe gets to the heart of things more quickly.

θυμός (thumos) is often translated as “heart” or “soul” or “mind” etc. but it is actually untranslatable. It is actually something like a homeostasis which monitors if you are being subjected to honour or dishonour.

If you are dishonoured, your “thumos” rages. If you are honoured, it purrs. It is a very complex word.

So back to PTSD. Once you are dishonoured and your world falls apart, you may act in ways to make you feel shame or bring dishonour, like a viscous cycle. Think of Achilles. If you have not read The Iliad lately, please do. It makes sense of trauma and Shay made an excellent choice of using it as his backdrop.

In the end, Achilles acts again, this time with honour in returning the body of Hector.

Aristotle picks up on this idea in his Ethics. Our ACTIONS make us who we are, too. Once we have TBI and PTSD, oh yes, it is hard. Impossible at times, but we can still choose to act when we are in choice mode.

I am not saying we can all the time. I can’t . I get depressed and angry and confused, but when I am in a good spate, I do all I can to do noble acts and make people happy in any way I can.

The more you can act in good ways, the more that is who you become. When I am unable to do good, I isolate.

I am not saying I have the answers, but Homer has a lot more than I do. Read the Iliad :slight_smile:

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I agree more than I can express with your statement "…but I am getting tired of that."
I have a family member who, to be honest, should know better but one day he pushed my buttons too far and I exploded at him. I’d had enough of his snide comments. I told him “If I want an a&%holes opinion I’ll fart, other wise shut your ^%$#@# mouth”. He was offended, but I’d put up with his smart arse remarks again and again with no reaction at all, so when I finally did react it was a bit of a shock to him. My cup overfloweth. I must admit I try to be tolerant of ignorance but you get me on a bad day and my tolerances are next to nil. You can see in my face when I’m not having a good day and to be ‘poking the bear’ on a bad day will get a reaction. He did not see my reaction as proportionate to his comment, but when you add it to his other remarks it certainly fitted the situation. Arrogant sod.
Approx 3 weeks later he had a flu, and had time off of work for it, so I had a similar dig at him and what a surprise, he didn’t like that at all. But guess what, he hasn’t made a comment since.

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Good for you, Merle! I am at the point its just a good thing I only live with my husband, although our kids will always be welcome here. They aren’t dumbaskes.
Why is it, there are rules for some and different rules for us? I am tired of being nice and helpful. I am tired of certain family members only calling me, or answering the phone when I call, when they need something. I was never like that and still am not.
I guess tonight I am just kind of in a snit.

I think it’s different for us because our injuries are not seen. If you break your arm, it’s in plaster and people can see it. Also with some injuries, they are sore and things heal and improve at a fairly much steady rate. Ours don’t. Ours can fluctuate massively from hour to hour, let alone day to day. For some people (including the medical fraternity) this is not ‘normal’, whatever the hell ‘normal’ is. Normally we hurt, we rest, we heal. That ain’t the case with a brain injury. This seems to be a frustrating fact for the medical fraternity as they seem to love making judgements, but if they think this is a leisurely walk in the park for us, they are sadly mistaken. For me I know they think my judgements of them are unfair and not warranted but my judgement of them has come as a result of their judgements of me. I’m a strong believer of what goes around comes around. Treat me with respect and I’ll respect you. Judge me and I sure as hell will judge them too.

Trauma is defined as anything that exceeds our emotional capacity.

So babies have trauma when they don’t get fed on time.

Brain Injury people have trauma because duh it exceeds our capacity.

So we all might have PTSD.

I feel somewhat better knowing that I am not the only one, at least with a BI.

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Thanks aly704 and it seems to me by writing we find hidden elements which provides the key for understanding the whole. And naturally we all realize we are not whole and creates this enormous stumbling block. My stumbling block in my environment was this terror and then my madman created this deep horror and uncertainty. It created a deep void and I never was able to talk about it. It seems now, with you and others here, I can express how I have deteriorated even into cynical mind. Also rather than forcing my experiences to a conclusion there is something allowed here to open up and just let go.

From this letting go by writing and reading what you have written the explanation becomes simpler and more clarity. The wholeness now is learning to be okay with a lack of wholeness and the struggle between thinking and not doing is also becoming okay. You and this site is giving me the ability to be okay in finding security in powerlessness and to create an opening.

So this is to say from you and your support it is just this place to begin. The beginning is to feel comfortable with you, which allows me to be direct and try to write with authenticity. My hidden mark is defectiveness and the wholeness truly is just an opening and a letting go. There is a spontaneous quality here and your support is part of this important quality by my finding wholeness in my being incomplete.


Thank you for clarifying the moral injury in reference PTSD. This writing was brief and I was assuming certain meaning into it. You make good sense about “thumos” and appears to be the richest part of consciousness. Also I like what you write, as you express: “The more you can act in good ways, the more that is who you become. When I am unable to do good, I isolate.” Bingo, no good and I will also isolate. I have so profoundly isolated I even became extremely cynical about the value of relating to anyone. It is like I became wedded to my ideas, to maintain my identity, and individuals needed to be discredited. Then everyone needed to be shown they were worthless, which solved my illusions and the world became a fool’s paradise. However, it turns out I was the fool by debunking others and what was positive in life. Seeing only potential threats also excludes the good , so thanks for helping me turn around.

I will sure look into the book “Achilles in Vietnam” and it feels like it can help my cynical mind. And thank you for putting clear thought on obscure matters.


I sure appreciate you expressing yourself effectively. It is like you have acquired the necessary emotional equipment to be realistic. To me this is effective leadership, as your realness takes away all inner doubt. I am really not sure why, but my own inner doubt seems to keep me away from being an adult and just living a cynical mind. It is like I cannot be honest about my deficiency and I have had a distrustful view of life. Maybe, after all, my cynical mind can bring good into existence because you make it clear our own value is without reference to anyone else. I grasp your wisdom in theory, and yet it feels like I need more opening to filter your wisdom into my consciousness. It is like this cynical beast is pounding at the door, the windows are broken, and something in my conscious control wants to keep it out. From you, though, it feels like there is no need to keep this horror and this the beast out. Naturally, you are saying open the door, let the rage out, and tame the beast.


Wow, as you say, “Trauma is defined as anything that exceeds our emotional capacity." It seems like our TBI takes away our flow and it seems to take away our flow into the wholeness of life. And yet it is people like you who allows me to not be whole, even in my inner deficiency and you allow me to stop making a lifestyle from this suffering. You offer this place to simply rest and for some reason I do not feel this need to project a certain image or idea with you. It feels like this could not be otherwise and truly this ability to slow down and rest makes all the difference from this PTSD. Thank you.

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Me too, Occipital. I just don’t know why one earth I never thought of that…duh!

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Okrad, I just order the book "Achilles in Vietnam” and will also look into Iliad as it been awhile sense I read it. Thanks again for making this all clear.

Wow, that is great! I look forward to hearing how you like it. You seem to be a deep thinker, so I really think you will like it. It is a very profound book. I also like what you wrote about how you looked at the world. It is so hard to look at things from an outside perspective. Especially with TBI. It took me so long, but I am better at it now than before I had TBI. Before TBI I just assumed stuff. NOW? Now I just assume I know nothing and so i have to examine every little thing. Be well!!!