Note: Content within this review regarding trauma and mental health challenges may be distressing to some people.
Not just soldiers are exposed to terrible soul-destroying trauma but first responders, aid workers, hospital staff and journalists. There is a community of common experience and healing journeys across these professions. Dean Yates writes from his experience as a journalist working for Reuters for 26 years but with lessons for others hoping for healing from Post-Traumatic Stress Disorder and moral injury, and those caring for and supporting them.
Two things make Yates’ memoir an invaluable read.
Firstly, Line in the Sand is a transparent story of a warzone journalist working through his traumas. He covered the Bali bombings, Boxing Day Tsunami and Iraq. The cumulative trauma peaked when he was bureau chief in Iraq in 2007 and two of his local staff were gunned down indiscriminately by an American Apache helicopter. The distressing scenes were made infamous when released by WikiLeaks as Collateral Murder. Over the following years, Yates faced the long and complex challenge of identifying and working through the associated Post Traumatic Stress and moral injuries. He describes the dizzying array of symptoms: nightmares, anxiety, panic attacks, flashbacks, depression, noise sensitivity, hypervigilance, and reckless or self-destructive behaviour including risky and coercive sex. He bemoans the inadequacy of self-medication, the indifference of his employer and the damage on his family.
The hopeful insights of Yates’s journey, however, include the different aspects of treatment that gradually helped him toward healing: therapy and medication, Melbourne’s Ward 17 psych unit and the Dart Center for Journalism and Trauma, mindfulness apps and Buddhist meditation, breathing exercises and EMDR (eye movement desensitisation and reprocessing).
Most valuable was the quality of his support networks. Family and friends can feel the brunt of trauma, as Yates acknowledged: “Trauma is like a cluster bomb. Everyone around you gets hurt” (29). Yet family support, community belonging and authentic professionals are foundational to recovery. In my lane, I was inspired particularly by a chaplain at ward 17, Cath Taylor, who used to say to Vietnam veterans, “The army taught you how to go to war. I’m going to teach you how to live.” (180) She led Yates through an exercise to identify his values and through a memorial service that were among his most significant episodes of healing and rediscovery.
Underneath the narrative of Yates’ journey, the volume reviews and applies the most helpful literature on trauma and moral injury. This is the second reason it is an invaluable resource for those who have faced anything similar or supported those who have been traumatised or morally injured. For example, Yates discussed what he learned from Viktor Frankl Man’s Search for Meaning and the path that sent him on to become a fierce advocate for workplace mental health including as Reuters’ Head of Mental health Strategy 2017-2020. He devoured the best literature on trauma including Bessel van der Kolk’s The Body Keeps the Score, Edward Tick’s War and the Soul and Babette Rothschild’s The Body Remembers. He learned from these writers and his Ward 17 therapists treating PTSD is like a cupboard with linen spilling out – the recovery task is not to stuff it back in but to slowly examine each piece, fold it and neatly place it back.
Yet traumatic events can also include moral injury – with many of the same symptoms of PTSD but more difficult to heal. Yates engaged with Brett Litz’s definition of perpetrating or witnessing or failing to prevent acts that transgress one’s moral beliefs, but also Jonathan Shay’s definition of moral injury as the rage from betrayal by someone in authority in high-stakes situations. Yates’ moral injury was multi-layered: initially witnessing the murder of his staff, then he and Reuters not doing enough to confront the American military, then feeling betrayed by Reuters for their lack of support while he struggled with mental health implications, and finally unpacking the guilt he felt towards his wife for trauma and unfaithfulness to her. Yates bounces off Litz and others’ development of “adaptive disclosure” and its focusing on acceptance, forgiveness, self-compassion, finding meaning, writing letters, sharing stories and undertaking ceremonies.
Yates’ therapeutic journey towards healing resonates with ADF’s Pastoral Narrative Disclosure process where Chaplains work 1-on-1 with individuals and the Warrior Welcome Home group retreat program. We need more thoughtful and sensitive application of such programs, and evaluation by both those who experience and those who deliver them.
As a guidebook to best practice in understanding and treating PTSD and moral injury, Line in the Sand is a helpful literature review. But it is much more as a first-hand account of the damaging consequences of PTSD and moral injury, and hopeful potential for healing. It is a gift for those who have faced similar challenges, and the families and professionals who care for them.
Notes:
Publisher details: Sydney: Pan Macmillan, 2023. ISBN: 9781761264429(pbk)
Dean Yates is an invited speaker at the International Moral Injury and Wellbeing Conference (19-20 Sep 2024 in Brisbane).
The views expressed in this article are those of the author and do not necessarily reflect the position of the Australian Army, the Department of Defence or the Australian Government.
About the Reviewer
Darren Cronshaw is a Chaplain who has served at Army School of Transport, Puckapunyal, 1st Recruit Training Battalion, Kapooka and Defence Force School of Signals. He is also Professor of Practical and Intercultural Theology with the Australian College of Ministries (Sydney College of Divinity). His hobby is pushing the boundaries of resilience in Ironman triathlons.