Transitioning Fractured Identities: A Grounded Theory Study of Operational Stress Injuries from Veterans’ Perspectives

Soldiers who are deployed to military operations are often exposed to unique occupational stressors, particularly when deployed to combat environments. Research has predominantly focused on soldiers’ exposure and experiences of traumatic stress or events which results in the diagnosis of posttraumatic stress disorder. More recently epidemiological research with post 9-11 veterans (those who served in Afghanistan and Iraq) has illustrated that these veterans are experiencing not only posttraumatic stress disorder, but a variety of physiological injures, psychiatric illnesses, and psychosocial challenges. In response, the umbrella term operational stress injuries was introduced to try and capture all injuries and harm, caused by serving within military occupations, regardless of the domain of health. Central to the change of operational stress injuries is not only the language, but also the recognition that there may be injurious components of military service that are currently unidentified or under-researched- including those which may transcend into the spiritual or existential elements of military service. The purpose of this doctoral research was to determine Canadian combat veterans’ perspectives regarding what elements of operational stress injuries they deemed to be most problematic and why. Initial broad searches of military trauma literature indicated that research was predominately focused on the psychological domain of health; (i.e., the development of psychiatric illness from traumatic or stressful experiences), with less understanding of potentially harmful spiritual and existential aspects of soldiers’ experiences. As a result, a systematic review was conducted to synthesize and critically evaluate the relationship between spirituality and mental well-being in post-deployment veterans. Next, a theoretical manuscript was written to discuss points of convergence and divergence when integrating the classical grounded theory method within a patient-oriented research framework. Finally, a patient-oriented research informed classical Grounded Theory study was designed and conducted to create a systematic mid-range theory of operational stress injuries from veterans’ perspectives. Findings from this doctoral research demonstrate that while traumatic stress outcomes such as post-traumatic stress disorder were problematic, most injurious to veterans were what they termed “fracturing experiences” and “limboizing.” Fracturing experiences were largely synonymous with the current classification of moral injury, while limboizing referred to the military-to-civilian transition. Participants identified that from their perspective unresolved morally injurious experiences were the cause of their mental health symptoms, which frequently resulted in formal psychiatric diagnosis and being medically released from the military. More, upon being released, participants struggled to successfully transition to the civilian world which further compounded their psychological, social, and spiritual challenges. Ongoing work to further examine how moral injury may influence veterans’ mental health and their ability to successfully navigate the military-to-civilian transition is crucial, as successfully addressing these injurious components may allow veterans to thrive and not simply survive in their new life.

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