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Opinion | Deborah Grassman

Help PTSD sufferers heal from ‘soul injury’

During 30 years as a VA hospice nurse practitioner, I helped more than 10,000 military veterans prepare for death. In the process I learned about “soul injury.”

My colleagues and I noticed veterans with post-traumatic stress disorder, PTSD, carried unmourned grief and unforgiven guilt that continued to sabotage their lives for decades. Veterans often bury that kind of pain and shame. But when people prepare to “meet their maker,” perspectives quickly shift; these issues surface unbidden, sometimes causing agitation that complicates peaceful dying. Helping veterans forgive themselves and grieve their losses became the primary tool we used to promote peacefulness. Many experienced a visible liberation.

We observed something else. Veterans asked, “Why didn’t I learn to do this decades ago? Why did I have to wait until I was dying?” Those frequently heard questions became the impetus in 2013 for founding Opus Peace, a nonprofit organization based in Tampa that provides programs that respond to soul injury.


“Neglecting soul injuries has created a gap in veteran services that may be contributing to their alarming suicide rate,” says Pat McGuire, a trauma bereavement specialist and cofounder of Opus Peace.

Soul injury isn’t limited to those who serve in the military. McGuire participates in a program for police and firefighters with PTSD. “First responders, victims of domestic violence or other crimes, those abused or traumatized, and people suffering chronic illness can benefit from looking beyond the mental and emotional injuries to their deeper soul wounds,” she says.

People with PTSD shift from trusting themselves to trusting their fear. Developing faith in themselves again means “disarming the heart” through grieving and forgiveness. Because these modalities are not routinely taught in health care curriculums, clinicians may not be equipped to assess and respond to soul injuries.

Opus Peace is starting a movement to address this gap. McGuire says the first step is to raise awareness about the little-known condition.

A soul injury is a penetrating wound within our deepest self that pierces the defenses of our ego. It disrupts our fundamental identity, shrinking our sense of inner goodness; it can even fuel a haunting sense that we are defective. A soul injury often perpetuates a profound aching caused by disconnection from the part of the self that is carrying the pain, creating a sense of meaninglessness.


While programs for the treatment of PTSD focus on the importance of managing symptoms, soul injury interventions concentrate on opening up to the symptoms and connecting with the part of the self that generates them. The process starts with breaking through stoic facades, allowing people to “re-own” their pain. Once we stop fearing our pain, we can “re-home” the part of the self that is carrying it. Re-homing exercises are then introduced to strengthen the part of a person that is responsible for their self-compassion and self-protection.

Soul injury “ambassadors” host seminars and community-engagement gatherings that promote discussion. Opus Peace also trains facilitators in providing “Soul Restoration Ceremonial Workshops” — ceremonies that educate participants about the effects of unmourned grief and unforgiven guilt, provides exercises that promote a liberating experience, and then offer tools to continue the healing process.

“Our dying veterans are no longer here,” McGuire says, “but the wisdom that they learned in the last few weeks of life about trauma is now being shared with the world.”

Deborah Grassman is chief executive of Opus Peace and author of “Peace at Last: Stories of Hope and Healing for Veterans.”