An Exploration of Spirituality and the Traumatizing Experiences of Combat

Spiritual Wounds of Combat

The inherent pandemonium in combat can create a paradoxical situation where seemingly contradictory behaviors not only coexist but also are essential to survival. For example, aggression and comradeship, control and chaos, group and individual, all need to coexist each and every moment, making the environment a challenge to maintain and handle. In other words, soldiers must keep “in control” of their emotions and actions in the midst of ongoing disarray. Parallel to their violent acts, soldiers may also display compassion and protectiveness for their fellow combatants. Despite the lack of individuality required by a rigid hierarchical system, they are also expected to show individual ingenuity to avoid casualties.

The coexistence of fantasy and reality is quintessentially inherent to combat. The looming possibility of dying, lack of refuge, and unforeseeable termination demand a solid ongoing base in reality; yet the situation has surreal qualities. Combat, and killing in particular, creates a unique state of mind in which repressed fantasies and impulses can be outwardly manifested and perceived as validated. In this scenario, the soldier becomes the protagonist of his or her own virtual world, much like the virtual world of many violent video games.

The contradictions of combat and atrocities to which soldiers are exposed evoke specific emotions as well as spiritual and moral quandaries (Drescher et al., 2011; Drescher & Foy, 2012; Litz et al., 2009; Maguen & Litz, 2012; Pitchford & Davies, 2009). Some of these include guilt (“I blame myself for what I have done”), shame (“How can I encounter people after what I have done”), hopelessness (“Am I damaged for life?”), survival guilt (“I should have died”), and abandonment/alienation (“Nobody understands nor cares”). Killing and death-related actions, in particular, may elicit a sense of having a moral injury (Drescher et al., 2011; Litz et al., 2009) and specifically evoke feelings of guilt, shame, and being morally wrong (Maguen et al., 2010). The commonly shared belief among soldiers that only fellow soldiers are capable of understanding their experience decreases hope and faith in the possibility of reintegration. Feeling like “the living dead,” an outcast in their own community, and that they do not belong in their homes (Sayers, Farrow, Ross, & Oslin, 2009) may impair returning soldiers’ ability to make this significant transition and role change. How to transform from hero/fighter to a law-abiding civilian becomes central to the process of reintegration and the central therapeutic task.

The exposure to traumatizing situations forces those affected to face a new reality in which safety and other basic concepts of the human condition are shattered (Grant, 1999). These trust-shattering experiences may trigger a reexploration of one’s view of the world and life, and the quest for new psychological resolutions. Traumatizing combat experiences may evoke existential questions to which combatants search for answers (Decker, 2007; Pitchford & Davies, 2009). Spiritual beliefs may be challenged by these situations, and as a result the individual may be in a temporary psychological and spiritual limbo.

Spirituality

The popularity that spirituality has gained in society over the past decades is reflected in the numerous studies conducted to understand its place in people’s life and experiences (Kapuscinski & Masters, 2010). This growing interest has brought forth the question of whether spirituality and religion are the same phenomena. According to Hood, Hill, and Spilka (2009), despite the lack of consensus in the literature, findings are providing support to the distinctive characteristics of spirituality and religion. Spirituality refers to personal experiences, beliefs and behaviors and is concerned with transcendental issues, while religion and religiousness are associated with institutionalized belief system. This article focuses exclusively on spirituality with the acknowledgment that an in-depth discourse on religion is beyond the scope of this article. Rather, this article acknowledges the paradox in describing an ineffable experience through the use of words.

Spirituality can be described as a human and universal need, a capacity and a tendency toward love, peace, well-being, connectedness, awareness, and wholeness. It can be experienced and practiced in myriad ways, such as through prayer, meditation, arts, poetry, dance, music, connecting and communicating with others, nature, and a higher power (Burkhardt, 1989; Walsh, 2009). Many have struggled with the definition of spirituality and overcoming the limitations imposed by language to describe its understanding. Most definitions of spirituality address the yearning for the true meaning of life experiences beyond the physical and/or mundane (May, 1982) and the experience of the transcendence. Shafranske and Gorsuch (1984) state that the transcendence is “discovered in moments in which the individual questions the meaning of personal existence and attempts to place the self within a broader ontological context” (p. 231). They point to the courage that it takes one to go inward and trust “a deep sense of belonging, of wholeness, of connectedness, and of openness to the infinite” (p. 223). Fulton and Moore (1995) describe spirituality as a basic need, which develops over time and increases people’s awareness of the quality of the relationship with the self, others, environment, and sometimes with a higher power, while Kelly (1995) emphasizes that spirituality may provide an individual with a transcendental connectedness with the universe.

According to Piedmont (1999), spirituality is the “personal search for connection with a larger sacredness” and “refers to the capacity of individuals to stand outside of their immediate sense of time and place to view life from a larger, more objective perspective” (p. 988). Pargament (2011) speaks of spirituality as a quest to connect with what is sacred and bring that sacredness into our lives or simply put, as a “search for the sacred” (p. 52). As explained by Zinnbauer, Pargament, and Scott (1999), the sacred alludes to the experiences that are different from the mundane and inspire a sense of awe, whether they are or not directly related to the divine. Kapuscinski and Masters (2010) also note that a commonly accepted definition of spirituality includes the “search for the sacred” (p. 194). As they state, “Spirituality need not incorporate a traditional religious understanding of the sacred, but inclusion of belief in some transcendent power as central to spirituality provides a conceptual formulation not found in other psychological constructs” (p. 195).

Spiritual Considerations in Healing From Traumatizing Combat Experiences

The healing of those who are affected by traumatizing experiences requires an integrative approach, focusing on the physical, psychological, spiritual, social, and overall personal values. Whether an event has a traumatizing impact depends on variables such as history of previous traumatizing experiences, psychological resources, social support system, and context (Krippner et al., 2012; Raviv, Bar-Tal, Koren-Silvershatz, & Raviv, 1999). The traumatizing experience of an event is also culture based (Helman, 2001), as it reflects the history and suffering of many generations in one location. Symptoms are rooted in culture; through language or behaviors they reflect valued personal and cultural beliefs and meaning (Good & Good, 1980; Wenger, 1993). The sociopolitical context in which the individual lives also affects how situations are experienced, therefore making it a challenge to differentiate between the individually and collectively traumatizing experiences (Kaplan, 2005). The interpretation and meaning that soldiers, as individuals, attribute to their experiences and symptoms are contextualized expressions of their individual, cultural, and political backgrounds.

Spiritual and psychological wounds result in the need for interventions that address both of these dimensions. Psychology and spirituality have different perspectives with regard to the treatment and healing of traumatizing experiences. Thus, their integration into a multidimensional treatment modality, such as a biopsychosocial-spiritual model, can provide an opportunity for the recovery and healing of a combat soldier’s traumatizing experiences. With the exception of some schools of thoughts, such as existential, humanistic, transpersonal, and Jungian, psychology addresses the wounds and questions from a self-oriented functional perspective and emphasizes personal identity, individualism, and self-fulfillment (Cushman, 1990). In the treatment of soldiers’ traumatizing combat experiences, psychology aims at reducing the symptoms, returning to premorbid functioning, and achieving a stable functioning level. The development of a renewed sense of grounding achieved through psychological interventions is crucial for the postcombat soldier’s life. However, often within these approaches there is an omission of the totality of the impact of the traumatizing experience, and as a result, significant aspects, such as meaning, purpose, and hope, remain unaddressed (Paulson & Krippner, 2007). That is, these interventions may miss the crucial issue: To go beyond symptom reduction to a larger perspective on life, supporting the spiritual and posttraumatic growth (Calhoun & Tedeschi, 1999). Thus, though these interventions treat the soldier’s wounds, they may not suffice to heal the soldier as a whole.

An important component of spirituality is the existential dimension: individuals’ need to find or create meaning and purpose in their life. In the context of psychotherapy, spirituality is the conduit for the quest for meaning of life. It provides a framework for the exploration of beliefs and ways of relating to the experience of the transcendence. It is not an inquiry of religion but rather an opportunity to examine and create belief systems of renewed hope (Shafranske, 2009). The interpretation of traumatizing experiences might then be reorganized into new existential schemes. Through its inherent comforting nature and release from guilt (Drescher & Foy, 1995), spirituality mitigates the brutal impact from the past. The struggle between the past and present, evil and good, guilt and forgiveness gradually evolves into a new meaning of life. It is the genesis of a new present that connects with the past but lives independently from the traumatizing experience. Revisiting the impact of this experience from a spiritual perspective of forgiveness and collective responsibility may reveal the “light at the end of the tunnel.” Spirituality’s understanding of a universal truth and collective existence may thus provide a combat soldier the vision for the future that is needed to leave the postcombat limbo. It is the quest for this meaning and not just living through the experience that opens up the door for the potential of posttrauma positive change (Joseph, 2009; Shaw, Joseph, & Linley, 2005; Serlin & Cannon, 2004; Tedeschi & Calhoun, 2004).

There is growing support for the effectiveness of integrative approaches inclusive of spirituality (Pargament, 2013). Findings link spirituality to posttraumatic growth and positive changes following adverse circumstances (Drescher et al., 2004; Shaw et al., 2005). Studies show it is a source of comfort and support to which people are particularly drawn in times of difficulty (Burke, Chauvin, & Miranti, 2005; Drescher & Foy, 1995; Pargament, 2013). The benefits of spirituality have also been associated with health, well-being, and healing (Ai & Park, 2005; Ben-Arye, Steinmetz, & Ezzo, 2013; Decker, 2007; Fry, 2000; Hill & Pargament, 2003; Idler, 2008; Koenig, 2004; Larson & Larson, 2003; Mueller, Plevak, & Rummans, 2001; Pargament, 2013; Plante, 2007; Seybold & Hill, 2001). Studies report a connection between spirituality and increased coping skills and longevity, and decreased depression, anxiety, and suicide (Mueller et al., 2001).

Secondary Trauma

Introducing spirituality into the psychotherapeutic relationship can also be beneficial to the clinician, as she or he can be affected by the soldier’s traumatizing experience and develop compassion fatigue (Figley, 1995, 2002a, 2002b). Bearing witness to the narratives of this experience can be demanding and lead to secondary traumatic stress and burnout (Adams, Boscarino, & Figley, 2006; Boscarino, Figley, & Adams, 2004). Clinicians working under these conditions, having a preexisting history of traumatizing experiences and limited coping resources, are at higher risk of emotional exhaustion and compassion fatigue (Figley, 2002b). So keeping a self-care perspective that considers spirituality may serve as a buffer for vicarious traumatization. Specifically, such a perspective allows for staying hopeful. It may also protect the soldier and the clinician from the effects of the clinician’s compromised ability to empathize as a result of his or her compassion fatigue (Adams et al., 2006).

Spiritual Competence

As addressed in this paper, spirituality is a critical dimension of human experience (Shafranske & Gorsuch, 1984; Burke et al., 2005), which should not be overlooked in the healing process (Burke et al., 2005). Even though spirituality is no longer alien to the field of psychology (Gonsiorek, Richards, Pargament, & McMinn, 2009; Plante & Sherman, 2001; Sperry & Shafranske, 2005; D. W. Sue, Bingham, Porche-Burke, & Vasquez, 1999), whether spirituality is included in treatment reflects the clinician’s perspective and attitude about it (Shafranske & Gorsuch, 1984). In this regard, it is the clinician’s personal bias and relationship to his/her own spirituality that affects the course and outcome of treatment rather than his/her professional judgment and competency (Gonsiorek et al., 2009; Shafranske & Newton, 1990). However, the clinician is not alone in this professional conundrum. In the United States, despite the recommendations of the American Psychological Association’s National Multicultural Conference and Summit in 1999 to recognize spirituality as a human dimension and develop training guidelines, the field of psychology has still failed to fully address this recommendation. Even though spirituality is often regarded as an aspect of multiculturalism, the term spirituality is still missing from the 2010 American Psychological Association’s Ethical Principles for Psychologists and Code of Conduct (Vieten et al., 2013). To address the issue of competency and inclusion in treatment, Vieten et al. (2013) proposed a set of spiritual and religious competencies for psychologists to use in psychological treatments.

Given the surmounting evidence of using an integrative treatment approach, and the interest among individuals in having their spiritual issues addressed in treatment (Pargament, 2013; Vieten et al., 2013), it is the clinician’s ethical responsibility to recognize the human potential for adversarial growth, remain alert to its expressions in the therapeutic relationship, and set the stage for the exploration of the meaning of the traumatizing experience from a spiritual perspective. Let’s consider the following case.

A Cultural Example: The Israeli Soldier

The contribution of spirituality to the treatment of traumatizing combat experiences is illustrated through the specific challenges faced by the Israeli soldier. The enduring wounds of this soldier reflect multigenerational and contemporary dimensions of loss and pain. Since all Israelis serve in the military, the military has strong bonds of friendship and relationship both within and in the surrounding culture. Israeli men and women are required to start military service at the age of 18 years, and many will soon after prepare for combat. Prior to their service in the army, these young adults were exposed to acts of war and violence (Krippner & McIntyre, 2003). As a result of growing in an unpredictable and unsafe world, they subsequently suffered, directly and vicariously, personal and community traumatizing experiences. As an example, statistics from the Israeli Security Agency (2014) indicate that from 2000 to 2009, a total of 1,778 Israelis were killed by terrorist acts of suicide bombers and 8,022 were injured. In 2002, there were 2,500 civilian wounded from 53 terrorist acts, which averages to one attack each week of the year. In addition, from 2005 to 2009, a total of 6,092 missiles were launched against Israel. Considering that the total area of Israel is only 7,849 square miles (Benjamin, 2014) and the combined population is close to 8 million (Government of Israel, Ministry of Tourism, 2011), these statistics are alarming.

Since Israel has a civilian army and soldiers are drafted from within a very small country with a tight community, many know each other from childhood or are connected in some manner. These soldiers have probably already lost loved ones from acts of wars and terrorism. If their grandparents were Holocaust survivors, for example, they may have been exposed to the impact of their grandparents’ traumatizing experiences (Cohen, Dekel, & Solomon, 2002; Lazar, Litvak-Hirsch, & Chaitin, 2008). If their parents/grandparents escaped massacres in their countries of origin, they have also had a first impact of a family legacy of traumatizing experiences and survival.

At the cultural and national levels, these soldiers were born into a collective consciousness of danger of extermination. From childhood, they grew up under the cloud of national political traumatizing situations brought on by the acts of terrorism and many wars (Raviv et al., 1999) as well as the negative impact of multigenerational transmission of Holocaust trauma (Danieli, 1998). Case reports document this transmission on second-generation Holocaust survivors (Baider et al., 2000). Furthermore, Schuman, Vinitzky-Seroussi, and Vinokur (2003) state that the Holocaust “remains a fundamental constituent of Israeli memory and therefore of Israeli identity” (p. 133); it is a meaningful living memory relating to the fate of the Jewish people and remembered by Israelis regardless of age, gender, and education. According to them, for many Israelis the legacy of the Holocaust might be a reminder of the fate of the Jewish people and the need for the establishment of a strong state to ensure their survival.

Service in the Israeli army, especially in combat, may reinjure these soldiers’ preexisting wounds, as well as cause new ones. In addition, soldiers’ postdeployment well-being is affected by the quality of the community to which they return (Solomon, 1993). On discharge from service Israeli soldiers do not return to a safe home, as the ongoing acts of war and violence in the community neither facilitate the process of reintegration nor promote healing. In fact, these conditions may contribute to the continuing reliving of traumatizing experiences. Solomon and Mikulincer (2006) point that “unremitting threats of terror in Israel” (p. 665) may have contributed to the exacerbation of posttraumatic symptoms seen in soldiers 20 years after their service in combat.

Since the Israeli soldiers and the community share the same need for healing and safety, emotional resources might be scarce. Healers and soldiers are both wounded, and psychotherapy is often with clinicians who share the same cultural and national wounds. Though the Israeli society is capable of enduring hardships, under the existential threat of survival, reassurances of safety are no longer accomplishing their purpose, and feelings of depression and helplessness often surface (Brom, 2006).

The sense of doom resulting from this web of cross-generational individual and collective fate requires restorative and redemptive interventions. There is a need for the recognition of the depth of the wounds and existential threats within a personal and collective perspective. These soldiers’ healing may demand more than the reestablishment of their premorbid functioning level. In the continuum of a historical context for struggle for survival, what is the Israeli soldier’s vision of the future? As a child of an ex-soldier and perhaps feeling destined to be the parent of a future combat soldier, what are this soldier’s prospects for healing and hope?

In many ways, the language of traditional psychotherapy may constrict the Israeli combat soldier’s search for the sacred and a new vision of hope. The language of spirituality amplifies the sense of connectedness (Walsh, 2009) and may help this soldier shift from a general feeling of personal disconnect to a sense of universal connectedness. This view of life, which takes a perspective larger than the immediate and concrete (May, 1982; Piedmont, 1999) may alleviate the fatalistic, individual, Jewish, and Israeli predetermination of misfortune. Exploring spirituality might also rejuvenate a sense of hope (Shafranske, 2009).

Within this spiritual framework, the soldier and clinician are both student and teacher in search of the sacred—the journey toward growth and finding meaning. This experience is more than merely treating a diagnosis; it is a contemplative experience from which hope grows from finding sacred in the ordinary. The process of growth, change, and healing in the psychotherapeutic relationship and spiritual encounter may have a ripple effect. Even though the focus of the work is to address the soldier’s traumatizing experiences, the healing that takes place in the relationship is reciprocal and could address many levels of wounds, personal, collective, and national for both, the Israeli soldier and the clinician. The following case study helps to demonstrate how a spiritual approach to working with traumatizing experiences may be used in a therapeutic process.

The Case of G

G., a 40-year-old Israeli former combat soldier moved to the United States for business with his wife and two teenage boys. For at least 15 years, he has been reexperiencing combat-related encounters and has increasingly become more disengaged from the family, isolated from others, and often angry, irritable, and with fits of rage. His wife told him that unless he attended therapy she would divorce him. G. did not think he had problems and was used to not sleeping well, being on edge, and spending time alone. His favorite phrase was “Ze hacahim ve ein ma laasot” (translated, “This is life and nothing can be done about it”). He didn’t believe in the use of psychotherapy but didn’t want a divorce. He came reluctantly but expressed feeling more comfortable to communicate with me in his native language of Hebrew (knowing I spoke Hebrew). G. stated he was angry for not having a choice in regard to therapy. This lack of choice has been his experience since the age of 18 when he had to join the army. “Don’t get me wrong I love Israel,” he said, “but I’ve seen a lot of friends die in war and lost others to suicide bomb attacks, this is our fate and there is nothing we can do about it.” G’s initial response to healing was “Do I really have a choice?” and this became one of the main themes of his treatment.

Treatment started with weekly sessions, and G. chose to save his marriage and decrease the frequency and intensity of his anger and isolation as his goals. Initially, the focus was on psycho-education about common reactions to traumatizing experiences, learning relaxation exercises, and stress and anger management skills. Six months into treatment, G. opened up about his vulnerabilities, additional symptoms, and difficult memories. He had never before spoken of these things because of his shame and fear he would “break down.” To break down, he explained, meant to feel incapable of managing his emotions and the demands of work but worse of all to expose his weakness and fragility. After fighting in combat, G. could not tolerate being a fearful veteran. He was distraught and scared and agreed to meet twice a week. He stated adamantly that he would not take medication and agreed to practice regularly the breathing exercises he had learned during our sessions. Over the course of the following year, G. experienced a range of emotions including rage, fear, guilt, hopelessness, helplessness, shame, and sadness. He was angry at the fate of Israel and the Jewish people and felt trapped in a chain that he felt could never be broken. He felt guilty for enjoying the relative calmness in the United States and hopeless about the perspective of peace with his wife and Israel. His memories of combat were at times hard to bear and he feared he would break down. During those times, we paused and G. was reminded of the choices he had in the present. G. liked having choices. It gave him hope. As he continued to feel more in control of his emotions he began trusting his ability to manage them. He was also clear about how much better he felt and was functioning with significantly less anger, rage, and isolation. However, he admitted he was not happy and did not think he would ever be because he could not forget the past or look into future. The recurrent threats and acts of terrorism in Israel were constant reminders of a foreshortened future and impending doom. He also realized that unless he changed he would not be able to save his marriage. He felt trapped and without a choice again.

At this point, G. was confronted to explore his life from a deeper lens of meaning and purpose. Desperate to save his marriage, and himself, he felt he had no choice but to accept and meet this confrontation of self. Throughout the course of therapy, references to spirituality had been included in comments such as “That seems to be synchronistic” or “Don’t you think that was a miracle?” In addition, at this point new questions were introduced: What can you learn from your life thus far? What is your purpose here? Have you ever felt connected to something bigger than yourself? Have you ever experienced a sense of oneness? Have you had the experience of everything being at the right place and right time? Have you seen miracles? Sessions turned around and filled up with light and hope reflected by his commitment and enthusiasm about coming to therapy. G. began to feel alive again, but he was afraid it might be temporary as he still struggled with his feelings of doom about his marriage, family, Israel, Judaism, and the world.

Close to the end of the second year, G. became progressively worried. His older son was turning 17, and given his age, within a year he would be required to enlist in the Israel Defense Forces. G. was torn between his desire to protect his son and the need to protect his people. A breakthrough was achieved when G. decided to share his agony with his family and had discussions about his son’s future. The family decided to move back to Israel to be close to their son while he served in the army. After months of wrestling with the meaning of gratefulness, it was this family sharing that helped G. understand and acknowledge how grateful he was for his wife and children and for being alive. We knew then that the goal had been achieved: He reconnected with himself and family, and chose to live. Walks in nature, creative prayer, and rituals, some of which were discussed in therapy, had become part of G.’s routine. By the completion of treatment, a symptom free, stable, and much happier former combat soldier said, “I never thought I could ever be this person, I changed and transformed into someone who is much better than before. It was hard work but I have my family back and they have me.”

As a clinician, the inclusion of spirituality in this healing process reinvigorated me thus, helping me remain engaged in the relationship and tolerate the intensity of the emotions shared. At the personal level, G.’s healing also reverberated in the healing of my own experiences of personal and cultural losses. Such experiences are not separate: a restoration of hope in the healing of the human spirit.

Conclusion

How do we stop the cycle of traumatizing situations that seem to reoccur, while also working to heal the ongoing, ensuing experiences that plague so many? Is it even possible? How do we address the impact of multilayered traumatizing experiences while there is ongoing exposure to existential threats as is the case with some returning soldiers and veterans in Israel and around the world? As a field, psychology needs to recognize spirituality is an aspect of the human existence (Cushman, 1995) and eradicate the existing polarization between science and spirituality (S. Sue, 1999). By dissecting the wholeness affected from traumatizing experiences into units of behaviors, clinicians may inadvertently contribute to the already existing schism between soldiers and society. Research and clinical experience have shown that traumatizing experiences affect the mind, body, and spirit: that is, biological, emotional, neurological, spiritual and/or existential dimensions (Krippner & Paulson, 2006; Serlin, 2002, 2008, 2009). The essence of spirituality can serve as a buffer to the progression and manifestation of PTSD as well as provide an avenue for healing.

The widespread interest in spirituality and challenges in the treatment of traumatizing experiences (such as PTSD) are gaining increasing recognition around the world. Some of the current integrative treatment modalities are inclusive of spirituality and address the dimension of forgiveness and that of reconnecting with the higher self (Pargament, 2013). MDMA (3,4-methylenedioxymethamphetamine)-assisted psychotherapy is being studied and used in the United States, Israel, Spain, and Switzerland (Parrott, 2007). As well, Israel has already incorporated art and dance therapy in the treatment of PTSD (Serlin, 2010). The Israeli Peace of Mind Project, though not a spiritual model, incorporates the outdoors in the treatment of postdeployment soldiers (Baum et al., 2013). The use of traditional interventions needs to be continually assessed (Joseph & Linley, 2006) for effectiveness and integration, where the overall goal is to adopt a whole-person approach that addresses the multiple dimensions of traumatizing experiencing (Joseph, 2009; Serlin, 2005, 2008).

Spirituality is a beacon of hope; its redemptive qualities guide the search that is needed to withstand the impact of traumatizing experiences. It is the road map to exiting the limbo state and developing the lifelong coping skills to feel “whole” and sacred again. This awareness provides soldiers with an opportunity to restore, repair, and renew the lost or broken sense of hope and faith. Healing the wounds of both the self and spirit may render a renewed openness in the way of relating to oneself, one’s world, and one’s universe. Specifically given soldiers’ traumatizing combat experiences, spiritual awareness may help a lonely, guilty, shameful, broken-hearted, hopeless soldier shift into a more self-forgiving, understanding, grounded, and mindful person. With a renewed sense of purpose and meaning, soldiers may then reconcile who they are with what they did, and find it possible to continue in the pursuit of a loving, connected, and balanced life.

This article offered perspective on the healing qualities of spirituality using as an example the challenges of the Israeli soldier. However, as an aspect of human existence, spirituality is universal and without borders. Much like the Israeli soldiers and Israel, other countries and soldiers have their own national legacies that might also be transmitted over generations and traumatically experienced on both a collective and a personal level. Soldiers worldwide in need of healing may benefit from embarking in a search for the sacred, as it speaks to them. It is the clinician’s responsibility to open this door in treatment. Considering the staggering numbers of returning soldiers around the world, further studies on spirituality and the traumatizing experiences of combat are recommended.