Jonathan Shay
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Jonathan Shay (born 1941) is an American
doctor Doctor or The Doctor may refer to: Personal titles * Doctor (title), the holder of an accredited academic degree * A medical practitioner, including: ** Physician ** Surgeon ** Dentist ** Veterinary physician ** Optometrist *Other roles ** ...
and clinical psychiatrist. He holds a B.A from Harvard (1963), and an
M.D. Doctor of Medicine (abbreviated M.D., from the Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional degree. ...
(1971) and a
Ph.D. A Doctor of Philosophy (PhD, Ph.D., or DPhil; Latin: or ') is the most common degree at the highest academic level awarded following a course of study. PhDs are awarded for programs across the whole breadth of academic fields. Because it is ...
(1972) from the
University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest-regarded universitie ...
.Jonathan Shay, Clinical Psychiatrist / Classicist
/ref> He is best known for his publications comparing the experiences of
Vietnam veteran A Vietnam veteran is a person who served in the armed forces of participating countries during the Vietnam War. The term has been used to describe veterans who served in the armed forces of South Vietnam, the United States Armed Forces, and ot ...
s with the descriptions of war and homecoming in
Homer Homer (; grc, Ὅμηρος , ''Hómēros'') (born ) was a Greek poet who is credited as the author of the ''Iliad'' and the ''Odyssey'', two epic poems that are foundational works of ancient Greek literature. Homer is considered one of the ...
's ''Iliad'' and ''Odyssey''.


Work with Vietnam veterans

Shay's early medical work was laboratory research on how
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...
cells are affected by
strokes A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop funct ...
, but after suffering a stroke himself, he went to work for the United States Department of Veterans' Affairs outpatient clinic in Boston. While working there, in his words, "The veterans simply kidnapped me," and his work with them "utterly redirected my life." In 1987, Shay shifted from
neuropathology Neuropathology is the study of disease of nervous system tissue, usually in the form of either small surgical biopsies or whole-body autopsies. Neuropathologists usually work in a department of anatomic pathology, but work closely with the clini ...
to the study of
posttraumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats ...
(PTSD) and published a short article linking the combat histories of patients at the VA with the experience of war described in Homer's ''Iliad''. He was then approached by classics professor
Gregory Nagy Gregory Nagy ( hu, Nagy Gergely, ; born October 22, 1942 in Budapest)"CV: Gregory Nagy"
''gr ...
who suggested that the topic might be expanded into a full-length book on the nature and treatment of PTSD. He has written two books, ''Achilles in Vietnam: Combat Trauma and the Undoing of Character''Shay, Jonathan. ''Achilles in Vietnam: Combat trauma and the undoing of character.'' Simon and Schuster, 2010. and ''Odysseus in America: Combat Trauma and the Trials of Homecoming'',Shay, J. (2002). ''Odysseus in America: Combat Trauma and the Trials of Homecoming.'' New York: Scribner. which discuss PTSD by reference to the experiences of American veterans of the
Vietnam War The Vietnam War (also known by other names) was a conflict in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. It was the second of the Indochina Wars and was officially fought between North Vietnam a ...
, and the experiences depicted in the ''
Iliad The ''Iliad'' (; grc, Ἰλιάς, Iliás, ; "a poem about Ilium") is one of two major ancient Greek epic poems attributed to Homer. It is one of the oldest extant works of literature still widely read by modern audiences. As with the '' Odys ...
'' and the ''
Odyssey The ''Odyssey'' (; grc, Ὀδύσσεια, Odýsseia, ) is one of two major ancient Greek epic poems attributed to Homer. It is one of the oldest extant works of literature still widely read by modern audiences. As with the ''Iliad'', th ...
''. Shay's research uncovered what may be the earliest historical reference to PTSD, in Lady Percy's soliloquy in Henry IV, Part 1 (act 2
scene 3, lines 40-62
. Written around 1597, it represents an unusually accurate description of the symptom constellation of PTSD. Shay has also done research on the use of
Prozac Fluoxetine, sold under the brand names Prozac and Sarafem, among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used for the treatment of major depressive disorder, obsessive–compulsive disorde ...
in treating PTSD in
Vietnam veteran A Vietnam veteran is a person who served in the armed forces of participating countries during the Vietnam War. The term has been used to describe veterans who served in the armed forces of South Vietnam, the United States Armed Forces, and ot ...
s.


Views on PTSD

Shay writes, "For years I have agitated against the diagnostic
jargon Jargon is the specialized terminology associated with a particular field or area of activity. Jargon is normally employed in a particular communicative context and may not be well understood outside that context. The context is usually a partic ...
'
Posttraumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats ...
' because transparently we are dealing with an injury, not an illness, malady,
disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
, sickness, or
disorder Disorder may refer to randomness, non-order, or no intelligible pattern. Disorder may also refer to: Healthcare * Disorder (medicine), a functional abnormality or disturbance * Mental disorder or psychological disorder, a psychological pattern ...
." Shay argues that PTSD is not an illness but the persistence of
adaptive behavior Adaptive behavior is behavior that enables a person (usually used in the context of children) to cope in their environment with greatest success and least conflict with others. This is a term used in the areas of psychology and special education. ...
s needed to survive in a stressful environment. For example,
emotional numbing Reduced affect display, sometimes referred to as emotional blunting or emotional numbing, is a condition of reduced emotional reactivity in an individual. It manifests as a failure to express feelings ( affect display) either verbally or nonverba ...
is useful in a disaster situation and maladaptive in a family setting, and loss of trust enhances survival in a prison but not in a community setting. Like Derek Summerfield, he also argues against
labeling Labelling or using a label is describing someone or something in a word or short phrase. For example, the label "criminal" may be used to describe someone who has broken a law. Labelling theory is a theory in sociology which ascribes labelling ...
and patronizing treatment. Shay recommends that we resocialize trauma survivors as a means of promoting socially acceptable behavior patterns. He cites classical Greek theater and the collective mourning described in the ''Iliad'' as possible precedents. In ''Odysseus in America'' he writes of "the circle of communalization of trauma": "When trauma survivors hear that enough of the truth of their experience has been understood, remembered and retold with enough fidelity to carry some of this truth ... then the circle of communalization is complete."


Prevention of PTSD

Shay is a passionate advocate of improved mental health treatment for soldiers and of more vigorous efforts to prevent PTSD, in addition to structural reform of the ways the U.S. armed forces are organized, trained, and counseled. He has collaborated with General James Jones, the past commandant of the Marines, and Major General
James Mattis James Norman Mattis (born September 8, 1950) is a retired United States Marine Corps four-star general who served as the 26th US secretary of defense from 2017 to 2019. During his 44 years in the Marine Corps, he commanded forces in the Persian ...
of the Marines.The Salem Award for Human Rights and Social Justice: Dr. Jonathan Shay: Advocating for Veterans.
He has promoted the concept of preventative psychiatry in support of military cohesion, leadership and training:
Prevention of psychological and moral injury in military service has three axes: cohesion, leadership, and training. First is keep people together. Train them together, send them into danger together, bring them home together, and give them time together to digest what they've just been through ... The second axis is expert, ethical, and properly supported leadership ... The third axis of prevention is prolonged, progressive, realistic training for what the troops have to do and face.


Concept of moral injury

Shay introduced the concept of "Moral injury" and recommended treatment strategies for it in his two books. Moral injury is a distinct syndrome from (but often
co-morbid In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary ...
with) PTSD and is one of the primary themes for the veterans described in his books, often leading to personality changes and obstructing successful treatment.Shay, J., Munroe, J. "Group and Milieu Therapy for Veterans with Complex posttraumatic stress disorder," in ''posttraumatic stress disorder: A Comprehensive Text'', Edited by Saigh, Philip A. and Bremner, J. Douglas. Boston: Allyn & Bacon, 1998. Pp. 391-413 Shay writes that his "current most precise (and narrow) definition of moral injury has three parts. Moral injury is present when (1) there has been a betrayal of what is morally correct; (2) by someone who holds legitimate authority; and (3) in a high-stakes situation." Factor (2) is an instance of Shay's concept of "leadership malpractice". Other authors have alternative definitions where (2) is by the individual.


Career recognition

Shay is respected in military circles, having conducted the Commandant of the Marine Corps Trust Study (1999–2000); serving as visiting scholar-at-large at the
U.S. Naval War College The Naval War College (NWC or NAVWARCOL) is the staff college and "Home of Thought" for the United States Navy at Naval Station Newport in Newport, Rhode Island. The NWC educates and develops leaders, supports defining the future Navy and associa ...
(2001); Chair of Ethics, Leadership, and Personnel Policy in the Office of the U.S. Army Deputy Chief of Staff for Personnel; and was
Omar Bradley Omar Nelson Bradley (February 12, 1893April 8, 1981) was a senior officer of the United States Army during and after World War II, rising to the rank of General of the Army. Bradley was the first chairman of the Joint Chiefs of Staff and over ...
Chair of
Strategic Leadership Strategic leadership is the ability to influence others to voluntarily make decisions that enhance the prospects for the organization's long-term success while maintaining short-term financial stability. Different leadership approaches impact the ...
at the US Army War College and Dickinson College (2008–2009).Dickinson College, Awards to Members of the Faculty
In 2007 he received a MacArthur "Genius Grant" fellowship. In 2010 he was awarded th
Salem Award for Human Rights and Social Justice
for "building public awareness and acceptance of post-traumatic stress disorder as a serious and '' bona fide'' war injury." In 2018,
Volunteers of America Volunteers of America (VOA) is a nonprofit organization founded in 1896 that provides affordable housing and other assistance services primarily to low-income people throughout the United States. Headquartered in Alexandria, Virginia, the organiz ...
established The Shay Moral Injury Center, named in his honor and dedicated to deepening understanding about moral injury in the many populations who experience it.


References


External links


Jonathan Shay talks about the concept of moral injury, part 1
an
Part 2
December 20, 2010
Why Study Thymos?
Video of lecture at Colgate University, April 24, 2013
"SCIENTIST AT WORK -- JONATHAN SHAY; Exploring Combat and the Psyche, Beginning With Homer," David Berreby, March 11, 2003


* ttps://www.nytimes.com/2008/01/13/us/13shay-interview.html?_r=0 Dr. Jonathan Shay on Returning Veterans and Combat Trauma ''New York Times,'' January 13, 2008.
Jeff Severns Guntzel, "Beyond PTSD to "Moral Injury." Interview with Dr. Jonathan Shay, March 14, 2013.

Jonathan Shay Extended Interview, March 11, 2011
* * {{DEFAULTSORT:Shay, Jonathan Living people MacArthur Fellows American psychiatrists Harvard University alumni Perelman School of Medicine at the University of Pennsylvania alumni 1941 births Moral psychology