What is Sanctuary Trauma?

Sanctuary Trauma

Written by Steve Rose

Steve Rose, PhD, is an addiction counsellor and former academic researcher, committed to conveying complex topics in simple language.

Some Veterans experience traumas beyond the battlefield. One of these can be called, “sanctuary trauma”.

Developed by Dr. Steven Silver, sanctuary trauma “occurs when an individual who suffered a severe stressor next encounters what was expected to be a supportive and protective environment’ and discovers only more trauma.”

Some veterans who face mental or physical injuries from service are finding themselves in a second battle with the bureaucracy upon return.

In Canada, there has been a great deal of politics around sanctuary trauma. Many veteran advocate groups have claimed that the government has not held up their end of the bargain.

The much-anticipated Report of the Auditor General of Canada reviewed mental health services for veterans and determined that although there are several mental health supports put in place, there is still a significant delay in access to disability benefits and clinical care.

These delays may contribute to a secondary traumatization in individuals whose mental health conditions are only exacerbated by stacks of paperwork, a seemingly endless wait, and perhaps even a wrongful denial on initial applications.

Instead of restating these are fairly obvious points, my purpose here is to specifically describe how this can produce “sanctuary trauma,” and how this is deeply rooted in a veteran’s sense of a ‘sacred obligation’.

The concept of ‘sacred obligation’ has gained frequent use in the media among Canadian Veterans Advocates. The Liberal Party also released a video on their commitment to a “sacred obligation” the same day the Auditor General report was released – keep in mind both parties are to blame for problems in the New Veterans Charter.

Politics aside, what is this concept actually referring to? And why is it important to injured veterans who feel uncared for?

Covenants, Not Contracts

A government’s sacred obligation to Veterans goes beyond a legal contract; it is a covenant made by a society to care for those who served in an unlimited capacity.

The major difference between a covenant and a contract is this level of liability. Contracts only hold parties liable to a degree limited by the terms and conditions of the contract, whereas covenants hold parties liable to an unlimited degree.

Christopher Coker, in The Warrior Ethos, describes the covenant as distinguished from the contract in three ways:

“First, they are not limited to specific conditions and circumstances; secondly, they tend to be open-ended and long-lasting; and, thirdly, they rarely involve individual advantage.”

What he is describing is the warrior’s covenant.

In the Canadian Armed Forces, the warrior’s covenant is characterized by “unlimited liability” – as described in Duty With Honour. This means:

“…members accept and understand that they are subject to being lawfully ordered into harm’s way under conditions that could lead to the loss of their lives.”

Accepting unlimited liability, serving members enter into a sacred covenant based in an altruistic commitment to self-sacrifice if required by the mission.

The etymology of the word ‘sacrifice’ is linked to the word ‘sacred’ because the two are anthropologically connected to forms of moral solidarity in traditional societies before the modern legal contract replaced these heartfelt bonds based in blood with rationalized bureaucratic state management.

The issue with state management of Veterans care services goes deeper than wait times. At its root, the issue is that the sizable minority of Veterans who experience a difficult transition to civilian life (25%) are coming from a period of their life where they lived the sacred obligation through the warrior ethos of mission before self.

Having held up their covenant to accept unlimited liability, they confront a system that is not able to hold up its end of the covenant. Individuals who suffer traumas in service expect to be taken care of upon return, but some instead find themselves engaged in a battle with bureaucracy.

Sanctuary trauma compounds the issues of war traumas, exacerbating feelings of isolation and hopelessness. For many embittered veterans, this is a feeling of institutional betrayal.

Sanctuary trauma is unique because it is caused by institutions that are initially expected to provide care. Although Veteran Affairs provides a great deal of care and now has increased funding for OSI clinics, Veterans who fall through the cracks may experience this form of trauma resulting from a society that falls short of the sacred standard of unlimited liability.

Legitimately injured Veterans don’t want a handout. They want a sense of security knowing the society they served is committed to serving them as well.

Fascinated by ideas? Check out my podcast:

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Other Mental Health Resources

If you are struggling with other mental health issues or are looking for a specialist near you, use the Psychology Today therapist directory here to find a practitioner who specializes in your area of concern.

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*As an affiliate partner with Better Help, I receive a referral fee if you purchase products or services through the links provided.

As always, it is important to be critical when seeking help, since the quality of counselors are not consistent. If you are not feeling supported, it may be helpful to seek out another practitioner. I wrote an article on things to consider here.

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  1. Princess Chaos's Oma

    Great article, Steve. Stumbled upon your blog after you started following me. I’m currently doing some interviews of veterans, (not just fellow Americans) about their experiences and how they feel about issues very similar to this. I will look forward to seeing your future posts!
    Regarding the article, I can appreciate the sacred trust, but I’m not sure it’s entirely accurate for American veterans. Our guys coming back from Korea and Vietnam were treated so poorly, not just by their communities, but the government agencies responsible for helping them, that I don’t rightly believe anyone who grew up in the 1960’s and 1970’s, and still joined the service had any expectation of that sacred trust being upheld. I hope I didn’t open a can of worms for you…

    • steveroseblog

      Thank you for reblogging my post! That is an interesting perspective. I’d be curious to hear the perspective of those individuals who joined without expecting to be properly cared for.

  2. Princess Chaos's Oma

    Reblogged this on Princess Chaos, Oma, and 2 Crazy Dogs! and commented:
    Here’s something I haven’t seen a name put to–sort of explains the angering disconnect many vets feel, when they have fought tooth and nail to get what they need from the system.

  3. angrytunbridgewells

    Reading your article reminded me of something my mother said about my father on his return home from WWII. She said he came home a stranger, I think she was referring to the change in his personality, no the effect of four years seperation.

  4. ThisGirl

    I can really relate to this. I’m not a veteran, but I have suffered Trauma and I’ve also experienced what I called ‘secondary wounding’ – which I think is what you’re referring to here? In my case, it was a lack of validation/belief from someone close to me and being told I was ‘crazy’ etc.

    • steveroseblog

      I’m sorry to hear about this experience. The concept of Sanctuary trauma does encompass experiences like this. Thank you for sharing.

  5. potterwillam3

    Great piece. I especially like the “Covenants, Not Contracts” perspective. We in the U.S are struggling with budget (contract) versus obligation (covenant).

  6. Greg Mercer, MSN

    Thanks, Steve, for this post and for following my blog! The concept is familiar, but I’d never heard the specific term. Helpful!

  7. Greg Mercer, MSN

    Reblogged this on Big Red Carpet Nursing and commented:
    Sanctuary trauma: heard of it? Imagine escaping from severe trauma, only to find more trauma from within your refuge?

  8. Marty

    Excellent points, may I add my cents,
    A great example of this is the Vietnam war, those American bets returned to being spit on, called baby killers, ostracized. The PTSD rates soared. Instead of coquering hero they were vilified.
    This is not only a military issue. Civilians face trauma, and childhood abuse, Complex PTSDAWAYOUT, domestic abuse, violence is epidemic.
    It is a known fact the quicker therapy or healing is initiated after the trauma the better.
    There is a stigma in the military about admitting trauma or PTSD. You are viewed as weak, bordering cowardice. The American military undertook a study which thought dropping the D Disorder off the PTSD would heal many.
    They are beyond lost
    Now we have a reality program in America where dogs are hooked up to vets with PTSD. This is wonderful, a great thing, I totally support this.
    No dog is going to cure PTSD. We place our emphasis in complex, government machines. Look at our psychiatry discipline. You think with seven per cent of the population diagnosed with PTSD it is going to be cured one on one in a therapists office.
    We lack the urgency and model to attack PTSD in bets or civilians.
    For profit and big government waste time and money

  9. frankusbeck

    Thanks for this post, Steve – I’ve stumbled over the term “sanctuarial stress” in “Human Adaptation to Extreme Stress” where Silver and John Wilson also discussed the implementation of traditional Native American veteran ceremonies, such as the sweat lodge (without appropriating culture-specific elements, of course). The notion of the covenant and of civilian responsibility to reintegrate soldiers also keeps coming back in my own research on war experience, war narratives, and community-based PTSD therapy, as well.
    I’ll be looking forward to hear more and maybe cross paths somewhere on the conference trail.
    Regarding Princess Chaos’s Oma’s post, this is a relevant caveat. However, I’ve found that many public expressions (Such as Col. Hanifen’s 2003 article on “Three gifts you can give a returning veteran”) immediately after the outbreak of the Afghanistan/Iraq wars seem to warn about sanctuarial stress and call on the public to prevent the social ruptures of the Vietnam era. In a sense, then, the many expressions of “thank you for your service” are part of this civic campaign, and might even be understood as rituals in civil religion, however shallow these expressions may seem in the light of ongoing massive traumatization.

  10. TLC

    Great article Steve. I add that society is experiencing the side effects of not honoring covenants in all areas. We pay a dear price for the disintegration of our covenants in marriage, family, church, government and God. The trauma one feels when they have been let down or betrayed by their government strikes at the core of human identity. We have taken too lightly what is sacred and why covenants are vitally important.

    • steveroseblog

      Thank you for your comment. I completely agree that covenants in general are becoming a lost form of moral solidarity.

  11. rodi (Rob and Diane)

    What you describe represents what the US military calls “collateral damage”, at least privately.
    I never thought that Canadian vets would have the same trauma re-entering society but why wouldn’t they? To me, the media plays a huge role in the USA but does little to help them. Americans are forced to be aware of the plight of vets due to the guilt trip shoved down our throats but in Canada it seems different to me because your military is not the underlying key to an empire trying to retain power in a new century. I hope Canada finds a way to deal with this issue in a positive manner.

  12. James, brother of Jesus

    Steve, some really insightful analysis here. I have often looked to Canada as an example that the US should follow, so it’s a bit distressing to read that this sad treatment of veterans is happening north of the border, too. Honestly, we have a moral civic obligation to anyone who accepted the covenant based on unlimited liability. For society to refuse to acknowledge its part of the covenant after the fact is reprehensible. For society not to honour our side of the covenant in order to cut taxes on the economic elite, as is happening here in the US verges on…disgusting. Thanks for shining some light on this issue. And no, I’m not a vet, but my dad was.

  13. Janet Coburn

    I am sending a link to your post to a friend who really needs to see it.

  14. Dr Susan Crowther

    Hi just read through your blog entries. I was moved by the compassion. You had joined my blog which explores the notion if the sacred from a different perspective you have provided an enriching deepened understanding of this precious word. I especially appreciated your explication of moral communities in the context of the sacred and sacrifice. It provided reflection on how sacrifice in an often over stretched stressful healthcare system can separate individiduals from their passion leading to seculisation of care and service.

    • steveroseblog

      Thank you for your comment! I am interested in expanding my Durkheimian concept of the sacred by integrating it with Meister Eckhart’s. Would you have any book recommendations? Also, you emphasized something about my post I didn’t realize: the connection between over-stretched healthcare, passion, compassion, and the sacred. This is something I’d like to explore further, potentially in relation to the emerging concept of ‘compassion fatigue’.

  15. katemartyn

    This is a most insightful blog, The focus on the unlimited nature of veterans’ service to society, and the covenant that morally should exist in the mind of the community they serve, is a most thoughtful and positive one. Good luck with your PhD and I hope you can do some good for struggling vets everywhere.

  16. dbp49

    Not to go off your topic here, but I think I mentioned to you before that the PTSD I’m receiving treatment for relates to several attempts on my life at an extremely early age (6-8 years old). I have always suspected that one of the worst parts of what I lived through was whenever I sought protection at the hands of my older siblings, I was most often met with open aggression. Would this not be very similar to what you are describing here as “sanctuary trauma”, since I had reasonable expectations of protection from my family, but found only violence instead? And on another topic, I’ve located a copy of “The Mind and The Brain” which I believe I first heard of through you, and I am finding it to be a fascinating read.

    • Mary Rogers

      As a non-professional it sure sounds like it to me. I can’t even imagine having to go through something like that, as a child no less. My parents protected me from a child molester who followed me home and a bully who threw a glass bottle at me. We had our issues in our family but one thing I never had to worry about was my safety. You are a survivor and a very strong person. I wish you the best of luck!

    • thereluctantbaptist

      This breaks my heart db49. I absolutely agree that it qualifies as sanctuary trauma. When I was a social worker I noticed that the unwillingness of the “good” parent to protect was harder to process than the abuse itself.

  17. Anthony Baker

    The men and women who fight and are wounded doing what we send them to do should never have to worry about care when they get back home. Period. It’s the least we can do.

  18. Mary Rogers

    I want to thank you for following my blog http://www.bipolarlessons.com
    This article brings up so many important issues dealing with how vets are treated. In America it seems to always come down to the bottom line, saving money. We have a lot of controversy here about entitlement programs and a lot people resenting having to pay for them. There certainly is room for discussion on the issue, but one thing that should never be on the table for cuts is the vets. It saddens me when I hear that they cannot get medical treatment and have to pay for their own physical therapy after being wounded. But the mental health issue is a much bigger one. If those who have experience extreme trauma are abandoned, they cannot function in society and may end up out of a job and homeless. Having worked with Mental Health America, i have seen how easy it is for the untreated mentally ill to end up on the streets, through no fault of their own.
    I may not agree with every war our country gets into but regardless of that I will always respect the men and women who put their lives on the line for us. And no one should ever be considered to be weak and defective simply because they have PTSD. We have known for a very long time how war affects people and before it was called PTSD it was called “shell shock”.We have no excuse. As a society we should be ashamed for judging people who have had hellish experiences beyond our comprehension. A covenant is exactly what we should have, one where we pledge to do whatever is necessary to get vets well, physically and mentally.

    • steveroseblog

      Thank you for this comment and your insight into mental health!

  19. hiMe

    I am sorry to read about the trauma post war those veterans suffer. I am forever grateful for the help from the Allies during the Vietnam war. My father himself was a Signal Corps Lieutenant Colonel who refused to evacuate and fought till last minute. He was in Communist “reeducation camp” for ten years. I deeply feel the altruistic actions the soldiers perform on the battlefield.

  20. thereluctantbaptist

    I live in the US, and I absolutely agree that we owe our veterans any and all of the help they need. Government bureaucracies are inefficient. I’d like to see the church spend less money on climbing walls and video game rooms and more money on actually helping people. For sure we can afford to listen to the stories of those with PTSD. We have doctors, nurses, dentists, psychologist who volunteer their time to inner city clinics. It would be more than great if they would also volunteer some of their time and professional expertise to our veterans.

  21. robertmgoldstein

    As a citizen of the United States I am familiar with “Sanctuary Trauma” — Everyone with a mental health problem is familiar with the trauma induced by systems that are designed
    to fail the people they serve. Thank you for posting this.

  22. MC

    I was hoping to find a more inclusive version of sanctuary trauma. LGBTQ2IS purge, systemic racism and military sexual trauma (including court trauma) are also part of sanctuary traumas experienced by CAF members. Veterans from minority groups (e.g.: women, LGBTQ2IS, black, indigenous) often experienced injuries that are less common in the majority group. Their unique needs are not included in research (such as research on moral injuries and sanctuary trauma). Their more unique injuries are not listed on VAC websites (eg. STD from sexual assaults). Being constantly dismissed, ignored, forgotten or not included in the care, programs, research and narrative of injured veterans is in itself part of a sanctuary trauma.

  23. Doug

    Thank you for writing this ! Although not military, my profession (paramedic) has similar statistics for sanctuary trauma. 18 year on and I had never heard that term until I a first responder therapist. Thank you for shining some light on this aspect that is still relatively unknown.

    • Steve Rose

      You’re very welcome! Glad it has been helpful!

      • Roy Mac

        Do you know if there is a current psychological study being conducted on Sanctuary Trauma that is looking for veteran volunteers to tell their story? Thanks.

        • Steve Rose

          Hi Roy, I’m not aware of any current research on this concept. I think the more common concept used these days is “moral injury” resulting from a sense of betrayal.



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