Have you heard of the term “PMIE”? It stands for Perpetration and Betrayal-Based Morally Injurious Events.” In a 2017 study, “Distinguishing War-Related PTSD Resulting from PMIEs” (authors Alexander Jordan, et al), the connection between PMIEs and PTSD sampled 867 Marines who experienced heavy ground combat while deployed overseas. The results showed that over a third of the Marines reported exposure to PMIEs. The researchers concluded that guilt and shame are not adequately addressed within the current classification of PTSD as defined in the DSMV (Diagnostic Statistical Manual of Mental Disorders, Fifth Edition). PTSD tends to focus on danger-based experiences, while shame and guilt are being overlooked in PTSD diagnosis and treatment. This study and many others are pointing to the psychological struggles of guilt, shame, and anger that are contributing to suicidal thoughts. We must educate and continue to study this phenomenon. Our active duty and veteran populations deserve to get the specific help they need.