Rich Lowry takes aim at the "obsession with PTSD" in several press reports about Hasan:
[I]t fits the media’s favorite narrative of soldiers as victims. Here was poor Hasan, brought low like so many others by the unbearable burden of Iraq and Afghanistan. Never mind that PTSD usually results in sleeplessness, flashbacks, and in the extreme suicide. [...]The press keeps mistaking Hasan for Private Ryan, when the closest he’d come to combat was counseling sessions with soldiers.
Lowry later airs an email from an expert who explains that military psychiatrists have indeed been known to suffer "vicarious traumatization" from their PTSD patients. However, the reader insists, Hasan probably wasn't one of them:
First, by all accounts Major Hasan's observed problems were not overcommitment compassion and over identification with traumatized soldiers. There is no suggestion that he identified with his clients, took his job overly seriously or that he habitually advocated for his clients and went beyond expectations to serve them. (There was, in fact, suggestion that he argued with clients, something rarely seen in cases of compassionate care.) As the previously mentioned characteristics are hallmarks of secondary or vicarious traumatization, it calls this 'diagnostic' explanation into question.
Second, there is ample evidence that Major Hasan experienced a long-standing personal religious/moral angst that was fueled by self-defined spiritual dilemmas. The reported chronology pre-dates the clinical work that allegedly produced secondary or vicarious traumatization. Over the course of his training and service with the Armed Forces, there appears to be a clear pattern of thoughts and behaviors that indicate escalating anger and frustration over the self-styled dilemmas created by his choice to be both a committed Muslim and an active member of the US Armed forces.
Given these observations, it is very difficult to characterize Major Hasan's behavior as being the consequence of his clinical experiences. It is more reasonable to conclude that Major Hasan's clinical work did not lead to a state of vicarious or secondary traumitization, although it may have served as the final straw or the catalyst which sent his spiraling rage and frustration into a murderous frenzy.