Update to last week’s post on suicide and combat guilt

 

I received a good number of emails, as well as a couple of comments asking for references on last week’s post. I’ll summarize my response here, as well as post an email I sent to the author of an essay in Task and Purpose, a military focused blog, on the relationship of PTSD and combat veterans. That letter, which was more than 600 words and documented, was not even acknowledged, let alone responded to or published…so it goes 😉

As I noted in last week’s post I am dealing with traumatic brain injury (TBI). I also have a diagnosed neuro-cognitive disorder. For the purposes of this blog and the work I try to take part in, this is causing tremendous problems. I suffer from constant headaches, migraines and fatigues, as well as difficulty with concentration, thought and cognitive tasks. Since I published that post last Tuesday, today is the first day,  the Tuesday before last, it’s now taken me more than ten days to have had the mental clarity, ability and energy to work on my computer, write and finish this post. I’ve had at least six migraines, lasting from four to sixteen hours, and the constant headaches and fog in my head have kept me just not off my computer, but away from reading books, essays and articles, as well as watching movies, documentaries and tv shows, walking my dogs and spending time with my partner. It should be noted that these cognitive and migraine problems can also be related to PTSD, depression, and alcohol abuse, but my doctors, both in NC and now here in DC, believe it to be rooted in brain injury. Most likely I believe this brain injury comes from the hundreds of explosive blasts I was exposed to during my time in the Marines, both in training and in Iraq, and as a government official in Iraq – live by the sword, die by sword. This type of brain injury may be similar to what football players and boxers experience later in life. I say all of this to explain why I have not responded sooner to requests for more information, as well as why I am not generally traveling, writing, commenting, appearing on media, etc these days.

However, back to the post from last week: When I speak of guilt, I am speaking of the guilt that comes from being ashamed of one’s actions, whether one engaged directly or indirectly in those actions, or whether one was trying to act morally as individual in otherwise immoral circumstances; eg. an individual takes part in the Iraq War, acts in a manner that an outsider would regard as moral, but because he/she has taken part in an event with ill aims and purposes he/she assumes a greater responsibility and role and feels as if he/she has transgressed his/her own morality. This form of guilt is known as moral injury and is becoming well understood to be one of the three signature invisible wounds of war alongside PTSD and TBI.

While different than PTSD and TBI, moral injury often co-exists and overlaps with either one or both. Often moral injury/guilt, PTSD and TBI reinforce and exacerbate one another and where one wound ends another may begin. However, it is important to remember that although the three wounds manifest symptoms in the same manner and are often closely linked, moral injury/guilt, PTSD and TBI are different from one another in their causes and treatment. Simply put PTSD is the body and mind’s reaction to a traumatic or series of traumatic events, TBI is actual damage done to the brain as the result of an external force, whether it be a physical blow or explosion, and moral injury/guilt is a psychological wound caused by the betrayal of an individual’s own values, ethics, morality etc. For further definitions please see here for PTSD, here for TBI and here moral injury/guilt.

With regards to guilt and moral injury, many people recognize that it can take the form of guilt that is widely known as survivor’s guilt. This is the guilt one feels from being left alive or unhurt when others were killed or injured. In veterans survivor’s guilt can be very pronounced as those that are killed or wounded are often friends or subordinates for whom the service member feels a parental like responsibility. I dealt with this in a very awful manner from a helicopter accident that I survived in 2006, but from which four others did not, including a man I consider a friend. In this case, my guilt was not because I solely survived and they died, but because I did not save them. This aspect, of not doing more to help or save others, is also seen often in veterans, as young men and women are recruited into the military and then conditioned to see themselves as heroes in the waiting.

There is another aspect of guilt and moral injury that comes with combat veterans and this is the guilt that comes from taking part in killing. Studies tell us the guilt that comes from this killing can come from either directly or indirectly taking part in the killing, e.g. you don’t have to have been the one who pulled the trigger, and that this guilt can come from not just the killing of civilians and innocents, but also from killing the “enemy”. This guilt over killing the enemy is particularly understandable if the veteran recognizes the enemy as human and as someone who is simply fighting occupation, ie. acting justly, such as the Afghans, Iraqis and Vietnamese fighting against occupation. In this enemy they recognize actions they would do themselves if the situation was reversed. For example, I used to say of the 153 Marines and Sailors I commanded in Iraq in 2006, that if they were young sunni males living in Anbar Province, 51 would be fighting us, 51 would be in Abu Ghraib and 51 would be dead. It is not a very long or difficult path for many veterans to reach this empathy for the enemy, particularly once they leave the bubble and cocoon of group-think that dominates military life and they are able to freely and independently examine both the micro and macro aspects of the war in which they took part.

In the video I shared last week, when I spoke of veterans killing themselves from guilt, I was referring to this guilt or moral injury: that of taking part in something criminal, unjust, and wrong and/or of having done something that violated spiritual, religious, professional or self-held values, principles, beliefs, etc. See the video I posted above for description of how the US Armed Forces mentally condition young men and women to see themselves as heroes and then what happens when they realize they are more a pawn or villain than a hero. For many this is the crux of moral injury and it is a soul crushing and existential crisis that I believe leads to a great many suicides.

In my case, my personal foundation, my very essence and being was ripped from me; to say my world was turned upside down is not just a minimalist description, but a trite one, as the experience, lasting years and managed now because of the great help of psychologists at the VA Medical Center in Durham, reached such depths as are only encountered in the most intense spiritual or awakened moments. Coupled with traumatic brain injury, depression, PTSD and alcohol abuse, it is easy to understand how with no ability to make amends and the constant hero worship of the American public this guilt could only be assuaged with thoughts of suicide. As my life crumbled and I believed in nothing, I was already an atheist, believing neither in the gods of Abraham or deism, despair and despondency became exaggerated and resounded in my head and soul with every little failure and misstep. Alcohol self medicated me for awhile, but the only escape from the sheer distress at the very base of my being was to end it.

Guilt driving someone to suicide should not be a striking idea, it is common in the literature and religion that we are first introduced to as children and teenagers: think of Judas in the Gospels or Lady Macbeth shouting: “Out, out damn spot!”. Guilt, however, has not been something men and women returning home from war have traditionally been screened for or asked about, more than likely I believe as any guilt associated and announced with the wars of the United States is politically and patriotically unacceptable (in that spirit RootsAction and myself received several angry and righteous emails denouncing the linking of suicide in veterans to feeling guilty about what they took part in during the war or killing the enemy).

As mentioned above, I will paste a letter I sent to the military blog Task and Purpose, but first I would like to list a number of references I use to support my conclusions that it is guilt that is the chief driver of suicides in combat veterans. Additionally, I have a pdf that contains links and abstracts to 25 separate studies that exam the relationship of guilt/moral injury, TBI, and PTSD to suicide in veterans. Please send me an email at matthew_hoh@riseup.net if you would like a pdf copy of that.

Data on veterans suicides can be found in the 2017 suicide data report published by the VA.

For information on suicide rates of veterans with PTSD compared to other mental health populations, please see Figure 3, page 9 in the report.

For information on suicide rates for veterans, broken out by age group and sex and compared to the US population, see Table 4, page 18

For information on suicide rate of Iraq and Afghan war veterans see Table 5, page 19 and Figure 22, page 33. By comparing these tables and utilizing the information available from the CDC in figure 2 of its suicide data on the general US population, you’ll see for example that the youngest male veterans of the Iraq and Afghan wars have suicide rates nearly 6 times that of other young men their age. By looking at other tables and figures in the suicide report and comparing them to the rate of civilian suicides you’ll note that veterans in the age groups where the United States was in major and lengthy wars (WWII, Korea, Vietnam, Iraq and Afghanistan) have significantly higher rates of suicide than non-veterans. During periods of time when the United States was not in these large wars veteran suicide rates are on par or below civilian suicide rates.

Of course, being in war doesn’t mean that a service member sees combat or takes part in the killing experience that may lead him/her to later take their own life. However, there have been a number of studies that have shown that veterans who have been in combat have a higher rate of suicide than veterans who have also deployed to war but not seen combat (and incidentally, despite common perception, Iraq and Afghan veterans have been more likely to be in combat than veterans of any previous war, see my letter below to Task and Purpose).

The linking of combat and suicide has also been reported through journalism, such as this NY Times story which tracked a battalion of infantry Marines after their return home and to civilian life after their time in Afghanistan. At the time of the reporting, this unit of approximately 1,000 men who had been engaged in heavy fighting in Helmand Province, had a suicide rate 14 times higher than their civilian male counter-parts. As I know Marines who were in this unit, nothing makes me suspect that the rate of suicide has lessened for these men.  Another news story detailed how WWII veterans kill themselves at 4 times the rate of non-veterans of the same age, which demolishes the myth that such a problem with mental health and suicidality didn’t exist for previous generations of war veterans or goes away with time and age. From the Washington Post linked in the previous sentence:

The reality was that of the 16 million Americans who served in the armed forces during World War II, fewer than half saw combat. Of those who did, more than 1 million were discharged for combat-related neuroses, according to military statistics. In the summer of 1945, Newsweek reported that “10,000 returning veterans per month . . . develop some kind of psychoneurotic disorder. Last year there were more than 300,000 of them — and with fewer than 3,000 American psychiatrists and only 30 VA neuropsychiatric hospitals to attend to their painful needs.”

One of those hospitals was the subject of John Huston’s 1946 documentary, “Let There Be Light,” which said that “20% of all battle casualties in the American Army during World War II were of a neuropsychiatric nature.” The film followed the treatment, mostly with talk therapy, drugs and hypnosis, of “men who tremble, men who cannot sleep, men with pains that are no less real because they are of a mental origin.” Huston’s movie was confiscated by the Army just minutes before its premiere in 1946 and was not allowed to be shown in public until 1981. The government rationale at the time was protecting the privacy of the soldiers depicted, though Huston maintained all had signed waivers..

and

“Most of the World War II men that I worked with came to me in their 70s or 80s, after retirement or the death of a spouse,” said Joan Cook, a professor of psychiatry at Yale and a PTSD researcher for Veterans Affairs. “Their symptoms seemed to be increasing, and those events seemed to act as a floodgate.”

For so many veterans, that was when they finally learned they were not crazy or weak. “Pretty much to a person, for them, learning about PTSD and understanding that people were researching it in World War II veterans was a real relief,” Schnurr said. “Many people felt isolated and crazy, and they thought it was just them. And they didn’t talk about it.”

For studies on the relationship of combat to suicide, please start with this meta-analysis of 22 studies on this topic done by the Center for Veterans Studies at the University of Utah in 2015. The conclusion was that there is a significant link between killing, combat and suicide:

“Across all suicide-related outcomes (i.e., suicide ideation, suicide attempt, and death by suicide), the relation of specific combat exposure with suicide-related out- comes was twice as large (r = .12) as the relation of general deployment across all suicide-related outcomes” and

“the difference between the relation of combat-specific experience and general deployment history with suicide- related outcomes was significant”.

The report goes on to say that being involved in combat increases the likelihood of suicide in veterans by 43%.

You can also watch a short video summarizing this report here.

The VA on its site dedicated to moral injury also includes a list of studies.

In the video from RootsAction I mention that as early as 1991 researchers had determined combat related guilt to be the most significant predictor of suicide in Vietnam veterans. That study can be found here. Its conclusion reads: “In this study, PTSD among Vietnam combat veterans emerged as a psychiatric disorder with considerable risk for suicide, and intensive combat-related guilt was found to be the most significant explanatory factor. These findings point to the need for greater clinical attention to the role of guilt in the evaluation and treatment of suicidal veterans with PTSD.”

Take note that the current checklist for screening veterans at the VA does not include specific questions about or references to guilt and a 2012 VA study noted:“Killing experiences are NOT routinely examined when assessing suicide risk. Our findings have important implications for conducting suicide risk assessments in veterans of war.” (emphasis mine)

As mentioned above I have links, citations and abstracts for 25 studies I have reviewed that are available online, primarily through NIH, that explore the connection of suicide, combat, guilt, PTSD and TBI. As it it 12 pages long I will not paste it here, but if you would like a PDF, please let me know by comment or by email (matthew_hoh@riseup.net).

As I noted in my original post last week, there is also a very real connection between TBI and suicides, and with so many Iraq and Afghan veterans living now with TBI many of the suicides that are occurring would likely be connected to TBI. More information on TBI and veterans is found in the letter below.

Please do not hesitate to contact me with any questions.

Peace to you.

Matt

Below is a letter I sent to the military blog Task and Purpose, which went unacknowledged, regarding many of the common misperceptions of PTSD and veterans.

  • From: Matthew Hoh
    Date: February 5, 2018 at 2:28:11 PM EST
    To: james….
    Subject: Your article on PTSD

    Dear James,

    Thank you for your recent article on PTSD and the effects of transition on veterans. I believe the broad outlines of the study and its conclusions are correct. It reminds me of what I heard said about American soldiers returning from WWI: “how are you going to keep them on the farm when they have seen Paris?” There are a few things that the study’s authors, however, did not take into account and that can lead to misunderstanding about veterans by the public, particular the effects of combat.
    First, the study’s authors do not differentiate between the veteran population as a whole, those who deployed, and those who saw combat. This is crucial for understanding the stresses and challenges veterans face and why they face them. For example,  a meta-study from the National Center for PTSD by Brett Litz and William Schlenger, examined 14 published PTSD studies of Afghan and Iraq war veterans, and found that troops who had seen combat had PTSD rates of 10-18% but for troops that had not seen combat the rate was only 1.5%. An important differentiation.
    The authors also do not make the correlation or connection to the symptoms that they identify in veterans due to transition stress to the same symptoms that occur in unemployed civilians. There is a vast body of literature on unemployment related symptoms that has come out of the Great Recession, particularly in men. These symptoms include depression, anger, listlessness/apathy, mood impairment, sexual dysfunction, relationship problems and other issues that are similar to the symptoms that veterans experience upon separating from the military.
    Secondly, the authors do not discuss the role of TBI in OIF/OEF veterans. Rates of TBI among all OIF/OEF era veterans range from 10-20% according to the VA. The Rand Corporation and the Congressional
    Research Service put the rate as high as 23%. So, more OIF/OEF veterans suffer from TBI than PTSD, and as you most likely know, TBI can have a latent development and is often under reported (as is PTSD).
    Among combat troops the rates of TBI are much higher. One study of over 1,000 Marines and Sailors that deployed to Afghanistan had a TBI rate of 57% prior to deployment and during that deployment nearly 20% of those deployed sustained a TBI. https://www.ncbi.nlm.nih.gov/m/pubmed/24337530/?i=4&from=/23129059/related
    Another study’s authors said this:
    “The soldiers in Iraq and Afghanistan are having a very unique experience both because they have very good body armor now and because of the way in which insurgents use a lot of explosives. The soldiers are exposed to a lot of explosions, so they get hit over and over again, but they’re protected from all but the worst cases of secondary and tertiary effects. Whereas had it been the Vietnam War, for example, they [the soldiers] would have been much more grievously injured and would have been evacuated.”
    And the study’s co-author said this:

    “Probably the only war that is comparable to the wars in Iraq and Afghanistan is World War I, the trench and artillery warfare. The term “shell shock” came from that war and that really refers to the effects of these post-concussive symptoms.

    In the group of veteran participants in this study, the average number of blast exposures that were severe enough to cause acute symptoms consistent with the diagnosis of mild traumatic brain injury was 20. It was more common to have been exposed to between 50 to 100 blasts than to have a single one.”

    That leads to my third point, which I think would make an excellent article for you. The notion as advanced terribly by Sebastian Junger that these wars have been safer is demonstrably false and there is no evidence to demonstrate such, rather OIF/OEF (not just combat arms but all veterans) have had higher exposure rates to combat, violence, death and injury than any previous generation of veterans. Looking at a broad range of studies and surveys we see that OIF and OEF veterans experience combat at rates of 50% or higher, again a higher rate than any previous generation of American veterans.
    I have pasted below summaries I have written from various studies on OIF/OEF combat exposure, please note that some of the studies, such as the last study I reference, include veterans who did not deploy, so the rate of combat exposure is much higher than stated for deployed veterans:

    Studies and surveys have shown that veterans from OIF and OEF have experienced greater or equal rates of combat/trauma exposure of veterans of other wars. For example, the 2010 National Veterans Survey reported that the overall veteran populatiohas experienced combat at a rate of 34%. However, among veterans who deployed to Afghanistan and Iraq 63% of veterans had combat exposure. For veterans who went to war zones prior to WWII the rate was 55.4%, for those who went to war zones during WWII it was 44.9%, in Korea it was 26%, in Vietnam it was 44% and in the Gulf War it was 41%. That information comes from a study done by Ryan Edwards of Queens College, City University of New York in 2014.

    Additional sources debunking Junger’s and others unsupported and undocumented notion that only 10% of American troops saw combat or experienced danger/trauma in Afghanistan and Iraq, include:

    a 2004 study by Walter Reed Army Institute of Research that found 77-87% of American troops discharged their weapons in Iraq and more than 90% reported coming under small arms fire 

    a 2009 study from the Rand Corporation, by the same authors from a Rand study that Junger cites in his book, reports that only 10-15% of Afghan and Iraq veterans report no combat trauma experienced at all during deployment and close to 75% report multiple exposures to combat trauma

    a 2011 study from the National Center for Veterans’ Studies at the University of Utah reported 58-60% of Afghan and Iraq veterans had experienced combat

    a 2014 study published by the British Journal of Psychiatry found that contrary to Junger’s claims on p87 of his book that British troops had half the rate of PTSD than the American troops that “were in combat with them”, both British and American troops that experienced comparable levels of combat exposure had comparable rates of PTSD. The authors of the 2004 Walter Reed report referenced above also shared this finding. In the 2014 study of the American veterans of Afghanistan and Iraq nearly 70% reported receiving small arms fire; 85% experienced artillery, rocket or mortar fire; 43% handled human remains; 62% experienced dead/injured US forces; 24% had a friend injured near them; 28% gave aid to the wounded; 42% experienced sniper fire; 50% cleared and searched buildings; 51% experienced hostile civilians; and 45% reported a threatening situation to which they could not respond

    a 2014 survey of studies by the Walter Reed Army Institute of Research and published in the Journal of Clinical Psychiatry found that among veterans and service-members the greatest predictors of PTSD were high combat exposure rates and sexual abuse as an adult, and not events that occurred prior to service in the military as is often alleged. This is confirmed by many other studies, including a study by the VA from 1991 that found the best predictor of suicide in Vietnam veterans was combat related guilt. 

    a 2016 study by Texas Tech University of student servicemembers and veterans found that 44% of those surveyed had experienced combat. This study included veterans and active duty/reserve service members, both those that deployed to Afghanistan and Iraq and those that did not.

    Suicide is another factor the authors do not address. According to the VA, among the youngest male veterans of OIF/OEF, ages 18-29, the suicide rate is almost 6x higher for them than for their civilian male peers. For veterans in their 30s it is 3-4x higher. Among combat units that have been tracked the suicide rate is as high as 14x that of their civilian peers. This high and exaggerated rate of suicide holds true for all generations of American veterans who served during a war era. WWII veterans have a rate 4x higher than their non veteran peers. The link between combat and suicide is undeniable and has been well documented (a meta-study by the National Center for Veterans Studies in 2015 found a significant and clear link between combat and suicide in 21 of 22 studies examined). For veterans who did not serve in a war era, the rate of suicide is comparable or less than the civilian peer population. Veteran suicide is very troubling and not something to be disregarded when talking about veterans issues, particularly mental health.

    https://www.mentalhealth.va.gov/docs/2016suicidedatareport.pdf

    https://mobile.nytimes.com/2015/09/20/us/marine-battalion-veterans-scarred-by-suicides-turn-to-one-another-for-help.amp.html

    https://psychcentral.com/news/2015/04/13/key-factors-predict-military-suicide-risk/83462.html

    https://www.google.com/amp/s/www.commondreams.org/news/2010/11/11/suicide-rates-soaring-among-wwii-vets%3famp

    One final note, and thank you for indulging this long correspondence, but the source in the study you write about, that cites less than a 10% PTSD rate in veterans comes from a survey of 700 Danish soldiers. The Danes faced very hard fighting in Helmand, at one point I believe they had the most casualties per capita of the nations in ISAF (they had one deployed battalion on infantry), but I think it is disingenuous and unwise of the study’s authors to use a study of Danish troops, to make a broad statement about American veterans.
    For your reference, I was a Marine combat engineer officer for ten years. I have PTSD, TBI and neuro-cognitive disorder diagnosis  from my time at war.
    Let me know if you’d like more information. Again, thank you for indulging this long email (I thought this a better format than leaving a comment), and please consider writing an article on the documented level of combat in OIF and OEF veterans to dispel the myth that only 10% see combat, that these wars were safe, OIF/OEF vets had it easy, etc.
    Peace brother,
    Matthew Hoh

 

 

 

Talk on Moral Injury and PTSD

From a talk I gave to the Licensed Professional Counselors Association of North Carolina in October on my own issues with PTSD, depression, moral injury, alcohol abuse and suicidality. Please feel free to share this video with others. Other men and women sharing their stories with me has helped in my recovery and I want to do my part and pass that kind of assistance along.

Prior to giving this talk, as I was driving to the conference and walking into the venue, I planned on drinking as soon as I was done. Not just a few beers to watch my Mets play the Dodgers in the playoffs, but a medicinal drowning and extinguishment of that all too familiar, exhausting and debilitating anguish in my head, heart and soul. When I was finished with my talk, although tired, the plan was still there. I drove to a bar, got out of my car, and walked to the bar door. My desire, at that moment, not to be a liar was stronger than my need to drink, and I got back in my car and drove home.

From watching the video I doubt you can tell the pain I was in during this talk, an emotional, existential pain, unlike any known physical pain, and a sort of pain that seems to have no hope or end to it. It is as if a wedge or filter is placed into my head, not allowing me to access the functional, rational, more evolutionary modern parts of my brain. I am living in the poisonous fog that William Styron so masterfully articulated in his Darkness Visible: A Memoir of Madness;  a book that I can’t recommend enough to help friends and family understand how such mental pain and torment seems inescapable and unending, and drives otherwise very strong men and women to levels of despair that self-euthanizing becomes, in that ill and pained mind, a prudent, practical and necessary option.

My greatest gratitude to my good friend John Shuford who organized this talk and provided me with the video. I hope, in the future, to provide more information on an initiative John is working on to provide greater clinical training to therapists assisting veterans with combat related issues of PTSD, moral injury, depression, alcohol abuse and suicidality.

[Note: The introduction to the video gives a bit of a distorted summary of my career. You can find a professional biography on the About Me page of this blog. Not that it really matters though, as Babe Ruth said: “yesterday’s home runs don’t win today’s ball games”]

 

Insulting America’s Sacred Idols: Helping Veterans Recover from Moral Injury

Back in March, Quaker House in Fayetteville, NC, the home of America’s largest military base, Fort Bragg, hosted me to discuss my recovery from PTSD and moral injury. The full video is below, along with a three minute clip that Lynn Newsom, the co-director of the Fayetteville Quaker House, is using in the talks she gives to military and non-military audiences on moral injury.

During my talk I am not very clear about the correlation, and, yes, I would also say causation, between combat and suicide. However, there is a very clear link between combat veterans and suicide, a link that is obviously very dangerous to cherished American myths of war, with all too familiar, prevalent and false motifs of justice, honor and redemption. To illustrate the connection between war, violence and suicide, a connection that manifests in veterans through PTSD, depression, substance abuse, and moral injury, I have included, at the end of this essay, 15 fairly easy to find studies of the last few decades documenting the prevalence of suicide in combat veterans.

Among the below studies, and among the most recent, dealing with my fellow veterans of the Afghan and Iraq Wars, researchers at the National Center for Veterans Studies have found that veterans who were exposed to killing and atrocity had a 43% greater risk of suicide, while 70% of those Afghan and Iraq veterans who participated in heavy combat had attempted suicide. We spends millions of dollars and thousands of hours to physically, mentally and morally condition each young man and woman who volunteers to serve in the military to travel abroad and kill, but upon their return, in reality, effective and thorough programs to decondition our veterans, help them reenter and reintegrate into society and regain emotional, moral and spiritual balance and health are nonexistent, while care for developed wounds, both physical and mental is underfunded. Continue reading

If there can be one thing I ask, please watch and share this video:

If I could articulate well and share succinctly my entire thoughts on PTSD, depression, moral injury, alcohol abuse and, especially, suicide, it would be ensconced in this 4 1/2 minute video from Ze Frank.

When I was first shown it, my shield went up and I spurned it, wanting to disregard his words, because he was talking about teenagers and that certainly doesn’t apply to the pain and experiences of a returned warrior [cue the self-indulgence…;)], but I listened and everything, EVERYTHING, he says applies to me and to so many like me who have suffered and are suffering from the pains of mental and psychiatric wounds.

Frank’s description of himself, his breakdown, his rejection of others, his forays into getting help and how bloody hard it can be, and how this mental pain, this psychiatric trauma, is worse than anything physical, applies to those of us who carried rifles in far away lands just as it does to civilians at home. This commonality of suffering does not just unite us as humans, children of a natural and spiritual order, but it a source of relief and compassion. For, as you may be suffering, just as Frank and I suffered, you know that you are not alone, and through that shared suffering, through this community and commonality, you can find assistance, begin recovery and, through time and effort, including seemingly inevitable regression and relapse, you can regain your life.

The video ends with words to the effect that “if someone sent you this video it is because they love you”. No one is going to ask you to watch this video who doesn’t care, who doesn’t love you or who won’t help you. Most importantly someone who has sent you this video is offering their hand. They are not going to leave you and they will help you get to that other side.

Please watch and share.

 

“Political Leaders Who Made Them Sacrifice For Nothing”

An interview I did with RT in London on Afghanistan regarding President Ashraf Ghani’s visit to the UK and assessing our war in Afghanistan and its long term effects.

Profile in VICE: The First US Official to Resign Over Afghanistan Is Fighting to Help Whistleblowers

I’ve liked VICE for a bit of time now, so it was pretty cool to have been profiled by VICE UK while I was in London. Much appreciation for to Joe Sandler Clarke and Adam Barnett for their time and effort telling my story.

The First US Official to Resign Over Afghanistan Is Fighting to Help Whistleblowers

whistleblower-matthew-hoh-interview-198-body-image-1417018880

 

 

 

 

 

 

 

 

 

 

It’s five years since Matthew Hoh became the first US official to resign in protest over the government’s handling of the Afghanistan war, resulting in a PR disaster for the US government.

“After I resigned, I was in a bar and it just so happened that I was sitting next to an editor from the Washington Post. We got talking and he told me to call the foreign affairs desk the next day.” He did and a few hours later, Post journalist Karen DeYoung was on the phone. They spoke for six hours and within days, his resignation letter was on the front page.

In the letter, Hoh explained he had lost confidence in the tactics being used in the conflict, and that he had no idea why it was going on. He wrote, “My resignation is based not upon how we are pursuing this war, but why and to what end.”

Today, sitting in his hotel room in central London, wearing a War Resisters International badge and with leather elbow patches sown onto his jacket, he admits he is surprised by his journey from Marine Corps captain to peace activist. “I never planned any of this,” he says. “In a year I went from thinking I would have 35 years in the government before getting a PhD and teaching at a small college somewhere to saying, ‘Fuck you, I am not doing this anymore. It’s wrong.'”

The years since he resigned have been marked by the current administration embarking on what Glenn Greenwald has called “the mo​st aggressive and vindictive assault on whistleblowers of any president in American history.” Of the 11 times the Espionage Act has been used to prosecute whistleblowers who have leaked information to journalists, seven have been under Obama. Pulitzer Prize–winning journalist James Risen is to this day ​facing possible prosecution for refusing to reveal the identity of his one of sources to the authorities.

Hoh now fears that if he had blown the whistle today as he had done in 2009, he would be facing prosecution. This explains his motivation for becoming an advisory board member at ExposeFacts, a new website led by veteran journalist and activist Norman Solomon. The project is designed as a place for people to leak information safely, while also offering better protection to whistleblowers and campaigning to shield reporters from state surveillance. It already has the backing of a host of Pulitzer Prize winners and Daniel Ellsberg, the man who leaked the Pentagon Papers to the New York Times.

The day before I meet him, Hoh was part of panel of former intelligence workers at the launch of ExposeFacts that told the world’s media that they were fighting back against the Obama administrations “war on journalism and whistleblowing.”

They aim to provide technology for secure, anonymous whistleblowing, and to push the actions of whistleblowers “to the forefront of the public consciousness.”

Having enlisted for the Marines in the heady days before 9/11, initially Hoh’s military career was “just like the brochure said it would be.” He was stationed in Okinawa, Japan, with his days spent training, traveling the world, and hanging out at the base’s private beach.

Hardworking and intelligent, with supreme self-confidence and an inherent curiosity about the world, Hoh enjoyed what he describes as a “Forrest Gump-like” rise through the ranks.

By the time US forces invaded Iraq, he was working for the Secretary of the Navy. By 2004, he was leading reconstruction projects in Iraq, handing out money to political leaders and making arrangements, ostensibly so the country’s devastated athletics facilities could be rebuilt. He would travel with his own security team, with a pistol tucked into his suit pocket and $25 million in cash.

“It was part Scarface, part Lawrence of Arabia,” he recalls. “But it was very instructive to me about the folly of war.”

Throughout the conflict, Hoh was skeptical about the reasons for going to war and the mission itself. “I certainly doubted why we were there and could see it wasn’t adding up. I was doing all I could to do it right,” he says. “But it doesn’t matter how much honor you possess if a war is morally fraught.”

He worked with a group of women in Baghdad and the memory of them haunts him still. They were modern and educated. They wore hijabs that matched their mascara and believed in the US mission.

“We gave them this hope and this promise and then we gave them a hell that you and I can’t even imagine,” he says. “I know one of them is still alive, but that is something that has haunted me ever since. I don’t know if they were blown up in a car bomb, or if they were raped, or if their families were killed. That’s where a lot of my moral injury comes from.”

After a period spent moving from one prestigious desk job to the next, Hoh was back in Iraq in 2007. He was with a small group of men when the helicopter they were traveling in crashed over the Persian Gulf. “It was kind of ironic because you go to the desert and almost die in the water,” he says. “Four guys died, including one who was a friend of mine and I could not save any of them. It crushed me. I had survivor’s guilt.”

On returning home he could barely function. While spending a day at the beach in Delaware, he had a flashback. “It came over me as soon as I went in the water. All the stereotypical PTSD symptoms you hear about not liking fireworks, or not being in crowds, they’re all a joke, compared to this moral injury. It’s just blackness,” he says.

“The alcohol became key. I was always a big drinker, but this was different. It was the only way I could get through the day. My days in this period consisted of getting up, going to work, leaving work as soon as possible, getting home, working out, drinking, blacking out by 10 PM and then doing it all again.”

Two years later, figuring that if he was going to die, it may as well be in Afghanistan, he went back to fight. He was the State Department’s senior representative in Zabul province, an area which had seen some of the fiercest fighting of the war. But five months into his year-long contract, he was done with the military.

“I didn’t believe any of what was being said. That we were there to protect ourselves from another 9/11 and all that stuff. It just wasn’t true,” he remembers.

That’s when he resigned and before long he was being chased by journalists who wanted to hear of his disaffection. “It was a huge deal,” recalls Hoh. “I had three TV news trucks outside my house and 75 media requests, the day after it broke.”

Despite US Envoy Richard Holbrooke telling him that he understood his misgivings about the war and that his letter was being “taken seriously,” after news of his resignation went public Hoh found himself cut off from the Washington establishment. A Wikipedia page about him that downplayed his role in the State Department and featured a clip of him being used in an al Qaeda propaganda video surfaced online. For more than two years, he couldn’t find work and had no money coming in. He found himself selling cars for a few months just to get by.

Being frozen out took its toll. By 2011, suicide had become a daily obsession. He would plan it meticulously, figuring out when and how he would do it, how he would tell his family. “The only thing I didn’t do was buy a gun,” he says.

Ultimately, it was through the support of family and an ex-girlfriend who forced him into therapy that he was able to dig himself out of that feeling. A sense of having a greater purpose helped too. Every time he saw a politician lie on TV, or when he read a newspaper article he knew to be untrue, he kept wanting to speak out. “I was out in public and doing media, so I felt like I couldn’t kill myself,” he says. “People would say, ‘You’re gonna listen to what that guy thinks about the war?! He shot himself in the head!’ I had this cause, this purpose and I could not discredit that by killing myself.”

Hoh is now 41. Having left Washington vowing never to return, he lives in Raleigh, North Carolina and earns $48,000 a year through his job the Center for International Policy. If he had stayed in the military, he says, he would be earning more than double that.

He’s turned his back on a career, a high salary, an institution, and a way of life—now he’s determined to help others who want to do the same. For all he’s lost by speaking out, he’s also gained a tremendous amount. “I’m very happy,” Hoh tells me later. “With the moral injury, the PTSD, the depression, the suicidality, I have my bad periods, but I’m getting through. I don’t own a gun, I don’t keep alcohol in my house, I see my psychologist every week, I take medication. I manage it like you would manage high blood pressure. I’m just happy that I can express my own thoughts and think my own way. That’s worth more than any amount of money.”

Recovering From the Darkness of PTSD After War

This is the second part of my interview with Amy Goodman of Democracy Now. We cover a lot of issues in the conversation and this is probably the most personal I have ever been on camera in terms of speaking of my own issues. Much thanks to Amy and Democracy Now for giving me so much time to speak.

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In 2009, Matthew Hoh became the first State Department official to resign protest from his post in Afghanistan over U.S. policy. Prior to his assignment in Afghanistan, Matthew Hoh was deployed twice to Iraq. In part two of our conversation, we speak with Hoh about what happened after he blew the whistle on the Afghan War and his long fight to recover from post-traumatic stress syndrome. On his website, Hoh writes: “In 2007, after my second deployment to Iraq, PTSD and severe depression took over my life. I began trying to drink myself to death. Thoughts of suicide became common until they were a near daily presence by 2011.”

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman. As President Obama announces more boots on the ground in Iraq, another 1,500, bringing the total, it’s believed, to about 3,000, with hundreds of bombing raids in Iraq and also Syria, we’re joined by Matthew Hoh. He is a former State Department official who resigned in protest from his post in Afghanistan over U.S. policy there in September 2009. Prior to his assignment in Afghanistan, Matthew Hoh served in Iraq. From 2004 to ’05, he worked with a State Department reconstruction and governance team. And from 2006 to ’07, he worked as a Marine Corps company commander in Anbar province. He’s now a senior fellow at the Center for International Policy. He’s joining us from Raleigh, North Carolina.

Matthew Hoh, welcome back to Democracy Now! for part two of our conversation. I wanted to ask you about the response to you as a whistleblower. At the time, you were the highest State Department official to resign over U.S. policy in Afghanistan. What happened to you after that?

MATTHEW HOH: Well, thanks for having me on again, Amy. You know, there was divisions within the Obama administration on the war in Afghanistan. And so, what I said about the war in Afghanistan—how I said our presence was fueling the insurgency, al-Qaeda had left there a long time ago, we were supporting a corrupt government in Afghanistan, our troops were dying for no good reason—many members of the administration believed, most importantly Ambassador Karl Eikenberry, who was our ambassador in Afghanistan, and Ambassador Richard Holbrooke, who was the special representative for Afghanistan and Pakistan. And they both, to some degree, I believe, protected me from attack from within the U.S. government; however, from the military side, I did take some pressure. I do know that General Petraeus’s command in Tampa, Central Command, actually hired a strategic communications firm to actively discredit me. So, when I would appear on television, this firm would say—would send emails to producers or to newspapers to try and get me pulled off or not written about, basically saying, “This guy isn’t who he says he is. This guy doesn’t really”—

AMY GOODMAN: What was the firm, Matthew?

MATTHEW HOH: I don’t recall—the name of the—and here’s the great—why I kind of believe, Amy, karma exists. The name of the firm—I don’t believe the firm exists any longer. The name of the fellow who ran the firm was Duncan Boothby. And this was the gentleman who introduced Michael Hastings to General McChrystal in 2010. So I do believe in karma to a certain extent. The guy who was actively seeking to discredit me then turned and introduced Michael Hastings, who wrote the great book The Operators, whose Rolling Stone article shone a light on how General McChrystal and his staff actually operated, and so I do believe there is some karma. And in one of those things that, you know, you can’t—where truth is stranger than fiction, I know all this because Duncan Boothby told me himself. He introduced himself to me at a Christmas party in December of 2009, just walked right up to me and said, “You know, I hope you don’t take any offense to it, but I’m the guy who’s been discrediting you to the media.” And, you know, but that’s the way Washington, D.C., works, and that’s the way our senior military works.

AMY GOODMAN: And so, what did it mean? How did you see that manifest?

MATTHEW HOH: I did notice that I started to appear less and less on news programs. I know I had articles about me pulled from publications like The Star-Ledger in New Jersey. I know when I would appear on CNN, I was told that, you know, “You can be on, but there has to be someone to counter you, because you have a bias.” And they would sometimes put somebody on who was independent, an independent analyst, so to speak, who was actually in the pay of the Pentagon. So, it really was—it was very absurd, very Kafkaesque. I had a long series of interviews with Dan Rather, who was going to do a special on me, and he actually pulled it because he received pressure from the Pentagon not to do that. So it really was. It was really quite absurd, quite Kafkaesque. But it wasn’t surprising, because I had worked in Washington, D.C., I had been around senior levels, and I understood what I had gotten myself into. I understood the politics of it, and I understood the type of people that were involved in it.

And it further fueled my desire to work to end the wars, because it just showed—and this is what’s important to know for Veterans Day—our men and women who are serving overseas, who are killing, who are being killed, who are being maimed, who are coming home with these psychological wounds that—you know, as we spoke in part one, 22 veterans a day are killing themselves—they’re dying in support of people who are making policies, who are so selfish in their own concerns that they disregard the reality of what’s happening in these countries, disregard the reality of our presence, disregard the effects that it has on our troops. And so, that campaign against me, that, you know, putting up a Wikipedia page, a false Wikipedia page about me with all kinds of false information, those kinds of things, that really only fueled me to work harder to try and stop these wars, to try and get our soldiers home, and to try and end the suffering for millions of people in those war zones.

AMY GOODMAN: Explain the Wikipedia page, the fake Wikipedia page.

MATTHEW HOH: You know, all of a sudden I had a friend of mine text me and said—because, Amy, this was—I was a marine, and I worked for the government. Before 2009, the last time I had been in the news was in 1991 for high school track. So, I hadn’t—you know, this wasn’t anything I was used to, nothing my friends were accustomed to, that I was, you know, on the television or in the newspapers. And all of a sudden, my friend texts me one day, and she says, “You’re on—you’ve got a Wikipedia page,” and was shocked. And there was a Wikipedia page about me, and it just had a bunch of half-truths and mistruths. You know, just it had some general biographical information, but then the information went on to say how I wasn’t really working for the State Department, I made up my position, I didn’t have the experience I was attesting to—basically casting doubt on my credibility, basically casting doubt on who I said I was. It prominently featured—al-Qaeda had put a propaganda out one time where they took a clip of mine and edited it and put it into their propaganda video. It prominently featured that, and, you know, so basically hinting at, was I—what I was doing, was that helping al-Qaeda? You know, so, it was that type of thing. And it went back and forth, because there are some very nice people out there who edited it on my behalf without my asking. And it finally got to the point where I actually contacted Wikipedia and said, you know, “I’m the subject of this piece, and it has a lot of inaccuracies, and I’m tired of it, and can you just get rid of it?” And they did. They deleted it. And that hasn’t been a problem for a couple years. But that was one part of that, you know, campaign.

And I’ve seen it with other people, too. You certainly see it with other whistleblowers. Lieutenant Colonel Danny Davis, who went to Congress with a report in February 2012 saying that, look, the war in Afghanistan is going very badly, the Afghan security forces are not ready to take control—all things that had been proven, in fact, since then—he was actively discredited by senior members of the Pentagon. They went after him behind the scenes to, you know, media executives. And then you’re seeing it to extreme lengths, of course, with whistleblowers like Peter van Buren, who wrote the book—who was a State Department official who wrote a book about his time in Iraq that the State Department did not like, and so they went after him, threatening him with legal action, threatening to take away his pension. Thomas Drake, of course, the NSA whistleblower, they trumped up charges, charged him with the Espionage Act. They actually—in Tom Drake’s case, the FBI raided his house, turned his house upside down, and they actually—he had documents there, work documents there, and in Tom Drake’s case, they actually retroactively classified the documents. So when Tom took those documents home, they weren’t classified, but after the FBI raided his house and they needed a reason to shut him up, to shut him down, to make an example of him, they retroactively classified the documents to say that he was spying. You know, and on and on. Of course, you have Chelsea Manning, you have Edward Snowden, you have a host of other whistleblowers out there, too, who have been actively campaigned against by the federal government, by the State Department, by the Pentagon. And it really is quite a shame. I mean, this president, President Obama, has persecuted whistleblowers to a greater extent than any previous president.

AMY GOODMAN: Matthew Hoh, I wanted to go to the issue, on Veterans Day, of your PTSD. In the first part of our discussion, we talked about, you know, what it means overall in the country. But I wanted to go back to that quote on your website, at MatthewHoh.com, where you wrote, quote, “In 2007, after my second deployment to Iraq, PTSD and severe depression took over my life. I began trying to drink myself to death. Thoughts of suicide became common until they were a near daily presence by 2011.” That’s what you wrote on your website. And I wanted to talk specifically about how you recovered. If you could talk about what you did dealing with PTSD, even when you realized you had it?

MATTHEW HOH: Well, you know, it first really hit me after my second deployment to Iraq, about four months after I was home. And it was like you read about or like you hear: There was this black wave that came over me. And at the darkest of times, I—I was always a big drinker anyway, but not in this sense. And it soon became where the only way I could survive, where the only way I could numb myself, the only medication that would make me be OK, where I could sleep, where I could kind of—where the pressure, the stress in my head was bearable, was by drinking. And soon that became my way of killing myself. It became a slow way to kill myself, you know. And, of course, one of the things with post-traumatic stress disorder and with alcohol abuse is that they fit one another. They reinforce one another. I like to describe post-traumatic stress disorder as, say, as if you have a bruise on your brain; when you water it with alcohol, it grows, and it takes over more of your brain. And that was absolutely the case.

And, I mean, here was something where there is a double standard, which I think most men and women in the military can identify with, where I used to stand in front of my marines and talk about these issues, but when it happened to me, I couldn’t get help. I wouldn’t get help. I tried to treat it myself. And this persisted until—through 2011. And by that point, as you say in that quote of mine, I was thinking of killing myself. And there was a plan, you know. And I think that is what’s frightening to a lot of us who go through this, is that—and when you relapse, when this is something you still struggle with. So as I still struggle with these issues, the frightening thing, Amy, is that when it comes or when you’re back in that spot, you pick up the plan from the same location. You know, you pick up from where you left it off. How are you going to handle letting your family know? Where are you going to do it at? What are you going to use? All those things are mapped out.

And so, basically, what happened in—beginning of 2012, I was in a relationship. We were living together, and it was just a nightmare for my ex-girlfriend. And she got us to go to counseling. And the second counseling session, the counselor said, “You know what? I think this is not about you guys. I think this is about you.” And fortunately, the counselor was a former sailor who had PTSD issues of his own, and I bonded with him. And I trusted him because he was a service—he was a veteran. He had gone through these issues. He knew what I was talking about. And he saved my life. His name’s Lenny Brisendine. He’s in Georgetown. And he saved my life. He got me to stop drinking. He got me to go to the VA, got me on medication, because at that point I had hit rock bottom, and it was really just one way or the other. And if it wasn’t for Lenny, if it wasn’t for my ex-girlfriend getting me into therapy, if it wasn’t for some great doctors down here at the VA in Raleigh, if it wasn’t for my family—I have tremendous support from my family—I wouldn’t be here talking to you. I mean, I am completely certain of that, that I wouldn’t have lasted another year. I would have killed myself—

AMY GOODMAN: For—

MATTHEW HOH: —because of—

AMY GOODMAN: For vets who are going through what you went through and what you continue to deal with, when you say that the therapist saved your life, what exactly did he do to get you to stop drinking, to go to the VA, to begin to take medication? When did it click for you?

MATTHEW HOH: I think it was—well, the clicking for me was when the one question he asked me was, “Tell me about your future,” and I said I had no future. And it was at that point I became self-aware, I believe, of what was really going on, even though I had been going through it for four years. I knew it was going on. I mean, my life was programmed around alcohol, the panic attacks, the breakdowns or the pressure. I mean, I knew what I was going through, but I didn’t care. I didn’t think there was any other choice for me. It was the only way I could deal with it. And so, sitting across from this man who had gone through the same thing himself, who opened himself up to me and who got me to admit a couple things about myself, all of a sudden it was something I could no longer ignore. And so, the importance about testimony in a case of what Lenny did, what others did, and then what I started to do then was I started to watch videos of other veterans who were going through the same issues, read about them, because what you find is you see yourself in them. You say, “Oh, my gosh, that’s exactly what I’m going through, and he’s saying he’s doing better now. Well, OK, let’s keep watching, or let’s turn the page and see what we need to do.”

I mean, there are a lot of things that go with PTSD, and also another component of this is what is called “moral injury,” which a lot of us suffer from, it is what I suffer from, which is different than PTSD but afflicts a lot of veterans. But there are a lot of components. We get ourselves into financial difficulties. We have intimacy issues. I mean, one of the hardest things for relationships is that veterans with PTSD, with moral injury, with these kinds of problems, will stop being intimate with their partners, and it destroys the relationship. And it’s certainly what was happening with me in my relationship. It’s a very difficult thing to talk about, very difficult thing to acknowledge, but it kills relationships. And then, once the relationship is gone, what keeps you from killing yourself is that you’re holding onto things that you have. So, for me, to be completely honest, one of the things that kept me alive was the fact that I was doing media, talking about the war. And so, I was afraid that if I killed myself, right, then those who were opposed to me would say, “Oh, you can’t listen to that guy. He ended up killing himself.” So you find these things to latch onto. And so, for a lot of veterans, it’s their relationship. And when that relationship goes, then there’s nothing left to hold onto. The distress is overwhelming. The pain is overwhelming. And so, the choice then is made that this is the only thing I can do to end my distress, to end my suffering. And unfortunately, as we noted before, 22—at least 22 veterans a day are making that choice.

AMY GOODMAN: We’re talking to Matthew Hoh, who’s a former Marine company commander in Iraq, talking about dealing with PTSD, as we move into Veterans Day. You know, the VA scandal continues to unfold. In the latest news out of the VA, Matt, they are saying that they’re considering disciplinary action against a thousand employees, as it struggles to correct systemic problems that led to long wait times for veterans, that led to falsification of records of the cover-up delays. That issue of long wait times is not just a matter of, oh, it’s inconvenient, you know, so someone has to wait a couple weeks—

MATTHEW HOH: Yeah.

AMY GOODMAN: —or couple months—actually, it might be a couple years. As you describe dealing with PTSD, post-traumatic stress disorder, that could be a matter of life and death, as real as any disease someone is suffering from.

MATTHEW HOH: Oh, absolutely, absolutely. And in fact, one of the issues with the wait times, the frustrations that you find in the VA—and let me be clear: In my, the VA I go to, I have had excellent care from the doctors and staff. They are truly wonderful, gifted people. But they work in a system that is just completely broken. When I moved down here to Raleigh a couple years ago, even though I was suicidal, even though I was being treated, it took me almost four months to see somebody in the VA down here, not because they didn’t care, not because they didn’t want to help, but because they are overwhelmed, they’re overburdened. The system is just broken. And so, what can happen is that if the veteran who is suffering from this has lost everything and he’s hitting that rock bottom and he’s finally going to the VA to help, and then he gets turned away or he gets frustrated, well, that’s going to make his situation worse. That’s going to make him or her more despondent. That’s going to make him feel as if there is going to be no end to this suffering. So, the option to kill himself is the best option for him. And it really is frightening how that does occur, how the system itself can contribute to these losses.

And again, as we mentioned in part one, there’s just been a serious, serious just managerial incompetence in the VA. Up until just a couple years ago, as we mentioned before, the VA wasn’t even collecting data on veteran suicides on a national level, and we’re still not collecting data on a completely national level. We still have 20-some-odd states that aren’t contributing to the database on veteran suicides. There is no way to make sure we’re capturing all veteran suicides, because only about 40 percent of veterans are registered with the VA. And if you ask why are only 40 percent of the veterans registered with the VA, I’ll tell you because the VA system has been a very frustrating, difficult and painful experience. I just finally—after about two-and-a-half years, I finally got my disability claim from the VA, and it’s completely wrong. I mean, I’ve been seeing a counselor for alcohol abuse for a couple years on a weekly basis, and the disability process in the VA said I didn’t have an alcohol abuse problem. So, it’s those kinds of things that I think turn people away, that chase people away, that don’t let veterans get help, because they get frustrated, they get sick over it, they throw their hands up. And then so they turn to what is working for them in the interim—alcohol, drugs—and unfortunately, that path more than likely ends up in suicide.

AMY GOODMAN: And, Matt Hoh, the definition of PTSD and what so many soldiers and veterans had to deal with for so long of even being categorized in that way, instead of being sent home with aspirin?

MATTHEW HOH: Yeah. So, with post-traumatic stress disorder, what it basically—and there’s a wide variety. This exists in the civilian world, too. Many people—survivors of sexual assault, survivors of accidents, survivors of abuse—they will all suffer post-traumatic stress disorder in a similar vein from veterans. I think post-traumatic stress disorder from warfare is a bit different, and I think there’s also a piece of this that is becoming more understood, better understood, this moral injury component, wherein that is, in your mind, the person you are did not do the things that you expected them to do. So, in my case, the moral injury is that I have guilt over things I did or guilt I failed to do. I didn’t live up to the expectations of myself in war. And when I come home, I now have to live with that. I now have to live that with this notion that I did things or I didn’t do things that I’m not morally OK with, that that’s not who I thought I was. So you have that destruction of your self-image. You have that destruction of the soul, basically.

And then, with post-traumatic stress disorder, you have basically, in some ways described as your fight-or-flight system is stuck open, that valve is stuck open, so you’re constantly in overdrive. So you’re constantly over-aware. You’re constantly reacting as if you’re still there. And this can take form in flashbacks, in dreams, in just a constant pressure, a constant stress that exists with you every day. And that then extends and breaks down your daily life. It breaks down your relationships. It breaks down your job performance. It breaks down your finances. And so, it has an effect that then radiates out. And because you’re not getting help, because maybe you’re turning to alcohol or you’re turning to drugs, it then cycles on itself, and it just continues to build, until the point comes that you hit rock bottom. And then it’s either one way or the other. And unfortunately, way too many of us are choosing suicide as opposed to getting help.

AMY GOODMAN: Matthew Hoh, would you do things differently, as you reflect back on your life now, from being a Marine Corps commander, a company commander in Iraq, to serving in Afghanistan as a State Department official, quitting and what you’ve done since then?

MATTHEW HOH: I don’t think so, Amy. You know, I’d like to say maybe, but I don’t think so. I think I’m at the place now because of the decisions I made, whether they were the right decisions or the wrong decisions. You know, I’ve—I actually saw a great—I’m 41, you know, so I’m going through what all of us who are turning in their forties are going through of “How did this happen to me?” you know? But I saw this little bumper sticker, and it said, “Life begins at 40. Everything before then is research.” And I think that’s absolutely true. I think that’s actually the case. I mean, that’s life and the journey we’re on. And it’s a constant journey. I’ve got another 40-some-odd years to make up for things maybe I did wrong, for mistakes I made, to improve upon things or to do things well again. And so, I think that’s the way I like to view it as, rather than looking back and saying, “I would have done this differently or that differently,” because I can’t honestly say I would have.

AMY GOODMAN: Matthew Hoh, Fallujah, Friday, it was the 10th anniversary of the second battle of Fallujah, where I think it was the bloodiest battle for U.S. troops. Something like a hundred died.

MATTHEW HOH: Yes.

AMY GOODMAN: Not clear how many Iraqis died. Now the Islamic State, ISIS, has control of Fallujah.

MATTHEW HOH: Yeah.

AMY GOODMAN: Can you comment on this?

MATTHEW HOH: Well, and they’ve been—since January, there’s been a lot of fighting in Fallujah. And Fallujah itself has never been entirely secure, particularly these last few years, the Iraqi government. But what you’re seeing is sectarian fighting. You’re seeing Sunni versus Shia. So, in January of this year, the people of Fallujah had basically had enough with the Shia government. They felt they were being preyed upon. They felt like they were being oppressed. And with the Islamic State, they have been fighting the Iraqi government, the Shia government, for control since then.

One of the things that’s important, I think, for folks listening and watching to be aware of is that this violence in Iraq is not new. It didn’t just happen again in the summer. Last year, almost 10,000 people were killed in bombings and shootings and in violence in Iraq, and this year, of course, it’ll be probably more than double that. So, it is. I mean, you look at it in the sense of 10 years ago, when we launched that operation in Fallujah, it was the bloodiest campaign of the war. Thousands were killed. Thousands were wounded. Horrible, horrible fighting. The city was destroyed, to a certain degree. And I think it’s an important lesson. I think it shows the mistake of trying to achieve policy goals with violence. By somehow achieving victory in the short term, you make sure you don’t achieve any stability or any peace in the mid or the long term.

And I think, too, the repercussions of the fighting in Fallujah from 10 years ago, of course, are still being seen now, because they’re still fighting. But also, too, as well, we have very severe concerns for the public health of the people in Iraq because of the depleted uranium that we used. Depleted uranium is very dense, and so we use it in our munitions, in our tank gun rounds and in our—in other munitions that we have, because it basically works so well when you’re trying to kill. But the problem is, is after you use it, it sits in the ground, and that uranium sinks into the ground and into the water supply. And now, these years afterwards, we now see very horrible incidence of cancer, of birth defects, of women bearing still-born babies. And so, not just do we have this legacy that’s still alive—the fighting is still going on, people are still being killed every day, the Islamic State is beheading people, the Iraqi government is shelling buildings, including schools and hospitals—but you have this, even if there was stability, even if there was peace, the people of Iraq would be suffering because their groundwater, their land is contaminated, and their children are dying because of it.

AMY GOODMAN: And the chemical exposure Iraqis face, and also U.S. soldiers, your response to the Pentagon admitting that 600 American servicemembers since 2003 have reported to military medical staff members they believe they were exposed to chemical warfare agents in Iraq, the Pentagon failing to realize the scope of the reported cases or [offer] adequate tracking and treatment to those who may have been injured, the Pentagon says. This was a big exposé in The New York Times.

MATTHEW HOH: Mm-hmm. Yes, I mean, certainly when I was there, we found them. I remember reading a report that a unit would find old chemical weapons shells, you know, and so the explosive ordnance disposal guys would have to go there and take care—and that’s one of the reasons why normal troops were not supposed to blow up any old Iraqi shells that they found, because they might be chemical rounds. I mean, this was widely known within the troops fighting over there that there were these old chemical munitions laying around. It was reported. And so, this idea that somehow the Pentagon is just realizing it now or that it wasn’t adequately reported is a lie.

And I think it falls into play with other aspects of how the Pentagon and our government has conducted itself over time. I mean, certainly the easiest and the clearest example is Agent Orange. I mean, Agent Orange was a defoliant we used in Vietnam to strip the leaves off of the jungle. It was assured to everybody—our troops and the people of Southeast Asia—that it was not going to be a problem. And, of course, you know, go over to the VA hospital, and it’s full of veterans suffering from the effects of that in terms of cancer, as well as, if you visit Vietnam or Laos or Cambodia, they are suffering the same.

So this notion that somehow the Pentagon didn’t know about it, that they didn’t understand it, it wasn’t being reported properly, is a complete lie. I’m just grateful that they are actually addressing it now, and hopefully those 600—and it may be more—servicemembers who were exposed to it, hopefully they had been receiving adequate treatment throughout this time and it’s not just that they’re going to their first doctor’s appointment for this this week.

AMY GOODMAN: And in Afghanistan, that’s the country you were where you quit the State Department. The latest news from The Washington Post, bombers targeted Afghanistan’s police, killing at least 10 officers and a civilian in two separate attacks in the latest sign of growing violence in the country. The attacks came one day after a suicide bomber infiltrated the heavily fortified police headquarters in the capital, Kabul, and blew himself up, killing a senior police official and wounding several others. We’ve talked a lot about Iraq. What about Afghanistan?

MATTHEW HOH: Well, Afghanistan, you know, unfortunately for the Afghan people, they’ve seen violence increase every year. Violence is worse now than it was in 2009 when President Obama escalated the war in Afghanistan. You’ve had a series of fraudulent elections in Afghanistan. This last one, the presidential election of this year, was so fraudulent, they couldn’t even release the numbers from it, and basically they had to create an extra constitutional position for—so that both candidates would accept victory, and you wouldn’t have a broadening of the civil war in Afghanistan. Basically, Secretary Kerry had to say, “You’re going to do this, in order for us to keep giving you the money.” And I think that’s what people should take away from it, is how much influence our money has in these conflicts, how they prop up corrupt governments, these kleptocracies.

The only thing that has prospered in Afghanistan since 2009 has been the drug trade. Every year, the poppy crops, the marijuana crops are larger than they were the previous year. And I should counter that with saying also, too, the Taliban have prospered, as well, because the Taliban are actually larger, stronger, more capable than they were in previous years. Every year, they grow in size, and you could see as reflected in the numbers of attacks they launch, IEDs they put in the ground, the number of police or soldiers they killed.

So, Afghanistan is in a very, very difficult position. The civil war is ongoing. The Taliban are in a position of power, where they can negotiate when they want to. The government is incredibly corrupt. There is no economy to speak of. And I think the Afghans will unfortunately have to suffer for quite a long time until stability comes there. They’ve been fighting for as long as I’ve been alive, or at least almost as long; they’ve been fighting since the mid-’70s. And so, I think, unfortunately, the Afghans are going to have to suffer and continue to suffer. And I think it should be a lesson on the limits of American power, what we can achieve and what we should try to achieve.

AMY GOODMAN: Matthew Hoh, on Sunday, former President George W. Bush appeared on CBS’s Face the Nation to talk about a book he had written about his father. The host, Bob Schieffer, asked him about a statement he makes in his book regarding his decision to invade Iraq in 2003.

BOB SCHIEFFER: You write in the book, when you decided to send troops into Iraq, it was not to finish what your dad had started.
GEORGE W. BUSH: Yeah. There are very few defensive moments of the book, and that happens to be one. I guess I was just responding to kind of the gossip that tends to work around the political circles, that clearly he had only one thing in mind, and that was to finish the job his father did, because my dad decided not to go into Baghdad after routing Saddam Hussein out of Kuwait. And the reason why is that wasn’t the mission he stated. And so, I went in there as a result of a very changed environment because of September the 11th. And the danger we were concerned about was that the weapons would be put into the hands of terrorist groups that would come and make the attacks of 9/11 pale in comparison.
AMY GOODMAN: That was George W. Bush. Matthew Hoh, your response?

MATTHEW HOH: It’s amazing, Amy. I mean, the president continues to lie about the Iraq War. In that clip there, he references 9/11. The Iraqis had nothing to do with 9/11. That’s been proven beyond a doubt. He references the weapons of mass destruction that Saddam Hussein was going to give to the terrorists to attack us, which didn’t exist. And it’s just—you know, I’m at a loss for words, because I had not heard that until now, and so I’m at a loss for words what to say about that, how insane it is that that is the man who was the president of the United States, that’s the man who was on Face the Nation, that’s the man who is seen, to some degree, as a kingmaker, in terms of pushing his brother to run for president, as well, and that a large percent of this country, while they will put the yellow ribbon on their cars, while they’ll give a standing ovation to the vet without legs at a baseball game, while they’ll all gladly take Veterans Day off to go shopping, won’t hold a man responsible for his actions that has killed thousands, wounded hundreds of thousands—and one of the things we don’t talk about a lot is the number of traumatic brain injuries in this country from the wars. We have about 250,000 soldiers who have suffered traumatic brain injuries from the war. And so, this dissonance, the absurdity that exists in this country that President Bush is able to say such things, and then for the Face the Nation host, Bob Schieffer, who’s been doing that job for 20-some-odd years, to not kick him off the show for outright lying and for being so disrespectful to those who died over there for that mistake, it’s just—again, I’m at a loss for words.

AMY GOODMAN: Finally, Matthew Hoh, as the veterans’ tributes begin for Veterans Day, what do you think would be the greatest tribute to veterans, as a veteran yourself?

MATTHEW HOH: I think the greatest tribute would be, to tie into what I was just saying, is some form of accountability, some form of holding responsible those who have made mistakes. You know, I only served 10 years in the Marines, but I’ve had friends of mine who have served 20 or 30 years, and they’ve spent half that time in the Middle East, and we’ve all had friends die. We’ve all seen people in Iraq and Afghanistan and other locations suffer, and that carries with us. And I think that’s one of the issues that we face, is that there has been no accountability, there has been no justice. These wars have been failures. They’ve been done for just reasons of malfeasance, of just reasons that seem to be unknown or you don’t want to understand what the actual reasons were. And so, I think the best thing that could happen for veterans is some form of accountability for these wars, people being held responsible, from both parties. You know, the Democrats are just as complicit in these wars as the Republicans are.

AMY GOODMAN: Matthew Hoh, thanks so much for being with us, former State Department official who resigned in protest of the war in Afghanistan, resigned from his post there over U.S. policy in September 2009. Before that, he served in Iraq; from 2004 to ’05, worked with a State Department team; from 2006 to ’07, worked as a Marine Corps company commander in Anbar province; now a senior fellow at the Center for International Policy, speaking to us from his home state of North Carolina in Raleigh. Thanks so much.

MATTHEW HOH: Thank you.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman.

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