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

An Excellent Article On Moral Injury

Quite possibly the best article on moral injury I have read. Thanks to The Atlantic and to Maggie Puniewska.

Healing a Wounded Sense of Morality
Many veterans are suffering from a condition similar to, but distinct from, PTSD: moral injury, in which the ethical transgressions of war can leave service members traumatized.

MAGGIE PUNIEWSKA JUL 3, 2015

Amy Amidon has listened to war stories on a daily basis for almost a decade.

As a clinical psychologist at the Naval Medical Center in San Diego, she works with a multi-week residential program called OASIS, or Overcoming Adversity and Stress Injury Support, for soldiers who have recently returned from deployments. Grief and fear dominate the majority of the conversations in OASIS: Amidon regularly hears participants talk about improvised explosive devices claiming the lives of close friends; about flashbacks of airstrikes pounding cities to rubble; about days spent in 120-degree desert heat, playing hide and seek with a Taliban enemy. Many veterans in the program are there seeking treatment for post-traumatic stress disorder.

But many of Amidon’s patients talk about another kind of trauma, a psychic bruise that, unlike PTSD, isn’t rooted in fear. Some of these soldiers describe experiences in which they, or someone close to them, violated their moral code: hurting a civilian who turned out to be unarmed, shooting at a child wearing explosives, or losing trust in a commander who became more concerned with collecting decorative pins than protecting the safety of his troops. Others, she says, are haunted by their own inaction, traumatized by something they witnessed and failed to prevent. In 2012, when the first wave of veterans was returning from the Middle East, these types of experiences were so prevalent at OASIS that “the patients asked for a separate group where they could talk about the heavier stuff, the guilt stuff,” Amidon says. In January 2013, the center created individual and group therapy opportunities specifically for soldiers to talk about the wartime situations that they felt went against their sense of right and wrong. (Rules of engagement are often an ineffective guide through these gray areas: A 2008 survey of soldiers deployed at the beginning of the conflict in Iraq found that nearly 30 percent of the soldiers in each group encountered ethical situations in which they were unsure how to respond.)

Experts have begun to refer to this specific type of psychological trauma as moral injury. “These morally ambiguous situations continue to bother you, weeks, months, or years after they happened,” says Shira Maguen, the mental-health director of the OEF/OIF Integrated Care Clinic at the San Francisco Veterans Affairs Medical Center and one of the first researchers to study the concept. Examples of situations that might precipitate moral injury are betrayals by those in leadership roles, within-rank violence, inability to prevent death or suffering, and hurting civilians. Sometimes it co-exists with PTSD, but moral injury is its own separate trauma with symptoms that can include feelings of shame, guilt, betrayal, regret, anxiety, anger, self-loathing, and self-harm. Last year, a study published in Traumatology found that military personnel who felt conflicted about the “rightness” or “wrongness” of a combat situation were at an increased risk for suicidal thoughts and behavior afterwards, compared with their peers who didn’t have that same sense of ambiguity. The main difference between the two combat-induced traumas is that moral injury is not about the loss of safety, but the loss of trust—in oneself, in others, in the military, and sometimes in the nation as a whole.
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The Blood Sacrifice of Sergeant Bergdahl

From today’s Huffington Post:

Last week charges of Desertion and Misbehavior Before the Enemy were recommended against Sergeant Bowe Bergdahl. Tragically, Sergeant Bergdahl was once again crucified, without evidence or trial, throughout mainstream, alternative and social media. That same day Sergeant Bergdahl was offered as a sacrifice to primarily Republican politicians, bloggers, pundits, chicken hawks and jingoists, while Democrats mostly kept silent as Sergeant Bergdahl was paraded electronically and digitally in the latest Triumph of the Global War on Terror, President Ashraf Ghani was applauded, in person, by the American Congress. Such coincidences, whether they are arranged or accidental, often appear in literary or cinematic tales, but they do, occasionally, manifest themselves in real life, often appearing to juxtapose the virtues and vices of a society for the sake and advancement of political narratives.

The problem with this specific coincidence for those on the Right, indulging in the fantasy of American military success abroad, as well as for those on the Left, desperate to prove that Democrats can be as tough as Republicans, is that reality may intrude. To the chagrin and consternation of many in DC, Sergeant Bergdahl may prove to be the selfless hero, while President Ghani may play the thief, and Sergeant Bergdahl’s departure from his unit in Afghanistan may come to be understood as just and his time as a prisoner of war principled, while President Obama’s continued propping up and bankrolling of the government in Kabul, at the expense of American servicemembers and taxpayers, comes to be fully acknowledged as immoral and profligate.

Buried in much of the media coverage this past week on the charges presented against Sergeant Bergdahl, with the exception of CNN, are details of the Army’s investigation into Sergeant Bergdahl’s disappearance, capture and captivity. As revealed by Sergeant Bergdahl’s legal team, twenty-two Army investigators have constructed a report that details aspects of Sergeant Bergdahl’s departure from his unit, his capture and his five years as a prisoner of war that disprove many of the malicious rumors and depictions of him and his conduct.
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I Stand With Charlie Hebdo, But I Also Stand With The Victims Of Our Bombs

From yesterday’s Huffington Post:

IMG_5620
Two young boys, whose names I do not know, killed by American bombs in Harem, Syria, in November, 2014. It is rare to see such images in American media.

The killings at the office of Charlie Hebdo in Paris are abhorrent. But let us not forget the daily abhorrence of our wars in the Muslim World, wars that have seen over a million Afghans, Iraqis, Libyans, Pakistanis, Somalis, Syrians and Yemenis killed and millions more wounded and maimed physically and psychologically, while millions of men, women and children endure another cold winter, homeless and hungry.

So as we question and fume, shocked and aggrieved at the hateful killing of journalists and satirists, police officers and a janitor, we should not be so insensible as to not acknowledge the horrid cost we have exacted on the populations of the Greater Middle East in pursuit of democracy, freedom and liberty; campaigns undertaken in the name of our values that are executed in the very manner as those murderers in Paris on Wednesday proselytized and witnessed their faith as Muslims.

We must recognize the extremists and war-mongerers in our societies, who like the members of al-Qaeda and the Islamic State, want war and require war to justify their own cosmic, religious and Manichean world views, or profit from the bounty of being an empire that has over 700 military bases around the world and sells nearly three-quarters of the world’s arms.

For to believe that the attack in Paris was a tragedy singularly about a cartoon or as an event solely to be defined as an assault on freedom of expression, is to be daft and incongruent with the history and reality of American and Western policy in the Middle East. For decades, American and Western policy, through action and subsequent backlash, has provided the world and, most sordidly, Muslims with such Frankensteins as the Saudi Royal Family, the Shah of Iran, Saddam Hussein, Hosni Mubarak, al Qaeda, the Taliban, and, now, the Islamic State. What played out and ended with the sickening execution of a wounded policeman on a Paris sidewalk is a direct outgrowth of American and Western policies to try and manipulate sects, tribes, ethnicities and religions in the Middle East to preserve or remove regimes in an absurd and defiled real life version of the board game Risk. It is a game that makes sense to very few outside of Washington, DC and London, but serves to validate and enrich a $1 trillion dollar a year US national security and intelligence industry, while making composite and real the propaganda and recruitment fantasies of al Qaeda, the Islamic State and other extremist groups that are parasites of war.

So I stand with Charlie, but I also stand with all those millions of voiceless victims of our wars and our policies in the Middle East. To do other, to condemn the killings of innocents in our lands, without offering the same condemnation of our government’s killings in their lands, is not just a cruel blindness to the human suffering inflicted by our own machines of war and their munitions; but it is unwise, because what we saw this week in Paris is just one other moment in the ever-continuing, never-ending cycle of violence between the Western and Muslim worlds.

Those in the West who proclaim the defense of democracy, freedom and liberty as justification for our bombings in the Middle East are of the same ilk, cloth and substance as those whose corrupted interpretations of Islam leads to slaughter on Western streets and genocide in Muslim lands. Stand with Charlie Hebdo, stand with our Muslim brothers, sisters and their children, and stand against the purveyors of hate and war in all societies.

Oscar Wilde’s De Profundis

At every single moment of one’s life one is what one is going to be no less than what one has been.

I feel as if I want to say I wish I had read Wilde’s letter from prison, De Profundis, sooner, but, as one of the themes of the letter, the continuance of the travels and development of your life suggests, I may not have been ready for Wilde’s themes of suffering, art and Christ. Not ready because I hadn’t suffered in the years before the wars, not ready because I was too blinded by drunkenness to understand myself or to care to understand myself, and, more recently, not ready, because I don’t think I was open enough to appreciate Wilde’s transition in life and his growth through suffering, as his own transition and growth without trying to transplant my experiences onto his.

Trying to learn from others, without trying to become others, has been a difficult process for me these last few years in recovery. I am not sure how many other men and women like me are beguiled by this trap, this trying to put a square peg in a round hole approach to “fixing” your life, but it has been a steady and challenging presence in my recovery. When someone else’s solution doesn’t fit, doesn’t take hold, transform and reveal a new life that leaves behind all the suffering, sorrow, guilt and anger of the past, discouragement and exhaustion give way to depression and despair, and one of those inevitable setbacks in my lifetime of recovery overtakes me.

In response Wilde offers: This New Life…is of course no new life at all, but simply the continuance, by means of development, and evolution, of my former life. So throw away those pegs and walk past the holes, find your way ahead, embrace what life has given you, what you have found through your decisions and through Nature’s circumstances, and understand your life as your life through the reflections of others, through art and through the Divine.

Keep moving forward, don’t give up and have the courage and compassion to love yourself-even you men whose lives have been testaments and self-edicts to leadership, self-sacrifice and duty. There is much strength, wisdom, and, ultimately, purpose in understanding and accepting your suffering. With such compassion towards yourself comes not mawkish grousing, but rather galvanized fortitude, sustainable confidence and insightful concern, not just for yourself, but for others and for our world. Denying yourself compassion and rejecting the concept of understanding your suffering to have a purpose in your life, although macho and tough, will put you in a place where ultimately the alcohol and drugs no longer bring the numbness that the barrel of your pistol can only achieve. It takes courage to do the above, but what other choice did I have, what other choice do you have?

Others have suffered, it is what unites us as men and women, it is our greatest commonality. Do not hide from it.

He [Christ] understood the leprosy of the leper, the darkness of the blind, the fierce misery of those who live for pleasure, the strange poverty of the rich. Some one wrote to me in trouble, ‘When you are not on your pedestal you are not interesting.’ How remote was the writer from what Matthew Arnold calls ‘the Secret of Jesus.’ Either would have taught him that whatever happens to another happens to oneself, and if you want an inscription to read at dawn and at night-time, and for pleasure or for pain, write up on the walls of your house in letters for the sun to gild and the moon to silver, ‘Whatever happens to oneself happens to another.’ Oscar Wilde.

Peace and Merry Christmas.

Peter Kassig’s Death: Revenge Is Not The Answer (from a college friend of Peter’s)

Angela Miller, my colleague at the Center for International Policy and Win Without War, was a fellow college student with Peter Kassig, the most recent Westerner to be publicly murdered by the Islamic State. In the below essay Angela argues against revenge and blood lust and movingly asks for compassion, intelligence, patience and wisdom in dealing with the Islamic State and the wars in the Middle East.

We have all seen those whose lives have been exposed and exploited by violence, very often the killing of a child, make public appeals for peace and reconciliation. Michael Brown’s parents in Missouri are the most recent example. And, of course, it seems that those who have not personally shared in the suffering wrought by murder and war, are those most triumphant, righteous and, tellingly, short sighted in their calls for revenge.

I am sorry for your loss Angela.

Peter Kassig’s Death: Revenge Is Not The Answer

“Sometimes rebels want to know if I will join the fight. I always tell them no … I can either be in a position to deliver tens of thousands of dollars of antibiotics for women and children, or I can be another young man with a gun.”

-Abdul-Rahman (Peter) Kassig

On Sunday, Nov. 16, the U.S. confirmed that Islamic State fighters had beheaded Abdul-Rahman (or Peter, as I knew him) Kassig, my classmate from Butler University.

The next day, I returned to work at the Win Without War coalition. One of my peers had been murdered, yet my job was to organize opposition to U.S. military intervention in Iraq and Syria. On a deeply personal level, I had to reconcile my career choice with the fact the Islamic State had just murdered my classmate.

When I found out about Peter’s death, my gut reaction was to seek immediate revenge, to see his murderers bombed. The Islamic State could not get away with kidnapping, torturing and beheading innocent American citizens and humanitarian aid workers, I thought.

However, by reflecting on Peter’s life and by speaking with others who knew him, I came to believe Peter would not have wanted us to continue bombing Syria in his name. During conversations with friends, professors and others from the Indianapolis community, no one mentioned the idea of vengeance. Instead, everyone spoke admiringly of Peter’s humanitarian work and brainstormed ideas of how we could carry on his legacy by helping the Syrian people. Many of us realized that what we wanted, more than retribution, was to make sure that Peter did not die in vain.

Peter first went to the Middle East as a U.S. Army Ranger. In 2012, he returned as a man of peace, founding a nonprofit called Special Emergency Response and Assistance, and using his emergency medical technician experience to aid Syria’s wounded. In a 2012 letter, he explained his resolve to work for peace: “War never ends, it just moves around … Loss and destruction in this land brings about only survival; the determination to press on and rebuild … because there is nothing else. To rubble and dust and back again.”

It takes strength to listen to our better angels instead of giving in to revenge. As a nation, we will benefit from resisting our initial instincts and asking the hard questions about our latest war in Iraq and Syria: What do our desire for vengeance and our revulsion at the barbarism of the Islamic State mean in real policy terms? Will airstrikes and ground troops actually degrade the Islamic State, or will they be counterproductive?

The majority of Americans believe this new enemy must be degraded; yet nearly 70 percent have little confidence that U.S. airstrikes will succeed in accomplishing that goal. After 13 years of endless war in Afghanistan and Iraq, Americans are right to believe that we cannot solve every problem with military might.

National security experts have presented viable and effective alternatives to endless war, and President Barack Obama should heed their advice. Instead of giving in to our first gut reaction, the American people should join these experts and demand, at a minimum, a more fundamental debate about the effective alternatives to military force that might allow us to address the threat from the Islamic State without perpetuating the cycle of violence.

The simple truth is that war isn’t working. After months of U.S.-led bombing in Iraq and Syria, the Islamic State is reportedly stronger than ever, controlling roughly the same territory they did when the first bombs fell. Instead of being degraded, the group has also seen a massive increase in recruitment and continues its horrific campaign of violence and terror. And, tragically, American bombs have killed innocent civilians and may be making political solutions to the broader conflict harder to achieve.

One way to honor Peter’s memory is to write your representatives in Congress and request they advocate for effective alternatives to endless war. As Iraq war veteran and Center for International Policy fellow Matthew Hoh explained, “The beheadings are bait. The Islamic State is a parasite of war. Its narrative needs war for their personal, organizational and ideological success.”

I understand the temptation to demand revenge, but we need to take a step back and reflect upon where retaliation through bombing ultimately leads.

Peter Kassig saw the futility of war and gave his life in the struggle to bring peace to the people of Syria. As Peter’s parents wrote in their statement on Nov. 16, “We prefer our son is written about and remembered for his important work, not in the manner the hostage takers would use to manipulate Americans and further their cause.”

ABOUT THE WRITER

Angela Miller is the digital director for Win Without War, a coalition of national organizations that aims to promote a more progressive national security strategy. Angela is a 2012 graduate of Butler University, where she was a classmate of Peter Kassig. Readers may write her at info@winwithoutwar.org.