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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Ida and the Cycles of Violence and Forgiveness

Have you seen the film Ida?

It is a Polish film from last year that is a powerful, brilliant piece of filmmaking. I use those words powerful and brilliant, because, 48 hours later, I am still contemplating and dissecting the movie; I am still in meditation over its meaning and in awe at how the film has stimulated my own thoughts and tested my beliefs.

The story is a road trip in the early 1960s in Poland between a young woman, brought up in a convent and on the verge of taking her vows to become a nun, and her aunt, a once leading figure in Poland’s post war Communist Party and now a judge. The young woman has no worldly or sensual experiences and is about to begin her adult life by joining the once almighty, but now politically bankrupt, morally spent, and intellectually disregarded Church. The older woman with her life ending professionally, and judging by her alcohol consumption, physically and emotionally as well, belongs to the new order, the new way of the world, the post war communist party promising brotherhood, meaning and purpose in the years after the cataclysms and holocausts of WWI and WWII. It is a political and philosophical movie, but it is also a deeply personal movie, as two individual life stories, differentiated by commitments to competing ideologies and life’s purpose, commitments that dominate and control their lives because of circumstance and history, more than by individual choice, are forced to look past the veneer and trappings of their costumes and titles, to examine who they are and why they are.

As I watched Ida the same challenges arose in me, and as a testament to the great storytelling of the film, are still resident with me. Most concerning, about 2/3rds through the film, I said to my girlfriend, “if I were them, I’d take that shovel and split his head”. It was an honest and true feeling. I was not acting or parading as some phony tough guy or a has-been Marine, but my visceral, gut reaction at that time, during that scene, was that I would commit violence and I would revel in it to assuage my anger and celebrate revenge. But, as the film went on, and as I reflected on those emotions, spurned by the actions of the characters, I realized how wrong, how foolish and how weak such a sentiment and desire was and how embarrassing my utterance.

In the scheme of the movie, killing the man would have been possible and it would have fulfilled some form of duty or obligation to my family, my community and my people, as well as fulfilling a duty to my own image of myself and my need for vengeance; vengeance based on personal, cultural and institutional values. However, taking myself away from that scene, watching the characters and applying my own life’s experience participating in and around the violence of war, I grudgingly recognize and must accept the futility of such violence. I say grudgingly, because violence and revenge is such a part of our identity and our culture that I am loathe to give it up, I am afraid to move on, and to recognize the myth of redemptive violence, as exactly that, a myth constructed primarily for the purposes of national, ethnic, sectarian or religious hegemony, dominance and absolution.

But if I had killed that man, if I had split his head with that shovel, seen death overcome him and gain the satisfaction of such grisly passage of state, what would come of it, what events would I now own? His wife and children, as innocent of crimes as those in whose name I murdered, would be widowed and orphaned on a struggling farm. His sons, would they not seek revenge and in time come for me and my family? Would not the children of my family, the next generation, be butchered in turn? My actions, murder and the infliction of suffering on the innocent, would begin a cycle of violence, an uncontrollable, bloody cycle without end, the likes of which we see in our wars overseas and in the wars in our own cities. And for me? My own experiences in war, my own and personal struggles with moral injury, is that not instructive to me? What would become of my mind and my soul after killing the man?

To move on and say nothing to the man is an option and a better one than violence. However, it is an incomplete option, leaving a chapter of life open ended and without closure, in essence running from a problem and not attempting a resolution, but it does not require the strength needed for a third, and rightful, option. Imagine saying to the man: “I forgive you” and giving him your hand and your blessing. How hard that would be! It seems nearly impossible to me and such a thought, such an option, which leads to an involuntary reflex and rejection within me, would stop the cycle of violence and lead to peace, both within me and my community.

The choice of mercy, of forgiveness, is anathema to my sense of manhood and my obligation for revenge and justice; but what would come of such forgiveness, besides a rejection of cultural and institutionalized violence and loss of personal pride, if I had the courage to enact it? A man would be given mercy and his family spared, and perhaps nothing more than that, but, with deep consideration, is anything else truly necessary? Breaking the cycle of violence is enough. Quite possibly, and maybe very likely, the man would be changed and his family enlightened, hell, maybe his daughter would grow to be the second coming of Mother Theresa, but such achievements or results would not be necessary to validate or vindicate the forgiveness proffered to the man. Stopping the cycle of violence is enough, the peace that would come to my mind and to my community would be enough.

I like to say that one of my favorite quotes is from Saint Francis de SalesNothing is so strong as gentleness, nothing so gentle as real strength. Yet, how difficult to turn such an outlook into an attribute, even when through personal experience you have seen the glaring failure and horrific counter-production of violence and have been affected so forcibly by grace, kindness and forgiveness as I have.

So please give Ida a watch. It’s a wonderful, well done, contemplative film and I trust it will challenge something in you.

*For another excellent film that takes on the myth of redemptive violence and exposes it for the tragedy it really is, please watch Blue Ruin. Both films are available on Netflix.

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.

 

Two Poems: One of Death, One of Life

I wrote an essay a couple of years ago expressing my views and feelings towards Veterans Day. I still hold those sentiments in my mind and soul as true.

At the end of my essay I emplaced Siegfried Sassoon’s World War One poem Suicide in the Trenches; which I vowed to read each Veterans Day, or Remembrance Day as Sassoon’s contemporaries, festooned with poppies on their lapels and overwhelmed by much dead in the ground and in their memories, would establish to mark the war to end all wars….

This year I read Suicide in the Trenches at our small Veterans for Peace Swords to Plowshares Memorial bell ringing service at the North Carolina State Capitol on Veterans Day. Here are Sassoon’s words, a more eloquent, concise and honest description of war I do not know:

I knew a simple soldier boy
Who grinned at life in empty joy,
Slept soundly through the lonesome dark,
And whistled early with the lark.
In winter trenches, cowed and glum,
With crumps and lice and lack of rum,
He put a bullet through his brain.
No one spoke of him again.

You smug-faced crowds with kindling eye
Who cheer when soldier lads march by,
Sneak home and pray you’ll never know
The hell where youth and laughter go.

War and its primary companion, suffering, may take possession of your life, but by no means does war need to be in permanent claim of your mind and soul, by no means does war need to be the victor. Through love, through mercy and though kindness your soul and your mind may find forgiveness in yourself, and this, which is a process and a journey, is often enabled and emboldened by the grace of a stranger.

Such a stranger sent me a poem. The life war takes away, love, and its acts, can restore.

The Summer Day – Mary Oliver

Who made the world?
Who made the swan, and the black bear?
Who made the grasshopper?
This grasshopper, I mean –
the one who has flung herself out of the grass,
the one who is eating sugar out of my hand,
who is moving her jaws back and forth instead of up and down –

Now she lifts her pale forearms and thoroughly washes her face.

Now she snaps her wings open and floats away.

I don’t know exactly what a prayer is.
I do know how to pay attention, how to fall down
into the grass, how to kneel down in the grass,
how to be idle and blessed, how to stroll through the fields,

which is what I have been doing all day.
Tell me, what else should I have done?
Doesn’t everything die at last, and too soon?
Tell me, what is it you plan to do
with your one wild and precious life?

So now I have two poems to read each Veterans Day. One to ensure those who have suffered never leave my purpose and my life, and the second, to remind me that this is my purpose and that this is my life.

Thank you Megan.