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.
Continue reading

Songs From A Friend

From songwriter and new friend Mary Ann Daugherty, a few songs of suffering, healing and peace. Thank you Mary Ann. If anyone would like to contact Mary Ann about performing or recording these songs, please let me know.

Back in South Bend
Lyric by: Mary Ann Daugherty

Verse
In the land where lightning strikes up from the ground
A private named Joey is the latest man down
An unlucky step, a mine he didn’t see
Cost him both legs below the knee

His brothers in arms rally after the blast
They call in for help and they tie the wounds fast
They’re shouting his name but he needs more time
To return from the hiding place deep in his mind
Continue reading

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.

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.

Individual Outreach

A veteran and counselor in upstate NY sent me this video he made as part of his outreach to help veterans and service members as they struggle with their own personal issues and sufferings inside their heads and souls from war.

It is this type of outreach, this type of effort, that serves to assist veterans in finding help, alleviating their suffering and regaining their lives.

Thank you Roland.