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

 

 

 

Veteran Suicide is More From Guilt Than From PTSD

It’s been almost five months since I’ve written anything, and this post is not going to contain much of my writing, but rather sharing with you a note RootsAction sent out to its vast membership containing a clip of me in a talk I gave in London at the end of February:

It should be noted that traumatic brain injury, which in some studies has been found to be present in more than 20% of Afghan and Iraq veterans, and from which I suffer from, also has a very real and significant link to suicide in veterans.

The full video of the talk in London is found below. That talk, titled: “War, Journalism and Whistleblowers — 15 years after Katharine Gun’s Truth Telling on the Verge of the Iraq War”, included Katharine Gun, Thomas Drake, Jesselyn Radack, Silkie Carlo, Norman Solomon and Duncan Campbell, all of whom are really incredible and brave people that I look up to and admire.

I would like to share other parts of that talk later, as we as a panel were questioned by two Iraqi women during the Q&A. Their questions, testimony and witness led to a very emotional and powerful session for many of us.

A couple of days later Tom, Jess and I participated in a panel in Graz, Austria, at the 2018 Elevate Festival. We were joined by Diana Bartelo, Cian Westmoreland and Lisa Ling, as well as by video by Dan Ellsberg.

Below is the note that RootsAction sent out. I hope to begin writing again in the near future. I appreciate all of you following this blog and my work. Peace.

——————————

In this video clip from a recent RootsAction Education Fund event, U.S. veteran and whistleblower Matthew Hoh shatters the popular myth that post-traumatic stress disorder is behind the high suicide rates for U.S. veterans. He notes that PTSD has the lowest connection to suicide of any mental health problem, according to the U.S. Veterans Administration (VA).

Well, then what’s causing so many people so frequently thanked for their “service” to kill themselves?

The answer turns out not to be a secret, but something that most people and most organizations would rather not mention.

Since 1990, Hoh tells us, the VA has known that guilt over participation in killing human beings is the best predictor of suicide. Veterans are killing themselves because they feel guilty for what they’ve done.

Ssshhh! You shouldn’t say that! It’s anti-veterans!

Really? Does it help current veterans or impede the production of more veterans to hush up the problems they face? Haven’t we learned that the first step in addressing a problem is identifying it?

Hoh is himself a veteran who has struggled with a wide array of issues, including guilt, PTSD, brain injury, and substance abuse. He has been certified by North Carolina as a Peer Support Specialist for Mental Health and Substance Use Disorder. He knows of what he speaks. His interest is in helping other veterans. In the video he cites the studies that back up his statements.

Will you help us to continue to support whistleblowers like Matthew Hoh and to produce events like the one in the video? Click here to donate what you can, tax-deductible in the United States.

Matthew Hoh had nearly 12 years of experience with America’s wars overseas with the United States Marine Corps, Department of Defense and State Department. In 2009, Hoh resigned in protest from his post in Afghanistan with the State Department over the American escalation of the war and, in 2010, he was named the Ridenhour Prize Recipient for Truth Telling.

Hoh has been a Senior Fellow with the Center for International Policy since 2010. He is a member of the Board of Directors of the Institute for Public Accuracy, an Advisory Board Member for ExposeFacts, North Carolina Committee to Investigate Torture, Veterans For Peace, and World BEYOND War, and he is an Associate Member of Veteran Intelligence Professionals for Sanity (VIPS).

Click here to see the video and consider making a contribution.

The event from which this video is taken marked 15 years since the March 2, 2003, story provided by whistleblower Katharine Gun revealed that the United States and Great Britain were working together to spy on other nations’ delegations to the United Nations as part of an effort to coerce them into voting for a war on Iraq.

We cannot create such events or provide support for such whistleblowers if you don’t help. Please donate!

Please click here. Your tax-deductible donation will help us continue.

Texas Speaking Tour October 19-23

Hi all,

Myself and three other members of Veterans For Peace, Ellen Davidson, Tarak Kauff and Chris Smiley, will be speaking in Texas in a couple of weeks. We’ll be in Dallas, Austin, San Antonio and Houston if anyone is able to join us. Thanks so much to the incredible Leslie Harris for making this speaking tour happen.

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Veterans For Peace Palestine/Israel Delegation Texas Tour: Walls of Racism and Oppression From Texas to Palestine and Beyond

DALLAS—Thursday, October 19, 6:00 pm reception; 7:00 dinner & program Kasra Persian & Afghan Cuisine, 525 Arapaho Rd., Set 21, Richardson, TX Contact: communicationsdpjc@gmail.com, jharris866@aol.com. Click here to RSVP/get info on Facebook

AUSTIN—Friday, October 20, 6:00 pm veggie meal & schmoozing; 7:00 program Friends Meeting of Austin, 3701 E. Martin Luther King Blvd, Austin, TX Contact: joannaredfield@gmail.com. Click here to RSVP/get info on Facebook

SAN ANTONIO—Saturday, October 21, 7:00 pm program Coates University Center, Fiesta Room, Trinity Univ., Trinity Pl., San Antonio, TX Contact: jnorman2@trinity.edu, jreyes@ivaw.org. Click here to RSVP/get info on Facebook

HOUSTON—Monday, October 23, 6:30 reception; 7:00 program Dominican Sisters of Houston, 6501 Almeda Rd., Houston, TX Contact: cnvhouston1@gmail.com. Click here to RSVP/get info on Facebook

A nine-person Veterans For Peace delegation visited Palestine/Israel earlier this year, where they met with Palestinian popular resistance leaders as well as members of the Knesset. They participated in nonviolent direct action and witnessed the resiliency, solidarity, creativity and courage of the Palestinian resistance to the Israeli occupation and the settlements that steal their land, water and other resources. Photographer Ellen Davidson, former State Dept official and USMC Captain Matthew Hoh, former US Army paratrooper Tarak Kauff, and filmmaker Chris Smiley are touring Texas to tell us what they observed firsthand, using dramatic video clips and photos of this eventful trip, soon to be made into a documentary series. Their experience helped them see how Palestinian struggles relate to those of oppressed communities in Texas and beyond. Click here to see a trailer for the documentary series.

I also wanted to share an interview I did last week, with RT, on veteran suicides in the United States, the relationship of suicides to being in combat, and the further connection to moral injury/guilt. It’d be nice to get the chance to talk on an American network about this topic…

Additionally, here are three podcasts of radio programs I’ve done over the last month with three people I greatly admire.

The first is with award winning journalist Dave Maresh, who I have been very fortunate to know, along with his wife Amy, for seven or eight years now. Dave’s experiences are pretty unparalleled. He’s now in some form of non-retirement in New Mexico where he hosts a daily hourly radio program on KSFR, Here and There with Dave Marash. It’s one of the few podcasts I subscribe to and so it was pretty incredible to now have been one of his guests.

http://hereandtherewithdavemarash.libsyn.com/here-and-there-september-5-2017-matthew-hoh

I was on with Blase Bonpane on his World Focus radio program earlier this month as well. I was also on with Blase again this past week, but I’ll do a separate blog post for that interview. Blase’s life story is heroic and amazing, he was a priest who defied the Catholic Church by practicing and living the liberation theology taught by Jesus Christ. My first interview, with a transcript, is with him here:

http://officeoftheamericas.org/world-focus-september-3-2017-matthew-hoh/

Finally, I was on with Army veteran Nate Bethea. I’ve known Nate for several years now. He’s been honest and forthright about his military service and his time during and after the wars, and his outspokenness on societal issues in the United States has earned him my deepest respect and gratitude, even though it has delivered him the scorn and vitriol of many from the Right Wing, including men with whom he served in combat. Nate now co-runs a podcast called What a Hell of a Way to Die. It’s a program by military veterans that takes on larger and broader issues from a socialist/leftist perspective. It’s fantastic.

Here’s my interview with Nate:

Breaking this Cycle of Imperial Violence

I was grateful for the opportunity to author a guest post over at the Strategies and Tactics for the Anti-War Blog at the Veterans Reparations Project. The Veterans Reparations Project is a joint project between Veterans For Peace and the Islah Reparations Project and is something very meaningful to me, something with which I hope to become more and more involved. Please visit the Veterans Reparations Project’s webpage to see how you can be involved and how you can help with the grassroots reparations process.

Breaking this Cycle of Imperial Violence:

I’m in my local Starbucks—yeah I know corporate evils and all that, but at 5pm on a Sunday in Wake Forest, NC you take what you can get, and I can walk here. So you take all the good you can get with the bad. Here in Wake Forest we’re not far from Ft. Bragg, home to the US Army’s paratroopers and special operations forces. Thousands of them have been ordered to deploy to Kuwait, where they will be sent into Iraq and Syria to make their own contributions to a decades long folly that has brought death, mental and physical mutilation, and societal destruction to the peoples of Iraq and Syria, profits to American defense corporations, corporate board memberships and university professorships to retired generals, and thousands upon thousands of new recruits to foreign terrorist groups; if there is something else these wars have brought, please leave a reply below, because I certainly can’t think of anything.

There is a large, neon green sign, hand written, like you would see announcing the homecoming dance in the high school hallway or your neighbor’s kid’s lemonade stand on your intersection’s stop sign: “Our Troops Are Deploying, Help Us Thank Them With Coffee.”  A large cardboard box is about a 1/3 of the way full of bags of coffee and boxes of k-cups, hopefully no decaf for those young paratroopers.

I’m not lying to you when I tell you I’m wearing a t-shirt with a Howard Zinn quote on it that reads “There is no flag large enough to cover the shame of killing innocent people” as I stand next to that box of coffee bound for the Persian Gulf. I linger for a bit hoping that maybe someone will read the shirt and the sign, that maybe something will register, someone will say something to me, something to medicate me, numb me, tell me that this cycle isn’t starting all over again for several thousand young men and women, barely more than an hour’s drive from me, about to travel halfway around the world to do irreparable harm to people they’ve never met and irredeemable harm to their own souls, hearts, and minds.

I’ve been involved in this war effort since before it even had a name, taking part in training exercises with Indonesian, Malaysian, Philippine, and Thai counterparts that actively engaged in fighting Muslim insurgents in their own countries prior to 9/11. Whether as a willing participant of the wars or as a vocal war opponent, as an occupier or now as someone who hopes to do more to support those who are occupied, I’ve seen very little explained as to how to right the wrongs done in war and even less done to repair, to rebuild, to resuscitate, or to resurrect. Surely, I have never walked into anyplace in America since we began killing more than 1 million people overseas in response to the attacks of 9/11 and seen a box asking for coffee for the people of Afghanistan, Iraq, Libya, Pakistan, Somalia, Syria, or Yemen.

Now, of course, reparations may be the proverbial bridge too far at this point, as all the nations for which we have transgressed against are still receiving the blows of our aggressions, and those of others, from both internal and foreign belligerents and villains. However, I do recognize that waiting for our government to act in the future to administer some form of restorative justice to the people of the Greater Middle East may be as great a sin as the original acts of violence themselves, because we know that our government, the United States, will never do such a thing, and if our government ever does act the list for such reparations will be a long and worthy one.

So, I am extremely grateful for what the the Veterans Reparations Project is doing. Through grassroots reparations projects we can make a difference, we can begin to help rebuild and repair, and we can begin to fix some of what we destroyed.

Nothing we do will absolve us of what we have done in these wars, I am clear on that; the spot is on and always will be on our hands, to use one of my favorite allusions from high school English class. So be it and so it goes. However, we don’t have to go along with the killing any longer and we don’t have to go along with sitting idly by either and not helping to rebuild and repair. We can and we must do what we can to help those who we hurt. I do not believe we have any other choice.

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

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

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