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

Behind the Mask: Facing Torture After War

If you watched the panel I participated in with Phil Donahue you will have seen a brave and thoughtful mother join our panel mid way through. This is her son’s story. It has become quite chic and trendy for non-veterans to write eloquent and idolizing, but dangerously simple and incomplete, brotherhood of war tropes. Here’s a more accurate portrayal of what the brotherhood of war actually means when young men come home with the moral injuries inflicted by war:

Panel on Moral Injury at 2015 Left Forum

This past weekend I was on a very special panel at the 2015 Left Forum. Entitled Betrayed by Our Government, I was joined on the panel by my friend, mentor and hero, Ray McGovern,  Cathy Smith, the mother of Tomas Young, and Kevin Lucey, the father of a young Marine named Jeff who took his life after returning home from the Iraq War. Phil Donahue moderated the panel.

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Click on the image of Phil and then scroll down the Live Stream page. The video is near the bottom, entitled Left Forum Military Families Speak Out

 

If you have not watched Phil Donahue’s film about Tomas Young, who passed away last November, please do so here:

Jesse Jackson’s Keep Hope Alive Radio

I had the pleasure of being a panelist on Reverend Jesse Jackson’s radio show during Memorial Day Weekend. The discussion lasted for two hours, so the audio is posted below in two separate files. It was great to be on the show with my friend Rory Fanning, as well to have such a platform to discuss veterans issues including moral injury, PTSD and suicide.

Part One:

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Honoring Our Veterans Part One

 

 

 

 

 

http://www.keephopealiveradio.com/media/podcast-audio-showaudio/honoring-our-veterans-26076161/

Part Two:

keep_hope_alive_logo_8-13_0_1375463833
Honoring Our Veterans Part II

 

 

 

 

http://www.keephopealiveradio.com/media/podcast-audio-showaudio/honoring-our-veterans-26076162/