I got a lot of nice feedback on the podcast I posted last month, so here’s another one.
This is a “paper” I submitted for a class final. Ignore the first few sentences however and it functions like a 50 minute podcast.
I hope this is of help to people who have loved ones struggling with moral injury, shame, guilt or perpetration induced traumatic stress, or themselves are suffering from such.
Please reach out to me anytime if I can be of any help.
This past weekend I spoke as part of the Poor People’s Campaign event: The Necessity of Moral Resistance in the Face of Militarism. Reverend William Barber was, of course, the main speaker, and if you are uncertain as to how war and militarism play a role in the demands of the Poor People’s Campaign or in the way war and militarism have always played an oppressive and devastating role in our society, then please listen to Reverend Barber’s sermon as he clearly and definitively explains those two things. My talk, on the effect of war on veterans, is here below, while Reverend Barber’s sermon and the comments from Phyllis Bennis are in the Youtube clip below. Wage Peace.
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.
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 population has 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 aRand 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 service–members 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.
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.
Bowe Bergdahl: Traitor to American Exceptionalism and White Supremacy
“There is no forgiveness in this loudly and righteously proclaimed Christian nation, only the scapegoating of a young man and his family for the failures of immoral and unwinnable wars.”
Sergeant Bowe Bergdahl’s guilty plea begins the end of this phase of an embarrassing, sad and morally absurd saga of American history. Sergeant Bergdahl, who was dismissed from the Coast Guard because of mental illness, recruited into the Army in spite of such issues, and then sent to the frontlines of Afghanistan where he walked away from his base and was captured, kept as a prisoner, and tortured by the Taliban for nearly five years, has been offered almost no compassion, sympathy or forgiveness by large swaths of the American public, political classes, veterans and the media.
The shameful blood-crazed calls for vengeance against Sergeant Bergdahl, screamed across Fox News, talk radio and Twitter, by millions of Right Wing Americans have begun again today with Sergeant Bergdahl’s guilty plea. Despite an army investigation finding no Americans were killed by Sergeant Bergdahl’s departure of his unit; despite the Pentagon admitting it was known that Sergeant Bergdahl was in Pakistan within a few days of his capture, thus negating the validity of the Right Wing talking points of continuous search missions for Sergeant Bergdahl that jeopardized American lives; despite the general who led the investigation of Sergeant Bergdahl’s disappearance stating Sergeant Bergdahl should not be punished and the colonel who led the Army’s version of a grand jury trial recommending the same; despite the United States military’s top prisoner of war expert testifying that Sergeant Bergdahl endured more torture at the hands of the Taliban than any American prisoner of war has endured since the Vietnam War, undoubtedly due to his multiple escape attempts and unwillingness to cooperate with his kidnappers; and despite repeated calls made by President Trump for Sergeant Bergdahl to be executed, as well as calls for retaliation against the military if Sergeant Bergdahl is not sent to jail by Senator John McCain, clear and blatant forms of wrongful and illegal command influence prohibited by military law against a defendant, Sergeant Bergdahl finds himself today having entered a guilty plea and putting himself at the mercy of a US Army judge.
In time, Sergeant Bergdahl may become just a footnote to America’s wars in the Muslim world, wars that have killed well over a million people since 2001, but his individual story relays the fundamental truths of these American wars against Sunnis and Shias, and Arabs, Africans and Pashtuns, (nearly all the people we have killed, maimed and made homeless have been Muslim and dark skinned) that there is no logic to our violence, only the unending and insatiable requirement for more war and more destruction, and there is no forgiveness in this loudly and righteously proclaimed Christian nation, only the scapegoating of a young man and his family for the failures of immoral and unwinnable wars on the murderous altar of the twin godheads of American Exceptionalism and White Supremacy. Sergeant Berghdal’s story does not just inform us of the madness of our wars overseas, but highlights our wars here at home; for our wars abroad come from the same root causes as our wars at home.
It was Sergeant Bergdahl’s parents standing outside the White House with President Obama that began the rage against him and his family. This was the treason that so angered and upset the white conservative audiences of Megyn Kelly and Rush Limbaugh. Sergeant Bergdahl’s white parents standing at the White House with that black president and thanking him for freeing their son began the scorn, the vitriol and the outrage against Sergeant Bergdahl, his mother and his father. The audacity of Jani and Bob Bergdahl, released themselves from the captivity of the unimaginable nightmare of the imprisonment and torture of their son for five years by the Taliban, to stand with Barack Hussein Obama and to give him thanks was a betrayal to the usurped, rightful and white structures that underlie so many white Americans understanding of United States history and society.
The grand mythology of American militarism, a key pillar of both American Exceptionalism and White Supremacy, does not allow for figures such as Sergeant Bergdahl. The greatest military in the history of the world is a required statement of faith for all American politicians and public persons, even though the American military has not achieved victory in war in over seventy years, so an explanation of collusion and cooperation with anti-American and anti-white forces is necessary to provide the causation of such an undermining. Of course, once Bob and Jani Bergdahl stood with President Obama, the racially fueled reactionary political anger appeared in Facebook posts and twitter rants and the lies needed to sustain that anger and turn it into a useful political tool arrived: Sergeant Bergdahl attempted to join the Taliban, Sergeant Bergdahl gave information to the enemy, Sergeant Bergdahl got Americans killed, Sergeant Bergdahl had anti-American beliefs, Sergeant Bergdahl’s father is a Muslim…all claims that were untrue and disproved over time, but such a straightening of facts is almost always inconsequential to those whose identity is an abominable mix of race, right wing politics and nationalism. People of such a type as those who believe Jesus is ok with them carrying handguns into church, demand that Santa Claus can only be white, and that the Confederate flag is a symbol of a proud heritage, have little time or consideration for the particulars of anything that triggers the base tribalism that dominates and informs their lives.
The fundamental aspects of Sergeant Bergdahl’s disappearance were well known and documented years prior to that White House announcement of his release. Veterans organizations called for his rescue and return at rallies and Republican senators enacted legislation to help release him . “Bring Him Home” and “No Man Left Behind” were echoed repeatedly by Republican politicians and pundits, and even Ronald Reagan’s most famed acolyte and Fox News hero, Oliver North, wore a Bowe Bergdahl POW bracelet. However, to be white and to stand tearfully and gratefully alongside that black president is unconscionable and unforgivable to many “true Americans” and so the parents’ sins became the son’s and Sergeant Bergdahl’s treason was a dog whistle to those who believe anti-whiteness and anti-Americanism are inseparable.
For the man who used race so overtly and effectively to become President of the United States, calling during his campaign for a traitor like Sergeant Bergdahl to face the firing squad, or be thrown out of a plane without a parachute, was a rudimentary requirement in order to Make America Great Again. Even General James Mattis, who hung outside his office a horseshoe that had belonged to Sergeant Bergdahl and had been given to the general by the sergeant’s father, understands the political importance of Bergdahl’s treason. General Mattis who previously had supported the soldier and given great comfort to the family, now, as Secretary of Defense, is silent. I believe Secretary Mattis to have higher ambitions than simply running the Pentagon and keeping that white base of support in his favor is not anything such a savvy and cunning careerist, such as James Mattis, would imperil.
We will soon know what, if any punishment Sergeant Bergdahl is to receive. Hopefully, he and his family will be spared further pain and they can begin rebuilding lives that were shattered by the unending war in Afghanistan and then shattered again by the race-fueled partisan politics of the unending war against people of color in the United States. For Bowe Bergdahl, a young man who never should have been inducted into the Army to begin with, his suffering is testament to the viciousness, callousness and hate that dominates American actions both at home and abroad. We deserve no forgiveness for what has been done, and may still be done, to him and his family.
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”]
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 →
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 →
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:
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.
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:
Matthew Hoh 