I uploaded another podcast. This one, Coming home, being even more distant…and not having sex, deals with the issues combat veterans and their partners experience with intimacy and sexual relationships. As with my other recordings, while I focus on combat veterans, much of what I say can be applied to others. I hope this may be of benefit to individuals and couples that may be struggling.Here’s the website. Apple and Spotify links are available below as well. Please share.
As many of you know my health has limited my ability to work for pay. Thanks to some really excellent care from my doctors at the VA I am now in a place where I feel healthy enough to accept a paycheck. These last several years I’ve been too beset with migraines, exhaustion, cognitive issues and other aspects of brain injury to allow me to reliably accept money in return for work. I am very happy and proud to say I feel I am past that point.
I’ve been been a Senior Fellow at the Center for International Policy (CIP) for almost a decade now and during my period of disability I have maintained that position. Unlike most think tanks we do not accept contributions from corporations for our work at CIP, rather we rely on support from individuals and non-profit foundations; I am sure you understand our reasons for doing so and how this makes CIP rather unique in the Washington, DC policy and advocacy world.
As a Senior Fellow, I am largely responsible for raising my own funding. Since I am essentially starting over, I have decided my first step will be to utilize Patreon to raise support from friends, associates and allies who value my work and would like to see it continue. If you are interested in helping me in my work, please go to my Patreon site. You will find a further explanation of why I am asking for your support, as well as what your support will assist me in doing. I appreciate any help you can provide, as I can’t continue to do this without support.
I’ve included a few interviews I have done in the last month or so in this message. The first two are in relation to Afghanistan, while the third interview is about the historical and current circumstances of veteran suicides. I honestly feel this third interview is one of the best interviews I have done in the last ten years.
Thank you for your support over all these years and thank you for considering to support me via Patreon.
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 email@example.com 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..
“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 (firstname.lastname@example.org).
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.
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.
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.
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).
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.
After almost 4 years I decided to give Twitter another try. I’m at @MatthewPHoh if you’d like to follow. I do interviews on a few radio and TV shows each week and so I figure Twitter might be a good, and simple, way to share those appearances.
With the assistance I’ve gotten from the doctors and the staff at the Durham VA Hospital, I also feel I am much more capable in handling the deluge of information that comes from Twitter and social media. An overabundance of information is something that easily overwhelms me cognitively and emotionally because of my TBI, Neuro-cognitive Disorder and PTSD. So let’s see how this works for me. I’m confident I’ll be able to handle it due to the training I’ve gotten from the VA to manage, adjust to and cope with the various issues in my brain. 🙂
A couple of weeks back I took part in the fifth installment of The Gathering, which is a call for the moral revival of our society by Repairers of the Breach and led by Reverend William Barber and Jonathan Wilson-Hartgrove. You can see an edited version of my interview with Jonathan below. Here is a link to the entire event, which included some pretty amazing singing and one, if not the best, anti-war speeches I’ve heard in the last eight years by Reverend Nelson Johnson. Reverend Johnson comes on at just about the one hour mark.
Finally, for Veterans Day, and yes I know that was already two weeks ago, hence my getting on Twitter to be maybe a little more timely, my name was on a letter sent out by Win Without War urging support for legislation introduced by Representative John Lewis. Representative Lewis’ legislation would not allow tax cuts for the rich until the trillions of dollars in debts, obligations and responsibilities for our wars are paid. The text of the letter is below and you can add your name to my petition supporting Representative Lewis’ amendment and calling on Congress to honor our veterans by accounting for the human, moral and financial costs of war.
$5.6 trillion, with no end in sight. That’s the cost of America’s wars since 9/11.
But as a Marine who served in Iraq, I don’t need a price tag to tell you about the cost of our wars for veterans like me. I’ve seen for myself the amputations, traumatic brain injuries, post traumatic stress disorder and moral injury that all lead to massively disproportionate levels of suicide, depression, substance abuse, domestic violence and homelessness in veterans returned home from war. And I’ve witnessed the human cost of our wars beyond our borders, in Iraq where I was stationed and for millions around the world.
Today, Veterans Day parades will celebrate the bravery of servicemembers, and I will be remembering those who were alongside me overseas. But before Cold War hysteria took over, November 11th was Armistice Day — a day for peace. The original Armistice Day marchers, veterans who survived the killing fields of the First World War, carried banners declaring “Never Again.” Imagine if we had listened to those veterans. Instead, our country continues to pour troops into stupid, bloated, and deadly wars.
That’s not honoring or respecting veterans. That’s putting war profits and reckless ideologies over our lives. Please join me in supporting Rep. John Lewis’ call to honor our veterans by accounting for the human, moral, and financial costs of war.
$5.6 trillion by next September works out to $310 billion per year to prop up our endless wars. That’s $23,386 per taxpayer per year. Slice it however you want, it’s an incomprehensibly massive number. And instead of asking ourselves if a single penny is worth it, we just keep freefalling into gargantuan war debt.
As for the spiritual, emotional, mental, and physical costs of my time at war — we won’t ever pay those off. Neither will the friends I remember today who died for a country that won’t acknowledge the cost of their loss. Neither will our families and communities who continue to shoulder the burdens of our service long after we leave the battlefield.
That’s why Rep. John Lewis is speaking up to demand a public, national conversation on war financing. His amendment to Trump’s tax bill would prohibit cutting taxes on the rich — a loss of revenue that would add right onto our pile of war debt — until we get our troops out of Afghanistan, Iraq, and Syria and eliminate the war deficit gobbling up our budget.
Thank you for all you do,
Matthew Hoh, Iraq War veteran