post traumatic stress

A Meditation on Moral Injury and Forgiveness

Preached at the Presbyterian Church of the Covenant

On May 5^th, 2019

By the Rev. Thomas C. Davis

Irish poet Thomas Moore and American hymnist, Thomas Hastings, gave Christians a beautiful hymn that isn’t in our Presbyterian hymnal. In the 70s my wife and I belonged to a racially diverse congregation in Pittsburgh called the Community of Reconciliation. It was there, sung by African Americans, that I first heard this pre-Civil War hymn, “Come Ye Disconsolate.” The first verse goes like this:

Come to the mercy-seat, fervently kneel;

Here bring your wounded hearts,

here tell your anguish,

Earth has no sorrow that heaven cannot heal.

We don’t use the word, “disconsolate,” much these days. It means inconsolable, hopelessly unhappy. Someone who has endured that sorry state of heart and mind for too long may feel that suicide is the only way out. But the hymn says no! For earth has no sorrow that heaven cannot heal.

Al Mills is an Iraq War veteran. He and his brother, Nnamdi, are the current Twin Poets Laureate of Delaware. Over coffee a couple years ago I learned that Al was struggling with anger and hyper vigilance, symptoms of post traumatic stress. And what bothered him even more was a deep sense of shame, on account of something he had participated in during his tour in Iraq. He belonged to an artillery unit. Soldiers in artillery units rarely see the damage they inflict. But things changed quickly for Al when his unit had to convoy through an urban area. Suddenly he experienced what it’s like to be an infantryman, to kill close up. Duty and fear carried him through a terrible episode, but afterwards, after he had had time to think, what he had done made him terribly ashamed, so ashamed that he was beginning to feel inconsolable, disconsolate.

I would not be sharing these personal details about Al’s experience, were it not for the fact that he has already done so himself in public, by means of a very moving poem which he read for the first time at the St. Stephens Lutheran Church. He worked up to writing that poem after sharing memories with fellow combat veterans in the Interfaith Veterans Workgroup. I was present on both occasions.

Al’s poem was a soul dump. With his pen he let go of so much pent up anger, so much horror, so much moral indignation, and yes, so much shame! Reading the poem among civilians took a lot of courage, because veterans don’t know whether civilians can understand what they’ve been through. A veteran with moral injury has already heaped so much shame on himself or herself, it’s difficult to risk having even more piled on by folks who don’t understand. Al took that risk, and now he was exhausted. I invited him to walk around the block with me

Neither of us said much for a while. Then, finally, to console him I said, “You know, Al, with this moral injury stuff you’re in good company. The Apostle Paul had moral injury, big time.”

I think the Spirit put that idea into my head. I hadn’t worked out the details yet. The elements of an argument were floating around in my unconscious. I just rushed to the conclusion that night to assure Al that he wasn’t a bad person for having done a bad thing.

Now that I have had time to ponder the truth of my intuition that Paul had moral injury too , here’s why I think so.

Moral injury was a term coined by Jonathan Shay, a therapist who was treating Vietnam veterans with post traumatic stress. He observed that some of their symptoms derived from a hyped up nervous system that couldn’t be quieted. But other symptoms related to a deeper level of the self. You could say they are spiritual afflictions. Shay observed that moral injury is a very deep wound to the conscience. As researchers caught on to this term, moral injury, they understandably linked it to an event, a trigger, something that a veteran had done or failed to do in the line of duty which led to grievous harm, often the loss of life.

More than two years of research about moral injury have convinced me, however, that we won’t understand moral injury adequately if we focus just on an event that triggered moral pain. There are high suicide rates among doctors, among police officers, among correctional officers, and small farmers. Researchers are beginning to use the term, moral injury, to refer to the psychological pain among people in these professions too. In many instances their moral injury did not derive from a particular trigger, but rather, from severe moral frustration. Many people choose such professions out of a deep desire to serve, to be helpful to others. Then, they find that they cannot help as they had wanted because the working environment makes this impossible. When they fail, sometimes they don’t blame a system, they blame themselves. A soldier doesn’t blame the craziness of war for his bullet which was meant to kill an enemy but stuck a civilian instead. He blames himself. A doctor doesn’t blame a health system that puts more emphasis on saving money than saving lives. She takes the blame herself. She thinks, “I just didn’t work hard enough.” A farmer doesn’t blame big agriculture and increasing urbanization for losing the family farm. He blames himself.

The most common denominator among sufferers of moral injury doesn’t seem to be a similar trigger, but rather, a quality of personality, namely, a very high dedication to service. People with very high ideals about serving others may be more prone to moral injury than others who are less altruistically inclined.

This brings me back to the story of Saul. He had very high ideals of service. He was a Pharisee, a protector of the sanctity of religious law. Pharisees get a bad rap in the New Testament. They generally were people with very high standards of behavior. I see Saul that way. He was a crusader for the right way of doing things, and he saw followers of Jesus as dangerous underminers of that long tradition. So, when the story in Acts 9 opens he is carrying letters from high priests in Jerusalem bearing the names of followers of Jesus who have fled persecution in Jerusalem to seek refuge in far away Damascus. He is carrying hit lists. He is out to arrest and imprison the enemies of religious rectitude.

But, I don’t think Saul is of one mind. I think he has doubts. Saul was present during the stoning of Stephen, and scripture says he approved of it. But I think there was a growing part of Saul that didn’t approve. Stephen’s bloody clothing was dropped at Saul’s feet. To dispose of it he had to get blood on his hands, and killing up close can change a person. Besides that, scripture notes that Saul was a student of the highly respected Rabbi Gamaliel. And Gamaliel recommended that angry crowds not pursue annoying Christians, because if they were truly doing God’s work, then nothing could stop them. So we notice that Saul’s own rabbi was not of one mind regarding the followers of the Way.

Neither, I think, was Saul. As he rode on to Damascus to take prisoners I submit there was an inner war going on in him. He was beginning to experience an extreme inner tension brought about by a conscience pulling him in opposite directions.

Saul astride his horse was a prime candidate for what mental health practitioners call “conversion disorder.” According to the Diagnostic and Statistical Manual of Mental Disorders, conversion disorder occurs when a person experiences neurological symptoms that are not attributable to any medical condition. The symptoms are real, not imaginary, and they can affect motor functions and one’s senses.

Conversion disorder tends to be manifest in persons who, like Saul, have endured extreme tension. A symptom of their disorder can sometimes be understood as their body’s way of releasing the tension. For instance, a woman who is afraid of showing strong emotion might develop temporary paralysis of her arm when anger motivates her to strike someone. Typical symptoms of conversion disorder are temporary paralysis, weakness loss of balance, and temporary blindness. The story about Saul falling off his horse, needing help to move about, and becoming blind, suggest to me that his body was relieving part of his inner stress by temporarily relieving him of the capacities necessary to carry out a mission about which he had growing misgivings. He was ready to meet Jesus, but didn’t know it yet.

Saul recovers his sight when blindness is no longer necessary to relieve his inner tension. He can see again when he no longer fears that being able to see will enable him to do something against which his conscience has been crying out no, no, no! Notice that he doesn’t receive this assurance until he is forgiven.

And it is Ananias who is the transmitter of a forgiveness coming from the risen Jesus. He says to Saul, “Jesus, who appeared to you on the road as you were coming here—has sent me so that you may see again and be filled with the Holy Spirit.”

Thus it is that Saul, tormented by conscience, is assured by another human being that the old is over and done with. Saul is forgiven and given a new and right spirit for moving ahead. A man who might have taken his own life from agony of soul is saved by the laying on of hands and a declaration of pardon.

This story is very precious to me, a veteran who was once plagued by moral injury, a veteran who fell into a deep depression almost two decades after combat. That’s how long a conscience can stew. The men and women suffering from moral injury are often the morally most sensitive. They blame themselves for failing to clear a high bar that they have set for themselves. I speak from experience. We need an Ananias, another human being, to assure us that there is indeed a balm in Gilead.

Maybe you are presently wrestling with some moral quandary, as Saul did. Maybe you are a mystic and will see Jesus in your own way on your own road, as I did in Vietnam. Maybe you will see Jesus in some modern Ananias who declares to you what you may have learned in Sunday school, or maybe from the Reverend Mr. Fred Rogers, that you are loved just as you are.

Come, ye disconsolate, where’er ye languish;

Come to the mercy-seat, fervently kneel;

Here bring your wounded hearts,

here tell your anguish,

Earth has no sorrow that heaven cannot heal.