This post includes an annotated list of resources for understanding and treating moral injury.
Many citizens realize that the suicide rate among U.S. veterans is very high. About 20 veterans take their own lives each day. The suicide rate is also high for veterans of other nations, including the U.K., Canada, and Australia. Many media articles link Post Traumatic Stress Disorder, PTSD, with deep depression which can lead to suicide. Fewer articles, though, reveal a link between the moral injury that many combatants suffer and suicidal ideation. This link has not been clinically tested, but anecdotal evidence suggests it is strong. Indeed, some researchers suspect that moral injury is the key engine of veteran suicide.
PTSD injures the nervous system, altering the brain in ways that manifest in various forms of anxious behavior, and often anger. Moral injury, on the other hand, wounds the conscience. Some say it’s a soul wound. Moral injury is the deep hurt that a combatant feels when he or she has done something or failed to do something in the line of duty which violated his or her deepest held values. Very often such an act of commission or omission resulted in the loss of another’s life, and that caused great guilt.
You Can Help Vets by Being a Non-judgmental Listener
When veterans have very troubling stories to tell often they are willing to share those only with other veterans who have experienced combat, because they trust they won’t be judged by “someone who’s been there”. But it doesn’t take combat experience to make one a non-judgmental listener. And it doesn’t take clinical experience either. What it takes is the humility and wisdom to realize that human beings have the capacity in the crucible of war, in the struggle for survival, to act in surprisingly noble and surprisingly ignoble ways. If you are able to accept your own shadow, then you can be a non-judgmental listener, and by being such a listener you could save a veteran’s life.
Following is a short, annotated list of resources that I’ve found helpful for understanding moral injury, and several that suggest ways your community of faith can help veterans come home.
The list begins with a series of three short videos, and then, an upcoming feature film. Then it cites two short articles, and finishes with eight excellent books. Please leave viewer/reader feedback about these resources at the IVW Facebook group.
Films About Moral Injury
A 3-part free web video series about moral injury, by war correspondent David Wood, called “The Grunts” This is the most cogent introduction to moral injury I’ve seen. Take time to watch all three videos. Informative and gripping!
Stay watching for an announcement about an upcoming feature film, “Thank You For Your Service.” If you belong to an organization that would like to sponsor a showing of this film at a local theater, follow the instructions to get in touch with that theater.
Web Articles About Moral Injury
“The Fighter” by C.J. Chivers, publised in the Dec. 28, 2016 issue of the New York Times. How a U.S. Marine sniper, Sam Siatta, came to experience remorse for killing. Most recent accounts of combat guilt relate to the killing of a civilian, or failing to save the life of a buddy. This story involves guilt for having killed even an enemy.
“How Faith Communities Can Help Veterans and Their Families Readjust” adapted by Chaplain David Lundell from speakingoffaith.org’s ‘The Soul of War’, this brief article offers suggestions relevant to diverse communities of faith.
Books About Moral Injury:
The Body Keeps the Score: Brain, Mind, and Body Healing of Trauma, by Bessel Van der Kolk, is not just about moral injury, but trauma in general, and not just trauma experienced in combat. Van der Kolk explains that all trauma injures the body and the brain, so treatments must address both. He also explains that trauma is cumulative. It is stored in the body, and each new trauma is added to the sum of previous ones. Soldiers who experienced traumas as children have injuries to their bodies and brains which may make it more difficult to recover from more recent traumas. This is a seminal book in the field of PTSD research. It’s long but very well written, and worth the read!
On Killing: The Psychological Cost of Learning to Kill in War and Society, by Lt. Col. Dave Grossman. The author spends considerable ink proving that in past wars many riflemen refused to shoot at the enemy, because they couldn’t bear taking another’s life. This is a challenge to military trainers, but good news about human nature! Grossman examines how training can desensitize soldiers to killing, and how the act of killing can plague them afterwards.
Packing Inferno: The Unmaking of a Marine, by Iraq veteran, Tyler E. Boudreau, an autobiographical account of a Marine’s moral injury and what he did about it. Boudreau’s superb prose will give you a visceral taste of combat and its moral ambiguities.
Guilt Free War: Post Traumatic Stress Disorder and An Ethical Framework for Battlefield Decisions, by John G. Sackett, Major USAF. Moral injury is a challenge to military trainers. If human beings have an inborn reticence to kill, how can they be trained to perform the job of killing without morally injuring themselves? Major Sackett proposes guidelines for preparing soldiers ahead of time to not hold themselves morally culpable for battlefield decisions they may be forced to make. His book is based on just war theory, which other authors in the list reject.
Killing from the Inside Out: Moral Injury and Just War, by Robert Emmet Meagher. This author digs deeply into western history to dispute the moral validity of just war theory.
Warrior’s Return: Restoring the Soul After War, by Edward Tick, Ph.D., An early author in the field of moral injury, Tick’s book is based on clinical work with many combatants.
Continuing Actions: A Warrior’s Guide to Coming Home, by Dan Sheehan. A former combatant who experienced moral injury describes in a style that will appeal to other warriors his own road to recovery. Shay is credited with being the first to use the term, “moral injury.”
Help for Moral Injury: Strategies and Interventions, by Cecilia Yocum. A fairly short book with concise descriptions of evidence based treatments helpful for treating veterans with moral injury. It is written for professional psychiatric and medical practitioners, and it involves mainly one-on-one techniques, but some of them could be modified for use in groups.