There is Hope
When coming home doesn’t leave the war behind. By Joy Evans Peterson, M.A.
Since the turn of the century, Middle East conflicts have claimed the lives of 6,850 U.S. service members in combat. More startling, 22 veterans each day take their own lives. The unprecedented rise of suicide in veterans arouses public concern and sounds an alarm.
The good news? There is hope. Communities are increasingly aware of the mental and emotional effects of combat for veterans. We know about post-traumatic stress disorder (PTSD) and have a layman’s understanding of the anguish of victims and the impact on families. PTSD is no longer a silent threat, and treatment is available. However, this hasn’t reduced the suicide rate…at least not yet.
Gig Harbor mother and activist Leslie Mayne experienced the failure of PTSD treatment firsthand when her son lost his life the day after being released from a VA inpatient treatment program. Many relate the same sad story. Leslie’s path to healing has not been solely a private agony, but a relentless voice in bringing the issue to public attention. She created the Permission To Start Dreaming Foundation (PTSD) which raises funds and awareness to help organizations that support veterans.
In recent years, there has been a movement to identify and research lingering combat trauma that isn’t adequately addressed by the PTSD diagnosis or treatment. The condition is known as moral injury (MI). Because MI shares similar symptoms, it is often incorrectly diagnosed as PTSD. But MI has a different root cause and emotional response.
Several years before the concept of MI emerged, researchers wrote:
“We conclude that veteran’s pursuit of mental health services appears to be driven more by guilt and weakening of faith than by PTSD symptoms or deficits in social functioning…spirituality should be central to treatment of PTSD.”
MI occurs as a result of committing, witnessing or failing to intervene in acts that violate one’s internal moral or ethical code, or a betrayal of trust by someone in authority. It’s a crisis of conscience, a soul wound. It leaves a legacy of guilt, shame, self-loathing and loss of faith.
According to experts in the field of combat trauma, the usual approaches by clergy and mental health clinicians are not merely ineffective; they may actually increase the feelings of hopelessness and worthlessness.
In 21st century combat zones the battle lines are unclear and the moral or ethical boundaries are ambiguous. Fundamental assumptions about life’s purpose and human values are shattered by frequent traumatic events and repeated violations of accepted moral standards.
“American Sniper” is a compelling portrayal of the reality of war and the inevitable soul wounding and relationship erosion that occurs. Chris Kyle was reluctant to "quantify the number of kills." He had to remain focused on his mission -- to protect his unit. In spite of sole commitment to the mission, disillusionment, anger, guilt and shame may be a lifelong legacy. Victims of PTSD/MI can lose a sense of mastery over their lives and resort to self-blame in an attempt to re-establish an illusion of control over their destiny. When that doomed strategy fails, life may no longer seem worth living.
Chaplain Jonathan Entrekin, currently stationed at Joint Base Lewis-McChord, has intently studied moral injury. He explains that we all belong to a moral community where we learned our deeply embedded beliefs about right and wrong. Throughout history moral communities have devised rituals and ceremonies for cleansing warriors with “blood on their hands” and restoring them to their community. Warriors went into battle with the knowledge that the normal rules of living in a community were temporarily suspended. They also knew there was a prescribed path to healing and reconciliation upon their return.
Native American warriors had the sweat lodge. Returning Crusaders were prohibited from taking communion until completing the Catholic Church’s repentance to reconciliation process. The Old Testament describes a seven-day purification for “anyone who has killed someone or touched someone who was killed.”
Today’s warrior is unprepared and goes to war without knowing the emotional and spiritual cost or assurance that there is a spiritual journey to healing within the community. A ritual that acknowledges the “blood on his hands” and promises forgiveness and reconciliation. The challenge today is that a supportive group can be difficult to find, especially when the victim’s inclination is to isolate and alienate the people he needs most.
Clergy and mental health providers are generally the first point of contact when a soldier is desperate. Keith Tanis, Executive Presbyter of the Olympia Presbytery, has been inspired to discover what could be done to get it right and prevent soldiers, especially those with MI, from falling through the cracks.
Military chaplains, the faith community, mental health and non-profits serving veterans have little opportunity to interact, and communication between healing disciples rarely occurs. Tanis’ Moral Injury Initiative and Mayne’s PTSD Foundation strive to change that. The Initiative’s objective is first educational, to teach the critical difference between PTSD and moral injury and what approaches are effective. The second is to understand the role each discipline plays in providing a cohesive healing community. And third to break down the barriers, joining hands and hearts to save lives and relationships.
The Center for Learning Connections at Edmonds Community College is home to Veterans Training Support Center, funded by King County and administered by Washington State Department of Veterans Affairs. Their mission is to train mental health clinicians and social workers about veteran’s issues and provide counseling and other direct services for veterans and their families.
What can the individual do to help? Most of us know veterans - from Vietnam among the Boomers - to the present day. Veterans themselves are often reluctant to admit they have a problem. Some of the signs to look for are withdrawal, isolation, paranoia, loss of faith, avoidance of social interactions, self-doubt, depression, insomnia, pessimism, rage and addictive behaviors. There are many paths to healing, but a caring advocate is often needed to point the way. Someone who believes in the worth of the individual when they have lost belief in themselves. The important thing is for someone to voice a concern and act as an advocate. They fought for us, we need to fight for them!
For further information on the Moral Injury Initiative in the South Sound please contact the coordinator, Joy Peterson at jep.13@comcast.net.
