Treating the Spiritual Wounds of War
And Why the Healing Efforts of the Military Are Inadequate
“War is Hell”
General Sherman, who knew more than a little about the value of shock and awe in waging war, was absolutely correct in declaring, “War is hell, and there is nothing you can do to refine it.” Of course, Sherman was thinking mainly about the fiery hell that the elderly, the sick, the pregnant women, the children whose fathers were away at war, or already wounded or dead, were about to find themselves in as he burned Atlanta to the ground –just as he had pillaged, ravished and slaughtered all the way there. But it is unlikely that Sherman thought much about the hell into which his own troops, in spite of victory, would descend as a consequence of carrying out his orders.
In countering the argument that the Iraq War would be a just and necessary war, there were voices questioning whether military action against Iraq met any of the criteria of a just war, including whether it would justify the costs – not only the costs in money spent and lives lost, but also with serious regard to the emotional, psychological, and spiritual damage it would do combatants. Sadly, the American people in their denial thought that if they applauded the men and women in uniform, that if they called them “heroes,” that if they “supported the troops,” all would be well in the end. This obviously has not proven to be true.
Distinguishing PTSD and Moral Injury
One cannot watch or read the news without being aware of the enormous suffering experienced by the troops returning from Iraq and Afghanistan – not only the terrible ordeal of physical wounds, but also the psychosomatic anguish of PTSD; and, the hell of moral or spiritual injury. Actually, until relatively recently PTSD and Moral Injury, the Marines euphemistically prefer to call it “Inner Conflict,” were undifferentiated. However, although each causes intense anguish, and while in many cases a dual diagnosis of both is warranted, they are not synonymous.
PTSD is a physical response to prolonged extreme trauma. It is a fear reaction to danger. In fact, it triggers a bio-chemical process in the brain that affects the hippocampus which itself regulates emotions connected to fear and memory. The ability, then, to manage fear and process emotions is impaired by a traumatic event. And, a previous history of emotional trauma or brain injury will serve to exacerbate the most recent trauma. Recent studies suggest that blast concussions themselves may result in trauma to the brain which is then manifested with the symptoms recognized as PTSD.
Moral injury can be attributed more to the violation of one’s own basic beliefs and moral identity. For those who have experienced moral injury the world no longer can be regarded as orderly or trustworthy, or human beings as basically good. Killing someone, torturing, abusing dead bodies, failing to prevent such acts, or even handling human remains in the violent context of war can result in moral injury. Seeing a comrade in arms violate significant moral values, or feeling lied to or betrayed by those in authority, may be significant contributing factors. Violating one’s conscience, even if the act was unavoidable or seemed the right thing to do at the time, can have devastating consequences and lead to debilitating depression, profound remorse, excruciating guilt, and self-medicating with drugs and alcohol. Further, violating one’s conscious, or even unconscious, core values, precisely because they are at the core of our very being, throws any healthy or anchoring sense of self-identity into utter chaos.
In an open letter to President Obama, Defense Secretary Ashton Carter and CIA Director John Brennan, four former drone operators told how they came to see themselves as complicit in the killing of innocent civilians. The four are Brandon Bryant, Cian Westmoreland, Stephen Lewis and Michael Haas. When he left the service Bryant was given a report of the number of killings he had been involved in – 1,626. What Bryant knew, and could not live with, was that in one study of a five-month period 90% of those killed were not the intended targets. He tells of one incident in which the drone team waited for five men traveling from Pakistan to Afghanistan with their camel to settle down for the night. And, then, without knowing who they were or what they were doing rained exploding fire down on them. “That,” says Bryant, “was cowardly murder.” What the military would do with Bryant and his three friends, is to help them in their rationalizations of the event – and that might even help for a while. But if the rationalizations begin to collapse, if as frequently happens the rationalizations, because they are after all only rationalizations, quit working, then hell returns.
Why the Military Cannot Heal Moral Injury
Sitting in a conference on ministry to the military, most of which dealt with the moral, religious, and spiritual aspects of PTSD, and how churches could be supportive of the troops coming home from Iraq and Afghanistan, I had an epiphany – a moment in which it became obvious just how incredibly difficult it is for anyone connected with and accountable to the military to be sufficiently helpful, not because they don’t want to help, or lack compassion or professional training, but because there are two simple propositions they cannot fully entertain.
The Two Propositions
First, helping professionals in the military cannot entertain the notion, or perhaps more correctly, they cannot accept the possibility, that those sent to the wars may have gone riding on a lie. After a presentation on Christian pacifism, a former Marine officer asked me about the possibility of a “just war.” My response was that even if one accepted the possibility of a “just war” it was an irrelevant concept for the person in uniform, since even if he or she thought the conflict unjust there was still no choice but to go and kill. The Pope, and the bishops and leaders of every mainline denomination in America, declared that an attack on Iraq did not meet the criteria of a just war. But when the U.S. Commander and Chief lies about weapons of mass destruction, imminent danger, and torture, it is a lie that has to be accepted, or at least rationalized, by those in uniform. So how, if you are part of the system, can you treat someone for moral injury who believes he or she has been betrayed by what they believed to be an honorable system? How, when you must argue against the very possibility, do you help someone heal who believes he or she has been manipulated into acting in ways so dark that they are a denial of one’s essential humanity?
Once it is accepted that the individual’s perception that he or she has been lied to, and betrayed by those in authority, is a valid point of view the question becomes, in terms of Cognitive Therapy, what does this belief or sense of betrayal mean, represent, or signify to that person? Using the downward arrow technique of Cognitive Therapy, Socratic questioning, or the sort of wisdom probing Jesus often engaged in, it should be possible to uncover those interpretations of the betrayal that are “unrealistic” and at the source of the suffering. Once that is done the work of reexamining and replacing those beliefs with more “realistic” beliefs and functional interpretations can begin. That is, the therapist must be able to say to the morally injured soldier, “So, if in going to war and killing you have been betrayed by our own government, what does that mean, symbolize, or represent about you personally? Let me play the devil’s advocate, so to speak, and ask, if this is all true, so what?” Note, it is necessary to “accept” the assessment of the injured person before exploring the event’s meaning. Cognitive Therapy is not a matter of disputing the facts of the situation, but of processing the implications even if they are true.
For example, soldiers who believe they were manipulated into an unjust war of aggression, may make the discovery that at a deeper level this sadly means to them that there is now no one and nothing in the universe that can be trusted, not even their own judgment, that there is nothing to hold to, nothing and no one to give guidance, nothing but deception and chaos everywhere. Recovery can only come when they choose to replace that belief by one that is more realistic; such as, “People and situations cannot always be trusted but God can.” Or, “There is nothing reprehensible about having been fooled, if we choose to change, with God’s help, what we can about ourselves once we recognize the truth.” Notice, however, that once again it is not the fact of what happened that is disputed, but what it means personally for the individual that is questioned.
Second, helping professionals in the military cannot acknowledge, dare not think, that the guilt and self-revulsion experienced by the morally and spiritually injured is a wholly valid response to a violation of real and non-disposable values – a betrayal of the Imago Dei. When someone like former Marine Captain Timothy Kudo, a veteran of the wars in both Afghanistan and Iraq, sees himself as a “monster” it must be taken with a depth of seriousness and understanding sufficient to the problem. Lt. Col. Dave Grossman, Psychology professor at West Point, in his excellent book, On Killing, engages in the very sort of denial he earlier decries as he writes: “Over and over again I have said. . . (Said to veterans), You did all that anyone could ask you to have done, and I am truly proud to have known you.” Grossman says of the veterans who have written of how they were “sickened” by killing, “I believe that as veterans write such narratives, they do not mean to say that the war was wrong or that they regret what they did, but that they simply want to be understood.”
The problem with Grossman’s intervention is that it lacks the therapeutic quality of appropriateness; and, is offered prematurely. “Appropriateness” refers to a response or level of thinking and imagination that is congruent with the seriousness or playfulness or intensity of the event. Telling a soldier who has shot to death a wounded Iraqi pleading for mercy that he or she has done nothing wrong, that he or she is a good person who was simply placed in a bad situation leads to a premature pseudo forgiveness that can do little to heal the anguish that tortures him or her day and night. Rita Nakashima Brock and Gabriella Lettini, the authors of Soul Repair, are correct in asserting, “Positive thinking denies moral truth, and inflicting harsh judgment on those who understand their moral transgression in war deepens the inner condemnation of conscience and steals the will to live.” Moral Injury needs to be understood as a normal reaction to an abnormal morality. And, although beyond the scope of this article, it should be further noted that some soldiers become addicted to killing. Leaving us to ponder which manifestation of injury is the more severe and tragic.
Moral Questions and Recovery
So what if there is a “way” and a not the “way” human beings were meant to live? What if there is a way organic to our humanity? What if there is an essentially moral nature to being human – to reality? What if killing is not wrong merely because someone fancies it to be wrong, but because it is in reality an egregious sin? What if, “Thou shalt not kill” was etched not merely in stone, but somehow mysteriously written in the human soul? In that case wouldn’t it be incredibly difficult, perhaps impossible, to free people from the terrible grip of their existential suffering, by convincing them that they only imagine they have “sinned against God and their neighbor?” O. Hobart Mowrer, in his The Crisis in Psychiatry and Religion, is more than a little helpful here. Mowrer, a humanistic psychiatrist who offended his students by using the word “sin,” wrote: “But what is here generally overlooked, it seems, is that recovery (constructive change, redemption) is most assuredly attained, not by helping people reject and rise above their sins, but by having them accept their sins.” Mowrer was convinced that it is impossible for someone living with real unacknowledged sin, or in the fog of unexpiated guilt, to accept him or her self – “not if he or she has any character at all.” Every effort to reassure such people and to help them find self-acceptance through positive thinking is doomed to failure. “But,” argued Mowrer, “the moment they (with or without ‘assistance’) begin to accept their guilt and their sinfulness, the possibility of radical reformation opens up; and with this, the individual may legitimately, though not without pain and effort, pass from deep pervasive self-rejection and self-torture to a new freedom, of self-respect and peace.” Mowrer rejected what he referred to as “the theological baggage” of the Judeo/Christian tradition; and, yet, believed there are “eternal verities in that tradition with which we must come to terms or get hurt.” Those “eternal verities” constitute the insurmountable problem for the military in the treatment of moral injury.
Military Virtue and Spiritual Morality
In 2009 the Department of Defense invested $125 million in developing the Comprehensive Soldier Fitness program. The CSF program evaluates fitness in five different areas, including spiritual strength. The military sees spiritual fitness as those qualities that sustain a person in times of stress, hardship, and tragedy. If soldiers believe in something higher than themselves, then they are far more likely to embrace the sort of “higher values” inculcated by the military establishment: Never leave a fallen comrade. Never accept defeat. Place the mission first – all values which make a soldier effective in combat. At the beginning of the Gulf War a young, bright and articulate fighter pilot was asked by a television reporter how he felt about the civilians killed by his exploding rockets. He replied something like this, “Sometimes you just have to be guided by higher values and accept the collateral damage.” There can be little doubt he possessed a number of high virtues that made him an admirable person and resilient as a combatant – duty, honor, loyalty, courage. But CSF leaves out the highest values – empathy and compassion for every human being. The approach of the military to spirituality is mechanistic and amoral, so that the most spiritually fit are those who can best rationalize or ignore the deeper, often agonizing questions, posed by war.
The Final Word is Grace
Moral healing can only be effected by spiritually moral means. Corrupt or self-serving means always lead to corrupt and self-serving ends. But here, one must also question the end itself. People of faith believe, of course, that no matter what there is always, at every level, hope of redemption. There is no act we can commit so heinous that it is beyond the healing grace of God, but grace is never cheap, casual, or an easy short cut. Genuine “faith healers” know this.