By Rita Nakashima Brock and Gabriella Lettini
Every day brings us new stories of soldiers affected by Post Traumatic Stress Disorder, which the VA posits as affecting one in five soldiers. What is less known is that in December 2009 a group of VA clinical psychologists, led by Dr. Brett Litz, identified moral injury as a wound of war, distinct from PTSD, that is rarely addressed.
The groundbreaking study suggested that PTDS does not fully capture the moral and spiritual distress of moral injury, which is especially connected with a sense of transgression of the moral order. While PTSD may accompany it, moral injury is not a medical or pathological condition, but a spiritual and moral issue.
The Litz study defines moral injury as resulting from “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.” The long-term impact can be devastating at the emotional, psychological, behavioral, spiritual and social level, wounds that can last an entire lifetime. Moral injury can be found in internal conflict and self-condemnation so severe that the burdens become intolerable and lead to suicide. People may lose their core system of beliefs and values and reach a point of not being able to make sense of life and human relationships. What people believed about the world, humanity and themselves no longer rings true.
The wars in Afghanistan and Iraq place soldiers in situations of much greater ethical ambiguity than traditional wars. With insurgencies and guerilla warfare, especially in urban contexts, soldiers constantly face the issue of harming or killing innocent civilians, even children. Furthermore, frequent redeployments force soldiers to experience morally shattering situations repeatedly. The psychological effect of witnessing or taking part in acts of brutality can haunt veterans for the rest of their lives, as people experience deep shame and self-condemnation that undermines their relationships to others and even to life itself.
Moral injury is not only connected to acts of moral transgression committed by soldiers, but also to the betrayal felt by soldiers when the motivations that were given for going to war were discovered to be false. This betrayal is what Marine Capt. Tyler Boudreau recounted in his testimony before the Truth Commission on Conscience in War. He shared his long struggle to finally admit that he was not in Iraq to discover Weapons of Mass Destruction and even less to help the Iraqi population. Many soldiers interviewed by Nancy Sherman in The Untold War reported that they felt “betrayed,” “used,” “morally tainted,” “suckered.”
The Truth Commission on Conscience in War recently released its report at an interfaith Veterans Day service honoring moral conscience in the military. We list among our recommendations that religious, educational and scholarly communities can have a fundamental role in addressing the moral injury of war by becoming more educated about the issue. Veterans should not be left alone in this struggle. The support and understanding of communities willing to listen to veterans’ experiences of moral injury and to help them struggle with their moral questions are crucial to their journeys towards recovery.
Why should you care? In his Truth Commission testimony in March, retired Army Chaplain Rev. Herman Keizer stated “If you sin against your conscience you commit moral suicide.” Moral injury is a serious, long-lasting injury of war. It affects and concerns not only war veterans, but our whole society.
The authors are Co-Chairs of the Truth Commission on Conscience in War.