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Vietnam vet Randy Sachs throwing medal during
1971 war protest (photo/Sheldon Ramsdell) |
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Often lost in the translation of war, for soldiers as well
as folks back home, is that much of what goes on in a war is a moral outrage.
After a decade and more of warfare by American military
forces in Iraq, Afghanistan, Pakistan and elsewhere in hot pursuit of elusive
bands of armed insurgents hiding amid sprawling cities, remote villages and
other gatherings of civilians, The Associated Press has unveiled another hidden
wound of war—one not listed in the usual litanies of battlefield injuries and
post-traumatic stress disorder (PTSD).
“With American troops at war for more than a decade, there's been an
unprecedented number of studies into war zone psychology and an evolving
understanding of post-traumatic stress disorder. Clinicians suspect some troops
are suffering from what they call ‘moral injuries’ - wounds from having done
something, or failed to stop something, that violates their moral code,”
reported AP staff writer Pauline Jelinek.
“Though there may be some overlap in symptoms, moral injuries aren't what
most people think of as PTSD, the nightmares and flashbacks of terrifying,
life-threatening combat events. A moral injury tortures the conscience;
symptoms include deep shame, guilt and rage. It's not a medical problem, and
it's unclear how to treat it, says retired Col. Elspeth Ritchie, former
psychiatry consultant to the Army surgeon general.”
Here’s where the US news media’s reporting on a touchy topic involving the
military too often ends. But Jelinek and other AP staff members kept digging. What
they found and reported is news for even military veterans who’ve been trying
to follow the twists and turns of PTSD directives from government agencies:
“Dr. Brett Litz, a clinical psychologist with the Department of Veterans
Affairs in Boston,
sees moral injury, the loss of comrades and the terror associated with PTSD as
a ‘three-legged stool’ of troop suffering. Though there's little data on moral
injury, he says a study asked soldiers seeking counseling for PTSD in Texas
what their main problem was; it broke down to ‘roughly a third, a third and a
third’ among those with fear, those with loss issues and those with moral
injury.”
The AP reporters sought out veterans who have suffered this seldom-discussed
injury.
“Lumping people into the PTSD category ‘renders soldiers automatically into
mental patients instead of wounded souls,’ writes Iraq vet Tyler Boudreau, a former
Marine captain and assistant operations officer to an infantry battalion.
“Boudreau resigned his commission after having questions of conscience. He
wrote in the Massachusetts Review, a literary magazine, that being diagnosed
with PTSD doesn't account for nontraumatic events that are morally troubling: ‘It's
far too easy for people at home, particularly those not directly affected by
war ... to shed a disingenuous tear for the veterans, donate a few bucks and
whisk them off to the closest shrink ... out of sight and out of mind’ …"
The only problem with this startling news report is that it could have been
done a decade ago, when US forces invaded Iraq in a massive assault that killed
large numbers of civilians—or for that matter, four decades ago during the
Vietnam war.
In 1973, however, there was no terminology, such as post-traumatic stress or
moral injury, for what a generation that fought in Vietnam brought home. But many veterans raised moral issues in protests against the war's continuation, including a 1971 demonstration in Washington where hundreds of veterans hurled war medals over a crowd control fence at the Capitol building, an event widely reported in the news media.
Here is what
a Marine veteran of that war discovered and has been writing about for years in
Internet postings.
“The observation that some human beings become moral casualties because of
their experiences in war is not new. Historically, many societies have
recognized war’s deleterious moral effects and required returning warriors to
undergo elaborate atonement and purification rituals,” notes Camillo Mac Bica, who
left the Marines to become a philosophy professor. “These ‘therapies’ provided
the means and the opportunity to cope with the moral enormity of their actions
in war.
“Tragically, the moral injuries of modern warriors, however, have been
virtually ignored, overlooked, or disregarded by the conventional therapeutic
community … Focusing, instead, upon stress and trauma, most moral symptoms
presented by returning soldiers are either not taken seriously or assimilated
under the diagnostic umbrella of Post Traumatic Stress Disorder. Consequently,
the veterans receive the signal that an inability to forget, to put the war
behind them, is either weakness or, perhaps worse, illness. … Unfortunately, in
most cases, moral injury neither responds well to medication nor can it be rationalized
away,” Bica added.
Coming home from war, he noted, “I realized that Vietnam had
profoundly affected my life, that war takes its toll on body, mind and spirit.
I realized as well that America
had little tolerance, interest or understanding for its returning warriors. I
was called a drug addict and baby killer by many in the general public and
ostracized even by fellow veterans from previous wars for being a crybaby and a
loser, for lacking dedication and effort, for disgracing the ‘uniform,’ ourselves
and the country for contributing to what was widely regarded as America's first
lost war. This realization that I was alienated and alone and that no one
seemed to understand or care about what I was undergoing, made me sad at first.
Soon after that sadness was replaced by anger and resentment.
“After several years of isolation and denial, trying to
avoid ‘contaminating’ friends and family and the stigma of being a Vietnam
veteran, I was convinced by another vet to seek help at the Veterans Administration
(VA). Almost immediately, I was assailed by VA clinicians who ‘diagnosed’ my
inability to cope, alienation, nightmares, etcetera as personal inadequacy and
weakness, probably due to some pre-existing condition, perhaps a personality
disorder, maybe even schizophrenia. Most likely, they hypothesized, my
difficulties had something to do with my mother being overweight or my being
toilet-trained too early. What was peculiarly absent from all this analysis and
testing and the ad hominem attacks, however, was any reference to the war.
"So,
I blamed myself for my weakness and my mother for her eating habits and for how
she raised me, and resigned myself to the fact that, for all intents and
purposes, at 25, my life was over. Was I crazy, a baby killer, a crybaby, a
coward? Perhaps I was all of these. Needless to say, I wasn't very pleased with
myself, with those around me, or with the fact that, other than a heavy regimen
of Thorazine, what some refer to as a ‘chemical lobotomy,’ VA doctors and
clinicians weren't offering much help and guidance. So, it became apparent to
me that if I was going to salvage what remained of my life - and I was not at
all sure healing was possible - I needed to do it myself, to come to an
understanding, perhaps even an acceptance, of what I had done and what I'd
become.”
The question now is how much has changed for the current
crop of war veterans? If moral injury is not officially acknowledged and
seriously addressed, could this account for the on-going suicide epidemic among
veterans and active duty troops?
The AP’s special report doesn’t ask these questions. Instead, it veers off track:
“Many in the armed forces view PTSD as weakness. Similarly,
they feel the term ‘moral injury’ is insulting, implying an ethical failing in
a force whose motto stresses honor, duty and country,” writes Jelinek, who
covers the Pentagon for the AP.
“At the same time, lawyers don't like the idea of someone
asking troops to incriminate themselves in war crimes — real or imagined.
“That leaves a question for troops, doctors, chaplains,
lawyers and the military brass: How do you help people if they don't feel they
can say what's bothering them?”
A fuller report would have added the insights of dissenting veterans
like Bica, who resigned from a Marine officer’s post, signed himself out of a
VA facility to study philosophy and continued over the years to ask fundamental
questions.
“Acknowledging the existence of moral casualties in war
demonstrates that the clinical model - pathologizing a veteran's readjustment
difficulties as mental illness - is inadequate and requires further evaluation,”
Bica wrote in a blog post. “On the positive side, it enhances our understanding
of the war experience and its devastating effects, expands our area of concern
beyond trauma and PTSD, and allows us to more adequately meet the needs of our
returning servicemen and –women.”
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