War Veterans and Moral Injury
Image via WikipediaThe number of our military personnel returning from Iraq and Afghanistan who are suffering fromPost-Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury is larger than what the resources provided to the military medical departments or Veterans Affairs Treatment and Hospital Centers can accommodate. By 2008, the number of military personnel who served in the wars in Iraq and Afghanistan in treatment for PTSD was 67,717. The number of those not seeking or not accepted for treatment in military or VA facilities is thought to be many times higher. Most of the troops serving in these wars are from the Reserves or National Guard. These personnel do not return to military bases but return to communities, like yours, in the civilian sector, where there are few with a knowledge of what they have experienced, nor are there enough facilities to treat them. The incidence of PTSD is compounded by a high suicide rate in the military, which is now about twice the national average. These figures alone should cause the church to pause and seek ways to help the returning service men and women.
There is a specific opportunity for the church in one important area: moral injury. In December 2009, Veteran’s Administration (VA) mental health professionals described, for the first time, a wound of war they call “moral injury.” They define it as the extreme distress brought about by perpetrating, failing to prevent or bearing witness to acts that transgress deeply held moral beliefs and expectations. They suggest that it contributes significantly to clinical depression, addiction, violent behavior and suicide, and that it may sometimes precipitate or intensify PTSD.
Moral injury is different from PTSD. Post Traumatic Stress is a fear-victim reaction to danger and has identifiable trauma symptoms such as flashbacks, nightmares, hyper-vigilance and dissociation. Moral injury is an inner conflict based on a moral evaluation of having inflicted har
Image via Wikipediam, a judgment grounded in a sense of personal agency. It results from a capacity for both empathy and self-reflection. Judgments pertain not only to active behavior, such as killing, but also to passive behavior, such as failing to prevent harm or witnessing a close friend being slain. Moral injury can also involve feeling betrayed by persons in authority. Even when an action may have saved someone’s life or felt right at the time, a veteran may come to feel remorse or guilt for having had to inflict harm that violates his or her inner values. Just having to view and handle human remains can sometimes cause moral injury.
Moral injury is a complex wound of the soul. VA studies suggest moral injury originates in an inner sense of agency by which soldiers make choices in life-threatening situations. They then measure those choices against their core personal values as having failed those values. These feelings are indicative of the profound crisis that moral injury presents, and processing them requires spiritual guidance and theological and ethical reflection. Healing requires access to a caring, non-judgmental moral authority and welcoming communities that can receive the testimony of veterans, provide means for making restitution, offer forgiveness and sustain their long-term community service and ties.
The call to the churches is to be sensitive to military persons and their families. In our worship we should take very serious our moments of confession and hearing the Word of God that speaks forgiveness. The coming of Christ, the King of Peace, may sound very strange to a believing young person who tried to love his enemy in a war that is very morally ambiguous. It should be a challenge to every person who plans worship and proclaims the joy of Christmas, that for some returning from the war, they only want the idealized memories of their pre-war experience: family get-togethers; mistletoe; chestnuts on an open fire; turkey with trimmings; decorated homes and trees; and memories of past joys. But what they really need is the ability to know that there is a God and a community ready to listen to their pain that only can be groaned or dreamed of nightmarishly. For most soldiers who carry the moral wounds of war, absolution is an intensely private matter, because we have devalued public confession and pronouncement of forgiveness.
I ask your sensitivity to those coming home for Christmas from the horror of Iraq. Love them with non-judgmental warmth and positive regard for them as image-bearers of God. Allow them to realize you are willing to wait with empathy for them until such a time as they will allow you into their struggle for forgiveness and absolution. Give them time to again find joy in their hearts.
Image via WikipediaHerman Keizer, Jr. is the retired director of chaplaincy ministries for the Christian Reformed Church in North America and chair of the National Conference on Ministry to the Armed Forces, the largest chaplaincy organization in the United States. A longer version of this piece originally appeared on the Calvin Institute of Christian Worship website.
