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Essay

Moral Injury

By November 18, 2013 No Comments
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A week ago was Veterans Day, an occasion to honor and thank those who’ve served in our armed forces. Along with showing our gratitude, however, our nation ought to give increasing attention to the physical and mental health needs of our veterans and active duty service members. In particular, the rise in military suicides warrants more urgent attention. Today I’d like to consider a story, some statistics, and one initiative hoping to help. 

A recent story of a military suicide was published last week on Veterans Day by Howard and Jean Somers, whose 30-year old son Daniel took his life this past June. You can read their story here: On Losing a Veteran Son to a Broken System. Daniel’s final letter is reprinted as well.

Daniel’s story puts a name and a face to a concerning set of statistics about the number of veterans and service members who are ending their own lives. In a May 2013 article, “Baffling Rise in Suicides Plagues the U.S. Military,” James Dao and Andrew Lehren describe the growing issue: 

“Of the crises facing American troops today, suicide ranks among the most emotionally wrenching — and baffling. Over the course of nearly 12 years and two wars, suicide among active-duty troops has risen steadily, hitting a record of 350 in 2012. That total was twice as many as a decade before and surpassed not only the number of American troops killed in Afghanistan but also the number who died in transportation accidents last year.

Even with the withdrawal from Iraq and the pullback in Afghanistan, the rate of suicide within the military has continued to rise significantly faster than within the general population, where it is also rising. In 2002, the military’s suicide rate was 10.3 per 100,000 troops, well below the comparable civilian rate. But today the rates are nearly the same, above 18 per 100,000 people.

…Yet deployment and combat by themselves cannot explain the spiking suicide rates, researchers say. Pentagon data show that in recent years about half of service members who committed suicide never deployed to Iraq or Afghanistan. And more than 80 percent had never been in combat.

What is known is that since 2001, more than 2,700 service members have killed themselves, and that figure does not include National Guard and reserve troops who were not on active duty when they committed suicide. Suicide among veterans has also risen somewhat since 2001, to an estimated 22 a day, according to the Department of Veterans Affairs.

 

22 per day. So it’s statistically likely that, in the past week since Veterans Day, 154 veterans have succumbed to suicide. As Daniel Somers points out in his suicide note, 22 is more than the number of children killed in one day at Sandy Hook, yet 22 veterans take their lives every day.

Veterans Day one year ago marked the official opening of the Soul Repair Center, a new initiative housed at Brite Divinity School in Texas and co-directed by Rita Brock and Herman Keizer (Keizer is the former director of CRC chaplains, by the way). The Soul Repair Center aims to address military suicides along with many other related afflictions that impact veterans, service members, and their families. You can read more about the Soul Repair Center here. 

The Soul Repair Center and its collaborators are exploring the concept of “moral injury,” which is gaining traction in psychological and pastoral research and practice. In “Moral Injury: The Crucial Missing Piece in Understanding Soldier Suicides,” Rita Brock and her colleagues define moral injury and explain how it is distinct from PTSD:

“The most serious blind spot in the reporting on military suicides is an absence of discussions about the moral impact of military training and its implementation in combat. Soldiers are trained to kill, which is regarded as criminal behavior in civilian life, and they are trained to be lethal without even thinking about it, a method of training called reflexive fire training. 

We suggest that moral injury is likely one of the most important factors in military suicide rates.

Moral injury is not PTSD. The latter is a dysfunction of brain areas that suppress fear and integrate feeling with coherent memory; symptoms include flashbacks, nightmares, dissociative episodes and hyper-vigilance. PTSD is an immediate injury of trauma.

Moral injury has a slow burn quality that often takes time to sink in. To be morally injured requires a healthy brain that can experience empathy, create a coherent memory narrative, understand moral reasoning and evaluate behavior. Moral injury is a negative self-judgment based on having transgressed core moral beliefs and values or on feeling betrayed by authorities. It is reflected in the destruction of a moral identity and loss of meaning. Its symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live.”

You can read more about what moral injury is on the Soul Repair site. For now, I’ll just commend these resources to you, and ask: What do you think? Do you have experience with this? What will it take to stem the tide of suicides and heal the complex wounds of war?

 

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