Veterans and the Moral Injury of War

[Posted by M. Bogen, 2-12-13] A reader recently contacted me to see if we were familiar with the work of Dr. Jonathan Shay, who lives and works, as we do, in the Boston area. I confessed that I, at least, was not, but soon investigated and found that Dr. Shay is not only an expert on post-traumatic stress disorder (PTSD), but is also at the forefront of helping us understand the "moral injury" that afflicts many of those who have experienced war as soldiers. In the introduction to an illuminating NPR "Talk of the Nation" episode on this topic, which featured Dr. Shay, we learn: "'Moral injury' is a term used in the mental health community to describe the psychological damage service members face when their actions in battle contradict their moral beliefs." Moral injury is a category distinct from PTSD.

Looking further into the topic I came across a well-researched article by Nan Levinson, also of the Boston area, called "Moral Injury and American War." I'll quote her intro at length to give you a sense of what's at stake:

The veterans at the heart of this story—victims, heroes, it doesn’t matter—struggle to reconcile what they did in those countries with the "service" we keep thanking them for. We can see them as sick, with all the stigma, neediness, and expense that entails, or we can recognize them as human beings, confronting the morality of what they've done in our name and what they’ve seen and come to know—even as they try to move on.

Levinson and others want us to understand that the victim-hero dichotomy and its corresponding sympathy-gratitude response pattern tempts us to avoid a "full reckoning" of the true costs of war, the complicity we all share in the pain veterans endure, and our shared responsibility in the healing that must occur.

Also appearing on the "Talk of the Nation" show was Tyler Boudreau, a veteran and author of Packing Inferno: The Unmaking of a Marine (Feral House, 2008). His take is that

it's very easy for the American public to say, hey, yeah, let's take care of those veterans. Let's get them to doctors. Now, with moral injury ... it's not necessarily a medical issue anymore. Now it's a social issue. Now when a veteran says, hey, I have something that's challenging my moral code, that means it's challenging society's moral code.

Our modes of warfare, like the very definitions of war itself, increase in ambiguity with each passing year. This increasing ambiguity calls for us to increase our compassion for veterans in equal or greater proportion, and, further, to redouble our efforts to minimize war-making and it's inevitable, tragic consequences. By better understanding moral injury we better understand a crucial dimension of Daisaku Ikeda's contention that nothing is as cruel and barbarous as war.

Also participating in the "Talk of the Nation" discussion was Rita Nakashima Brock, who explores these themes in her book Soul Repair: Recovering from Moral Injury After War (Beacon Press, 2012), co-authored with Gabriella Lettini.

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