After Moral Injury: Backing Through a Side Door into Consciousness
It should make you shake and sweat,
nightmare you, strand you in a desert
of irrevocable desolation, the consequences
seared into the vein, no matter what adrenaline
feeds the muscle its courage, no matter
what god shines down on you, no matter
what crackling pain and anger
you carry in your fists, my friend,
it should break your heart to kill
– Brian Turner in Here, Bullet
Soldier, Operation Iraqi Freedom
No matter how necessary, war is never just and always a choice. Memorial Day then is an opportunity to take stock of what war is, and what it is we are really asking: War is organized killing and when we choose war, we are sending moral Americans into impossibly difficult situations.
Too often, their traumas last a lifetime.
• • •
I came home from Vietnam shorn of all that I previously believed in,
my old values system destroyed forever
– Stefan Malecek in The Moral Inversion of War
Social Work/Clinical Psychology Specialist, Vietnam
Fifteen years ago, I went to war. One year later, I came home with a hard-earned lesson: Within each of us is a beautiful contradiction. We are immensely brittle, and yet, boundlessly resilient.
This knowledge is not new, only recently uncovered by wise people.
Charles Darwin, in The Descent of Man, said that of “all the differences between man and every other animal, our moral sense or conscience is by far the most important.” Michael Tomasello, an anthropologist and behavioral scientist believes that “our morality defines us as a species.” The Harvard experimental psychologist, Steven Pinker, is convinced that our “moral goodness gives each of us the sense that we are worthy human beings; that morality is close to our conception of the meaning of life.”
Then there is Gita Sereny, a British biographer, historian, and investigative journalist who spent decades studying the nature of evil. Her search revealed that “When morality is extinguished, there is no human being,” an insight with implications for nearly everyone. For, over the course of a lifetime, our morality becomes inseparable from our identity. Our identity, however, is a set of normative thoughts about the self. An overwhelming experience, therefore, can separate that self from those views. When this happens, we are shorn of that which gives life meaning. Overwhelming experience may even leave us with a self we detest, which we can no longer live with.
I am left with basically nothing.
Too trapped in a war to be at peace,
too damaged to be at war.
How can I possibly go around like everyone else?
There are some things that a person simply cannot come back from.
– Daniel Somers’ last words to his wife.
Soldier, Operation Iraqi Freedom
Like a bullet which strikes the heart, overwhelming experiences can remove “rightness” and “wrongness” from a person. The wound is a moral injury. Dr. William Nash, the director of the U.S. Marine Corps mental health programs, describes the injury differently. Certain beliefs, he explains, act as the “glue” that holds together the core self, and that the violent contradiction of these beliefs by one or more overwhelming life event can negatively impact a person’s emotional, psychological, and spiritual well-being.
In contrast to post-traumatic stress disorder (PTSD), which requires that a person have an experience of overwhelming fear for a diagnosis, moral injury is not officially recognized nor do those afflicted receive broad understanding or treatment. David Wood, the Pulitzer prize winning journalist, claims, however, “that it is moral injury, not PTSD, that is increasingly acknowledged as the signature wound of this generation of veterans: a bruise on the soul, akin to grief or sorrow, with lasting impact on the individuals and on their families.”
Though moral injury can happen to anyone, in any environment, it is intrinsic to all war, and most apparent in good people who are given the responsibility and power to kill for their country.
• • •
The author before accompanying Iraqis on a mission to capture suspected insurgents (Photo taken by Iraqi soldiers, given to author, and reviewed and approved for public release by the Department of Defense).
In 2005, Mosul, Iraq was in the convulsions of anarchy. I was a young and idealistic Special Forces captain living on a small Iraqi base in the center of the city. I worked inside of a basement Iraqi prison advising a hardened Iraqi intelligence officer who had been interrogating terrorists, traitors, and criminals for over 30 years. My responsibility was to assist his interrogations and to try to ensure no torture took place. I wanted to make a difference, so I immersed in the experience.
From within a makeshift basement prison, over countless midnight and predawn hours, life quickly became a never-ending cycle — helping him find, capture, and then interrogate suspected terrorists, so he could find, capture, and then interrogate more.
Iraqis returning with captured insurgents (Photo taken by Iraqi soldiers, given to author, and reviewed and approved for public release by the Department of Defense).
The daily routine was to help him fight the insurgency, one prisoner — one interrogation — at a time, and to then deter his predilection for inflicting suffering. But I couldn’t give orders, so I used the only tool at my disposal: persuasion. And when abuse did happen, I would document the outward sign.
As the weeks turned into months — as the dozens of interrogations became hundreds — reality became condensed and came at me in a thick and steady pour. Power over life? It is real, and forever, and the emotions quickly became painful, and then unbearable.
Iraqi interrogator questioning a prisoner (Photo taken by Iraqi soldiers, given to author, and reviewed and approved for public release by the Department of Defense).
Some prisoners provided information that later saved lives: One little boy we found was chained to a wall inside of a hidden room. He was being used as a sex slave. Some prisoners would describe their inhumanity — the shootings, bombings, kidnappings, rapings, and executions — in perfect antiseptic detail. Once, we pitted a father, his son, and brother against each other: The son shouted “No! It was not me but him who had sex with her,” as he pointed to his uncle. “He had sex with her and then killed her with two rounds in the head.” “Yes,” responded the father, “but you had sex with her also, and you threw her into the river!”
Some prisoners, however, stayed silent, and so, without a confession, we released them back onto the streets. Some went on to kill innocent Iraqi men, women, and children, and American servicemembers: Master Sergeant Anthony Yost was killed entering a house booby-trapped by a prisoner I convinced the Iraqis to release.
Innocent prisoner who confessed to things he did not do (Photo taken by Iraqi soldiers, given to author, and reviewed and approved for public release by the Department of Defense).
Many prisoners, however, were completely innocent, and were released only when the interrogators were convinced they were free of guilt or sin, or that they did not have any useful information. The man pictured above confessed to things he never did. “Why did you lie?” asked the Iraqi interrogator. His reply: “Sir, you destroyed me! Your slaps were so strong that I thought if this was your slap, what happens when you use a cable!”
After one year, I left that basement prison and began a journey to a dream: a return to moral tranquility. When I came home there were no visible wounds, but something was different inside. I did not want to feel anymore. However, some memories never fade away, and when left alone, they came alive to seep and reach through time with searching and grasping claws. Ignored, they consumed me. So how did I make things right? I wrote.
When I came home, I began writing through the long nights and early mornings, and each time I would confront my enemy — each and every painful memory. The enemy and I would sit in the same room together and just glare from a distance. But over time something changed. One day I found I could look him in the eye. Then over time I discovered I could move my chair closer, millimeters at a time. Soon I was close enough to feel each breath on my cheek. That’s when the screaming began, but over time the hate become loathing, then revulsion turned to disgust. Suddenly we’re conversing, never friends, just enemies who were talking, suffering a different perspective. And when I thought I understood, I’d change my viewpoint. I’d stand up, move myself to another angle and start the process all over again. Over time self-disgust transformed into just a problem, and that’s when the nuances became debatable.
Then I’d start everything all over again, but with a new memory.
Over and over again, for three fucking years I did this, and after those countless therapy sessions I had with myself, painful memories transformed into understanding. By rethinking every thought, every word, every choice, I was able to make the sense of my experiences that I required so I could put my memories where they belonged, in my past. My narrative? That, sometimes, good people are confronted with horrible choices, and we call it “hard decision-making” for a reason. That, in the face of evil, it may be a sin to remain sinless. That I am a good person who made the best of an impossible situation.
It took a long time, but eventually I inched away from the abyss. I crested the rim and noticed just a sliver of light in the distance. I paused, took a deep breath, and then backed through a side door into consciousness.
• • •
Pride and shame flash on the screen of my mind
during the day and night…the fear at the bottom
of all of this is that I am not good.
We come into this world endowed with a stunning ability and intense affinity. We are able to imagine the conscious events that comprise another person’s life, and then we can step into that experience. When we do this, we can mirror what we perceive to be in them: We can feel a person’s emotions, viscerally. And our affinity? When we perceive harm, there is a deep inner drive to respond. We are born wanting to alleviate adversity.
We refer to this ability and propensity as “empathy” and “compassion.” They are with us on our birthday, and then we nurture or atrophy them over the course of a lifetime. For some of us, however, the words “empathy” and “compassion” come with baggage. We use them with abandon. They have become feely and touchy, and may imply weakness. Therefore, some hide their strengths: “I try to hide it. I try not to think about it…because I’ve got to stay 100 percent. I’ve got to keep a good example in front of the other soldiers. I’m sorry,” cries Sergeant Louis Loftus, an 82nd Airborne soldier who is heartbroken for a dead comrade.
Regardless of how we choose to understand them, empathy and compassion are the wellspring of our morality. They are, actually, the basis for our morality in general. They are how we can perceive harm and why we want to lessen it. They are innate but they are also capable of development into actuality. They are how we make moral judgments, and how we maintain them over a lifetime. They are how we sense, and then act, on “rightness” and “wrongness.”
Iraqi Prisoner who confessed to 10 executions (Photo taken by Iraqi soldiers, given to author, and reviewed and approved for public release by the DoD).
I don’t remember his real name. When the Iraqi army captured him, they suspected him of being a terrorist. But there was no evidence, and he stayed silent. I asked the Iraqi interrogator to not hurt him, and likely since it was early in my deployment, my reasoning prevailed. The reason for coaxing’s success: Early on, the interrogators were more inclined to listen to appeals for leniency, for not torturing. But over time, they became frustrated with what they saw as my very American hypocrisy, how we would abide by every rule to protect each killer inside of their prison, but on the streets we would minimize, circumvent, and sometimes even forget every possible rule, disregard every consequence, make every conceivable effort just so we could kill him.
I cannot know for certain, but it is likely, then, that my arguments resulted in the prisoner not confessing to wrongdoing. So, a few days later, he was released. A few months later, the Iraqi Army captured him again, and returned him to the prison where I worked. I came to learn that after we first released him, he had enthusiastically returned to his predisposition. He spoke about the 10 executions he went on to commit, and I watched the videos tapes that were found with him. “Cutting off the heads or killing them by a bullet to the back of the head,” were the words he used. He did not know their names. All he knew was that he was paid 50 dollars for each of his victims. Logic is emotionless, and I felt responsible.
For years afterwards, there were never-ending terrors during both sleep and wakefulness. I would just stand there, holding a knife, then I would start sawing, and my victim’s legs would begin twitching and then kicking. And those weren’t the first nor last deaths that seemed to condemn me to moral failure.
Even today, I ask: Did my empathy and compassion guide me rightly? I felt in visceral detail the emotions that came off prisoners: their fear, confusion, and terror. Their hatred, comradery, rage, and their love for a child. Their pain, hardship, and suffering. My empathy and compassion guided my judgments and choices, so I pled, vociferously, against inflicting adversity. Later on — after hundreds of prisoners and interrogations — my attention turned elsewhere: to the future harm that I could prevent by acting in the moment. I began to hear everything, even the now-silent prayers of their future victims. I could see everything, every drop of moisture that slid down the cinderblock walls. I could hear perfectly, every breath, every heartbeat of the innocent men, women, and children. I learned that I had a shadow.
As I look back on this, and other similar moments, there were moral reasons to do one of several things, but choosing more than one was an impossibility. Ethicists refer to these as moral dilemmas: facing situations that seem to condemn you to violate your core values and ideals. The term “moral dilemma,” however, is devoid of intense feeling. How, sometimes, compassion seems futile. How, sometimes, acting compassionately is counterproductive to our good intentions, which can be soul-crushing.
Sometimes, it is not possible to avoid a minefield of mutually exclusive moral mandates. Sometimes, every step — every choice — feels like dying a little death. Sometimes, war creates a living purgatory.
Moral dilemmas, however, are an intrinsic part of the human condition. For most of us, an existential crisis happens by chance, and when it is over, we quickly return to blissful moral clarity. There are some people, however, who consciously choose to risk, continuously, the integrity of their identity. These people make the conscious choice to immerse into the crucible of human existence, for it is there that empathy and compassion can do the most good for the most people.
They work in emergency rooms. They hold hands with the terminally ill and assist in end-of-life decisions. They deliver food, medicine and health-care to the poorest and most vulnerable in the most violent of environments. They are first responders, to fires and car crashes, to natural disasters and man-made atrocities. They comfort neglected and abused children. They are chaplains who share in immense grief and suffering. They serve in the profession-of-arms.
These people, and all the others I have failed to mention, choose to leave the comforts and safety of home to help those who are less fortunate. They choose to embrace the inevitable anguish of existence, and when they return home, they sometimes carry within them the burden of immense betrayals: how experiences seem to prove their values and ideals absurd. How the world is not benevolent. How the world is not meaningful. How the self is not worthy.
• • •
It’s been hard over the years coming to terms with what actually happened over there. I don’t know if I’ll ever have closure.
– Jonathan Millantz in None of Us Were Like This Before
Soldier, Operation Iraqi Freedom
Maurice Russell was a World War II veteran and my grandfather. He piloted amphibious landing crafts in the pacific islands. My grandmother and my mother tell me that when my grandfather came home, he was a different person. He never once spoke about those experiences. Forty years after the war, when my grandfather was dying, and in the delirium of morphine, I sat next to him and held his hand. He was crying and mumbling, and I was confused. I struggled to understand his murmuring: He spoke and trembled softly about the thousands of boys. I came to see that he believed he had delivered those kids to those beaches to die horribly. My grandfather received the Silver Star for heroism.
That memory of my grandfather’s last moments is as clear as if it happened yesterday, and with the prescience of experience I can still feel, with each tear and mumble, his guilt, self-loathing, and shame, slowly emerge into cleansing light. During his last moments, he began asking for forgiveness. I know now that over his last 40 years my grandfather had been living in purgatory. After he passed away, I did not understand why he had never sought absolution. Now, the touchstone of like experience provides me with a little wisdom: It was not his guilt. It was shame that denied my grandfather redemption. Shame was the cause of his never-ending suffering.
Dr. James Schultz, a Jungian analyst, believes that “guilt is about what we do; it motivates confession, it may deserve punishment, and it is relieved by restitution, compassion, and forgiveness.” My grandfather’s shame, however, was something entirely different, and immensely deeper. It was about who he was as a person; he needed to hide it for no one could understand. His shame deserved dismemberment, and there was no restitution. Shame can cause you to want to sink into the floor and disappear. Shame becomes a whole-body experience, and is utterly exhausting.
Empathic distress, and the seeming futility of compassion, can create an echo chamber of grief, right here, right between your ears, and how, sometimes, one just needs to lay down and rest.
In 2011, five years after coming home from Iraq, I became this desperate. I started to imagine doing something really, really stupid, like jumping off a cliff or driving the car off the side of the road … there I am, hands on the wheel, and I see a tight corner approaching. My speed stays constant and my hands stay locked on the 10 and 2. I close my eyes and I imagine myself floating. I am smiling. There is no fear, and I feel a release.
Fortunately, I found a way to coexist with my mortal enemy. I learned how to live in my own skin. Tragically, too many servicemembers never get the opportunity.
• • •
War changes you. Changes you.
Strips you, strips you of all your beliefs,
your religion, takes your dignity away,
you become an animal
– Anonymous Vietnam Veteran in Achilles in Vietnam
As a young U.S. soldier, Noah Pierce, among many things, accidentally crushed an Iraqi child under his vehicle. Written on the back of his first letter home were the words “War is horrible…Hopefully, I will be able to forget most of it someday, but I doubt it.”
Noah Pierce (drawing downloaded from the Fallon Heroes Project and used with permission).
Noah’s mother said that her son “couldn’t forgive himself for some of the things he did” and that the kind of wound Noah had “kills you from the inside out.” Noah’s journal from Iraq ended with these final words: “I am a bad person.” In 2007, Noah took his own life: For some, the burdens become too heavy to bear for even one more day.
This pain, however, is not a weakness; it is a strength that is an essential part of being human (watch Resurface). Unfortunately, we have learned and then forgotten this, repeatedly, over the course of human history. You can, however, pick up and read 5,600 years of ancient observation. Read the myths, the stories, and the real-life narratives that document this wisdom for posterity: how our ability to empathize, and how our need to act compassionately, affect the human psyche.
2,500 years ago, in the classic tale of “Ajax,” Sophocles composed theatre about this wisdom. Tecmessa, the wife of Ajax, appeals to her husband’s comrades to intervene in his psychological downward spiral. She implores “…our fierce hero sits…in his tent, glazed over, gazing into oblivion. He has the thousand-yard stare.” Tecmessa failed, for Ajax takes his own life.
As the classicist Robert Emmet Meagher and Doug Pryer write in the Introduction to the anthology War and Moral Injury: If you are Christian, you’ve likely read about it, and just didn’t realize it. “It is the ‘mark of Cain’ borne by the first fratricide, when he was banished in shame.”
We can also see it in the penances imposed on Christian warriors in the Middle Ages, and we read about it in the Navajo creation story: The Holy People talked it over and decided that the Two Brothers, who got thinner and sicker, had gone to where earth people should not go. Therefore, after four prayers in four directions, they gave the brothers a personal blessing. The Two Brothers were healed.
The Greeks told us about this “miasma,” which is like moral pollution, and like the prayers and ceremony for the Two Brothers, Greek priestesses purged their returning citizens. And similar to the Navajo, the Greeks held a social ritual of cleansing, a process they called “katharsis.”
Sometimes, however, katharsis feels undeserving. This may be what happened, say Meagher and Pryer, when “so many RAF bomber crews [refused] to take Communion before their life-taking missions over Germany and occupied Europe, despite the odds against their safe return.”
In our present day, the daily barrage of human suffering that is at our fingertips may serve to amplify these ancient observations, and help to create some new understandings.
Our emotions and thoughts entwine, and similar to the impact of a massive explosion, feelings, emotions, and thoughts have the kinetic power to change the structure and function of the brain, in both positive and harmful ways. This is such a truism that we fail to grasp the implications of two simple words: We learn.
Learning may lead to self-actualization. Or it may result in a loss of normal functioning. When we consider the impacts of an overwhelming moral experience, the symptoms and outcomes may become social withdrawal and alienation. There may be anger, anxiety, and depression. We may feel a loss of trust in morality, loss of meaning, loss of religious faith, and fatalism.
• • •
Shame is a soul-eating emotion.
Shame is one of the scars of trauma.
In September of 2011, 6 years after coming home from Iraq, all of the feelings, emotions, and thoughts I had locked behind doors came back instantly: I would slip out of my present so easily and so often that I was shocked by a sound or touch. I would move from a basement prison cell to then find myself floating in the present, then sinking, with nothing to grab onto. The echoes were so real, and even now I hear the screams and I want to slide into dark corners. Even now, when I look down to the center of my chest, I search for the crack that must be there, somewhere.
My downward spiraling, however, was not from an experience of an overwhelming life threat. There were times when I was scared, when I feared about possibly, or even almost, dying, but my fears did not result in self-deprecating moral emotions and cognitions. Fear did not cause me to feel damaged. Fear was not the cause of my self-loathing. My fear of almost not living did not result in the shame of living.
Fortunately, I found hope in an unlikely place: the Tibetan adept, the 10,000-plus hour meditator. This is just a few of the unique individuals who can submerge and then emerge from crucibles with their identities unscathed.
There is so much we can learn from people who have the ability to feel at will. So, how does the adept accomplish the seemingly impossible?
Research shows it is not that they are experiencing numb serenity. They can and do feel acutely the deep press of another person’s suffering, but then they release that suffering more quickly. The psychological impacts of empathizing, and then acting compassionately with seeming futility, therefore, are much briefer than what happens to normal people. In other words, they have developed resilience, the ability to return to equilibrium with rapidity.
It is unrealistic, however, for most of us to accomplish this degree of mastery, so what we can do is understand the principals. First, we can appreciate what is not happening: Moral anguish is only felt by a moral person, but removing morality must not become the solution to prevent this injury. The goal then, is to feel suffering intensely, to let feelings, emotions, and thoughts drive us to act compassionately … and then to exhale.
When I sat with a prisoner, or when you’re comforting a neglected child, or when you’re giving food to those who are starving, or when sitting with a person suffering from intractable pain, or when you decide who receives the medicine or life-saving care, or when you make the perhaps necessary, but never just, choice to kill, feel the resonance. It is then possible to consciously activate a realization: It is another person who is suffering, and if I were to succumb, continuing to act morally becomes increasingly challenging. Trust me, eventually the accumulation of overwhelming emotion can move the needle on our moral compass.
So, the solution is exercise, which is always accomplished retroactively, but for those who cannot or do not practice, the spaces between feeling, emotion, thought, and acting rightly — and then releasing — can become a bottomless chasm. For too many, this unburdening may never happen. The key then, for me, was to learn that emotions were not happening to me. They were not objects coming from the outside. My never-ending pain was, actually, merely me guessing about what my body was feeling. I was, unconsciously but continuously, constructing my self-loathing and shame. Eventually, I learned that I had the power to guess differently.
For those who experience a shattered identity, however, it may feel, at first, like gratuitous cruelty — like judgment — to be told: “you’re drowning in the water that you’re pouring.” In time, however, and with persistence, understanding becomes liberating. To go from sinking, to treading, to swimming, however, we may need some compassionate nudging: how small changes, in the words we use or the way we think, can have an immense impact on our wellbeing.
At first, I struggled with the memories and emotions that came from that basement prison, those interrogations, and the consequences of my choices and actions, and I tried, desperately, to look away, or to even hide. My pain, however, was a paradox, and ignoring it seemed to only to make the pain worse. What I needed, then, was to learn how to embrace every moment, for my “bad” feelings are useful, and these feelings could become immensely beneficial.
• • •
If you want the truth to stand clear before you,
never be for or against. The struggle between for and against
in the mind’s worst disease
Almost 10 years ago, I began to practice this contradiction, and over a long time, I came to see that I am what I seek. This, however, was not in any way perceptiveness. Practicing self-empathy was pure reflex, and it was both traumatic and therapeutic.
When I came home from Iraq, I blocked everything out but what I needed was to open suffering’s cage. Therefore, I began to write, instinctively, and then to write, and then to write some more and this writing forced me to practice a powerful axiom: What I can hold, I can process. What I can process, I can transform. And what I can transform no longer haunts me.
Over time, the hurt began to change, and slowly this process became kathartic, which I learned could be something we practice before, during, and after an existential crisis.
If overwhelming experience can shatter one’s core moral-self, doesn’t it make perfect sense that moral-repair requires an act of creation? And there are so many different ways to do this, to exercise the mind. Of course, one can write: The process of turning emotion and thought into word, words into sentences, and sentences into meaning is meditative in principal. One can also volunteer: Using the lessons from an impossibly bad situation to later bring about goodness is both contemplative and therapeutic. Or one can create art or music. There are so many different ways to reconstruct a shattered identity — to exercise the mind — but healing can only begin when we embrace two things: admitting to ourselves that we are injured, and then taking charge of our own healing.
This is where all of us can help, and our role is quite simple: Work to create a safe place, physically, spiritually, emotionally, and psychologically. Then just listen without judgment. If they are ready, the morally injured may begin to tell their story in their own unique healing voice. Realize, however, that there is a weight to all moral choices, and by merely attending we can share in their burden. When we do this it is possible to witness a miracle: A person may learn to forgive, to offer absolution to the world, to another person, or to the self. When forgiveness becomes possible, living can suddenly become more bearable.
As Archbishop Desmund Tutu explains: Forgiveness is an absolute necessity for continued human existence.
Bill Edmonds is a father, husband, and Special Forces officer. He is the author of God Is Not Here and A Soldier’s Story, and a contributor to War and Moral Injury. Contact him at firstname.lastname@example.org. The views and opinions expressed are those of the author and do not necessarily reflect the official policy or position of the U.S. Army, the Department of Defense, or any agency of the U.S. government.
Image: U.S. Marine Corps photo by Sgt. Robert A. Sturkie