Tag Archives: War

Moral Injury: What Leaders Don’t Mention When They Talk of War

By Lt. Col. Douglas A. Pryer

I received a Combat Action Badge because, for a short time in Iraq, I seemed to be a magnet for enemy fire. Years later, explosions still cause me minor discomfort. The sounds of fireworks, gunfire and engines backfiring are unsettling. But was I traumatized by enemy fire? No, I was not.

What caused me to suffer some symptoms associated with post-traumatic stress disorder (PTSD) does not actually meet the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders for this condition. My most significant combat experiences are sewn together with a thread other than extreme, life-threatening violence. This thread is moral dissonance. It is clear to me today that I and others sometimes failed to make wise choices. To our shame, we should have known better.

A growing number of mental health experts argue for the existence of a condition that may explain my symptoms better than PTSD. In a 2009 article in the Journal of Traumatic Stress, a team of experts defined moral injury as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.”

PTSD, they contended, is physical in origin, while moral injury is a “dimensional” problem. Physically stressful experiences may cause PTSD, but nonthreatening events may still serve as a source of moral trauma. Some traumatic events serve as a source of both PTSD and moral injury. The two conditions share some symptoms, but others are unique to moral injury, such as shame, guilt, demoralization, and the potential for self-harm. Those who suffer from PTSD can be helped by such physiological remedies as drugs and rapid eye movement treatment, but the morally injured require counseling.

Moral injury is not unique to warriors, the experts contend. Those who fight wars simply tend to feel it more deeply. In the strange world that warriors enter, they may assume an identity—a posture toward large groups of fellow human beings—that seems just as alien and remote to them as the land and war in which they fight. This alien identity may or may not be something they can easily live with.

Moral injury is real, and any nation that desires to truly honor its warriors must place perceptions of “what is right” at the forefront of its deliberations on when and how to wage war.

Moral Injury Isn’t New

The psychiatrist Jonathan Shay popularized the term moral injury in his 1994 book, Achilles in Vietnam: Combat Trauma and the Undoing of Character. At the heart of Homer’s The Iliad, Shay says, is a story of sullied honor. Agamemnon, the Greek army’s commander, “betrays ‘what’s right’ by wrongfully seizing Achilles’ prize of honor,” the captured princess Briseis. Achilles is outraged, withdraws from the Greek army and the war, and “cares about no one but a small group of combat-proven comrades.” When the Trojan hero Hector kills Patroclus, Achilles “is tortured by guilt and the conviction that he should have died rather than his friend,” and “he goes berserk and commits atrocities against the living and the dead.”

“Moral injury,” Shay writes, “is an essential part of any combat trauma that leads to lifelong psychological injury. Veterans can usually recover from horror, fear, and grief once they return to civilian life, so long as ‘what’s right’ has not also been violated.”

The classics are rife with examples of warriors suffering grievously from moral distress. Ajax, driven temporarily mad by a perceived insult, slays a herd of sacred animals. When he recovers, he “is doubly humiliated, religiously defiled, and kills himself by falling on his sword.” Many of Shakespeare’s warriors—driven by guilt—kill themselves, including Othello, Cassius and Brutus.

Literature’s most famous sufferer of moral injury may be Kurtz in Joseph Conrad’s 1899 novel, Heart of Darkness. Initially an idealistic imperialist, Kurtz witnesses and perpetrates atrocities. His soul becomes as afflicted as his body, which succumbs to jungle fever. As he dies, he seizes Marlow, the book’s narrator, and cries out madly at Marlow and life: “The horror! The horror!”

In our era, many mental health studies have concluded that warriors’ moral distress can cause enduring problems. Studies of Vietnam veterans linked guilt to PTSD, depression, violent actions and such self-handicapping behaviors as drinking and suicide. Similarly, a study of Gulf War veterans found guilt over killing others is a significant predictor of PTSD symptoms and alcohol abuse.

Such studies are supported by a staggering amount of anecdotal evidence. Some stories have gained much media attention. There is, for example, the sad tale of Alyssa Peterson, a young intelligence analyst who committed suicide in 2003 after being reprimanded for refusing to participate in “torture-lite” interrogations. Peterson’s case points to an important truth about moral injury: Unlike PTSD and traumatic brain injury, it is sometimes preventable. If Peterson had not felt tortured by what she had been ordered to do, she might not have felt so distressed as to take her own life.

Moral injury results in mental torture to the troops, whose care is entrusted to American leaders. It leads servicemembers to try to drown their sorrows in alcohol or drugs, to be involuntarily separated from the service due to disciplinary action, or to voluntarily leave the service—or the world, by killing themselves. It greatly burdens the U.S. military and civilian health-care systems. It hurts the ability of veterans to positively contribute to society. It distresses and may lead to the physical harm of those who interact with afflicted soldiers.

Operation / Excerice NameCredit: U.S. Army/Sgt. Jonathan W. Thomas

Links to Suicide

Of the adverse effects of moral injury, the role that moral injury may play in the U.S. military’s high suicide rate has attracted the most attention. Prior to the wars in Afghanistan and Iraq, the active duty suicide rate of each service remained steady at about 10 suicides per 100,000 servicemembers. Since 2003, this rate has doubled for the Navy and Air Force, making it comparable to the rate among U.S. civilians of like age and gender, but this rate has more than doubled among marines and tripled among soldiers.

Not all veterans of our recent conflicts suffer from moral injury, but the potential for it is great. The military’s 2006 and 2007 mental health surveys of marines and soldiers in Iraq and Afghanistan found that 10 percent believed they had mistreated noncombatants or damaged property “when not necessary.” This percentage did not include those who may have been afflicted with other sources of moral injury, such as the legally justifiable killing of enemy combatants and the unintentional killing of noncombatants. Even legally justifiable actions can greatly trouble warriors.

Some leaders—especially those who hold a self-delusory faith in “American exceptionalism”—can and do protest that moral injury cannot possibly apply to U.S. servicemembers. Despite their protests, large numbers of American troops clearly believe they did or witnessed something wrong downrange, perhaps terribly wrong, and what matters here is how the individuals judge their experiences, not what others say.

Moral injury cannot be the sole reason for our military’s growing suicide rate. Other factors include PTSD and traumatic brain injury, which have also been linked to increased suicide risk. Another factor has been the increased operational tempo of all units, including recruiting, training and test units. This high tempo can damage servicemembers’ relationships with the very people they depend upon for emotional support.

Still, it is troubling that the military does not even acknowledge moral distress can lead to suicide, as literature, numerous empirical studies and a massive amount of anecdotal evidence overwhelmingly indicate. This is exactly what is happening, though. Millions of dollars are spent collecting suicide-related data, but this data largely involves misbehaviors that are rightly considered effects of psychological injury rather than root causes. We know, for example, some suicide victims drank too much before they died, but we rarely know what drove them to drink.

Until we understand deeper causes, we will not meaningfully reduce or prevent such negative outcomes from psychological injury as suicide.

Moral Injury and the U.S. Servicemember

Ethics does not consist of purely academic, impractical restraints. It is firmly rooted in human biology. Our capacity for seeing others as beings like ourselves, who should be treated as we want to be treated, is an important reason our species dominates the planet. Indeed, without innate moral forces, Homo sapiens would be unable to live in large, powerful nations. America’s very existence would be impossible.

War is a moral contest, and the last side to believe that it is right to fight is the side that most often wins. Only wars in which an enemy population is exterminated, broken or scattered are decided by another calculus, and, in the information age, such cruel tactics are rarely (if ever) possible for mature democracies like America.

Beyond “victory,” another enduring effect of war’s moral dimension is psychological injury. Technology is unlikely to limit such injuries. Although remote-controlled warfare reduces or prevents PTSD and traumatic brain injury, cases of moral injury will only increase as sensors become more advanced and killing becomes more intimate for drone operators.

In his 2009 book, Packing Inferno: The Unmaking of a Marine, former marine Capt. Tyler Boudreau declares it obvious that moral concerns deeply impact the psyches of warriors, and he rails against the inability of societies to learn from their own literature. Until citizens take responsibility for their wars and the invisible injuries of combat veterans, Boudreau argues, they will mistakenly see these injuries as resulting from veterans’ moral or mental deficiencies.

Leaders, not mental health professionals, play the key role in reducing moral injury. Adopting a morally focused approach to war would reduce dissonance by causing servicemembers to align who we say we are and who we often believe we are with who we actually are. During my combat deployments, I never once witnessed a staff debate the perceived justice of an act. Unless a lawyer says a tactic is illegal, the typical U.S. military leader believes he or she has the moral “green light” to do it.

Our military’s narrow, legalistic approach to waging war is tragically ironic because it undermines what should be our nation’s greatest strength—our strong tradition of respect for basic human rights. The Declaration of Independence established this tradition and codified it in the Bill of Rights. Gen. George Washington set a modern precedent for treating prisoners with dignity and respect, a tradition U.S. soldiers have adhered to more often than not. More than any other nation, the U.S. is responsible for the Law of Armed Conflict, publishing this law’s foundation as General Order 100 of the Union Army during the Civil War. That record stands in stark contrast to that of our nation’s jihadist foes today, who have no similar tradition and have shown little capacity for accommodating different cultures and faith groups.

Will our nation and military learn to see the pursuit of perceived justice as absolutely essential to success in modern war? Will we come to see morally justifiable actions as the crucible in which the psychological cost of war to America’s warriors is lessened and redeemed? It is not at all obvious these things will happen. Human beings are creatures of passion, and war displays this passion at its noblest and cruelest extremes. It stands to reason that our nation will not always choose only just wars to wage and that servicemembers will not always perform just combat actions. Nevertheless, human beings are also governed by moral forces. The great cost of underestimating these forces in the information age is surely too great to go long unnoticed and inadequately addressed.

Our nation will not always be able to wage just wars justly, but we must try much harder to do so.

Lt. Col. Douglas A. Pryer has held numerous command and staff positions in the U.S., the U.K., Germany, Kosovo, Iraq and Afghanistan. He currently serves as a planner for the Joint Chiefs of Staff. He has a master’s degree in military history from the U.S. Army Command and General Staff College and is the author of the book The Fight for the High Ground: The U.S. Army and Interrogation During Operation Iraqi Freedom, May 2003–April 2004 as well as numerous essays on the human and moral domains of war.


Peace I Leave With You

“And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” Philippians 4:7  peace i leave with you

We all want peace. We want peace in the world, so we get into wars. We want peace in our countries, so we vote for the person we think will do the best. We want peace with our friends, so we do what we can to not offend them. We want peace in our family, so we work hard to put a roof over their head and money in the bank for retirement. Lastly, we want peace in ourselves, so we compare ourselves to others and say we are much happier with what we have. People spend their whole lives working for peace. Unfortunately, true peace is not something that can be achieved, it can only be received.

True peace can only come from God (John 14:27). This peace doesn’t affect our surroundings, it affects our inner souls. Paul says that it will go deep into our hearts and minds. It isn’t something that can be explained in a self help book or with a few simple steps, it is only something that can be received from God. As a follower of Jesus, we should be the ones looked to when others need peace. Not because our surroundings are peaceful, but because our hearts and minds are at peace with God. We no longer fear death, hunger or war. We know that our treasure is in heaven and we will one day reign with the one true Peace Maker.

Easter Musings

“Jesus said to her, “I am the resurrection and the life. He who believes in Me, though he may die, he shall live.” John 11:25

4525749Below is Some Easter Musings from Military Outreach Greater Chicago

Easter is a wonderful time for Christians as we reflect on the resurrection of Jesus Christ from the dead.  It’s the miracle of all miracles and the basis of our Christian faith!  When thinking about Easter, we also think about Jesus’ final hours and words to those of us here on Earth.  Looking at Jesus’ words to his disciples before His ascension and the rest of Scripture, one can see similarities regarding how Christians are called to live here on earth and what our soldiers around the world are called to do on a daily basis to protect our country.  It is interesting to see the overlap and perhaps, no one is better prepared to understand what it means to be a Christian than one of our military men or women.

  1. Longing for Home – Christians recognize that this world is not our home.  We will never feel at home here on this earth and experience a sense of longing for the day when we will join our Savior in heaven.  Our men and women serving in the Armed Forces experience a sense of homesickness every day they are away from family, friends, and the familiar surroundings they leave behind to serve our nation.  They are foreigners in a land that is not their own and one they are unfamiliar with.  They long for home.
  2. Ambassadors to Those Around Them – Our military men and women often serve as the first faces many non-Americans see and as such often are the first impression that a foreigner has of who an American is.  Likewise, Christians are called to be ambassadors of Christ, serving as a sort of first example to the people around them of who Christ is and what it means and looks like to be a Christian.
  3. Facing Difficulties and Trials – Jesus never promised us that the Christian life was going to be a picnic. It was going to be tough and filled with suffering.  Our troops go through unimaginable suffering from both visible and invisible wounds they might carry for the rest of their lives.  Both overseas and at home, our troops face unique challenges that require physical and mental fortitude.
  4. Fighting An Unseen Enemy – The Bible tells us that our struggle as Christians is not against other humans, but against spiritual forces and Satan.  Similarly, our military members are often fighting unseen enemies.  Sometimes these are people who seem friendly but are really suicide bombers.  At other times, it is the emotional and physical forces that our military personnel must wrestle with.  Our military personnel must always be ready for the unpredictable.
  5. Prepared to Fight – The Bible calls us to put on the full armor of God which will protect us against the enemy.  We are to be prepared for battle and ready to give an answer to anyone who has questions about our faith.  Likewise, our soldiers have to be constantly vigilant and prepared for battle.  They need to be properly armed and equipped to face those that seek to destroy them.

As we reflect on Easter and all that Christ accomplished for us, we should be mindful of our military members who face similar and far harder situations on a day to day basis than most of us deal with here in the United States.  Have a wonderful Easter and remember, Christ has Risen!!

You’re Helping to Build the Army of God!

1 Chronicles 12:21-22 “They helped David against the band of raiders, for they were all mighty men of valor and were commanders in the army. For from day to day men came to David to help him, until there was a great army, like an army of God.”
Hebrews 10:25 “Not neglecting to meet together, as is the habit of some, but encouraging one another, and all the more as you see the Day drawing near.”
It must have been amazing to watch David amassing men around himself until it was like the army of God — Jesus is doing exactly the same thing in our days. The difference is the kinds of battles we’re fighting. David and his men engaged in physical warfare against bands of raiders; Philistines and local Canaanite tribes. We are in a spiritual war against “…principalities, against powers, against the world-rulers of this darkness, against the spiritual hosts of wickedness in the heavenly places.” [Ephesians 6:12]
A program by National Geographic gives a powerful illustration for us. In the great annual wildebeest migration in Serengeti National Park in Africa a giant herd, thousands of wildebeest, slowly move in groups across the plain. They are invariably followed by stalking lions. But the lions never attack the herd – they simply watch carefully for the stray wildebeest, either careless or seeking greener grass, who separates himself from the larger groups of animals. The isolated wildebeest will become the sudden prey of the lions who attack with lightening speed and ferocity.
In spiritual warfare isolation is equally dangerous, as our enemy roams like a roaring lion looking for separated brethren to prey upon. We all need real relationship and spiritual community for protection against our enemy who is constantly stalking vulnerable prey. It’s not enough to simply “go to church”. We need to be the community of believers, actively participating in loving, serving, praying, counseling, encouraging, admonishing, eating, rejoicing, weeping, and forgiving as the family of God.
Far too many are isolated, and seriously vulnerable to the spiritual attacks. Are you one of them? Do you know someone who is in this dangerous condition? David’s army was successful and safe because they were together in mind heart and purpose. Wildebeest, as well, survive when they stick together. Find your spiritual community and be faithful to it. It should not be a formality, but a family reality with a warfare mentality.

In War You Need Chutzpah!

Genesis 14:14-16 “When Abram heard that his kinsman had been taken captive, he led forth his trained men, born in his house, 318 of them, and went in pursuit as far as Dan. And he divided his forces against them by night, he and his servants, and defeated them and pursued them to Hobah, north of Damascus. Then he brought back all the possessions, and also brought back his kinsman Lot with his possessions, and the women and the people.”
Abraham’s rescue of Lot and his household from the four Mesopotamian Kings in the middle of the night was an act of holy chutzpah! Israel’s first patriarch demonstrated great faith, courage, family loyalty, and military strategy during this successful rescue operation.
This example of courage and daring ought to inspire us in certain situations where evil should be boldly and radically confronted. There are times when we, too, can and should operate with holy chutzpah, surprising the enemy with fearless courage, faith-filled action, and laser sharp strategy. “Behold, I have given you authority to tread on serpents and scorpions, and over all the power of the enemy, and nothing shall hurt you.” [Luke 10:19]
There is a time to wage war with holy chutzpah. When our cause is righteous and the goal is rescue and deliverance from evil then we ought not to be passive. In these situations we need the Lord’s strategy and the courage which comes with true righteousness. Perhaps it will require a strong word spoken in love; perhaps a day or a week of serious fasting and prayer. It may even involve addressing an evil spirit as the Apostle Paul did in Philippi [Acts 16:18]. There are times for radical action without fear that it can’t be done. Our Lord, on the cross, exemplified tremendous courage and heroism to rescue us from our sins and the devil’s power. In the power if His spirit we also can be instruments of dramatic deliverance – with Holy chutzpah!

You’re at War?

2 Corinthians 10:3-6 “For though we walk in the flesh, we are not waging war according to the flesh. For the weapons of our warfare are not of the flesh but have divine power to destroy strongholds. We destroy arguments and every lofty opinion raised against the knowledge of God, and take every thought captive to obey Christ, being ready to punish every disobedience, when your obedience is complete.”
We are already at war spiritually. Constantly contending in our minds, we battle over thoughts and emotions which flow through them. The enemy often attacks by bringing up issues from our past. Failures, regrets, wounds, and traumas all have the potential to drag us down into doubt, darkness and despair. Our tremendous challenge is not to respond to these memories with old destructive thought patterns. Our victory lies in responding to these thoughts and feelings.
While we don’t necessarily ignore thoughts and feelings from the past, it is vital that we don’t allow them to control our souls and emotions, but that we take them captive through prayers and declarations inspired by our spiritual mind.
The battle over past issues is won we  takes authority over their meaning, purpose and definition in our lives with Jesus on the throne of our hearts and minds, everything in our past is brought under His authority and works together for our good!