The Trauma of Following Orders

A colleague and I were discussing one of his veteran clients.  My colleague is a Vietnam Era veteran and I am a Desert Storm veteran and we often consult with each other about our cases. His client William, is a Vietnam Veteran in failing health. I had met William through another veterans program and referred him to my colleague because I felt he would be a better fit. Due to his failing health William is starting to look back at his life and psychologically preparing for his passing. Like many Vietnam veterans William is struggling with what he had to do in Vietnam to survive. The Vietnam battlefield used civilians, women and children to carry out some of their attacks. As a Soldier, Sailor, Airman, or Marine you had no idea who your enemy was. All you could do is make instant life or death decisions, follow orders, and hope you are doing the right thing.  

When William’s unit entered a village in Vietnam, they were ordered to destroy the village and kill or capture anyone who was there, including women and children. Military intelligence had informed his commanding officer (CO) that the village was a haven for Viet-Cong and needed to be destroyed. Williams platoon completed their mission and proceeded to kill those who refused to surrender, and burned the village to the ground. What was ordered and accepted by his superior’s is something William would live with the rest of his life. Since the age of 19 he has spent most of his life self-medicating with drugs and alcohol trying to forget the action he had to take in that village. He wonders how he could go to heaven after killing so many people.

William is suffering from what is called moral injury. Moral injury is a relatively new term, but its pain is as old as war. It is a negative self-judgment based on having transgressed core moral beliefs, values or on feeling they possess. The term is described as “the psychological burden of killing and the betrayal of leaders”. Moral Injury appears to be a slow burn that takes time to sink in. The victim of moral injury needs to accept moral reasoning, evaluate behavior, experience empathy, and create a coherent memory narrative. Many times, soldiers are placed in no win situations by their leadership and told they must betray there since of “what’s right”. These actions cause confusion concerning one’s morality because they knew it was wrong, but were told by your superiors its ok. For some it takes minutes, for others it takes years to feel the sadness or sorrow of not following your moral beliefs. Veterans try to suppress their moral injury and some succeed through the use of drugs and alcohol. Others work hard to support their families and place their moral injury on the back burner, they are doing what is moral, providing for their family and working.  

A common theme is veterans feel nothing can prepare you for what war is really like. To some when they return home it feels like they have lost their soul. It is tough when society states, thou shall not kill, and military states thou better kill, be killed, or suffer the shame of not trying. Many have endured the moral pain of driving past wounded women and children and not stopping for help because of orders, having to shoot civilians because you don’t know who your enemies are, killing families because of one enemy sympathizer, or killing someone over anger because they killed or shot your comrade. There appears to be no end, the symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live. In war military members have to follow orders without question, and at times those orders shake our moral beliefs.

Moral injury is not something that can be cured by medication. The restructuring of their moral identity and meaning is the key. Seeking help from clinicians and chaplains is the first step. What it takes is the support of a caring non-judgmental community who can find a way for veterans to forgive themselves. Our communities need to understand the war doesn’t end when our troops return home, it is just the beginning of their battles. Some Vietnam veterans are still dealing with this issue 40 plus years later. We now have a new generation of troops who will be facing the same issues. In the future moral injury is going to explain why some veterans suffer. Some feel moral injury is one of the primary factors in military suicide rates. The key is for friends and families to be on the lookout and get them the help they deserve. There is hope, the VA is funding a 4 year study on moral injury in Marines and there are numerous counseling options for veterans and their families.  

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

The Cost of Doing the Right Thing

Francisco is a Marine veteran client that I work with. He had two tours in Iraq and struggles to deal with what happened. Francisco was in-voluntary extended after his 4 years in the corps because he was supposed to be a part of the “surge”. His last tour he had a fellow marine from his unit die in his arms on his first tour and now he had to go on another one. Francisco lives with the feeling that his fellow Marine took his last breath while he was holding him. Francisco continues to feel that last breath leaves the Marine before he died. That incident effects his decisions to this day. One of the reasons he made the decision to do what he thought was right the rest of his time in the Marines, and that decision cost him.

What he was concerned about the most is his inability to not make lance corporal. He separated from the Marines as a corporal. This is very demeaning to him, especially the reason why he did not make rank. You see, Francisco made the mistake of standing up for an inferior marine why he was beaten by his Sargent. His Sargent was beating a fellow Marine in the next rack while he was trying to sleep. Francisco continually tried to stop the Sargent from beating the Marine. He was told to stay out of it. After the sergeant was done beating the Marine he proceeded to treat the marine by doing CPR. The Marine was beaten so bad he had stopped breathing. He then filed a complaint and the sergeant was reprimanded. After that incident Francisco was always having to look over his back. He was ostracized as being a trouble maker and a rat. He was treated with little respect by his peers in the corps. After he had decided to leave the Marine Corps he was offered a promotion, which he refused. After being treated the way he was for saving his fellow Marine he decided he would get out. He feels he is being looked down upon by fellow veteran Marines for doing the right thing.

Francisco continues to struggle by questioning his choice to do what he felt was right. He has seen many that have done questionable things and have gotten away with them, and even becoming better off than they were. He feels doing what was right has cost him many times in his life and he consistently asks me why he should keep doing what was right because it has not helped him, it has only hurt him. It is a difficult task to convince someone that doing the right thing is what is best even if it cost them. He tried to do what the Marines told him to do, he followed the written code to the letter, and the problem was he did not follow the unwritten code of not telling on others when he sees hazing of another Marine.

Another issue that Francisco deals with is what other Marines say about him behind his back. He has told several people this story since he got out and they have looked down upon him as if he was still in. What Francisco needs to learn is he owns his story that he does not have to tell everyone about his situation. Francisco is an honest person who feels bad about holding back anything from his time in the Marines. He has lived his life being the honest person, he feels like it has backfired. Unfortunately, his case is not the only one I've heard. It is difficult to make these decisions and he made it. Francisco did the right thing but paid the price of doing it.

From a clinical standpoint it is difficult for young man to deal with this type of burden. In his mind the choice he made will affect him for the rest of his life. Many men and women in the military are brave enough to stand up for what they feel is right. There are those that stand up for what they believe is right knowing there will be consequences to their actions. Some accept that responsibility and move forward. Others struggle with their decision and consistently wonder if they made the right one. Many things the Marine struggles with when he gets out in society often does not do the right thing. Even though all military branches are taught integrity loyalty commitment not all people follow that code. Doing what's right can often lead to struggles. Many civilians do not make ethical decisions and that bothers those who do. Those who do the right thing start to question whether they're doing the right thing by sticking to their morals. This type of stuff happens and some pay the consequences. My opinion is we should all stand up for what is right even though it costs us. If everyone used this code the military, civilians, and society would all be a better place.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Moral Injury, Another Veteran Crisis

William is a Vietnam Veteran in failing health who I met through a veteran’s program. William is starting to look back at his life and starting to prepare himself for his death. Like many Vietnam veterans William is struggling with what he had to do in Vietnam. The unconventional battlefield that started in mass numbers during the Korean uses women and children to carry out some of their attacks, service members have no clue who their enemy is, you just have to follow orders, make judgement calls, and hope for the best.  

When William’s unit entered a village in Vietnam, they were ordered to destroy the village and kill or capture anyone who was there, this included women and children. Military intelligence had informed his commanding officer (CO) that the village was a haven for Viet-Cong and must be destroyed. They completed their mission and proceeded to follow orders to burn the village to the ground and kill all those who refused to surrender, even women and children. What was accepted by his superior’s and his chain of command as following orders is something William would live with the rest of his life. William is starting to look back at his life and wonders how he could go to heaven after killing so many people and breaking his moral code. Thanks to following orders William has spent most of his life self-medicating with drugs and alcohol trying to forget the pain he has had since he was 19 years old. William is not only suffering from PTSD, he is suffering from moral injury.

Moral injury is a relatively new term but the idea is as old as war. The term was first used in the late 1980’s and described as “the psychological burden of killing and the betrayal of leaders. The definition of moral injury is the damage done to one's conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress their own moral and ethical values or codes of conduct. Moral Injury is a slow burn that takes time to sink in. It requires a healthy brain that can understand moral reasoning, evaluate behavior, experience empathy, and create a coherent memory narrative. It is a negative self-judgment based on having transgressed core moral beliefs, values or feeling. Many time in war soldiers are placed in high stress situations and are told they must betray there since of “what’s right” to carry out orders given by someone who has the position of legitimate authority.

When we think of what military members go through we look for and expect to hear fear. But what is coming to light is sadness related to loss, but also attributed to bearing witness to evil and human suffering including death you participated in. There is fear in most who have seen combat, but what happens after fear. For some it takes minutes, for others it takes years to feel the sadness or sorrow of forgetting your human morality. Veterans try and suppress their moral injury and some succeed through the use of drugs and alcohol which brings on its own set of issues. Others work hard to support their families and place their morality on the back burner, they are doing what is moral, providing for their family and working. 

A common theme is veterans feel that nothing can prepare you for what war is really like. When they return home to some it feels like they have lost their soul. It not hard to believe when society states, thou shall not kill, military culture states thou better kill, be killed, or suffer the shame of not trying. In today’s wars veterans do not know who their enemies are. Many women and children, including babies have been killed by accident or necessity. Driving past wounded women and children and not stopping to help because of orders, making the decision to shoot civilians because you don’t know who your enemies are, killing families because of one enemy sympathizer, killing someone over anger because they killed or shot your comrade are all breaches of Americans moral code.

In war military members must follow orders without question, and at times those orders shake the soldier’s moral beliefs. There appears to be no end in the breach of moral codes in war. The symptoms of moral injury include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live.

Some military leaders reject the idea of moral injury and one leader advised a suicidal soldier to “be an adult” and get over it. In the future, the loss of morality and moral injury is going to explain a big chunk of why veterans suffer as they get older. Some feel moral injury is one of the primary factors in military suicide rates. The key for friends and families is to be on the lookout for moral injury and get them the help they deserve.

Many soldiers who serve in combat reach out to counseling from Chaplains. The same mental health stigma is not attached to talking to the Chaplin as a mental health professional. Also speaking to a Chaplin will not go into their permanent records. They also believe that most therapist do not have knowledge of theological issues such as morality concerning good and evil, or religious meaning. Veterans also believe when they raise moral questions about conscience in therapy they get referred. There is nothing wrong with reaching out to both. There are also clinicians who have been trained in religion and are pastors who are licensed therapist.  

Moral injury is not something that can be cured by medication. The restructuring of their moral identify and meaning is the key. What it takes is the support of caring non-judgmental community who can find a way for veterans to forgive themselves. Our communities need to understand the war does not end when our troops return home, it is just the beginning, just ask the Vietnam Veterans who are still dealing with this issue 40 plus years later. There is hope, in the VA there is funding for a 4-year study on moral injury in Marines. Let’s see where that leads.  

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

The Trauma of Following Orders

A colleague and I were discussing one of his veteran clients.  My colleague is a Vietnam Era veteran and I am a Desert Storm veteran and we often consult with each other about our cases. His client William, is a Vietnam Veteran in failing health. I had met William through another veterans program and referred him to my colleague because I felt he would be a better fit. Due to his failing health William is starting to look back at his life and psychologically preparing for his passing. Like many Vietnam veterans William is struggling with what he had to do in Vietnam to survive. The Vietnam battlefield used civilians, women and children to carry out some of their attacks. As a Soldier, Sailor, Airman, or Marine you had no idea who your enemy was. All you could do is make instant life or death decisions, follow orders, and hope you are doing the right thing.  

When William’s unit entered a village in Vietnam, they were ordered to destroy the village and kill or capture anyone who was there, including women and children. Military intelligence had informed his commanding officer (CO) that the village was a haven for Viet-Cong and needed to be destroyed. Williams platoon completed their mission and proceeded to kill those who refused to surrender, and burned the village to the ground. What was ordered and accepted by his superior’s is something William would live with the rest of his life. Since the age of 19 he has spent most of his life self-medicating with drugs and alcohol trying to forget the action he had to take in that village. He wonders how he could go to heaven after killing so many people.

William is suffering from what is called moral injury. Moral injury is a relatively new term, but its pain is as old as war. It is a negative self-judgment based on having transgressed core moral beliefs, values or on feeling they possess. The term is described as “the psychological burden of killing and the betrayal of leaders”. Moral Injury appears to be a slow burn that takes time to sink in. The victim of moral injury needs to accept moral reasoning, evaluate behavior, experience empathy, and create a coherent memory narrative. Many times, soldiers are placed in no win situations by their leadership and told they must betray there since of “what’s right”. These actions cause confusion concerning one’s morality because they knew it was wrong, but were told by your superiors its ok. For some it takes minutes, for others it takes years to feel the sadness or sorrow of not following your moral beliefs. Veterans try to suppress their moral injury and some succeed through the use of drugs and alcohol. Others work hard to support their families and place their moral injury on the back burner, they are doing what is moral, providing for their family and working.  

A common theme is veterans feel nothing can prepare you for what war is really like. To some when they return home it feels like they have lost their soul. It is tough when society states, thou shall not kill, and military states thou better kill, be killed, or suffer the shame of not trying. Many have endured the moral pain of driving past wounded women and children and not stopping for help because of orders, having to shoot civilians because you don’t know who your enemies are, killing families because of one enemy sympathizer, or killing someone over anger because they killed or shot your comrade. There appears to be no end, the symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live. In war military members have to follow orders without question, and at times those orders shake our moral beliefs.

Moral injury is not something that can be cured by medication. The restructuring of their moral identity and meaning is the key. Seeking help from clinicians and chaplains is the first step. What it takes is the support of a caring non-judgmental community who can find a way for veterans to forgive themselves. Our communities need to understand the war doesn’t end when our troops return home, it is just the beginning of their battles. Some Vietnam veterans are still dealing with this issue 40 plus years later. We now have a new generation of troops who will be facing the same issues. In the future moral injury is going to explain why some veterans suffer. Some feel moral injury is one of the primary factors in military suicide rates. The key is for friends and families to be on the lookout and get them the help they deserve. There is hope, the VA is funding a 4 year study on moral injury in Marines and there are numerous counseling options for veterans and their families.  

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

The Cost of Doing the Right Thing

Francisco is a Marine veteran client that I work with. He had two tours in Iraq and struggles to deal with what happened. Francisco was in-voluntary extended after his 4 years in the corps because he was supposed to be a part of the “surge”. His last tour he had a fellow marine from his unit die in his arms on his first tour and now he had to go on another one. Francisco lives with the feeling that his fellow Marine took his last breath while he was holding him. Francisco continues to feel that last breath leaves the Marine before he died. That incident effects his decisions to this day. One of the reasons he made the decision to do what he thought was right the rest of his time in the Marines, and that decision cost him.

What he was concerned about the most is his inability to not make lance corporal. He separated from the Marines as a corporal. This is very demeaning to him, especially the reason why he did not make rank. You see, Francisco made the mistake of standing up for an inferior marine why he was beaten by his Sargent. His Sargent was beating a fellow Marine in the next rack while he was trying to sleep. Francisco continually tried to stop the Sargent from beating the Marine. He was told to stay out of it. After the sergeant was done beating the Marine he proceeded to treat the marine by doing CPR. The Marine was beaten so bad he had stopped breathing. He then filed a complaint and the sergeant was reprimanded. After that incident Francisco was always having to look over his back. He was ostracized as being a trouble maker and a rat. He was treated with little respect by his peers in the corps. After he had decided to leave the Marine Corps he was offered a promotion, which he refused. After being treated the way he was for saving his fellow Marine he decided he would get out. He feels he is being looked down upon by fellow veteran Marines for doing the right thing.

Francisco continues to struggle by questioning his choice to do what he felt was right. He has seen many that have done questionable things and have gotten away with them, and even becoming better off than they were. He feels doing what was right has cost him many times in his life and he consistently asks me why he should keep doing what was right because it has not helped him, it has only hurt him. It is a difficult task to convince someone that doing the right thing is what is best even if it cost them. He tried to do what the Marines told him to do, he followed the written code to the letter, and the problem was he did not follow the unwritten code of not telling on others when he sees hazing of another Marine.

Another issue that Francisco deals with is what other Marines say about him behind his back. He has told several people this story since he got out and they have looked down upon him as if he was still in. What Francisco needs to learn is he owns his story that he does not have to tell everyone about his situation. Francisco is an honest person who feels bad about holding back anything from his time in the Marines. He has lived his life being the honest person, he feels like it has backfired. Unfortunately, his case is not the only one I've heard. It is difficult to make these decisions and he made it. Francisco did the right thing but paid the price of doing it.

From a clinical standpoint it is difficult for young man to deal with this type of burden. In his mind the choice he made will affect him for the rest of his life. Many men and women in the military are brave enough to stand up for what they feel is right. There are those that stand up for what they believe is right knowing there will be consequences to their actions. Some accept that responsibility and move forward. Others struggle with their decision and consistently wonder if they made the right one. Many things the Marine struggles with when he gets out in society often does not do the right thing. Even though all military branches are taught integrity loyalty commitment not all people follow that code. Doing what's right can often lead to struggles. Many civilians do not make ethical decisions and that bothers those who do. Those who do the right thing start to question whether they're doing the right thing by sticking to their morals. This type of stuff happens and some pay the consequences. My opinion is we should all stand up for what is right even though it costs us. If everyone used this code the military, civilians, and society would all be a better place.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Moral Injury, Another Veteran Crisis

William is a Vietnam Veteran in failing health who I met through a veteran’s program. William is starting to look back at his life and starting to prepare himself for his death. Like many Vietnam veterans William is struggling with what he had to do in Vietnam. The unconventional battlefield that started in mass numbers during the Korean uses women and children to carry out some of their attacks, service members have no clue who their enemy is, you just have to follow orders, make judgement calls, and hope for the best.  

When William’s unit entered a village in Vietnam, they were ordered to destroy the village and kill or capture anyone who was there, this included women and children. Military intelligence had informed his commanding officer (CO) that the village was a haven for Viet-Cong and must be destroyed. They completed their mission and proceeded to follow orders to burn the village to the ground and kill all those who refused to surrender, even women and children. What was accepted by his superior’s and his chain of command as following orders is something William would live with the rest of his life. William is starting to look back at his life and wonders how he could go to heaven after killing so many people and breaking his moral code. Thanks to following orders William has spent most of his life self-medicating with drugs and alcohol trying to forget the pain he has had since he was 19 years old. William is not only suffering from PTSD, he is suffering from moral injury.

Moral injury is a relatively new term but the idea is as old as war. The term was first used in the late 1980’s and described as “the psychological burden of killing and the betrayal of leaders. The definition of moral injury is the damage done to one's conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress their own moral and ethical values or codes of conduct. Moral Injury is a slow burn that takes time to sink in. It requires a healthy brain that can understand moral reasoning, evaluate behavior, experience empathy, and create a coherent memory narrative. It is a negative self-judgment based on having transgressed core moral beliefs, values or feeling. Many time in war soldiers are placed in high stress situations and are told they must betray there since of “what’s right” to carry out orders given by someone who has the position of legitimate authority.

When we think of what military members go through we look for and expect to hear fear. But what is coming to light is sadness related to loss, but also attributed to bearing witness to evil and human suffering including death you participated in. There is fear in most who have seen combat, but what happens after fear. For some it takes minutes, for others it takes years to feel the sadness or sorrow of forgetting your human morality. Veterans try and suppress their moral injury and some succeed through the use of drugs and alcohol which brings on its own set of issues. Others work hard to support their families and place their morality on the back burner, they are doing what is moral, providing for their family and working. 

A common theme is veterans feel that nothing can prepare you for what war is really like. When they return home to some it feels like they have lost their soul. It not hard to believe when society states, thou shall not kill, military culture states thou better kill, be killed, or suffer the shame of not trying. In today’s wars veterans do not know who their enemies are. Many women and children, including babies have been killed by accident or necessity. Driving past wounded women and children and not stopping to help because of orders, making the decision to shoot civilians because you don’t know who your enemies are, killing families because of one enemy sympathizer, killing someone over anger because they killed or shot your comrade are all breaches of Americans moral code.

In war military members must follow orders without question, and at times those orders shake the soldier’s moral beliefs. There appears to be no end in the breach of moral codes in war. The symptoms of moral injury include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live.

Some military leaders reject the idea of moral injury and one leader advised a suicidal soldier to “be an adult” and get over it. In the future, the loss of morality and moral injury is going to explain a big chunk of why veterans suffer as they get older. Some feel moral injury is one of the primary factors in military suicide rates. The key for friends and families is to be on the lookout for moral injury and get them the help they deserve.

Many soldiers who serve in combat reach out to counseling from Chaplains. The same mental health stigma is not attached to talking to the Chaplin as a mental health professional. Also speaking to a Chaplin will not go into their permanent records. They also believe that most therapist do not have knowledge of theological issues such as morality concerning good and evil, or religious meaning. Veterans also believe when they raise moral questions about conscience in therapy they get referred. There is nothing wrong with reaching out to both. There are also clinicians who have been trained in religion and are pastors who are licensed therapist.  

Moral injury is not something that can be cured by medication. The restructuring of their moral identify and meaning is the key. What it takes is the support of caring non-judgmental community who can find a way for veterans to forgive themselves. Our communities need to understand the war does not end when our troops return home, it is just the beginning, just ask the Vietnam Veterans who are still dealing with this issue 40 plus years later. There is hope, in the VA there is funding for a 4-year study on moral injury in Marines. Let’s see where that leads.  

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Terrorist Events Difficult for Veterans

Michael is a Purple Heart recipient who attends a local college in San Bernardino California. He was a combat medic for two tours during Operation Iraqi Freedom Veteran (OIF). He has Post Traumatic Stress (PTSD) from when his Humvee was attacked using an improvised explosive device (IED) on a bridge in Iraq. Months prior to the terror attacks in San Bernardino Michael saw a (mine-resistant, ambush-protected truck) MRAP at a stop light in San Bernardino. The sight of the truck in his city caused him to freeze; when the light changed, he just sat there. He was confused for a second and thought he was back in Iraq. At the time Michael was one of the biggest opponents of using military equipment by police in the United States I have ever met. At the time, he was concerned over the misuse of the equipment by police, after our discussion I found out he was not alone, many veterans feel the same way as Michael about the use of military equipment by police.

Over the past couple of months, before the terrorist attack in San Bernardino, the conversation over military equipment continued in the veteran’s center. Over time, veterans researched which local police forces had gotten military equipment. To their surprise, they found local police forces have gotten allot of military equipment. Since the North Hollywood shooting southern California cities and counties have received military equipment included three automatic rifles for use by the Baldwin Park CA. Unified School District. The city of Covina CA received night vision sniper scopes for their officers. Redlands CA received 32 automatic rifles and a mine resistant vehicle. San Bernardino County CA has gotten millions of dollars in air support, including helicopters and a transport airplane. It is my guess that San Bernardino CA and surrounding police forces used much of this equipment when the terrorist attack in San Bernardino occurred.

The use of this equipment and the tactics on American soil in San Bernardino caused some veterans and their family’s severe distress. Watching the incident unfold on television caused a range of emotions in veterans. Seeing the images on television of armored vehicles, assault weapons and military tactics caused some to feel they needed to protect their families and their country. Some went on with their lives, even driving in the assault area, armed with the gunmen at large. A couple of veterans indicated the sight of the police using their equipment and tactics caused them to have flashbacks. Another said, “The police looked like us when we were advancing into cities in Iraq. I now understand why the Iraqi and Afghanistan people were afraid of us. “I felt like an Iraqi kid”. Other veterans felt the need to be armed and ready. One carried his handgun with him when he left his home that day. Another barricaded his family in his house and went into full battle mode. A client wanted to get his gun and go looking for the assailants. Each veteran handled their feelings differently, some went into a defensive posture, others wanted to go into assault mode and some kept doing what they normally do. The sight of these tactics and use of military equipment is something they thought they left behind and would not have to see on American soil, they were wrong.

I saw a gamut of emotions from our veterans during the San Bernardino terrorist attacks. Some wanted to attack and others wanted to cry, others were in pure defiance mode, either way their lives were changed, and their training kicked in for some. This terrorist incident so close to home and the use of military tactics used in an American city is distressing to many citizens especially veterans. The actions by some of our veterans during the terrorist attack has caused discussions between them and their families that had not previously taken place. Some of these discussions could lead to problems between veterans and their families. When a veteran goes into “battle mode”, it scares their families and they start to question their loved one’s sanity. As a society, we cannot underestimate the impact this type of incident has on our veterans and their families. These necessary actions distress all of us but it affects our veterans differently. I talked to Michael a couple of days ago. He has started to look at the use of military equipment by police differently, but it still affects him.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

The Trauma of Following Orders

A colleague and I were discussing one of his veteran clients.  My colleague is a Vietnam Era veteran and I am a Desert Storm veteran and we often consult with each other about our cases. His client William, is a Vietnam Veteran in failing health. I had met William through another veterans program and referred him to my colleague because I felt he would be a better fit. Due to his failing health William is starting to look back at his life and psychologically preparing for his passing. Like many Vietnam veterans William is struggling with what he had to do in Vietnam to survive. The Vietnam battlefield used civilians, women and children to carry out some of their attacks. As a Soldier, Sailor, Airman, or Marine you had no idea who your enemy was. All you could do is make instant life or death decisions, follow orders, and hope you are doing the right thing.  

When William’s unit entered a village in Vietnam, they were ordered to destroy the village and kill or capture anyone who was there, including women and children. Military intelligence had informed his commanding officer (CO) that the village was a haven for Viet-Cong and needed to be destroyed. Williams platoon completed their mission and proceeded to kill those who refused to surrender, and burned the village to the ground. What was ordered and accepted by his superior’s is something William would live with the rest of his life. Since the age of 19 he has spent most of his life self-medicating with drugs and alcohol trying to forget the action he had to take in that village. He wonders how he could go to heaven after killing so many people.

William is suffering from what is called moral injury. Moral injury is a relatively new term, but its pain is as old as war. It is a negative self-judgment based on having transgressed core moral beliefs, values or on feeling they possess. The term is described as “the psychological burden of killing and the betrayal of leaders”. Moral Injury appears to be a slow burn that takes time to sink in. The victim of moral injury needs to accept moral reasoning, evaluate behavior, experience empathy, and create a coherent memory narrative. Many times, soldiers are placed in no win situations by their leadership and told they must betray there since of “what’s right”. These actions cause confusion concerning one’s morality because they knew it was wrong, but were told by your superiors its ok. For some it takes minutes, for others it takes years to feel the sadness or sorrow of not following your moral beliefs. Veterans try to suppress their moral injury and some succeed through the use of drugs and alcohol. Others work hard to support their families and place their moral injury on the back burner, they are doing what is moral, providing for their family and working.  

A common theme is veterans feel nothing can prepare you for what war is really like. To some when they return home it feels like they have lost their soul. It is tough when society states, thou shall not kill, and military states thou better kill, be killed, or suffer the shame of not trying. Many have endured the moral pain of driving past wounded women and children and not stopping for help because of orders, having to shoot civilians because you don’t know who your enemies are, killing families because of one enemy sympathizer, or killing someone over anger because they killed or shot your comrade. There appears to be no end, the symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live. In war military members have to follow orders without question, and at times those orders shake our moral beliefs.

Moral injury is not something that can be cured by medication. The restructuring of their moral identify and meaning is the key. Seeking help from clinicians and chaplains is the first step. What it takes is the support of a caring non-judgmental community who can find a way for veterans to forgive themselves. Our communities need to understand the war doesn’t end when our troops return home, it is just the beginning of their battles. Some Vietnam veterans are still dealing with this issue 40 plus years later. We now have a new generation of troops who will be facing the same issues. In the future moral injury is going to explain why some veterans suffer. Some feel moral injury is one of the primary factors in military suicide rates. The key is for friends and families to be on the lookout and get them the help they deserve. There is hope, the VA is funding a 4 year study on moral injury in Marines and there are numerous counseling options for veterans and their families.  

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.