Moral Injury: The Hidden Scars of Trauma

Commentary
By Brian Powers 5-22-2017

The Department of Veterans Affairs estimates that as many as 1-in-5 veterans from the recent conflicts in Iraq and Afghanistan return with some degree of Post-Traumatic Stress Disorder (PTSD). While the categorization of PTSD largely describes those who suffer from the physiological effects of stress on the body, psychiatrists note that there are less visible psychological wounds of war.

One of the most damaging and persistent of these wounds is what has come to be recognized as “moral injury.” It concerns the profound way in which the moral ambiguities and high-stakes situations combatants face profoundly affect their sense of “right” and “wrong.” While different definitions exist, it is broadly understood as the result of participation in, failure to prevent, or simply being witness to actions that one understands to transgress or betray some moral boundary.

As combatants’ actions are often performed in service of a greater “good,” there is a profound cognitive dissonance when they experience shame and guilt in the aftermath. As a result, some morally injured veterans subsequently mistrust the “goodness” of any set of ideas, and isolate themselves from others as they struggle to make meaning of their own lives and actions.

Within the context of moral injury, imagery from 1 Peter in the Bible — specifically 1 Peter 4:12-14, and 1 Peter 5:6-11 — resonate in a vivid way. Here, the author exhorts his readers to stand firm in the face of persecution and suffering, acknowledging that they are enduring a “fiery ordeal.” He urges the members of this Christian community to be vigilant in living out the moral vision he has previously expressed for the community, because “like a roaring lion your adversary the devil prowls around, looking for someone to devour." This devil, it seems fair to say, seeks not simply to kill them, but to isolate them from their Christian calling as members of a community, to drag them from the moral path, and devour their “goodness.”

Many combatants join the military with the desire to serve the “good” of national security. Their sense of the goodness of military endeavor is fortified in their training, and their skills are sharpened through repetition and conditioning. As a result, their combat actions (firing a weapon at an enemy target, reloading, etc…) are honed into a nearly reflexive action in response to battlefield stimuli.

After experiencing those actions’ real consequences in actual combat — enemy bodies, dead animals, a wedding celebration turned to carnage by an errant bomb — some combatants come to regret that their actions, and decision-making process are bound in service to goals they no longer view as entirely morally good. Some lament that the forces that condition their adherence to it have conscripted their very identities and senses of agency. They are not killed by these forces, but like the flesh devoured by a lion, they are consumed by it.

Those suffering from moral injury perhaps remind us how easily our ideas about what is “good” in the world are distorted and devoured by powerful forces of culture, society, and politics. This facet of moral injury resonates deeply with what the influential fifth century theologian Augustine of Hippo understood to be the consequences of humanity’s initial fall from grace.

When Adam rejected God’s “good” as ultimate, Augustine contends that all humanity became alienated from God. Unmoored from God, our sense of “good” became deeply malleable and vulnerable to external influence. As a result, we pursue what we understand to be an absolute good with zeal, only to be left morally troubled at the guilt, shame, and suffering that result. We may understand veterans and others who experience moral injury to contend with these distortions in acutely damaging ways.

These passages from 1 Peter does not simply highlight the ways in which sin and the devil may devour, confuse, and ensnare our very moral capacities. It also provides a sense of hope and encouragement for a community that is exhorted to remain humble. The author encourages the community to remember the sufferings of others outside its group, and promises them that, in Christ, God will ultimately “restore, support, strengthen, and re-establish” them.

Like the women in the documentary After Fire, veterans suffering from moral injury often find healing in community with each other, embodying the idea from 1 Peter that the community should build its hope upon the knowledge that they do not suffer alone. They often find a sense of renewed purpose and the power to resist the distorting forces that injured them through friendship with one another, helping members in need and speaking out against the insidious harm that preys upon the concepts of service, honor, and loyalty as it creates situations of cruelty and abuse.

In this, these communities provide a model for the Christian community to emulate. If we remember the morally injured on this Memorial Day, then perhaps we should also take a moment to critically examine the values that shape our collective ideas about goodness. This passage attempts to reorient the church’s idea of what goodness is, imploring the community to “discipline” itself, to “keep alert,” and to “resist” the devil’s devouring influence. It implicitly suggests, in doing so, that such vigilantly guarded goodness should include a humble yet determined effort to embody the restoration, support, and strength in Christ to those who are suffering.

Perhaps on Memorial Day, it is a call to extend this particular form of healing and grace to those who suffer from moral injury.

Via ON Scripture.

Brian Powers is an alumnus of Emory University's Graduate Division of Religion, with a Ph.D. in the Theological Studies area, and a veteran of conflicts in Iraq and Afghanistan.

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