As may be expected, the prevalence of moral injuries suffered by those who fought in a morally ambiguous war, or in a counter insurgency/guerilla war, such as in Vietnam, Iraq, and Afghanistan, where, for example, the distinction between combatant and noncombatant is obscure at best, will be significantly greater and the symptoms more severe. However, all wars yield moral casualties. J. Glenn Gray, a philosopher, writes of his experiences as an Intelligence Officer during World War Two;
"My conscience seems to become little by little sooted . . . .. (only) if I can soon get out of this war and back on the soil where the clean earth will wash away these stains! I have also other things on my conscience . . . A man named H., accused of being the local Gestapo agent in one small town was an old man of seventy . . . . I was quite harsh to him and remember threatening him with an investigation when I put him under house arrest . . . Day before yesterday word came that he and his wife had committed suicide by taking poison . . . The incident affected me strongly and still does. I was directly or indirectly the cause of their deaths. . . . I hope it will not rest too hard on my conscience, and yet if it does not I shall be disturbed also." [7]
Gray's insights are especially valuable as they illustrate that even the actions and experiences of those involved in a "good" war and not directly confronting the enemy on the battlefield, can precipitate moral injury. Consequently, those military theorists who have argued that debilitating remorse, guilt, shame, etc., may be avoided by "educating" soldiers, probably convincing is better, about the justness and necessity of war and the "appropriateness" of their combat behavior, [8] could benefit from Gray's observations.
To correctly identify and adequately treat the Combat Related PEM Injuries suffered by our servicemen and women in war, we must appreciate the relevancy of moral values and norms to defining ourselves as persons, structuring our world, and rendering our relationship to it, and to other human beings, comprehensible. We must understand that these values and norms provide the parameters of our being - - what I term our "moral identity." Most importantly, we must recognize that combat behavior often violates our moral identity and negatively impacts our self-esteem, self-image, and integrity causing debilitating remorse, guilt, shame, disorientation, and alienation from the remainder of the moral community -- moral injury.
Acknowledging the existence of moral casualties in war demonstrates that the clinical model -- pathologizing a veteran's readjustment difficulties as mental illness -- is inadequate and requires further evaluation . On the positive side, it enhances our understanding of the war experience and its devastating effects, expands our area of concern beyond trauma and PTSD, and allows us to more adequately meet the needs of our returning servicemen and women.
The Normal Response Model
Though Professor Caplan's concerns regarding the pathologizing of the invisible wounds of war are well founded, her Normal Response model, I fear, may exacerbate the plight of veterans still further. First, to characterize veterans' "disturbed and lasting emotional response" as normal may be misunderstood and/or exploited by the uninitiated and more importantly, by those concerned more with budgetary constraints than with the well-being of veterans. If (a) veteran difficulties are merely clusters of "normal" personality and behavioral responses to battlefield conditions (clearly an abnormal situation), and (b) the traditional clinical psychiatric methods utilized by the Veterans Administration are costly and ineffective, even detrimental to healing, and (c) if veteran needs can better be met by volunteer, sympathetic, civilian listeners, I fear that Professor Caplan's program, though certainly well intended, will lead to cuts in Veterans Administration funding and of other critical veteran programs. Further, I believe, it diminishes an appreciation for and understanding of the scope and seriousness of the invisible wounds of war raising the question as to why, during this critical economic crisis and with support for the wars and subsequently for the warrior waning, do we need to continue to spend billions of scarce resources compensating veterans for behavior that is normal. Finally, and perhaps most importantly, from the veteran's perspective, she understands that her life has changed dramatically since returning from theater. She realizes that she doesn't fit in any longer, feels anger, shame, frustration, alienated and alone. So while a veteran may prefer not to think herself mentally ill, she certainly understands that something is not right, that her feelings and behaviors are not normal, that is, as they were before.
In regards to the efficacy of Professor Caplan's Listen to a Vet Program, here again I would offer some personal experiences to corroborate my point. It is clear that many veterans choose for any number of reasons not to discuss their experiences in war, especially with those who "were not there." Others, however, feel obligated to do so. Together with many other members of Veterans For Peace, for example, I have spent many years talking to students, church groups, community organizations, basically, anyone who would listen, about my personal experiences in war and, in so doing, about war's nature, reality, and consequences. I do so in order to educate and enlighten, believing, at least initially, that war was a deficiency of information, understanding, discernment, and vision and that those who make war, or support war, or just ignore war, do so because they just don't understand its realities. But, with age, experience, and study, however, I have realized that war is not a deficiency at all, but an excess, of greed, ambition, intolerance, and lust for power. And we, the warriors, are its instruments, the cannon fodder, expendable commodities in the ruthless pursuit of wealth, power, hegemony, and empire.
Despite this realization and the discomfort I feel standing in front of a group of strangers, sharing with them my most secret and distressing feelings, nightmares, and flashbacks, I continue to do it, not because it is curative or purgative or cathartic, but because it is necessary. Many of us who have seen humankind at its worst realize a responsibility to continue to sacrifice, to work for war's eradication. Or perhaps, we do it as retribution, as penance for our participation in the sacrilege of war. I think it accurate to say that no matter how many times we relate these incidents and experiences to "civilians," or how understanding and sympathetic the listeners may be, it never gets easier. It is always overwhelming, takes a great personal toll, and requires many hours to regain our calm and composure.
Professor Caplan is correct, however, in stressing the importance of listening. Should a veteran, for example, especially a family member, feel inclined to discuss her experiences in war, what she is feeling, etc., by all means, have an open mind and listen. Despite the fact that you may be made uncomfortable by what she has to say, by what she has seen and done while in war, and despite the displeasure you may feel with the realization that as a citizen in a democracy, you must bear some culpability for a war being fought in your name and for the injuries she incurred, have some courage, accept some responsibility and listen to what she has to say. Feel fortunate for this opportunity to learn and that she is willing to share with you such personal and troublesome feelings and experiences. Here I believe Professor Caplan's guidelines for listening will be helpful. But what is crucial to note, however, is that while not listening will send the wrong message to the veteran -- that what she did was wrong, unimportant, of no interest to civilians, etc., -- thereby exacerbating her distress and anxiety, listening, even compassionately, understandingly, and non judgmentally, is not in itself the elusive cure that has escaped us these many years.
What I would strongly advise against, therefore, is Professor Caplan's suggestion that civilians seek out veterans and invite, even encourage, them to "share" their experiences, impressions, and feelings, about war in a well-intentioned attempt to help. What Professor Caplan seems not to appreciate is the extent, severity, and complexity of the veteran's injuries. Not only will such an encounter not be beneficial, it may well be harmful, especially to young veterans who have yet to begin the work of "sorting out" the experience and may be coaxed by well meaning listeners into unchartered and dangerous areas accompanied only by civilians, individuals who have no idea about the nature of war and what they may well encounter while on this journey. It is probable, therefore, under such conditions, neither the veteran nor the civilian will benefit from such an interaction.
Perhaps this might sound rather cynical, but contra Caplan, my advice to civilians would be to just stay out of the way and do no harm. Realistically, they are ill equipped to help as, and I know this is clichà ©, they just weren't there, and, therefore, cannot understand, perhaps feel is better, what the veteran is experiencing. Friedrich Nietzsche said it best I think;
"It makes the most telling difference whether a thinker has a personal relationship to his problems and finds in them his destiny, his distress, and his greatest happiness, or an "impersonal' one, meaning he is only able to touch them with the antennae of cold, curious thought. In the latter case nothing will come of it, that much can be promised; for even if great problems should let themselves be grasped by them, they would not allow frogs and weaklings to hold on to them." [9]
We hope that civilians will become educated about the nature and reality of war and its effects on those who experience it, mainly so as not to be misled should some other megalomaniacal leader again attempt to send our children into harm's way. It is not, however, the veterans' responsibility to provide this education, though veteran voices can be an effective and powerful tool. Nor does their healing require civilian understanding, sympathy, or compassion, nor is healing enhanced by civilian appreciation, respect, and admiration. An important part of healing is for veterans to confront and then to work through the enormity of the experience of war, the trauma, and the moral realization that she has participated in an enterprise whose only purpose is to kill and mutilate other human beings for a cause that is at best legally and morally questionable and ambiguous. On the road to understanding and to healing, when a veteran has finally put aside the mythology of war's glory and nobility, she cannot help but see war for what it truly is, brutality, cruelty, and a violation of all that she, and most of society, holds as sacred and right. So appreciating and thanking a veteran for her "service," calling her a hero, is counterproductive as it creates a distraction from the difficult task of confronting the moral enormity of the enterprise of war. That is, it provides a sanctuary of sorts, the mythology, to which she may escape when the healing journey gets tough and threatening -- and it will -- as it is much preferable and comfortable to think oneself a hero, flawed though we may be, than a murderer and a dupe. Besides, all such gestures of respect and appreciation are, in reality, a charade, insincere, pseudo patriotic talk intended to hype sales at the mall, and to entice other naà ¯ve young people to believe war is glorious and heroic luring them into military service to become the tools and cannon fodder of future wars for profit and power.
Unfortunately healing, coming home, is a difficult, complex, and perilous journey of introspection and understanding. So, while it is important that veterans not be ostracized, shunned or ignored should they want to talk, if healing is to occur, it must be with the help of others who have shared the experience, who know the horror first hand, and not through telling war stories to voyeuristic, though well-intentioned civilians.
"When a warrior fights not for himself, but for his brothers, when his most passionately sought goal is neither glory nor his own life's preservation, but to spend his substance for them, then his heart truly has achieved contempt for death, and with that he transcends himself and his actions touch the sublime. This is why the true warrior cannot speak of battle save to his brothers who have been there with him. The truth is too holy, too sacred, for words." [10]
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