Going beyond PTSD to help soldiers who have suffered a 'moral injury'

The military is going beyond PTSD to help soldiers who have suffered a 'moral injury'
PRI's The World
Reporter Susan Kaplan
December 27, 2013

The trailer for the new Peter Berg movie “Lone Survivor” says it all: for soldiers, there are decisions that truly change your life.

In one scene, the small Navy SEAL team assigned to kill an al-Qaeda leader is surrounding a young Afghan goat-herder in the middle of the Hindu-Kush Mountains. Taylor Kitsch’s character says, “The way I see it, we got two options: one, let 'em go, roll the dice. The second that they run down there, we've got 200 on our backs. Two, we terminate the compromise.”

Mark Wahlberg’s character cuts in: “…Not killing kids, not feeling it. This is not a vote, we're gonna cut them loose and we're going home.”

Those choices often haunt veterans for the rest of their lives. Today, officials in the Department of Veterans Affairs say psychological damage from particularly egregious war violence — like killing children or seeing friends killed — can create an affliction of the soul. And they call it moral injury.

Serving in Operation Iraqi Freedom in 2004, Army Sergeant First Class Robin Johnson's platoon was running a routine checkpoint, hoping to nab people carrying car bombs or explosives in their vehicles. Suddenly, Johnson says, a car comes out of a side street and speeds up, heading straight towards them.

“The window [of time] of signaling shooting for a warning shot, shooting to disable and then engaging can be milliseconds,” he says. “You have to make that judgment call of ‘Is this a threat?’”

Johnson's platoon engages. He's one of the first to fire.

“Once it was done … it was just a family. You know, a mother, father and infant, in the mother's lap, and then two little girls in the back seat,” he says.

Johnson re-lives that day over and over again in his mind, and often finds himself angry at the father driving the car.

“You know, 'why didn't you just stop, like, why didn't you stop?'” he asks. “What was his logic? Was he trying to get down the next side street? Did we scare him? What was going on in his head at that moment? Now, this whole family is gone — they got up that morning and they ate breakfast together, they talked and they laughed and they planned out their day, and now, they're gone.”

Retired Navy psychiatrist William Nash says, “What makes a warrior a warrior is taking personal responsibility. And when they fail to live up to that enormously high ideal, that's moral injury.”
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Sounds all too familiar. Almost the same thing happened to a young Iraq veteran I was helping a few years back. He was a member of the National Guards. All he could remember were the kids in the back seat of the car. He forgot what he tried to do to prevent it from happening. It took about 5 phone calls before he opened up on what was destroying him emotionally. Every time he looked at his own kids, he saw their haunting, lifeless faces.

Once he was able to remember everything that happened that horrible night, forgive the Dad for causing it to happen and forgive himself for having to make the choice of pulling the trigger, he began to heal.

This isn't magic. It isn't about pills as the answer to all. It isn't about fame or money or anything other than understanding human nature and what makes servicemen and women so different from the rest of us.