Before moral injury can be acknowledged and addressed, Brock and Keizer believe, veterans first need to deal with the question of PTSD, an identifiable brain injury that can be diagnosed and treated, if present.
Keizer tells endless stories of the perpetual stress and horror many returning veterans endure. From one who involuntarily cowered at the sound of Fourth of July fireworks to a young man who habitually picked the phantom body parts of a dead colleague off of his skin, the chaplain has counseled veterans in situations a civilian could hardly understand.
Fortunately, the medical community in recent decades has made much progress in identifying and treating the brain injury known as post-traumatic stress disorder.
Although there is still no magic cure for PTSD, “A clinician knows how to handle it, and there are actually drugs that even help, and meditations, and eye-movement therapy –– all kinds of ways that they’re working with that part of your brain to help heal it,” Brock said.
Ironically, increased success in dealing with PTSD has also made more clear the existence of moral injuries that had been masked by the stress disorder but remain once the PTSD is no longer a factor. The leaders of the Soul Repair Center are expanding the alternatives to help veterans still suffering in that way.
“Because soldiers are being treated properly [for PTSD], they’re learning to cope and deal with those issues, and then there are questions about the morality,” Baker said. “They start thinking about the things that they were a part of, that they saw or did, and then these problematic feelings start to come up.”
Brock said that, “Once those symptoms start to calm down, once you stop flashing back and … can actually construct a memory with a cause-and-effect relationship between events, rather than being taken over by them and reliving them in crazy ways … then you can put a memory narrative together, and then the moral injury kicks in.
“We keep saying that you have to have a healthy, functioning prefrontal cortex to have moral injury because that’s where the moral reasoning happens.”
For many veterans, part of that moral reasoning involves making peace with the American citizens and politicians who sent the military into life-threatening, morally confusing situations and financed the operations with tax dollars.
For Prysner, working through feelings of intense anger was part of his healing journey. The lack of attention most civilians pay to the ongoing wars is one part of a larger problem, he believes.
“A lot of veterans have a lot of anger over being sent to a war that they don’t understand,” he said.
From mythologizing war and soldiers to basically ignoring the reality the veterans endure, civilians rarely “get” the scope and human impact of overseas military endeavors.
Though President Obama plans to end combat operations in Afghanistan in 2014, many troops will remain to “support” the Afghan units poised to take over the U.S. military’s role in fighting the Taliban. If history is any indicator, active U.S. military bases will remain in the country for decades.
After 12 years of battles, suffering, death, and service by American troops, Afghanistan “is a war that is off the front pages,” Prysner said. “There’s no real passion in the United States about the fact that there are young men and women getting their legs blown off every day in Afghanistan. Coming home to a country where there’s been a concerted effort to make people not think about the war and not pay attention to the fact that people are being killed and soldiers are dying –– that’s a very alienating experience to come back to.”
Instead of wallowing in guilt and anger, he chose to funnel those emotions into positive activity. “I became angry at the people who really made the war happen,” he said.
After his contract with the army ended, Prysner jumped into political activism. He has organized forums and shared his own experiences in Iraq and the uphill battle many veterans face when trying to claim rightful benefits or treatment from the U.S. Department of Veterans Affairs. He gathers other activists to travel to Washington, D.C. for protests outside of the Pentagon and the U.S. Capitol.
In 2008, he founded March Forward!, an organization for Iraq and Afghanistan War veterans and active duty service members that works to rectify sexism, racism and homophobia in the military as well as to ensure that veterans receive the benefits they were promised.
March Forward!’s newest initiative, Our Lives, Our Rights, led by young vets and active-duty troops, hands out thousands of fliers and makes banners to hang outside of military bases. Prysner and his group want to inform troops slated for deployment that they have a legal basis for objecting if they have questions about the mission.
Ultimately, the sense of empowerment he has created for himself and other veterans has made all the difference in returning him to a sense of wholeness.
“Nothing can really undo the person I was and the things I did in Iraq,” he said. “If I can somehow use those experiences and divert that negative energy into something positive, like trying to stop the wars altogether, then absolutely, that’s the only thing I can see as something that can kind of correct the past.”
In Prysner’s opinion, the best thing the public can do to support soldiers and veterans is to become politically active. When he returned from Iraq, he thought that few people cared about the war and its ugly parts, but, “coming home to massive demonstrations of hundreds of thousands of people who are trying to take action against the war, that was extremely inspiring and encouraging for me,” he said.
In founding March Forward!, he has found a home for the ideology and service he had planned to give through his years in the military.
Brock often hears stories of moral injuries from veterans who have held them inside for more than 40 years. One Cold War pilot divulged the lifelong stress he experienced from simply agreeing to drop nuclear missiles on Korea. Though he never had to actually do so, his willingness left a hole in his sense of humanity that still needs repairing.
Whether because of PTSD, moral injury, or just high stress levels, one out of seven homeless Americans is a military veteran. Nearly one million vets live below the poverty line. The divorce rate for military couples increased 42 percent during the wars in Iraq and Afghanistan.
As with other misfortunes, the reasons for incarceration vary, but veterans make up 10 percent of the United States’ huge prison population.
Brock has found great success talking to a veterans-only group about moral injury in California’s San Quentin prison. Despite the initial reservations some had, “They just said it was the most helpful thing for all of them,” she said.
Now, each of the 15 vets who participated in the initial moral injury group leads another group of incarcerated vets. “For them,” Brock said, “moral injury, understanding it and talking about it, had really been a key piece of the whole journey together.”
For vets whose lives and families remain intact, the burden on spouses and kids can be especially heavy. While Keyte was overseas, her husband, also in the National Guard, was dispatched to the U.S.-Mexico border. They had to leave their young son in the care of his grandmother during a very formative year.
When Keyte returned, she was dealing not only with guilt over her son but also with the fact that so much had changed. “Your family evolves. People take on different roles,” she said. “It’s a big transition for everybody, and that can be a struggle.”
Through her work at Grace After Fire, Keyte has learned valuable lessons about healing and returning to wholeness from the spiritual wounds that war and absence inflicted.
“You learn the true thing of learning to forgive,” she said. “Of not only learning to forgive others, but to kind of forgive yourself.”
This weekend, Oct. 10 through 12, the Soul Repair Center will conduct a conference at Arborlawn United Methodist Church on “Veteran Recovery from Moral Injury: How Everyone Can Participate.”
Psychiatrist Dr. Stephen Xenakis, founder of the Center for Translational Medicine, will speak as well as Dr. Kristen Leslie, considered one of the foremost experts on military sexual trauma. A panel of veterans, including Keyte, will share their experiences and perspectives.
Center directors are fielding interest from Australia to Colombia and said they will work with people in other countries to set up similar programs.
The Lilly Foundation grant can be extended to five years, and if the center can raise additional money, the directors will hire more staff. Brock said the current staff is already working at capacity.
Eventually, they would like to expand beyond veterans and work with other groups whose members experience moral injury. Nurses, veterinarians, and police officers describe similar moral quandaries with their jobs.
For now, Brock and her colleagues would like for civilians in general to consider a new dimension of discussion about veterans and perhaps set aside their own beliefs about war and heroism.
“Our mission is not to take care of or to help vets,” she said. “It’s to help society learn to respect them. And that means that civilians who want to engage in helping vets recover from moral injury have to stare into their own moral culpability, which includes paying taxes and benefiting from wars fought in our name.
“When you admit to having some culpability,” she said, “it also means you have some power next time.”
Local freelance writer Caroline Collier can be reached at email@example.com. Her novel The Shining City on the Hill was released in 2012.