Moral Injury May be Most Important Factor in Military Suicides

Child cries after surviving a vehicle checkpoint shooting by American soldiers in Iraq that killed most of her family. Many doctors are suggesting a condition known as ‘moral injury’ may be increasingly a factor in the rising rate of military suicide. (Chris Hondros)

MORAL INJURY: The Crucial Missing Piece in Understanding Soldier Suicides

by Rita Nakashima Brock
Huffington Post, July 23, 2012

Note: This piece was co-authored by Col. Herman Keizer, Jr. (ret.), Co-Director of the Soul Repair Center, who served for 34 years as a military chaplain, and Dr. Gabriella Lettini, co-author of ‘Soul Repair: Recovering from Moral Injury After War,’ Beacon, forthcoming November 2012.

The crisis of military suicides, averaging one a day, has captured national attention. The July 23 cover story in Time magazine summarizes much of this coverage. Unfortunately, it is misleading.

The article presents the suicides of two officers — a helicopter pilot who served in Iraq and a medical doctor who did not serve in Iraq or Afghanistan. This example skews the article in two ways. First, in focusing on officers, it selects a group that tends to see less direct combat than the enlisted men who both do more direct fighting and commit suicide at higher rates than officers. Second, in contrasting the two officers’ deaths, it suggests that suicide rates are the same for those who serve and those who do not serve in combat.

Soldiers are trained to kill, which is regarded as criminal behavior in civilian life, and they are trained to be lethal without even thinking about it, a method of training called reflexive fire training — Dr. Rita Nakashima Brock, founding co-director of the Soul Repair Center at Brite Divinity School

However, the medical doctor first was an enlisted soldier who worked on a bomb squad and served in Bosnia. He was also in Oklahoma City just after the federal building was attacked — years before he decided to become a doctor.

It’s likely he saw war conditions during his earlier service.

We need to remember that the U.S. has sent its forces into violent conflicts every year since World War II, except one, so Iraq and Afghanistan are not the only ways a soldier may have experienced combat.

The most serious blind spot in the reporting on military suicides is an absence of discussions about the moral impact of military training and its implementation in combat. Soldiers are trained to kill, which is regarded as criminal behavior in civilian life, and they are trained to be lethal without even thinking about it, a method of training called reflexive fire training.

We suggest that moral injury is likely one of the most important factors in military suicide rates.

Moral injury is not PTSD. The latter is a dysfunction of brain areas that suppress fear and integrate feeling with coherent memory; symptoms include flashbacks, nightmares, dissociative episodes and hyper-vigilance. PTSD is an immediate injury of trauma.

Moral injury has a slow burn quality that often takes time to sink in. To be morally injured requires a healthy brain that can experience empathy, create a coherent memory narrative, understand moral reasoning and evaluate behavior.

Moral injury is a negative self-judgment based on having transgressed core moral beliefs and values or on feeling betrayed by authorities. It is reflected in the destruction of a moral identity and loss of meaning. Its symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live.

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2 Responses

  1. […] Moral Injury May be Most Important Factor in Military Suicides. […]

  2. Perhaps moral suicides can be separated from other forms; however, both are based on disillusionment and despair…an Ego State that leaves little room for recovery. The ego feels trapped with no hope and options are not readily accessible during isolation and withdrawl from everyone and everything, including the real self or spirit. My approach as a trauma therapist is to engage the Injured Warrior with various forms of meditation and relaxation to help slow down the mind so that the Warrior can join Nature. When experiencing this relationship, the service member realizes he-she is not alone….everything is participating and interacting with them. They have never been alone in Nature-Reality, only the Ego separates itself from All that Is. Beware of labeling and drugging the Injured Warriors as they will be unable to experience this relationship. See our recommended Plans and Programs for serving injured warriors and their families returning to our community.

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