June 12, 2015

A Missed Opportunity

Annalaura Montgomery Chuang’s “Formed by War”, the cover article in the June issue of Christianity Today, brings war and moral experience to the foreground as an aid in helping Christians think with greater precision regarding veterans and military service. Most crucially, Chuang’s article contributes to ongoing efforts to introduce the idea of “moral injury” – a proposed but often contested subset to the Post-traumatic Stress Disorder (PTSD) diagnosis – to ever larger audiences, especially Christian ones. Moreover, she cites and thereby brings to the public mind some of the major voices in moral injury work today: Jonathan Shay, Brett Litz, and, especially useful to Christians, the theologian and psychiatrist Warren Kinghorn – probably the first to introduce the concept of moral injury to Christian academic circles.

The recent surge in interest in moral injury has been largely motivated by psychiatric battle casualties suffered in Iraq and Afghanistan, but of course combat veterans throughout history have staggered home suffering not necessarily from physical injuries as classically perceived but injured all the same. Following clinical interaction with Vietnam veterans, psychiatrist Jonathan Shay began to give greater articulation to this phenomenon after realizing that many of his clients all-too-often suffered symptoms atypical to their PTSD diagnosis. These vets did not necessarily present the paranoia, hyper-vigilance, or other typical responses to life-threat ordeals but instead what he would later describe as soul wounds: crippling degrees of guilt, shame, sorrow, and remorse – most often following a sense of staggering betrayal. In response to this, Shay proposed a new diagnosis, terming the sequela “moral injury.” Over time, subsequent studies by other clinicians have deepened our understanding of moral injury and proffer modest definitional distinctions. My own doctoral research, a theological defense of killing in war in response to moral injury, predominately deals with that species of moral injury resulting from doing or allowing to be done that which goes against deeply held normative beliefs.

This emphasis is echoed in the extraordinary meditation on combat, What It Is Like To Go To War, by Vietnam combat veteran Karl Marlantes:

The violence of combat assaults psyches, confuses ethics, and tests souls. This is not only a result of the violence suffered. It is also a result of the violence inflicted. Warriors suffer from wounds to their bodies, to be sure, but because they are involved in killing people they also suffer from their compromises with, or outright violations of, the moral norms of society and religion. These compromises are not generally discussed and their impact on a warrior’s mental health and soul is minimized or even ignored entirely, not only by current military training but by society at large.

While psychic injuries ought to occur following the willful commission of atrocities or might reasonably occur after the accidental slaying of the innocent, large numbers of warfighters are suffering from having done the most basic business of war: killing the lawful enemy even under conditions commensurate with the rules of armed warfare. This is a crisis. Clinical studies reveal that having killed in combat is the chief predictor of moral injury and that moral injury is, itself, the chief predictor of veteran suicide. Warfighters are dying by their own hands at a troubling rate, casualties of war even after battle has ended. Chuang makes much of this. Setting up her disquisition on moral injury, she quotes approvingly the assertion that one of the obvious markers of the war-torn soul is suicide and then cites some of the hard statistics: veterans commit 1 in 5 suicides in America, at the rate of 8,000 per year. Because news accounts of military suicides have become a commonplace, the tragedy of the situation often seems to have become mere background noise for many war-saturated Americans who would rather forget all about our active duty and veteran neighbors, except during a handful of national holidays – or the next major threat. For all the above reasons, there’s much to commend in Chuang’s work in making plain the importance of moral injury. But with the praise comes a few reservations.

My first complaint is going to make it appear that I am contradicting myself: Chuang makes too much of veteran suicide. While it’s important that we as a nation address the crisis of military suicide we need to be sure we understand that crisis. Having linked the “war-torn soul” with suicide, Chuang allows the reasonable-seeming impression to form that veteran suicides are largely combat-veteran suicides. According to a study published in The Journal of the American Medical Association in the summer of 2013, this appears to not be the case. Rather, more than half the veterans who have taken their lives never deployed. Moreover, additional factors such as longer deployments, the increased tempo of deployments, and combat experience didn’t appear to elevate suicide risk. In fact, a separate Army finding shows that while suicide rates for Iraq and Afghanistan veterans doubled between 2004 and 2009, the rate for those who never went to war nearly tripled. The same study also found that roughly a third of those troops who had attempted suicide in the same time period had a history of mental health disorder before they even entered the military. Finally, we need to remember that the suicide crisis is not unique to the military – the civilian suicide rate has also soared in the same time period as it has soared among military personnel. Let me be clear: none of this is to diminish what is a crisis. It is only to soften some of the perceived link between having been to war and moral injury – and thereby to loosen the tight link between war and suicide.

That said, the situation is still complex. Several studies have linked the specific action of having killed in combat to a doubling of suicidal ideation compared to those who have not killed in combat. This statistic seems to remain firm even after isolating consideration to only the killing of a lawful enemy slain under the rules of war. As to why this might be so, my own research echoes Marlantes’ claim about the violation of the moral norms of society. Time and again, whether in memoirs, interviews, or clinical interactions, combat veterans will use some form of the locution: killing is wrong but in war it is necessary. If moral injury results from doing that which you believe to be wrong this idea that “killing is wrong” makes warfighting morally injurious by definition. If this is true then there’s no way out: neither serving with honor; nor a commitment to proportionality, discrimination, and the rules of war; nor the cultivation of a internal disposition of neighbor-love toward one’s enemy makes any difference. War is morally injurious. Against this Chuang offers no argument.

Indeed, my second complaint is that Chuang, instead, seems to encourage the necessary connection between killing and moral injury. Over the course of the article she highlights three veterans including Army vets Michael Yandell and Logan Mehl-Laituri Isaac and Marine vet Rob Sarra. All three happen to be associated with Iraq Veterans Against the War. Isaac, who Christianity Today placed on the cover, is a well-regarded in Christian pacifist circles. His book Reborn on the Fourth of July has a forward by Shane Claiborne in which Claiborne absurdly presents Timothy McVeigh’s 1995 bombing of the Murrah Federal Building in Oklahoma City as morally equivalent to American combat activities against Iraq. While I don’t know whether Yandell or Sarra consider themselves pacifists, Yandell is a seminary student at Brite University and is associated, as is Isaac, with Brite’s Soul Repair Center, a center to which Chuang directs our attention and one with a reputation for being grounded in pacifist theology.

Why, on balance, does Chuang seem overwhelmingly to turn to representatives of pacifism as a means of addressing moral injury? A possible answer is suggested in the essay’s concluding section in which Chuang considers saints Francis of Assisi, Martin of Tours, and Ignatius of Loyola. All three, she notes, demonstrate that veterans have much to offer the church – but perhaps only under particular terms:

All were veterans who laid down their weapons and pledged allegiance to Christ. But in so doing, they didn’t abandon their gifts of military formation and training. As Isaac says, “There is good in war as well as bad.” And one of the goods is soldiers’ willingness to serve and sacrifice for the mission and for each other. The military forms people “to be ready to die, suffer, and persevere despite suffering—and that is something the church can learn from.”

On whether there is any other way outside of abandoning their military service by which veterans might contribute to the church, Chuang remains silent, perhaps deafeningly so.

From where I stand, the essay is a lost opportunity. The intersection of moral injury and the ethics and psychology of combatant-combatant killing is, in my judgment, where the most work needs to be done. The question of whether killing a lawful enemy is, in fact, morally evil in itself forms a core component of the moral trauma besetting our nation’s warfighters. They are not being morally formed by our social institutions – including our families and our congregations – to navigate that question prior to combat. Such a complex inquiry is most helpfully framed if we understand the broader Christian intellectual and moral tradition in which the church’s theological ethical reflections have been grounded for two millennia and from which the best analysis of the psychological implications are derived and take their bearings. Why does Chuang not include someone from within the just war tradition to address moral injury? Why, indeed, in an essay on a military crisis, does she not highlight someone currently operating from within the system who clearly articulates having reconciled his or her Christian faith and military service and who can point to the theological resources that have helped them wrestle with the morally injurious business of warfighting without becoming irretrievably morally injured?

If a efficacious response is going to be found to moral injury, it has to include chaplains well-versed in the Christian ethical tradition on war, as well as those military leaders – both officers and NCOs – who set the command environment for our fighters downrange, and those military personnel who can demonstrate that faith and martial service are compatible. Scores of them are available and it is not hard to find them. They are eager to talk. CT missed an opportunity to highlight them and to support them. That’s a real shame.


 

One Response to A Missed Opportunity

  1. Tom says:

    Marc

    Thanks for this. I enjoyed Chuang’s article but also know that her suicide stats were misleading. (I’m a veteran and also work for Department of Defense.) I wonder if she’d been steered to some of her sources, which then raises the question by whom?

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