More Powerful Than PTSD (Moral Injury) (Claim Your Freedom #10)

 

Throughout this series of talks we’ve addressed soul wounds that are primarily mental (our mindset) or emotional (our feelings). But, there’s another area we haven’t spoken about- namely, spiritual health (our faith). 

In the same way our emotions can be “broken,” so also can the unique connection between our soul and our spirit. Perhaps this story will help illustrate what I mean…

Washington Booker III is one of the warriors featured in the documentary Honoring the Code. I’ll explain more about that documentary in a moment. 

Booker was a U.S. Marine Corps sniper during the Vietnam War. When he was interviewed for the film, he said bootcamp actually altered his definition of what it meant to be human. At least, it did for a moment.

He said, “When you show up for boot camp, and you go to infantry training school, they constantly drill into you that your job is to close in and kill the enemy.”

He reminded us there’s a tension you feel, because “When you begin, killing is not normal to you. They turn it into something else and make it acceptable. They run you until you almost fall out, and then you yourself begin saying, Kill! Kill! Kill! You begin to cheer for something you were once adamantly against.”

More relevant to our discussion about overall wholeness, Booker told a story from the battlefield. He reported, “I was a sniper. During a battle I killed an NVA lieutenant. It was about 4 or 5 o’clock in the morning when they hit us. I remembered where he fell…”

Notice what he said. In the same way a hunter makes a mental note as to where the deer or bird fell so that he can later collect it, Booker marked where his target died.

He confessed why: “So I could go and search the body for souvenirs after the battle.”

The battle raged most of the day. Late in the afternoon, well after the U.S. forces pushed the Viet Cong troops back, Booker looped back to check the body.

“I checked his belt, and I took his weapon,” he said. “Then, I opened his wallet.”

Remembering what he saw next, he reminisced, “There were some pictures in there-  probably some place in North Vietnam. And in those pictures were him, a woman, and some children. I knew then that they were his wife and his kids.”

Those few seconds changed him. At bootcamp killing became acceptable. And encouraged. It no longer felt that way. The pendulum jerked back in the opposite direction. An invisible wave of regret crashed over him, submerging him amidst his thoughts as he stood on the battlefield. 

Booker revealed, “That very second, the man I killed became a human— not a combatant. He was no longer some evil force moving along ridge lines or shadows. He became a person. His wife and his kid were now somewhere crying. Needless to say, I never searched another body.”

 

The unexpected plot twist

If you follow me on social media, you know I wrote a book and have created a course for veterans who struggle with the invisible scars of war. I did so in partnership with a nonprofit known as Crosswinds. That’s how I got introduced to Booker and his story. 

My friend Bob Waldrep founded the organization over a decade ago. Shortly thereafter, as an overflow of some the projects he found himself and his new organization involved in, he launched Front Porch Media & Entertainment in 2012. His goal was to better utilize film as a means of serving others.

It became apparent that the first full-length feature needed to focus on the facet of his organization that focused on public policy and military service, specifically by creating a documentary aimed at helping military personnel who were suffering mental and emotional trauma (such as PTSD) as a result of their deployment, combat experience, or separation from family members who had been deployed. 

The nonprofit released the first film, Invisible Scars, in 2014 and immediately gained wide grassroots distribution- largely by word of mouth. DVDs of the film were passed from person to person, and- through generous donors- provided free to veterans and their families. 40,000 were given away in the first few years. This “accidental” method of mass distribution created a relational connection between the organization, government agencies, service providers, and current and former soldiers.

Here’s where it gets super-interesting…

When you film a documentary, you have an idea of where the film will most likely take you, but you’ve got to remain open to the possibilities that it might take a turn you don’t expect. It could lead you somewhere else completely.

Icarus, the documentary which won an Academy Award for Best Documentary Feature, is a prime example. I streamed the film on Netflix one evening and was shocked at the radical turn it took. 

The film began as a study in illegal sports doping. The filmmaker wanted to know if he could improve his performance with drugs. Along the way, the he connected with a Russian scientist who became a trusted friend, a friend who later revealed that he ran a state-sponsored doping program for the Russians. The result was a full-fledged, totally-filmed whistle-blow on the Soviet’s Olympic doping program. No one (particularly the film-maker) saw that coming.

In some sense, this sort of plot twist happened with Invisible Scars. Bob and his team thought they were “just” creating a documentary about PTSD. Along the way, though, they continued bumping into something known as Moral Injury. 

“It looks like PTSD at first glance,” many professionals and service providers said, “but the same treatment protocols don’t help. It’s clearly not PTSD.” And, “If you treat it like PTSD, it doesn’t work. You’ve got to do something else.”

Others observed, “Sometimes, you find them together- both PTSD and Moral Injury. But they’re different.”

MI looks like PTSD at first glimpse because the symptoms- the externals (the “fruit”)- manifests in common expressions. Notice the following graphic:

In-depth interviews with soldiers, their family members, and additional professionals revealed that what they kept hearing to be true was, indeed, true. Different than PTSD, Moral Injury is a real issue. Not only that, it’s deep.

In time (and through many conversations) it became apparent a follow-up film was needed. So, in 2016 Crosswinds released Honoring the Code, a film addressing issues of Moral Injury (which you may not yet have heard of) and Survivor’s Guilt (which you probably have heard about).

The short version is this: Moral Injury most often occurs when your conscience is violated.

Think back to Dr. Perkus’ “Three Facts About Human Nature” we discussed earlier: 

  • Fact #1 = we’re designed to explore and grow. 
  • Fact #2 = as we explore we bump into things which cause us pain, something we want to avoid. 
  • Fact #3 = we create internal rules- often subconsciously to help us manage the tension between Facts #1 and #2.

Turns out, there’s also “human code” that’s hardwired into the far, vast majority of us- a set of subconscious rules. C.S. Lewis, the English professor who wrote The Chronicles of Narnia, likened it to a moral compass. Theologians refer to is as the image of God and the “law” that’s written on our hearts. Whatever you call it, there are certain rules that are common across all cultures, all people groups, and virtually all times in history. 

Everyone knows, even subconsciously, without being taught-  

  • Murder is wrong
  • Lying, cheating, and stealing aren’t right
  • Rape and sexual assault are unacceptable 
  • Men should defer to and honor women, children, and the elderly

In other words, we come hardwired with a set of rules. When we break these rules, even if we’ve never been told not to, we feel deep internal unrest. We feel pain. We may even feel broken.

Why? 

Because each of us have a conscience which actively communicates with us. Moreover, that conscience connects to the deepest, richest part of us, our spirit. 

 

Your moral compass

Webster’s Dictionary defines conscience as, 

the sense or consciousness of the moral goodness or blameworthiness of one's own conduct, intentions, or character together with a feeling of obligation to do right or be good.

In general, here’s how the conscience tends to affect people:

  • If you know to do right but do the opposite the result may be a guilty conscience. 
  • If you know right but observe someone else do the opposite without trying to stop it, the result may be a guilty conscience. 
  • If you do what is right, the result should be a clear conscience. 

In other words, if you put a gag on the voice of “do right” you will most likely experience a sense of guilt- even if you have no choice but to remain silent. Sometimes this is a misplaced guilt as the “wrong” committed is not your fault- it could be something someone else did or it could be something was done to you- or wasn’t actually a wrong.

Some people think of the conscience as that inner voice which helps us distinguish right from wrong, like a “moral compass.” Others believe it springs forth from our inner being (from our spirit or soul), giving it more of a “religious” or “spiritual” connection. 

You may have seen the conscience depicted as an angel and a devil with one sitting on each shoulder of a person, whispering in their ear. The angel tells us to do right; the devil tells us to do wrong.

One of the professionals featured in Honoring the Code, Dr. Rita Brock, offers incredible insight here. To better understand this issue, consider the causes and consequences of Moral Injury (MI) she identifies.

  1. Violating or going against one’s core moral beliefs, one’s conscience (this may be a personal choice or, as is the case soldiers often experience, one demanded or ordered by someone in authority).
  2. Evaluating one’s behavior (actions) negatively to the extent they can no longer think of themselves as a decent human being.

Notice her second point. PTSD most often occurs when a person experiences, witnesses, or encounters a traumatic event. Though PTSD (even if undiagnosed) makes us feel uneasy, the issue often remains “out there.” We can separate ourselves from it. MI, on the other hand, becomes so intertwined in the soul that we begin questioning our decency as humans. 

The expression of the two is often different. Whereas PTSD creates a “flight or fight” response (attack the issue that’s “out there” or run away from it), MI typically manifests as overwhelming feelings of guilt or shame. 

You’ve probably heard the saying, "Wherever you go, there you are.” When the issue is “in you” (i.e., your conscience), you can’t fight it or run from it. It remains present at all times.

Earlier in this series we talked about perceptions and reality- and how PTSD (or any emotional trauma) affects both our mindset and our emotions. We think one thing is happening in the present (based on our past experience), so we sometimes react inappropriately.

Moral Injury is different. Whereas PTSD primarily deals with our mind and our emotions, MI primarily deals with our mind and our spirit.

To be clear, our emotions can be involved with MI and our spirits can be involved with PTSD. These are each parts of our soul. Anything having to do with any part of us can affect every part of us. But, these simplistic graphics help provide a general framework to distinguish the two.

Furthermore, since PTSD and MI are two different issues, they must must be addressed in a much different matter.  PTSD must be addressed as being primarily a mental and emotional issue while MI, though it may have an emotional component, is basically a moral or spiritual issue.

A few talks ago, I referenced a first responder-friend who, by his own admission, carried a weight of survivor’s guilt. Remember, the man who trained him died one day while taking a routine call while my friend was scheduled “off” from work.

“It messed me up,” he said. And- “I should have been there to stop it. Or it should have been me.”

As he spoke more about his feelings related to the loss of a close co-worker, he described tangible guilt and unworthiness. In my opinion, he wasn’t dealing with PTSD, he was sorting through Moral Injury. Remember, whereas PTSD elicits the “fight or flight” response, Moral Injury is accompanied by a sense of guilt and/or shame. 

For a moment, let’s separate the two concepts of guilt (what we do) and shame (who we are). The two, though related, are different. And this helps explain why MI is so devastating. 

Whereas guilt focuses on actions (what we do), shame declares identity (who we are). People can repent of actions, but they can’t repent of their identity. 

Like we discussed earlier, an identity change requires we do more than rewrite the script. To change an identity we must re-cast the character. Or, to say it another way, we must address the root causes rather than looking at the fruit symptoms.

Undiagnosable skeletons 

Here’s the strange thing about MI: everywhere I talk about it, as many people resonate with it as they do PTSD. By that, I mean this: 

  • In the same way most of us are not diagnosable with PTSD, understanding it helps us navigate our own emotional wounds. Most of us do not have Moral Injury, but we do struggle with feelings of guilt and shame.
  • We see something tangible that we connect with- even though what we see, sense, or feel in our own lives may not be as extreme as the full-blown psychological condition. Seeing the “outlier” provides language for us whereby we can understand our own experience.
  • Based on what we learn, we find ourselves more equipped to step towards overall health. The goal remains not to receive or reject a diagnosis, either way; the goal remains living whole.

Here’s the kicker, though: no one can currently be diagnosed with MI. It’s not included in the DSM-5, which provides the basis for receiving any diagnosis.

But then again, remember, our goal isn’t to get diagnosed (nor is it to avoid a diagnosis). Our goal is to walk in total health. That is, we want to define where we are, so we can walk into who we’re designed to be. 

 

Not as bad as Booker

You probably don’t have a story like Booker’s. Few people do. Your story may be something more like this…

A few years ago I met a friend for coffee every Tuesday evening at 8:30pm (right after we tucked our kids in bed and had time to make a quick drive to the nearby Starbucks). It was our weekly 1:1 “small group.” 

One evening, he told me needed to get something off his chest. It was something he’d done a long time ago, something he’d never told anyone- not even his wife.

“What’s up?” I asked.

“A few years ago, I ____________.” 

He completely filled in the blank, telling me in a few short paragraphs the situation, the sin, and the strangle-hold which the secret held on him since the event he was hiding first happened.

I thought for a moment. Then I looked at him. 

Is that it? Is this what you’ve been carrying?” I expected something more, a somewhat bigger reveal. I mean, what he told me wasn’t a “small” issue. It was significant, but the shame he expressed disproportionally outweighed the guilt of what he had done.

Immediately, I learned two things. 

The first is that the power of hidden secrets grows exponentially the longer we keep them dead-bolted behind closed doors. No matter how big they are, and no matter how much we fear sharing them, the sooner we release them the easier.

The second is that, like we discussed with emotional wounds, the size and scope of sin is often in the eyes of the beholder. Don’t misunderstand me. Wrong is wrong. But for various reasons, it affects each of us differently. 

In the end, comparing one person’s moral high ground to another person’s low is a lot like comparing the summit of Everest to the depth of the abyss in the Pacific… from the Moon. The other day I heard that the surface of the earth is proportionally to its size smoother than an eight ball. Though the differences look radically disparate from here, grace heals them all the same.

I told him, “I’m sorry you’ve been weighted by this. That was then. You’re free from it. I know who you really are. God forgives you. Set it down and don’t pick it back up."

“I think I can now,” he said. Then- “It seemed bigger when it was inside me.”

Don’t get me wrong. It wasn’t a trite little thing he revealed. It’s just that, well, in his words, “I guess I needed to let that skeleton out of the closet. He seemed scary when he was in there. Turns out, this whole time, he was just bones leaning up against that closed door, threatening to come out and pounce me.”

I listened a moment, soaking his words. At that point, I had secrets, too. 

He continued, “I just opened the door to you, afraid of what that skeleton would do to me when I did. But he didn’t do anything. He just collapsed on the floor. He didn’t have any strength at all.”

“No,” I replied, as if to coach myself about releasing my own skeletons, about yanking them out of the closets where I’d shoved them away, out of sight but not out of mind. Then- “Skeletons don’t have any muscle. No voice, either- so they can’t accuse.”

“They can’t stand up or do anything on their own…”

“We’re afraid of the light until we actually get there,” I added. “Then we find it’s the safest, easiest, most life-giving place to be.” 

It’s scary, but it’s safe.

The problem, of course, is that it can seem like a long way to get there. Whereas flipping a light switch in your house instantly pushes all the dark away, virtually eliminating the shadows in a moment (and confirming that no monsters live in the closet, under the bed, or any other tucked-away place), flipping the light on in life seems more like a process.

In a word, here’s why: fear. 

Again, even if the light is the safest place to be, it’s also the most vulnerable and frightening. Our timidity about being exposed has to do not only with what we’ve experienced but who we think we are and who others will think we are because of what we’ve done, what was done to us, or what we failed to do.

Get ready for the next talk in this series. There’s a simple cure, but it’s used far too little in comparison to the powerful potential it has to revolutionize, well… everything.

 

 


Links for this talk

Warrior Hope- the book- (8.x5x11, 230 pages)- https://amzn.to/2NY0Td2  

Claim Your Freedom- the book- (5.5x8.5, 264 pages)- https://amzn.to/2xwQcEY   

Stream the PTSD documentary, Invisible Scars, at https://www.warriorhope.com/IS

Stream the film, Honoring the Code (Moral Injury), at https://www.warriorhope.com/HTC

"Perfect Love Casts Out Fear," talk #58 at https://www.jenkins.tv/blog/58 

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