The human mind is extremely compacted and also unique even for identical twins. Yet, it is the principal obligation of the study of psychology to seek and understand it. It is possible for one person to work in an execution room and retain mental health through to a ripe old age while another person will witness the gory scene and require institutionalization for the rest of their life. What happens to soldiers who have been on active duty has been the subject of study for as long as streamlined fighting has been in existence. Among the major discoveries in the subject of psychology is Post-traumatic stress disorder (PTSD) (Maguen & Litz, 2011). This is, however, an actual mental disorder but a recent study has sought to understand the emotional and perceptional impact of fighting actively in combat and how it affects different people. Among the discoveries made in this study and acts as a bearing factor in the understanding of PTSD is moral injury. This is when a soldier in or after active combat feels that a personal act or omission went against their principal personality (Maguen & Litz, 2011). This feeling affects the soldier at a moral level and might exacerbate with devastating consequences. It is this moral wounding and the extent of its consequences that informs the essence of this research paper.
Practical Overview
On the sixth day of August 1945, a single man pulled a lever releasing a bomb called the little boy. As a veteran bomber pilot, this is an action that he had done several times in combat. Further, it was just a lever, pulled inside a plane that was thousands of miles over Hiroshima. His colleagues in the next plane were at hand to record the results of the pulled lever. These results included a large ball of fire, the vaporization of thousands of people, the death by burning, radioactive poisoning and injury of tens of thousands of others and the condemnation of hundreds of thousands to direct and indirect harm over a period of over a century. What was once a city, before the lever was pulled became a wasteland seconds after. If a hundred people would be placed in that scenario, all of them would react in a unique way over a period of time. None would be exactly as the other but if they were to be studied carefully over a couple of years by a professional, clusters of reaction would begin to form. Some would be alright and moving on with their lives but would privately remember that incident. Others would be seemingly fine but devastated inside, and also in private (Arrow & Schumacher, 2017). Further, some would be openly affected and would require a lot of support and counseling while others may break down and need to be institutionalized and tranquilized soon after. However, for others, no effort would manage to save them from dying by their own hand or from the ensuing depression. All these individuals would have suffered a moral injury as they would have done something that goes beyond what any human being would call normal human conduct (Maguen & Litz, 2011). The differences would arise based on the extent of the injury, psychological constitution, and coping mechanisms.
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How Moral Injuries Occur In Combat
A soldier is not like an ordinary citizen and usually undergoes a lot of raining to psychologically prepare them for combat missions. Therefore, normal combat occurrences may not impact upon them as they would on normal people. For example, during training for the Marine Corps, the trainees are insulted repeatedly to eliminate psychological shock effects from their systems. Grave insults revolving around the self and even parents may be involved. This galvanizes the soldiers in preparation for how grueling the battle scenes may be. Therefore, moral injury from the perspective of military veterans is different from moral injury in ordinary citizen. For example, the act of killing or witnessing death may not cause moral injury for a soldier but may do for an ordinary citizen, even when they kill in perfect self-defense. For soldiers, a good kill regardless of the number of times it happens may neither cause remorse nor moral injury (Purcell et al, 2016).
A good example of the cause of moral injury would be the Vietnamese War. Many brave young men registered for service around this war because they wanted to save the South Vietnamese from the horrors of communism. This was mainly based on extensive capitalist propaganda. The young men sauntered into South Vietnam expecting a hero’s welcome from those they had gone to save. Instead of a hero’s welcome, they would find a villain’s welcome by a populace that wanted them gone and would do anything to hurt them. The result would be soldier sometimes having to fight and kill the same people they thought they had come to save. This would have a profound negative impact on the minds of these young men leading to moral injuries (Arrow & Schumacher, 2017).
Another plausible cause for moral injury while still focusing on the Vietnam War example is accidentally killing the innocent while trying to kill combatants (Purcell et al, 2016). The US armed forces had been used to fighting a clearly visible or noticeable enemy mainly in remote areas. In Vietnam, the enemy took the fight to highly populated residential areas where they would place ambuscades for American soldiers. With time, the soldiers would develop great fear due to repeated sneak attacks and anything that moved would seem like an enemy. This resulted in many accidental shootings of innocent women and children, the old or the ill whose only mistake was turning a corner at the wrong time or walking out the door as the patrol was passing. Taking a shot that kills a little child or a mother who is carrying a nursing baby can cause grave moral injury (Purcell et al, 2016).
The Pacific theatre of the Second World War presented some of the largest naval battles and formations in history. Hundreds of ships would move in formation as America made the final push to the Japanese home islands. In a desperate attempt to stop them, the Japanese launched Kamikaze attacks. This would involve a suicide pilot who would try their best to fly their planes directly into enemy vessels. The largest ships were aircraft carriers which would have thousands of sailors. Support vessels would, therefore, be ordered to protect the massive carriers at all cost. In the melee, it was common for one support vessel to fire explosives which would miss their targets and land on other friendly vessels causing death and destruction. Killing a fellow soldier while fighting in the same side is called fratricide or friendly fire and is a very common cause of moral injury (Arrow & Schumacher, 2017).
Finally, it is possible for a clean fight in the battle to still cause moral injury based on the outcome (Shay, 2014). Among the youngest veterans in the USA today include those from the two wars in Iraq. The second Iraq war was modeled around a desire to stop the Iraqi government from using weapons of mass destruction. Iraq fell within a fortnight of commencement of the war mainly due to the gallant efforts of US soldiers. A massive search for the weapons of mass destruction ensued but even after the finding and hanging of Saddam Hussein and the conquering of the entire Iraq, not a single weapon of mass destruction was found. Further, little if any good seems to have come from that war effort as it would lead to the advent of ISIL. A war veteran who had finished duty in Iraq then had to watch ISIL Mujahidin beheading American citizen may develop moral injury by feeling that perhaps an unjust and unsuccessful war had been waged (Shay, 2014).
Impact of Moral Injury to War Veterans
Biological Impact
The biological impact of moral injury relates to how these injuries affect the bodies of the veterans from a medical perspective. The moral injury is not physical in nature although the event that caused a moral injury could also have caused a physical one. It must, however, be noted that moral injuries affect the mind and the mind is closely intertwined with the body (Kruger, 2014). It is the mind, through the brain that controls bodily functions through neurological and chemical processes. Stress and mental trauma caused by a moral injury will have an adverse impact on important bodily processes leading to biological impact. For example, reproductive systems in both men and women are controlled by hormonal systems controlled by the brain. When the mind is affected by a moral injury, this may lead to a hormonal imbalance that has actual biological consequences (Kruger, 2014). For men, this may cause temporary erection dysfunction and in women, it can disrupt the menstrual cycle. Chemical imbalances in the body can also have adverse biological consequences such as the advent of ulcers. From another perspective, moral injury has been known to have consequences such as insomnia or anorexia which both can have adverse biological consequences.
Social Impact
This is one of the areas of key concern because of its high prevalence. Reverting to the earlier example about pulling a lever at Hiroshima, for each of the candidates, no matter how strong they seem, their social life would be impacted. Human beings are social beings whose life depend inter alia on a complex set of relationships (Koenig et al, 2017). All relationships are about balance. Among the most common areas of balance s distance. This may not necessarily refer to physical distance but moral distance as two people can be in the same room but still seem distant from one another. Being too distant strains social relationship and sticking too close can also have the same effect. Moral injury leads to a low self-esteem. It may also make individuals feel as if they are unworthy or judged by others because they are condemning themselves. It is easy for such people to keep a distance from friends and relatives and avoid close interaction. This will affect social relationships. The exact opposite is also possible. A person who suffers from moral injury may also attempt to overcompensate (Koenig et al, 2017). A war veteran who has been aware of the family and suffered moral injury may try to overcompensate by being too caring and clingy. This does not also auger well for social relationships. One way or the other, unmitigated social injury can easily lead to loneliness because the social circle has inadvertently been pushed away. The absence of social connection will then exacerbate the condition (Shay, 2014)
Cultural Impact
In sociology, culture refers to ideas, customs and social behaviors that an individual identifies with. Cultural identity is a major determinant of how people perceive themselves. Decades ago during the Vietnamese War, a draft existed where young people would be selected to serve in the armed forces. By the time of the Gulf War, this had ended and military service made voluntary. In many cases, it is the cultural belief that would cause people to join the military (Koenig et al, 2017). This includes patriotism and a desire to see good triumph over evil. Moral injury can arise when such cultural beliefs are contradicted by what happens in active service. A realization that a war effort was erroneous can have such an impact. This can lead to individuals deeply questioning their cultural standing thus leading to an identity crisis. From a different perspective, a moral injury can arise from an action that goes against the very belief that a soldier upholds. Active fighting can get ugly even for the most disciplined soldier leading to acts such as collateral deaths (Yan, 2016). A Christian, for example, can believe that an act or omission done was too evil to be forgiven or considered as Christian anymore. This can have a significant cultural impact. Not having a well-established identity can lead to social and psychological problems.
Psychological Impact
This is another crucial impact area due to high preponderance and impact. Psychological impacts vary exponentially and several impacts can manifest in the same veteran because of moral injury. One of the major psychological impacts of moral injury might be causing or exacerbating mental illnesses. One of the key modern research into the issue relates to the relationship between moral injury and PTSD (Kruger, 2014). For example, an incident that causes PTSD can also cause a moral injury such as survivor’s guilt. Soldiers walking together and one steps on a landmine but in spite of all the efforts of the other soldier the injuries seem fatal. Researchers are seeking to establish how moral injury under the circumstances can be a bearing factor on PTSD. This research also seeks to establish of the advent of PTSD can be directly caused by the moral injury itself, or the moral injury just contributed to the factors that caused the PTSD (Kruger, 2014).
Stress that can lead to clinical depression is also another psychological impact of moral injury. This happens when moral injury operates as a stress factor. If proper extenuation of the stress does not take place, this stress can lead to adverse consequences such as clinical depression (Yan, 2016). Clinical depression is one of the most common mental health issues facing veterans in America. A large cross-section of the same is caused by moral injury. This is more so the kind of moral injury that leads to personal condemnation and a hatred towards the self. Further, mental problems caused by moral injury can also lead to physical injuries as well. The United States Department of Veterans Affairs between 1999 and 2010, a US veteran would commit suicide every 65 minutes. This lead to thousands of deaths (Yan, 2016). For every suicide, there are several failed attempts that lead to injury and also very many suicidal ideations. Moral injury has contributed exponentially to this problem.
Spiritual Impact
Yan (2016) defines spirituality as rising above just organized religion and into a belief in transcendence or even merely a search for transcendence. Further, the same research came to the conclusion that when human spiritually is adversely impacted, the same can have a massive impact on the psychological and physical well-being of an individual. The focus of this research revolved around Operation Enduring Freedom/Operation Iraqi Freedom veterans. These veterans were found to have had a major adverse impact on their spirituality mainly based on moral injury. May people who are willing to run the kind of risks that are associated with active combat have a strong belief in the existence of a supernatural being, more so God. Many of the veterans who went to fight in Iraq were of Christian faith. What happened in the war caused many of them to develop strong doubts about this faith or in themselves as Christians (Yan, 2016). Some, due to the moral guilt opined that they could no longer have a healthy relationship with God. Mental anguish and distress caused by the effects on spirituality by moral injury led to psychological and other consequences among this veterans.
Discussion on Saint Leo value of community Perspective
St. Leo University is much more than just a motley collection of people, brought together by the common agenda of seeking for an education. Instead, it is a community of people whose relationship rises above the common goal of academia. The Saint Leo value of community is based on the Christian faith and seeks to develop hospitable communities within the community and to all that this community interacts with. Among the key principals of this value of fostering a sense of belonging, oneness, interdependence on a foundation of mutual trust and respect. The value also engenders listening, learning, transformation, and service.
When people come together for any reason, a social essence ensues that will have a singular and collective impact amongst them (Shay, 2014). As there is no neutral impact, the social impact of interaction will either be positive or negative based mainly on the individuals who come together and the terms of their having come together. For example, Saint Leo brings together a student body. A pursuit of education is what brings them together but much more than education happens at Saint Leo, people make friendships, bonds, and interactions. It is the values under which people meet and stay together that determine if the impact will be negative or positive. The very well-established and implemented Saint Leo value of community as ensured positive interactions that leave the students better in spite of the grueling experiences of academic pursuit. On the extreme end of the divide, the US military juggernaut collects the cream of the US society then spends billions of dollars training them (Yan, 2016). They then send them out for the noble cause of fighting for freedom. Something between their leaving and return goes wrong leading to scary statistics such as suicide every 65 minutes. The goal upon which people find themselves together is not enough, terms of association, such as the Saint Leo value of community need to be developed to ensure constructive, not destructive engagement.
It would be very unfortunate if any of the gallant men who make many sacrifices to fight for the USA and liberty to consider those who died in battle to be the lucky ones. Among the reasons that would lead to this unfortunate outcome is moral injury revolving around active military service. Most soldiers join military expeditions with an active desire to positively change the world. Yet, when they get engaged in combat, some will come to the realization or assumption that their sacrifice may be making the world a worse, not a better place. Others may be involved in accidents and incidents that scar their consciences forever. This is the essence of moral injury. No matter how pronounced, moral injury can be mitigated upon and no matter how seemingly trivial, moral injury can exacerbate unless properly mitigated upon. Like the Saint Leo value of community, the US military needs to work on their terms of association, even as they work on their core obligations. The oneness that comes with joining the army ought to be constructive and not destructive. This will mitigate upon and even reduce moral injury.
References
Arrow, h., & Schumacher, W. (2017, May 29). "Moral injury" in veterans can be as harmful as physical wounds. Retrieved October 28, 2017, from https://www.salon.com/2017/05/29/what-is-moral-injury-in-veterans_partner/
Koenig, H. G., Boucher, N. A., Oliver, R. J. P., Youssef, N., Mooney, S. R., Currier, J. M., & Pearce, M. (2017). Rationale for spiritually oriented cognitive processing therapy for moral injury in active duty military and veterans with posttraumatic stress disorder. The Journal of Nervous and Mental Disease , 205 (2), 147-153
Kruger, L. E. (2014). Is there more to the experience of war trauma than PTSD? The development of moral injury and its impact on soldiers. Journal of Military Government Counseling , 2 (2), 136-145
Maguen, S., & Litz, B. (2011, December 23). Moral injury in the context of war. Retrieved October 28, 2017, from https://www.ptsd.va.gov/professional/co-occurring/moral_injury_at_war.asp
Purcell, N., Koenig, C. J., Bosch, J., & Maguen, S. (2016). Veterans’ perspectives on the psychosocial impact of killing in war. The Counseling Psychologist , 44 (7), 1062-1099
Shay, J. (2014). Moral injury. Psychoanalytic Psychology , 31 (2), 182
Yan, G. W. (2016). The invisible wound: moral injury and its impact on the health of Operation Enduring Freedom/Operation Iraqi Freedom veterans. Military Medicine , 181 (5), 451-458
