Moral injury to the body politic

It is a truism that we often come to our insights by circuitous, even unexpected routes.  I never imagined that reading a book about the trauma suffered by combat veterans of the Vietnam war would lead to reflection on the U.S. body politic.  And that this train of thought occurred without the prompting provided by hypertext or Wikipedia is perhaps even more amazing!  (Small rejoicing here from a semi-Luddite.)

As is often the case these days, my exploration began with a mother’s interest in her offspring’s endeavors.  In his field placement as part of his work for a master’s degree in social work, my son counsels veterans, mostly Vietnam-era men, at the vet center in his hometown.  Somewhere I’d seen a reference to the book Achilles in Vietnam  by VA psychiatrist Jonathan Shay, who works with veterans suffering from severe, chronic post-traumatic stress disorder (PTSD).  I thought that reading the book might help me learn about the experiences my son is having in his field work.  I can’t say whether that purpose was accomplished because my son, quite properly, doesn’t share with me his experiences in his counseling work.  But the motivation was sufficient to get me to open the book, and from the first page on, I was completely engrossed in Shay’s compelling analysis.

 Achilles in Vietnam fascinates on more than one level.  With great creativity, Shay sets the story of Achilles in the classic poem The Iliad alongside the story of Vietnam combat veterans as revealed in their own personal narratives.  The similarities in these two stories, occurring millennia apart, go beyond the specifics of battlefield strategies and military organization, beyond even the horror and fear that are part and parcel of war.  Each narrative, whether of Achilles on the outskirts of Troy or of the veteran of reconnaissance patrol on Highway One along the South China Sea, reveals the same kinds of soldiers’ experiences that result in what Shay names as “the undoing of character.”  More significantly, each narrative serves to inform the other, so that appreciation of the Homeric epic is enhanced and deepened by the stories Vietnam combat veterans have to tell us.

However, Shay’s principal concern in writing the book is this:

 “…to put before the public an understanding of the specific nature of catastrophic war experiences that not only cause lifelong disabling psychiatric symptoms but can ruin good character.  I have a specific aim in doing this:  to promote a public attitude of caring about the conditions that create such psychological injuries, an attitude that will support measures to prevent as much psychological injury as possible.  It is my duty as a physician to do my best to heal, but I have an even greater duty to prevent.

Most of this book describes in great detail the evolution of combat trauma, both in The Iliad and in the lives of Shay’s patients.  Only the last 25 pages does he approach questions of possible healing of PTSD (see endnote) and lessons that may be learned toward the goals of treatment and prevention.  He concludes with his proposal for a “species ethic” that includes this rule:  “Refrain from doing that which causes PTSD symptoms and character damage.”

In all, this is the most sobering book I have read in quite some time, with much to feed reflection.  But what has any of this to do with our body politic, or the common life we share as citizens?  I began to get an inkling of an answer to this question even in the opening sentence:  “We begin in the moral world of the soldier — what his culture understands to be right [italics added] — and betrayal of that moral order by a commander.”  Now I’ve never served in the military, never experienced the battlefield variety of combat , but these words called up feelings that seemed somehow familiar.  Betrayal of the moral order by a leader, violation of what we believe to be right…isn’t that what brought millions of us to the streets in February, 2003, to protest, nonviolently and peacefully, as our political leaders were taking our country into an invasion for which no moral ground was apparent? 

Shay notes that there is no one word in English that entirely expresses a culture’s definition of right and wrong.  The ancient Greek word that Homer used, thémis, encompasses meanings conveyed by terms like moral order, convention, normative expectations, ethics, and commonly understood social values.  As an equivalent of thémis, Shay uses the phrase “what’s right” as that which is betrayed, not by just anybody, but by leaders, those in positions of authority.  If we look back into the history of our country honestly and clearly, don’t we see evidence of this sort of betrayal over and over? 

For just a few examples, how about PG&E’s conflicting statements on the San Bruno gas pipeline, or various corporate statements on the Gulf oil spill?  Think of President Bush, Vice President Cheney, national security advisor Rice, Secretary Powell, Secretary Rumsfeld, and so many others invoking ever shifting justifications for invading Iraq.  Or, closer to Shay’s concerns, what of generals who articulate grand schemes with PowerPoints in the safety of the rear echelon, grand schemes that send our brothers and children and spouses into harm’s way for dubious ends?  Recall, sadly, the unfulfilled promises of President Obama to close the Guantanamo detention camp.  How about Congress bailing out an insurance company and preserving tax cuts for extremely well-off people at the same time that millions are losing jobs and homes?  Need I mention certain leaders of the Roman Catholic Church, or assorted Christian evangelical pastors?  These are merely a few instances, in just the past decade, in which leaders in high places with great authority told their fellow citizens what turned out to be — let’s not mince words — lies.  Is not the making of statements with intent to deceive a betrayal of “what’s right”?  How could any of this fail to result in feelings of having been betrayed and abandoned by leaders?

Now it’s certainly the case that the lies of political, corporate, and religious leaders will not have the profound effect of the commander’s betrayal in battle.  I am not claiming anything like that; to do would be to diminish the destructive effects of combat trauma on soldiers.  These are in no way comparable.  Still, the kind of betrayal in which our leaders have engaged has, I believe, resulted in an attenuated form of moral injury.  Just as happens with combat trauma, the cumulative effect of these failures of leaders has been to decrease the capacity for public trust in any leadership to nearly the vanishing point.

A second aspect of moral injury is what Shay terms “shrinkage of the social and moral horizon.”  the continued and prolonged betrayal of “what’s right” leads to a contraction of loyalty, a decline in the sense of connection to those outside one’s immediate circle.  Again, this sounds sadly familiar.  Robert Putnam and others have documented the decline in “social capital” in the United States, as our political parties and religious bodies are becoming more rigidly ideological and insular.  We don’t know any more how to have even a conversation with those who hold views different from our own.  Some of us congregate only in order to mine our grievances.  Even (some would say, especially) in the church, we don’t want to challenge the comfort level attendant on worshipping with people who look, think, and believe the same as we do.  Dr. King, whose birthday we observe this month, claimed that “We are caught in an inescapable network of mutuality, tied in a single garment of destiny.  Whatever affects one directly, affects all indirectly.”  His vision has receded considerably since those days in the Birmingham jail from which he wrote these words.

In combat trauma the betrayal of “what’s right” by leaders and the shrunken social space combine with the grief attendant upon loss of comrades to produce a rage that cannot be quelled.  These circumstances may eventuate in the behavior that Shay describes as “berserk,” in which violent abuses are committed one after another.  Characteristics of the berserk state include the following:

 Beastlike

Godlike

Socially disconnected

Crazy, mad, insane

Enraged

Cruel, without restraint or discrimination

Insatiable

Devoid of fear

Inattentive to own safety

Distractible

Indiscriminate

reckless, feeling invulnerable

Exalted, intoxicated, frenzied

Cold, indifferent

Insensible to pain

Suspicious of friends

Berserk is a ruinous state for combat veterans, who Shay believes are changed forever by it.

Berserking emerges in the body politic only occasionally, thank goodness.   I believe it is currently manifested primarily in the violence of speech.  For examples of berserk speech in our national life, we can point to media figures on the right (Fox) and, regrettably, on the left (MSNBC) as well.  Politicians in both major parties engage in speech that exhibits many of the berserk state’s characteristics.  If you’re skeptical about this statement, just tune in to C-SPAN when Congress is in session, and listen to the so-called debates in both houses.  Even people in the so-called peace movement often use language about those with whom we disagree that belies the beliefs we claim to hold.  The public discourse has been coarsened by all of these practices, and we appear to have diminished our capacity for caring about the well-being of others.  In the extreme, the consistent assault of berserk speech on our ears may well lead to physical violence.  In the wake of the shootings in Tucson, much has been said about the possible influence of violent rhetoric on the alleged shooter.  The motivation for his actions is far from clear, but what is clear is the continued pitched-battle aspect of the commentary on them.  As has been said, words have consequences.

What is the way back from this phenomenon of moral injury to our body politic?  If, as Shay asserts, the essential injuries are moral and social, the central treatment must be moral and social.  In Shay’s work, the essential first step is for the veteran to establish his own safety, sobriety and self-care.  Creating one’s own narrative of the trauma and sharing it with a trustworthy community of respectful listeners may work to help heal the changes in personality and character wrought by the trauma.

I’m not a professional healer of any sort, and I wouldn’t know how to construct the kind of environment or conditions that would facilitate healing the moral injury to our body politic.  As a person of Christian faith, I would like to think that our churches could be places of such healing.  We could start by acknowledging our own contributions, whatever they might be, to the moral injury that afflicts our body politic.  (There’s a reason that most of our liturgies begin with confession.)  Yet, as I look around, I see few religious settings that might desist from their doctrinal (or anti-doctrinal, for that matter) preoccupations long enough to provide the safety and hospitality necessary for the morally injured, who are all of us, to find respite within their walls.  Since Christian hope is a state of mind independent of the state of the world, however, I live in the hope we in the church might be found “a trustworthy community of respectful listeners” to our sisters, our brothers, and even ourselves. 

Shay has written a second book, Odysseus in America, in which he examines, again through the lens of combat veterans’ experience, what it means to return from war to civilian society.  The concluding paragraphs of that work, published in 2002, appear to have been added in the aftermath of the attacks on September 11, 2001.  Shay reports that the veterans in his care, while reliving their own gut-wrenching symptoms, also “reported seeing the light of comprehension coming on in the eyes of family members, neighbors, employers….Like combat vets with PTSD, ordinary Americans had nightmare, intrusive memories, constant obsessive thoughts about airplane and anthrax attacks.  Like combat vets with PTSD, they lost interest in many things they had previously thought very important….They became jumpy and hypervigilant.”  If each of us recalls our own responses to 9/11, perhaps through that experience of moral injury as citizens and human beings, we can find solidarity with these veterans who have suffered so greatly.

Finally, I join Dr. Shay in gratitude for the generosity of those veterans who shared their stories for his book.  Such courage should not go unnoticed.

NOTE:  Shay now prefers the term “moral injury” rather than PTSD, and so I have used the former term in this writing.  For a recent interview with Dr. Shay that enlarges on this point, visit www.pbs.org/wnet/religionandethics/episodes/may-28-2010/jonathan-shay-extended-interview/6384/.

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4 thoughts on “Moral injury to the body politic

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