In August of 2022, the Pentagon—in response to articles in the New York Times—seemed on the verge of officially acknowledging the large number of civilian deaths that resulted from the United States air war in the Middle East and Afghanistan since 2014. But the Pentagon did not explicitly do so. They have focused instead on measures to reduce the killing of civilians in future air strikes—not how to relieve the suffering of those U.S. soldiers who did the killing in the past. This reveals a profound ignorance of how moral injury does emotional and psychic damage to individual combatants over time. It leaves those soldiers who did the killing still carrying the guilt for the death of those innocent civilians who perished. The refusal of the U.S. government to admit and accept responsibility for the civilian deaths their air strikes caused only exacerbates the pain felt by those with moral character who cannot forget what they have done—even if their military superiors would like them to.
The idea that moral injury afflicts our service men and women may seem vague and abstract for us in the United States. But it is important for us to understand the true meaning of moral injury and its long-term effects. That soldiers will suffer on account of not being believed when they speak of war crimes or atrocities they have witnessed or committed—is so far outside the experience of most U.S. citizens and their political leaders that it escapes being comprehensible. Perhaps seeing the death and devastation in the Ukraine war can help us understand the depth of anguish felt by combatants whose stories we cannot bring ourselves to listen to, let alone believe. Perhaps we can better imagine the suffering of our own combatants as we see the leaders of another nation, Russia, deny the crimes their soldiers commit. Perhaps through their denial, we can better perceive our own.
To state a fact that you have lived through and then be told by your government that it did not happen—is a surreal experience. When the fact being denied is murder and mayhem, the surreal effect is magnified to the dimension of mental dissociation—where the mind splits off from reality and enters a realm of deep mental suffering. This experience is known as cognitive dissonance. It occurs whenever an individual has observed or taken part in a factual event and then is faced with the denial of all evidence and corroborating testimony that supports the individual’s perception of the denied event. Most of us cannot grasp the devastating effects it can have on an individual’s life.
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The scholar Nick Turse has researched the Vietnam War Crimes Working Group files, compiled by a secret Pentagon task force assembled following the My Lai massacre to ensure the army would never again be caught off-guard by a major war crimes scandal. He reported the appalling details of widespread atrocities committed by American troops throughout the war in a book he published in 2013, Kill Anything that Moves. Again and again, soldiers who reported the crimes were generally not believed, and the military commanders responsible were never held accountable. But the soldiers who knew the truth suffered the moral injury. As a psychotherapist who has treated many U.S. veterans, I can share the experience of two of my patients who served in Vietnam.
Russell sought therapy because he had bad dreams. He had served as a young man in 1967 patrolling the canals of the Mekong Delta in a Swift Boat armed with a machine gun. He remembered firing randomly at farmers near the river or at sampans plying the banks.
“ We turned our weapons on whoever appeared and fired. We were told that was our job. But it never seemed right to me. These people were just trying to make a living.”
When he returned stateside, he rarely discussed his service but when he did share details his friends and family didn’t believe him. He gradually became more withdrawn and stopped socializing, spending most of his time alone when not at work at the print shop. His depression deepened despite medication which made him feel listless. Yet he was quite agitated when he spoke to me in sessions.
He said I seemed to be the only person who would listen to him. I recommended a veterans group but he was too paranoid to join. Fearing he was a suicide risk, I called the fire department to check on him whenever he missed sessions and refused to answer my phone calls. He refused to enter a hospital for intensive treatment. He was convinced that by his own efforts he could heal himself of the mental wounds he suffered. But he figured wrong.
He took his life one afternoon in the little house where he lived by himself.
Gabe came to me as a referral from a heroin addiction treatment program. As a young Marine, he had served in a company stationed in the central highlands. In our interview, he recalled a day on patrol with his unit west of Danang.
“ We had been warned of enemy forces in the area and we were on edge for a firefight. But when we entered the hamlet, all we found were villagers—frightened women and children”.
Suddenly, shots were heard and the entire patrol began shooting wildly and indiscriminately. He recalled the screaming of children and thoughtless killings of farmers in their fields.
“What we did to those poor people was inhuman. How do you live with the memory of that?
There was no official record or acknowledgment of the incident. All the dead were listed as ‘enemy body count.’ Yet, I still remember the faces of those we killed that day.”
Gabe worked with me for many years but was never fully able to kick his heroin addiction. Eventually, he slowly succumbed to drug-induced dementia—finding, at last, some respite from the memories he suffered.
I return now to the moral injury the Russian soldiers are experiencing. I end with a letter I wrote to a Russian psychotherapist, a colleague.
I deeply empathize with the revulsion you feel as a citizen of Russia opposed to your nation’s aggression against Ukraine. For most of my adult life, since 1965, I have been actively opposed to the many wars of aggression my country, the United States, has initiated against much weaker nations: Vietnam, Cambodia, Panama, Guatemala, El Salvador, Iraq, and Afghanistan—just to name a few. The pain and shame and guilt you express is quite familiar to me—as well as the attacks from fellow citizens who accuse me of treason.
But we who oppose the wars must always remember that our opposition is never in vain.
That by our acceptance of shame and guilt—in a small way—we share the deep remorse of our fellow citizens in uniform who are forced to murder and maim citizens in a foreign land. They suffer moral injury because their government denies and does not acknowledge the carnage and destruction inflicted on innocent civilians and children—so they must bear it alone. Our solidarity with these soldiers is essential for their healing. The moral injury that always accompanies wars of aggression oppresses the foot soldiers not the generals and presidents.
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