Treat­ing war’s moral in­juries

Re­turn­ing sol­diers’ feel­ings of guilt, shame, re­sent­ment and be­trayal are sep­a­rate from PTSD.

Los Angeles Times - - OP-ED - By Nancy Sher­man Nancy Sher­man is the au­thor of “Af­ter war: Heal­ing the Moral Wounds of our Sol­diers.” She is a pro­fes­sor of phi­los­o­phy at Ge­orge­town Uni­ver­sity.

When the Greek play­wright Sopho­cles came home from war, in the 5th cen­tury BC, trust and be­trayal must have been on his mind. He wrote “Philoctetes,” about a wounded Greek war­rior aban­doned by Odysseus on the way to Troy.

The stench of Philoctetes’ wound and his wails of dis­tress made him a li­a­bil­ity. That is, un­til Philoctetes’ sa­cred bow, a gift from the god Her­a­cles, turned out to be the Greeks’ last hope for de­feat­ing the Tro­jans. Odysseus re­turned to res­cue Philoctetes (or at least his bow), but he dared not show his face to the man he had left be­hind. Hid­den, he coached a young sol­dier, Neop­tole­mus, on how to build rap­port with Philoctetes in or­der to ex­ploit it to get the bow. The twist in the play is that real trust is cul­ti­vated in­stead; and with it, hope that heals.

The an­cient Greeks un­der­stood Philoctetes’ agony and sal­va­tion in the con­text of the Pelo­pon­nesian War. Mod­ern Amer­i­cans can ap­ply it to the long­est con­flicts in Amer­i­can his­tory: the wars in Afghanistan and Iraq, in which 2.7 mil­lion troops have served. Many are bring­ing home the weight of re­sent­ment and be­trayal, and of­ten guilt and shame, even if it’s masked by a stoic mil­i­tary de­meanor. Like Philoctetes, some feel be­trayed by com­man­ders or unit mem­bers; some by civil­ians who’ve been “at the mall while we’ve been at war”; and some by politi­cians they think have failed to take full re­spon­si­bil­ity for the wars they started.

The term “moral in­jury” res­onates with th­ese troops. It’s an old con­cept. The no­tion of a wound that is moral, or oc­ca­sioned by “contempt” and “injustice,” is the cen­ter­piece of ser­mons by Bishop Joseph But­ler in early 18th cen­tury Eng­land. From the philoso­pher’s per­spec­tive, the con­cept is a way of talk­ing about an­guish caused by wrong­do­ing (real and per­ceived ) — oth­ers to­ward you, you to­ward oth­ers, oth­ers to­ward oth­ers, you to­ward your­self. Agent, vic­tim and wit­ness are all play­ers in the moral con­science.

And trans­gres­sion isn’t the only is­sue at the heart of moral in­jury. So is fall­ing short of the lofty ideals of mil­i­tary honor. That the mil­i­tary code — never aban­don a buddy, bring all your troops home, don’t put in­no­cents at risk — is im­pos­si­ble to meet doesn’t al­ways reg­is­ter deep down. The re­sult may be shame, and all too of­ten sui­ci­dal shame.

Moral in­jury is dis­tinct from post-trau­matic stress dis­or­der, which is gen­er­ally thought of nar­rowly as a fear-con­di­tioned syn­drome marked by hy­per-vig­i­lance and flash­backs. The pre­vail­ing treat­ment for PTSD is ther­apy to “de­con­di­tion” the fear re­sponse. But guilt, shame, rag­ing re­sent­ment and be­trayal are dif­fer­ent from fear. To over­come them re­quires re­la­tion­ships that rebuild a sol­dier’s sense of trust in him­self and oth­ers, no small or­der given the ef­fects of war.

Take Sgt. Ed­uardo “Lalo” Panyagua. He joined the Marines as a way out of a tough life in an L.A. bar­rio. At high school he met Donna Her­nan­dez, a dark-haired, dark­eyed Goth girl with street smarts and a book­ish sen­si­bil­ity. Fast for­ward a few years. She ended up at Ge­orge­town Uni­ver­sity and he joined the Marines, de­ploy­ing to Fal­lu­jah in Iraq, and later to Mar­jah, in Afghanistan. Be­fore that last de­ploy­ment, in 2009, they eloped. In her se­nior year, she be­came my stu­dent, and I met Lalo, home from Afghanistan, work­ing at Quan­tico Marine Base and strug­gling with state­side life.

His desk job was noth­ing like the com­bat roles he ex­celled at. His phys­i­cal wounds re­quired treat­ment and his com­man­der read it as ma­lin­ger­ing. His flash­backs had him fling­ing his wife across the room and wield­ing a knife for her pro­tec­tion.

At Donna’s in­sis­tence, he went to see the “wiz­ard,” Marine talk for a coun­selor, but it wasn’t enough. He was treated, cor­rectly, for PTSD, re­play­ing his story over and over, try­ing to de­sen­si­tize him­self from his adren­a­line-fu­eled fear and rage. But what re­ally wracked him was guilt and shame. He felt he had be­trayed three of his “baby birds,” Marines who didn’t make it home.

“I was in charge of guys,” he told me, “and my big­gest fear out there was los­ing any one of them. They’re all like lit­tle broth­ers who I trained.”

One in­ci­dent stood out. In a con­voy near Mar­jah, Panyagua’s unit had been em­plac­ing ground sen­sors. Cpl. Justin Wil­son needed a pit stop. Wil­son jumped off his ar­mored ve­hi­cle, found him­self an empty hut for pri­vacy, and got pul­ver­ized. Lalo lit­er­ally picked up the pieces. That was bad enough, but what re­ally ate at him was this: When­ever one of his guys stepped off an MRAP, he had re­minded them to be care­ful, to open their eyes. But he wasn’t sure he re­peated the mantra that day.

Lalo is lucky in hav­ing Donna. Pa­tiently, au­then­ti­cally, in a way rem­i­nis­cent of the young sol­dier in “Philoctetes,” she has boot­strapped trust and hope in her hus­band, an­swer­ing his self-re­proach with a cor­rected vi­sion of who he was in the war, what he did, and who he can be now.

“Ev­ery­one falls in love with Lalo,” she says, mean­ing not just that he charms but also that he is wor­thy of love. She re­minds him of the truth he has trou­ble see­ing: He was a good Marine; he sur­passed ex­pec­ta­tions in ev­ery mission he was as­signed. At her re­quest, he was in full re­galia at her grad­u­a­tion from Ge­orge­town, an ac­knowl­edg­ment of his hon­ors and his ca­pac­i­ties. Her en­dur­ing sup­port is res­cu­ing a self-ma­rooned war­rior.

There is a fi­nal link to the Philoctetes story. Like Neop­tole­mus, Donna has had to scheme to con­fis­cate Lalo’s weapons. First it was a knife — gone. Then he took up archery. “He can’t re­ally hurt any­one with a bow and ar­row,” Donna laughs, but even that is over now. Their re­la­tion­ship pro­vides him with a dif­fer­ent kind of pro­tec­tion, the kind that saved Philoctetes and that so many of our vet­er­ans need.

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