Invisible Wounds

What stress does to the soul

Help for Wounded Souls

The Soul Repair Center will help emotional injuries.

There’s new hope for combat vets who have what I’ve been calling “wounded souls.” (See my blogs Wounded Souls I-III.)

Last week, the military newspaper “Stars and Stripes” reprinted an article about a new treatment facility called the Soul Repair Center at the Brite Divinity School at Texas Christian University.

It reflects a growing recognition that post-traumatic stress disorder is a medical diagnosis that’s too broad. Part of PTSD involves the stress of being targeted, shot at, mortared or bombed; warriors have experienced these symptoms for thousands of years. But after observing returning Iraq and Afghanistan vets, some mental-health professionals, military chaplains and civilian ministers now call some of those symptoms "moral injuries."

"In the medical model, all the bad mental-health things that can happen come from PTSD," Brett Litz, a clinical psychologist and professor in Boston who is conducting research funded by the Defense and Veterans Affairs departments, told the Fort Worth Star-Telegram. "That's simplistic thinking. It says that the only harmful aspects of war are about life threats. That's too narrow. Even though it's controversial, it is critically important that we think about other ways that war affects people psychologically, biologically, spiritually and morally."

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About 2.6 million men and women have served in Iraq or Afghanistan, including hundreds of thousands of National Guardsmen and reservists. Most of them have served multiple tours of duty in guerilla warfare combat. Roughly 2 million of them have already left military service, and the VA is finding that one vet in three is seeking medical help for emotional injuries such as PTSD, anxiety or major depression.

According to the current DSM-4, PTSD is a medically defined anxiety problem caused by a life-threatening event, with symptoms that include flashbacks, nightmares, hypervigilance and emotional withdrawal.

Moral injuries are different in that they are brought about by "perpetrating, failing to prevent or bearing witness to acts that transgress deeply held moral beliefs and expectations," according to the VA. While an individual can have both PTSD and moral injuries, experts said, the causes of moral injuries are often different.

One of my friends came back from Vietnam, where he’d been a dog handler, and told me that he had violated every moral principle that he’d been taught in church and in the Boy Scouts. While medical and counseling treatments are available for PTSD, there is a growing recognition that moral injuries need to be treated differently.

"The VA can't do anything for someone who says, 'I have sinned,'" said D. Newell Williams, president of the Brite Divinity School. "Religious communities have answers to confessions of sin."

Brite intends to develop a curriculum to teach divinity students how to work with veterans; conduct research and publish papers; work with other divinity schools nationwide; reach out to military chaplains; and build a Web site for clergy to consult when someone in their congregation is struggling.

The school also intends to form a "think tank" of scientists, clergy, mental-health professionals and combat veterans to drive all of its missions, Williams told the Star-Telegram.

"Five years from now, what we'd like to see is, if you are a veteran who lives on the West Coast or in the Northeast, that there would be a trained clergyperson you could go to within a day's drive and talk to," Williams said. "If, after five years, all there is is a center at TCU that helps veterans in this area, we will have failed."

Eric Newhouse is a Pulitzer Prize-winning journalist and the author of Alcohol: Cradle to Grave and Faces of Combat: PTSD and TBI.

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