Examining the psychological an moral condition of our nation’s veterans.
Posted Jun 09, 2015
I spoke with John Waters about my book Afterwar: Healing the Moral Wounds of Our Soldiers, which examines the collective psychological and moral condition of our nation’s 2.6 million soldiers returning from wartime service—the greatest number since Vietnam. The concept of ‘moral injuries’ associated with combat experience, an affliction of growing interest to both military and healthcare communities, features prominently throughout the book.
John Waters and I talk about my in-depth interviews with modern-day military veterans, my familiarity with America’s military institutions and my professional background in philosophy and psychoanalysis. It's an exploration of what is often glibly labeled ‘the civ-mil’ divide. Below is an adapted transcript of my interview with John Waters.
John Waters: Who is the intended audience of Afterwar and what do you hope readers take away from the book?
Nancy Sherman: The intended audience includes all groups of people. I’ve had the privilege of welcoming many of our nation’s veterans into my classrooms here at Georgetown. And, as I address in the book, part of the challenge in truly ‘welcoming them home’ is finding a more meaningful introduction than the phrase, ‘Thank you for your service.’ Even though only a small percentage of us serve in the military, it’s important that everyone understands that the veterans come from us, and come back to us when the wars end. In short, the audience for Afterwar is both military and civilian.
JW: How does the ‘civ-mil’ divide of this generation compare to the Vietnam-era, for example?
NS: I think we are way beyond where we were during the Vietnam War. As a society, we have learned to separate the war from the warrior. However, I also believe we all should be having much more lively debates about the War Powers Act (originally passed in 1941 and associated with the War Powers Resolution of 1973; it strengthened the executive branch and the president’s ability to declare war).
JW: Mental health professionals, Veterans Affairs (VA) and Department of Defense (DoD) officials and journalists have been increasingly attentive to the concept of ‘moral injury’. In an article last year for the Huffington Post, writer David Wood called it “the signature wound of this generation of veterans.” However, moral injury is not a formal diagnosis. What is moral injury, and is it unique to this generation of military veterans?
NS: Moral injury is complex, difficult to identify and, like our understanding of it, has been evolving over at least the past several decades. Terms such as shell shock, war nerves and neurasthenia have all been used to describe aspects of this condition. Following the Vietnam War, mental health professionals struggled to diagnose unusual behaviors in returning veterans; the behavior wasn’t simply personality or anxiety disorder, nor did it fit the definitions of depression or schizophrenia.
Around 1980, the American Psychiatry Association (APA) included Post-Traumatic Stress disorder (PTSD) in its Diagnostic and Statistical Manual of Mental Disorders (DSM), which represents the standard for classification of mental disorders in the United States. This decision ‘operationalized’ PTSD as a diagnosis for returning war veterans, among other groups of non-military people who suffered from symptoms such as hyper-vigilance, intrusive thoughts or flashbacks and numbing. (See Judith Herman’s Trauma and Recovery).
This diagnosis was a positive development in the professional field, and it focused on fear, specifically ‘life threat’ triggered by stressors. Yet in my personal interactions with military veterans at the Naval Academy, in the classroom, or with clinicians, some of the most lingering and crippling injuries are moral in nature. It’s moral anguish that sticks with people, and the sense of moral violation or failure (yours or others) – I failed to bring all of my soldiers home from war; my decision cost that Marine his life; I wasn’t as good as I thought I was; others, with whom I am partnered or at higher pay grades, betrayed me. I think of moral injury as a wound that comes with holding yourself and others to account for past transgressions, or for falling short of one’s ideals. Young military service members are especially prone to this injury, in part because they hold themselves to lofty ideals that they can’t perfectly fulfill. And they often think of morality in black and white terms, yet war is filled with moral gray. Currently, the VA is working on operationalizing the diagnosis of moral injury.
JW: Writing for Cicero Magazine, Robert Emmet Meagher asserts that, “Just War Theory, in its long journey from Saint Augustine to President Obama, has promised the possibility of war without sin, without criminality—war in which men and women imperil their lives but not their souls or their humanity.” Do you believe this is possible?
NS: No, I do not believe it’s possible to prosecute war as if it weren’t war. War has its own permissions and its own obligations that are not precisely the same as self-defense in peacetime.
JW: Has our national understanding of the wars in Iraq and Afghanistan changed over the past 15 years? How has this shift impacted returning service men and women?
NS: Yes. The missions and, consequently, the public’s perception of the wars in Iraq and Afghanistan have always been in flux. This process started with fall-out over the complete absence of ‘weapons of mass destruction’ in Iraq, and continues with ISIS’s gains. It is difficult for a conscientious soldier, sailor, airman or Marine to see areas that they stabilized, at great cost and bloodshed, come under siege again and not question what his or her service meant. The politics of Iraq—Shia in power with Sunnis excluded—has left the region in chaos and war. A thinking soldier has to question just what the mission was.
JW: Writer and Vietnam veteran Karl Marlantes once commented, “The Marine Corps taught me to kill but it didn’t teach me how to deal with killing.” In light of a recent report that the USMC’s ‘operational stress control and readiness’ program, or OSCAR, has had no impact on Marines’ mental health, does the military need to re-evaluate its institutional processes for rehabilitating and reintegrating warfighters post-deployment?
NS: Absolutely. There has to be more discussion about what it will feel like to kill, or to be in the midst of killing. Beyond physical exposure to mortal violence, we also need to give our soldiers moral exposure to these experiences before they deploy to combat zones. ‘Live-tissue training’ (military training that involves employing life-saving techniques on a mortally wounded pig) is outstanding for its physical realism – why not similar emphasis on the moral realism of combat trauma? This should include case studies or small-unit discussion groups where individual soldiers talk through their experiences of witnessing traumatic violence while deployed and share these stories with one another in uniform. Recently, there has been talk of sending re-deployed military men and women on a weeklong retreat to work through the emotional aftershock of a combat tour abroad. Regardless of the venue, we have to open the conversation, not just between veterans and civilians after war, but also between fellow servicemen and servicewomen.
JW: Do military veterans miss war? How much of the recurring emotional and psychological traumas experienced by the veterans you encountered are rooted in nostalgia for the family they left behind? Journalist and author Sebastian Jungerspoke of this phenomenon in a recent TED talk and wrote about it for Vanity Fair.
NS: Yes. Josh Mantz, who I open the book with, “died” for 15 minutes during his 2007 deployment to Iraq. His femoral artery was severed by a sniper’s round, and he flat-lined for 15 minutes. Because an Army medic decided to continue working on him after he had died, Josh survived the wound and woke up nearly two days later in the Green Zone without any brain damage. Josh told a group of us that as soon as he was able, he “did everything he possibly could to fix his medical records so he could get back out to his unit.” This is a remarkable story, but familiar in war, going back to Homer and the love between Achilles and Patroclus. English poet and World War I veteran Siegfrid Sassoon wrote eloquently on this topic in his collection The War Poems. The bonds between military veterans are unlike anything before or after war. In Greek, nostalgia translates to ‘pain at coming home.’ Ironically, it is pain at going back home – an act that should be joyous – that is so difficult for our war veterans.
JW: In the chapter “Don’t Just Tell Me ‘Thank You’,” you outline the ‘us (veterans) vs. them (civilians)’ moral tribalism that exacerbates the feelings of isolation military veterans frequently report upon departing the service. How much is the separation between ‘those who served’ and ‘those who stayed’ a product of our uniquely post-9/11 society?
NS: This is a legitimate question. Personally, I think it strikes at the broader relationship between the American military and civilian society: The military belongs to [society] – the military is not a militia. This is one of the first lessons we taught Midshipmen at the U.S. Naval Academy, that [officers] will ‘support and defend’ the Constitution. Although I do not presently advocate conscription, we are paying the price of civilian, public disengagement from the professional military. We are an admiring but disengaged public, with few in political office who have served. As the book highlights, we need to look beyond simplistic rituals, such as “thank you for your service," and engage one another in meaningful discourse that can re-build our communities here at home.
JW: What is your hope for recent combat veterans and their generational peers who did not go to war?
NS: First, I hope for a greater sense of community that crosses boundaries. As a college professor at a non-Academy institution, I think it’s my duty to facilitate conversation about service, helping to underline the fact that we all may serve in different ways. I know that many of the young people I interact with who have an interest in public or foreign service are awestruck by the experiences and responsibilities of our military veterans.
I think the model of serving is the one that should come out of this generation. I would love to see a ‘national service’ initiative. Most students at Georgetown, in my experience, are looking for internships oriented around service – they want that life experience. I hope we can find a way to harness this generation’s energy in a way that brings people together, creates cross-boundary service opportunities and transcends socio-economic classes. The potential is tremendous.
This interview with John Waters appeared in RealClearDefense.