Friday, October 25, 2013

Mental Health Support - Individual/Group & Moral Injury/PTSD

Greetings, friends,

We've been talking about Moral Injury on the American Heroes Network radio broadcast lately (15Oct), and a new discussion yesterday has provoked new thinking.  

[An example of moral injury would be a fierce firefight that resulted in the inadvertent killing of innocent civilians that haunts a veteran afterward. This has gone on as long as war has been waged.]

Two issues are provided for your thought here today.  

When a unit experiences a trauma together that goes against personal values and creates a moral dilemma, service members are forever changed.  In past eras, it was very hard to reconnect with members of a unit, especially if the war fought was considered an Unjust War (Vietnam).  With today's Social Media capabilities, we learned a great deal from a wonderfully articulate Marine who has found 80% of his unit.  This online effort has now grown to include annual reunions that are highly significant and meaningful to them.

This unit/peer connection appears to be a growing phenomenon and began years ago with Facebook pages for a specific unit, and has morphed into using GPS geo-locators for identifying other veterans (POS REP). The action of organically connecting to prior unit members is showing positive outcomes for many, including finding some semblance of peace and improved mental well-being.  

Interestingly, most mental health care is administered to each individual. Which works best?This is a tough question to answer since everyone is different, but research appears to be saying that for combat vets, a shared experience and peer connection may be an excellent way to heal.  

Secondly, is Moral Injury separate or a component of PTSD?  Moral Injury is under study to discern whether it is separate from PTSD, even though many symptoms may be the same. Is moral injury defined by guilt and a moral disagreement with personal values and PTSD more a danger response (with biological, psychological symptoms) coupled with a spiritual outlook?  Does this help explain drone operators who are not in physical danger, but suffer greatly as we now know.

This topic will be discussed more fully on the American Heroes Network ( on 05 November at 11am EST and archived afterward on iTunes and the AHN website.  Let us know what you think of the group versus individual approach to Moral Injury and/or PTSD may be?

Linda Kreter & the VeteranCaregiver team

Friday, October 11, 2013

Moral Injury & PTSD - One Story


We will be talking Tuesday with two cutting edge researchers on the American Heroes Network about Moral Injury:  PTSD and Suicide in the U.S. Military. This term is not often heard, but the stark truth written below may help with greater understanding of our troops' sacrifices and invisible injuries that linger after they return home.  This story was written in 2005 and rings true today (link:

Wednesday, May 04, 2005

--by Sgt Zachary Scott-Singley


It was still dark. I got dressed in that darkness. When I was ready I grabbed an MRE (meal ready to eat) and got in the truck. I was going to go line the truck up in preparation for the raid we were about to go on. The targets were three houses where RPG attacks had come from a few days prior. Sitting there in that darkness listening to the briefing on how we were to execute the mission, I let my mind wander from the briefing and said a prayer. "Just one more day God, let me live one more day and we will go from there..." It was the same prayer I said every day because every day I did the same thing. I left the base. With a small team I would go out each day on different missions. I was their translator.

There were different people to meet each day. There were some who would kill you if they could. They would look at you and you could see the hate in their eyes. I also met with people who would have given me everything they owned. People, that were so thankful to us because we had rid them of Saddam. Well, this day was not really much different from all those other days so far. After the briefing we all got into our assigned seats and convoyed out to the raid site. I was to go in directly after the military police that would clear the building.

The raid began without a hitch. Inside one of the courtyards of one of the houses, talking to an Iraqi woman checking to see if her story correlated with what the detained men had said, I heard gunfire. It was automatic gunfire. Ducking next to the stone wall I yelled at the woman to get inside her house, and when the gunfire stopped I peeked my head around the front gate. I saw a soldier amongst the others who was pulling rear security by our vehicles. This soldier I saw was still aiming his M249 (a fully automatic belt fed machine gun) at a black truck off in the distance. His was the weapon I had heard.

I ran up near his position and overheard the Captain in charge of the raid asking what had happened and why had this soldier opened fire. The soldier kept his weapon aimed and answered that he was sure he had seen a man holding an AK-47 in the back of the black truck. I was amongst the four (along with the soldier who had fired on the black truck) who had been selected to go and see what was up with that truck.

We were out of breath when we got to the gun-truck nearest to the black civilian truck (a gun-truck is a HUMMWV or sometimes called a Hummer by civilians, with a .50 caliber machine gun on its roof). There was a group of four Iraqis walking towards us from the black truck. They were carrying a body. When I saw this I ran forward and began to speak (in Arabic) to the man holding the body but I couldn't say a word.

There right in front of me in the arms of one of the men I saw a small boy (no more than 3 years old). His head was cocked back at the wrong angle and there was blood. So much blood. How could all that blood be from that small boy? I heard crying too. All of the Iraqi men standing there were crying and sobbing and asking me WHY? Someone behind me started screaming for a medic, it was the young soldier (around my age) who had fired his weapon. He screamed and screamed for a medic until his voice was hoarse and a medic came just to tell us what I already knew. The boy was dead. I was so numb.

I stood there looking at that little child, someone's child (just like mine) and seeing how red the clean white shirt of the man holding the boy was turning. It was then that I realized that I had been speaking to them; speaking in a voice that sounded so very far away. I heard my voice telling them (in Arabic) how sorry we were. My mouth was saying this but all my mind could focus on was the hole in the child's head. The white shirt covered in bright red blood. Every color was so bright. There were other colors too. The glistening white pieces of the child's skull still splattered on that so very white shirt. I couldn't stop looking at them even as I continued telling them how sorry we were.

I can still see it all to this very day. The raid was over there were no weapons to be found and we had accomplished nothing except killing a child of some unknowing mother. Not wanting to leave yet, I stayed as long as I could, talking to the man holding the child. I couldn't leave because I needed to know who they were. I wanted to remember. The man was the brother of the child's father. He was the boy's uncle, and he was watching him for his father who had gone to the market. They were carpenters and the soldier who had fired upon the truck had seen someone holding a piece of wood and standing in the truck bed.

Before I left to go back to our base I saw the young soldier who had killed the boy. His eyes were unfocused and he was just standing there, staring off into the distance. My hand went to my canteen and I took a drink of water. That soldier looked so lost, so I offered him a drink from my canteen. In a hoarse voice he quietly thanked me and then gave me such a thankful look; like I had given him gold.

Later that day those of us who had been selected to go inspect the black truck were filling reports out about what we had witnessed for the investigation. The Captain who had led the raid entered the room we were in and you could see that he was angry. He said, "Well this is just great! Now we have to go and give that family bags of money to shut them up..." I wanted to kill him. I sat there trembling with my rage. Some family had just lost their beautiful baby boy and this man, this COMMISSIONED OFFICER in the United States Army is worried about trying to pay off the family's grief and sorrow. He must not have been a father, otherwise he would know that money doesn't even come close... I wanted to use my bare hands to kill him, but instead I just sat there and waited until the investigating officer called me into his office.

To this day I still think about that raid, that family, that boy. I wonder if they are making attacks on us now. I would be. If someone took the life of my son or my daughter nothing other than my own death would stop me from killing that person. I still cry too. I cry when the memory hits me. I cry when I think of how very far away I am from my family who needs me. I am not there just like the boy's father wasn't there. I pray every day for my family's safety and just that I was with them. I have served my time, I have my nightmares, I have enough blood on my hands. My contract with the Army has been involuntarily extended. I am not asking for medicine to help with the nightmares or for anything else, only that the Army would have held true to the contract I signed and let me be a father, a husband, a daddy again.