Mad, bad, sad: What really happens to US soldiers

By Nan Levinson, via Al Jazeera:

Former army staff sergeant Andy Sapp spent a year at Forward Operating Base Speicher near Tikrit, Iraq, and has lived for the past six years with PTSD. Seven, if you count the year he refused to admit that he had it, never leaving the base or firing his weapon – and who was he to suffer, when others had it so much worse? Nearly 50 when he deployed, he was much older than most of his National Guard unit. He had put in 17 years in various branches of the military, had a stable family, strong religious ties, a good education, and a satisfying career as a high-school English teacher. He expected all that to insulate him, so it took a while to realise that the whole time he was in Iraq, he was numb. In the end, his PTSD would be be diagnosed he would be given an 80 per cent disability rating, which, among other benefits, entitles him to sessions with a Veterans Administration psychologist, whom he credits with saving his life.

Andy recalls a 1985 BBC series named “Soldiers”, in which a Marine commander says: “It's not that we can't take a man who is 45 years old and turn him into a good soldier. It's that we can't make him love it.” Like many soldiers, Andy had assumed that his role would be to protect his country when it was threatened. Instead, he now considers himself part of “something evil.” So at a point when his therapy stalled and his therapist suggested that his spiritual pain was exacerbating his psychological pain, it suddenly clicked. The spiritual part he now calls his sacred wound. Others call it “moral injury”.

It's a concept in progress, defined as the result of taking part in or witnessing something of consequence that you find wrong, something which violates your deeply held beliefs about yourself and your role in the world. For a moment, at least, you become what you never wanted to be. While the symptoms and causes may overlap with PTSD, moral injury arises from what you did or failed to do, rather than from what was done to you. It's a sickness of the heart more than the head. Or, possibly, moral injury is what comes first and, if left unattended, can congeal into PTSD.

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