Naming the pain
AMBS Chapel of the Sermon on the Mount
Tuesday, February 28, 2012
Speaker: Carolyn Holderread Heggen
Years ago a Vietnam Christian Vet came into my therapy office, carrying a Bible, and he said, "If you want to know what it feels like to be me, read these verses." He started pointing to some of these verses Michele read this morning (Psalm 38). I don't know specifically what precipitated the Psalmists despair that caused him to write these verses, but I do know that I have been told by numerous Vets that it's a good description of what they feel like. Thousands of years after those words were written psychiatrists and psychologists came up with an official diagnosis, and a new name for an old malady, a malady as old as war itself. And in 1980 the term Post Traumatic Stress Disorder, or PTSD as we commonly call it, was coined and since then has become part of our medical and lay vocabulary.
Throughout history, different names have been used to describe the effects of the emotional and spiritual pain people who have been asked to kill experience. The name has changed but when you go back and read some of the old medical journals and diaries of medical people you realize they are talking about the same thing. Way back in the 1600's Swiss soldiers were said to have nostalgia. During the US Civil War, writers called it "the staggers" or "irritable heart," some interesting names. The terminology of WWI it was Shell Shock, and then in WWII it was Combat Neurosis and Battle Fatigue. And like I said, for the veterans of the Vietnam War, the term was Post Traumatic Stress Disorder.
Some of us, for years have been calling that Post Traumatic Soul Disorder. And it's interesting that although the Psalmist doesn't use scientific, psychological language, it's rather startling how similar the feelings he describes are to what vets have been saying for a number of years. Listen again to what the Psalmists says "There is no health in my body, my guilt has overwhelmed me, my wounds fester, I am bowed down and look very low. All day long I go about mourning. My heart pounds. My friends and neighbors stay away from me. My strength fails me. The light has gone out of my eyes. I am troubled by my sin."
For those of us in the therapeutic world, it was very useful new diagnosis to have a name for something that we sensed for years but couldn't quite put our fingers on. And it also became easier for Veterans, after PTSD became a part of our official language, to get insurance coverage for their war related emotional problems. And I confess that there was at least one Mennonite therapist who, humbly I hope, said, I told you so.
I remember having some interesting conversations with some of my colleagues about some differences we noticed about the group of clients who were diagnosed with PTSD, and they happened to be victims of sexual assault and rape, and veterans. What we were intrigued by is that while they all had some common debilitating symptoms that were similar. There seemed to be something different about the veterans. There seemed to be a sense of shame, sadness, a sense of self-loathing that we didn't see in non-veterans. But it was something that was hard for us to get our hands on and it certainly wasn't part of the PTSD paradigm.
In 1980 there was a young journalist named Peter Maurin, who was asked by Rolling Stone Magazine, to write a story about the experience of Veterans who were coming back from Vietnam and trying to become reintegrated into their communities. Peter wrote an article after he interviewed many soldiers and listened to them. And when he turned in the story to Rolling Stone Magazine they thanked him and said this wasn't quite what they had in mind. What Peter said in that article was that, he had found a deep sadness. And their sadness seemed less connected to things that had happened to them, but more related to things that they had done, or what they had seen their buddies or officers do.
So a year later, after Rolling Stone Magazine turned down the story, it was published in Psychology Today, and the name of that article was Moral Pain. And Maurin described moral pain as having done something or seen something done that violated some deeply engrained sense of right and wrong. And I think you theologians call that a conscience. It was really encouraging to Christian therapists to realize that a secular publication was naming something that might open the door for conversation on spiritual issues, and the soul wounds of Veterans.
In 1986 I met a man by the name of Fr. William Mahedy. And I just want to say, I want to dedicate in my own heart this week's interchange with you to Fr. Mahedy. He died in July.
He was a Catholic priest that joined the military as a Chaplain during the Vietnam War, and became profoundly disheartened and disillusioned at what he was asked to do as a Chaplain. He realized he was asked to alleviate Veterans guilt so they could go back and do more killing. He had a profound crisis of conscience and dedicated the rest of his life as a social worker in San Diego, starting Veterans Centers and writing profound pieces about the spiritual woundedness of Veterans.
I was introduced to Fr. Mahedy when I was working for the Center for Justice and Peace Building through one of my students who was married to the man who was the Chief of Chaplains at that time. And when she went through my class on recovery from trauma she said, you have to do something like this for Veterans. And actually, the Johnsons, he was Chief of Chaplains for the military, gave a significant amount of money for me to do research on how to understand better the wounds of war, and that's when they introduced me to Fr. Mahedy. He wrote the book, Out of the Night: The Spiritual Journey of Vietnam Vets, which is one of the most insightful books, I have found, about the spiritual wounds of war. And Fr. Mahedy, often said to me, "Carolyn, you Mennonites, you Quakers, you Church of the Brethren people, you are the ones who need to be working in recovery of the spiritual wounds of Veterans. Because you've known from the beginnings how war and violence damage the soul." He was my greatest cheerleader in any work I have done with Vets.
Peter Maurin's term moral pain, and the term Fr. Mahedy came up with, moral strain, which are really the same thing when you listen to them talk, were terms that were put out there. But as a nation we weren't quite ready to start really looking at the implications of the things we asked Veterans to do in the name of our country, many of whom were 18 year olds when they went to that war, and 58,000 of whom came home in body bags. I don't know how many Veterans have said to me, the lucky ones were the ones who came home in body bags. I remember something that Plato had said, "The war is only over for the dead."
So we as a nation watched as thousands and thousands of Vietnam Veterans came home, and turned to violent, abusive and self-destructive behaviors. We saw them more and more filling our homeless shelters and living on the street. But there were some peculiar things about that war. There was a national shame that we had lost that war. I think it was much easier for us to blame the Veterans for the condition they were in psychologically and spiritually then analyze what the war had done with us as a people. And so when people would talk about the problems of Vets it was often language like, "what's wrong with him, or what's wrong with them?" And the conclusion that many people reached was that there must be some type of preexisting character fault or mental weakness for the problems they were having. It was very rare that I heard anyone ask the question, "What happened to him?"
I don't know how it is here in Indiana but out West I'm sensing a much more compassionate, much more open hearted response to our returning Veterans. And I must say many Vietnam Vets, especially the ones who have managed to stay alive, are often the ones who have spurred our communities to do a better job at walking with veterans.
There is a deep sense that I am feeling that we have somehow failed our veterans, and it's really exciting as a Christian to realize it's not just pastors and Christian therapists who are starting to talk about the spiritual issues of war, but it's become a much broader conversation. There is a new term, and I hope you'll watch for this because it's being used more and more in military language. A lot of what I know about the psychologists who are employed by the military comes from a friend who went as a captain to Baghdad. After three months as her role as a Field Psychologist, where she would try to medicate the depressed traumatized Vets, would give them twenty-four hours rest so they could go back and continue the fighting, after only three months had her own breakdown and was diagnosed with PTSD, and is on permanent disability.
I have another friend who worked for Walter Reed with returning veterans, and she became so overwhelmed with the pain of returning vets, a few months ago another friend found her on the top of the building where she was going to jump off because she was so traumatized and in such despair just from listening to the stories of vets and realizing the degree of pain and brokenness they are returning with.
In December of 2009 there was a journal article that appeared in Clinical Psychology Review, which made it the first professional journal that used the term moral injury. And it said, "Moral injury occurs in war when a person does things that transgress deeply held beliefs, witnesses that in others, or witnesses intense human suffering and cruelty." In that same month, in December of 2009, there was a group of clinicians that work for the V.A. who were called together because of the alarming rates in suicide. I don't know if you realize but there are over eighteen Veterans a day in this country who successfully commit suicide. The people in the V.A. say the number is probably higher because the motorcycle and car accidents that kill Veterans are probably intentional. And the number keeps going up as deployments continue, as people go to their third, fourth and fifth deployments in Afghanistan.
An article written from this V.A. gathering says, when they were describing moral injury, "Moral Injury is the extreme distress brought about by perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations." This is from a military gathering. And they made clear Moral Injury can occur from things that you do, or things that you witness. The conclusion from this large gathering of V.A. psychologists was that moral injury is a significant factor in the high rates of addiction, homelessness, suicide, and clinical depression in vets. They made such a persuasive case that the V.A. has given the National Institute of Mental Health fifty million dollars to study the effects of war. I find this very, very encouraging.
I don't know how it is in Elkhart and Goshen, but I know it's hard in Oregon to pick up the newspaper any day and not see a story of a terrible murder or an atrocious act that has happened. I want to tell you, and some of you were here in Chapel when I told the story of Joseph Dwyer, but I want to tell you that story again because, to me, it has become a central story in understanding the pain of Veterans. I'm going to pass around a picture that I have of him because I want you to look at the face of this man, and I want you to look into his heart.
Joseph is a young man who after the events of 9-11 volunteered with the Army because he wanted to do something for his country. But he told his family, "I don't want to kill people, I just want to help." And so he volunteered as a medic for the Army. He had only been in Iraq for one week and there was a fight in the outskirts of Baghdad. There was a young boy in this picture who was four, who was caught in the crossfire and had a serious wound on his leg. Joseph was standing with a group of American soldiers and he instinctively ran over to where the father was holding this boy and waving a white handkerchief. Joseph ran over to try to help this boy. There happened to be an Army photographer who happened to catch this photo of the boy being helped by Joseph. And I remember right away seeing this picture in our newspaper and it became this kind of iconic picture of an American soldier trying to liberate the Iraqi people.
Sadly Joseph had another experience with a little boy not much time after he helped the first little boy. This boy was about 12 and he was riding a bicycle and Joseph was standing with a group of American soldiers. There was a gun that someone had dropped on the road. The soldier next to Joseph mumbled under his breath, "don't pick it up boy, don't pick up that gun." The boy got off his bike and picked up the gun, and the soldier riddled the boy with bullets. Joseph ran out and there was nothing he could do to help this boy.
Things went downhill very quickly for Joseph after that. He stopped eating, he started having profound symptoms of trauma. Only 91 days after Joseph got to Iraq he was shipped home. His medical reports say he had dropped from 220lbs to196 lbs 91 days later when he reached Walter Reed. He didn't want to go out in public, even after he was released from Walter Reed. He had the classic symptoms of PTSD; he would sit in the back of places and wouldn't talk to anyone.
They gave him the best medication they know to give people with PTSD. But he told his family over and over that he just could not get the picture of the dead boy that his buddy had killed out of his head. And so, because of these disturbing pictures in his mind he couldn't sleep at night. He was given sleeping pills but that didn't work so he started huffing aerosol. He became addicted to aerosol and became extremely violent. His wife, fearing her safety and her child's safety, left him. They moved out.
Joseph was then admitted to an Army medical center, this time for inhalant addiction. People at the medical center said he would sit in the dining hall, hour after hour, long after meals were over, and he would alternate flipping through the Bible he had, and reading passages in the Bible. I wish I knew what Joseph was looking for. I have a guess though.
After six months he was released and sent home with over a dozen prescriptions. None of them seemed to heal the anguish of his heart and none of them helped him sleep. There was a long series of violent things he had done; he tried to shoot up the apartment, guns were then taken away from him. And one night he called a taxi, a driver who had frequently taken him to the hospital. The taxi driver couldn't open the door so he asked him if he could call the police to help him get in. Joseph said yes. The police came, and opened the door by force. They found Joseph in a pile of dirty clothes with feces and urine and aerosol cans all over him. The police called the hospital and got an ambulance. Joseph died that night on the way to the hospital.
At his funeral, his mother said he wasn't Joseph anymore. "My Joseph never came home from Iraq." His widow said he's at peace now. "He doesn't have to deal with those horrible pictures in his head."
I confess that it's pretty easy for me to get overwhelmed when I think of over 300,000 veterans coming back from our current wars. I sometimes wonder where the hope is. It is interesting that some people point to me the passage in Mark 5, the account of Jesus healing the man with a demon. I think it fascinating that when Jesus asks the demon his name, the demon responds Legion, which as I understand is the largest unit of the Roman army. Mark tells us that he was living in the local cemetery, that he was violently out of control, that he cut himself, that he scared other people. That sounds an awful lot to me like the veterans living under the bridge in my home town of Corvallis, today. After Jesus heals him, He sends him back, like Jesus so often does, back to his community into his family, and the Bible says, "And all the people were amazed." I bet they were.
I can tell you that I did not learn anything in my secular academic program of psychotherapy which would have helped me help this man. Treatment protocol that is coming out now to help veterans seem to suggest that what's needed are some things that are unique to us as people of faith, and to congregations. And I want to quote directly from a military manual; "Returning veterans need access to a caring, non-judgmental moral authority, involvement in a welcoming community who can listen to their stories, provide a means for making restitution, offer forgiveness, and sustain long term ties." If that doesn't sound like an invitation, indeed a plea, for pastors and congregations to walk with vets, I don't know what is.
Healing happens best in community, and the V.A. says, in the same protocols, "The traditional individual counseling approaches that have been used do not seem to be effective with returning vets." I hope that as we move through this week together we will come to understand what it might mean for us as congregations, as people of faith, to be a community that can bring healing and hope to the many, many wounded Veterans that are coming back to our congregations, to our communities, and to our nation.
And I pray, if I dare, that God would let our hearts be broken by the things that break God's heart so that we might reach out with hope, healing, and tender mercy for veterans, their families, and loves ones whose hearts are so profoundly wounded.
Transcribed by Christopher Albanese