We Can Prevent Veteran Suicides

Janci, an Air Force veteran of Iraq, swallowed an entire fistful of pills and a bottle of wine. She called a friend and asked him to take care of her young daughter, who was in school. She locked all the doors and windows and waited for the mercy of death to free her from the ghosts that haunted her after a deployment with a mortuary unit. With virtually no training, she was given the job of processing the casualties of a war defined by exploded bodies that have to be pieced from parts, often burned or liquefied beyond recognition, so something can go home to families.

The friend she called broke down her front door a few minutes after Janci called, made her throw up, and walked her around her house all night to save her. Today, leader of a veteran peer network in Midland, Texas, she tells her story publicly so other veterans feel less isolated and desperate and know someone else understands what it is like to live with the traumas of military service in wartime.

Despite many efforts to stem rising suicides in younger veterans, the heartbreaking stories continue. The daily rate for veteran suicides is 22. This 2012 average, nearly one an hour and three times the general population, is disproportionately women. As tragic and alarming as that number is, it's a serious undercount because it comes from only 21 states, with numbers from both Texas and California missing, and it doesn't count accidental ways to deliberately kill oneself, such as a motorcycle crash or prescription drug overdose.

When a veteran's unit experiences multiple suicides, such as the Second Battalion, Seventh Marine Regiment suicides reported in the New York Times Sept. 20, the survivors can feel demoralized. When someone they thought would never kill themselves does so, they may wonder how they can hold on.

One of the worst aspects of returning from combat and leaving the military is the extreme isolation. Talking about their pain can be nearly impossible because of the stoic ethic of military training. In addition, a veteran may believe he or she is no longer a good person because of having done "evil" or unforgivable things in combat. So they isolate themselves and shut down their capacities for intimacy, vulnerability, and connection to others.That isolation is compounded by the common desire to be back in combat--after the intense bonding and drama of war, ordinary life can seem dull, gray, and futile.

Religious communities can help to allieviate the isolation and despair so many veterans can feel--but only with some education. Even if well meaning, we can make it hard for veterans to be with us. For example, being singled out and hailed as heroes or being thanked for serving can be alienating to veterans. These pieties and formulaic greetings treat veterans as if they were all the same instead of seeing each one as a real person. If they are experiencing moral injury, the cookie-cutter treatment can make them feel worse.

The term "moral injury" is still unfamiliar to many, but we should become familiar with it. Unlike PTSD, which is a terror reaction to life threatening conditions that causes our fear system to over-function, moral injury isn't based in fear. It's the response of moral conscience to trauma, the experience of the collapse of one's moral foundations or sense of meaning. In examining one's role and behavior in extreme conditions, a person can experience survivor guilt, shame, grief, despair, disgust, alienation, and outrage. Many VA clinicians have concluded that moral injury is a greater factor in veterans' mental health than PTSD--and even the non-religious among VA psychiatrists suggest that religious communities should be involved in the recovery process.

Recovery from moral injury happens when we can listen with open hearts to the burdens veterans carry, without needing to fix them or tell them what to think or believe. The recovery process and reintegration into society happens when we can hear what veterans have experienced and support their putting their experiences into perspective as a part of who they are, not the driving force of who they are. That process takes a long time and some good friends who can hang in there for the long haul.

In the past three years of such listening, I have found myself transformed for the better, including becoming a better listener. I've also been profoundly heartened in discovering how resilient and persistent moral conscience remains in the face of unimaginable trauma.

Since 2012, we at the Soul Repair Center have been working with senior experts in pastoral theology and care from Jewish, Christian, and Muslim traditions to explore how we and our communities can better support recovery from moral injury. We have also helped 7 regional groups host events to educate people about what we all can do to improve the mental health of veterans. This October 28-31, we are presenting the results of this work in Kansas City for everyone who cares about veterans and about peace. Join us.