Following Basic Principles to Address the Dilemma of Moral Injury

Author: Manuela Joannou

The definition of a warrior is someone who is willing to put themselves in harm’s way for the benefit of others.

In the lives of our first responder and military warriors, intense, dangerous and critical scenes and incidents occur regularly. The daily stress combined with one too many tragic circumstances can lead to physical and psychic injury in caring individuals. This is what we call operational stress injury or post-traumatic stress. Very often the condition involves ethical dilemma or moral injury. This can occur if one must helplessly bear witness to unjust human suffering or is left wondering if they could have or should have done more or better. With a split second to decide, a police officer may do what he has been trained to do following exact protocols, and then may face criminal charges for having done so. A soldier may have been carrying out orders when he or she caused untold suffering. The feelings of guilt and resentment may be compounded if it is believed that the war had no noble cause.  Moral injury occurs when we veer off the course that is charted by our moral compass, either by choice or by order.  Feelings of guilt, sadness, anger or resentment at having been put in certain situations or being treated unfairly often combine to create an emotionally messy situation. Suicides can be the outcome of suffering caused by a seemingly unsolvable moral dilemma, leading only to more tragedy for those of us left behind.

 

When you are caught up in an emotional tornado, it is sometimes difficult to see the possible ways out. It can be even more difficult to choose the best one.

I learned long ago that the best way to deal with an emotionally complex and messy situation is to break it down into “basic principles”.  Basic principles are those dictated by our deeply held values: love, respect, freedom, loyalty, integrity, compassion, honour, humility, peace. These trump matters of preference such as personal ease and comfort, pleasure, being “right”, winning the argument and getting our own way.

As parents, we try to teach our children right from wrong. We want them to grow up to be mature, successful, law abiding citizens who function well in society, who can sustain loving relationships and be employable. Ultimately we want them to be happy and at peace. We teach our children these basic principles by instructing them not to hit or bite others.

We encourage them to share in the sandbox and not steal other’s toys. If they have been mean to others, we make them apologize. If they destroyed someone’s property, they are made to clean it, repair it or replace it. We teach them to say things like: “thank you”, “I’m sorry”, “how can I help?”, “how are you?”, “want to come over?” We instill in them the Golden Rule. Life is difficult. Life is therapy. Our life story is a movie where we are the star character. We have many supporting actors, some who play major roles throughout our movie.

Some just make cameo appearances but may be integral to very significant scenes and plots that deeply affect us. Throughout our life movie, we are given many lessons in which to apply our basic principles. Some of us show up for these and do the homework. Some of us just don’t bother.

If we learn our lessons well, we evolve into centered, mature, wise and peaceful human beings. If we don’t heed them, we stay stuck, and because our lessons seem to come with ever increasing intensity, we often end up miserable.  Sometimes the lessons are brutal. Tragic events, unfortunate choices, unforeseen circumstances, crimes inflicted upon us through the use of free will by others, all are the crux of the intense plots of our life stories.  To a certain extent, we can’t avoid them.

Going back to basic principles can lead us out of the quagmire of messy emotions. You will note that most of the values that make up our basic principles involve our interactions with others. This is no accident. We are hardwired for struggle, but this is mitigated because we are also hardwired for connection.

Harboring feelings of guilt, regret, anger and desire for revenge are a waste of psychic energy and often times destructive.

They arise from a feeling of separation from others, from a desire to protect or punish the ego and the self, not from an empathic place of connection. But we have the choice to stand down.

  • We can always choose peace.
  • We can let go of our drive to be always “right” and drop the argument.
  • We can allow ourselves to be vulnerable.
  • We can make amends by saying we are sorry.
  • We can do our best to atone for serious transgressions or soothe painful empathy by personally addressing the victims if appropriate, or by honouring them through meditative acknowledgment and mentally sending them apologies and blessings.
  • We can pour our energies into restitution by making sure the same things don’t happen to others in the future. We can lobby politically for awareness and change.
  • We can get better and “pay it forward”.

When we follow what is dictated by basic principles, we are offered a more gentle and sensible way through the emotional tornado. Because basic principles arise out of time honoured values, they are steeped in the noble choices recorded in the great stories of history and mythology. We honour the stories of our brave warriors who faced danger, loss and adversity but who ultimately did the right thing. We honour ourselves and our own stories when we also feel we are doing the right thing in the circumstance of trials and tribulations. Making good choices about one’s attitude and best course of action is difficult, especially when post-traumatic stress symptoms affect judgement and lead to isolation.  Traditional societies did not let their warriors reconcile and process their experiences alone. Tribes celebrated their returning warriors and honoured their war actions with the acknowledgement that difficult choices were made for the good of the community. Ceremonies retold the stories of courage, strength, and victory but also the stories of sacrifice, loss and hardship. These are the themes of human existence, where the richness of human experience truly reside. Contemplation of the human condition in the supportive environment of a closely knit society where all members are granted unconditional positive regard leads to psychologically healthy processing of psychic and moral trauma.  Sadly, our warriors do not experience this in our current social climate. The good news is that they can.

Project Trauma Support is a new Canadian initiative that promotes connection and honours the warrior story and spirit. Promoting time tested values and unconditional acceptance, the program helps participants transition from post-traumatic stress to post traumatic growth.

So you went through a PTS cohort, now what?

The  6-day PTS program is exhilarating and exhausting. You most likely have never gone through anything like it before.  You quite possilbly came face to face with some raw emotion. Some of your previously troubling and confusing experiences, memories and feelings had their chance to escape. The cohort provided the safe container where you could finally put down your load. You were surprised by some of the things you were packing. They slipped out of your subconscious into your awareness like the genie let out of the lamp after many years. Your story mingled with the stories of all your comrades in the cohort. It was like everyone’s  baggage got  piled up on the runway before it got loaded onto the plane that was taking you all to new vistas. But then you realized you didn’t want to bring it with you.

Possibly just when you thought you had processed some things, another wave crashed over you and there were more memories presented to you.

You had the chance to listen to other people’s stories. It was made very clear to you that this was not a contest, but some of the other stories were even more astounding than yours. Suddenly you knew that you were no longer alone. There were other travelers on this road of human hardship. You had friends you could trust because they too knew. It felt good.

You learned to get back in touch with some old parts of you. You found out some new things about you. Some parts you like. Some parts you don’t. You learned that some parts of you were just doing what they needed to protect you. You were shown that deep down, your pilot light was still on. You still had that desire to serve. For 6 days, you started to fan it. There were stirrings of what was left of some old embers. Some new, tentative small flames started. You were surprised that you could fan the flames of your fellow travelers just a bit. That too felt good.

You were told that the PTS cohort was just the beginning. While you were going through the week, all your problems were back home getting stronger. Waiting to challenge you in a new way when you got home, as if to say “so you think you’ve got it all figured out now, right ?” You were told that your life would not be better when you get home, the re-entry; it would be harder. During the cohort you may at times feel you were squeezed through a keyhole, like you went through a portal into a new world. The new world had enticing new sounds, sights and smells. It promised new adventures. But you soon found out that as enchanting as this new world was, you had no map. You really had no clue where you were. It can be scary. Your travelling buddies are now far away. You can connect, long distance, but because they are not right there to check out the landscape with you, they can’t help as much. In this new world, you meet the same old people in your life, but everything is a little different. You have a new lens. You look at them a little differently. They look at you differently now too because you travelled away. There was this pattern disruption. But are you really different? How does the 6 days change you? How does it change your life?

You weren’t given the exact map of your new world, but you were given the cartographer’s tools. You were given a compass. More accurately, you were shown your own compass. The true north of your soul.

Now it is up to you and your soul to forge ahead. Carry on with the healing journey. So what are you supposed to do?

Oh yeah, Meditation. You were introduced to that. You might remember thinking “OK now this is lame” at the beginning. You had heard about it before. It’s the weird thing that some people do. You did not think you could get into it. But maybe you decided that you would play the silly game and participate in the meditation. It seemed sort of okay because everyone else was doing it, and some of those others were way tougher than you.

Suddenly, you were surprised. You were unprepared for the release. There was suddenly a little unfamiliar feeling of peace. And hope. But it was elusive. Like a chest of riches in a dream, but when you woke up it was gone.

You are back home. You have your mementos. But you have so much more.

You did the beginner’s course in meditation. Now keep going. Meditation leads you to your soul. The true nature of your soul is to be at peace.

So fear not, friend. You are more than enough. You have everything you need to find your way. Lean in, do the work. Explore the new world view with the new lens. Construct your own map of this new world, together with your inner healer.

The true gift of following your dreams is who you become in the process. As Joseph Campbell says in “The Art of Living” the privilege of a lifetime is being who you are”.

Peter’s thoughts on light love pain and suffering

I am reminded in this time of suffering of the two paths we can all choose. Retreat into a solitary safety or walk into the darkness knowing and trusting you are able to call upon light and love any time you want. Suffering as Buddha has taught is the nature of life but what is important to remember is he also told us the nature of that suffering comes from within each us, that our desire to want things to be different than they are, is the source of our experience of suffering.
I work and collaborate within this community of individuals (that’s you guys, my friends) who all suffer in such extremes that many people will never experience, so much so that suicide is a constant with notices delivered on a weekly basis and sometimes daily. But it is also with this group that inner strength from learning to embrace pain is discovered.
Lesson number one, what exactly is pain? I can tell you it is not what most people think. It is not the instinct to pull away from a hot stove, a sharp knife, a gun pointed at you or a clenched fist. No. Pain is a reminder, an indicator, that something is off balance and needs your attention. Pain is nothing more than a sensation of extreme discomfort meant to alert you to the need for attention, it is not meant to make you hide or withdraw. It’s purpose is to focus your attention.
In the end of course this is a choice. This is in fact the choice that Joseph Campbell means in the Hero’s Journey. This is the point where you are standing on the edge of a threshold and have to choose to accept the “Call to Action or Adventure” or return to your “normal” life.
Thich Nhat Hanh discusses this extensively. He tells us that pain is a reminder of a deep wound within that requires healing. Indeed this wound could be from another life and it could be shared family pain. Whatever the source it requires acknowledgement and it needs to be able to express itself. He tells us it needs to be allowed to emotionally surface in a safe manner and embraced with love until you can no longer bear it and then it can be returned within. This needs to be done as long as it takes so that you can bring that experience to the surface so that you no longer suffer at its recall.
Today so many people are suffering and we can all feel it. It is tempting to not only self-distance but to even isolate. Many people are using all to common avoidance techniques to hide from the pain such as entertainment, alcohol, anger, violence, etc. We on the other hand have been trained and given tools many people don’t have. We are very well positioned to embrace the suffering and to help it heal and not let it’s pain consume us. We do this by keeping active, eating healthy, meditating, doing something creative and keeping in contact with those people who are important in our lives. Some people may have nobody else, but as a minimum we all have the Project Trauma Support tribe. We are in a position to walk in the dark suffering that others are feeling and to bring in the light and love that they cannot see for themselves. We cannot and should not be cutting the cords of the collective just to protect ourselves – we are better than that.

Peter’s thoughts on light love pain and suffering, part II making it personal

I thought I would take that earlier post one step further by making it personal. How have I made my way through this journey of pain and suffering to discover the light and love inside myself? What is the source of my own pain and how do I find the light?
When I first sought help for PTSD in 2011 I was convinced it was all about my work and the deployments. I was angry, fuck I was pissed! A lot shit had happened on my watch, I was frustrated but didn’t know how to express it then because I didn’t truly understand where my anger came from. I knew what PTSD was but I didn’t know what moral injury was.
It took me many years of slow work talking to therapists, trying out different medications before I found what worked best for me. The turning point was Project Trauma Support. Part that was the timing in my life but the bigger part was the approach that Dr’s Joannou and Besemann had toward our injury. It was here as well, starting with that very first day where we had to present a childhood photo that it really clicked that the injury and pain I was dealing with was far deeper and older than what happened in the Army.
I still struggle with this but I do accept it as true. That is the feeling of pure anger I felt when I was cornered into advising a commanding General against an air assault on a target based on faulty information that he wanted me to support with my own sources thereby validating the target. The attack went through, they missed the target and killed a lot of civilians. It is very hard for me to get that the anger I felt at not being heard was the very same anger from when I was seven years old and was blamed for not protecting my mother when we were mugged in the street at knife point. The same anger I felt when a girlfriend ignored my concerns and told me to suck it up, and later when an intimate partner told me to take it like a man and my wife told me I was to sensitive. These were the same as when I was ordered to lead a night patrol into Serbian territory where the roads were known to be mined, I was ignored when advised not to give life saving information to a friendly patrol in Afghanistan that got hit. Or the time I objected to a hostage extraction plan that was to use the same extraction route as the ingress.
What do all these have in common for me. I was not heard. I had a voice, I had offered alternate choices and was ignored. The source of my pain and injury was not being heard. It still is. This is the source of my challenging relationship with women and with authority, which of course only got worse since I didn’t understand this and went through one bad relationship after another and also became an officer, an authority figure.
After PTS in 2017 my last marriage fell apart, thankfully, I stopped drinking, I quit my job for mental health reasons and pursued art as my outlet. I then somehow met the most amazing woman in my life and am so lucky to be with her still. This has changed me dramatically. I have found helpful healing words in the writing of Buddhist monk Thich Nhat Hanh, Herman Hesse, John O’Donohue and Brene Brown.
Now in a better place I dig into the pain of the hurt I feel and it gets easier each time and it makes it easier to talk about. Being heard and feeling understood for me was the key to opening my heart and letting the anger go. Getting to that point happened in large part because of PTS, though it also took a lot of hard work on my part and it still takes work every day. Many days that work is simply being gentle with myself, giving myself permission to go easy if I’m feeling down. It takes discipline each day to continue the healing journey. This means for me, getting outside for exercise, eating well, meditating, practicing art and extending that gentleness to my partner. I know it is helping and I know it’s worth it. I know there is a light inside me that is beginning to shine through.
I also know that each one of you also has that light within. Your journey is your own, but you aren’t alone. Your experience is unique to you but the answers are the same for all of us.