William Sherman, Union Army general and veteran of the Civil War, is famously attributed with coining the phrase "war is hell" back in 1879.
Today, anyone can do a quick Internet search and see what Sherman was referring to: graphic images and reports about the atrocities and violence that are an unavoidable consequences of going to war.
But what happens when veterans return to society? How can civilized people be expected to return home from the "hell" of war, where they likely witnessed or took part in actions antithetical to everything they'd been taught?
Veterans make up just 7 percent of the U.S. population, and yet they account for 20 percent of American suicides. There are plenty of horror stories regarding post-traumatic stress disorders in veterans, but there's another condition you hear a lot less about: moral injury.
In the book "Soul Repair: Recovering from Moral Injury After the War," co-author Rita Nakashima Brock examines the powerful sense of shame, grief and remorse many soldiers feel because their experiences conflict deeply with their morals.
How moral injury differs from PTSD:
"PTSD is an extreme sort of terror reaction to trauma, and it actually affects how your brain functions and you lose the capacity to calm down fear, so what happens is you have flashbacks and nightmares and you can be in a hyper-vigilant fear state all the time. Moral injury is you think about what happened and you start to realize you don't feel good at all about what happened, you feel like you violated some deep part of yourself. We call it a soul injury. If it's severe enough you can feel like you're not a decent human being anymore and you don't deserve to live. And you can also live in a sort of twilight depression for life because meaning breaks down for you and you don't feel like you have a moral identity anymore."
On how soldiers are afflicted by moral injury:
"Civilians are not taught to kill, in fact, we're taught to regard killing as a crime, it's criminal behavior. So we have to take an ordinary person, people, members of our families, they go into the military and they're taught to kill without thinking, because if you think about it its harder to do it. That process is a rigorous and fairly sophisticated process of creating a good army. Then we throw them into the maws of war…War in many circumstances causes people to start to question why they're there and to feel upset and traumatized morally by the things they have to do. Unfortunately, we do this sophisticated training to put them there, put them through the process of war and then we bring them home with almost no process of bringing them back to civilian life. So basically they're dumped into civilian life amongst people who don't really understand what they went through and just kind of expect them to just forget about it and get on with their lives, and that's an impossible thing to do."
On what kind of help someone with moral injury needs:
"It's a social condition, in many ways, of the society not taking responsibility for having sent people to war. So it's more like being a friend to a veteran, taking on the struggle of a veteran to recover their moral identity, which can take a very long time. We believe that's a social responsibility and it requires caring people not a clinical treatment because you learn your moral values in a large social system, from your family, your neighbors, your religious communities, whoever you're around who teaches you moral values. So to rebuild a moral identity requires that kind of support system, you don't build that moral identity alone, and if you build it in treatment, but you go back to a community that doesn't affirm it, it's really hard to hold onto it."
On how moral injury is affecting a wide variety of veterans:
"There are 18 million American veterans of combat, the larger majority is not from these wars. Moral injury is something that afflicts anyone that has to go to war, we certainly have WWII vets who have spoken to us, my father served in Vietnam and I think he had moral injury when he came home, we didn't know what was wrong with him we just knew he wasn't the person who left. I think people might be surprised how their lives are touched by the aftermath of war if they just look around."
On how an atrocity her father experienced in WWII changed him forever:
"This project has changed my whole sense of who my father was, actually. He was a WWII veteran and he'd survived that war as a POW and he had electroshock, so I don't think he had much memory of that war. … He did a second tour and something terrible happened to him in that second tour and I didn't know that, but when he came home he was emotionally withdrawn and very controlling and angry in ways that were really different than the father I grew up with. In order to get away from him I moved out my first year of college and never lived at home again, I just didn't want to be around him. He died eight years after the war and we were not reconciled at all, I just tried to stay out of his way and out of his life as much as possible.
"I didn't know what had happened to him until I was talking to an older cousin of mine who was very close to my father. I was telling her about moral injury and she said, 'Oh, I think that's what your daddy had.' I said what do you mean? She said, 'You know there was a thing that happened with that spy or informant or girl that he worked with.' My father had sent me tapes when he was in Vietnam and I knew that he had a 16-year-old Vietnamese woman who was his guide when he would give medical help to villagers in the hills around where his field station was, and she was bilingual and knew the territories, and guided him and translated for him when he went to help villagers. He thought very highly of her, I remember he just talked a lot about how great a young woman she was and I think he was very proud to know her.
"I asked my cousin what happened to her and he said, 'You know, your daddy found her body, and she'd been raped and tortured by the troops. I think he never got over that.' I was stunned. I had no idea that she'd been killed much less in a horrible way. I started thinking about what that must have done to my father, how he might have felt guilty for putting her in harms way, I knew he felt angry at the military, he came home and got out, he retired as soon as he possibly could. When my mother argued with him and asked him to stay in a full 30 years, which would have been two more years, he said, 'This man's army is not my man's army, I didn't sign up for this.' And he got out. Now I understand that and I understand his behavior and I regret that I didn't know about moral injury so that I could be more patient with what was happening to him and try to understand."