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Sunday, May 26, 2013

THROUGH A GLASS DARKLY

Welcome to this month's AGC Shofar Blog/magazine.  This month is the final installment in the series dealing with combat trauma and PTSD.  As our title so abtly suggests, somethings are not so clear.  In the Biblical context found in 1 Cor 13:12, the KJV mentions that the early Christians had only a partial revelation of understanding the difference between the spiritual gift of speaking in tongues and prophecy. They only knew things "Through a glass darkly."  This meant that at first God did not reveal everything to us and it caused some confusion, but now that Scripture was completed believers had the completed Word of God to make things easy to understand. 
  As believers, we do not have to wonder in the dark or "see through a glass darkly" when it comes to things like PTSD caused by combat stress.  God has given to us a wonderful blueprint to understand our humanity and use God's powerful Holy Spirit for healing.  It's quite simple, but yet powerful and profound.  The only prerequisite is for us to believe and do it God's way, rather than think we can solve our own problems.  So with that introduction, feel free to read the first two parts and then finish with the third part to understand this provocative part of how Christian Chaplains use God's Word to help our Soldiers', Sailors', Marines and Airmen. God bless. 

A NEW OLD WAY- Part three of three
  By Chaplain Tim Libertay
 
How Moral Injury Works and Solutions 

               In this new paradigm of thinking, we have postulated a new anthropology of how we are wired as people.  Furthermore, a new causation for the epidemiology of PTSD of moral injury is essential to understand the road to recovery for those who suffer from the said affliction.  Sin is the culprit and theology as found in the Scriptures explains it succinctly.  For the purposes of this study, there are two different types of sin which goes to the heart of why people suffer from PTSD.  There is sin which someone else does which affects an individual and sin which a person commits which tears them apart inside due to guilt.  

The Effects of Two Different Types of Sin
               The first type of sin is the one where an individual is the recipient of someone else’s sin.  Physical and emotional abuse takes this form.  Whether it is an abused child or spouse, many studies have already been done to demonstrate this effect on people.  When it deals with PTSD however, it takes a form which causes the individual to withdraw and become reclusive.   Excessive loneliness is a result.  The individual loses hope and lives in despair and of course it eventually takes a toll on the individual’s physical health.  The Psalmist describes it when He is a victim of other’s sin towards Him: “Do not take my soul away along with sinners or my life with men of bloodshed. In whose hands is a wicked scheme and whose right hand are full of bribes.” (Ps 26:9-10).  In this Psalm, the writer expresses a request to avoid evil.

   Furthermore, the feeling of oppression from others who have done wicked things and still oppress a person has its effects on one’s sanity and health: “The cords of death encompassed me, and the torrents of ungodliness terrified me.  The cords of Sheol (hell) surrounded me; the snares of death confronted me” (Ps 18:4-5).  

               In the examples, the Psalmist doesn’t understand how he could be innocent, but
                              
still suffer from the hatred of others.  In the context of the Psalmist, he has incurred the wrath of King Saul because of petty jealousy.  David is totally innocent and cannot find a rational explanation for why the King wants to kill him.  He has to flee for his life and in this moral question is seeking answers.  It affects his understanding of what he knows as right and wrong and just doesn’t make any sense to him.    He feels alone, dejected and has no answers.  He is a victim of someone else’s sin and hatred.
  With this Biblical illustration comes a true story of someone I counseled in the past who was diagnosed with PTSD.  I hesitate to use this story because it incriminates our own military and fighting forces, but in times of war, nothing is perfect.  I was sworn to confidentiality, so for the sake of this illustration I will use it.  I also understood that this is/was someone’s perception of reality, so it could be distorted as to the facts.  However, in this case, even perception was reality because the individual demonstrated the same effects of what they experienced as the Psalmist did. 

  This Sailor was assigned to a unit as support.  There was a convoy that went into a village and something happened where there was an indication of hostile intent.  A fire fight ensued and the whole village was leveled:  Men, women and even children.  As the Sailor told me the story, it was still vivid and real and evoked a terrible memory and brought tears.  As I asked questions one statement stood out: “I joined the military to do good things, not to be a part which kills people.”  This was definitely a case for Moral Injury if there ever was one.  It concerns one’s view of evil.

               The solution to this will be developed in the next chapter.  What is interesting is how the person got better and learned to deal with this event as a result of my counsel in reference to the moral question.  For now however, a simple summary is needed to bring out the main point of this illustration.  Sin caused by others has the potential to effect and cause moral injury to an individual’s peace of mind.  It is something certainly one cannot prove empirically, but has demonstrative effects on the well-being of a person who experiences this type of event.  This is one type of sin which I will call debilitating sin because sin caused by others can and does affect all.  It is the type that can induce guilt, (even though it doesn’t have to), but its horrific memories evoke a helplessness which
cannot be answered in one’s own world view or experiences.  In reality it’s a different side of the same coin, but the next type of sin has a more devastating effect on a person’s overall well-being. 

 The Mechanism of Moral Guilt

  To remind the reader, if one accepts the premise that we are all created in the image of God, we have an intrinsic sense of what is right and wrong.  We are all “hard-wired” sort of speak to know and understand morality.  Morality has traditionally been defined in terms of Theological constructs.  In other words, what is right and wrong for all people is inherent within us because God has put it there.   There are certain spiritual laws and to break them brings certain negative consequences.   

  For instance, we understand what love is because God is love (1 John 4:8).  We know what righteous (a state of being right) judgment is because God is a Righteous Judge (John 7:24).  Judgment is something we know exist and seek after it.  These are of course moral and hence, non-empirical truths.  However, we know these truths to be self-evident.  These are truths which cannot be confirmed empirically, but deep down we know them to be true nonetheless.  They exist and to deny they do not exist is to deny obvious truth.    
  It is in this realm that the key towards “moral injury” dwell.  A working knowledge of theology is essential at this point because without it, one is totally in the dark.  This is where modern education has fallen because up to a generation ago, all education included it.  Even if one was not a believer in it, at least those of the past had a working knowledge of it. Scientists understood it as being part of the greater whole.  Even a deist like Thomas Jefferson when he started the University of Virginia felt it important to include the Scriptures in his introduction of a non-religious curriculum. 
  In the previous study of sin, one cannot answer the question of evil and all of the terrible things it wreaks on a society or individuals.  In moral guilt, one feels guilt, shame and other emotions due towards an action one has committed or not committed.  The mechanism behind feelings in our soul and spirit are due towards our falling short of what God desires, expects and wants from us.    It is this falling short of God’s standards which an individual uses to come to God through prayer or personal intercession.  If something is wrong, there is an inherent sense of guilt and shame.  As one has this sense, one can choose to ignore it or do something about it.  If ignored, the person can either live with this guilt or find other means to deal with the internal pain.  This is not a good thing because often this type of person seeks a cure which will only treat the symptoms, rather than get to the cause of the problem.  These are the people who seek after drugs, alcohol or other means to mask the pain.  This type of individual manifests destructive behavior found in self-destructive behavior or relationships.
  The other alternative to deal with moral guilt is for a person to use their pain as a means to approach a benevolent God and ask for forgiveness.  This is the key which unlocks the mystery of who we are as humans.  If one accepts the premise that there is non-empirical truth and we are indeed created by an Omnipotent and Omniscient God who has offered total forgiveness for our moral guilt (sins) through Christ, then this makes perfect sense.                                                                     

                                                          Case Studies
 
Tom (not real name) was a sniper for the SEALs.  We had worked together intermittently for about a year when I noticed that Tom had lost a lot of weight and he looked “tired.”  Furthermore, the word through the grapevine was Tom had just gotten divorced from his wife.  Understanding the symptoms, but not knowing the details, I invited Tom to lunch on my dime.  Eventually we developed not a close friendship, but a mutual acquaintance where we could talk openly about almost anything.  I had prayed for Tom and I asked the Lord to give me some opportunity someday to help him. 
  That day finally came after six months.  Tom came in and closed the door behind him.  It was here that Tom finally told me he was on an Op (SEALs are known as “Operators” and “operators” do “operations” or “ops”) and he took someone out.  He said he was good at what he did and he had excellent training to do his mission.  Even though he had done many such ops, this one bothered him because when he looked through his scope on what he had done, he could see the brain matter and blood splatter on the wall behind the individual he had just killed. 
  From this experience he started to “self-medicate” (drink) himself.  From an increase in alcohol abuse he said he started having nightmares, then daymares.   He was listless and couldn’t sleep and he said it cost him his marriage.  Now it was affecting his health and his life in the “Teams” (this is unit where other operators work).  He had gone to the Navy Psychologists and after a year of drugs, therapy and treatments; he still couldn’t get rid of the deep anguish he was going through.   He was desperate and definitely hurting. 
  This was an obvious case of moral guilt which led to his head and heart telling him two different things.  He did his job, but was not trained in how to deal with moral issues.  Understanding Ps 51 like I did, I then told him that he did what he was trained to do, but that we have a soul and a spirit that communicates with a Holy and Perfect God.  In this context, I was able to put his experience in Theological terms of sin, guilt, forgiveness and redemption. 
  Of course the redemption was the forgiveness of our sin through Jesus Christ’s payment on the Cross of Calvary.  At this point, Tom asked for forgiveness and I believe at this point there was also a spiritual conversion on his part.  I could see it in his eyes that he understood what had happened and there was a change in the air of our discussion.  Tom told me he felt that a huge burden had been lifted off his shoulders.  The whole discussion took about an hour and Tom left to go home.
  The next day was a normal work day and I was curious to see how Tom was doing.  In the early afternoon, he stopped by my office and made some amazing confessions to me.  With his deep and penetrating look, he told me that he was able to sleep for the first time in about 2 years.  Not only that, but his nightmares and daymares were gone.  In his words, “he was a new man.”

  The big question now is: did it stick?  My answer is an unequivocal and emphatic “yes.”  Tom did grow in his Christian faith in the few months we had together, but I lost track of him over the years since.  Last I talked to him; he wanted to get back with his wife.   This was a complete success story of how a religious conversion makes a difference.  Not all of them end up like this, but all who have heard this explanation get better because they understand something that cannot be codified or empirically understood.  This is why it is essential to understand this question in terms of a theological answer towards guilt, Forgiveness and redemption.   This is shared in “Brian’s” (not real name) story.

Case #2
    Brian was also a SEALs sniper who had been home from his last deployment about four months.  He was drinking heavily and was having some serious fights with his wife.  He came in on his own recognizance because he knew there was something wrong with him and he didn’t want to “self-destruct.”   He had all of the same “symptoms” as Tom and many others like him who had gone through the horrors of multiple deployments in Iraq. 

  As I always do, I explained to Brian how the soul and spirit react towards doing something that goes against how God made us.  He was patient as I went through all of the theology of morality and the non-empirical world of spiritual truth.   From his body language however, I could tell that he wasn’t interested in some of the “God talk.”  When I told him that I wasn’t looking for a conversion because that is a personal choice and decision between him and God, I only wanted him to know and understand the mechanism of how his actions have caused him inner pain.  To which Brian expressed how he couldn’t forgive himself for what he had done. 
  There was something there that resonated with Brian.  Even though he was not a religious person, spiritual truth hit to the very core of who he was as a person.  It was a different reality for him and he had never thought in terms or categories of “sin,” “redemption,” or “forgiveness.”  Again, it was like a light bulb was turned on and it sparked something in him that made sense.  He had wrestled with some spiritual truths of good and evil and wasn’t able to put them in the proper perspective.  Now he had the tools to deal with his moral injury or moral guilt.  He understood what was happening to him and his inner anger.  Life once more made sense to him. 
  It was at this juncture I felt my time was ending with Brian. However, after a week he called me again to deal with some other questions he had in his life.  He did share that he was at peace once again and he wasn’t drinking anymore.  We saw each other for a few more counseling sessions.  He had a lot of questions which were spiritual in nature.  I never knew if Brian had made a conversion or not because I leave that up to the individual and God, but I do know that our first encounter helped him to put life into a proper balance. 
  These two examples are just two of many which typify and illustrate how moral guilt or injury is a factor in taking someone’s peace of mind.  Since it is a question which deals with our mind, emotions and will via the soul and spirit the best way to resolve it falls in the theological realm.  Of course with some this is not even an option due to their anti-religious bias, however, one cannot argue with success.  If it walks like a duck, quacks like a duck and looks like a duck, common sense tells one that it usually is a duck.  
                                                          Conclusion

                There is a plethora of therapies out there which all have some very limited success.  Like the proverbial “blind men and the elephant” illustration, everyone thinks their method is the one which will help those suffering from military PTSD the most.  Science and modern psychiatry has come full circle now and is wrestling with a new concept which theologians have known for centuries: Moral Guilt.  Guilt destroys lives and crushes dreams.  It is an equal opportunity destroyer, especially for those who have done or experienced terrible things. 
  Much to the chagrin of atheists, scientists, therapists and agnostics, our humanity rests on our soul and spirit and its relationship to God.  It is just simply a fact of this life.  Whether one believes it or not will affect ones’ value system and world view and reveal bias’s which normally are never discussed or brought up in an empirical world. 
  As a result, I challenge the scientific communities to include theology in their training and discussions.  Not every fact in this world can be verified by the scientific method.  To ignore this truth is done at our own peril and will have severe limitations in the long run. 
  The logical conclusion of all this is to have a correct epistemology where all truth is incorporated and welcomed and has a place of the table of solutions.  We must understand the dual nature of truth.  One leg can be understood in the physical world and be verified by our senses.  The other leg is a reality where there is a spiritual dimension.  The two are not mutually exclusive, but have an intersection which affects our lives. 
  The Judeo-Christian world-view is one in which our laws, civilization and education is built off of certain axiomatic truths.  To ignore this aspect is to deny truth.  This is a mistake because answers to help our fighting men and women are found in this paradigm.   A true scientist will seek the truth of their data based on their research.  A true theologian will explain all truth while understanding how all of the disciplines come together through one unified whole, namely God.  This is an axiomatic truism which has always existed, we have merely chosen as a society and discipline to ignore.  We can do better.  WE must get beyond our bias’s and embrace anything which will help our country’s most precious resource: our fighting men and women in uniform.
  It is the least we can do to help those brave men and women who have given so much of their lives for the preservation of our country.    
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