➣ Soul Injury Ceremonial Workshop
by Deborah Grassman
There is a gaping hole in our society caused by the aftermath of war: Unmourned deaths of comrades killed in war, as well as unforgiven guilt they sometimes hold onto for things they did or did not do. The hole this leaves in surviving comrades’ hearts continues to exert its influence throughout their lives until the deaths are acknowledged, honored, mourned, and redeemed. The burden of the guilt they carry also needs to be laid down. I believe that our civilian society has a responsibility to help heal our nation after war. Soul Injury Ceremonies can help restore wholeness to our broken nation; we struggle together to heal the wounds of war.
Opus Peace has developed a Soul Injury ceremonial workshop. This occurred when we were providing clinical consultation services to staff at a state veterans’ home so they would better understand how to care for the unique needs of veterans as they die. I asked a Vietnam Veteran, “Is there anything from the war that might still be troubling you now?” The veteran, hardly able to talk due to severe COPD, nodded his head. Then he said, “My brother and I both went to Vietnam, but I was the only one who came back.” Tears slowly ebbed down his cheeks while we waited in calm silence. Then, he added: “I didn’t even get to go to his funeral.”
We explained that we could design a ceremony to honor his brother and create space for his grief and his guilt. we explained the value of unmasking unresolved grief. The veteran’s face visibly lightened and he eagerly participated in the designing of the service. That’s when I realized the gaping wound in many of the veterans at the State Veterans Home so we invited all of them to the service to mourn their comrades fallen during battle. About 25 showed up! There were many tears as these veterans allowed themselves to confront their losses and begin moving through them.
The resultant service can be a model for other organizations to provide so that our nation can be healed from this gaping wound. If you would like to help heal our nation from the aftermath of war, please consider sponsoring a community event that invites combat veterans to come mourn their fallen brethren. Go to www.soulinjury.org to learn more about this compelling program, or e-mail Pat@OpusPeace.org. We will help you.
A History of the Problem
Marine veteran and philosopher Camillo Bica used the term “moral injury” in his Vietnam War journals. He detailed the inner turmoil he experienced as he judged how his actions violated core moral beliefs. However, Bica was not the first to describe moral injury. Mythological stories, Shakespearean literature, Greek epics, and many ancient legends describe their character’s despair. The Bible is filled with stories of moral injury. For example, Job experienced the deaths of his 10 children, failing health, and the loss of his wealth. He understandably became angry with God, questioning what he had done to deserve his fate. He aptly describes his anguish with “I should prefer choking and death rather than my pains.” Some of these ancient figures also exhibit symptoms of Post Traumatic Stress Disorder (PTSD); others wrestle with their dilemma without accompanying symptoms. Native Americans have long recognized the soul injury of war, designing rituals that help warriors “decontaminate” their hostile energy before reintegrating into the tribal community.
More than 15 years ago, Veterans Administration psychiatrist, Dr. Jonathan Shay, sought a name that could describe the psychological damage experienced by veterans during dangerous military assignments. He titled this ethical conflict “moral injury.” He states that many of the features of moral injury lie outside the criteria for making the diagnosis of PTSD. The term moral injury has subsequently been adopted by both the VA and the Department of Defense. Opus Peace prefers the more comprehensive term “soul injury.” This term not only captures the moral injury described by Dr. Shay, it also includes soul-impacting injuries that may or may not violate personal moral codes and may not involve personal feelings of having done “wrong.” Soul injuries might be incurred by witnessing trauma, experiencing military sexual assault, struggling with spiritual despair accompanying a deep sense of injustice that sometimes occurs as an aftermath of trauma, and a penetrating loss of personal and relational intimacy that pervasively impacts well-being. The term “soul injury” is often more acceptable than “moral injury” to people who have experienced wounding beyond their body and mind; soul injury does not imply judgment or condemnation by self or others.
In 2004, Grassman, a Hospice practitioner, described how soul injuries surface at the end of life. “When veterans are getting ready to meet their Maker the next day, the next week, the next year, they review their lives. Tumultuous memories stored in their soul can no longer be repressed as their conscious mind gets weaker; they come forth unbidden. This can greatly complicate peaceful dying.” As a result of this information, hospices across the country were trained in how to assess and respond to soul injuries.
In 2005, The New Yorker published an article entitled “The Price of Valor.” Although the author, Dan Baum, does not use the term “soul injury,” he describes its manifestations as he reports on his interview with Major Peter Kilner: “Even some of the most grievously wounded Iraq-war veterans seem more disturbed by the killing they did than they are by their own injuries.” A former West Point philosophy instructor, Kilner went to Iraq so he could write about the war’s history. When he returned, he spent a week among amputees at Walter Reed Medical Center in Washington, D.C.. “I was struck by how easily they could tell the stories of the horrible things that had happened to them. They could talk about having their arms or legs blown off in vivid detail, and even joke about it, but, as soon as the subject changed to the killing they’d done, a pall would settle over them.”
This pall is intended; it is a requirement for the battlefield. “To win war, the Army must turn soldiers momentarily, into reflexive, robotic killers,” writes Baum. But there are consequences for these actions; Baum notes that during World War II, the American military lost more front-line soldiers to psychological collapse than to death by enemy fire. He quotes S.L.Marshall, a Lt. Colonel during World War I, who later became a reporter and quasi-historian of WWII: “Fear of killing, rather than fear of being killed, was the most common cause of battle failure in the individual.” He cites Rachel McNair, who examined data from the Vietnam Vets Readjustment Study for her doctoral dissertation: “Soldiers who had killed in combat (or believed they had) suffered higher rates of PTSD.”
Gaps and Unfulfilled Needs for Veterans and Their Families
In his 2005 article, Baum further addresses the denial of governmental agencies to respond to the soul injury that killing causes. Traditionally, he says, neither the Army nor the Department of Veterans Affairs surveys soldiers about the circumstances under which they killed, let alone how the incident affects them. For example, soldiers returning from combat in Iraq fill out a four-page form checking boxes that describe their experiences. The closest that the form comes to asking about killing is the question, “Were you engaged in direct combat where you discharged your weapon?”
Baum cites the VA’s 207-page Iraq War Clinician Guide. He says it discusses the trauma of killing only with regard to civilian casualties, wholly ignoring the effects that killing enemy combatants might have. The Army’s 500-page medical-corps text on combat trauma, War Psychiatry, is no better. It contains a chart that lists 20 “Combat Stress Factors,” including fear of death, disrupted circadian rhythms, loss of a buddy, etc. The chart makes no mention of killing and offers no suggestions for ameliorating any psychological aftereffects, even though elsewhere, the text acknowledges “casualties that the soldier inflicted himself on enemy soldiers were usually described as the most stressful events.”
Opus Peace believes that it is unrealistic to expect the Department of Veterans’ Affairs or any other governmental agency to respond to the “soul injuries” that warriors sustain. Because of the implicit need to “separate church and state,” attempts to provide soul-sustaining treatment modalities are met with justifiable resistance. The danger of crossing the line from “soul” into “religion” is simply too great for a governmental agency to risk. Even unintentional or misperceived crossing of boundaries can cause public outrcry and negative media attention. Most governmental agencies are understandably unwilling to take this risk. Thus, the work of soul recovery has to originate within the civilian, philanthropic sector such as Opus Peace. Peripheral access by referral from governmental agencies can then also be coordinated. Civilian, philanthropic organizations can also target the 80% of veterans who do not use the VA for their health care.
The moral-injury literature also cites another complicating factor: society not examining its responsibility for sending individuals to war and how civilians receive veterans upon their return. The civilian factor has been wholly ignored by traditional therapeutic programs. This not only contributes to a lack of efficacious recovery for veterans, but misses the opportunity to heal the unconscious wound that civilians sustain. Opus Peace programs integrate civilians into war-recovery programs by educating them on their roles and responsibilities, as well as providing them with tools for how to provide safe emotional environments for their veteran loved ones. They are an integral part of the Soul Injury Ceremonies.
Another well-known problem for healing emotional, mental, and soul injuries with veterans is that they are reluctant to seek help. Some are stoic and do not want to acknowledge the need for help. Some do not want mental health services because they do not want PTSD identified on their medical record or do not want it to interfere with getting a promotion. For those with PTSD, it may be difficult to be confined in a weekend retreat or a 28-day treatment program. Yet, these veterans are the very ones who need care and support. Opus Peace responds to this gap by targeting this patient population. The three-hour ceremony is designed for Veterans and their families to lay down the burdens of their soul. For many, the ceremony is all that is needed to open the door for natural, interior, healing processes to begin. For others, the ceremony funnels veterans into other programs that they are willing to participate in once they have experienced the Soul Injury ceremony.
The Opus Peace Vision for Responding to “Soul Injury”
It is one thing to witness trauma; it is another to cause the trauma. The latter is a deeper level of injury – a soul injury. Soul injury can subtly and not-so-subtly rob veterans of their vitality. Veteran suicides average one every eighty minutes, an unprecedented eighteen a day or six thousand a year. They are 20 percent of all U.S. suicides, though veterans of all wars are only about 7 percent of the U.S. population. Between 2005 and 2007, the national suicide rate among veterans under age thirty rose 26 percent. Suicide is yet another manifestation of soul injury. Soul injuries do not just impact veterans; their families also suffer. Research on the effect of families, friends, and communities, however, is scarce.
The source of soul injury is unmourned grief from fallen comrades and other losses, as well as unforgiven guilt and shame over things veterans think they should or should not have done. Unmourned grief and unforgiven guilt can sabotage lives. Military programs have provided few forums that respond to soul injuries, leaving veterans carrying these burdens alone. Family members of combat veterans are also affected; their wounds, too, often go unnoticed and untended. Complicating matters further are civilians, who may not recognize their role in supporting the reintegration of veterans back into a non-warrior culture.
The primary modality for achieving this mission is the Soul Injury Ceremony. This three-hour ceremoy is the culmination of the work of the Opus Peace co-founders, Pat McGuire and Deborah Grassman, as well as Marie Bainbridge, the Opus Peace president and a Vietnam veteran. As hospice workers for the Department of Veterans Affairs, they have more than 60 years of working with dying veterans and their families. Unmourned grief and unforgiven guilt commonly surface as veterans die. Grassman’s observations, recommendations, and strategic planning for helping veterans have a peaceful death have been embraced by the Department of Veterans Affairs. She has also written two books on the subject that have been widely endorsed by both the VA and hospice communities. She has been a frequent speaker on the topic, presenting in more than 400 cities across the nation in the past decade. Currently, the WYSH (Welcome Your Soldier Home) foundation is partnering with Opus Peace to respond to the need to prevent suicide with our current war veterans (Houston KVUE site to view CBS news story:
Soul Buddies (see dolls below) are also made by volunteers and provided to children of veterans at the ceremony to provide comfort and security to youth who often feel overwhelmed and confused by the changes their parents experience after war.
Soul Injury ceremonies are designed to be replicated throughout the nation. Facilitators will be trained via a required 4-day retreat format. A curriculum manual and Opus Peace staff will mentor affiliates until their competency is certified.