The Invisible Wounds of War
by Tom Voss and Rebecca Anne Nguyen

After serving in a scout-sniper platoon in Mosul, Tom Voss came home carrying invisible wounds of war—the memory of doing or witnessing things that went against his fundamental beliefs. This was not a physical injury that could heal with medication and time, but a “moral injury” — a wound to the soul that eventually urged him toward suicide. Desperate for relief from the pain and guilt that haunted him, Voss embarked on a 2,700-mile journey across America, walking from Milwaukee, Wisconsin, to the Pacific Ocean with a fellow veteran. Readers walk with these men as they meet other veterans, Native American healers, and spiritual teachers who appear in the most unexpected forms. At the end of their trek, Voss realizes he is really just beginning his healing. He pursues meditation training and discovers sacred breathing techniques that shatter his understanding of war and himself, and move him from despair to hope. Voss’s story will give inspiration to veterans, their friends and family, and survivors of all kinds.

Moral injury is a wound to the soul. It happens when you participate in or witness things that transgress your deepest beliefs about right and wrong. It is extreme trauma that manifests as grief, sorrow, shame, guilt, or any combination of those things. It shows up as negative thoughts, self-hatred, hatred of others, feelings of regret, obsessive behaviors, destructive tendencies, suicidal ideation, and all-consuming isolation.

You may experience moral injury if you’ve survived abuse, witnessed violence, participated in the chaos of combat, or experienced any form of trauma that’s changed your understanding of what you, or other human beings, are morally capable of. For many combat veterans, moral injury is inflicted during war, when they are split into two different versions of themselves: the person they were before war, whose morality was ingrained in them by their parents, religion, culture, and society, and the person they became during war, whose morality was replaced with a sense of right and wrong that helped them survive in a war zone.

When the smoke clears and the chaos of war ends, these two selves, with two different sets of moral values, confront each other and continue to battle. The prewar self points to the postwar self and says, “Hey! I know what you did. I know what you saw. You were wrong, you are bad, and you can never be good again.”

A soldier may experience moral injury when reflecting on his or her actions during combat. But they can also experience moral injury by bearing witness to the actions of others. The cool indifference of a commanding officer as he stands over a dying civilian; the capture and torture of men who are known to be innocent; the bomb that was planted purposefully to destroy human life: all can call into question our deeply held cultural belief that all people, deep down, are innately good. Bearing witness to the moral indifference of others, or the premeditation of violence, is enough to warp your understanding of morality and make you question the moral character of everyone you meet. This makes it hard for veterans to trust other people and to assume the best in others, and in themselves.

In addition to participating in and witnessing violence, there’s a third, lesserknown cause of moral injury that impacts soldiers returning from war. It’s the sense of confusion, powerlessness, and betrayal that soldiers feel when they come home and try to transition back to civilian life.

Some people call them heroes, but most veterans don’t feel like heroes, so there’s a disconnect between the actual experience of war and the perceived experience of it. That disconnect makes veterans feel isolated and misunderstood. Others question veterans’ moral character for participating in wars started on false pretenses, or in any war at all. A small but vocal minority calls veterans leeches or lazy. They say veterans are taking advantage of the government, and subsequently taxpayers, when they partake in the benefits promised to them for their service. When faced with these accusations, misunderstandings, and questions, veterans start to question themselves.

Moral injury is emotional, psychological, and spiritual. This makes it different from post-traumatic stress disorder, which is more of a physiological reaction—the brain and body’s responses to extreme, prolonged stress or fear. Some of the symptoms of PTSD—nightmares, flashbacks, insomnia, disassociation—can be stabilized with medication. But moral injury doesn’t seem to respond to medication, at least not permanently. Not at the soul level.

Time in and of itself is also not enough to heal the suffering of moral injury. Time can soften the sting of moral injury, but it can also harden memories, making emotional scar tissue even tougher to heal. That’s what happens if you leave a wound to fester without tending to it. And that’s why so many Vietnam veterans take psychiatric medications for decades and then, when they retire or divorce, or are otherwise forced to face themselves and their past, still find a world of pain waiting for them. The medication has only treated their symptoms, not the root cause of those symptoms. The wound can grow so big, so consuming, it feels like the only way to escape it is death.

The VA estimates that in the United States, twenty veterans take their lives every day.* While the majority of those who die by suicide are over the age of fifty, the number of younger vets who contribute to that twenty-a-day statistic is steadily increasing. If the veterans of the wars in Iraq and Afghanistan fail to acknowledge and heal moral injury, the millennial generation of veterans will continue to face the same fate as those who’ve gone before.

* Office of Public and Intergovernmental Affairs, “VA Releases National Suicide Data Report,” US Department of Veterans Affairs, June 18, 2018, https://www.va.gov/opa/pressrel/pressrelease.cfm?id=4074.

I happened upon an unexpected antidote to moral injury. It shows how healing is possible even when traditional methods like talk therapy, EMDR (Eye Movement Desensitization and Reprocessing), and medication have failed. This healing method is accessible to anyone who’s willing to sit still for a few moments and just breathe. As soon as an individual is willing to take responsibility for his or her own healing, grace rushes in to relieve the pain, unravel traumatic memories, and release the past for good.

Meditation, breath work, and the body’s natural intelligence can help heal deep trauma in ways the mind can’t. You can’t think yourself into feeling better. You can’t will yourself to heal. But in taking on a discipline like meditation, you create the space where healing can happen, naturally. The act and discipline of meditation can redeem a life—no matter how deep the wound.

The responsibility to acknowledge, accept, and heal from moral injury doesn’t just belong to those suffering from moral injury. When we send our youth into battle on our behalf, we are complicit in their actions. We are responsible for bearing our portion of the pain those actions cause. And in taking responsibility, we are empowered to help these women and men rebuild their moral scaffolding, reclaim their place in the society they volunteered to protect, and remember what it means to be human—and to belong.

Excerpted from the preface of the book, Where War Ends: A Combat Veteran’s 2,700-Mile Journey to Heal — Recovering from PTSD and Moral Injury through Meditation ©2019 by Tom Voss and Rebecca Anne Nguyen. Reprinted with permission from NewWorldLibrary.com.

Tom Voss served as an infantry scout in the 3rd Battalion, 21st Infantry Regiment’s scout-sniper platoon. While deployed in Mosul, Iraq, he participated in hundreds of combat and humanitarian missions. Rebecca Anne Nguyen, Voss’s sister and coauthor, is a writer based in Charlotte, North Carolina.

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