Moral Injury Healing: Not a Mission Impossible
Monday, July 12, 2021, my new client showed up to his first session and the first words out of his mouth were, “I heard you can help people heal from the devastating impact of trauma. I am going to tell you things I have never told anyone. After you hear my shitful story, I am sure you will agree with me, that I am a monster and too messed up to heal.”1
For 45 minutes without emotion, Engelberg, a former sharpshooter and sniper told me countless stories where he was instructed to kill certain people in the Middle East. He did it effortlessly and never missed his mark. Then came what he calls, “That morning.” He was given his usual assignment to kill a certain person. He never questioned his superiors, he just did his job, kill, take a picture, report back, and wait for the next assignment.
On “that morning” his subject (as he called him) was sitting in the driver’s seat of his car. Engelberg was about half a mile away and he noticed in the passenger seat a little boy approximately 10 years old. For the first time in his life Engelberg froze because of the little boy. He wondered what had just happened because he never froze on assignment. He recollected himself, checked the wind, and seconds later pulled the trigger. The man was shot in the head and he slowly slumped down into the little boy’s lap. Engelberg could not hear but he could see the boy’s face of horror as he screamed. Seconds later, a woman came out of the house screaming and crying as she threw herself onto the man.
For the first time in his life, Engelberg questioned himself as he saw the horrific scene play out before him and he thought, “What did I just do? I killed a man right in front of his son and wife? Who was he? Why did I have to kill him? What did he do wrong? Who was he?”
Engelberg has no idea how many men he has killed but “that morning” changed his life because he couldn’t get that little boys face out of his mind. During our session he painfully said, “How can I tell my 2 little boys I killed a little boy’s father? How can I tell my wife I killed a woman’s husband and I have no idea why or who he was?”
This week I was reminded of Engelberg’s many sessions as I read, The Good Kill by Mark LiVecche. LiVecche addresses the issue of moral injury among warfighters as a result of armed conflict. A moral injury according to LiVecche is “an injury that results when soldiers violate their moral beliefs and thereby feel they no longer live in a reliable, meaningful world and can no longer be regarded as descent human beings.”2 What is insightful about LiVecche’s work is when it comes to war, it is “not the rightness or wrongness about the warfighters action, rather what the warfighter internally believes about the action that matters.”3 This is why Lisa Lopez Levers wrote concerning combat, “The lived experience of trauma becomes an unfathomable concept to grasp.”4 Combat becomes an unfathomable concept to grasp because the warfighter internally interprets her situation and it is nearly impossible to understand someone else’s interpretation of a given situation. There is so much to talk about in The Good Kill, but I will only focus on how a moral injury impacts a person, specifically, Engelberg and what I said in that first session to begin the healing process.
In regard to moral injury, LiVecche’s purpose in writing his book is to “reevaluate false beliefs about what it means to kill in war, to interrogate deeply held principles, reinterpret them and thereby grow in wisdom, emotional and spiritual health and resilience.”5 He takes a theological approach and not just a therapeutic approach.6 He strongly believes faith communities are a necessary step to helping warfighters to work through their deep wounds and scars. Actually, LiVecche is closer to psychological thinking than he realizes because part of the way I help warfighters work through their moral injury is to help them understand:
- A theology of trauma/moral injury
- Psychonueroimmunology (the interaction between the nervous system, body, brain, and immune system)
- Community ~ How to connect with self and others emotionally.
- Exercise/yoga ~ How movement releases and discharges emotions and sensations.
- Eating well ~ Work with a nutritionist or doctor to develop good eating habits.
- Sleeping well ~ If necessary, work with a doctor to ensure consistent sleeping patterns.
According to LiVecche those with a moral injury from combat “seek forgiveness and healing”7 “realize war is hell on the soul”8 “seek validation they are still good people”9 “carry it forever”10 “can lead to suicidal ideation”11 With all this in mind, back to Engelberg.
Near the end of our first session, I told Engelberg that I actually saw post traumatic growth in his excruciating painful story. It was the only time he raised his voice in our session. He responded, “WHAT?!” I preceded to tell him, post traumatic growth is when your purpose becomes greater than your pain. This is why you are here. Not because someone told you about me, but because you still believe you have hope. Truthfully, your nervous system may still be stuck in a state of survival because what we suppress, the body will later express. What we resist, will just persist. When we suppress, avoid emotion or feeling our brain actually interrupts the emotional process. Every time you pulled that trigger, your nervous system went into fight or freeze mode and once that happened, your brain released the hormones adrenaline and cortisol that kept you in survival mode.
By staying in the fight or freeze mode, you were not able to process the emotion you were feeling, therefore you suppressed it. When this happens, we get stuck with all that adrenaline and cortisol living in our nervous system and the result is depression, generalized anxiety, and/or chronic mental or physical health issues. In other words, Engelberg, processing our emotions is actually the first step in nervous system regulation or in your case working through a deep moral injury. To be honest with you working through this moral injury will seem like Mission Impossible but I am willing to crawl with you through this tsunami of pain.
- Engelberg is not my clients real name and he gave me permission to share a small part of his story.
- Mark LiVecche. The Good Kill. 2.
- 5.
- Lisa Lopez Levers. Trauma Counseling: Theories and Interventions. 391.
- Mark LiVecche. The Good Kill. 6.
- 195.
- 4.
- 18.
- 33.
- 34.
- 34.
About the Author
Todd E Henley
Todd is an avid cyclist who loves watching NASCAR, photography, and playing Madden football. He is addicted to reading, eating fruits and vegetables, and drinking H2O. His passion is talking about trauma, epigenetics, chromosomes, and the brain. He has been blessed with a sensationally sweet wife and four fun creative children (one of which resides in heaven). In his free time he teaches at Fresno Pacific Biblical Seminary and is the Founder/Executive Director of Restore Counseling Center.10 responses to “Moral Injury Healing: Not a Mission Impossible”
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Oh, Todd. What a gift you are.You end with “but I am willing to crawl with you through this tsunami of pain.” Hope. Not only did he have that ounce of hope to believe things could change. Your willingness to travel with him, is an added force of acceptance and validation. I am curious, what has been the most successful form of therapy that can help in this area?
Thank you for your powerful post.
Hello Esther. Thank you for your kind and gracious words. I have so much respect for you, therefore, your words really hit home and were very encouraging.
Now, to answer your question? The answer is a complex one because a person’s trauma and moral injury is so complex. Here are a few things to take into consideration.
1. How has the person responded to relational challenges before the moral injury?
2. What has been their support system since childhood?
3. How did their parents comforted them when they were emotionally dysregulated as children and/or teenagers?
4. How have they been indirectly taught to feel their feelings?
I could go on but I’ll stop there for now. Now we get into the question. There is definitely no specific form of therapy that works for every person. And yes, I am well aware you know that. 😊 The three I would start with are:
1. EMDR
2. Somatic Therapy
3. Psychodynamic
While doing two or all three of these, other therapies to highly consider are:
1. Message Therapy
2. Equine Assisted Therapy
3. Music Therapy
Esther, even though these therapies are different one thing most of them have in common is helping people connect with the areas in themselves they have disconnected with. Many people with a moral injury have not only disconnected with their emotions, they struggle to connect with others due to a lack of genuine empathy. The above therapies are quite helpful to help a person to work through woundedness they are not even aware of.
Please let me know if you have any more questions and if you would add a certain therapy(ies)? Thanks for the question.
Hi Todd,
You wrote, “By staying in the fight or freeze mode, you were not able to process the emotion you were feeling, therefore you suppressed it. When this happens, we get stuck with all that adrenaline and cortisol living in our nervous system and the result is depression, generalized anxiety, and/or chronic mental or physical health issues. In other words, Engelberg, processing our emotions is actually the first step in nervous system regulation or in your case working through a deep moral injury.”
This is the first post that I read that explains what post traumatic growth can look like. The clinical and emotional explanation are exactly what our cohort pastors need to hear.
One of the reasons I recommended the book is the fear that we, as leaders, were ignoring the global conflicts happening outside of our academic ivory tower.
I would love to see you lead a class (for the school) that helped pastors get ready for the coming conflict (there is always a conflict on the horizon). Marc’s book opened a door for pastors to consider. IF there are soldiers in their congregations are our pastors ready to help before, during and after?
Jenny Dooley suggested we help soldiers put on the armor for their soul.
I wish that your comments could be added to Marc’s book.
Shalom…
Hey my brother Russell. Thank you my brother for your comments. Actually, as I was reading this book, my first thought was, “I can’t wait to read Russell’s post” I’ll be reading it very soon.
I definitely agree with you, we need to be more intentional about walking alongside our soldiers. Please let me know, if I could ever do anything for you and your ministry, even if it’s providing information or material. It would be an honor to work with you my friend.
Thanks Todd,
As I gear up for Ukraine I will want to be more educated on Trauma therapy for Ukrainian Christians who are loving God, and loving kids.
I am trying to set up a program with Ukrainian trauma therapists in Kyiv. They have asked for a proposal/agenda? Not sure what that might look like. I have 19 soccer coaches and 3 chaplains that will be my primary focus.
If you have thoughts on the subject, I would love to hear it.
Russ
Hey Russ, it would be good for us to connect to talk more. One thing that I’m finding out is therapists outside the U.S. tend to know more about trauma and moral injury that those like me who live in the U.S. This is because trauma tends to happen all around them throughout their entire life and they are more used to it than those who live in the States. Any way, let’s plan to connect because I want to help out in anyway possible.
Hello Todd,
I think there are two points that I am interested in 1) training these coaches on ministering to children/families dealing with trauma. 2) helping coaches develop methods for self care.
I received a response from one of the directors at http://www.ODUkraine.com (in Kyiv)….So our therapists can help facilitate some Psychoeducation (stress management skills; Dealing with struggles or failures) or other mental health related “classes”/groups that might be needed. They could also help with any breakdowns or struggles the kiddos may have during their time there.
A lot of this is over my head. In short, I work with 19 coaches (20 somethings) who have 300 soccer kids in a war zone. Sigh…any suggestions, thoughts etc…are welcome.
Hey Russell. What you wrote is very very helpful. Let me give some thought to this and then I will get back to you, man. Blessings to ya!
Todd,
My heart shuttered as I read your description of Engelberg. That moment of realization that the child was be cradling the head of his slumped over father was crippling for me. I cannot imagine what it was like for Engleberg, the child, the wife.
I thank God for you Todd and the work that you do. It is the Lord’s work, and I am grateful that you are so committed to healing the wounded. God Bless you, my brother.
Awwww, thank you my dear Jonita! It sure was tough absorbing his experience. And I appreciate you my sister!