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NEWS | March 1, 2013

From risk to resiliency

By Chaplain (Capt) Robert Duplease 497th Intelligence, Surveillance and Reconnaissance Group

"I don't know what to do any more ... I'm in so much pain." Those were the tearful words I heard just after my office door closed. What followed was a story of seeing a friend die. Then, there was the sorrow, anger and other elements which accompany grief. The person in pain was an Airman assigned to a unit within the 497th Intelligence, Surveillance and Reconnaissance Group.

What happens in our facility is remarkable. ISR warriors are always on watch. The impact on operations down range is understood by our Airmen. What they do is awesome, and classified. They cannot talk about it except with someone cleared to the same level with a need to know. Their role and responsibilities are understood by everyone assigned here.

The cost of America's defense is often measured in terms of lives. Every life lost for America's defense is reason to pause and give thanks for a life well lived. And that's where most people leave it. Rarely is much thought given to the ongoing cost of protecting our nation.

In this instance, I don't refer to those whose life was lost; sadly, their race is run. I make reference to those who have been wounded by things they've repeatedly seen. I refer, in this case, not to those who have been physically wounded--their life-altering challenges are all too often blatantly apparent. I now refer to those whose wounds are more latently evident; those who have suffered the effects to varying degrees of moral injury.

"Moral injury" is a relatively new term in the care-giving arena. It's not a synonym for, and should not be "lumped in" with post-traumatic stress, though many may try to do so. A hallmark indicator of PTS might include an individual's perception that death is imminent.

In the case of moral injury, an individual has, by whatever circumstance, been involved in or witnessed events in which friends or loved ones were killed or maimed.
Moral injury might also be perceived by an individual who is involved in--actually or virtually--situations which cause unintended and unforeseen collateral damage. In the case of some engaged in the daily enterprise of distance warfare, theirs isn't a PTS issue as much as the potential of being morally injured ... being involved in things which cause internal conflict or pain to the deepest part of who a person is--their soul.

Often, when a person is physically wounded, healing results. With time and physical therapy, a new measure and realization of wholeness might be attained. Likewise with the psychological aspect; with the right tools employed, a person can often be restored to life with greater abilities to cope and win. Socially, usually a person can be taught skills to adapt to most any social situation imaginable.

Moral injury brings pain which permeates the soul; there is no psychological or physical remedy. The distress and pain in a person's spirit can cause distraction, degrading usually sharp skills. Mistakes result. Or, another person has to relieve the wounded warrior which can cause distress to a crew which may already be thinly stretched.
In my experience, moral injury can cause relationship challenges and even sleep distress. There can be feelings of being defeated ... even worthless or helpless to overcome the pain. This scenario can lead to suicide.

Moral injury can be mitigated, if not totally prevented with resiliency education. Most helping agencies offer assistance based on a continuum which starts at the left side of the page. Beginning with the traumatic event it works to the right side with steps to be taken in response. This approach is totally reactionary. But there is another way.

When painful things happen predictably, prudence dictates that we act to get ahead of the negatives by emphasizing the positives. To get ahead of something, to live intentionally, proactively ("left of the bang") is where wholeness is found, in spite of distress. That's how to move from risk to resiliency. This can happen through peripheral training at tech-schools, at a pipeline or lateral Airman's first assignment, or at First Term Airman Center.

To head off moral injury Airmen should engage the situations they might see, thereby being better prepared. Chaplain Corps Teams are Resiliency SMEs as are Mental Health teams, all of whom can guide Airmen to thoughtfully engage their thoughts and beliefs regarding those situations.

By understanding in advance what might be encountered and applying a person's known strengths to get through the situation, the more likely to minimize the effects of moral injury. A richer, more balanced life can be realized.