A COMPASSIONATE NUDGE THE ANCIENT BUDDHIST PSYCHOLOGY AND PRACTICE OF DEPENDENT ORIGINATION AS A MEANS OF HEALING WAR-RELATED MORAL INJURY King’s College of London Department of Defence Analysis Submitted in Partial Fulfilment of the Requirements for a Degree of Master of Fine Arts Word Count: 14982 1 INTRODUCTION: WAR STRIPS YOU OF ALL...BELIEFS War changes you, changes you. Strips you, strips you of all your beliefs, your religion, takes your dignity away, you become an animal.1 - Anonymous veteran The notion of “moral injury” is neither new nor novel. Although the term only re-entered conversation over the past decade, the wound is intrinsic to all war, as the following accounts demonstrate: Doug Anderson served as a U.S. Marine Corp corpsman in Vietnam. On his first day in country he knew that something was terribly wrong. A squad leader beat an old man for no reason other than being Vietnamese. His fellow Marines no longer cared what the war was about or why they were all fighting and dying. Anderson felt that there was no longer a noble cause or strategy, only survival. His first patrol was the beginning of his education. “An immense darkness opened under me” he said.2 “What I saw that day in these men was a kind of soul damage.”3 Chester Nez was a U.S. Marine Navajo Code Talker in the Second World War. After returning home he tried to return to his past self, but his “memories were not peaceful like those of [his] grandparents, father, siblings, and extended family.” 4 Nez later said, “The dead Japanese wouldn’t let me sleep or function normally. The quiet grew increasingly disturbing and unreal…all of the blood I walked through had stained my mind.”5 Stephane Greniér is a retired Canadian Army officer who served in the U.N. mission in Rwanda during the genocide in 1994.6 Over a 100-day period, an estimated 800,000 1 Jonathan Shay, Achilles in Vietnam (New York: Scribner, 2003), 83. Shay is a clinical psychiatrist who compared the experiences of veterans with descriptions of war and homecoming in Homer’s Iliad and Odyssey. 2 Doug Anderson, "Something Like a Soul," Massachusetts Review, February 2011, 32. Anderson has published three books of poems on war and one memoir. 3 Ibid. 4 Chester Nez, Code Talker (New York: Caliber, 2012), 17. After the war, Nez was a painter for twenty-five years at a V.A. hospital. In 2001 he received the Congressional Gold Medal. 5 Ibid. 6 William Nash, Introduction, in God Is Not Here (New York: Pegasus Books, 2015), 7. Nash is a psychiatrist, a retired Navy captain, and the current director of the U.S. Marine Corps’ mental health programs. He has 2 Rwandans were slaughtered. Greniér had no choice but to stand aside, unable to stop the murder of innocent men, women and children. He struggled for the words to describe the anguish he felt for the deaths he could not prevent. Years later he could only say: "For those who understand, no explanation is necessary; for those who don’t, no explanation is possible.”7 Then there is Daniel Somers, an American who served in intelligence units in Baghdad and Mosul. Five years after returning home, Somers wrote a letter to his wife and then died from a self-inflicted gunshot wound to the head.8 In his heartbreaking last words, he asked his wife “How can I possibly go around like everyone else? There are some things that a person simply cannot come back from.”9 These accounts represent different generations, wars, nations and, most importantly, wartime experiences. What they all have in common, however, is that each finds different words to describe three enduring truths.10 First, that there are limits to human endurance. Second, that war pushes people to and beyond those limits. Third, that war does this by relentlessly attacking and, sometimes, utterly defeating very necessary and deeply held moral beliefs in warfighters. These truths – which are hard-learned in every war and too easily forgotten – are captured in the term “Moral Injury”, a controversial term which theorists and practitioners increasingly believe is the “enduring if hidden signature wound of…war.”11 And though this wound is more apparent in warfighters12, is it critically important to note that moral injuries can happen to anyone in any environment.13 The veteran Monisha Rios, for example, is a survivor of Military Sexual Trauma and strives to propel the conversation on Moral Injury beyond stereotypical, heterosexual, male combat spent decades attending to the grief, and sharing in the suffering, of warfighters and their loved ones. His experiences and efforts has informed his pioneering research on Moral Injury. 7 Ibid. 8 Daniel Somer’s suicide note was first published at "I Am Sorry That It Has Come to This," Gawker, June 23, 2013. See also Steve Vogel, "After Veteran Daniel Somers's Suicide," The Washington Post, August 23, 2013. 9 Ibid. 10 Nash, Introduction, 15. These three truths are taken from Dr. Bill Nash’s Introduction to God Is Not Here. 11 David Wood, What Have We Done (New York: Little, Brown and Company, 2016), 10. 12 The U.S, U.K., Canadian, Australian, and New Zealand Armed Forces have been at war since late 2001. Eighteen years of operational deployments have increased the opportunities for researchers to collect empirical data on war’s psychological impacts. Additionally, society has become less equipped - and less willing - to meaningfully prepare for, and then engage with, war’s moral corruption. For these two reasons, moral injuries are more apparent (and perhaps more prevalent) in warfighters. 13 Monisha Rios, "The Glue Is Still Drying," in War and Moral Injury, ed. Robert Meagher and Douglas Pryer (Eugene, OR: Cascade Books, 2018), 83. 3 narratives.14 Another example is Project Trauma Support, a new Canadian initiative that addresses Moral Injury in First Responders (e.g. firefighters, paramedics, and emergency room doctors).15 Though these various accounts show that moral injuries can occur in diverse environments, result from a variety of difficult situations, and happen to many demographics, the notions behind this wound are less clear and little understood which drives several key questions. How can ‘morality’ be attacked? How do defeated moral beliefs result in injury? How can moral wounds so negatively affect a person’s well-being and why is this wound so resistant to healing? One possible answer is that all moral choices have a ‘weight’. In war, however, this weight can become a burden that literally injures. Timothy Kudo, a former U.S. Marine, hints of this weight when he said “It’s not the sights, sounds, adrenaline, and carnage of war that linger. It’s…the responsibility…for the lives of others and the consequences of…our actions.”16 Thomas Gibbons-Neff, however, is more explicit about how the weight of moral choices may impact a person’s well-being. Gibbons-Neff, a journalist and a former U.S. Marine, recounts the story of Jeff, a friend who shot an Afghan child who picked up a Kalashnikov.17 Jeff later described “the way the kid fell and how he wasn't sure he'd done the right thing.”18 Five years after Jeff made the decision to kill, he put a shotgun in his mouth but did not pull the trigger. Instead, Jeff just sat on his bed “staring at…his life he could no longer understand.”19 Jeff told Gibbons-Neff "I'm not crazy" and Gibbons-Neff knew he wasn’t: Ten years ago we would have just called it post-traumatic stress disorder. Sixty years ago, it would have been combat fatigue. And in the shell-raked trenches of the Western Front, it would have been shell shock. But Jeff's dead kid was none of those things. Jeff's weight [emphasis added] was something else.20 14 Ibid. 15 SJ Dentry et al., "Addressing Moral Injury in First Responders," Mental Health in Family Medicine, 13. 16 Nancy Sherman, The Untold War (New York: Norton, 2011), 1. 17 Thomas Gibbons-Neff, "Why Distinguishing a Moral Injury from PTSD Is Important," Stars and Stripes, March 2015. Gibbons-Neff deployed twice to Afghanistan. 18 Ibid. 19 Ibid. 20 Ibid. 4 What was the weight that Jeff felt, about which Gibbons-Neff writes? One possible answer is that this weight is the felt experience of the moral emotions of guilt and shame, two of the many emotions that are central to warfighter experiences.21 Research shows, however, that it is shame, rather than guilt, that is the more difficult affective issue.22 Shame is one important reason why warfighters may disengage cognitively or emotionally from a painful memory, in order to deny, avoid, suppress or become numb to it.23 Shame is why warfighters often suffer alone, and in silence. Shame is, therefore, one reason why moral injuries are often so resistant to long-term healing. There is, fortunately, an ancient Buddhist psychology and practice that may provide warfighters with a path to ease suffering and which may encourage long-term healing. This ancient practice and psychology is termed Dependent Origination. A review of extant scholarship shows that the therapeutic benefits of Dependent Origination to relieve the suffering connected to moral injuries may be unexplored. This thesis attempts to correct this gap. The first half lays the groundwork for an exploration of the concept of Moral Injury. First, the core moral-self is established and shown to be vulnerable to injury. Shattered Assumption Theory is then used to explain how our core moral-selves can be damaged in war.