Were you aware of the limbic and prefrontal cortex components of Post-Trauma Stress (PTS)?

Moral injury is particularly common in modern warfare because civilian casualties are high and there are no distinct battle lines, said Donna Smith, a senior minister at the Center for Spiritual living in Anacortes, Washington, who also served 32 years in the military, including on the planning committee for the Iraq war.

Smith referenced a scene in “American Sniper,” a controversial 2015 film based on real-life events, in which a Navy seal shoots a little boy carrying a bomb. It’s a common scenario in today’s wars in the Middle East, she said.

“That just doesn’t resonate with American soldiers, having to shoot children who have grenades, whose parents have strapped some kind of an explosive device to them. It’s one thing to be fighting the adults, but when they send their children in with explosives, that’s even harder to deal with,” she said.

Troops can enter a city thinking it’s friendly only to be engaged in a firefight, she said. They have the constant adrenaline push of never knowing whether the person walking toward them or driving up to a checkpoint is a friend or an enemy. Opposition fighters use women and children as human shields. Soldiers are left questioning the split-second decisions they make — decisions that could have had negative moral repercussions either way, making moral injury practically unavoidable.

Civilian deaths have been high in the Iraq conflict. A conservative estimate is that 137,000 civilians died as a direct result of war in that country between October 2001 and April 2015, according to the Costs of War project at Brown University. By comparison, just 4,489 U.S. troops died in Iraq during the same time period. Civilian deaths have been steadily rising in Afghanistan in recent years, with 3,699 documented in 2014 alone.

A 2003 study of 3,761 troops who had just returned from Iraq found that 28 percent of Marines and 14 percent of Army soldiers said they were responsible for the death of a noncombatant. Large percentages (69 percent of soldiers and 83 percent of Marines) also reported seeing ill or injured women or children whom they were unable to help. Roughly half had handled human remains.

In addition to moral emotions such as shame, guilt and anger, symptoms of moral injury can include spiritual struggles and issues with forgiveness, especially self-forgiveness, Phillips said. They can also include renegotiating a relationship with a person’s faith or faith community.
http://www.deseretnews.com/article/865640794/What-faith-communities-can-do-to-help-veterans-heal.html?pg=2