A moral injury is a stress injury "about which medical and psychological scientists know the least, even though it has been part of human experience for as long as humans have existed."* It is caused by events that violate deeply held beliefs — especially moral codes regarding right and wrong — and it can be as mentally painful and debilitating as the stress arising from a threat to life.
Can such profound events be forgotten? Perhaps not, but the stress injuries they cause can be successfully treated to relieve a person’s anguish. For Marine Sgt. Joshua Deeds, the treatment known as Virtual Reality has given him back his life.
Growing up in West Virginia, Deeds always wanted to become a police officer, and it was the career he would find in the Marine Corps. "From the minute I got off the bus at boot camp in 1999, I wanted to do 20," he recalls. "I loved everything about the Corps, especially its structure. I needed the structured life it gave me."
In early 2003, Deeds deployed to the Mideast as a military police officer with the 1st Marine Division, one of the first units to roll across Iraq when the war began. He witnessed two horrific events that tore him apart. One of his Marines had to shoot a young Iraqi girl in the moment before she detonated an anti-tank grenade around her waist as she neared their patrol of nine men. He also raided a brothel where enemy soldiers sexually abused women and young boys they had restrained.
"It's a cop's job to fight against the abuse of people being taken advantage of," Deeds says. "I couldn't understand how anyone could do something so horrible to children. I tried to push (the memories) down as far as possible, but it didn’t work."
Deeds returned to Camp Pendleton after his tour in Iraq and the nightmares, he says, began immediately. He guesses he never slept more than three hours a night. His behavior became increasingly reckless, including driving at very high speeds and picking fights.
He refused to talk to anyone about his experience, especially his wife, who was begging him to get help. He wouldn't go to a restaurant, movie or visit with friends. He became obsessed with playing violent and graphic computer war games and would only leave the house to go to work.
After seven years of anger, nightmares and isolation, Deeds went to his master gunnery sergeant last December and told him, "I'm not here in the head, and I need help." It was a hard moment for the 32-year-old police officer, but one he has not regretted. The step led him to psychological healthcare providers at Naval Medical Center San Diego and a diagnosis of severe PTSD.
Deeds was enrolled in the hospital’s Virtual Reality (VR) treatment program, a method of psychotherapy for war veterans that uses elaborate computer constructions to re-create the sights, sounds and even smells of scenarios that caused trauma in a patient. During carefully monitored sessions, a patient retells the trauma over and over, with the goal that the repeated exposure will reduce the traumatic stress responses.
Deeds has completed the first phase of VR treatment, attending two sessions a week for 10 weeks and doing "homework" that required him to listen to his retelling of events on tape.
He refused to talk to anyone about his experience, especially his wife, who was begging him to get help. He wouldn’t go to a restaurant, movie or visit with friends. He became obsessed with playing violent and graphic computer war games and would only leave the house to go to work.
He says the results have been remarkable, and he ticks off the good changes. He seldom has nightmares and doesn't start fights. He is no longer obsessed by video games and has taken up golf. He goes to church and enjoys shopping with his wife. Moreover, the couple’s three young children no longer know their father as just an angry man.
"VR is very difficult," Deeds says. "If you're not in it to win it,
don't do it."
Deeds knows he’s winning and he plans to enter a second phase of the treatment that will be as demanding as the first. "I've never quit anything in my life and I'm not going to quit this." He adds, "If I'm this much better after three months, I can only imagine how far along I'll be after the next."
*From the draft version of the joint Navy-Marine Corps Combat and
Operational Stress Control Doctrine.
A Postscript
Sgt. Joshua Deeds is currently a military police officer posted at Marine Corps Air Station Miramar in San Diego. As part of his treatment for post-traumatic stress disorder, he is on anti-depression medication prescribed by his military physician. Because of this, he is not allowed to carry a firearm and his security clearance is on hold. He is assigned to the military police supply section on base.
Deeds does not know if his treatment for PTSD will harm his Marine Corps career. He knows it is the official policy of all branches of the military to end stigma concerning mental health issues and encourage service members who need treatment to seek it. He also knows stigma still persists.
"Despite all that's being said, I have heard of and seen Marines who have lost their careers because they came forward," Deeds says.
The sergeant is thankful for the support he has received, especially from several Marines in the enlisted ranks above him.
(First published in 2010)
Compassion In Combat