Combat Stress as 'Moral Injury' Offends Marines

Post date: May 4, 2011 1:09:24 PM

Courtesy of Stars and Stripes|April 29, 2011

SAN DIEGO, Calif. -- The new buzzwords in the mental health community for types of combat stress are "moral injury" -- and some Marines don't really care for the label.

On the third day of the Navy and Marine Corps' annual conference on combat and operational stress control, moral injury was the guiding topic. One Marine commander roped into a panel discussion at the last minute bluntly took issue with the phrase: "As a Marine, I'm insulted."

Lt. Col. James "Hall" Bain, commander of 3rd Combat Engineer Battalion, said he thought the term implied that Marines were stressed as a result of immorality.

The Corps trains Marines to have "the skill and the will to kill," he said. "It's based on an ethical standard."

In the mental health community, moral injury is defined as stress arising from witnessing, perpetrating or failing to stop actions that violate a person's deeply held belief system. In combat, this could be the killing of a woman or child, the inability to save a fellow Marine, or the failure of leadership to live up to a moral code.

For the struggles that Marines have with combat stress from actions in war, the Corps likes the term "inner conflict." Brett Litz, who is with the National Center for PTSD and presented at the conference, says he prefers "moral injury" over "inner conflict" because it is evocative and specific.

"Inner conflict," he said, describes all kinds of combat stress.

Research is just beginning on moral injury, Litz said, but so far data shows that while it isn't prevalent among service-members, it is one of the greatest sources for long-lasting scars of war.