The physical, mental, and emotional injuries of war are readily identified. An equally prevalent but seldom talked-about wound is “soul injury.” This injury can subtly and not-so-subtly rob traumatized people of their vitality. The source of soul injury is unmourned grief and unforgiven guilt and shame over things we think we should or should not have done. Unmourned grief and unforgiven guilt can sabotage lives. Military programs have provided few forums that respond to soul injuries, leaving veterans carrying these burdens alone. Family members of combat veterans are also affected; their wounds, too, often go unnoticed and untended. Complicating matters further are civilians, who may not recognize their role in supporting the reintegration of veterans back into themselves. Non-military trauma is similarly managed, with focus on mental, emotional, and social recovery. Soul Injury programs include the deeper, more intimate, aspect of ourselves: the soul self. The soul is the repository of Truth, holding our fears and revelations about who we are and who we are not, including the PAIN of our truth. The soul thrives on images and metaphor, rhythms, and artful, paradoxical mystery. So, it speaks in a different language that we have to learn to value and respect if we are going to access it. The soul lives in the “Now” and yields its Vitality in the everpresent “Now.” It is the source of both wisdom and compassion. The soul is vast and fiercely strong: strong enough to carry our deepest pain…our soul injuries.
Our soul might become weary without sustaining an outright injury. Certain professions are vulnerable for this kind of soul weariness: police, firefighters, emergency room staff, hospice workers, trauma counselors, bereavement staff, etc. This is sometimes described as “burn-out” or “compassion fatigue.” Self-care workshops often focus on helpful tools that develop resiliency. However, relief is often only temporary with symptoms returning in a few short weeks or months. Restoration of the soul requires an approach that reaches beyond the mind and beyond the heart into the depths of our gut…to that place that is generating the empty weariness…to that part of self that is carrying unmourned grief and unforgiven guilt. Re-owning and re-homing this part of self “restoreths our souls.”
History of Soul Injury
Soul Injury: A History of the Problem
More than 15 years ago, Veterans Administration psychiatrist, Dr. Jonathan Shay, sought a name that could describe the psychological damage experienced by veterans during dangerous military assignments. Dr. Shay believed that much of the distress suffered from veterans represents an inner conflict between their moral beliefs and their actions during military service. He titled this ethical conflict “moral injury.” The term moral injury has subsequently been adopted by both the VA and the Department of Defense. Opus Peace prefers the more comprehensive term “soul injury.” This term not only captures the moral injury described by Dr. Shay, it also includes soul-impacting injuries that may be independent of moral conflict or confusion. Thus, soul injuries might be sustained by simply witnessing trauma, experiencing military sexual assault, struggling with spiritual despair accompanying a deep sense of injustice that sometimes occurs as an aftermath of trauma, and a penetrating loss of personal and relational intimacy that pervasively impacts well-being.
In 2005, The New Yorker published an article entitled “The Price of Valor.” Although the author, Dan Baum, does not use the term “soul injury,” he describes its manifestations as he reports on his interview with Major Peter Kilner: “Even some of the most grievously wounded Iraq-war veterans seem more disturbed by the killing they did than they are by their own injuries.” A former West Point philosophy instructor, Kilner went to Iraq so he could write about the war’s history. When he returned, he spent a week among amputees at Walter Reed Medical Center in Washington, D.C.. “I was struck by how easily they could tell the stories of the horrible things that had happened to them. They could talk about having their arms or legs blown off in vivid detail, and even joke about it, but, as soon as the subject changed to the killing they’d done, a pall would settle over them.”
This pall is intended; it is a requirement for the battlefield. “To win war, the Army must turn soldiers momentarily, into reflexive, robotic killers,” writes Baum. But there are consequences for these actions; Baum notes that during World War II, the American military lost more front-line soldiers to psychological collapse than to death by enemy fire. He quotes S.L.Marshall, a Lt. Colonel during World War I, who later became a reporter and quasi-historian of WWII: “Fear of killing, rather than fear of being killed, was the most common cause of battle failure in the individual.” He cites Rachel McNair, who examined data from the Vietnam Vets Readjustment Study for her doctoral dissertation: “Soldiers who had killed in combat (or believed they had) suffered higher rates of PTSD.”
Gaps and Unfulfilled Needs for Veterans and Their Families
In his 2005 article, Baum further addresses the denial of governmental agencies to respond to the soul injury that killing causes. Traditionally, he says, neither the Army nor the Department of Veterans Affairs surveys soldiers about the circumstances under which they killed, let alone how the incident affects them. For example, soldiers returning from combat in Iraq fill out a four-page form checking boxes that describe their experiences. The closest that the form comes to asking about killing is the question, “Were you engaged in direct combat where you discharged your weapon?”
Baum cites the VA’s 207-page Iraq War Clinician Guide. He says it discusses the trauma of killing only with regard to civilian casualties, wholly ignoring the effects that killing enemy combatants might have. The Army’s 500-page medical-corps text on combat trauma, War Psychiatry, is no better. It contains a chart that lists 20 “Combat Stress Factors,” including fear of death, disrupted circadian rhythms, loss of a buddy, etc. The chart makes no mention of killing and offers no suggestions for ameliorating any psychological aftereffects, even though elsewhere, the text acknowledges “casualties that the soldier inflicted himself on enemy soldiers were usually described as the most stressful events.”
In 2003, Deborah Grassman identified how soul injury surfaces at the end of life when veterans enter hospice care. Entitled, Wounded Warriors: Their Last Battle, the video was produced by the Department of Veterans Affairs and distributed by the National Hospice and Palliative Care Organization to all member hospices. In it, viewers learn how soul injuries sometimes cause spiritual distress as veterans age and prepare to “meet their Maker.” This can sometimes manifest itself as agitation that does not respond to conventional hospice interventions. Grassman’s subsequent book, Peace at Last: Stories of Hope and Healing for Veterans and Their Families, describes unresolved soul injury and its impact on the lives of deaths of veterans and those who love and care for them.
At about this same time, psychologist Ed Tick, was identifying how soul injuries were sabotaging veterans lives, as well as their families. He focused especially on Vietnam veterans, taking them back to Vietnam for forgiveness and reconciliation work. His book, War and the Soul, reflects the journeys that veterans make to re-encounter their soul.
The current wars in Iraq and Afghanistan are precipitating high rates of suicide that are catching the attention of the American public and the Department of Defense. Admiral William McRaven who leads the Special Operations Command, has created a “Preservation of the Force and Family” task force to respond to the physical, mental, and emotional needs of his troops to “help leaders at all levels do everything we can to prevent a suicide.” This will, no doubt, need to include interventions that include soul injuries. LeBaron Productions in Austin Texas is supporting the Welcome Your Soldier Home (WYSH) project by making a film linking soul injury to the suicides connected with our current war.
A Call to Action: Responding to Soul Injury
Opus Peace believes that it is unrealistic to expect the Department of Veterans’ Affairs or any other governmental agency to respond to the “soul injuries” that warriors sustain. Because of the implicit need to “separate church and state,” attempts to provide soul-sustaining treatment modalities are met with justifiable resistance. The danger of crossing the line from “soul” into “religion” is simply too great for a governmental agency to risk. Even unintentional or misperceived crossing of boundaries can cause public outrcry and negative media attention. Most governmental agencies are understandably unwilling to take this risk. Thus, the work of soul recovery has to originate within the civilian, philanthropic sector. Peripheral access by referral from governmental agencies can then also be coordinated. Civilian, philanthropic organizations can also target the 80% of veterans who do not use the VA for their health care.
The moral-injury literature also cites another complicating factor: society not examining its responsibility for sending individuals to war and how civilians receive veterans upon their return. The civilian factor has been wholly ignored by traditional therapeutic programs. This not only contributes to a lack of efficacious recovery for veterans, but misses the opportunity to heal the unconscious wound that civilians sustain. Opus Peace programs integrate civilians into war-recovery programs by educating them on their roles and responsibilities, as well as providing them with tools for how to provide safe emotional environments for their veteran loved ones. Civilians are an integral part of the Soul Injury Ceremonies.
Another well-known problem for healing emotional, mental, and soul injuries with veterans is that they are reluctant to seek help. Some are stoic and do not want to acknowledge the need for help. Some do not want mental health services because they do not want PTSD identified on their medical record or do not want it to interfere with getting a promotion. For those with PTSD, it may be difficult to be confined in a weekend retreat or a 28-day treatment program. Yet, these veterans are the very ones who need care and support. Opus Peace responds to this gap by targeting this patient population. The three-hour ceremony is designed for Veterans and their families to lay down the burdens of their soul. For many, the ceremony is all that is needed to open the door for natural, interior, healing processes to begin. For others, the ceremony funnels veterans into other programs that they are willing to participate in once they have experienced the Soul Injury ceremony.
The Opus Peace Vision for Responding to “Soul Injury”
It is one thing to witness trauma; it is another to cause the trauma. The latter is a deeper level of injury – a soul injury. Soul injury can subtly and not-so-subtly rob veterans of their vitality. The source of soul injury is unmourned grief from fallen comrades and other losses, as well as unforgiven guilt and shame over things veterans think they should or should not have done. Unmourned grief and unforgiven guilt can sabotage lives. Military programs have provided few forums that respond to soul injuries, leaving veterans carrying these burdens alone. Family members of combat veterans are also affected; their wounds, too, often go unnoticed and untended. Complicating matters further are civilians, who may not recognize their role in supporting the reintegration of veterans back into a non-warrior culture.
The primary modality for achieving this mission is the Soul Injury Ceremony. This three-hour ceremoy is the culmination of the work of the Opus Peace co-founders, Pat McGuire and Deborah Grassman, as well as Marie Bainbridge, the Opus Peace president and a Vietnam veteran. As hospice workers for the Department of Veterans Affairs, they have more than 60 years of working with dying veterans and their families. Unmourned grief and unforgiven guilt commonly surface as veterans die. Grassman’s observations, recommendations, and strategic planning for helping veterans have a peaceful death have been embraced by the Department of Veterans Affairs. She has also written two books on the subject that have been widely endorsed by both the VA and hospice communities. She has been a frequent speaker on the topic, presenting in more than 400 cities across the nation in the past decade. Currently, the WYSH (Welcome Your Soldier Home) foundation is partnering with Opus Peace to respond to the need to prevent suicide with our current war veterans (Houston KVUE site to view CBS news story:
Opus Peace Buddies (see dolls below) created by Sheila Lozier, an Army veteran and treasurer of Opus Peace, are also made by volunteers and provided to children of veterans at the ceremony to provide comfort and security to youth who often feel overwhelmed and confused by the changes their family members experience after war.
Soul Injury ceremonies are designed to be replicated throughout the nation. Facilitators will be trained via a required 4-day retreat format. A curriculum manual and Opus Peace staff will mentor affiliates until their competency is certified.
To summarize, our vision is to:
• Educate individuals, companies, and communities about Soul Injury, its impact on veterans and their families, and the role of civilians in fostering reintegration and healing of our nation’s warrior heroes.
• Apply principles of Soul Injury to non-veteran segments of the population that have been traumatized.
• Promote a simple, highly-effective, efficient intervention that responds to Soul Injury so healing processes can begin.
• Support a nation-wide network of affiliates who can provide Soul Injury Ceremonies that allow combat veterans to come forth to lay down their burdens of unmourned grief and unforgiven guilt they may still be carrying.
• Develop a network of like-minded associates who live and promote the mission of Opus Peace.
• Receive donations and grants from individuals and organizations who passionately promote the mission of vision of Opus Peace.
What does Soul Injury mean ?
The concept of “soul” defies definition. It has been described in many different ways, yet there lacks distinctive qualities because in many ways the “soul” defies definition. Nevertheless, when we hear the word “soul,” we somehow experience its meaning on some level. Webster’s dictionary defines soul as “the vital or essential part.” Commonly, people say that the soul is the essence of our being, providing us with an interior “true north” that speaks to us “in our gut.” I sometimes think that the soul is like the giant oak tree housed within the proverbial acorn. The soul housed within us imprints an intention that outlines our destiny or purpose that we are born to fulfill (if we have the honesty, courage, and humility to do so). Thus, the soul acts as a “homing device” guiding us back to our true self. Some would say that the soul is the Source of our vitality; others say that the soul is where our unique identity intersects with Infinitude, Eternal consciousness, God, or a Higher Power.
A soul injury is a penetrating breach of integrity within our deepest self that pierces beyond the defenses of our ego. It often includes:
*a disruption of a person’s fundamental identity that shrinks their sense of goodness/beauty and fuels a haunting sense that they are defective/tainted.
*a sense of betrayal by another person, themselves, an organization, God, their religion, etc.
* exudes a vague or profound sense of emptiness caused by disconnection from the part of self carrying the pain.
The soul can be injured but not extinguished. We separate our selves from our soul when we cover up, numb out, or run from our Truth. In an anti-pain American culture, we don’t learn how to open up to pain in a way that connects us with our soul. Yet, the SOUL is vast and fiercely strong, which is why it holds the pain – is the part of self that holds the truth of what was experienced. Numbing or covering up our pain disconnects us from our Soul. Neglected, soul injuries start generating symptoms of their own.The soul is the repository of Truth, holding our fears and revelations about who we are and who we are not, including the PAIN of our truth. The soul thrives on images and metaphor, rhythms, and artful, paradoxical mystery. So, it speaks in a different language that we have to learn to value and respect if we are going to access it. The soul lives in the “Now” and yields its Vitality in the everpresent “Now.” It is the source of both wisdom and compassion. The soul is vast and fiercely strong: strong enough to carry our deepest pain…our soul injuries.
What are the symptoms of Soul Injury ?
In addition to depression, anger, addictions, and loss of trust in the world/others commonly experienced by people with PTSD, Soul Injury symptoms might include:
- A disruption of a person’s fundamental identity that shrinks their sense of goodness/beauty and fuels a haunting sense that they are defective, tainted, or unworthy.
- A sense of betrayal by another person, themselves, an organization, God, their religion, etc.
- A vague or profound sense of emptiness caused by disconnection from the part of self carrying the pain. This can cause a penetrating loss of personal and relational intimacy.
- Struggling with an unfulfilled inner hole that causes spiritual distress or a vague sense of meaninglessness
These symptoms can range from mildly annoying to intensely overwhelming with thoughts of suicide.
Most PTSD programs only focus on the soul dimension peripherally. Symptom management becomes the goal of care. In soul injury programs the focus is on opening up to the symptom and connecting with the part of self generating it. Medications are an important component for both PTSD and soul injuries. Medications may be needed to control symptoms (anxiety/depression) that prevent doing soul work while in “survival mode” of trusting fear.However, medications CAN’T re-connect a person with their soul. Thus, soul injury programs use medications if they help people connect with the part of self carrying pain, but medications are used with caution if it numbs their pain. This distinction is an essential, often neglected, component of assessment.
After trauma, people shift from trusting themselves to trusting fear; treatments that ignore the soul might focus on helping people manage their triggers. Healing the SOUL requires more than this. It requires cultivating the courage to love, forgive, and trust ourselves to navigate in the world again. Learning how to disarm our heart while cultivating personal intimacy with scattered aspects of our own self is a very different approach that requires development of a different skill set.
Resources to learn more
Publications & Resources
Purchase our publications or join our book club. We’ll help you start one!
What do veterans, veteran organizations, and civilians who care about veterans have in common?
They participate in book circles utilizing Peace at Last: Stories of Hope & Healing for Veterans and Their Families:
• “I met myself on the pages of this book! Now I understand Soul Injury.”
• “The veterans in this book taught me things about myself that my veteran friends don’t even know.”
• “I understand veterans in a way I never did before.”
What do churches, civic groups, healthcare agencies, and prisons have in common?
They participate in a book circle utilizing the book, The Hero Within. It provides clear, practical, and meaningful perspectives that are shared simply and powerfully, while providing therapeutic tools for personal growth and healing:
• “I needed something that helped me grow into other aspects of myself than just the personn with PTSD.”
• “I wish I would have known about this book years ago. It would have saved me a lot of heartache.”
• “Sharing the concepts within a community was simply awesome.”
Those who may have sustained a soul injury include:
- Victims of Sexual Assault, Crime, Accidents, Natural Disasters, Abuse, Neglect, Burn-out
- People who have Experienced Loss of Personal Health or a Loved One’s Health, Death of a Loved One, Betrayal by a Significant Other
- Veterans, First Responders, Trauma Counselors, ER staff, Hospice Workers
- Families of the Traumatized
- Civilians who have lived in War Zones
- Personal and Professional Caregivers
The American Psychological Association (APA) uses a Post-Traumatic Growth Inventory to assess changes sustained after life-altering events. The scale is useful in assessing a person’s relationship to any event, even if it’s not traumatic. The APA identifies life-altering events as: loss of a loved one, chronic or acute illness, violent or abusive crime, accident or injury, disaster, job loss, financial hardship, career or location change/move, change in family responsibility, divorce, retirement, combat, and other. It is interesting to note, that many of the measures for evaluating “growth” relate to soul issues: value of life, spiritual matters, compassion, faith, intimacy. This clearly suggests the value of bringing “soul injury” to the table for assessment and treatment. Go to OpusPeace.org/PTG-Inventory to view the APA’s PTSD growth inventory in its entirety.
Another reason it is important to start addressing Soul Injury is because interventions are different. Forgiveness, including self-forgiveness, is an essential element of soul restoration, yet there are few authenticated curriculum criteria that teach the forgiveness process. The few professional articles or courses that do, often focus on head/heart intervention. True forgiveness is done in the soul…in the gut. Until we recognize that, forgiveness remains a “letting go” concept without depth and without long-lasting effect.
Soul Injury and Soul Restoration ceremonial workshops respond to wounds generated by unmourned grief and unforgiven guilt that occurs during trauma, abuse, and neglect. The goal of the workshop is to help traumatized people learn how to love, forgive, and trust themselves to navigate in the world again by disarming their heart while cultivating personal intimacy with scattered aspects of their own self. The Soul Injury program focuses on traumatized populations; the Soul Restoration program focuses on self-care for caregivers. Both ceremonial workshops are 3-dimensional providing education for the mind, safety for the heart, and courage to develop a new relationship with the pain in their soul. Children receive “Soul Buddy” dolls to help them give voice to the pain and anger they might experience due to the soul injury in the family.
At a Soul Injury Ceremonial Workshop, you will learn how:
- Soul injuries are stored in the body, mind, and spirit, as well as how this affects whole family systems.
- Unmourned grief from losses, as well as unforgiven guilt and shame over things you think you should or should not have done can subtly and not-so-subtly sabotage your life.
- To love, forgive, and trust yourself to navigate in the world again by disarming your heart while cultivating personal intimacy with fractured aspects of your own self.
- Experience some level of healing even if you only witness the ceremony without participating in it.
At a Soul Restoration Ceremonial Workshop, you will learn how to:
- Identify the essential elements of unmourned grief and unforgiven guilt and how this relates to soul weariness.
- Re-own and re-home the part of yourself carrying pain and guilt so that part of self is no longer left homeless.
- Love, forgive, and trust self to navigate in the world again by disarming the heart while cultivating personal intimacy with scattered aspects of your own self.
- Experience at least 6 ways that caregivers can respond to soul weariness and wariness.
Meet the Soul Injury Team
We are a team of dedicated professionals, ready to do whatever it takes to respond to Soul Injuries.
Is a mental health Advanced Practice Nurse Practitioner with 30 years experience working with veterans at the Department of Veterans Affairs. She is the CEO of Opus Peace nonprofit organization. She is the author of two books: Peace at Last and The Hero Within. She is well-known as one of the leading experts in caring for Veterans nearing the end of life. She is on the advisory boards for the Elisabeth Kubler-Ross foundation and the Ira Byock PBS film project The Best Care Possible.
Is an ADEC-certified bereavement counselor specializing in grief and traumatic loss with 20 years experience working with Veterans.Bereavement interventions that she has developed have been used extensively throughout the Department of Veterans Affairs system nationwide.She is the Chief Operating Officer of Opus Peace nonprofit.
Marie is a Vietnam War Veteran and Bronze Star recipient. Her career as a nurse spanned forty years and included both, Walter Reed Army Hospital and the Department of Veterans’ Affairs.
Naomi a LCSW, is a passionate advocate for restoring peace in the aftermath of trauma. As a child of parents who survived Auschwitz Concentration Camp, she is especially sensitive to the needs of family members.
Kathy, an RN, MSN, is Veteran Care Liaison for Hospice of Dayton. She has received RYT200 training in Yoga and training in “Warriors at Ease,” Trauma Sensitive Yoga and Meditation for Veterans and Military Communities and faithfully implements these skills with Veterans and their families.
Sheila is an Army veteran with a lifelong career as a nurse for the Department of Veteran Affairs. She is an advocate for responding to the soul injury of children whose families have experienced trauma. She is the designer of “Soul Buddy” dolls.
Shaku worked as an RN for 30 years at the Department of Veterans’ Affairs. She has had a lifelong desire to promote and achieve inner and outer peace.
Dr. Abi Katz currently serves as Medical Director for the Post-Acute Care Continuum for Kettering Health Network in Dayton Ohio. She has worked with veterans and cilvilians with soul injuries at the end of life for seven years. Her passion is using her skills to assure that all people get the best care possible, at the right time, in the right place.
Dr. Carroll is a Radiology physician with Quantitative Imaging, Inc. specializing in brain imaging. His work has been cited in 587 journals in the past 5 years, including:
NEUROTRAUMA CONFERENCE (Recovery from Fully Disabling Traumatic Brain Injury - 15 Year Followup)
EIGHTH WORLD CONGRESS ON BRAIN INJURY (Quantitative Assessment of Glucose Metabolism in 83 Brain Structures of Eighteen Motor Vehicle Accident Patients)
Patty Ann is an Army Veteran and licensed massage therapist specializing in clients with PTSD and Military Sexual Trauma. She assists in Hounds 4 Heroes of Tampa Bay.
Diane Jones, SW, has 35 years of experience in hospice and palliative care, including consulting with the VA for 16 years. In her efforts to improving access to end-of-life care for veterans, she founded the Hospice-Veteran Partnership program and assisted with the development of NHPCO’s We Honor Veterans program.
Estephania is a film producer affiliated with the non-profit "Welcome Your Soldier Home". Currently she is spearheading a documentary file, “Frozen in War,” about preventing veteran suicide.
Marybeth is a licensed physical therapist who is committed to helping others abide and reckon with their suffering so they can be restored to wholeness.
Jim is the proprietor of Veterans Funeral Care. He has selflessly championed the needs of veterans and their families at the end-of-life..
Ann is a Licensed Clinical Social Worker who specializes in Accelerated Resolution Therapy with Veterans and trauma victims.
Kathleen is an Iraq War Veteran who volunteers for Opus Peace Non-Profit Corporation.
Tommy is a Vietnam Veteran with PTSD who has utilized artwork to express his soul injury.
Dan is a Chaplain and Navy Veteran who spent his career working for the Department of Veteran Affairs.