Moral Identity and Moral Injury:
Combat Trauma
My conscience seems to become little by little sooted … [H., accused of being the local Gestapo agent] was an old man of seventy. His wife and he looked frightened and old and miserable. I was quite harsh to him and remember threatening him with an investigation . . Day before yesterday word came that he and his wife had committed suicide … At the bedside was a card on which he had scrawled: “We must perish miserably. God forgive us. We have done no one any harm.” The incident affected me strongly and still does. I was directly or indirectly the cause of their death … I hope it does not rest too hard on my conscience, and yet if it does not I shall be disturbed also.
—J. Glenn Gray, The Warriors: Reflections on Men in Battle, quoting his own 1945 wartime journal
In the 1982 Falklands War, 256 British combatants were killed. Twenty years later, in 2002, the South Atlantic Medal Association said that those killed during the war were outnumbered by the 264 former combatants who had committed suicide.1 In both 2009 and 2010, more active-duty U.S. troops committed suicide than were killed fighting in Iraq and Afghanistan. In 2010 there were 468 suicides compared to 462 killed in combat.2 By 2011 there were 197,074 soldiers (about 15 percent of the total number back from Iraq and Afghanistan) being treated for post-traumatic stress disorder.3 These psychiatric conditions are a major feature of modern war. In some of them, but not in others, the soldier’s sense of moral identity has taken a battering.
In my opinion, the person who went to the Falklands and the person who returned are two different people. I feel I lost my boy in the war, only he didn’t die. I fear it is only a matter of time before he takes his own life and finally gets some peace.
—Tony McNally’s father, in Tony McNally, Watching Men Burn: A Soldier’s Story
In the Falklands War, Tony McNally was a rapier missile operator. His job was to shoot down Argentinean aircraft attacking British targets. Because of a technical fault, when he aimed at Argentinean planes attacking the British ship Sir Galahad, pressing the fire button did nothing. The bombs exploded on the ship, which was laden with fuel and ammunition. Forty-eight men were killed, with many more were badly burned and wounded: “Soldiers were jumping into the water, their clothes on fire, as others ran around on the deck trying to get off. As the carnage unfolded in front of me, I could do nothing but stand there, watching men burn … The Paras turned their anger on us, screaming and shouting obscenities … How do you explain that it wasn’t our fault? That a fuse had blown, or the computer had crashed?”4
The aftermath of this experience was felt much later. “As night fell, we switched to our normal routine—food, sentry duty and sleep. It sounds harsh, but life had to go on. It’s no use crying over burnt Guardsmen, and we didn’t. Though it would eventually hit me hard, very hard—terrible feelings of guilt, sobbing tears, horrific flashbacks, wishing I’d died out there myself—my mind had shut down those emotions for the time being. All that lay a good ten years in the future.”5
Back in England, the problems started. “I went totally berserk with my family a week or so into the leave. We had a row about something irrelevant and I smashed up the house and stormed out. That night I dug a trench in the garden and slept in there, wearing my combat gear … It was obviously very odd behaviour—though I didn’t realise it at the time—and I slid further and further out of control … I’d wake up, often in a cold sweat, at 2 a.m. or 3 a.m., and find myself replaying the events of the attack on the Galahad over and over again in my head.”6
Some years later the factory where Tony McNally worked was closed down. He had no hope of finding work. He felt low and the nightmares of death and horror started again. “I thought a lot about the Sir Galahad, and would find myself in tears, wondering why the fucking Rapier hadn’t fired, feeling a mountain of guilt on my shoulders for all those deaths and the awful injuries of many of the survivors.”7 Later he had terrible flashbacks and night terrors, and became violent and destructive. His wife tried hard to cope, but “I’d put her through hell” and she left him, as did his second wife.
No one could reasonably hold Tony McNally responsible for the deaths of the troops on the Sir Galahad. The technical failure was out of his control. But the terrible feelings of guilt, however unjustified, are part of a cluster of natural human reactions. A suicidal person jumps in front of a train. The train driver is in no way to blame, but he is still likely to feel terrible. Before backing out of the parking space, the driver takes all reasonable precautions, including checking in the mirror to see that no one is behind his car. But he runs over a small child, too low to be seen, who had crawled into his path. The car driver’s role is more active than that of the train driver, but he still cannot reasonably be held responsible. He will still feel terrible, though, because “It was me who ran over her”—what Bernard Williams called “agent regret.”8
Nancy Sherman has rightly said that in military contexts the phrase is inadequate: “ ‘Regret’ for these kinds of tragedies is, in fact, too light a word, not close enough to remorse and too close to the kind of regret we feel about inclement weather.”9 So, although the term “agent regret” is well entrenched in philosophy, here “agent reaction” may be a better phrase. Tony McNally’s agent reaction to its being his gun that failed was long-lasting. It shows how much a matter of bad luck, how unfair, and yet how devastating, feelings of guilt and self-blame can be.
Karl Marlantes grew up in Oregon. Aged 19 and with Marine training, he was in the Marine Corps reserve. After studying at Yale, he was a Rhodes Scholar at Oxford. But in 1968, after one term, he left to fight in Vietnam. He commanded a platoon and was awarded fifteen medals, including the Navy Cross, two Navy Commendations for Valor, and two Purple Hearts. After a year he returned to Oxford and completed his degree in philosophy, politics, and economics. Thirty years after Vietnam he asked Veterans’ Affairs for help with his post-traumatic stress disorder.
Once, Marlantes went to shoot two enemy soldiers who were attacking his platoon with grenades. There was “one particular NVA soldier whose desperate fearful eyes I still vividly recall, standing out like black pools in an exploding landscape of mud and dying vegetation … I can still see him rising from his hole to throw a hand grenade at me. The wild desperation, the animal cornered … His friend crumpled over next to him, dead. He was a teenager, like my radio operator.”10
Some would believe what Karl Marlantes did was wrong. Absolute pacifists would think so, as would those of us who think the Vietnam War was immoral and that killing in such a war cannot be justified. But Karl Marlantes did not hold either of these views. He believed he was justified in fighting. Given that, it is hard to see he had any rational basis for guilt. Killing an enemy soldier who is attacking your unit, and who is about to throw a grenade at you, is surely one of the easiest acts of wartime killing to justify. And Marlantes clearly did not feel guilt. Asked about it, he said, “Well, it’s hard to say that it’s guilt. Because I’ve killed people, more than one. And I feel sadness about it, a great deal of sadness. That’s different than guilt.”11
At the time he felt only exhilaration that the grenade threat was over. But ten years later, in a therapy group, he was asked to imagine saying sorry to the mother and sister of someone he had killed: “Within a minute of starting the apology I broke down wailing like a frightened child. Out came a torrent of terrible memories and remorse. This was the first time I felt any emotion about having killed … The crying started again the next day, and would start again days and even weeks afterward and go on for hours at a time. Even at work the faces of dead friends and mutilated bodies on both sides would come unbidden to mind. I’d have to make excuses to go outside where no one could see me shaking, throat aching to hold back the sobs … It went on like this for months, until I quit my job. I got into something new and everything went away, until next time. This pattern went on for nearly three decades.”12
Jonathan Shay, a Veterans Affairs psychiatrist who has treated the war-induced problems of many returned American soldiers, says that soldiers who rout the enemy single-handedly often have episodes of going berserk. A Marine veteran described one: “He fired and I felt this burning on my cheek … I emptied everything I had into him. Then I saw blood dripping on the back of my hand and I just went crazy. I pulled him out into the paddy and carved him up with my knife. When I was done with him he looked like a rag doll that a dog had been playing with … I felt betrayed by trying to give the guy a chance and I got blasted.… I felt a drastic change after that. I just couldn’t get enough. I built up such hate, I couldn’t do enough damage … Got worse as time went by. I really loved fucking killing, couldn’t get enough. For every one I killed I felt better. Made some of the hurt went away [sic]. Every time you lost a friend it seemed like part of you was gone. Get one of them to compensate what they had done to me. I got very hard, cold, merciless. I lost all my mercy.”13
Among the triggers of going berserk, Jonathan Shay lists being wounded, surrounded, overrun, or trapped. He also cites grief at the death of close comrades, compounded as a trigger by the sight of seeing their bodies mutilated by the enemy. This grief can swing between rage and emotional deadness. It can also involve guilt, and sometimes the thought “I should have been the one who died,” a thought that can lead to suicide.
Tony McNally describes a group of British troops looking into a hole at the headless torso of an Argentinean soldier. Two were prodding the remains with sticks, trying to open the rib cage. “We were all giggling like adolescents as the two with the sticks started to flick bits of rotting flesh at each other. One of the lads ended the game by throwing a small Argie grenade into the hole … This act was to haunt me to this day. It was a shameful thing to do, impossible to justify or even to explain, and I have asked the dead soldier for forgiveness for being part of it. Although I wasn’t physically involved, I should have intervened. In our defence, all I can say is that we weren’t ourselves that day … The war had dehumanised us and we didn’t give too much of a toss about anything.”14 Years later the eyes of the abused Argentinean soldier looked at him accusingly in a dream.
Sometimes, whether about dishonoring the enemy or simply killing them, human responses can break through. A psychiatrist was told by a veteran that killing the enemy was fine until he looked in one dead man’s wallet and saw pictures of the man’s family, very like those in his own wallet. The sudden empathy triggered a lot of guilt.15
It is also possible for an officer to succeed in creating such breakthroughs in his men, and thereby help keep their humanity alive, despite their dishonoring the enemy dead:
I mean we had been fighting for days. And their friends had been killed. And the dead bodies laying around the hole. So they cut some ears off … the corpses of the enemy. And they stuck them to their helmets. And like I said, these are 18-year-olds. So it’s like a high school letter. “Hey, look, I shot these two guys” … And I said … “You can’t do this … You’re going to bury those two bodies” … That restored their humanity. They realized they were burying another person. And they felt sadness. Again, I don’t think the word is guilt. Those people were trying to kill us. But the sadness that those people were there just like we were. They were 18. We were 19, 18. And there we are killing each other. That broke through for that moment … you kill them when they are animals. And then you have to try to come back. If you don’t, then the atrocities can start.16
It is the darkest pit of therapy for the common soldier. It is where my vets least want to take me but most need my help. It is where I am least able to help them. All I can do initially with them is listen and hold their hands, if they want, praying silently that they can get through this. When I first started this work I couldn’t go there with them. I was afraid. I eventually learned what I was afraid of: they never told me anything so awful that I could not imagine doing it myself.
—Larry Dewey, War and Redemption: Treatment and Recovery in Combat-Related Posttraumatic Stress Disorder
The psychology of soldiers going berserk or dishonoring their enemies has elements that come close to being human universals. Of course very many soldiers do not do these things. But the pattern cuts across cultures and historical periods. Jonathan Shay, whose books compare the narratives of his patients with The Iliad and The Odyssey, has shown many striking parallels between the psychology of combat in Homeric times and now.17
These are dark parts of our psychology, as Karl Marlantes sees: “There is a dark side that can come out instantly if the bonds are removed … And when you get in combat, you’re going to die if you don’t do it. And believe me, the old civilizing things that’s saying, ‘Well, let’s be nice. Let’s see if we can be good to the guy and stuff.’ It’s like when it’s your organism at stake, all that stuff finally disappears. And that’s why I think there’s a deep genetic component to us. That we just don’t want to admit. It comes out. Carl Jung talks a lot about shadow, how we have a violent side of us that we don’t like to talk about.”18
Returning soldiers notice how people are in denial about this. Jonathan Shay quotes what one said about a dinner given for his return: “Her father said, ‘So, tell us what it was like.’ And I started to tell them. And I told them. And do you know within five minutes the room was empty. They was all gone, except my wife. After that I didn’t tell anybody I had been in Vietnam.”19 Before being in combat, those who become soldiers may be as much in denial as anyone else about the dark side of human nature. Part of the trauma of such things as having gone berserk may be the sudden breakthrough of awareness of the dark side, compounded by the horror that the discovery is in themselves: that they have done these things.
One veteran had started in Vietnam at 18 with strong religious beliefs:
I was no angel either … But evil didn’t enter it ’till Vietnam. I mean real evil, I wasn’t prepared for it at all. Why I became like that? It was all evil. All evil. Where before, I wasn’t … I look back today, and I’m horrified at what I turned into. What I was. What I did. I just look at it like it was somebody else. Somebody had control of me. War changes you, changes you. Strips you, strips you of all your beliefs, your religion, takes your dignity away, you become an animal … You know, it’s unbelievable what humans can do to each other. I never in a million years thought I would be capable of that. Never, never, never.
Another was similarly changed: “When I just come there, I couldn’t believe what I was seeing. I couldn’t believe Americans could do things like that to another human being … but then I became that. We went through villages and killed everything, I mean everything, and that was all right with me.”20
Torture is also something that can traumatize soldiers who obey orders to take part in it. Daniel Keller had blasted loud music in victims’ ears and had poured gallons of water into their mouths and noses as they gasped for breath. Afterward he had therapy, which partly wiped the memories. But he still had to deal with it, as these impressively honest comments show: “None of us were like this before. No-one thought about dragging people through concertina wire or beating them or sandbagging them or strangling them or anything like that … before this … I don’t think I’ll ever be done coming to terms with it for the rest of my life. I am just going to learn how to be a better person and live with what I have done.”21
I shall argue what I’ve come to strongly believe through my work with Vietnam veterans: that moral injury is an essential part of any combat trauma that leads to lifelong psychological injury. Veterans can usually recover from horror, fear, and grief once they return to civilian life, so long as “what’s right” has not also been violated.
—Jonathan Shay, Achilles in Vietnam: Combat Trauma and the Undoing of Character
Some psychiatrists object to the term “post-traumatic stress disorder” to describe the condition they treat. Jonathan Shay says it is better seen as an injury: it is more like losing a limb in battle than like a psychiatric disorder. Edward Tick quotes one veteran saying that PTSD is “a name drained of both poetry and blame” and that a name is needed for “a disorder of warriors, not men and women who were weak or cowardly but … who followed orders and who at a young age put their feelings aside and performed unimaginable tasks.”22
It was only after large numbers of affected soldiers returned from Vietnam to the United States that post-traumatic stress disorder (PTSD) was included in the DSM. The criteria in DSM-5 for identifying the disorder still do not distinguish combat-related trauma from other kinds. The first criterion (A) says the origin must be exposure (personal, or through witnessing the exposure of others) to actual or threatened death, serious injury, or sexual violation.
The resulting disturbance is identified by four further criteria:
(B) Intrusion symptoms (such as recurrent intrusive memories, dreams, flashbacks, etc.);
(C) Avoidance of memories, thoughts, feelings, or other reminders of the traumatic events;
(D) Negative changes in cognitions and mood (such as not remembering aspects of the trauma, persistent, distorted negative emotions or beliefs about oneself and others, feeling detached or estranged from others, or inability to have positive emotions);
(E) Marked alterations in arousal and reactivity associated with the traumatic events (such as being irritable, aggressive, excessively vigilant or startled, or having problems concentrating or sleeping).
PTSD is usually seen as a unitary condition that happens to have various origins. There are some good reasons for this context-neutral view. Rachel Yehuda points out that “the demonstration of a distinct set of biological alterations that correlates with symptoms of PTSD has served as an important validation of the concept of PTSD.”23 Some medications and kinds of psychotherapy seem helpful in treating PTSD in general. And “traumatic events able to cause PTSD vary considerably, but the core symptom domains remain remarkably consistent across populations.” The context-neutral view is reflected in the goals of treatment: to “reduce the frequency and intensity of intrusive trauma memories, restore social and occupational functioning, and enhance resilience against future traumatic life events.”24
But there are also limitations to the context-neutral account of PTSD. The view is from the outside. It ignores differences between being a passenger in an air crash and the experiences described by Karl Marlantes or Daniel Keller. The air crash is unlikely to lead to guilt, agent reaction, or to damage to the sense of moral identity. When symptoms are seen as floating free from context, this flattens the contours of the returned soldier’s inner landscape. The goals of treatment make no reference to moral identity or to healing moral injury.
Although all post-traumatic stress involves inner turmoil, there are different ways of not being at peace with yourself. The air crash may come up in terrible flashbacks, but without self-accusation. Even where there is agency, there are different reactions. Tony McNally was changed, but he knew he was not responsible for the gun breaking down and so there was no violation of his moral identity. And Karl Marlantes, who was responsible for his acts, felt no guilt. He saw his act as a necessary defense of himself and his comrades in a war he believed in. His tears at the therapy session, the torrent of terrible memories and the unbidden images of mutilated bodies, were a breakthrough of previously rejected human responses. But they were not signs of damage to his moral identity. He believed what he had done was horrible but justified.
Perhaps the most important boundary is between those cases and ones where moral identity has been damaged. As Jonathan Shay says, there may be a different prognosis if “what’s right” has been violated. This is most likely where someone has gone berserk, dishonored the dead, or tortured someone. From the outside Tony McNally, Karl Marlantes, and Daniel Keller may all show similar DSM symptoms of flashbacks, negative emotions, and feelings of estrangement. But inside there is a world of difference between Karl Marlantes’s sadness without guilt and Daniel Keller’s thought, “I don’t think I’ll ever be done coming to terms with it for the rest of my life. I am just going to learn how to be a better person and live with what I have done.” It is hard to believe that these differences are irrelevant to the kind of help needed.
Many people, for good reasons and bad, avoid discussing the war with returned soldiers. Some suspect they would be disturbed by what they might hear and so shy away. There is also a decent concern not to cause distress by opening psychological wounds. So veterans are often met by silence on the topic. Some, like Karl Marlantes, say they would like to talk about it and be listened to. “You know, you come back and there is this code of silence … And it’s all done out of trying to be kind. But you know, it’s like, ‘Well, I don’t want to say something that upsets him …’—and the fact of the matter is if someone would genuinely ask, ‘Well, you know, can you talk about it?’ I think most guys would be delighted, you know? And sure there are those who are going to say, ‘I don’t want to talk about it’ … So then you wait a year or two and ask him again. And believe me, at some point, they’re going to want to talk about it.”
Awareness of the silence also goes with a sense of alienation. Karl Marlantes accepts that some things, which to a soldier in combat seem a terrible but necessary duty, will to most people seem horrific: “ ‘Thou shalt not kill,’ even for the atheists in our culture is a tenet you just do not violate unless you’re, you know, crazy or a sociopath or something. And so all your young life, that’s drilled into your head. And then suddenly, you know, you’re 18 or 19 and they’re saying, ‘Go get ‘em and kill for your country.’ And then you do that. And then you come back. And then it’s like, ‘Well, thou shalt not kill’ again. Well, believe me, that is a difficult thing to deal with.”
But Marlantes thinks talking could lead other people to make the effort to understand. “And then you say, ‘Hm, maybe I should feel bad that I feel good about this.’ And so you get these moral reverberations going around in your head that you’re sure no-one else is going to understand. I think that’s probably not true. I think people with a certain amount of wisdom can certainly try to understand it. But you do have a sense of alienation.”
The alienation comes partly from the sense that only soldiers are held responsible for terrible acts of war whose origins reach back into the whole society. Karl Marlantes: “It’s the sense that you’re carrying the entire burden. And no-one is aware of it, no-one wants to cop to it.” He points out that people pay taxes that support the war and scientists build bombs in factories that society funds. “Everyone in this country is involved in that war. What the soldier did is at the end of an enormous long chain, he pulled the trigger. That was his part. But we all like to believe that he did it. We didn’t do it … people come back, and they realize that nobody really cared. And they don’t even want to take responsibility for the fact that they were part of the enormous machinery that had all this take place.”
Marlantes thinks an ideal response to the returning soldier would not be silence. But it would not be cheering either. “What they need is recognition that what they’ve just done is something that should be thanked not cheered.”25
What often is not recognized is the help the returning soldier needs to cope with trauma. When Tony McNally was diagnosed with post-traumatic stress disorder, he took part in a class action of 1,900 people against the Ministry of Defence for compensation. They claimed the MOD had known of the likelihood of post-traumatic stress disorder and had failed to give the help they could. It was “mainly because I wanted someone, somewhere, to recognise what had happened to me … it was never, for me really about money. I wanted someone to put their hands up and say, ‘Sorry, we could have done more.’ ” The judgment went against them. Although effective treatment was available, it was ruled that the MOD had no duty to identify sufferers to get them help. “War and warlike operations inevitably take their toll, both physical and psychological.” Tony McNally commented, “That didn’t mean, apparently, that those in charge needed to give much of a toss about the people at the sharp end.”26
Returned soldiers with these psychological injuries, whether or not they think their traumatic experiences involved acts against their own moral identity, need healing. Karl Marlantes eventually came to identify the healing he needed: “I killed him or Ohio did and we moved on. I doubt I could have killed him realizing he was like my own son. I’d have fallen apart. This very likely would have led to my own death or the deaths of those I was leading. But a split occurred then that now cries out to be healed. My problem was that for years I was unaware of the need to heal that split, and there was no-one, after I returned, to point this out to me.”27
What are the prospects of healing such a split? What of other psychological damage—the sense of being already dead, the uncommunicated grief that turns into rage? How far is cure possible?
The answers vary with different people and their different histories, and also with what is meant by “cure.” Jonathan Shay says clearly, “If recovery means return to trusting innocence, recovery is not possible.” But he says partial recovery can take place, although by DSM standards the people who have partially recovered “remain highly symptomatic.” Even if they have persistent problems like difficulty being in public spaces, many of them have flourishing lives. The best treatment puts the survivor in control: “Healing is done by survivors, not to survivors.”28
How can psychiatry help them to heal themselves? Different wounds may need different help. It is possible that, even for those who did not violate their own ethical beliefs, some kind of expression of sadness and process of purification might be appropriate. Penances were often imposed on returning warriors in the early Middle Ages. The eighth-century Penitential of Theodore said, “One who slays a man in public war shall do penance for forty days.” Wisdom about the horror and burden of killing, even killing that was believed to be justified, may have been reflected in the early ninth-century Penitential of Pseudo-Theodore; it said that the man who is blameless in committing homicide in war should still seek purification because of shedding blood.29
There are many ways to help the healing. Those who were not responsible for any horror, but who feel agent reaction because of their close involvement, might benefit from questions about agent reaction in other kinds of case. “Do you blame the driver of the train that kills the person who jumps into its path?” “Should he go on feeling bad about what happened if it is possible to stop doing so?” “Are you really so different from the train driver?”
Jonathan Shay says that “narrative enables the survivor to rebuild the ruins of character,” but “only if the survivor finds or creates a trustworthy community of listeners,” people willing to experience something of the same terror, grief, and rage. His suggestion for this “communalization of the trauma” is, like taking Shakespeare to Broadmoor, an Aristotelian appeal to what tragic theater can do: “Combat veterans and American citizenry should meet together face to face in daylight, and listen, and watch, and weep, just as citizen-soldiers of ancient Athens did in the theater at the foot of the Acropolis. We need a modern equivalent of Athenian tragedy.”30
For Bill Ridley, the healing started on a journey of reconciliation back to Vietnam. He had been in the battle that destroyed much of the city of Hué. Returning thirty-five years later, he worried about his likely reception. A Vietnamese guard, “wearing the uniform [Ridley] had fought against,” recognized him as an American. The guard smiled and said, “Let me be the first to welcome you back. You are our honored guest.” After two days, Bill Ridley said, “The VA hospital has given me dozens of different pills in every combination for sleep, nightmares, nerves, stress, depression, and every damned PTSD symptom you could name. Tell me why none of it ever worked. Then tell me why it only took two nights back in this country to get my first full night’s rest in thirty-five years!”31
The split Karl Marlantes saw in himself was between what he did, justified according to his beliefs, and what he needed to blank out: “I doubt I could have killed him realizing he was like my own son.” One of the deepest debates in ethics is about how far what is right or wrong can be detached from which acts we do or do not find humanly possible. Perhaps most combat is possible only with this blanking out. If so, the issues raised by Karl Marlantes have near-universal military significance.
His own healing started with facing up to this conflict between doing what he thought right and its human horror. “I forced these images back, away, for years. I began to reintegrate that split-off part of my experience only after I actually began to imagine that kid as a kid, my kid perhaps. Then out came this overwhelming sadness—and healing. Integrating the feelings of sadness, rage or all of the above with the action should be standard operating procedure for all soldiers who have killed face-to-face. It requires no sophisticated psychological training. Just form groups under a fellow squad or platoon member who has had a few days of group leadership training and encourage people to talk.”32
Those who did some of the clearly horrible things like torturing people, or killing when berserk, may need to forgive themselves. There are complications to this. Torture may wreck the lives of victim and torturer. It is right to help rebuild the life of the guilt-ridden torturer, but the victim should not be forgotten. Any pretense that the act was not all that bad is a failure of moral seriousness. (The issues of combat trauma have some parallels with those raised by the Broadmoor interviews.)
The seriousness should go with gentleness. We who have not experienced combat should remember the huge pressures on fighting soldiers. Would we have returned with less to forgive? And the person with flashbacks about torturing or bestial killing, while rightly being held responsible, is often far less culpable than the politicians who too lightly declared war or who authorized torture, or than the many other people who too easily accepted these things.
Another complication is found in Glenn Gray’s journal: “I hope it does not rest too hard on my conscience, and yet if it does not I shall be disturbed also.” This too is a matter of moral identity. His impact on the old couple was far more than he intended or had reason to predict. Even so, he did not want to become a person who took such things lightly. It mattered to him that forgiveness should not come too easily. And this should go for those who have done more terrible things. Daniel Keller avoided paralyzing guilt while facing what he did with seriousness: “I don’t think I’ll ever be done coming to terms with it for the rest of my life. I am just going to learn how to be a better person and live with what I have done.”
When I talked at a meeting about the need of people who have done some of these things to forgive themselves, Thomas Nagel raised a deep skeptical question about whether this is intelligible. What does forgiving oneself mean? First I thought the difficulty was about self-forgiveness. But perhaps it is about any forgiveness. What is it to forgive those who have harmed you? It is not to forget what they did, nor is it to stop thinking it was wrong. It is to stop holding it against them. But what does this mean? If they sincerely express regret and resolve to act differently in future, you can decide not to judge their reformed character in the light of their repudiated past. The result can be the fading of resentment, and an easy relationship may develop. Self-forgiveness can be like that too. It is neither forgetting what you did nor denying its wrongness. It is not holding it against yourself: not tormenting yourself about it but starting afresh. Daniel Keller put it well: learning how to be a better person and living with what you have done.
Psychiatrists should aim to help those burdened with a damaged moral identity to forgive themselves. The forgiveness should obliterate neither the memory nor the wrongness. Larry Dewey sees denial as an obstacle to healing: “The beginning of this last phase of spiritual or moral healing always seems to start with having the courage to face the truth no matter how painful and shameful it may seem to be. Once the truth is faced, we can start looking for further understanding and resolution. At this point have we left the realm of psychiatry? I am not sure what the realm of psychiatry is any more. I have been changed by this work.”33 Psychiatry should be changed by it too.