no dares saying. we dare to ask. welcome to on contact today we discuss veteran suicides with former marine company commander about you and i have believed that many others believe is the main driver in side is not p.t.s.d. per se however it's something called moral injury and moral injury is you know it's kind of a fancy term for guilt but it goes much deeper than that and more injury occurs when you transgress when a person transgressions against his or her belief system against their fundamental values against their what they believe you know whether it be based from a higher power whether it be because what they are raised as the values talk to

them by their families you know by their by their communities or whether it's just basically something they have come to on their own but you transgressed that you've committed an act so by also a pouring in your own to your own senses that you are no longer the person you once were or the person that you thought you would be. military veterans make up 8 percent of u.s. adult population but account for 13.5 percent of the adult suicides in the united states data from veterans affairs shows among veterans that had deployed to iraq and afghanistan suicide rates are $4.00 to $10.00 times higher than their civilian peers but even these statistics may be understating suicide rates among combat veterans in a 2015 story a marine corps infantry unit that was tracked after coming home from war saw suicide rates among its young men for. times greater than other young male veterans

and 14 times that of civilians this high rate of suicide in veterans leads to a total number of deaths of combat troops at home that surpasses the totals killed in the war in 2011 an investigative piece in the bay citizen that examined public health records found that 1000 californian veterans under the age of 35 died from 2005 to 2008 that is 3 times the number killed in iraq and afghanistan during the same period close to 2 afghan and iraq veterans died by suicide each day on average meaning the estimated $7300.00 veterans who have killed themselves since just 2009 after coming home from afghanistan and iraq are greater in number than the 7012 service members killed in those wars since 2001 why is suicide such an epidemic among combat veterans from our wars in the middle east joining me to discuss

veteran suicides is matthew hoh who served as a marine corps company commander in iraq in a later as a state department official in afghanistan resigned in protest over the escalation of the war. so matthew and i spent 20 years covering war i didn't carry a weapon and that's an important distinction but certainly dealt with p.t.s.d. as i know you have let's 1st just explain what p.t.s.d. does to you and i know you've fought this battle to. chris and thank you for having me on and i think that point you you made is something you know we'll get into about the difference. as a perpetrator of war as say i was as opposed to somebody who has taken part in the war as you were but weren't was not a perpetrator of the violence and i don't i want to know as i think you know that's

a very important distinction which i've always very yes makes my struggle with p.t.s.d. far easier than yours. yes but i don't think that's fair though i don't think that's truly fair because i think what when it comes down to when you're talking about veterans suicides eat don't see post right excessed stress disorder per se as the reason for veterans suicides so post max stress disorder is what occurs when somebody you know and it doesn't have to be a military member certainly p.t.s.d. affects people in all aspects of life people who are in car accidents people who are victims of the abuse people who are victims of physical violence you know p.t.s.d. is that the body has been triggered into a state of survival all those survival chemicals in you so whether it's a. you know the cortisol is the adrenaline's that are produced by the

body in order for the body to. escape in order for the body to survive and in order for you to persevere through a life threatening a vent. or continually triggered over. and over again in instances where it is not necessary now for someone like yourself chris or someone like me or other veterans of war or people who participated in one of the real struggles with p.t.s.d. is that say for someone who goes to iraq or afghanistan and of course this is you know we can get also to how this affects the people in these countries but let's just talk about how it affects veterans for the moment so you're in iraq or afghanistan you're a marine or you're a soldier or sailor airman and every day you're leaving your base and you are hunting for other people in other people are hunting for you and you do that for 7 or 8 months 9 or 10 months a leveller 12 months when you come home that survival mechanism in you. is not

turned off and so you're constantly in a state of hyper awareness hyper vigilance all those survival chemicals are continually being kicked through your systems with say nightmares you have issues with sleeping you have issues with personality problems irritability you know as well then too that then turns into other issues such as depression relationship issues problems at work you know and so you can understand how that spiral then turns into mental health disorders substance abuse etc and can ultimately lead to suicide however i have believed what many others believe is the main driver in suicide is not p.t.s.d. per se however it's something called moral injury and moral injury is you know it's kind of a fancy term for guilt but it goes much deeper than that it more injury occurs when

you transgress when a person transgress is against his or her belief system against their fundamental values against their what they believe you know whether it be based from a higher power whether the. because what they are raised as the values talk to them by their families you know by their by their communities or whether it's is basically something they have come to on their own but you transgress that you've committed an act so vile so abhorrent in your own to your own senses that you are no longer the person you once were or the person that you thought you would be and i can't emphasize enough how deacon destructive that is for me going through those periods where i realized i had done this i had had had had this moral injury it was a period of blackness it was a undercutting of the very foundations of who i was and you see this in study after study that's been conducted by the u.s.

veterans administration by american universities by various researchers also in international organizations in countries including say in vietnam or israel where that syrians who have taken part in killing that guilt that moral injury has come home and it it subsumes it can it takes over their lives these ghosts as you will take over their lives and ultimately the stress is so great that the only way to get out of that distress the only relief from it seems to be through suicide and this is not something that is new this is something that has occurred for as long as there is recorded history of warfare there has been whether there is recorded instances and certainly you're not going to have statistics going back to the roman say but certainly have anecdotal 'd evidence and recorded history as well that is for

a back of the romans suicide among veterans was very common i want to talk because there are different types of war all of which i covered i covered the civil wars and central america cover the 1st gulf war which was largely mechanized or. there in the desert between saudi arabia and kuwait but the war that you fought in iraq and afghanistan is much like the israeli occupation so as soon as you left the wires soon as you went on the perimeter of wherever your base was you were in hostile territory in those kinds of wars the enemy is often elusive they're i.e.d. zenon actually see them you are taking casualties it's very difficult to strike back because it's not a conventional war situation and robert j. lifton calls it atrocity producing situations this is what happened in vietnam when he was writing about viet nam where suddenly especially if you start losing people in your unit everyone becomes the enemy and everyone becomes

a legitimate target and those kinds of wars are always very dirty i mean when i talk about the difference between my p.t.s.d. which was quite severe after the war in yugoslavia i do think it is there is a distinction in that i never harmed anyone i never shot anyone i call it moral injury that's a very good term and my anecdotally from having been around a lot of combat veterans i think the worst p.t.s.d. or the worst struggle if you want to call it that moral injury comes from what you did i had all the adrenaline and endorphins everything else kicking in and had the fright and the nightmares and i think what just want to say about p.t.s.d. because i think a lot of people haven't gone through it don't get it what it does is it renders you at least in my case numb i couldn't sleep i didn't tend to have nightmares in the war zone but i always have them when i got out i don't know what your experience was and sometimes you don't remember them sometimes you do but over a period of nights you don't sleep and you're exhausted you stumble into bed at 9

and then by 11 o'clock here or 12 your your heart is racing you just sit there until you know the light comes through the window and and what that does is it just i can remember in my worst case just to get up. and shower and shave was almost a heretic yulian effort you feel like you're crawling up you know and you have no energy from the bottom of this dark black hole and i mean i managed to crawl out you managed to crawl out but i certainly through that experience understood that you know that the psychological and physical distress is so debilitating so crippling and so frustrated i got why people kill themselves. yeah it is i think it's appropriate like many other forms of mental health experiences you know whether say it's an eating disorder or whatever unless you've experienced it yourself it's really difficult to understand what the person is going through in my case exactly as you describe chris i dealt with the inability to sleep by drinking

myself to the point where i was able to sleep at and certainly other nightmares night terrors you know i heard women who were sharing my bed with me you know because you know you you you act out those night terrors whether you're flaring now or actually punching you know i mean you are a danger to others and so exactly you know as you were describing you have this spiral with p.t.s.d. that ultimately leads to you know you lose your relationships whether they be with a significant other you know another aspect of p.t.s.d. that is hardly ever spoken about is sexual dysfunction you won you lose intimacy but then too you also do have an inability to be intimate and then if you're on a lot of the drugs that they give you for these types of problems that often has an effect on your ability to have sex and so you can imagine you know being a young couple and being unable to be intimate being unable to have sex it's just

one more major problem that ends up destroying relationships as well into your unable to work as you say you end up causing issues with for. and family so you end up becoming a real burden on your community you know on your neighbors on your family etc so this ripples out and affects people in such a great degree and then of course you know when a suicide occurs the effect that that has that has an effect on directly it has an effect on the numbers i've seen from one of the water suicide prevention networks in the united states is that approximately 165 people are directly affected by each suicide so you can imagine how this ripples out and how it affects. so many people who have been connected to this person so it is not just while it is an invisible wound in is occurring within somebody it is affecting you know mass amounts of

wife mass amounts of people and entire you know relationships work structures neighborhoods etc and you wrote a very fine piece. and the armies that remained. suffered veterans moral injury but in the piece you. make a strong argument in fact the number of the official data that we have on veterans suicide is probably way too low. correct absolutely it's hard to 11 of the problems is that about 70 percent of the veterans who are now killing themselves are not in veterans' health services are not receiving care from the when we come back we'll continue our conversation about veterans' suicides with former marine corps commander and if you go.

with good reason probably just course is focused on addressing and finally each containing the cobe in $1000.00 pandemic now the focus is on devastated economy we're in a recession will. into a depression will the recovery be you. welcome back to on contact we continue our conversation about veteran suicides with matthew . matthew before the break we were talking about the difference between being under care or not being under care and you said that if people are being monitored by the v.a. their suicide rate is lower. that's correct that's correct the v.a. is criticized and rightly criticized for a number of different issues in my opinion those criticisms basically fall into the fact it's not resourced well enough for example there are roughly about 50000

vacancies in v.a. staffing right now however if a veteran is under veterans' health care and is receiving care from mental health specialist at the at the v.a. that veteran has a much lower chance of killing themselves then if they are not under care but this goes back to your previous question chris about how the numbers that we do know you know according to v.a. data and this is this data is almost a year old already but 7300 veterans from the iraq and afghan wars have killed themselves just since 2009. you know how do you there are often times. undercounting so if a veteran is in the spare. and he or she o.d.'s a veteran is drunk and crashes car into a tree and dies you know that does not count as a suicide however very much the curd the events that

lead to that death or all the same events all the same stressors all the same type of distress that a veteran who. puts a gun in his mouth and pulls at the rigger is going through i know that's important point and my uncle fought in the south pacific in world war 2 and did never recovered he was wounded both physically and psychologically came home to a small town in maine and drank himself to death. we didn't know the term p.t.s.d. at the time i want to talk about the kind of existential crisis that veterans go through because. you know especially in elite combat units you often find very idealistic young men and women who believe that you know they're going over to a place like iraq and afghanistan to help that they are bringing liberty and democracy they believe all of the lies they are told by the government and church on hollywood that we are a virtuous people etc and they get run right into

a reality that is very disquieting and one that the wider public back home just refuses to recognize that we in fact can perpetuate evil as ruthlessly as terrorist groups like al qaida. you know people in iraq and afghanistan don't want us there the military itself which is kind of deified in american society is. like any totalitarian hierarchical institution. you know i watched i mean senior officers colonels on top of particular were sending kids off to combat missions which they were going on so they could get their combat infantry badge so that under the uniform of sas they could all of this is quite shattering and and so veterans such as yourself will come back and speak this truth but it's

a truth that the wider society not only doesn't recognize but doesn't want to hear and that creates i think an existential crisis that goes along with moral injury and goes along with p.t.s.d. . the. absolutely you know just jump back one quick moment it's important for people to remember that p.t.s.d. wasn't a recognized diagnosis in the american medical community until 1980. as well then to your point about your own goal. drinking himself to death you know that certainly was my way to do it as well until it got so bad that i want to put a gun in my mouth so certainly yeah there are all these other aspects about this that makes this this very nuanced and very complicated but certainly too when you go overseas and i should say with moral injury it doesn't just have to be something that you do it can be something that you neglect to do so if you see it right i mean or it can be something that is done to you so if you deploy to or the

iraq war and you think you're going over there right chris because you're going over to help liberate the iraqi people because you've been told that iraq is connected to al qaida except her and then when you found that you're alive too and you've seeing your friends killed for this you've taken part in killing that's another form of moral injury that the trail as well as to and this is something that is becoming more understood. you know one in between one in $4.00 and $1.00 in 3 women in the military will be sexually assaulted or raped and that itself is a form moral injury because most of the time they're being raped or sexually assaulted by their superiors so that's what the trail of trust that turns into a moral injury but then when you go to these wars a value for lack of a bare term to feel that you have a white hat on that you're going there to help people. because of whether these wars are based on lies whether because what occurred is out of your control you know i mean 90 percent of the casualties in these wars you know depending on how

you count them are civilians so even you know you could be in a unit and i like to say this actually you yourself could be over there trying to do trying to be as moral as tom. but when you're in an immoral situation that's not going to work out you're going to take part in things that are inherently immoral because of the nature of war because of the nature of these wars in particular with the killing of civilians with the fact that they're based built on lies you know and so when you come home and you leave that that protective bubble of the military and you leave behind all the conditioning the military did to try and make the military did to turn you into a killer and you come home and that conditioning starts to fade away and evaporate and you're now face to face of what you did over there what you took part in over there as well as who used to be and who you believe yourself to be. that dissonance

causes this moral injury causes this incredible distress and i should also want i want to bring up to that you know everything we know about all american wars is that suicide rates have been exceptionally high for veterans that we only have data in the last couple decades on our current veterans whether they're from the world war 2 generation they're from vietnam or from from iraq and afghan wars and we know statistically that all veterans have seen elevated rates of suicide as early as 2 i'm sorry as late as 2010 world war 2 veterans and so many of them are dying off because they're now mostly in their late eighty's and early ninety's but world war 2 veterans had suicide rates in 2014 times higher than their civilian peers and that was the good war right we know from from we know from literature we know from newspaper accounts we know from g.l. records we know from from different forms of media dating in the decades after the

civil war the other good war in american history right that hundreds of thousands of civil war veterans including veterans of the north end up drinking themselves to death and up killing themselves ended up homeless ended up destitute many of them literally hundreds of thousands of the killer of them were opium overdoses because of what they were going through and again that was another good war so this idea that somehow that either this generation my generation of veterans are somehow mentally or emotionally weaker than past generations or that past generations didn't have these episodes inst and actually are still in during these episodes of suicide is just completely false and is based completely on ignorance i want to talk about the hyper masculine culture you marie and i wanted to quit with 1st battalion 1st marines are very one unit actually one of the things that i like the marines. but in the army. there is

a more egalitarian quality to it. but what i did see in the marine corps was a lot of hazing and that hyper masculine motor which was always part of marines really became exacerbated in combat zones and there are suicides in combat zones but oftentimes those. suicides are people who are. being hazed by the unit or because they're overweight or they're different or whatever reason and they go in a port a potty and take the barrel long barreled weapon and they're trying to blow their brains right i want to talk about that hyper masculine culture because that's also . a contributor i think to the psychological distress that veterans have to cope with. it is it is you know it is pronounced itself in other ways you know when you're

a crew from the marine corps and the same thing for the army infantry whereas. other aspects of the military stress college to wishin stress gaining job skills you know education and seeing the world you know what have you when it comes to recruiting for say the marine corps ning army infantry and of course a special operations it's about being a warrior it's about protecting your country is about proving yourself physically and that is. that is found throughout the entire lifecycle or career cycle of someone who does that line of work whether it's just for 3 and a half 4 years or whether it's for 20 or 30 years that type of machine for lack of a better term is prevalent and it pervades everything you know and it falls into line with the you know there are a. it's a substance abuse you know it's really alcohol but there's also some drug use you

know go hand in hand this glorification of masculinity is glorification of alcohol use as well as to this glorification of violence you know and so it's something that is stuck with you it is something that is a part of you you are conditioned to kill because it's not inhuman nation in nature to kill it's human nature to protect right but it's not in human nature to kill and that's why the marine corps and the army have spent so much money studying on how to train to kill and how if you join the army infantry or the marine corps infantry you spend months being taught how to kill and then they remain your time in the middle not doing well in iran not only not having read the studies it's called operant conditioning and it's exactly the same way you train a dog. repetitively right needed response under true stress. i i think that hyper masculinity is also crippling in terms of intimacy and relationships and

a lot of veterans will come and cling to it but it's very self destructive i want to because we're almost done i want to ask you a question i which i have thought a lot about do you believe in heroism. yeah well that's a that's a good question and 111 quick trip back to the hyper masculine you see this in really high rates of domestic violence in the military community and in veterans communities that that's there's a very high rate of domestic violence well above what the rate should be when compared to civilian rates but in terms of heroism you know chris yes i do and it's not in the it's not in the heroism that you get from. you know the television advertisements you know i think back to stanley kubrick's great film full metal jacket and when. the hero of that film if you will goes to marine corps boot camp he calls parris island the home of the faith. tough in the phony break i would say

i got to have to stop you there matthew because the son but you know what you're talking about is moral courage as opposed to physical courage and not about a field you can see a lot of physical courage but not much moral courage and you're right and for me that is heroism as opposed to physical courage all right thanks matthew that was great thanks for being on the show that was matthew hoh former marine corps company commander in iraq now an activist on combat veteran souls. join me every thursday on the alex simon show and i'll be speaking to guest of the world of politics sports business i'm showbusiness i'll see of that.

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