SCSU professor in New Haven tries to help combat veterans heal

Sebastian Perumbilly, a professor at Southern Connecticut State University has done research on “moral injury,” which is a person feeling guilty over what they perceive as a violation of their morals.

Sebastian Perumbilly, a professor at Southern Connecticut State University has done research on “moral injury,” which is a person feeling guilty over what they perceive as a violation of their morals.

NEW HAVEN >> As higher rates of American veterans continue to die by suicide compared to their civilian counterparts — the widely cited number is 22 veterans per day — an assistant professor of marriage and family therapy at Southern Connecticut State University began to wonder what role therapy could play in addressing the issue.

Sebastian Perumbilly said mental health issues for veterans first came across his radar in a serious way when he was working as a clinician in Seattle near Fort Lewis from 2009 to 2012.

“In the world of veterans, it’s a different world,” he said. The rate of suicides among veterans is an “epidemic” and “a wake-up call for us in the field.”

The more Perumbilly looked into things, the more literature he encountered postulating that not all psychological trauma experienced among combat veterans is post-traumatic stress — he learned of something called moral injury.

Moral injury is when soldiers see or commit acts conflicting with their moral code, Perumbilly said. Although they are trained on the rules of engagement, soldiers are sometimes put in scenarios where they must kill or be killed. Some carry with them the trauma of murdering civilians either through human error or by following orders, he said.

With the hopes of observing veterans attempting to cope with trauma, Perumbilly joined Edward Tick, executive director of Solider’s Heart. Through Solider’s Heart, Perumbilly observed several Vietnam War veterans as they traveled to Vietnam to meet with Viet Cong soldiers and visit the battlefields where they once fought, in an effort to address their trauma.

Perumbilly said the group started in Ho Chi Minh City before traveling north to Hanoi, visiting the War Remnants Museum along the way, which documents the opposition to the war and the lasting effects of Agent Orange, which continues to cause mutations among some Vietnamese today.

Perumbilly said Tick has six steps of treating veteran trauma: a period of isolation and tending; a period of purification and cleansing; an affirmation of the “warrior identity,” that their purpose was to protect their country; storytelling, which Perumbilly said was the most important step for him as a therapist; welcoming the veterans back into the community, or society; and inducting them as “elders” into that community.

Ordinarily, Perumbilly said, veterans are made to skip the first step by being reintroduced into civilian life almost immediately. Where things have become even more complicated since Vietnam, he said, is that enlisted soldiers today may be deployed multiple times after returning home, leading to instability in their homes and raising the potential for lasting trauma.

The best way to think of veterans dealing with moral injury, Perumbilly concluded, was not to think of them as operating at a “deficit.”

“The breakdown is treating them as sick people instead of as transformed people,” Perumbilly said. “There’s no going back to the old self. That’s gone.”

Instead, Perumbilly prefers to view veterans as people on a “hero’s journey” as described by the writer Joseph Campbell.

“A hero receives the call, goes to the place where he meets the beast and comes back as a transformed person,” Perumbilly said, in summary. “What happens to our veterans is they see the beast in combat, are transformed and return, but they don’t return at all. These are interrupted journeys.”

As to whether combat veterans, who serve as instruments in war, are heroes at all is ambiguous, especially to many traumatized veterans, he said. For those that killed or witnessed the killing of civilians especially, Perumbilly said it is very difficult for them to conceive of themselves as being morally good at all.

With veterans post-9/11, where veterans chose to enlist unlike in the Vietnam War when there was a draft, he said many veterans came to realize there was a difference between the war that was sold to them and their experiences in the Middle East.

“Our research is inadequate or limited,” Perumbilly said.

That is why Perumbilly said SCSU is introducing three new graduate level courses for therapists: one on dealing with military families, available in fall; one on dealing with combat trauma, available in spring, and one in development on the veteran population in general.

Jack Mordente, coordinator of veterans and military affairs at SCSU and an Army veteran, said all people are raised under the commandment “Thou shalt not kill,” but soldiers are raised to kill.

“It’s something our 18-, 19- and 20-year olds have to deal with,” he said. “Once you experience combat, any illusions are dashed.”

He said of all the combat veterans he has encountered in his job since 1975, none would want to be in combat again.

Mordente disagreed with Perumbilly’s assessment that mental health services weren’t able to meet veterans where they are, saying the Veterans Affairs hospitals are “very, very competent in providing services” aside from problems stemming from bureaucracy.

Mordente said Vietnam veterans experienced something that seems to have abated with passing generations of veterans: a large share of the blame from anti-war protesters, whereas the blame should rest with the powerful individuals making decisions.