Since Vietnam, conventional thinking was that veterans coming home with severe mental problems brought with them the intense “I’m-going-to-die” fear common to those engaged in waging a war. As a result, they still suffered from Post-Traumatic Stress Disorder or PTSD.

So if these mostly combat-hardened men and women were able to deal with this carry-over anxiety — through talk therapies, psychiatric help or even medications — they could lead normal lives. And, in fact, these treatments did work for lots of America’s servicemen and servicewomen.

But for other wounded warriors who saw action in Vietnam and, more recently, Iraq and Afghanistan, no amount of psychotherapy or drugs made them better. Debilitating depression lingered. Destructive behaviors included drinking and drug abuse, spousal abuse, hair-trigger aggression and alienating self-isolation. Suicide attempts by discharged veterans spiked to nearly 1,000 every month, with at least one-out-of-three tries being successful.

During the last few years, however, a whole new theory of what warfare does to human beings has emerged.

The emotional underpinnings are guilt, regret and shame, not fear. These troubled vets are overwhelmed by what they did or didn’t do in combat. Issues of killing civilians by accident or intentionally flare up. There’s often second-guessing about not being able to save a buddy. Carrying out less-than-honorable commands by superiors are questioned.

Former Catholic soldiers are primed for these conscience-raising internal debates, which can lead to deep so-called “moral injuries.”

nThe mind remembers

“When you experience any kind of traumatic event that you think you’re going to die, then the mind remembers. It’s like a movie camera. It remembers what you heard, what you felt, what you experienced, what you thought at the precise moment. And then a way for you to psychologically adapt to that traumatic event is you replay it over and over and over again,” said Val Reyes.

The licensed clinical social worker at the Del Amo Military Hospital and Veterans Program was one of eight speakers at the Moral Injury and PTSD: Warriors, Families and Communities workshop at Loyola Marymount University. The November session was facilitated by Mark Mitchell, a licensed marriage and family therapist.

“With moral injury, a lot of veterans replay those emissions or commissions that brought them a sense of shame and guilt,” Reyes explained. “And when you replay an event, there’s a thought process or a belief system that’s attached to those images. We tell ourselves this is the part where ‘I did something or didn’t do something, because I know it was my fault.’ So there’s the emotion of shame and guilt.”

The retired lieutenant colonel talked about one of his first combat clients — a star high school athlete who graduated from the U.S. Military Academy at West Point. It was the young woman’s first combat command ever in Afghanistan. In a nighttime search-and-destroy mission, the convoy she was leading accidently ran over an Afghan boy. After hours of investigation by the company commander, she ran into Reyes’ quarters, sobbing for five minutes.

When she stopped crying, he carefully listened to what had happened. “Every traumatized person has a story to tell, from beginning to middle to end,” he said. “And what’s important is that we allow each veteran or soldier to bring personal meaning and talk about any conclusion they want to bring to their own narrative.”

U.S. Army Command Chaplain Terry McBride, from Fort Irwin in Barstow, got back after serving in Afghanistan only a few months ago, where he was the theater command chaplain for the entire country. He told the 50-plus therapists, educators, clergy members and veterans at the workshop in Westchester that “you can’t even imagine your worst nightmare” there right now, stressing that the longest war in American history continues even with much publicized withdrawals.

“Not every veteran who serves in a combat environment has problems with PTSD. Let’s get that thrown out there right now,” he said. “And I hate the word ‘disorder.’ It makes me feel like these soldiers are dysfunctional.

“But many do have what I like to call ‘spiritual issues,’ which for a chaplain is my number one priority to look at. From my foxhole, it’s spiritual and moral issues.”

McBride has been deployed seven times to combat zones since 9/11. He said after every rotation from Operation Iraqi Freedom to his Special Forces unit home base in Colorado Springs, “somebody either blew their head off, hung themselves, cut their wrists in a bathtub or hung themselves in their room.” He stressed that the U.S. Army during the last 24 months has had more suicides than in its entire history.

“There is an assault that is going on for the minds of military personnel,” he said. “And it may be many years that the person may be OK, but something triggers that. And there’s an assault on their heart. There’s a lot of issues that are skin deep. But we’ve got to peel back that onion and look deeper in what I call the soldier’s core that is hurting.

“And for a chaplain, what works for me is to be able to start with three things: the spiritual injury, the moral injury and the ethical injury. And it has to do with back-to-back-to-back deployments. I mean, I was there. So we have to have chaplains just be more passionate in their faith with soldiers, sailors, airmen and Marines where God has placed us.”

n‘Ripping apart’ families

U.S. Army combat chaplain Father John Quinn, who was with the 4th Infantry in Vietnam, pointed out how the “ripping apart of military families” by multiple deployments has severe consequences that will take at least three decades to heal.

“We just can’t forget our present vets from Iraq and Afghanistan,” the Jesuit and former Marine said. “Otherwise, we end up with another situation like we had 30 years after Vietnam.”

Jim Burklo, associate dean of religious life at USC, noted, “We’ve got a country where for millions and millions of people a soldier is like a rare animal. I think everybody needs to think about that and be sensitive to that, and respect that they’d better not treat military veterans like they’re freaks. We all need to be aware of judgments we may have about this population reentering our society.”

Another USC scholar, Nathan Graeser, who holds graduate degrees in social work as well as divinity, said the moral ambiguities of war present difficult personal choices for those serving. He defined moral injury as a violation of a moral code or a deep spiritual injury — a betrayal of one’s conscience of what was done or wasn’t done when the stakes were high.

“Often the veteran hates himself and the things he’s done in the so-called ‘fog of war,’” he observed. “So there are these deep wounds, which can be just surviving.

“So we need to bear witness, to create faith. The community has to receive back vets and hear their stories no matter how horrible they really are. They need help in transitioning from military to civilian life. The churches have all the tools already; they just need to work healing ceremonies and rituals into their liturgies for vets.”