Contemporary Insights from Biblical Combat Veterans through the Lenses of Moral Injury and Post-Traumatic Stress Disorder.

This psychological exegesis reconsiders biblical characters through recent theories on moral injury and post-traumatic stress disorder (PTSD). The purposes of this article are to shed new light on these characters and to engage in conversations of what the findings may mean for pastoral care and their connections to theology. The findings include the proposal of four categorical types of combat veterans that illustrate the development of PTSD, resilience, moral injury, and unfaltering abidance to the warrior ethics.

Introduction

A relatively recent shift in the discipline of Bible studies has made psychological perspectives of the Bible more visible (Rollins, 1999). The emergence of psychological approaches to biblical texts partly follows from the expanding influence of psychology on Western culture in general (Kille, 2002). The application of psychology to biblical texts serves as an alternate avenue to biblical interpretations, and psychological interpretations of biblical texts are proving to be a growing field. According to Rashkow (2006) researchers in the field apply specific psychological approaches to specific biblical texts; for example, Genesis 3 has been processed through Freudian, Jungian, and developmental psychologies (Kille, 2001), the prophetic books of the Bible have been filtered through a Jungian perspective (Edinger, 2000), and the evolution of Adam and Eve has been cultivated through the developmental theory of Erik Erikson (Cohen, 1998; cf. Hunt, 2018), to name but a few.

The absence of a conceptually unified approach to psychological exegesis has instigated the emergence of varying psychological perspectives. However, the psychoanalysis paradigm has held an influential position in psychological exegesis. Much psychological exegesis, for example the long tradition of Freudian criticism, has investigated the text for concealed desires, motives, and hidden neurotic conflicts of the author, or the author's characters, or in our own minds. Yet very few, if any, psychological approaches on biblical texts can be found that utilize current theories on moral injury (MI) and/or post-traumatic stress disorder (PTSD) as a psychological framework through which to consider the author's characters and ourselves in the context of war, and combat, and their aftermath (cf. McDonald 2017). This is interesting because many of the stories and characters in the Bible involve war and combat, and this is especially true of the Old Testament. The interpretations made about behaviors and actions performed by biblical figures often lack psychological discussions of how war, combat, and killing influenced these biblical characters in their behaviors and psychological well-being. This is a shortcoming that begs for more psychological focus, and one purpose of this article is to broaden understanding of how the reality of war may have affected these biblical figures through psychological exegesis. Through this hermeneutical approach new light may be shed on current discussions on combat veterans and better facilitate conversations of what these insights may imply for pastoral caregivers, care receivers, and how they may connect to theology.

There are many reasons to read, understand, and describe the Bible's combat veterans through current theoretical and practical research on combat veterans in addition to bridging a gap and widening knowledge. Today's theories can teach us about the Bible's veterans and trauma, while the Bible's veterans and trauma can return clues and insights that may aid us in pastoral care among those who have served on much more recent battlefields. Insights can be gained into how different biblical characters handled their darker war selves and deplored actions, their potential moral and/or spiritual injuries in relation to God and others, their commitment to military purpose, loyalty to unit and battle buddies, and their difficulties in readjustment after combat.

Conceptualization Of Moral Injury

Although MI is often referred to as a quite recent concept, it may well be described as a new term for an old condition. Service members' internal costs amid war and combat have been given many names throughout the history of warfare, such as nostalgia, shell shock, battle or combat fatigue, and soldier's heart (Shay, 2003; Tick, 2005). The understanding of these inner injuries of war and combat throughout time may very well be something that pastoral caregivers were confronted with and had knowledge about before the modern psychiatric and medical paradigm (Lindsay et al., 2016). Today the complexity of the hidden wounds of war (Rambo, 2010; Shay, 2003; Stallinga, 2013; Wortmann et al., 2017) and soul repair (Brock & Lettini, 2012; Graham, 2017), and the difficulties of transitioning from war back to civilian life (Shay, 2002) have been given new attention and emerging voices through concepts such as MI.

MI is a dimensional problem (i.e., there is no diagnostic threshold and instead severity is seen as varying widely for any given veteran with time and circumstance), which in and of itself is fully capable of deeply afflicting the lives of veterans who have experienced trauma amid military service and deployment (Brock & Lettini, 2012; Drescher & Foy, 2008; Shay, 2014; Vargas, Hanson, Kraus, Drescher, & Foy, 2013). There are at least two clear directions regarding conceptualizations of MI that imply somewhat different interpretations of what happens when moral damage occurs. Shay and Munroe (1998) were the first to coin the term moral injury. Their definition of MI had three components, which were based upon veterans' narratives of injustice via leadership malpractice: (a) betrayal of what was considered morally right in the local culture, (b) by someone who had been legitimately granted authority within the social system, and (c) in a high-stakes situation(s). This definition tends to emphasize authorized yet bad command and the implications thereof for the individual service member. This approach to MI was rooted in Shay's groundbreaking works Achilles in Vietnam (2003/1994) and Odysseus in America (2002). In these books Shay described his experiences working primarily with Vietnam combat veterans by utilizing the ancient works of Homer's Iliad (the story of Achilles during war) and Odyssey (Odysseus's long and toilsome way back to civilian life after war). Shay suggested that there were deep layers of war wisdom in the Iliad and the Odyssey that provided numerous helpful insights into the consequences of war upon the combat veterans with whom he worked in therapeutic settings. Shay suggested that the betrayal of what is considered right can cause an MI, which in turn may dissolve the moral code and replace it with wrath or indignant rage arising, often as a consequence of the death of a battle buddy, from this social betrayal. Shameless behavior is likely to follow after the loss of a comrade(s) in which abuse after abuse is committed (e.g., dishonoring the enemy, brutal killing, berserk state) as an implication of such an MI. An additional consequence of betrayal is that social trust is devastated.

Other researchers over the recent decades have approached MI with a specific focus on the violation of personal moral codes in the line of duty. Such an approach was presented by Litz and colleagues (2009) when they offered an understanding of potential MI experiences as implications of, “Perpetuating, failing to prevent, or bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations” (Litz et al., 2009, p. 700). This formulation has gained acceptance in research literature as a working definition of MI that spans from participation in or witnessing inhumane actions, to failure in preventing them from happening, to even relatively and/or seemingly subtle acts or experiences that at a later time come to be perceived as violations of a personal moral code. Transgressive acts may result in aversive and haunting conditions of inner conflict and tension (e.g., including emotional responses such as shame, guilt, anxiety, and anger). Behavioral manifestations of such MI may include alienation, loss of purpose, social instability, withdrawal, self-condemnation, self-harming, and self-handicapping behavior (Maguen & Litz, 2012, 2018).

Conceptualization of PTSD

PTSD is a mental disorder with a well-established and accepted psychiatric diagnostic tool (a distinction in comparison with MI). PTSD is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which has been developed over the last decades by the American Psychological Association (APA). The fifth edition, (5th ed.; DSM–5; American Psychiatric Association, 2013), moved PTSD from the class of anxiety disorders into a new class of trauma and stressor-related disorders wherein, for instance, depression and reoccurrence of panic attacks are experienced as part of PTSD symptoms. PTSD can occur when a person has been exposed to actual death or threatened by death through direct exposure, witnessing the trauma, or indirect exposure to aversive details of the trauma. Deployment to war zones and combat is particularly likely to expose veterans to such situations. PTSD manifests as its sufferers persistently re-experience and re-live a traumatic event(s) through unwanted memories, nightmares, flashbacks, and emotional and physical distress, which are typically stimulated by exposure to traumatic reminders that may seem normal and mundane to the un-afflicted. This drives the victim to try to avoid trauma-related stimuli/reminders after the trauma. In addition to this, negative thoughts or feelings begin or worsen after the trauma, which include, but are not limited to, overly negative thoughts and assumptions about one's self or the world, exaggerated blame of one's self or others for causing the trauma, negative affections, decreased interest in activities, and feelings of isolation. Arousal and reactivity also begin or worsen after the trauma and contain irritability or aggression, risky or destructive behavior, hypervigilance, heightened startle reaction, difficulty concentrating, and difficulty sleeping. In order to be diagnosed with PTSD one or even two criterion per block (exposure, re-experience, avoidance, negative thoughts or feelings, and arousal and reactivity) is/are required. In addition to this, Shay (2002) suggested that combat PTSD is a war injury, and he made a distinction between simple PTSD (the persistence into civilian life of adaptations required to survive battle) and complex PTSD (which includes both simple PTSD and the destruction of the capacity for social trust).

Returning to the conceptualization of MI itself, MI is not fully encompassed within the diagnosis for PTSD, yet at the same time these two could be related and/or overlapping (Drescher et al., 2011; Maguen & Litz, 2018). There is no consensus over one final definition of MI, and even the choice of the word injury has been questioned (Lindsay et al., 2016). Nonetheless, this term has catalyzed a growing exploration and conceptualization and become very common in the body of literature that has evolved around it, and therefore this article continues to utilize the term moral injury. Those who use this term often have at least one of two common focuses: transgression of a moral code on an individual level and/or betrayal via malpractice of authorized leadership. This article will concentrate more on the betrayal perspective.

Method

The method was based on a close reading of the Books of Samuel (1 and 2) through the conceptualizations of MI and PTSD. These conceptualizations were employed as lenses during the readings with the potential to sift out and highlight relevant content within the biblical narratives. The subsequent step was to specifically investigate and psychologically reflect upon four important characters in the books that is, Saul, David, Joab, and Uriah through these lenses. This psychological exegesis resonates with what Rashkow (2006) describes as “examining the minds of the author's characters” (p. 450). The motives for the selection of these Books includes the recognition that they describe war and combat in detail, including commanders and warriors, and the fact that the main characters are rarely described as heavy-combat veterans with potential psychological wounds. But most significant to this investigation is the fact that all four of these combat veterans are described in the context of war as well as in the context of civilian life. This is crucial because the culturally expected behaviors and actions in combat are quite opposite when compared with the expectations of society in regards to how to function as a civilian member. While aggressive and brutal behavior in combat could be explained by stress and the need to survive an extreme life-and-death situation, dysfunctional behaviors in civilian society and life (e.g., aggression, destructive and/or reckless behavior, mood swings, depression) may suggest potential indications of combat trauma and psychological wounds.

This psychological exegesis considers MI as one or more perceived betrayal(s) of what was considered morally right by a combat veteran, a transgression that may lead this character to revenge and/or rage as an implication of the perceived betrayal. Thus the focus is upon narration of an event that can be interpreted as a type of betrayal from the point of view of the combat veteran character.

This psychological exegesis focuses upon the PTSD criteria described in the conceptualization, which implies that a combat veteran character is potentially considered to be manifesting PTSD when s/he meets at least one criterion per block (exposure, re-experience, avoidance, negative thoughts or feelings, and arousal and reactivity). Descriptions by the author of a radical and more permanent change or alteration of a combat character's psychological well-being (e.g., in current PTSD terminology reoccurring panic/stress attacks, aggression, destructive behavior, emotional and physical distress, withdrawal, etc.) are also crucial.

The hermeneutical approach to the suggested potential PTSD and moral injury findings is based upon the principle that behaviors, actions, and expressions of the actors could be described in light of the symptoms of MI and PTSD, and in turn that such symptoms could be seen in the narratives and therefore provide alternate insights about the four characters in these Books (cf. Ricoeur, 1998).

The results of the investigation and interpretation are presented as two short stories that revolve around the main characters of Saul and David, accompanied by the two minor characters of Joab and Uriah, so as to highlight key findings.

The Story Of Saul

Saul was anointed as Israel's first king during times of oppression by the Philistines, and other groups in the area, when the Israelites wanted a king. The first heavy battle against the Ammonites under the king's command was accomplished about a month after the anointment. Saul was victorious. Sometime later Saul commanded a regular troop of 2,000 service men in Mikmas, while his son Jonathan had 1,000 service men under his command in Giva. During this early period of Saul's rule Jonathan killed an official Philistine leader who was located in the area. The Philistines' reaction was to assemble for a major battle. When the troops of the Israelites saw the power of their opponents they were frightened, and the combat morale declined radically. Troops began to desert Saul, who felt that the Philistines were to march against him in this weakened state, and amid these circumstances Saul disobeyed God's command to wait for the prophet Samuel. Saul instead made his own sacrifice to God in preparation for combat. When Samuel finally came he declared that this was a great sin that transgressed God's will. In spite of this sin, the troops of the Israelites, under the command of Saul and Jonathan, conquered and killed the Philistines. However, Saul did not find much peace after this battle as he was engaged in wars against enemies in all directions (Moab, Ammon, and Edom). In addition to this, he led a successful war campaign against the Amalekites and killed their warriors. Exposure to war, combat, and killing was the everyday life for Saul as a commander and king, and the realities of war most likely affected Saul. God demanded absolute loyalty from Saul, but Saul demonstrated conflicting loyalties to the duty as a king and commander, to the troops, and to God. God was not pleased with this. God's spirit left Saul relatively early during Saul's rule, and Saul grew bothered by what the Books of Samuel call an evil spirit sent by God. This evil spirit caused him much trouble. Saul's servants noticed this new/altered/different state of mind, and their solution was to find someone (the young sheep herder David) to play harp music to him so as to calm Saul when the evil spirit came to him, which it did over and over again. Through the PTSD lens we suggest an alternate understanding of this new condition of Saul's inner life. Saul had begun to experience a type of panic and stress attack that continued to reoccur and deeply affected his life. Because of the exposure to heavy combat and killing, Saul had begun to develop PTSD wherein he re-experienced unwanted memories, and emotional distress plagued him. The music was a way to avoid/calm this condition and re-direct his attention once it reoccurred, and it helped to some degree. Over time Saul's PTSD symptoms worsened to additionally include negative thoughts and feelings, reckless/destructive behaviors, and exaggerated blame of others. So, one day, after the young David had killed an enemy known as Goliath in combat, Saul's irritability, aggression, and destructive behaviors reached a new level when Saul, during a panic attack, twice tried to kill David with a spear. In spite of Saul's condition he continued to command in battle and rage war with the Philistines. But Saul's PTSD symptoms worsened further and, during yet another panic attack, Saul tried to kill David in his home, again with his spear. Later Saul experienced a rage attack wherein he almost killed his son Jonathan. Over the course of this story it is suggest that Saul developed what Shay (2002) would describe as a complex form of PTSD wherein the social trust of others was destroyed. In contrast, time and again, David illustrated how much he could be trusted by not killing Saul when he had the chance; whereas Saul could only trust David for a moment and shortly thereafter was once again back to his previous state of mind, killing innocent people whom Saul's paranoia misconstrued as collaborating against him. In spite of repeated proofs of trust Saul could not re-establish a sustained social trust in David in particular, and in others for that matter. Saul's life ended on the battlefield, in intense combat. When Saul was injured by an arrow he chose to take his own life by throwing himself on his sword. While Saul may not have lived up to God's absolute demands of loyalty, Saul's life story as the heavy-combat veteran and commander resonates with the realities of war and combat.

The Story of David, Joab, and Uriah

The herdsmen and musician David followed Saul as the next king of the Israelites; David in his youth had already shaped himself as a warrior when he had killed Goliath. In spite of the complicated relationship with Saul, David had already commanded troops in battle and combat. David was an excellent commander and warrior and succeeded well in all the war campaigns he participated in. As a warrior, already illustrated during the slaying of Goliath, David was an efficient and brutal killer who got the job done. In contrast to Saul, David appeared to be resilient, in spite of war and combat, and did not show any signs of PTSD as far as the Bible narrates. However, there were two instances where David's leadership malpractice in high-stakes situations illustrated potential MI events for service members under him. One of the commanders who answered directly to King David was named Joab, and he played an important but complex role in David's military organization. During the battle between Saul's and David's clans, one of Saul's commanders, Abner, had killed Joab's younger brother (a youth who was no match for the veteran Abner). Sometime later Abner decided to join David and visited him to discuss the future. It was a festive day, and they were in agreement. Meanwhile Joab was out on a campaign with his warriors, but once he returned and was told about Abner's visit and the recent development he was very upset and approached the king and asked him if he had just let Abner walk away. Through the lens of MI it is suggested that Joab felt betrayed by David's leadership (malpractice) with regard to what was considered doing right by warriors (such as Joab) in a military high-stakes situation of a fallen brother. Directly after he left the king, Joab secretly sent a message to Abner who then unsuspectingly returned to be killed by Joab and his brother (also an experienced commander) in order to avenge their fallen brother. Another event that was perceived as a potential betrayal by Joab was when David appointed Amasa as a commander instead of Joab. When David's son Absalom revolted with troops against David, Amasa was appointed as a commander by Absalom. While David had to escape for his life, David ordered his troops, with Joab in command, to combat Absalom. David did not wish them to harm Absalom. Joab successfully succeeded with the mission, but he also intentionally killed Absalom and David was very sad. From what followed after the combat, Joab was puzzled, perhaps even angry, because of David's reaction and withdrawal, so Joab went into David's room and spoke to him bluntly, to implore him to “soldier up” – to go out to show the troops and officers gratitude for their loyalty and sacrifices on the battlefield. David did that, however, sometime later he appointed Amasa (who David's son had previously anointed as a commander during the revolt) as a commander instead of Joab. During a new rebellion that followed, during combat, when Joab had the chance, he killed Amasa with a concealed sword, successfully accomplished the war campaign, and was reinstated as a commander.

Another example of a potential MI event by the betrayal of what is considered morally right was when David committed adultery with Bathsheba and then conspired to kill her husband Uriah the Hittite, who was himself one of David's 37 acknowledged upper echelons of warriors. Once Bathsheba found out that she was pregnant to David and revealed this to him, David gave the order that Uriah would be released from combat and sent home because David assumed Uriah would resume intimate relations with Bathsheba and thus help to hide the evidence of adultery. However, instead of having intercourse with Bathsheba, Uriah spent his nights in a staff house with the servants. David seemed puzzled by this fact, which itself is interesting because in an earlier episode (Samuel 1) when David fled from Saul, David, suffering from hunger, wished to eat consecrated bread that belonged to the priests; he stated that neither he nor his men had lain with any women, which was a rule of conduct when they were on duty in the field. Since Uriah had just been temporarily released, and his battle buddies were still in combat, it seemed unlikely that Uriah would break the ethics of a warrior in regards to intercourse with women, a rule that David had articulated previously. The story ends when David instructed Joab to relocate Uriah to where the combat was most intense, and then for the other soldiers to slightly withdraw so that Uriah should be left to take the brunt of the battle and fall, which he did. Through the lens of MI it is proposed that this betrayal of what was morally right further eroded Joab's psychological constitution, and this adds new layers to the understanding of his disobedience and rage against perceived enemies.

In summary, varying psychological approaches to biblical exegesis have considered varying avenues to understand the minds of the characters. Yet the heavy-combat veterans in the Books of Samuel can be understood in a slightly different way through the lenses of MI and PTSD. Moreover, this psychological exegesis provides us with four theoretical categorical types of combat veterans. Demonstrating the first category, Saul can be seen as a veteran who in the line of heavy-combat exposure developed severe and ultimately complex PTSD so that in the end he took his own life after being injured on the battlefield. Illustrating the second category, David can be understood as an extremely resilient veteran (resilience is here defined as the lack of PTSD symptoms). Moving on to consider the third category, Joab on the other hand was exposed to several events that he could have perceived as betrayal and which may have inflicted MI on him, a possible explanation for his revenge, rage, and disobedience. Finally, Uriah the Hittite can be considered as illustrating the unfalteringly loyal type of service member and veteran who unfailingly abides by the ethics of a warrior. Uriah also represents what is often considered to be the ideal military type: one who subordinates him- or herself to the system so dutifully that s/he can be used and even abused by commanders and rulers as s/he always remains loyal to the mission and their battle buddies, at least until the point of a perceived betrayal of what is considered morally right.

Four Types of Combat Veterans

Through the psychological exegesis, four categorical types of combat veterans have emerged. The rigor of this psychological exegesis cannot be compared with the approach for a clinical diagnosis, but that is not the intention here. Instead, by reading the Books of Samuel through the lenses of MI and PTSD, a story emerges that includes four heavily experienced combat veterans with varying psychological developments over the course of the narratives. The psychological exegesis can tentatively decode the mind of the combat veteran characters by utilizing current theories of war trauma as long as there is information about their actions, behaviors, and expressions in war as well as in civilian life, as is the case with these four characters. The claim here is not that this exegesis is necessarily the correct psychological interpretation, but instead to suggest that Saul may have developed a complex form of PTSD over the course of his life as an implication of his combat experiences. Another psychological paradigm could suggest another form of psychological disorder. However, given the fact that Saul should be considered as a heavily experienced combat veteran, this could be a possible explanation for his altered psychological condition and incapacity for social trust (Shay, 2003, 2002). It seems reasonable from a contemporary outlook to suggest that many combat veterans during biblical times also suffered from the psychological wounds of war and PTSD, while others were more resilient. Moreover, that the Bible testifies in its own language to the timeless implications of war and warfare. In the light of these findings the four types, which are illustrated by Saul, David, Joab, and Uriah, will be further elaborated. For the sake of clarification, these types are not necessarily equivalent to Saul, David, Joab, and Uriah in the Books of Samuel but rather a theoretical development and categorization of the characters.

The Saul Type

Those contemporary veterans who are understood as fitting the Saul type have, during or after military service over the course of their life, developed simple or complex PTSD. They may have been medically released due to PTSD, or they may have been released long before they developed PTSD. The Saul type struggles with the aftermath of military service in civilian life. Metaphorically speaking these combat veterans may be continuing to live their civilian lives even while waging internal combat with their PTSD. They are, metaphorically speaking, wounded in combat and have an increased risk of ultimately deciding to end their lives, like Saul. Suicide as an escape from war-related mental injuries is a far too common route for wounded combat veterans (Bryan, Graham, & Roberge, 2015; Castro & Kintzle, 2014; Kopacz & Connery, 2015; Maguen et al., 2011; Maguen & Litz, 2012). While the enemy of Saul in the Books of Samuel was another warrior, the enemy of this theoretical Saul type is also the psychological wound (PTSD) and the perception of suicide as a solution. While Saul became lonelier over time in the Books of Samuel, that development is precisely what the Saul type needs to struggle against in an effort to learn to trust others again and to have faith in others. Other important issues for Saul in the Books of Samuel were that God abandoned Saul and did not forgive him for his wrongdoings in the eyes of God. This theoretical Saul type struggles and suffers from a similar perceived silence and/or lack of acceptance from God.

The David Type

Contemporary veterans who are understood as fitting the David type show resilience amid combat and war, and in its aftermath. This is not to say that they are unaffected. Within the Books of Samuel, David is depicted as an emotional person who cried for himself as well as publically, and who showed emotional pain when he lost friends, partners, and children in combat or by the hands of assassins. But David always recovered, and he did not show any PTSD symptoms over the course of his life according to the author of the books. There are many possible answers to this (cf. Isaacs et al., 2017), and some distinct differences between Saul and David. David did not grow hardened in himself over the course of combat and war; instead he sustained his emotional self and expressed himself through dance, music, and by composing lyrics. David interpreted different episodes in life such as sadness and happiness through dance, music, and lyrics. David had the capacity to forgive others and re-evaluate a decision, and even to change his mind. David also cultivated deep friendships with battle buddies, for example Saul's son Jonathan; he and David developed a rare friendship and trust for each other. He maintained his capacity for social trust, even with former enemies such as Abner and Amasa. David's relationship with God remained intact over time, and even when David did wrong, he asked God to forgive him, which God did, whilst also punishing him. David was at the same time a brutal and experienced heavy-combat veteran. In addition to this, David committed adultery, ordered an innocent and loyal warrior into a death trap on the battlefield in order to hide his own adultery, and eventually formerly claimed his warrior's wife – exercising leadership malpractice in regards to potential MI events.

The Joab Type

Contemporary veterans who are proposed as fitting the Joab type are understood to be loyal and efficient combat veterans who at some point in their service perceive a betrayal in a high-stakes situation. This betrayal may develop internally into an MI, which in turn may be externally expressed as rage, revenge, and disobedience (Shay, 2003, 2002). Joab had a complex relationship with David because Joab perceived David as having betrayed what was considered morally right on several occasions, and this suggests that the Joab type may experience complexity in regards to loyalty to battle buddies and how this may conflict with loyalty to the chain of command. Joab was loyal to his troops, and in this theory the Joab type also serves with loyalty to battle buddies, whereas the commander may be met with suspicion, disobedience, or even aggression. While the Joab type indicates varying degrees of MI, the criteria for PTSD are not fully met even though some criteria may be (i.e., negative thoughts or feelings, aggression). Although Joab's relationship with God is not broadly elaborated in the Books of Samuel, the fact that Joab when he was about to face death fled to the tent of the Lord and wished to die there suggests that he had a relationship with God.

The Uriah Type

This is the fourth type found within the Books of Samuel, and this type illustrates the unfalteringly loyal type of a warrior. Like Uriah, the Uriah type is committed to battle buddies, commanders, and missions. The bond between battle buddies has been illustrated to have a psychological strength that may be best described in terms of a sacred commitment (Grimell, 2018). The Uriah type would not do something that would break such a sacred commitment between battle buddies, even if it was something that under civilian circumstances or from a civilian standpoint would seem very normal, even expected. This is also a reason why a betrayal from a commanding officer could inflict MI upon the Uriah type, as the sacred commitment could be damaged or even destroyed. It could be proposed that Joab may have illustrated the Uriah type until he perceived betrayal when David allowed the slayer of his much less experienced younger brother to be an unpunished ally. The risk may be that the realities of war with time could eventually transition Uriah-type individuals into Joab or Saul types.

Discussion

Through the four proposed types of Saul, David, Joab, and Uriah there is a possibility to tap into and draw from their biblical stories and link care receivers to combat veterans within the Bible. This suggests that contemporary combat veterans could be connected to a timeless community of warriors who can be recognized in the Bible. Within this timeless community of combat veterans there could be a wide range of psychological injuries such as PTSD and MI. The Saul type and the Joab type imply such psychological combat wounds that, depending on the severity of the wounds, a potential care receiver may require encouragement to seek out clinical support instead of pastoral care. S/he may also, at that time or later, benefit from pastoral care, and in the North American context these two approaches could even been combined (Bobrow, Cook, Knowles, & Vieten, 2013).

Recent clinical/treatment developments in combat-related PTSD and MI have begun to recognize and highlight the positive impact of forgiveness within spiritual/religious traditions as a path forward to help recovery or healing from psychological wounds (Currier, Drescher, Holland, Lisman, & Foy, 2016; Harris, Park, Currier, Usset, & Voecks, 2015; Koenig et al., 2017; Vieten et al., 2016; Wortmann et al., 2017). In addition to this, the social dimension of a spiritual/religious community has been perceived as a nurturing and important aspect for recovery (Kinghorn, 2012; Lindsay et al., 2016; Sippola, Blumenshine, Tubesing, & Yancey, 2009; Weaver, Flannelly, & Preston, 2003). These two components particularly should be further investigated and applied to the Saul type, for those who may have developed a complex PTSD wherein the destruction of social trust may to varying degrees be at hand. The road to re-establish social trust may be arduous, but a spiritual/religious community may serve as a relational cradle for this development to happen. Honest and open relationships coupled with a sense of belonging and support can greatly assist such a process. On the other hand, it could be dauntingly difficult for the Saul type to find forgiveness from a silent God, a God who seemingly does not respond to their need for forgiveness. Saul in the Books of Samuel continued to live his life and command troops while afflicted with psychological struggles until he eventually, after also being physically wounded in combat, sought escape by taking his own life; suicide may be a dire risk for the Saul type who yearns for forgiveness from a silent God (cf. Berg, 2011). There are no simple solutions for the Saul type to enable them to reinvigorate a personal relationship with God, but it could help to begin the toilsome process of restoring social trust within a warm and supportive community. Perhaps then, once this trust is eventually restored, a Saul type may begin to hear God's voice again. For the Joab type, the need to forgive is more closely located on the interpersonal level (Meninger, 1996). The Joab type should be encouraged to cultivate the capacity to forgive the one who caused the perceived betrayal(s). This also revolves around the capacity to re-establish social trust, however not from the same depths as the Saul type with complex PTSD. A supportive community is a vital component for the Joab type to regain social trust so as to ease the suspicious mind and to encourage the capacity to forgive (cf. Herman, 2015). Amid this process there may emerge a need to be forgiven for deeds committed. This may involve God and/or others.

Contemporary clinicians/researchers such as Shay (2003, 2002) and Tick (2005) have pointed out the lack of rituals for combat veterans who return from war and transition back to civilian society. Pre-combat and post-combat rituals were often practiced in ancient cultures but lost during the modern era. The contours of such a program of rituals can be found in Numbers 31 where the commanders, officers, and soldiers were instructed by the clergy to stay out of civilian society for seven days that were dedicated to cleaning rituals as they had shed blood and were perceived as dirty (un-clean). There may no longer be such ritually designed programs of cleansing bloodshed from contemporary combat veterans, even though such spiritual/religious preparations for a transition from war to civilian life and society may work in the service of health and well-being of at least some combat veterans. A pastoral caregiver may, however, utilize the rich variety of existing rituals and sacraments (as long as these prove to be valid for a care receiver) within the spiritual/religious tradition wherein s/he is rooted as ways to offer care, forgiveness, and atonement which help in the process of transition and reintegration (Malmin, 2013; Ramshaw, 1987; Stallinga, 2013).

Pastoral care and community support may serve as important aides to a process, which eventually may lead combat veterans with psychological wounds to varying degrees of recovery from MI and PTSD symptoms. Such a process also includes identity development and identity reconstruction around what remains of the psychological wound in the aftermath of recovery (Grimell, 2016). Identity reconstruction is here understood from a narrative perspective as a reformulation of the story of “who I am” (McAdams, Josselson, & Lieblich, 2006). Care, forgiveness, atonement, community life, and restored social trust work in the service of reshaping the identity of the combat veteran, which may be described as the story of a “redemptive self” (McAdams, 2013).

This identity reconstruction connects particularly well to “the theology of remaining” by Rambo (2010). Rambo has built a theology around spirit and trauma that is rooted in and understood through the Holy Saturday, the theological day between death (Good Friday) and life (the resurrection on Easter Sunday). This has an important implication for pastoral care that involves the Saul and Joab types because the old narrative character must die in order for a new narrative one to emerge. The old character with its demons and sufferings does nonetheless persist to varying degrees in the shadowlands of the self (Grimell, 2016). This theological perspective gives a realistic footing to the story of a redemptive self. A reformulated identity that is shaped through pastoral care, potential clinical treatment, and relational support does not elide and absolve sufferings to rewrite a purely happy ending to the story. This identity does not imply a wholly new and victorious life, but is rather a middle ground between death (Good Friday) and life (Easter Sunday). The new identity is constructed around what remains in the aftermath of combat, trauma, recovery of psychological wounds, and PTSD. This reformulated identity is more uncertain and tentative as the psychological wounds of killing, violence, pain, and suffering still exist in the landscape of the self (cf. Drescher, Nieuwsma, & Swales, 2013). The presence of the Spirit (or God) in a reshaped identity that is connected to the Saul or Joab type is more fragile and can be difficult to recognize: “It is divine presence marked by absence” (Rambo 2010, p. 13). The sense of forsakenness, abandonment, and alienation are truths of the cross that remain, extending beyond death, to transform a landscape of life embodied into an emerging identity of a redemptive self. Yet this identity is the bearer of hope and growth, which suggests that identity reconstruction could be connected to a concept such as post-traumatic growth/PTG (Tedeschi & Calhoun, 1995, 2004). However, while PTG may imply a more stable evolution and understanding of a recovery from a psychological wound, the theology of remaining recognizes a position and identity in the middle ground between death and life in the recovery and aftermath of a psychological combat wound.

Concluding Remarks

A psychological exegesis provides us with a certain lens through which a multi-layered biblical text can be filtered for a specific psychological purpose. A lens like this, however, for the time being distances the biblical exegesis from some of its traditional richness in order to give new findings room to emerge (at least in the length of this article). This loss may be a shortcoming or even perceived as a simplification of the exegesis, but nevertheless it brings new psychological perspective(s) to the forefront, which may be useful in pastoral care, and others are welcome to expand upon this in various directions. Future research is encouraged to advance understanding of how the Bible can be utilized in pastoral care and theology in the interests of psychologically wounded combat veterans so as to better assist the men and women who have served on the battlefields or war zones of today. The emerging research on combat veterans suggests that spiritual and religious dimensions are more crucial than they were assumed to be 10 to 15 years ago (Brémault-Phillips et al., 2017; Edwards, 2018; Koenig et al., 2017). This suggests that pastoral and spiritual caregivers may play a vital role in assisting combat veterans in the aftermath of military service (Graham, 2017; Nieuwsma et al., 2013; Sippola et al., 2009; Vieten et al., 2016).