- [Announcer] Funding for this program provided by the Yocha Dehe Community Fund.

This program contains combat experiences and images that viewers may find disturbing.

(helicopters rumbling) (ominous music) - [Dr. Keenan] "I was inhuman, I'm a monster."

(helicopter rumbling muffling) I remember going to buy a brand new car and I said, "I don't deserve this car."

(helicopters rumbling) (gunfire rattles) - We're talking about deep guilt and shame.

- I drank to forget and I was so good at drinking that I lost my job.

(ominous music) - In the dream, I felt everything.

I saw you step on the IED right in front of me and I saw your body blow into red and pink pieces of flesh and mist.

(helicopters rumbling) - If you don't give me help right now, this will be the last time you will ever hear from us.

- Go, go back!

(gunfire rumbling) - But when we're talking about moral injury, we're really talking about a soul wound.

- Right, there are people suffering and dying because they're not getting treatment for this, no more.

(ominous music) (dramatic music) (dramatic music continues) (gun fires) - [Narrator] Killing, torture, the destruction of human life, the worst humanity can dish out.

We see it on the news, we scroll through it on social media, but most of us will only ever interact with this kind of violence through a book or a screen.

For the next hour, we will follow combat veterans as they struggle with life-threatening guilt and shame.

And the Northern California clinician who cracked the code on how to treat them as they struggle with moral injury.

- There's two kinds of people in the world.

There's people that are sociopaths and they have no conscience, and then there are the rest of us.

- [Narrator] Since 1965, 12 million men and women have been asked to navigate conflicts, from Vietnam to Iraq, and Afghanistan.

Dr. Melinda Keenan has treated thousands of them.

- In the Civil War, they called it soldier's heart and then shell shock, combat fatigue, combat neuroses.

That was when it was first put into the DSM, it was called combat neuroses.

And then after that, that's when it morphed into the post-traumatic stress.

- [Narrator] Moral injury is related to post-traumatic stress, but has different neuropsychological markers.

It impacts different parts of the brain, which is why Dr. Keenan and her staff say traditional treatments for PTS do not work.

- Right, there are people suffering and dying because they're not getting treatment for this.

No more, no more.

- [Narrator] For the next hour, we will follow individuals whose lives have been impacted by Dr. Keenan's work, each a unique situation, but each being helped by a revolutionary treatment.

- The data that we have show that it works.

It reduces suffering.

- [Narrator] Moral injuries healed through letters to the dead, and for the living, a redemption to the innocence that once made them whole.

(gentle piano music) - My grandma used to have this wall that we used to call the Wall of Fame with my uncles and my dad and cousins that have served.

So that always stuck with me in the back of my head and I was like, "Oh, maybe one day, "I wanna be a part of that wall."

(gentle piano music continues) You know, I joined pre 9/11, so there was really nothing going on.

I was like, the best thing I could do is probably go to Japan or something and get to see that and have fun.

(gentle piano music continues) - [Narrator] While stationed in Japan and out one night partying, Diego Mendoza and his friends were called back to their marine barracks on base.

- MPs came out into the town and said, "Everybody's gotta get back to base."

And I was like, "Okay, whatever."

I went back into the barracks room, we saw one of the planes hit the towers, and I was like, "Dude, turn this stupid movie off."

He's like, "This is happening like right now back home."

And then that's when everything really kinda sank in, like, okay.

all right, now we're not really at a peacetime military anymore.

(gentle piano music) (seatbelt clicks) (gentle piano music continues) - You must be Diego.

- Yes, I am.

(door clicks) - Hi, nice to meet you, I'm Dr. Keenan.

- Nice to meet you, Doctor.

- Come on in.

- [Narrator] All these years later, Diego is at the Center for Post-Traumatic Growth in Rancho Cordova, California To see Dr. Melinda Keenan.

- I know it can be really hard to kinda walk through that front door.

- Yeah.

- So what I'd like to do just in the next maybe hour or so is just kinda get to know you a little bit.

And so I'll ask you some questions, but maybe if you could start just sort of, well, how you got here and then maybe a little bit about what you're struggling with so I can see how I might be able to be helpful.

- I mean, I've been having a lot of trouble, like, it feels like being in my own skin.

- [Narrator] Those problems have taken Diego through nine alcohol rehabilitation stints, two psychiatric admissions, and a suicide attempt.

- I feel like everything I've learned growing up is just like got thrown out the window.

- Right, exactly, that's the moral injury is when you go into to a situation where you have particular moral values that you've grown up with, and then those get turned on their head and you have to break 'em.

- Yeah, and it's, that's, it feels like I'm, that's why I feel like I'm out of place.

- Yeah.

- Right?

And it's just this, just all this time of this just weird feelings like, "Oh," helpless.

- [Narrator] To treat him, Dr. Melinda Keenan needs Diego to go back to the exact moment of his moral injury, to identify the severed relationship that caused it and be willing to write a letter, not about the trauma, but to the other person in that relationship, no matter if that person is friend or enemy.

- So the way we treat here in our program is very different than lots of places and we use group.

And I know most (chuckles) (Diego chuckles) most combat vets go, "I don't wanna do group," because you imagine I'm gonna be putting you in with a bunch of civilians.

- Right.

- But what we realize here is that you guys have to have other people that have walked the same walk as you to heal.

And this is about reconnecting not only with other people, but with yourself and with the person that you feel like you lost and you didn't get to say goodbye or you feel like you harmed.

So I don't know if that would be something you'd be willing to give a try.

- Yeah.

- [Narrator] Diego's objective now is to embrace his participation in the group and then to ultimately write his letter to whoever he feels he hurt, betrayed, or killed.

- Shouldn't have happened.

- Right.

- [Soldier] Go, go back!

- [Narrator] For men and women in combat, moral injury can come from a person's actions.

(helicopter rumbling muffling) (gunfire rumbling muffling) Sometimes from their inaction and sometimes from a situation in which they had no options.

(helicopter rumbling muffling) (gunfire rattling muffling) But the resulting disaster falls heavily on their souls.

(helicopter and gunfire rumbling muffling continues) (somber music) - This letter is addressed to the Recon Team Flight Time and its members.

Lance Corporal Douglas Barnett, Lieutenant Michael O'Connor, PFC Robert Pearcy, PFC Arnold A. Scaggs, Corporal William Buck Jr., and Corporal William Wellman.

(somber music continues) On the morning of 4, July, 1969, I was the radio operator on the recon radio relay station, Foxtrot at Landing Zone Stud.

I was on duty at the relay station to keep track of all the recon teams in my area and to assist them in any way that I could.

At approximately 0300 hours, a team attempted to contact me.

- [Dispatcher] You were taking the first job or second- - Okay.

- Heavy ground fire.

(static buzzing) And there's six more people (chattering indistinct) on the ground to the next stop... - I determined it was you, Flight Time, and that you had enemy movement near your location.

I immediately contacted air control and requested air support and an evacuation of the team.

- Hold it right there?

- Yeah, hold it right there now.

- At that time, all aircraft had been grounded due to bad weather and no aircraft were available.

I heard all hell break loose on the radio.

(soldiers on radio indistinct) (gentle piano music) - There was tremendous amount of gunfire, screaming and yell going on, and I know that you guys were fighting for your lives.

(soldier shouting indistinct) (radio static drowns words) - I was frustrated and felt helpless, but I wouldn't give up.

I kept trying to give you guys encouragement... (dramatic music rising) When you said on the air the words I will never forget.

"If you don't gimme help right now, "this will be the last time you will ever hear from us."

At that moment, I knew that I had failed you and that you were gonna die.

(overlapping soldiers on radio indistinct) - Okay, two-seven (indistinct) (overlapping soldiers on radio indistinct) - We are on station.

- Roger that.

- [Soldier] Five-six (indistinct) - [Soldier] Go back!

- [Narrator] The entire unit of Flight Time was lost on that day in 1969.

- I am so sorry... That I couldn't save you.

I hope you understand that I did everything I could and I pray that you will forgive me.

(chuck sniffles) (soft music) When I saw the six of you being flown in on straps under the choppers, a big part of me died along with you on that day.

I was so overwhelmed with such grief and guilt that I've never recovered from that day.

God took you to heaven on that morning because you had just spent your time in hell.

Rest in peace, brothers, semper fi.

(dramatic music) (gentle piano music) - My family was in the military.

I had a grandfather, my mother, my father, my uncle, and I just wanted to follow in their footsteps, and so I did.

(gentle piano music continues) I was 17 when I joined the Navy.

My first duty station was in Okinawa, Japan with 3rd Dental Battalion - [Narrator] As a hospital corpsman, Sarah Molloy cared for US troops overseas in much the same way they got care at home.

- Somebody has the flu or somebody needs to have an ingrown toenail removed, I mean, you know, we operated as we normally would if we were stateside.

(car honks) - [Narrator] A hurricane near Haiti meant Sarah would be leaving Okinawa.

- It was a humanitarian mission and I was really excited to go and help with the hurricane.

- [Narrator] Then, a last-minute change of plan.

- So my commanding officers came to me and said that they had a spot open for deployment to Afghanistan.

- [Narrator] Her mission would go from humanitarian to combat zone.

(explosion rumbles) - I was stationed at the Role 3 Trauma Hospital in Kandahar, Afghanistan.

The day-to-day in Kandahar was really unpredictable.

Some days were normal and just you would wake up and go to work, and then other days, you would have a pager on your uniform for let's say a mass casualty and everyone had to report to the hospital to assist with the incoming traumas.

The level of stress in retrospect was really intense.

(monitor beeping) So there's a lot of noise, there's a lot of commotion, there's a lot of blood, there's a lot of, there's a lot of everything.

(eerie beat) - [Narrator] The days, the injuries were piling up.

- I think that emotionally, under the surface, I was very unsettled, but I couldn't bring that to the surface, at least not there.

And it just, all the feelings from all of the things that happened in Afghanistan stayed buried deep.

You know, in the military it's always mission first.

(helicopters rumbling) (distant siren howling) - [Narrator] Another day and an urgent call.

Mass casualties were being flown into Role 3 Hospital.

- We got the page that it was an alpha.

The team that I was working with for the day, they went to the flight line to get the patient off of the bird, as we called it, the helicopter.

And now that I'm talking about it, I recall it was a pretty busy day in the trauma, in the trauma bays.

I remember walking out of the door into the ambulance bay to open the door to get the patient.

And when I opened the door to grab the stretcher, I just remember looking up and all I could see were organs on the stretcher and blood and mid stomach down.

(explosion rattles) - [Narrator] The soldier had stepped on an improvised explosive device and the bottom half of his body was gone.

- I think internally, I was just begging for... Begging for him not to die.

I just remember seeing him and just in those moments... Saying, "Please don't die."

- [Narrator] Sarah had been trained that if a patient made it to the hospital alive, they had a 98% chance of survival.

- And so in my mind, I'm frozen, right?

But my body is still moving because this guy is gonna die.

He was still alive.

So it was such a weird place to be.

- [Narrator] It took her 30 minutes to stabilize the soldier for surgery.

- IEDs are designed to explode and travel upwards.

And so when you have an open wound and then you have all of this dirt, metal, trash, bodily waste that they put in these things, all of that goes into your open cavity and really wreaks havoc on the body.

And so they took him into surgery.

I know they cleaned him out really well as well as they could.

- [Narrator] She never knew his name, but she knows how long he survived.

- About 24 hours, and I think that his heart stopped in the ICU, presumably from blood loss.

(flatline beeping) I don't remember a name or a face.

I just, I remember a feeling tied to this man and I just, I just felt so much...

I don't know what the word would be, I don't wanna say love.

It got to a point where he wasn't the only casualty that was lost, and it just got to a point where all of them just started piling up and it got to you.

(crickets chirping) And I just remember sitting with my girlfriend in the Humvee, just crying hysterically and just cursing the world, cursing God and all of my beliefs and humanity.

And I mean, it just, it really just destroyed a part of me.

(gentle piano music) - I knew she was pregnant before I left Japan, and she written me a letter.

(gentle piano music continues) - [Narrator] Deployed from Japan to Kuwait in January of 2003, Diego Mendoza already knew his girlfriend was pregnant and he would soon be a father.

- I was on a machine gun team, did an enormous amount of security.

(machine guns rumbling) Then I got a letter that, you know, my son had been born.

So I mean, that was probably the happiest day of my life, you know?

(gentle piano music) It brought a lot more hope, something to look forward to, to come back home to.

- [Narrator] Diego's marine unit was on the move daily.

- We pushed all the way from Kuwait, all the way into Baghdad.

You know, I was there for the invasion.

We were always like on the move, there was a lot of checkpoints, a lot of clearing out little mud huts.

- [Narrator] The letters and pictures of his new son kept coming.

- It made everything like worth it.

It seemed like I was doing something honorary, you know?

And thinking of him and the stuff that I was gonna be able to do with him and, you know, holding him, spending time with him, sharing the pictures, you know, with the guys and, you know, like, "Oh, you're gonna be a dad, "that's awesome."

"You know, you're gonna be a little league coach, "you're gonna be doing able to do this."

So yeah, it was like, I just couldn't wait to get home.

(dog barking) Well, there's one day where we were at this checkpoint, I think it was outside of Nasiriya, and these vehicles kept coming and, you know, I could still see the vehicle.

It was this white pickup with like this railing on the sides and it wasn't gonna pull over.

So I was telling it to pull over and I was like, in my mind, I was like, I'm gonna be on CNN for like blowing this truck away.

And so once they pulled over, I like went over there, I was pissed.

I was yelling and doing all this stuff.

There was these two little kids in the back that were... (clears throat) They were like crying their eyes out, you know, 'cause here's this guy yelling at 'em and like dragging 'em by the arm to pull 'em out of the vehicle.

You know, they have weapons in their family's face, and the grandpa was in the back with them, like all kind of like shaking.

And I can still see their faces in my head.

You know, after that, it's like, man, I really (censored) these guys up for life.

(gentle piano music) - [Narrator] The children were about seven years old.

- What I was taught was like, you're supposed to protect kids.

You know, you're supposed to, you know, help them.

But here I was like, doing the complete opposite.

- [Narrator] It was days later when Diego was summoned to his commanding officer's tent.

- Sergeant Park was his name, I remember his name.

I'll never forget that name.

And he was like, "Are you Lance Corporal Mendoza?"

And I said, "Yeah."

And he looked at me and went, "Oh my God, I can't read this to you."

And he handed it to me, and... That's how I found out.

- [Narrator] A Red Cross message with one sentence: "We regret to inform you that your son has died of SIDS."

- I felt because of what I had did, like by pulling those kids out of the car or putting that fear in them, it was kind of like, "Okay, you do something bad, "then something bad happens to you," right?

So I felt I was being punished, like God was punishing me for something.

That's exactly where it happened, that moral injury.

(gentle piano music continues) (gentle piano music) - [Narrator] The term moral injury wasn't a part of the medical literature until the 1990s.

But the first written account of the concept comes from the ancient Greek epic, "The Iliad", when the hero Achilles loses his friend in battle and tortures himself with blame for not shielding his friend.

It's that guilt and self-blame that turns traumatic memories into moral injury.

(gentle piano music) A memory doesn't exist in a single neuron or brain cell.

Each memory is stored across the brain in multiple neurons.

You can think of neurons like a series of notes that make up a melody.

Each melody played in a specific way is a memory.

(gentle piano music continues) - So almost a symphony of cells within an area that are encoding and creating that memory.

- [Narrator] Dr. Sharon Furtak says, in those with moral injury, the traumatic memories also light up a section of the brain called the precuneus.

- The important piece about the precuneus is it's very involved with our sense of self.

If we wanna consider the I, like, "Who am I?"

It is that sense of self.

So it is very involved in conscious awareness of our ideas of self-identity and sense of self.

- [Narrator] When we do something that violates our sense of self, it activates our precuneus.

Scientists can see the activation and measure the additional energy that portion of the brain uses when someone is experiencing moral injury.

- If they are recalling that memory repeatedly and having negative emotions with it, having shame, blaming themselves, that's all being integrated into that memory.

- [Narrator] An active precuneus is one of the unique biomarkers of moral injury.

But because moral injury involves our actions in relation to someone else, Dr. Keenan says the letter-writing therapy is very specific.

- Unlike other trauma-focused treatments where they have people write about the incident, okay, that's a trauma account, so you write about.

This is writing to and it's writing to the person that you lost or that you believe you've harmed in some way.

- [Narrator] Quieting the precuneus portion of the brain is key to relieving moral injury.

That comes through both the writing of the letter and sharing it out loud in a group of worthy others.

- [Dr. Keenan] And they know who they need to write to typically because these people are living in their heads and hearts all the time.

(light music) - It's in the process, I'm kinda in the early stages of this letter.

- [Narrator] Carlos's military career ended with an injury from an improvised explosive device that gave him neurological damage.

It makes him sensitive to light.

His letter is to an enemy combatant he killed.

- Your voice and face are haunting me, day and night, light or dark.

Look what you made me do.

I still hear the echoes of your screams.

What do you want from me?

My mind keeps destroying me.

And you are one of the reasons I'm losing my sleep.

My decision was made before that night and I didn't know it will be you.

But if you ask me, my answer is yes.

Killing you was my decision and my intentions.

It wasn't easy.

But I never thought that after will be this painful.

I'm here trying to fix what I have broken.

And you were not the only casualty because taking the life was our exchange.

And you had taken the best parts of me: my innocence, my ability to love, my pride to serve, my peace.

I can see the IED hitting the vehicle that took their life.

I can hear them, the loud noise and the high whistle all in my ears.

I can see their wounds, I can smell the fumes of their vehicles being blown.

I can see them, but I cannot feel them.

Only you, always you.

So I will bring this shame to the light so I may lose this power, perhaps subside my pain so you can go.

It's difficult to live in war and I no longer want to fight.

So I was talking to an individual in which I shot and killed.

And that's the individual that I'm actually speaking to.

It encompass how do I feel about myself and everything that I lost with that act.

(soft music) (flatline beeping) - Unless you've seen trauma or death or violence (explosion rumbles) for prolonged periods of time, people don't really understand it and it takes some of that innocence away from a person.

- [Narrator] Home from Afghanistan and out of the military, Sarah Molloy was still in the medical industry and still dealing with the cumulative memories from her time at Role 3 Hospital in Kandahar, Afghanistan.

- When I first started talking about it, and just all of the experiences that I had in Afghanistan with all of the patients, it was such a visceral experience.

Like my throat started closing up and I couldn't stop coughing.

Just, yeah, it was really hard to talk about at first.

- [Narrator] But it was at night in her dreams that the soldier missing half his body kept coming back to her.

- And the dream was I was in Afghanistan and I was there when he stepped on the IED and I just remember watching him explode into nothing in the dream.

And then I remember waking up crying.

And it was such...

It was such a defining moment for me.

- [Narrator] Sarah decided it was time for help and reached out to Dr. Keenan, who she found through a therapist at the VA. - Dr. Keenan talked about when we experience trauma, the three main beliefs are broken and those beliefs are, (dog barking) I am good, people are good, and the world is good.

And the severing of those beliefs from your mind really just takes so much away from somebody's innocence.

- [Narrator] When Dr. Keenan asked Sarah to write a letter to reconnect with the person at the core of her moral injury, Sarah knew among all the people she had seen who she needed to write to.

- I don't see his face.

Forever, I see blood, I see intestines, I see bones, I see gore.

I can't see his face.

So I knew that I needed to write the letter to this man.

(soft piano music) - [Narrator] Home from Iraq, everything had changed for Diego Mendoza.

His son was dead.

The relationship with his son's mother had ended.

He buried everything, the combat, the memories of the children he frightened, and any dreams of being a father.

- [Diego] Like I was taught, you don't talk about it.

You kinda just keep moving forward in life.

- [Narrator] Landscaping, construction work, and finally a job at the Department of Motor Vehicles.

Life settled down, but inside Diego, a building storm.

Nine years later, he heard children crying at work and the dam broke.

- I came home, and I immediately went to the bottle.

Of all that stuff had just been built up, right?

It was like that snowball, and I just broke.

(soft piano music) Something about hearing those babies cry took me straight back there.

And I never talked about the death of my son either.

So, you know, those things kind of like coming together, I just couldn't take it anymore.

- [Narrator] He moved to Mexico to bounce at a bar, which suited his need to fight and drink, but came back to make multiple attempts at getting sober.

- You know, I went to the nine detoxes, you know?

I went to the inpatient treatment down in San Diego for 45 days before they put me on a 5150 hold.

A 5150 hold is like a psych hold that either the doctor puts you on, but I got put on by the sheriff's.

- [Narrator] After years of daily bottles of brandy, Diego tried to take his own life.

- I had some sleeping pills in my hand and... A bottle of brandy, go figure.

And I was gonna plan on taking 'em, and...

I passed out.

And I woke up with like the pills on the floor.

So that's when I was like, okay, I don't wanna say like I don't have the balls to do it, but I just knew that there was something in me that didn't want to.

- [Narrator] Living in his parents' home at 39 years old with a string of broken relationships, Diego knew he had to get clean and he had to get help.

- To see like the pain in my parents' eyes... And... That's when I was like, enough is enough.

I'm tired of being tired, you know?

And that's when I made the choice to live again.

(soft piano music) - Shut them up, make them quiet, stop the screaming; we did.

We paralyzed their little voices and shot them full of drugs.

- [Narrator] Wendie and her team were caring for two badly burned girls as their distraught mother tried to get into the hospital room.

- Stop the screams, stop the anguish.

We stuck and lined and whisked them away.

We only stopped for one minute to let the anguished mothers see them as we passed out the door with our little cocoons, wrapped and sequestered into silence while we whisked them away where they peeled off their skin.

- [Narrator] The mother never saw her girls alive again.

- We kept her away from them with our judgment.

No touching or soothing.

Oh, little girls, how different I would do it today.

Calculating and dosing, jabbing and cutting your little bodies apart so my machines could blow air into your lungs.

Where was the soothe?

The touch, the soft touch?

The calming words?

Lost in the command of, "Do this and that," and, "Follow the protocols."

Oh, how I wished I had stopped and whispered into your little ears.

- [Narrator] Wendie says the girls reminded her of her and her own sister who set fire to their room as children on accident and barely escaped when their own mother rescued them.

- [Wendie] It was so scary.

We could have been like you and your sister on our way to heaven.

I still smell the smoke.

- [Narrator] The two events collided in that medical facility, causing Wendie's moral injury.

Her letter is to the little girls.

- So, little ones, I'm so sorry I didn't let your mother come into comfort you.

Then maybe you would've known how loved you were and not fled your little bodies and stayed on earth.

- [Narrator] The grief and guilt Wendie felt that day made her question her career, her humanity, and caused a constant screaming in her ears that she described as tinnitus, the screams of the little girls.

- I had to really soul search and think what happened to, you know, put that scream in my head.

The burn patients downrange, remembering the incident of flying these little girls, and those all came together and that's how the letter, you know, sort of as I started writing, it all came together.

(soft piano music) - When you came into the hospital, I never dreamed I would see a human being in such distress.

Physically, your face crossed my path vision.

And I know I looked at your face, but I didn't see it.

All I could see was the carnage spilling out of your abdomen, leaking onto the stretcher and pulling at my feet and finally resting on top of the dusty concrete.

There are still drops of blood on my boots.

I still wear those boots to this day, and they're the most uncomfortable boots in the world, and yet they bring me comfort and I don't know exactly why.

You came in in the afternoon.

The scene was chaotic.

It was a mass casualty, 30 or so patients.

You stepped on an IED and from the middle of the abdomen below, you simply didn't exist.

Astoundingly, you had a pulse.

Though weak and intermittent, it was still there and we had it all drilled into our heads from the day we got there, "If they came in with a pulse, they had a 98% chance of surviving."

They rushed you off into surgery and you were completely forgotten about in the sea of bodies that kept coming in.

Hours later, we learned that you made it through surgery and we were also happy and hopeful.

We thought of your life back home, how it would be so different, but how you'd be alive and with your loved ones, that maybe you'd smile and laugh again.

Hours later, your heart stopped beating.

In attempts to resuscitate, you blew out the clots forming at the vestiges of your lower body and then you died.

And when we found out, we said, "(censored), that sucks."

And we moved on with our shift with a strange sense of normalcy and I don't think I ever revisited the thought of you in the last hours of your life until years later when you came to me in a dream.

In the dream, I felt everything I had to repress in your dire time of need.

I could feel myself crying, but I couldn't wake myself from the dream.

I think I wanted to stay with you and try to save you.

I don't know what I need to say to you to let you go, to free you from my head and my thoughts and my dreams.

I'm sorry, it seems so unworthy, impersonal and shallow.

And I know that nothing that I or anyone else could have done would've kept you alive.

You deserved more than an apology, you deserved life and I couldn't give you that.

I pray that you and your family are at peace, and that they were spared the details of the horror of your final hours that myself and so many other people witnessed.

Rest in peace.

(soft music) (Sarah sniffles) (Sarah sniffles) (light music) - [Steven] I had a camera in my hand from the time I was in high school, and I just loved photography.

(light music continues) (camera clicks) - At 19 years old, Steven Stafford took his high school camera with him to Vietnam.

(camera clicking) (light music continues) - I photographed whenever I could, you know, the villagers in the middle of the jungle, my platoon mates, dead bodies, of course, helicopters coming in with emergency resupplies.

And every chance I had, I would take it out and take pictures.

- [Narrator] Steven was one of Dr. Keenan's first clients to write a letter to a North Vietnamese soldier that he killed.

His moral injury came by causing the same kind of death that he was seeing through his camera lens.

- I documented a lot of things and some things I didn't document that I wish I would have, but I felt guilty taking pictures of our dead soldiers.

So I didn't do that.

- [Narrator] Steven had spent 12 months in country and lost 17 friends.

On the night before leaving for five days of R&R in Hawaii, he was ordered beyond the wire.

- That night, they sent me out on a listening post, maybe a good quarter of a mile in front of the perimeter.

Well, that night at about two in the morning, there was a figure about maybe, oh, 10 feet in front of me and it was pitch black, and we saw each other at the same time.

And without thinking, I just opened up fully automatic with an M16.

(machine gun rattling) But I thought, that's a point man.

Never shoot a point man because there's 100 behind him.

And I was requesting to come back into the lines and they wouldn't let me, they told me to hold the line.

- [Narrator] Steven stayed quiet and sat still for hours, waiting to be overrun.

- When morning came, I was allowed to come back in and I didn't even look to see what took place.

I was on a helicopter going to Da Nang Air Base, and I was on a MAC airlift going to Hawaii.

And it's just hard to fathom to think that 24 hours ago I killed somebody and I don't know who they were.

And now I'm laying in a hotel with a real bath, real water, real food to eat.

(soft music) - [Narrator] Steven poured his photography and memories into a book.

But until he wrote the letter to the point man he came eye to eye with before killing, his guilt and shame kept him from enjoying his life.

- That weighed on me all my life.

I remember going to buy a brand new car and I said, "I don't deserve this car."

Anyhow... (camera clicks) - [Narrator] Steven still lives with all that happened in Vietnam, those he lost and the lives he took.

But writing the letter to the point man he killed helped him move on.

- Now that still filters by me daily, maybe five or six times a day.

It's like a little hologram.

It goes by even after all of the counseling in her classroom.

But it fades, as fast as it comes, it fades, it goes away.

(gentle piano music) - Before I wrote the letter, I actually, I really hated God.

Like, he was like my number one enemy.

(gentle piano music continues) - [Narrator] After weeks of therapy with a group where he mostly listened, Dr. Keenan told Diego Mendoza to write his letter to the person at the center of his moral injury.

Diego chose to write the letter to his dead son.

- [Diego] I could not ever forgive myself for the loss of my son, never.

- Diego is just a pillar of a guy, he's already soft.

He already, he'd been through some other treatment.

He's very relational, he's about connection to people.

And so he's a great candidate.

- It wasn't part like, of like war, it didn't have, you know, it was this event that happened and it changed my life.

I wanted to forgive myself.

I just didn't know how to.

- [Narrator] After weeks of writing and dozens of drafts, Diego was ready to read his letter to the group.

- Welcome, you guys, I'm glad you're here for group.

Today, Diego, you said you were ready to read your letter to us.

- Yeah.

- Is that still true?

You feeling ready for that?

- As ready as I can be.

- I know, I know, okay.

(gentle piano music) - We had already taken Baghdad and we, well, I was on my way back down south on Highway 1.

I had gotten news and a picture of you and it seared into my brain.

We had got to another (censored) hole named Al Diwaniyah.

(clears throat) That was where I would get the devastating news (sniffles) that you had died due to SIDS.

(gentle piano music) (Diego sniffles) Reading that message that day put me in a state of permanent shock.

I'd already seen dead children (sniffles) and I even participated in dragging them out of vehicles, homes, and traumatizing them for life.

That's where the Red Cross message of your death took me, and to this day, still does.

It's not normal to bury your child.

The sacrifice I made for this country, I only thought it would be good outcomes.

I remember that day where I tried to drink myself to death and shove (sniffles) away all this guilt, shame, and hopelessness.

I remember that my heart rate was slowing down and I was fading (sniffles) in and out.

And you said, "Dad," which woke me up and I came to.

There were so many things that I wanted to do, many things with you, and one of the biggest was to meet you.

I was so ashamed of not being home and not protecting you, and I didn't think I deserved anything good.

(sniffles) Forgive me and I'm very truly saddened and will not forget, God bless you.

- The hurt that you experienced hasn't gone away, yeah.

I think the biggest thing that is helping you now is finding support and perspective as to what happened.

I mean, for all of us, is finding a way out of that, the intensity of the experience.

- Community.

- It's community, it's brotherhood.

It's, you know, sharing, sharing the load with a brother here.

- It really does feel good to let it all out.

- And every time you read it, something different, you'll notice something different.

- Your letter is an expression of your humanity now.

Good man just experiencing a terrible event.

You know, we take it on very personally.

That's the wounding we're trying to, in our moralities that we're trying to resolve within our own minds.

- Shame doesn't prosper, right?

When we talk, when we have light.

- They say things like, "I was inhuman, I'm a monster.

"I don't deserve to be loved."

These are the kinds of experiences of what moral injury really is.

(people chattering indistinctly) - [Narrator] It's been many months since Diego first read his letter to group.

- [Diego] I don't feel like a horrible person.

I'm not a bad father.

(gentle piano music) - [Narrator] Diego is in fact a husband again and a new father to twins.

- My life today is complete, it's full.

(gentle piano music) I have two beautiful babies, twins, one boy, Ezekiel, and one daughter, Eliana.

I'm sober, I'm married, I'm happy.

(gentle piano music continues) - [Narrator] When asked how many children he has, Diego now says three.

- I can share that now without feeling guilty.

I can share that now with like pride.

I can share that now with love.

And I feel that it's like mended something inside of me.

(uplifting piano music continues) - Dr. Keenan's process was very difficult at first.

I did not think it would work.

- [Narrator] For 40 weeks, Sarah worked with her group in Dr. Keenan's program in Northern California, writing multiple drafts of her letter.

When she read her letter to the group, it lifted a burden.

- It changes the way that you carry it in your head and in your day-to-day life.

- Sarah is now happily raising her son in Virginia.

- Life today is great, I'm happy.

I feel like I've processed a lot of the trauma that I experienced while I was deployed.

It doesn't affect me the way that it used to.

(gentle piano music) - [Narrator] The veterans in Dr. Keenan's treatment report many unexpected experiences, transformational dreams, encounters, and what Dr. Keenan calls restorative interactions.

- We probably have touched about 10,000 veterans' lives.

And so what we have is many, many, many people with their testimonials, much like you will see with the veterans in reading their letters about how their lives have been changed.

- After I wrote that letter, you know, that part of being free started like kind of consuming, like my heart and like my soul, I felt better.

- [Narrator] For Diego, the letter reconnected him to his faith.

- I actually smiled after writing the letter because I knew, and I know now, you know, I used to search for all these answers and all these ways in order to find that answer, but I never did.

And I feel by writing that letter, it opened up a lot of doors in my life, but mostly to know where my son's at.

And that's with God.

- [Narrator] For Wendie, the screams of the little girls faded along with her guilt and shame.

- My life has changed so much because guess what, the screaming is gone.

I no longer have to live... All the time it's like having, it was like having tinnitus, but it was a scream, you know, in my ear all the time, and now I don't have the scream.

And also, so much of the guilt and shame has been lifted around not letting those little girls see their mom and be comforted and my lack of comfort for them.

So I think there's been so much healing and my life is better because of it.

- [Narrator] Dreams that ease moral injury are the most reported result.

- I even had a visitation, it was pretty phenomenal, that I was laying on the couch and, somewhere I was laying on the couch in my dream, but I was awake.

It was like sleep paralysis.

And I was awake and this soldier walked in with a green uniform on, North Vietnamese, and he just stood there and looked at me and I couldn't move.

And then he turned and walked away, as if to say, "It's okay, "I would've done the same thing to you, we're good."

- [Narrator] Science does offer an explanation for the dreams involving how phase of sleep help add context to existing memories, like pulling a file out of a filing cabinet and adding documents before it's refiled.

- After I wrote the letter and I had this dream, I got on a jet and flew all the way to Vietnam and put that letter near the same spot and left it.

And I had closure.

- [Narrator] There are experiences Dr. Keenan and her staff can't explain, and for which science has no answer.

Chuck says he was visited by the six members of Flight Time and he was wide awake.

- I was on my way to work and it was foggy, very foggy, and all of a sudden, I just felt like there was somebody in my car.

There was some type of a presence.

The further I went, it felt like more than one presence.

And I finally realized that Flight Time was with me and all six of 'em were there.

And they were happy.

They were there to let me know that things were okay with them and that they forgave me, and that they knew that I did everything that I could to try and save them.

It was a happy presence and I just knew, I just knew it was them.

- [Narrator] Peace for these veterans is the goal.

The letters reconnect those severed relationships and build context around the fault they feel.

It's redemption, it's restoration, it's renewal.

- It's been such a gift for me to be able to help relieve some of their pain.

And they've given me, you know, the gift of trusting me with that.

And then these letters, you know, we're calling this the Sacred Texts of War because there's nothing like these letters anywhere.

These letters talk about what the real truths of war are and how they affect people.

And I get to watch these people get redeemed and it just has, they make me a better person.

It's the truth about war, they're the sacred texts.

They're from the heart.

(gentle piano music) (tranquil piano music) (tranquil piano music continues) (tranquil piano music continues)