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Reading: Writing of Moral Injury and Mental Wellness: A Book Review of Fidelis, by Teresa Fazio


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Writing of Moral Injury and Mental Wellness: A Book Review of Fidelis, by Teresa Fazio


Kate Hendricks Thomas ,

George Mason University, US
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Maggie Shields

Fort Lewis College, US
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In lyrical and brilliant prose, Fidelis offers a war story you have not read before. Women constitute approximately 15% of the armed services (Makowski & Everett, 2016; Murdoch et al., 2006), and represent a growing segment of the veteran population. Over 200,000 have deployed to Iraq and Afghanistan, yet their status as a numerical minority means that many of the war and war-injury stories we read about are from the perspective of male service members. Author Teresa Fazio’s unflinchingly honest book adds her voice to this space, and makes a sorely needed contribution to the dialogue about military women, mental health, and reentry to civilian life.
How to Cite: Thomas, K. H., & Shields, M. (2020). Writing of Moral Injury and Mental Wellness: A Book Review of Fidelis, by Teresa Fazio. Journal of Veterans Studies, 6(2), 66–69. DOI:
  Published on 19 Oct 2020
 Accepted on 06 Oct 2020            Submitted on 29 Sep 2020

Fidelis: A Memoir

T. Fazio|Potomac, 2020|232 pp. ISBN: 978-1640123557

In lyrical and brilliant prose, Fidelis offers a war story you have not read before. Women constitute approximately 15% of the armed services (Mankowski & Everett, 2016; Murdoch et al., 2006), and represent a growing segment of the veteran population. Over 200,000 have deployed to Iraq and Afghanistan, yet their status as a numerical minority means that many of the war and war-injury stories we read about are from the perspective of male service members. Author Teresa Fazio’s unflinchingly honest book adds her voice to this space and makes a sorely needed contribution to the dialogue about military women, mental health, and reentry to civilian life.

In 2005, Teresa Fazio was a communications officer in charge of a platoon of Marines in Iraq. Their mission was to ensure data connectivity for their forward operating base (FOB). Of this time, Fazio writes about the work as something she loved and felt purpose doing. The complications of her deployment were not professional, rather they were a result of the myriad competing pressures she combatted serving as a woman in the Marine Corps, where only 4% of officers are women (Albright et al., 2019; Hoge & Castro, 2012). Working to command the respect of subordinates, colleagues, and supervisors, Fazio was hard on herself. She was constantly conscious of how she presented herself, working hard against stereotype threat. She did not intend to form a romantic relationship with a married colleague in Iraq, but his pursuit led to friendship, and then to love. Such romances were forbidden overseas, and it was a line-crossing for which Fazio struggled to forgive herself. To “fraternize” with a colleague in a deployed environment went against every deeply held belief that Teresa had, and created cognitive dissonance for her.

Her experiences, vividly shared in her lyrical prose, were not unusual for military women. In fact, women report unique experiences in the military and work hard to avoid being sexualized and professionally dismissed (Duhart, 2012). Women are more likely than male peers to face issues of discrimination and belonging in general (Thomas et al., 2016). Additionally, the majority of women veterans report having endured ongoing sexual harassment (Street et al., 2009; Rogers & Kelly, 2011). Many servicewomen report feelings of alienation and decreased feelings of unit cohesion while serving; these women are at increased risk for mental health problems, including depression and PTSD (Levahot & Simpson, 2013; Shields et al., 2020).

Fazio’s story is a coming-of-age tale, set against the backdrop of war and moral injury. When she leaves Iraq and returns home, she writes poignantly about her challenges living in American consumer culture again. As her love affair becomes lost to her in part to his worsening stress injuries and in part to his decision to stay in his marriage, she leaves the Corps to find a new professional path.

Fazio writes of her struggle to find herself in the civilian world, and hints at her struggle with mental well-being during this time. She chose solitude much of the time, feeling that it was hard to connect with civilian women that she did not dress, speak, or act like. Again, Fazio writes of a personal experience that resonates with fellow women veterans. Veterans report significant difficulty connecting socially in the civilian community and finding a sense of meaning in their life as a civilian (Hoge, 2010; Thomas et al., 2020). Response to changes—such as reintegrating post deployment or leaving active service or activated status—can force service members to navigate huge changes in their identity, employment, sense of purpose, and membership in a social group (Tanielan & Jaycox, 2008). In addition, any loss to one’s social community may cause significant problems during transition (Junger, 2015; Thomas & Plummer Taylor, 2015). Although transitions that occur during and after military service can be challenging for men and women alike, health outcomes for military women have declined over the last 15 years (Thomas et al., 2016). Research shows that women and racial/ethnic/sexual minority veterans have higher rates of poor outcomes related to the aforementioned-reintegration issues (Pelts & Albright, 2015; Thomas et al., 2015; Wilcox et al., 2013).

Fazio’s story brings the data to life; her transition was a rocky one. She wasn’t sure what to call the isolation, the anger, and the other symptoms of moral injury or stress injury that she was suffering. She had loved being a Marine, but she wasn’t sure what life outside of that identity was supposed to look like. She wasn’t sure what sort of Marine she had been, or who she wanted to become in the future. Transition was a time of liminality for her, a time where she worked hard to shake off the cobwebs of prior painful experience.

Her story illustrates this broader issue of social support and connecting for military women, both in and out of the service. In garrison and deployed environments, issues of social support and unit cohesion are uniquely problematic for military women (Kline et al., 2013). Collectively, the challenges women veterans leaving the active duty component face with financial stability, family caregiving responsibilities, and social support contribute to stress injury and depression rates that are over 2.3 times higher than male veterans (Thomas et al., 2015; Washington & Yano, 2013). Interestingly, predictors of veteran mental illness (for male and female veterans) are not combat deployments; instead, important correlations are seen with a recent service separation (Friedman, 2015).

And yet, Fazio’s story is not just one of deployment and military service creating negative health outcomes—it is also a story of resilient leadership. Resilience is the ability to become strong, healthy, or successful again after something stressful happens (Richardson, 2002; Thomas, 2016; Thomas & Plummer Taylor, 2015). Military service is stressful for a variety of reasons: deployments (sometimes multiple), family stress, and transitions from active duty to civilian status in a community where only a small percentage of the population has served and even smaller percentage have shared experience (Coughlin, 2012; Thomas & Albright, 2018). Fazio’s writing paints this picture in personal and vivid fashion. Fazio’s story morphs from a war story to a love story, to a story of resilience in recovery. She fights to complete her education, seeks healthy friendships, and works to let go of the past. One way she finds social support is by spending time with fellow veterans at her university. In her opinion, they “got it” more than her civilian peers who were more likely than not traditional students with limited life experience.

Her story may cue readers to think about social support and service transition for military women; it is not a direct call to action, but the poignancy has the power to inspire such interest. When considering ways to enable successful reintegration for veterans in general and female veterans in particular, social support inevitably emerges as a predictor of successful transition and self-reported well-being (Bossarte, 2013; Thomas et al., 2019). Social support is a known contributor to health and longevity, with recent studies indicating that high levels add 7.5 years to the average American life expectancy (Egolf et al., 1992; McDaniel et al., 2017). Studies have shown that there is an inverse correlation between lack of social support and increased depression symptoms, comorbid depression and anxiety, decreased scores for health measures, and more suicide attempts reported, specifically for women veterans (Lehavot & Simpson, 2013; Thomas et al., 2015; Thomas et al., 2018). Readers following her journey will see the change in Fazio’s life trajectory when she finally begins reaching out. Such social support is what saves her from repeating mistakes or lamenting the loss of her Marine Corps identity.

One place veterans find support after service is within Veteran Service Organizations and Military Service Organizations (VSOs/MSOs) (Thomas et al., in press). The literature indicates that interventions working to increase social connections and facilitate the cultivation of resource networks offer protective effects against isolation, loneliness, mental and physical health problems, and suicidality (Bossarte, 2013; Thomas & Hunter, 2019), but women veterans take advantage of such programming in comparison to their male peers at lower rates (Thomas et al., 2017b). Gender norms and gendered experience differences are incredibly valuable for contemporary MSOs and VSOs to understand (Godfrey et al., 2018). VSO/MSO programming should consider gender-based norms and recognize that barriers to women veterans’ participation in VSOs exist (Held & Owens, 2013; Rogers & Kelly, 2011; Thomas, 2016). Studies have shown that up to 71.43% of female veteran respondents are not current members of an organization, and are not availing themselves of those opportunities because they don’t see VSO/MSO’s as spaces that include them (Thomas et al., 2017a). Noticing that is just the beginning; outreach must be thoughtful, peer-led, and considerate of the culture of women warriors (Thomas & Hunter, 2019).

This is perhaps the largest contribution Fidelis makes to the genre. In accessible, engaging prose, Fazio shares her own experience with navigating gender as a minority in the midst of a war zone. The fallout she experiences is not novel, but the way she navigates a resilient return to civilian life offers a road map for all veterans to emulate and civilians to act as allies. This book is a must-read for anyone who works in the veteran space.

Competing Interests

The authors have no competing interests to declare.


  1. Albright, D. L., Thomas, K. H., McDaniel, J. T., Fletcher, K. L., Godfrey, K., Bertram, J. M., & Angel, C. (2019). When women veterans return: The role of education in transition in their civilian lives. Journal of American College Health, 67(5), 479–485. DOI: 

  2. Bossarte, R. M. (Ed.). (2013). Veterans suicide: A public health imperative (1st ed.). American Public Health Association. 

  3. Coughlin, S. S. (Ed.). (2012). Posttraumatic stress disorder and chronic health conditions (1st ed.). American Public Health Association. 

  4. Duhart, O. (2012). PTSD and women warriors: Causes, controls and a Congressional cure. Cardozo Journal of Law & Gender, 18, 327–331. 

  5. Egolf, B., Lasker, J., Wolf, S., & Potvin, L. (1992). The Roseto Effect: A 50-year comparison of mortality rates. American Journal of Public Health, 82(8), 1089–1098. DOI: 

  6. Friedman, J. (2015). Risk factors for suicide among Army personnel. Journal of the American Medical Association, 11, 1154–1155. DOI: 

  7. Godfrey, K., McDaniel, J. T., Davey, L., Plummer Taylor, S., & Isana Garcia, C. (2018). Mental fitness and military veteran women. In K. H. Thomas & D. L. Albright (Eds.), Bulletproofing the psyche: Preventing mental health problems in our military and veterans (pp. 101–123). ABC-CLIO/Praeger Publishing. 

  8. Held, P., & Owens, G. P. (2013). Stigmas and attitudes toward seeking mental health treatment in a sample of veterans and active-duty service members. Traumatology, 19(2), 136–145. DOI: 

  9. Hoge, C. W. (2010). Once a warrior, always a warrior (1st ed.). Lyons Press. 

  10. Hoge, C. W., & Castro, C. A. (2012). Preventing suicides in U.S. service members and veterans. Journal of American Medical Association, 308(7), 671–672. DOI: 

  11. Junger, S. (June 2015). How PTSD became a problem far beyond the battlefield. Vanity Fair. 

  12. Kline, A., Ciccone, D. S., Weiner, M., Interian, A., St. Hill, L., Falca-Dodson, M., & Losonczy, M. (2013). Gender differences in the risk and protective factors associated with PTSD: A prospective study of National Guard troops deployed to Iraq. Psychiatry: Interpersonal & Biological Processes, 76(3), 256–272. DOI: 

  13. Lehavot, K., & Simpson, T. L. (2013). Incorporating lesbian and bisexual women into women veterans’ health priorities. Journal of General Internal Medicine, 28(2), 609–614. DOI: 

  14. Mankowski, M., & Everett, J. E. (2016). Women service members, veterans, and their families: What we know now. Nurse Education Today, 47, 23–28. DOI: 

  15. McDaniel, J. T., Albright, D. L., Beck, A., Fletcher, K. L., Thomas, K. H., & McDermott, R. J. (2017). Social support mediates the relationship between mental-physical multiple morbidities and engagement in aerobic physical activity among military service members and veterans. Journal of Veterans Studies, 2(2), 69–80. DOI: 

  16. Murdoch, M., Bradley, A., Mather, S. H., Klein, R. E., Turner, C. L., & Yano, E. M. (2006). Women and war: What physicians should know. Journal of General Internal Medicine, 21(3), S5–SS10. DOI: 

  17. Pelts, M. D., & Albright, D. L. (2015). An exploratory study of student service members/veterans’ mental health characteristics by sexual orientation. Journal of American College Health, 63(7), 508–512. DOI: 

  18. Richardson, G. (2002). The metatheory of resilience and resiliency. Journal of Clinical Psychology, 58(3), 307–321. DOI: 

  19. Rogers, J., & Kelly, U. (2011). Feminist intersectionality: Bringing social justice to health disparities research. Nursing Ethics, 18(3), 397–407. DOI: 

  20. Shields, M. M., Thomas, K. H., Bernard, C., & Lumsden, D. (2020). The correlation between female veteran mental health and branch of military service. Journal of Health Education Teaching, 11(1), 14–23. 

  21. Street, A. E., Vogt, D., & Dutra, L. (2009). A new generation of women veterans: Stressors faced by women deployed to Iraq and Afghanistan. Clinical Psychology Review, 29, 685–694. DOI: 

  22. Tanielan, T., & Jaycox, L. H. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. RAND. DOI: 

  23. Thomas, K. H., Angel, C., Armstrong, N. A., Erwin, M., Pinter, J. J., & McDaniel, J. T. (In press). Sex differences in baseline enrichment levels in a large military and veteran service organization: A secondary analysis of new member surveys. Journal of Community Engagement and Scholarship. 

  24. Thomas, K. H., & Plummer Taylor, S. (2020). Stopping military suicide: Veteran voices to prevent deaths. ABC-CLIO/Praeger Publishing. 

  25. Thomas, K. H., & Hunter, K. (Eds.). (2019). Invisible Veterans: What happens when service women become civilians again. ABC-CLIO/Praeger Publishing. DOI: 

  26. Thomas, K. H., McDaniel, J. T., Grohowski, M., Whalen, R., Fletcher, K., Albright, D. L., & Haring, E. (2019). Depression prevalence and geographic distribution in United States military women: Results from the 2017 Service Women’s Action Network needs assessment. Journal of Military, Veterans and Family Health, 5(2), 6–15. 

  27. Thomas, K. H., & Albright, D. L. (Eds.). (2018). Bulletproofing the psyche: Preventing mental health problems in our military and veterans. ABC-CLIO/Praeger Publishing. 

  28. Thomas, K. H., Albright, D. L., Phillips, D., Roosevelt, K., Crawley, R., & Plummer Taylor, S. (2018). Mental health status in service member and veteran students at four-year postsecondary institutions: A pilot needs assessment. Best Practices in Mental Health, 14(1), 1–14. DOI: 

  29. Thomas, K. H., McDaniel, J. T., Albright, D. L., Fletcher, K., & Haring, E. (2017a). Mental health needs of military and veteran women: An assessment conducted by the Service Women’s Action Network. Traumatology, 23(4), 104–112. DOI: 

  30. Thomas, K. H., Haring, E., McDaniel, J. T., Fletcher, K., & Albright, D. L. (2017b). Belonging and support: Women veterans’ perceptions of veteran service organizations. Journal of Veterans Studies, 2(2), 1–12. 

  31. Thomas, K. H. (2016). Warrior culture. O Dark Thirty, 4(2), 47–61. 

  32. Thomas, K. H., & Plummer Taylor, S. (2015). Bulletproofing the psyche: Mindfulness interventions in the training environment to improve resilience in the military and veteran communities. Advances in Social Work, 16(2), 312–322. DOI: 

  33. Washington, D. L., & Yano, E. M. (2013). PTSD: Women veterans’ prevalence of PTSD care. Journal of General Internal Medicine, 28(10), 1265–1265. DOI: 

  34. Wilcox, S. L., Finney, K., & Cedarbaum, J. A. (2013). Prevalence of mental health problems among military populations. In B. A. Moore & J. E. Barnett (Eds.), Military psychologists’ desk reference (pp. 187–196). Oxford University Press. DOI: 

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