Moral Injury: Six Questions Answered

Here's a look at moral injury, a relatively new term for the emotional and spiritual pain that can afflict soldiers and others who are asked to perform actions that run counter to their moral codes.

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- Posted on Apr 25, 2017

A solider, alone with his thoughts, on a train

Moral injury is a relatively recent term used to describe a crisis that soldiers like Marshall Powell have faced for centuries, the internal suffering that results from doing something against your moral code. In essence it is a wound to the conscience.

What causes moral injury? In a combat situation such as Powell’s, the damage done to a person’s psyche might result from following or issuing certain orders or from simply witnessing something that is deeply offensive to his or her moral sense.

What are the symptoms? Rita Brock, research professor and codirector of the Soul Repair Center at Brite Divinity School in Fort Worth, Texas, describes the “feelings of guilt, shame, meaninglessness and alienation” that arise from knowing one has transgressed “one’s most deeply held beliefs and moral values—and therefore, one’s core sense of self.” Sufferers subsequently struggle to connect and empathize with others. They become alienated from societal norms.

How is it different from PTSD? Post-traumatic stress disorder is fear-based. Moral injury is not. The treatment for PTSD often involves reliving the traumatic incident in a safe environment to defuse the fear. But that very same therapy, Brock points out, can sometimes agitate moral injury, “bringing it emotional immediacy” that makes it harder to address.

What is the best treatment? Military veterans like Powell have found support by meeting with other veterans, either one-on-one or in a group. A chaplain or clergyperson can offer guidance. Some have turned to writing or public speaking, trying to make sense of what happened. Prayer and meditation provide spiritual reassurance. But with something as recently identified as moral injury, there is no single best agreed-upon treatment. As Brock says, “Recovery can be a lifelong process.”

Does it apply only to soldiers? Not at all. In times of stress, people can act against their moral code. A poverty-stricken mother abandons her children; a drug addict commits a crime to support a habit; an office worker fabricates documents for fear of losing a job.

How can you help a loved one who suffers from moral injury? Listening is important. Brock has noticed that when people are introduced to the term, their eyes light up in recognition. “They know it for themselves,” she says, “or they know someone who has it.” The first step for healing is identifying the problem. The second is to reach out to someone who will understand.

Read Marshall Powell's inspiring story of healing from moral injury.

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