MORAL INJURY

Moral Injury is the damage done to one's psychological, emotional, and spiritual state when that person perpetrates, witnesses, or fails to prevent acts that transgress one's own moral beliefs, values, or ethical codes of conduct. This injury is more common within military, law enforcement, first responder, and medical communities; however, not exclusive. The need to respond to situations in crisis and fear, either to fight or flee, is sometimes hampered by being trapped, frozen, or unresponsive in the traumatic situation. This may create a moral or psychological dilemma due to a perceived inability to react appropriately when faced with the situation, leaving a person feeling powerless or helpless to have stopped the trauma, or acting in self-expected ways necessary in that situation.

Some key emotions involved with Moral Injury are: guilt, shame, unresolved grief and loss, and a lack of self-forgiveness. Furthermore, one’s core beliefs that the world is generally a safe place, that other people are good, and that they are good are shattered. These normal thoughts and emotions that flow from personal trauma can be wrongly “pathologized” and misdiagnosed for post-traumatic stress disorder and/or other disorders.

Who Can Receive a Moral Injury?

  • Military personnel

  • First Responders: Law Enforcement, Firefighters, EMT’s, Chaplains

  • Correction Officers

  • Medical doctors and other medical personnel

  • Counselors

  • Pastors and other religious leaders

  • Accidental death, i.e. car accidents leading to another’s death

  • Those struggling with an addiction

Survivor’s guilt and Institutional betrayal also stem from a moral injury and are related issues, which can negatively impact individuals, families, and organizations.

How to Address Moral Injury

Healing moral injury may require different treatment approaches some of which may take more time. Current treatments generally used for PTSD may not be fully effective and tend to focus on superficial reduction in symptoms. In some cases these treatments can be detrimental and even harmful. Moral injury must be addressed from “the inside out,” with great care and patience on the part of the therapist. Group therapy is the preferred modality for treating moral injury, however, a combination of both individual and group therapy is ideal.

If you or someone you know may be dealing with moral injury as a result of trauma please reach out to me today.