What is a “Moral Injury”?
What Can We Do about It?
Let us start with some possible examples to illustrate the concept of moral injury. Imagine being raised by parents, teachers, and perhaps religious advisors on the proper and honorable way to conduct life. Imagine that we are taught to tell the truth, to stand by our word once we have given it, and to refrain from harming other people when at all possible. We are further instructed that it is wrong to steal or to cheat people, but that we should treat them with respect. These principles may serve us well as we progress through life as others find that we can be trusted and our self-esteem is strengthened.
Later on in life, we may find ourselves in a situation where we are expected and ordered to do things in conflict with these principles. Maybe we work for a company that promises its workers certain things in exchange for their work and their loyalty: continued employment, a livable wage, a safe work environment. When ordered to take actions against our co-workers that break these agreements, we have a moral dilemma. Do we endanger our own employment or break with what we understand to be right and fair? Our superiors in the company may bring persuasive argument to bear on the matter, or outright threats. Either way, the dilemma hurts.
In another example, you might find yourself employed by an insurance company and ordered to take all possible evasive actions against paying insurance claims made by the company’s customers who expect that the insurance they have paid on for years will now be there to help them in an unforeseen disaster.
Or you may belong to a military force to which you have pledged your allegiance. In the course of your work you are ordered to commit harm to innocent noncombatants, violating not only your own sense of what is right but also what you understand of international law,
On the other side of that ledger, you may have been promised a secure livelihood, ongoing medical support as needed, an old age pension, and a measure of respect. If the group you have pledged to support and that has likewise pledged to support you turns against you, betraying these agreements, that too is an example of a moral injury.
Moral injury is the psychological, emotional, and spiritual distress that arises when a person acts in ways or witnesses actions that violate their deeply held moral beliefs or values. Unlike post-traumatic stress, which is often rooted in fear-based experiences, moral injury centers on guilt, shame, betrayal, or a sense of having transgressed one’s own ethical code. At its core, moral injury involves a rupture in one’s sense of integrity. The result is often a lingering internal conflict: “I am not the person I believed myself to be,” or “The world is not as just or trustworthy as I thought.”
What can we do in the face of the pain of moral injury?
The first step toward healing a moral injury consists of naming and acknowledging it. Significant value comes from discussions about this phenomenon. Sufferers of moral injury who are able to fully express what happened and everything they feel about it get some relief by being heard, understood and acknowledged without judgment. Applied Metapsychology, including Traumatic Incident Reduction, provides an ideal space for this due it its person-centered framework.
Beyond that crucial first step, the techniques of the subject can help us to focus on the various aspects of the situation: how we were harmed, how we may have harmed other people, and how we witnessed harm being committed and felt powerless to prevent it. A case plan to address each aspect brings relief a step at a time until the job is done. That occurs when we have viewed, expressed, and integrated the entire experience, discharging all the pain it contained. A new sense of freedom and certainty results from doing this important piece of work.
To benefit from Applied Metapsychology, see:
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