A few years ago, I was introduced to a concept called ‘Moral Injury.’ Moral Injury is best defined as “the damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct.” https://moralinjuryproject.syr.edu/about-moral-injury/ It is usually defined in the context of military service. Moral injury is a lot of the pathology that soldiers return home with is along the lines of this issue. It’s not quite PTSD, but rather, the injury to the soul when you have to act in such a way that runs against your moral code. For instance, moral injury occurs when you have no choice but to stop a child wielding a gun or wearing a bomb on his or her body. It hurts our soul when we “follow directions” when it violates our own belief systems. When a soldier follows the directive of his superior and is forced to kill another, that causes a psychic dissonance in a person. It violates their moral code of keeping the commandment of “thou shalt not kill.” Even when we know that our actions are justified, it still does damage to our psyche and soul.
How Does Moral Injury Affect Us?
Although I had heard about this syndrome within the context of war, it can be applied to any situation. Pain is pain, and if we find that we have compromised our moral code in some way, then we suffer. Here are some examples of how moral injury can affect one in a profession:
- Doctors who desire to heal their patients but feel they cannot treat them the way they want to. If they feel they are bound by the insurance companies and cannot practice medicine that benefits the patient, then they suffer. When a physician feels they can’t treat a patient’s needs or cannot provide them with the highest levels of care, that causes moral injury or psychic pain.
- When a teacher feels he or she cannot teach the students in the best way possible. For instance, the teacher wants to teach a student how to think, but she is told she must teach the student to do well on a state test, that causes personal injury.
- When a clergy person feels he or she cannot call out injustice because it may offend a high donor, or cost them their job, that sets up an inner conundrum and causes moral injury.
Moral injury can affect all of us, not only at our various professions, but also in everyday situations.
A Biblical Story of Moral Injury
In the Torah, or Old Testament, there is a story of Joseph and his brothers. Joseph was the favored son of Jacob and his brothers hated him as a result. One day while they were working in the fields, they saw Joseph approaching and they made a plan. Originally, they were going to kill him. As Joseph came toward the brothers, they tackled him. Reuben, the oldest, suggested that they not kill him, but rather to throw him into a pit, until they decided the best plan of action. At that same moment, a caravan of spice traders came along and they decided to profit from selling him into slavery. The Ishmaelite band of rogues took Joseph to be sold in Egypt. The brothers were initially elated with this scenario, but it wore on them. They had sold out their brother for a profit. Talk about insult to injury! And years later, they were still suffering from the guilt of having done that act.
Symptoms of Moral Injury
Moral injury causes pain to our psyche which can manifest in various ways. The most presenting symptom is exhaustion. We are walking around our lives, exhausted, not realizing we are suffering from moral injury. We don’t even realize that our capacity for joy, for deeper trust and for accepting love, comes from this place of pain. If we let it go undetected and untreated, it can actually affect our ability to be fully present in our lives. Without healing, we become more debilitated and unable to live fully.
A Modern Story of Moral Injury
I had a friend who was approaching the end of his life. He had lived a long life and had gratitude for all that he’d been able to accomplish. But he confessed to me one afternoon before he died, that he had one regret. He had a secret which he had planned to take to his grave about something he’d done in his past. He trusted me enough to tell me the story. Many years prior, he watched his friend violate a young woman while he watched. He felt powerless to stop his friend, even though he knew he should have. It affected him for most of his life: He became an alcoholic and even after he got sober, he continued to feel tremendous shame and guilt. He didn’t know how to come back from his inaction and what he perceived to be his own cowardice to ever confront his friend.
Healing From Moral Injury
The first way to begin healing from this syndrome is to become aware that it is a real thing. It is now being discussed by healthcare professionals, therapists and other healers. The consensus is that one must treat each individual according to their needs. Treatments such as
- Talk therapy,
- Framing it within a religious context,
- Art therapy,
- Group support etc., all have had some success.
I will also offer that the act of making restitution and confession of harm has also been effective. In the case of my friend, he did his best to make an amend to the woman he felt he harmed, as well as making peace with his younger self. From this healing, he died peacefully, knowing he did the best he could to confront his past and deal with it. Once we name the scope of the issue, it can begin to be healed.
Finally, to be the person to hold the space for someone to share their pain is a holy endeavor. When we allow another to process the event, without judgment, it can have a powerful effect on the healing process. But we cannot heal, if we are not aware of the scope of the problem. So, I encourage you to consider ways you have suffered moral injury and begin to explore modes of healing.
I welcome any and all feedback about this topic! Until we meet again, may you be blessed on your spiritual journey!
A peripheral topic to moral injury:
