• Regarding Moral Injury

This comes by way of the May 2017 issue of Christian magazine Guideposts.

The Price of Caring

Moral injury is a wound to the conscience, and nothing inflicts it more deeply than war

[What follows is the story of Sergeant First Class Marshall Powell, U.S. Army, retired; he was serving in a hospital in Iraq in 2007 when they received a deluge of patients.

Among them was a five or six year old girl who was mortally wounded. There was no way for the girl to be saved. She lay in the hallway moaning in pain. There was nothing that could be done for her.

Powell administered enough morphine to knock her out and take her life – he did this to end her suffering. He spent years harboring guilt over this and suffered side-effects. What he underwent is known as “Moral Injury”]

From page 43:

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.

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.

What are the symptoms?

Rita Brock, research professor and codirector of the Soul Repair Center at Brite Divinity School in Forth 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…

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.”

… VOA (Volunteers of America) has reached out to veterans from many … conflicts.

With 30 affiliates nationwide and staff trained to work with sufferers of moral injury, the organization has become a leader in the field.

Find out more at voa.org/veterans

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.

Additional resources or commentary on the topic:

The Moral Injury Project 

Moral Injury The Invisible Wounds of War

Moral Injury: ‘I’m A Good Person And Yet I’ve Done Bad Things’

Why distinguishing a moral injury from PTSD is important 

The Unseen Wounds of War: Moral Injury

A NEW THEORY OF PTSD AND VETERANS: MORAL INJURY

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