Quaker Universalist Conversations

Moral Injury

Moral injury is an emerging concept whose deep spiritual reality should be obvious to Quakers.

A deep sense of transgression including feelings of shame, grief, meaninglessness, and remorse from having violated core moral beliefs.

Rev. Rita Nakashima Brock and Gabriella Lettini
Soul Repair: Recovering from Moral Injury after War (2013)

A violation of conscience regarding what a person did, or sometimes what the person did not do, in a morally ambiguous situation under authority in a military system.

CDR David Thompson, CHC, USNR (Ret)
“Moral injury: an often untreated veteran injury,”
The Military Chaplain, Volume 87, Number 3, Fall 2014, (6-8)

The damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress their own moral and ethical values or codes of conduct.

The Moral Injury Project,
Syracuse University

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The phenomenon of moral injury is currently being explored seriously in the areas of military service and torture experience, and it has been recognized as a genuine challenge by leaders of the U.S. Armed Forces branches and the Department of Veterans Affairs.1 It is also becoming the object of broader serious discussion in areas of human experience relating to sexuality, abortion, child abuse and poverty.

In recent years staff of Quaker House in Fayetteville, NC, have carried out a mission to inform Quaker Meetings and the larger community about moral injury. (See Quaker House Moral Injury Resources, and “Matthew Hoh: Recovering from the Darkness of PTSD and Moral Injury.”)

Alice and Laughton Lynd In 2015, Quaker House published an important and useful introduction to the reality of moral injury, Moral Injury and Conscientious Objection: Saying No to Military Service [full text PDF], by Alice Lynd, with the assistance of Staughton Lynd.

This quiet pamphlet documents the serious groping of earnest people in identifying this experience of moral injury and to permit people to move forward in their lives by identifying strategies for its relief and mitigation. The pamphlet focuses primarily on the experience with moral injury of members of the United States military.

Help for Moral Injury: Strategies and Interventions, by Cecilia Yokum (2016) More recently, Quaker House has published Help for Moral Injury: Strategies and Interventions, by Cecilia Yokum, Ph.D. (2016).

Another important source of thinking and resources on moral injury from an additional Christian perspective is the Soul Repair Center at Brite Divinity School.

See also the perspective of the National Catholic Partnership on Disability.

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When humans, most recently and visibly women and men in the military, believe they did or witnessed something that violates their deep sense of right and wrong, that experience creates an inner conflict. Self-blame can challenge their moral foundation in all aspects of life. They feel that what they did or passively witnessed is unforgivable. They have experienced moral injury. It poisons all their current and future relationships and motivations.

This moral injury reaches beyond personal acts of killing or cruelty. The self-betrayal also involves experiences of passive observation, helpless inaction, or chosen inaction to stop or mitigate the death or cruelty that violates what is right in the view of the morally injured person.

Moral injury also includes the experience of personal reactions to atrocities that are commanded or condoned by superior authorities. Right or not, moral injury discussion usually focuses less on this betrayal of trust by higher authorities in the organization. Currently, the professional discussion of moral injury focuses more on personal acts and personal observation of the acts of others.

U.S. soldiers stand at a checkpoint around Lakokhel camp in Afghanistan in 2010. Many soldiers return from war suffering from "moral injuries," or dealing with the fact that their sense of right and wrong was violated. Martin Bureau/AFP/Getty Images

Are there universal characteristics for moral injury? There are differences among individuals and among groups regarding what acts of killing and cruelty trigger moral injury. The injury depends on the moral world of the individual and on the shared moral values of the individual’s group. It is easy to project different and lower standards of moral injury on current enemies and equal standards on friends.

Are there universal human limits to the cruelty we do or observe?

There is a growing understanding that moral injury overlaps with but is not the same as Post-Traumatic Stress Disorder (PTSD). A person can suffer from both PTSD and moral injury, and the two phenomena have a complex relationship.

PTSD results from being the target of others’ attempts to kill or injure, or from having survived injury or death when others did not. PTSD creates a sense of fear and constant mortal threat from all persons in all contexts. It signifies a violation of trust between the person and the world, and it includes the loss of a general sense of safety.

By contrast, moral injury is the effect of being a killer or injurer, or of failing to prevent death and injury at the hand of others. Moral injury deals with shame, anger, outrage, and guilt. It involves the lost ability to trust and the loss of one’s own and others’ ability to keep our shared moral covenant.

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Cure and mitigation of moral injuries reaches deeply into the area of religious experience. Quaker House and Brite Divinity School are examples of our human groping, within our religious communities, for recognition of and assistance in healing such woundedness. Both groups provide language and documentation of research regarding moral injury, particularly in the area of military moral injury. These institutions offer leadership and advocacy. They collect insight and experience in effectively addressing moral injury in the lives of persons from many backgrounds.

Quakers have been helpful in identifying and implementing practical ways for preventing wars, and for mitigating the effects of wars, for applying faith and practice to historical situations. Quaker experience with conscientious objection (CO) engages the issue of moral injuries, even though the concept of moral injury has been little recognized until recently. Quakers also influence public policies that supports and provides services for children, mentally ill, prisoners, and veterans.

Moral Injury: What can Quakers say? What can we humans say? What can we do for moral repair?


Notes

1Moral Injury in the Context of War,” by Shira Maguen, PhD and Brett Litz, PhD, PTSD: National Center for PTSD, U.S. Dept of Veterans Affairs (2016).

Other sources

U.S. soldiers stand at a checkpoint around Lakokhel camp in Afghanistan in 2010. Many soldiers return from war suffering from “moral injuries,” or dealing with the fact that their sense of right and wrong was violated. Martin Bureau/AFP/Getty Images.

  • The Moral Injury,” by David Brooks, The New York Times, February 17, 2015.

Comments

I believe that we need to “walk the earth speaking to what we consider that of “not-G-D”. Moral injury is a good way to do that with soldiers and police officers and others as well. Can Moral Injury also be something we could use to help those who have “followed orders” that diminish others in schools, at work and also in our personal lives?

I am wanting to discern how “moral injury” may be combined with “restorative justice” to help people who have committed crimes to do a better job of re-entering society.

Friends,

One of the reasons I chose to publish Larry Spears’ piece on moral injury now is that we have seen one after another mass shooting done by people who clearly have that sort of inner woundedness.

What brings someone to the point of imagining that murdering numbers of innocent people is a solution to inner pain?

We at Quaker House see and hear about Moral Injury often. Mostly it comes to us in the form of stories from the individuals suffering the pain, shame and guilt of a moral injury.

There are the veterans who tell us forty five years after serving in Vietnam that they are a “bad person and can never be good, but can do good in this world to make amends.”

We hear from hospice nurses who tell us that dying vets from all of our wars confess to war deeds before dying—they must tell someone even if only a hospice nurse.

There are soldiers who get sober enough to tell us that they accidentally killed some innocent child/children or woman/women in Iraq or Afghanistan and can’t serve anymore. They need our help to get out of the military.

There are the three artillerymen from the same unit, being treated for alcohol abuse, who confessed to their counselor that they transposed the coordinate numbers in the heat of battle and blew up a school/child care center instead of a group of enemy warriors. Following the battle, they went to see what they’d done.

These are the quiet veterans of my youth who would sit in the VFW hall and regularly drink themselves into oblivion. Their brothers at arms seemed to respect that they needed to do so. They were never judged by their peers.

I used to wonder why not.

Stephen Newsom
Director, Quaker House

Many clients come to the Quaker House unsure of how to classify their feelings. They have been told they have Post-Traumatic Stress Disorder (PTSD) or PTSD-like symptoms, but they often don’t reach out for help. Those that have reached out for help (therapy) might find that, while some of their trauma symptoms diminish, their overwhelming guilt, self blame and, at times, self hate are still strong.

We allow those Service Members and Veterans a safe place to vent their feelings, frustrations and emotions. At the same time, the co-directors and I are working on learning everything we can about Moral Injury and about effective, evidenced-based treatments for such.

If nothing else, we need to get the term “Moral Injury” to be recognized among all. This will allow those that live with it to learn that they are not alone and that they can have hope.

Thank you Mr. Spears for this excellent blog post, which will hopefully reach many.

Joanna, MSW, LCAS, LCSW, CCTP
Victims' Support Program Coordinator
Quaker House of Fayetteville