Understanding the impact of moral injury in the Military

Q: Can you explain what moral injury is? 

While it can be difficult to define precisely, moral injury (MI) refers to the experience of sustained and enduring negative moral emotions - guilt, shame, contempt, and anger - resulting from the betrayal, violation, or suppression of deeply held or shared moral values. This includes the negative moral judgments about our own actions, inactions, or participation in events that psychiatrist Jonathan Shay calls “high-stakes situations.”  Systemic betrayals of moral values have been felt deeply amongst military members, healthcare professionals, law enforcement officers, veterinarians, and others.

MI is a significant predictor of suicide in those suffering from trauma and can result in a broken trust in ourselves, our leaders, governments, and institutions to act in just and morally “good” ways.  It often involves a total judgment of the self – “I am a bad person.”

Q: Why is an interdisciplinary approach important in this field of research?

Clinical research has been critical to developing the idea and treatment of moral injury, which has led to improving mental health outcomes. However, psychology’s vocabularies and tools begin to find their limits when approaching the ideas of guilt, shame, and contempt - particularly when these emotions arise in combat situations where extreme violence is carried out. 

Giving attention to these moral emotions involves examining the basis upon which we form our worldviews.  Religion, theology, and philosophy hold the conceptual vocabularies that most directly inform our fundamental ethical ideas about the world and are the building blocks that determine which actions merit praise or blame.  It is vital to understand how we form frameworks of meaning, how they often collapse after experiences of conflict, and how we can rebuild new ones that can bear the weight of experiences of injustice, betrayal, and violation. 

Religious language and artistic expressions are vital ways in which we can name the pain of moral injury, give it voice, and express it to others. 

Q: What are some real-world applications for research into moral injury?

The most critical application of this research is in improving care for those experiencing moral injury.  The research done by the Centre seeks to inform and explore new frameworks of understanding, collaborate with those who have illuminated different aspects of MI, and provide resources to caregivers – particularly chaplains and clergy – who encounter morally injured individuals. This may mean exploring ways that conceptions of things like ‘sin’ are useful in providing a way of working through feelings of guilt and contextualising one’s actions so they can accept responsibility without a totalising sense of blame. 

We’re just now discovering how to contextualise MI and the most prominent clinical studies acknowledge that there is a place for clergy and religious communities in the process of recovery.  However, many well-meaning clergy who possess this valuable conceptual vocabulary around sin, guilt, atonement, salvation, and reconciliation are often unprepared to hear detailed wartime experiences involving violence. A veteran may confide in a spiritual leader about their participation in acts of wartime violence only to have that leader instinctively react with revulsion. This can be experienced as a deep rejection and close off an avenue of healing.  Training clergy on what to be prepared for and understanding the depth of wounding that moral injury causes can help prepare them to use the resources of their traditions in the most effective way. 

Given these encounters, research into understanding ways that religious traditions can exacerbate and also ameliorate MI’s effects can be critical and life-saving.   

Q: What is the International Centre for Moral Injury currently working on and what are you looking forward to in the future?

We recently hosted an international conference here in Durham in April, which featured a diverse group of chaplains, healthcare professionals, researchers, clinicians, professional artists, and others engaging the topic of moral injury from a variety of cultural perspectives.  We’re currently planning a conference next year featuring European narratives of MI.

We host monthly webinars that include a wealth of information from scholars around the world that look at MI from different perspectives and post recordings of them as resources on our website.

Our own research on MI continues with work on theologies of penance and lament in the context of moral injury and I’m working on finishing a monograph on Resurrection hope in a morally injured world.  We have two graduate students doing work on MI from their own experiences and are looking to recruit more. 

We are exploring several pioneering research projects in the field, such as one study that will measure moral injury in retired military chaplains and explore how their theological orientations may have provided a bulwark against or a vulnerability to MI. 

Finally, we are working to establish a program that will better equip civilian clergy to attend to the needs of military veterans with moral injury. 

Find out more:

• Reverend Dr Brian Powers is Assistant Professor (Research) - Vann Fellow in Christianity and the Armed Forces in our Department of Theology and Religion and Executive Director of the International Centre for Moral Injury.
• We previously interviewed Brian on Moral Injury here.
• Check out our International Centre for Moral Injury webpages for more information.
• Videos of their previous webinars are available for viewing.

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