On Moral Injury

Moral InjuryMoral injury is 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. Moral Injury has occurred during the Covid-19 pandemic, and it also impinges on individuals, families, communities and organisations.


There can be moral injury in families, there can be moral injury in the community in times of lockdown and emergency response to pandemic. Forgiveness for self and for others is an important key to recovery.

 

What causes moral injury
Moral Injury:

  • leads to depression
  • leads to distress
  • leads to suicidality
  • destroys trust
  • impinges on family

Moral injury is damage to the Soul.

Moral injury is frequently the outcome of participation in War and warlike theatres of action by defence forces. It is also the outcome of abuse, rape, and violence – to the individual, or in the family. These are not the only things that cause soul wounds or moral injury.

 

Diagram of moral injury

 

Moral injury pivots with time

  • moral codes evolve
  • conscience becomes enlightened
  • changes and transitions in life inform perspectives that form/inform new perspectives about old events (this is why forgiveness is important)

Moral injury must be acknowledged.

  • PTSD is acknowledged
  • the cost of trauma is acknowledged
  • So we must acknowledge moral injury

Treatment of Moral Injury follows beliefs and needs:

Outlets for Acknowledging / Confronting Moral Injury

  • Talk therapy
  • religious dialogue
  • Art therapy
  • Writing
  • Discussion
  • talking circles
  • spiritual gatherings

Moral injury is a burden in isolation

Community affects of Moral Injury

Moral emotions are the guardians of right order in society. Moral emotions are the searchlight in the heart pointing the way home.

Positive side of Moral Injury

  • Post traumatic growth
  • Improved psychological resilience
  • Esteem, compassion, engagement
  • Positive feelings
  • Positive affection
  • Positive gratitude
  • Positive development of feelings and professional responsibility
  • Positive sense of competence
  • Positive self reflection
  • Positive insight

Moral Resilience is fostered by

  • Meaning making
  • Fostering self awareness
  • Self regulation
  • Sense of ethical competence

Summary:

* Events witnessed transgresses deeply held moral beliefs
* An individual feels betrayed
* An individual witnesses others behaving in ways that are morally wrong
* This impacts the psychological, social, spiritual domains of the human person.

Community affects of Moral Injury

Moral Injury Strategies

For OrganisationsFor Individuals
Acknowledge stressorsAccess material, take up self-learning
Create a supportive cultureTake up stress reduction activities
Support volunteersSelf-care activities: exercise and good eating
Rotate staff through the coalface of injurySelf-care: maintain social connections; maintain rest habits
Remove decisions from front-line workersSupport one another
Rosters follow circadian rhythmsSeek help; there is no stigma
Organised group debriefs for frontline workersParticipate in debrief sessions

 

 


 

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