Moral Injury
This is the term for the deeply held beliefs, standards, and rules of right and wrong that form a person's inner compass.
Answer: What are moral values or moral code?
This emotion, which involves a sense of responsibility or regret for an action, is a hallmark of moral injury.
What is guilt?
While PTSD is primarily driven by fear or a threat to life, moral injury is primarily driven by a threat to this.
What is one's moral compass (or values)?
This practice involves extending the same kindness, patience, and understanding to yourself that you would to a good friend.
What is self-compassion?
Name one way a supportive community or group can help someone who is healing from a moral injury.
(Group Discussion) Focus on validation, listening without judgment, and reducing isolation.
Unlike physical injuries, moral injury affects this non-physical aspect of a person, often described as their inner compass.
What is the conscience (or soul/spirit)?
A strong feeling of being fundamentally "bad," broken, or unworthy, which often leads to severe isolation.
What is shame?
This symptom, involving flashbacks and a heightened startle response, is a classic diagnostic criteria for PTSD but not necessarily for Moral Injury.
What is hyperarousal (or re-experiencing)?
Often done in a group therapy setting, this is the difficult but healing process of sharing one's story without judgment.
What is disclosure (or vulnerability/talking about it)?
Share an example of a small, everyday way someone can practice self-forgiveness.
(Group Discussion) Focus on positive self-talk, acknowledging mistakes without internalizing them as character flaws, and mindfulness.
Moral injury can happen not just from actions you take, but from actions you witness or this type of inaction.
What is failing to prevent harm (or omission)?
Following a morally injurious event, a person might lose this essential feeling - toward themselves, others, or the world.
What is trust?
While PTSD is considered a mental health disorder primarily rooted in the brain's fear and survival circuitry, Moral Injury is best described as this kind of wound.
What is a moral, spiritual, or existential wound?
This action, though difficult, involves letting go of resentment towards oneself or others who contributed to the moral injury.
What is forgiveness?
Why is it sometimes easier to forgive others than it is to forgive ourselves?
(Group Discussion) Explore the inner critic, the illusion of control, and how shame operates differently than anger toward others.
This term describes the psychological impact of not acting in accordance with what's right by someone who holds legitimate authority.
Answer: What is betrayal (by a leader or others)?
Moral injury frequently leads to this behavior, where a person intentionally pulls away from friends, family, and support systems.
What is withdrawal (or isolation)?
In PTSD, the primary emotion is often anxiety or fear. In Moral Injury, the primary emotions are usually these two.
What are guilt and shame?
Engaging in activities that align with your core values, such as volunteering or helping others, to rebuild a sense of purpose.
What is making amends (or values-based action)?
What is one personal value that is important to you to uphold in your daily life as you move forward?
(Group Discussion) Focus on identifying core values (e.g., honesty, service, family, integrity) and committing to them.
The concept of Moral Injury was heavily researched and popularized in relation to this specific group of professionals, though it applies to many others.
Who are military service members (or veterans)?
This crisis involves a deep questioning of one's religious, philosophical, or core life beliefs after a traumatic event.
What is a spiritual crisis (or loss of faith)?
Both PTSD and Moral Injury can lead a person to do this—staying away from places, people, or memories associated with the event.
What is avoidance?
A specific type of therapy often used for moral injury that focuses on accepting difficult emotions and committing to positive behavior change.
What is ACT (Acceptance and Commitment Therapy)?
How can we tell the difference between healthy regret (which helps us grow) and harmful shame (which keeps us stuck)?
(Group Discussion) Regret/Guilt says "I did something bad." Shame says "I am bad." Discuss how to transition from shame to productive growth.