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Bari Sobelson, MS, LMFT

Michelle is a wife and a mother of two boys. She has served two tours in Iraq. On the last week of her last tour in Iraq, Michelle encountered a situation that forever changed her life. She was driving and a young boy was riding his bike next to her vehicle. He cut right in front of her and she was unable to stop. She wanted to turn around so badly but she was instructed to keep going, as it was unclear whether or not this was a setup. Michelle constantly thinks about that child and she finds herself consumed by the shame and guilt. She does not like for her boys to go anywhere without her, for fear that someone will do to her children what she did to another woman’s child. She has flashbacks of that moment and replays the scenario in her head to try to figure out how she could have avoided the situation. She doesn’t sleep well.

The above is based on real-life events. However, names and parts of the story have been changed. Although the story has been modified, the trauma of the event has not. A year ago, if I had read this scenario, my first thought would have been that she was suffering from PTSD from the event that changed her life. I would still contend that many of her symptoms fit the diagnosis of PTSD, but there is an added element to her reaction to this event; shame and guilt. Michelle has done something that she may never be able to forgive herself for doing.  It has shaken her entire moral foundation as a human being, a mother, a wife, and a soldier.

Although the concept is still in its infancy, Moral Injury is gaining more momentum through research and discussion amongst mental health professionals and religious leaders. National Center for PTSD states,

“Military personnel serving in war are confronted with ethical and moral challenges, most of which are navigated successfully because of effective rules of engagement, training, leadership, and the purposefulness and coherence that arise in cohesive units during and after various challenges. However, even in optimal operational contexts, some combat and operational experiences can inevitably transgress deeply held beliefs that undergird a service member’s humanity. Transgressions can arise from individual acts of commission or omission, the behavior of others, or by bearing witness to intense human suffering or the grotesque aftermath of battle. An act of serious transgression that leads to serious inner conflict because the experience is at odds with core ethical and moral beliefs is called moral injury.”

Rev. Rita Brock, PhD, is someone who recognized the need for education on ways professionals can “enable the return to ordinary life of those who experience moral injury.” She states that “moral injury has a slow burn quality that often takes time to sink in. To be morally injured requires a healthy brain that can experience empathy, create a coherent memory narrative, understand moral reasoning and evaluate behavior. Moral injury is a negative self-judgment based on having transgressed core moral beliefs and values or on feeling betrayed by authorities. It is reflected in the destruction of a moral identity and loss of meaning. Its symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live.”

Soul Repair Center was established in 2012. In addition to offering public education, they are also continuously conducting research on the topic. People, like Michelle who was described at the beginning of this blog, are not alone in their experiences and Rev. Brock and many other professionals see that this is a topic that needs our immediate attention.

If you would like to learn more about Moral Injury and the ways in which it impacts families, please join us for OneOp Virtual Learning Event 2016 – Strengthening the Family CORE – Session 4 entitled: Exploring the Impact of Moral Injury on Military Families on September 22nd at 11:00 am EST. This webinar will be presented by Rev. Brock. It is our hope that you will join us in learning about this incredibly important topic.

References

Maguen, S. & Litz, B. (2012). Moral injury in veterans of war. PTSD Research Quarterly, 23(1), 1050-1835.
Brock, R. & Lettini, G. Soul Repair: Recovering from Moral Injury after War. Boston: Beacon Press, 2012.

 

Blog Image: Photo from Flickr [DN-ST-91-05864 by Expert Infantry, February 21, 2011, CCO]