Moral injury is a transgression of conscience. It is what happens when a person’s deeply held values, beliefs, or ways of being in the world are violated. That violation could result from things the person did themselves, things they witnessed others doing, things they were forced to do against their will or better judgment, or things they couldn’t stop from happening. And it’s more prevalent than many would think.

Story: Blocked

Background
The phrase “moral injury” was coined in the 1990s by psychiatrist and author Jonathan Shay to describe the trauma soldiers suffer on the battlefield when they are placed in morally compromising situations—like a commanding officer who orders his troops to leave behind one of the fallen despite the warrior ethos, or a sniper whose job it is to protect his fellow soldiers and has to choose in a moment between saving their lives or the life of an innocent baby strapped to the chest of an enemy sniper.

But moral injury is not a new concept. It is a pall that has blanketed individuals, families, and communities throughout time and across culture: on the battlefield, in hospitals, at the frontline of disaster, behind closed doors of churches and temples, in back alleys and in bedrooms, in bars and in brothels, in prisons, refugee tents, abortion clinics, soup kitchens, unemployment lines, at borders, in detention centers, on school playgrounds and social media, even in the unsuspecting house or office next door. The list is endless.

This is because wherever human beings are, so too will moral injury be. We are, as a species, hardwired to embody goodness, love, compassion, empathy, and a sense of right and wrong. Moral expectations are at the heart of who we are as people and as societies. But human beings are also imperfect and limited. We can’t always meet our own moral expectations, nor can others always meet them. Sometimes life throws us into situations where the stakes are high and no outcome is good, and we or others act, doing what we or they otherwise know to be bad, aware that harm will come, in one way or another, to ourselves or to another. Sometimes that “other” is simply life.

Moral Injury: Craggy Tree

Another Type of Trauma
Moral injury has been likened to post traumatic stress disorder (PTSD). But while the intrusive “seeing” of the past is similar in each experience, unlike PTSD, with moral injury, memories don’t trigger fear; they beget shame, guilt, rage, disgust, emptiness, and despair. With PTSD, the primary concern is physical safety; with moral injury it is existential safety—or trust. Moral injury makes a person question themselves, others, life, or their God. It makes them question their or others’ ability to do right or be good. It deteriorates character, ideals, ambitions, and attachments. It leaves people feeling contaminated in their soul or that something they once held dear is now sullied. “Unworthy,” “beyond redemption,” “gone forever,” and “emotionally dead” are how many people have described the experience. “A soul divided against itself,” is how author and scholar Rita Brock put it.

Unlike PTSD, moral injury is not a clinical diagnosis; it is a fundamental human struggle—our natural human response to something that defies and defiles what we hold sacred. Moral injury is also not a disorder of the mind. Rather, it is a burden carried by the heart and soul.