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Monthly Archives: September 2013

First PTSD, Now Moral Injury — Battling the Cost of War

The Good Chaplain and I recently attended a military chaplains’ conference in North Carolina where the main topic was moral injury. Although not a new concept, I was not familiar with it and found it fascinating. And it made a lot of sense.

In their book, “Soul Repair: Recovering from Moral Injury after War”, the conference saluting soldierspeaker, Rita Nakashima Brock and her co-author, Gabriella Lettini, describe moral injury as “violation of core moral beliefs.” It is not post traumatic stress disorder. It goes beyond that and usually appears after dealing with the PTSD symptoms.

“Moral injury can result in agony from inner judgement against oneself, anger, survivor guilt, isolation, despair and/or the loss of the will to live,” Brock said.

She told us that while PTSD is a physical change in the brain, moral injury is more of an emotional response, the inner judgement of what a soldier experienced in war is morally wrong, yet that soldier participated anyway.

Reflexive fire training, which teaches soldiersĀ to fire instantly without thinking about it, is one instance of a “morally disruptive aspect of war,” according to Brock. Others include dehumanization of the enemy, encountering and handling human remains, a perceived betrayal by authority and doubt or uncertainty about the goals and missions of the war.

When a soldier uses judgment to decide if their actions violate their core moral beliefs, they often feel shame, depression, a collapse of their moral identity and meaning system that supports their identity. They often wish to die.

Although moral injury has been around since the ancient Greeks, it is not recognized or dealt with much today. And that’s the problem. Veterans are committing suicide nine times more than civilians, Brock said. Veterans also make up a disproportionate rate of homelessness, unemployed, poor, divorced and imprisoned. And this is with better mental health screening and treatment for PTSD. The real culprit is moral injury.

In my next blog, we will look at some ways Brock says moral injury can be dealt with.

For more information on this topic, visit the Soul Repair Center, Brite Divinity School.