Post-Traumatic Stress Disorder or PTSD is a well-known and documented condition amongst our Veteran and Active duty community. We know that PTSD is not limited to those who have experienced wartime trauma and that it can be treated through proper diagnosis and therapy. However, PTSD can be very difficult to unravel and to add an extra layer of complexity it can often be accompanied by Moral injury.
Moral injury occurs when a person feels that they have violated their moral code, conscience, or deeply held beliefs by committing, taking part in, witnessing, or not being able to stop an act from occurring.
This can be applied to numerous situations for anyone who has served during the past 20 year. The Department of Veteran Affairs (VA) defines it as,
“moral injury in the context of war comes from participation in actions related to combat warfare, such as killing or harming others. Moral injury can also come indirectly from acts like witnessing a death or others dying, failing to prevent similar immoral acts, and granting or receiving orders that can be viewed as immoral or inhuman.”
Moral injury and PTSD are remarkably similar, they share many of the same characteristics, but to understand how they differ you have to pull them apart and see them as individual and separate issues.
Just look at the Venn Diagram below. The complexity and similarity in these mental health issues are depicted.
Seem a little vague or unclear, here’s an example.
“As a Staff Sergeant in charge of your vehicle while conducting convoy operations in Iraq you failed to stop your gunner from engaging a random parked car. There was no threat or danger, he was just bored and wanted to shoot at a random car. You knew that wasn’t right, but you didn’t try to stop him. As you investigate the wreckage, you learn that the car was filled with 40 stray kittens and 101 Dalmatians.”
You were raised to love, protect, and care for all animals. Protecting all animal life was a deeply held moral belief. As a soldier, your ethics were to always do the right thing and lead by example. The shock of seeing such a violent act carried out against helpless animals has affected you deeply. In this example, you have just suffered Moral Injury.
Moral injury is not a new concept, it has been discussed by scholars and poets as far back as ancient Greece, but like many injuries that cannot be seen, it’s hard to diagnose. It’s up to us to understand our own experience with PTSD and Moral Injury to discuss them healthily and productively with our counselors, Therapists, and Doctors.
Ignorance and pretending that the problem doesn’t exist will never get us anywhere. Take action today! Be an active participant in your recovery and start learning more about Moral injury and how it can affect us. Follow the links below to some awesome books and more!
1. What Have We Done: The Moral Injury of Our Longest Wars: https://www.amazon.com/dp/B01CO4AXHY?ref=KC_GS_GB_US
2. Link to Sage Journal Article –
3. VA website page on Moral Injury https://www.ptsd.va.gov/professional/treat/cooccurring/moral_injury.asp
4. Additional books on moral injury –
https://www.goodreads.com/shelf/show/moral-injury
Thanks so much for posting this. This is one of the major issues that we at Advancing Warriors International work to help address. Moral injury really is that "elephant in the room," but it's an elephant that no one knows is there and don't know what it's called. There are so many veterans and first responders (and anyone for that matter) who fortunately do not suffer from PTSD, but that there are still crippling effects from moral injuries in their lives. If you're up for it, would love to connect at dan@advancingwarriors.org. Thanks for what you do!