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Moral Injury


Isn't Moral Injury Just PTSD?

Moral injury and PTSD have some symptoms in common, but moral injury is also a separate clinical problem. The shared symptoms of PTSD and moral injury are:

  • Recalling the experience when you do not want to (e.g., nightmares)
  • Avoiding thoughts/feelings, and situations related to the experience
  • Reduced interest in things and people that were once pleasurable
  • Negative thoughts about oneself or the world

One of the things that is unique about moral injury is that people can develop it from experiences that are not life-threatening. The types of symptoms that are unique to moral injury are:

  • Distressing beliefs about the self or the world which come from accurate beliefs about moral harms
  • Shame or anger must be present
  • Changes in one’s beliefs about the goodness of oneself or others
  • Harshly judging oneself or others
  • Social exclusion or rejection of others
  • Behaviors that are harmful to the self or others
  • Changes in beliefs about life’s purpose or loss of religious or spiritual beliefs or practices

Moral Injury is an Uncommon Clinical Problem

Not all experiences that violate our beliefs about right and wrong lead to moral injury. Some experiences might violate these beliefs but may not affect us directly or have been going on for a long period of time. These experiences are called moral challenges, and they may lead to moral frustration. A good example of this are concerns about climate change. These experiences are so common that they are unfortunately normal and expected parts of being human.

Similarly, some experiences may directly affect us but not in a serious way. These experiences are called moral stressors, and they may lead to moral distress. Moral stressors do not happen as often as moral challenges and more is at stake with these kinds of events. Moral distress may make us feel bad and it may be on our mind a good deal, but we are able to function in our lives. Examples of moral stressors include hurting someone you love or someone you respect violating your trust. People who struggle with moral distress do not always believe that they or others are defined by the experience.

Potentially morally injurious events involve serious threats to your way of life. These experiences are not very common, and they are the most likely to affect relationships, the ability to work, and self-care.



Next: What are the Symptoms of Moral Injury?
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