About Moral Injury

Trauma can happen to anyone, out of the blue, unexpected and violent. The repercussions of trauma can last a lifetime rendering a person impaired if it is not recognized and dealt with. The ways a trauma can occur are countless, and the ways each person deals with it will vary.  Post Traumatic Stress Disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.[1]

Moral Injury often accompanies PTSD and even shares some of the symptoms, but Moral Injury affects a person’s core values, including their relationship with their higher power, their selves and their very soul.

Moral Injury is what results when one feels they have violated their conscience or moral compass by perpetrating, witnessing or failing to prevent an act that violates their own beliefs, values or ethical code of conduct. While Moral Injury and PTSD can affect anyone, our focus here is on veterans.

“The consequences of violating one’s conscience . . . can be devastating. Responses include overwhelming depression, guilt, and self-medication through alcohol or drugs. Moral injury can lead veterans to feelings of worthlessness, remorse, and despair; they may feel as if they lost their souls in combat and are no longer who they were. Connecting emotionally to others becomes impossible for those trapped inside the walls of such feelings. When the consequences become overwhelming, the only relief may seem to be to leave this life behind.”[2]

The United States Department of Veterans Affairs (VA) does not offer services for wounds of a spiritual nature.  They have plenty of programs to help with the fear aspect we see with Post Traumatic Stress Disorder.  But Moral Injury is a shame-based issue, and speaks more to how a person deals with the things they witnessed or engaged in that went against their moral compass.  Coming to a resolution with their higher power can be extremely complex.  They may feel they are unworthy, or be angry with God for putting them in the situation in the first place.  This is an opportunity for faith communities to come together as an educated group and make a difference, literally saving lives.

The problem is that most Veterans with Moral Injury or PTSD will not be able to make it through the front doors of the church or faith community building to begin spiritual healing.  Churches in general are not physically set up for the person with PTSD.  These people typically can’t be in close quarters with strangers, or have anyone sit behind them and they need to have a view of all the entrances and exits of the building in order to feel safe.

This means that each congregation needs to look at their physical facility and see if changes could be made to make it easier for the veteran to get through the door.  The other option is that the church goes to the veteran.

This year, St. Clement’s Episcopal Church in Rancho Cordova along with nonprofit 4 Paws 2 Freedom were awarded the first ever Episcopal Community Services, Barry L. Beisner Social Justice, Multi Year Grant to build a program for churches across the region to address the needs of Veterans suffering with Moral Injury.

St Clement’s Church and 4 Paws 2 Freedom, a local nonprofit organization that helps Veterans with PTSD heal through the use and training of service dogs, will work together to create the workshops and manuals.  The workshops in 2020 will be held at St. Clement’s Episcopal Church in Rancho Cordova in Spring, Summer and Fall.  These workshops are open to the many churches and faith communities in the Sacramento area to educate them about PTSD and Moral Injury so they can implement programs within their parishes.

Workshops and/or webinars for 2020 will include

  • Educating your congregation about Moral Injury, Post Traumatic Stress Disorder(PTSD), Traumatic Brain Injury and Military Culture
  • Creating Safe, Sacred Space for Veterans
  • Finding Healing Scripture, Rites and Rituals
  • Finding or creating rich healing resources in your community for those who suffer from trauma


Together we can make the difference.


[1] (www.mayoclinic.org).

[2] Soul Repair: Recovering from Moral Injury After War, xv-xvi

About PTSD

When I began training service dogs for veterans with Post Traumatic Stress Disorder over ten years ago, most people had never heard of it.  Most people, including myself thought it was a condition that only happened to people who had seen the horrors of war.  Little did I know back then, that I actually also had PTSD.

Post Traumatic Stress Disorder is defined as an exposure to a  traumatic event in which the person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others. And that the person’s response involved intense fear, helplessness, or horror.

When you are in the throes of PTSD there is no peace, no joy, no quality of life.

One of the interesting things about trauma is that it does not always lead to PTSD. Some people, my Dad for example, have PTSD and then seem to recover from it and live seemingly normal lives.  My dad fought in WWII.  I remember him having terrible nightmares when I was a child.  But those went away with time, and he could tell stories about the war without triggering events.

Some people experience trauma and it doesn’t seem to cause PTSD.  Others are able to put off the PTSD for many years, by keeping themselves busy with life and family, only to retire and have the symptoms of PTSD show up then.  Who will develop it seems to depend on the event and the person.   In a study by Kessler et al., 1995 20% of women developed PTSD and only 8% of men.

Other interesting statistics indicate that being poor, having less education, having a bad childhood or previous psychological problems may put you at higher risk of developing PTSD after a traumatic event.

The symptoms of PTSD are pretty much the same no matter what the event was that caused the trauma.  To help people with PTSD feel safe, here are some guidelines for what to do and not to do.

If we have no peace, it is because we have forgotten that we belong to each other. Mother Teresa

Terry Sandhoff

When interacting with Veterans with PTSD:

  • Listen quietly and attentively, be relaxed and respectful
  • Offer compassion, with strength and without judgment
  • Understand the impact of TV – war movies can cause PTSD symptoms in veterans
  • Crowds or large groups are very difficult for people with PTSD
  • Loud noises, especially sudden noises will likely cause an exaggerated response
  • Many veterans are light sensitive due to Traumatic Brain Injury, or seizure activity
  • If a veteran is Sleeping  or having Nightmares Do NOT try to wake them by touching them
  • No “fooling around”:  Don’t sneak up on someone, don’t make sudden noises behind them
  • When we help a Veteran to heal, we help his or her family to heal, and from there, the community, and from there, our Countr

Moral Injury Blog

In any faith-based society we are brought up under the basic rule that life is sacred … “thou shalt not kill.” All the religions of the world state this belief in various ways, it forms the basis of being a civilized society. Yet in war, we place our men and women in situations where they have a duty to fight and kill others. This moral conflict can be devastating for returning servicemen and women (and their families). For many this struggle emerges years after the events of war. It can be seen in many forms PTSD, Moral Injury, Alcoholism, and Homelessness. … All can be the result of these moral conflicts.

St. Clement’s has long had the heart to serve our veterans. Last month, 4 Paws 2 Freedom, a nonprofit organization that is led by Terry Sandhoff, approached the Vestry with the opportunity to join forces to build a safe place for veterans and their families to get education and support. The Vestry agreed to provide the portable and the surround grounds for this expanded ministry to use on a full time basis. Over the next 6 months, we will be creating new programs and opportunities to improve the lives of those who served our Country. The Safe Harbor for children will become the Safe Harbor for Veterans.

One of the most exciting things about this new venture is that anyone who feels the call to be a part of this ministry can do so. The goal is to have someone in the portable full time, so that veterans can stop and find peace, a kind word, a place to have purpose and be loved. This is who we are at St. Clement’s. We will be teaching classes; offering support groups (Grow Groups), and meet-ups for Veterans and their families.

If you have a skill you would like to share with others, you can teach a class, or if you like to cook and want to prepare cookies or try out new recipes, you can bring those to be enjoyed by an appreciative audience. The thing is: YOU have a place here too!! Whatever your skill is, chances are, this is a place you can use it to help others. If you need a peaceful place to regroup, you will find it here.

On July 1, we have called on our veteran friends to come out to St. Clement’s for a clean-up day, to start the beautification of the grounds. Monday July 11th we will be starting weekly classes. From 1-2pm we will be teaching a weekly Meditation Class. From 2-5pm we will be offering crafting time, starting with a Learn Basic Crochet Class. We are looking forward to gardening and music opportunities in the near future.

This is an exciting new ministry that helps all of us, while we help others.

Terry Sandhoof