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.
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.”
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.
Together we can make the difference.
 Soul Repair: Recovering from Moral Injury After War, xv-xvi
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
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