eteran man meeting with therapist.

Learn More About How to Heal From Moral Injury

It can be hard to seek help for an event that may make you feel ashamed to talk about. But finding ways to deal with a moral injury is important to your overall health and wellness.

Most often when we think of getting injured, we think of harm done to our bodies – a broken leg, a concussion, scrapes and bruises. We use the health care system to fix ourselves up, get bandaged and heal. But what about a moral injury? What is it and how can you treat it?

Veterans, as well as first responders, health care workers, law enforcement officers and even civilians, can experience moral injuries. This article will explain what a moral injury is, its symptoms and what treatments and resources are available to help you manage this type of injury.

What Is Moral Injury?

Moral injury occurs when a person feels like they have violated their conscience when they take part in, witness or fail to prevent an act that goes against their own moral values or principles.

According to the Department of Veterans Affairs (VA), moral injury occurs when an individual feels like a transgression occurred and that they or someone else crossed a line with respect to their moral beliefs, often leading to overwhelming guilt, shame or anger.

The nature of war and combat can create situations that may lead to increased chances for moral injury to occur. As a Veteran, maybe you witnessed something during your Service that doesn’t align with your core beliefs or values. Or maybe you feel remorse or shame for something you did that is making it hard for you to forgive yourself. Maybe you experienced an event that caused you to question your own spiritual beliefs or values. According to VA, in the context of war, morally injurious events might include:

  • Killing or harming others
  • Making decisions that affect the survival of others
  • Being unable to care for all who were harmed
  • Freezing or failing to perform a duty during a dangerous event
  • Failing to report an event that violates rules or ethics
  • Engaging in acts of disproportionate violence and feeling nothing

Any situation when a person experiences events that contradict their values and beliefs can lead to moral injury. It isn’t just found in Veterans. For example, a health care worker may have to make decisions about saving lives based on what resources are available. First responders may suffer guilt over being unable to save a patient they believe they should have.

What Are the Symptoms of Moral Injury?

Like many mental health issues, moral injuries don’t look the same for every person and there is no single test that can determine if what you’re feeling is a moral injury, but there are some signs to look out for. Here are some common symptoms found in people who experience moral injury, according to an article from the Disabled American Veterans (DAV) as well as VA:

  • Being overwhelmed by negative emotions, including guilt, shame and remorse from an act that violated your morals
  • Feeling depressed and unworthy because of something you witnessed, experienced, or failed to stop
  • Having trouble trusting others or sustaining relationships because of how you feel about yourself or what you have seen others are capable of
  • Taking part in self-destructive behaviors such as turning to drugs or alcohol to escape the moral guilt associated with past experiences or traumas
  • Being diagnosed with mental health conditions such as depression, anxiety or post-traumatic stress disorder (PTSD) as a result of trying to deal with a morally injurious event
  • Reliving the event through nightmares or painful memories
  • Avoiding situations or people that remind you of the event
  • Being unable to forgive yourself and consistently feeling like you don’t deserve to succeed or find happiness after what happened

A moral injury has a lot of overlapping symptoms often associated with PTSD, but the two are not exactly the same. Both often begin with a traumatic event. Both may lead to symptoms of guilt and shame, but PTSD often includes additional symptoms such as hyperarousal or vigilance, which is not often associated with moral injury. To find out if you have a moral injury, reach out to your health care provider to discuss your symptoms.

How Can I Manage or Treat a Moral Injury?

Moral injuries need to be managed and healed, just like physical ones. It can be hard to seek help for an event that may make you feel ashamed to talk about. But finding ways to deal with a moral injury is important to your overall health and wellness. Here are some suggestions:

  • Find a way to help others. According to a VA News article, many Veterans find comfort in giving back and helping others. Finding a volunteer opportunity or a way to practice meaningful community service may provide you with positive feelings, allowing you to release some of the guilt or shame you may feel. Check out these articles for some ideas on giving back and volunteering in meaningful ways.
  • Make a lifestyle change. Feeling your best physically can provide manyHealthy food and exercise. benefits for your mental and emotional well-being. Eating healthy foods and staying active can improve your mood, reduce your stress levels and alleviate symptoms of depression, anger and fatigue.
  • Practice gratitude. Instead of feeling like you don’t deserve happiness or have to live with guilt and shame over the past, try doing the opposite. Appreciate and focus on the good things you have done in your life and the people who care about and value you. Practicing gratitude offers many health benefits, including increasing your feelings of happiness and hope, reducing your risk for anxiety and depression, and increasing your resilience in the face of trauma and stress.
  • Give mindfulness and meditation a try. When you focus on the present without making judgments, or you concentrate on your breathing or a mantra you repeat over and over, you can help yourself avoid dwelling on the past and provide yourself with a sense of peace and calm. Check out this easy guide for getting started.
  • Find a new purpose. If you’re dealing with feelings of shame or guilt over events in your past, it may be helpful to find a new way to establish meaning and purpose in your life. It may be through a volunteer opportunity, or it may be a health-related goal that makes you feel accomplished or proud, or maybe it’s a relationship you work hard to mend or rebuild in your life. Finding something that makes you feel good may help you release some of your anger or shame.
  • Seek out support. Think about ways to find the support you need to deal with your moral injury. Consider a peer support group, for example. Talking to someone who has experienced something similar may give you the comfort you need to work through some of your emotions. You may also explore other supportive opportunities and programs, such as a service dog or another program that helps Veterans connect with animals or others in a meaningful way. Find environments that are nonjudgmental and supportive to be a part of.
  • Get the professional help you deserve. Sometimes lifestyle changes and modifications aren’t enough to deal with the heavy emotions associated with moral injuries. There is no shame in asking for help. It doesn’t make you weak and you don’t have to worry about being judged for your experiences or actions. Explore VA’s mental health resources and begin healing today.
  • Learn more about the treatments available to help. According to an article in the military times, VA has begun additional research into the prevalence of moral injuries, as well as studies for successful treatments. Possible treatments include cognitive processing therapy, acceptance and commitment therapy, trauma-informed guilt reduction therapy and more. Learn more about different treatments for moral injury, as well as what treatments VA is using to help Veterans manage moral injuries.

You don’t have to live consumed by guilt or shame from your past. Moral injuries can be managed and treated, just like physical ones. Get the support you deserve.

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