Understanding moral injury
What is Moral Injury?
Overview
Less recognized than PTSD, “Moral Injury” is a condition introduced by clinical psychiatrist Jonathan Shay through his work with Vietnam War veterans treated in the Department of Veterans Affairs, as outlined in his book “Achilles in Vietnam: Combat Trauma and the Undoing of Character” (1994).
Shay delineates moral injury into three components: a betrayal of moral correctness by a legitimate authority figure in a high-stakes scenario. While Shay’s definition is widely acknowledged, other interpretations exist. The Syracuse University Moral Injury Project describes it as damage inflicted on one’s conscience or moral compass when they perpetrate, witness, or fail to prevent actions that violate their own moral beliefs, values, or ethical codes.
The toxic silence
Shaming another person has a toxic effect, stripping them of dignity and self-respect while stifling their ability to speak out. During the Vietnam War, approximately 2.7 million American men and women served, with over 58,000 losing their lives. As the war lost favor, blame shifted from political and civilian leaders to individual soldiers, leading to a surge of shaming behavior directed at returning combat veterans by the anti-war movement.
While many suffered from combat experiences, not all were diagnosed with Post-Traumatic Stress (PTS). Dr. Shira Maguen’s research revealed that some veterans exhibited symptoms beyond PTS, such as shame, guilt, and loss of identity due to moral conflicts. This recognition birthed the concept of “Moral Injury.”
Further studies uncovered the detrimental role of shame and shaming behaviors in exacerbating emotional distress among combat veterans and their families. Central to this is “toxic silence,” where shame isolates veterans, hindering their ability to discuss experiences openly. Breaking this silence allows veterans to share their stories empathetically and diminish the power of shame.
“Shame flourishes in isolation, thriving in the voids between individuals, where feelings of separation and alienation abound.” — Brené Brown
The dark side of shame
Empathy dismantles shame’s stronghold, fostering connection and restoring self-worth. Returning one’s voice disarms shame by dispelling secrecy and granting recognition. “Lending Our Ears to Give Them Their Voice”™ embodies this ethos.