Helping heal moral injury

Often public service requires actions that require compromise with our values. Actions that are at odds with faith and practice.

That can cause long-term emotional stress and cognitive challenges. This can include a lot of things. Shame at perpetration. Guilt at surviving. Anger at being on the sidelines. A loss of trust in oneself. All of the above are signs of moral injury. 

Some of you are wondering the hell am I talking about? What's moral injury? Some call it a soul wound, but that doesn't really explain it does it. So I'll turn to a couple definitions to lay the ground work. 

First from the VA's National Center for PTSD, "In traumatic or unusually stressful circumstances, people may perpetrate, fail to prevent, or witness events that contradict deeply held moral beliefs and expectations."

And a similar definition from Syracuse University's Moral Injury Project, "Moral injury is the damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct."

I can think of a few times where actions I had to take in military service and in emergency medical situations that I have felt this occur. It's haunting. There's guilt and shame. Long lasting. Painful. It impacts daily life. 

I've heard a lot of people say that faith should be enough. That should sustain healing in such a scenario. But it's not enough. 

One of the biggest issues is I don't know how to talk about the moral injuries and wounds of my soul in a more open worship and fellow-shipping position. It's not exactly something you know how to bring up in Priesthood or a testimony meeting. I'm not sure how talk about it to leadership. There's just not enough voices that have an understanding, let alone a connection or shared experience. There was a time when there was a lot of veterans and first responders in the quorums. But ages have changed, and there are just less of my age group that are of those demographics. Quite the change from my childhood when the majority of the Quorum of the Twelve were. 

Why does that matter? 

Connection. PTSD, moral injury, that pain, they runs away from support. And the reconciliation that's needed, it requires others. 

For a part of these concerns you turn to therapy. A support group. Start addressing you symptoms. Address your behavior, your cognition, and your emotions. Start to get a hold. Try to live again. And you'll usually get somewhere. I mean that. It's hard. It takes a lot of work. But there are dividends there.

I've been there. I've seen it work. I've found recovery. That long process. The new way to live. 

But there are things I can't shake. 

Guilt can be a positive emotion. But it can take over. And it can happen even when it's not your own. 

Surviving, betrayal. The actions of superiors. All of it weighs on you. Time just compounds it. 

Then there are your actions. When you have to inflict pain. Stand by when violence (righteous or not) occurs. The strain builds.

The problem is we do things that are required that fly in the face of our faith, our morals, our upbringing and it's unavoidable. You find yourself questioning self. For the long term. And you lose the connections that supported you through the worst. 

The toll is paid. In the harshest ways. 

Veterans just leave life behind. 

The average person knows about 3 people that have committed suicide. I hit that my first year in service. I've been in the double digits for years now. And I'm not the exception for veterans. I'm the rule. More than one vet of my age is surprised if they here a fellow veteran died of natural causes. That's the way it is. And more than once, I've wondered why I'm not just a statistic too. Being alive just adds to the guilt. 

That's why moral injury needs more than just therapy. It needs more than just faith. And it takes time to heal.

That's why vets are different. Why first responders often are. They paid a price. And the wages are still paying out. 

There's hope. It's not all over. 

The VA has started groups led by a mental health professional and a chaplain. They put veterans with similar backgrounds, moral injury, and desire to recover together to start the hard work. And it's effective. 

Some church's have established similar recovery programs and groups. Bridging faith and mental health. 

They've both had good success. 

I'm not writing this from a place of current despair but from where I've been. Where I am now and where I hope to get to. 

I'm currently in a place where I'm attempting to continue to find meaning and purpose. One of the paradoxes of moral injury is that juxtaposition where the moment you had the greatest purpose is when you did the most damage to your soul and psyche. You felt simultaneously like you were making a difference and felt the most mundane in the moment. And you were surrounded by people who felt the same way. Were doing the same thing. Day after day. Then it just stops. 

That's the struggle. How do you find that again in life? Do you find fulfillment in family? In faith? Your next career? Do you feel like you deserve it when you do? Can you find a similar level of connection that you once felt?

That's the constant challenge that every veteran faces. Then it's compounded by moral injury. Did I sell my soul? Can I be redeemed? Am I worthy?

That's the greatest challenge. 

We have people coming home. And we don't always know how to answer those questions. We don't properly prioritize religious practice during the times of strife and action. General religious communities do not have the experience to bridge the gap. 

But they can learn. They can support what they don't understand. They can say they don't know. They can encourage relationships that are beyond them. And hopefully they can keep people here when they come home. 

Because we can get there.

General fellowship. Large meetings. Spiritual platitudes only go so far. Sharing scriptures only get so far. 

Prayer and study help. Pondering is happening with these people. Often at a level that many others can't comprehend. 

Few people have to negotiate thou shalt not kill, turn the other cheek, and actual harm committed. 

That's the depth of conflict. The density of the scar. The weight they carry. 

Recovery is work for that. Repentance often seems out of reach. Salvation is a struggle. 

Remember that. 

When you thank a veteran for their service. When you see a first responder. Recognize the depth you don't understand. 

That's all they need. Support. And sometimes you won't be enough. Nothing alone may be. 

That's ok. That's life. And not all wounds heal nicely. 

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