Understanding the Definition of Moral Injury

  • Billy Cobb
  • Nov 05, 2023
Understanding the Definition of Moral Injury

The Definition of Moral Injury

Moral injury can be understood as a psychological response to an event that contradicts a person’s moral beliefs and standards. This wound on the conscience or an individual’s soul can be caused by either the act of committing or witnessing something that is considered immoral. The concept of moral injury is often used in contexts where soldiers and veterans are exposed to combat situations that violate their ethical principles, but it is also relevant to people in other professions that are exposed to morally challenging situations.

Moral injury is not a new concept. In fact, it has been discussed by philosophers and theologians for centuries. However, it was not until recently that the term began to gain widespread recognition. The term ‘moral injury’ was first used in the medical literature by Dr. Jonathan Shay, a psychiatrist who worked with Vietnam War veterans. Dr. Shay noticed that many of his patients were struggling with psychological issues that went beyond the typical symptoms of post-traumatic stress disorder (PTSD). He used the term ‘moral injury’ to describe the effects of combat on a person’s sense of right and wrong.

In the context of military service, moral injury is often caused by actions that are taken or not taken in the line of duty. These actions could include killing or injuring civilians, following orders that go against one’s moral principles, or failing to protect one’s comrades. Many veterans who experienced moral injury feel alone and unsupported, which can lead to feelings of shame, anger, and isolation.

Moral injury is not limited to the military context, however. It can also occur in other fields where people are exposed to morally challenging situations. For example, healthcare professionals may experience moral injury when they are forced to make difficult decisions about patient care due to limited resources. Journalists may experience moral injury when they are forced to report on traumatic events or cover stories that are in conflict with their ethical beliefs.

The symptoms of moral injury can vary, but they often include feelings of guilt, shame, and despair. People who experience moral injury may also have difficulty sleeping, lack energy, and have a general feeling of disconnection from others. They may struggle with relationships and may feel that they cannot trust anyone.

While moral injury is a serious issue, it is treatable. Therapy, medication, and support groups have all shown success in treating the symptoms of moral injury. It is important for people who have experienced moral injury to seek help and support. By acknowledging the injury and taking steps to heal, individuals can move past the pain and reconnect with themselves and others.


Moral injury is a psychological condition that occurs when a person’s moral beliefs and standards are violated. It is often associated with military service, but it can occur in any field where people are exposed to morally challenging situations. The symptoms of moral injury can be debilitating, but it is treatable with therapy, medication, and support groups. By seeking help, individuals can move past the pain of moral injury and reconnect with themselves and others.

What Causes Moral Injury?

Moral injury is a term that has gained increasing attention in recent years. It refers to the psychological damage that one can experience when their actions or inactions violate their moral code. While it was originally applied to military veterans, it has been recognized that this type of injury can affect anyone who faces difficult ethical situations.

There are several causes of moral injury, each with their unique characteristics that can trigger negative emotions and long-term consequences. Let’s examine them closely:

Military Combat

The original use of the term “moral injury” was in military contexts, and it still stands as one of its most common causes. Soldiers often find themselves in situations where they must make choices that result in harm to themselves or others, and such experiences can be overwhelming and lead to feelings of guilt, shame, or betrayal of their moral values. The aftermath of combat can also be an extremely difficult time, where returning soldiers often feel that they are unable to integrate back into their previous lives and feel disconnected from their old selves. This disconnect can further exacerbate their moral injury.

Medical Errors

Medical professionals can also suffer from moral injury. They often face scenarios where they are unable to provide the best possible care for their patients, whether due to resource limitations, organizational culture, or simply human error. These situations can cause healthcare providers to feel that they have violated their very calling as healers, and the resulting emotional distress can have a serious impact on their ability to continue providing quality healthcare services.

Ethical Dilemmas in the Workplace

Moral injury is not limited to military and healthcare environments. In fact, anyone may experience moral injury in the workplace when faced with ethical dilemmas—such as corporate fraud, discrimination, or harassment. These scenarios can leave employees feeling helpless, distrustful of their colleagues, and disillusioned with the organization. This, in turn, can result in a loss of engagement, job satisfaction, and even mental or physical health issues.

Overall, moral injury is a complex and multifaceted phenomenon. Many people may experience it in different ways, but the common thread is the violation of deep-seated moral beliefs. Identifying the factors that can cause moral injury is a crucial first step in both preventing and addressing this often-underrecognized issue.

What Are the Symptoms of Moral Injury?

When someone experiences moral injury, it can have significant lasting effects on their mental health and well-being. The symptoms of moral injury can vary greatly but typically include a sense of deep emotional distress and inner turmoil. Those who have suffered from moral injury may feel shame, guilt, anger, sadness, and hopelessness.

Depression is one of the most common symptoms of moral injury. People who are struggling with moral injury often feel overwhelmed by a sense of grief, guilt, or anguish. This can lead to feelings of sadness, hopelessness, and worthlessness. They may find themselves withdrawing from social situations, avoiding friends, and seeking isolation.

Another symptom of moral injury is anxiety. People struggling with moral injury may feel anxious or worried about a variety of issues, such as their moral beliefs, their sense of self-worth, and their ability to function in society. They may experience panic attacks, difficulty sleeping, and a constant sense of worry.

Substance abuse is also a common symptom of moral injury. People who experience this type of injury may turn to drugs or alcohol as a way to cope with their painful feelings. Drinking or using drugs can temporarily provide a sense of relief, but over time, it can become a damaging cycle that only fuels their problems.

Suicidal thoughts are unfortunately another common symptom of moral injury. When people feel overwhelmed by the pain and distress of moral injury, they may feel like there is no way out of their emotional pain except through ending their life. This means it is crucial to address the effects of moral injury to avoid the possibility of suicide.

Finally, those experiencing moral injury may feel a loss of faith or purpose. They may struggle with internal conflicts regarding their belief systems, moral codes, and personal values. They may feel that they have lost a sense of purpose or meaning in life, leading to a sense of hopelessness and despair.


The symptoms of moral injury are complex and can affect many different aspects of one’s life. There is no one-size-fits-all solution to treat this type of injury, but it is important for individuals experiencing these symptoms to get support. Treatment options may include therapy, medication, and peer support groups. Healing from moral injury takes time, but with the right support, individuals can begin to work through their feelings of guilt, shame, and grief, and move towards a healthier, happier life.

How Is Moral Injury Treated?

When a person experiences a moral injury, they may feel a profound sense of shame, guilt, or remorse. Moral injury can be the result of a variety of experiences, including war, interpersonal violence, and betrayal by people or institutions that the individual trusted. Moral injury affects not only the individual but can also have broader implications for their relationships, work, and overall quality of life. So, how is moral injury treated?


Therapy is one of the most effective treatments for moral injury. Various types of therapy can help individuals deal with moral injury in a healthy way and work towards a resolution. One type of therapy that has been shown to be particularly effective in treating moral injury is cognitive-behavioral therapy (CBT).

CBT is a type of therapy that helps individuals identify and change negative or dysfunctional thought patterns and behaviors. A therapist using CBT may help an individual examine the event that caused the moral injury and the beliefs they hold about it. This can help the individual reframe the event and their beliefs about it in a way that is more positive and constructive.


In some cases, medication may be prescribed to help individuals deal with the symptoms of moral injury. For example, antidepressants may be used to treat depression or anxiety that can result from moral injury. However, medication is not a substitute for therapy and should only be used in conjunction with other treatments.

Support Groups

Participating in a support group can also be helpful for individuals dealing with moral injury. Being part of a group of people who have had similar experiences can be reassuring and provide a sense of community. In a support group, individuals can share their stories, discuss their feelings, and offer each other support and encouragement.

Integration of Actions and Beliefs

Another key element of treating moral injury is finding ways to integrate one’s actions and beliefs. For example, an individual who experienced moral injury as a result of their actions in war may find it helpful to volunteer with a veterans’ organization or otherwise work to support veterans. By doing so, they can find ways to “make amends” for their actions and feel that they are living in accordance with their values.

In conclusion, there is no one-size-fits-all approach to treating moral injury. Everyone’s experience of moral injury is unique, and their treatment should be tailored to their individual needs. However, therapy, medication, support groups, and finding ways to integrate one’s actions and beliefs are all effective treatments for moral injury that can help individuals move towards healing and resolution.

What is Moral Injury?

Moral injury is a term used to describe the psychological distress that results from actions or situations that violate a person’s moral or ethical code. It can occur as a result of an individual’s own actions or as a result of actions that are seen as condoned or sanctioned by the individual’s community or culture. Moral injury is not a recognized psychiatric condition, but it has been identified by mental health professionals and is increasingly being acknowledged as an important aspect of trauma.

Examples of Moral Injury

Moral injury can result from a variety of events in both civilian and military situations. Examples of moral injury include witnessing or participating in acts of extreme violence, experiencing or participating in sexual assault, being forced to make choices that go against one’s personal values, and being held responsible for actions that are beyond one’s control. Moral injury can also result from the accumulation of smaller events that over time erode an individual’s sense of morality or ethical values.

Signs and Symptoms of Moral Injury

The signs and symptoms of moral injury are similar to those of post-traumatic stress disorder (PTSD). These may include feelings of guilt, shame, anger, or regret, as well as a sense of feeling stuck or trapped in a situation that cannot be resolved. Other signs of moral injury may include difficulties with sleep, concentration, or memory, feelings of isolation or disconnection from others, and a sense of loss of purpose, meaning, or faith.

Treatment for Moral Injury

Treatment for moral injury varies depending on the severity of the injury and the individual’s specific needs and circumstances. Generally, treatment for moral injury involves a combination of therapy, medication, and lifestyle changes. Therapies that have been found to be effective in treating moral injury include cognitive-behavioral therapy, trauma-focused therapy, and exposure therapy. Medications that may be prescribed include antidepressants or antianxiety medications to help alleviate symptoms such as depression or anxiety. Lifestyle changes may include avoiding triggers or situations that may elicit feelings of shame or guilt, engaging in physical exercise, and practicing relaxation techniques such as yoga, meditation, or deep breathing.

Why Is Understanding Moral Injury Important?

Understanding moral injury is important because it can help individuals and communities recognize the signs and symptoms of moral injury and provide appropriate support and treatment to those who have experienced it. It is also important because moral injury can have a negative impact on an individual’s mental health, their relationships, and their ability to function in daily life. By understanding the causes and consequences of moral injury, we can work to prevent it from occurring in the first place and help those who have experienced it to heal and recover.

Originally posted 2023-06-13 15:48:26.

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