On Moral Injury
On Moral Injury
Resistance is the road to recovery.
The term moral injury emerged from studies on trauma, specifically in veterans. In 1994, Jonathan Shay originally defined it as the "betrayal of what's right, by a person who holds legitimate authority in a high stakes situation." On a broader level, moral injury refers to the "psychological, social and spiritual impact of events involving betrayal or transgression of one's own deeply held moral beliefs and values occurring in high stakes situations." Moral injury happens when you betray your own code out of necessity, or someone else does it to you.
The first studies focused on veterans. Now research is showing that moral injury goes well beyond the battlefield. As Harold Koenig and Faten Al Zaben write, moral injury "has expanded...to include similar emotions experienced by healthcare professionals, first responders, and others experiencing moral emotions resulting from actions taken or observations made during traumatic events or circumstances."
Koenig and Al Zaben trace the concept of moral injury all the way back to 416 BCE, when Euripides described his post-war trauma:
Where can I hide from all this and not be found? What wings would take me high enough? How deep a hole would I have to dig? My shame for the evil I have done consumes me. I am soaked in blood-guilt...
You see something similar in Shakespeare, when Lady Macbeth realizes she'll never wash the blood off her hands.
Over the last several years, psychologists have developed an inventory of moral injury with up to 45 statements that participants can rank on a scale of 1-10. A few years ago, a team led by bioethics experts at Duke adapted the inventory for healthcare workers.
Here's a summary of the statements you can rank:
I feel betrayed by leaders who I once trusted.
I feel betrayed by those close to me.
I feel guilt over failing to save someone's life.
I feel ashamed about things I did or didn't do.
I'm troubled by things I've done or seen.
Most people are trustworthy.
I'm able to forgive myself.
I'm able to forgive others.
I'm inclined to feel that I am a failure.
I feel like God is punishing me.
I find no meaning in life.
These questions were designed for veterans and traumatized healthcare workers, but they speak to the circumstances we all find ourselves in now. If we don't feel guilt over spreading disease, we see plenty of people who should but don't. We see leaders of a coup walking around free, even running for public office, while peaceful protestors get prison sentences for trying to save the planet. Our leaders won't ban assault weapons, but they'll ban mask mandates and even masks. It's abundantly clear we live in an unjust world.
Just like Euripedes wrote thousands of years ago, it feels like there's no place high or low enough to escape this feeling. We're not soaked in blood guilt. We're soaked in a deep sense of betrayal and injury.
It's with us all the time.
We carry it.
Research on moral injury so far promises recovery, suggesting that with enough therapy or counseling you can somehow readjust your moral compass and learn to live with the things you've seen and done. But they assume the trauma comes from discrete events, things that happened in the past.
What if the source of your moral injury never stops?
What if it's ongoing?
Just like complex PTSD describes the more severe, likely permanent impact of chronic trauma, what we're feeling looks more like chronic moral injury, an injury that never ends but simply accrues. It's like the difference between getting stabbed once, and getting stabbed every day for going on five years, and the people stabbing you pretend they don't have a knife.
After all, it's not just the injury. It's the gaslighting that goes along with it, and the insistence that somehow it's our fault.
Beneath moral injury lies a sense of helplessness. We often feel helpless to watch our leaders destroy public health, democracy, and the planet itself. The celebrities who once offered us a distraction from the carnage now gleefully participate in it, spreading disease and spewing carbon into the sky, while threatening legal action against anyone who tries to stop them. The progressive politicians we once supported have chosen complicity.
I'm glad a term like moral injury exists, because anxiety and depression don't begin to do justice to what we're feeling. More often, these terms are simply used to dismiss and trivialize our experiences. They're used to make it feel like we're the ones responsible.
So, where do you fall on the moral injury scale?
How do you answer the questions?
The God item presents a little bit of a problem for atheists like me, but I can see what it's getting at. There's no god to punish us, but we all know the feeling that we're living through some kind of weird simulation run by sadists who just want to see what we'll do next. That's a good analog.
As for the other questions, that would be a hard no on feeling like we can trust most people, including our leaders.
And yes, sometimes we feel like a failure for not doing better to protect ourselves or provide for our families.
It's bigger than Covid.
If it feels like our social and economic systems are designed to make us fail and feel like failures, there's plenty of evidence that's true. It's hard to dispute when the heads of companies like Pfizer actively celebrate our infections and describe them as growth opportunities. It's hard to put the lies we were told in the past when our public health agencies are lying to us again, about another pandemic coming our way.
Kent Drescher describes moral injury as the "disruption in an individual's confidence and expectations about one's own or others' motivation or capacity to behave in a just and ethical manner."
Yeah, that's taken a hit.
We can't trust leaders who gaslight us daily about diseases while funding genocide, jailing climate protestors, and then posing for maskless photos with vulnerable and disabled people. That's the daily injury, the continued negligence and denial by institutions we know are presiding over death while nurturing cultures of silence and complicity.
We can't trust friends who practice and preach eugenics at us, telling us that if we die or develop permanent disability that it's somehow part of a bigger divine plan. We can't live easy in a world where ideas once widely condemned four years ago have become normalized on a disturbing level.
Yesterday, I was wondering when America would finally start building concentration camps for all their undesirable populations. Then I realized something. We already have concentration camps.
They're called prisons.
We're all morally injured.
Life in end stage capitalism, in all its genocidal eugenic horror, is a life of chronic sustained moral injury. There's only one way to get through this, and that's to devote ourselves to resistance and recovery.
Every day, we resist. We resist by doing what we know is the right thing. We resist by advocating and informing. We resist by telling the truth about the present and the past.
And then we recover.
There's not going to be a permanent, lasting recovery in a world that inflicts moral injury on us every day. We have to spend a part of every day recovering the best we can, repairing our armor, and going again.
The only way to recover from moral injury is to fight it.
The only alternative is to give up. That would mean submitting to these eugenic healthcare policies, drinking down the lies, and celebrating a culture of denial, wishful thinking, and overconsumption.
That's never gonna happen.
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