Thank you Kate for this thoughtful essay on moral injury. I really appreciate how you and Will are not afraid to tackle difficult topics even when your opinion differs. I love how active listening, like you described in this article between yourself and Michael, opened the door to a respectful understanding and hope!
I really appreciate Michael’s perspective of how when one experiences moral injury, it’s an indication of health rather than a disorder. Personally, I feel the same way about PTSD. I will never forget my professor in grad school (waaay back in the last century!) when PTSD had recently been added to the DSM) putting PTSO on the board and explaining that when you consider trauma, it seems more reasonable to look at the symptoms as in fact an “orderly” response to such events! It’s people who have no disturbing symptoms following trauma that indicate “disorder”. Therefore, I prefer calling it PTSI referring to it as an injury that can and does heal (with treatment of course) and therein lies the need for it to be listed in the DSM for our medical/healthcare systems like the VA to serve our warfighters who suffer from the symptoms.
Thank you again for your thoughtful and articulate articles on important but very challenging issues!
I don't think a clinical model for moral injury is inappropriate.
It's one thing to bring yourself to medical care after a lifetime of self-neglect, and it's another thing to bring a healthy body to medical care after it has undergone trauma.
I myself had a very severe trauma as a child that led to depression, anxiety, and multiple personality disorder. I have spent decades in recovery— I would not in any way characterize it as “bouncing back,” but after decades of wrestling with symptom after symptom and roadblock after roadblock, I am healthier than I have been since I was two years old.
Also, in your essay you speak about one kind of moral injury in which a person does not live up to their ideals. Does this include witnessing other people doing actions that you cannot control rather than committing deeds about which you are ashamed?
How about a multidisciplinary approach? Clinical, humanities, spiritual?
Hi Kathleen! Michael and I landed at the same place as you: moral injury deserves, and requires, and multidisciplinary approach. After all, it is an injury of the mind, body, AND soul.
And yes, moral injury can absolutely be incurred just by watching someone commit an act over which you have some engagement, but no actual control. Afghanistan’s veterans are a great example of this. They couldn’t alter the government’s decision to withdraw, but felt it was a deep and personal injury to their own moral compass.
I found your comments really enlightening and I’m so glad you shared!
Thank you Kate for this thoughtful essay on moral injury. I really appreciate how you and Will are not afraid to tackle difficult topics even when your opinion differs. I love how active listening, like you described in this article between yourself and Michael, opened the door to a respectful understanding and hope!
I really appreciate Michael’s perspective of how when one experiences moral injury, it’s an indication of health rather than a disorder. Personally, I feel the same way about PTSD. I will never forget my professor in grad school (waaay back in the last century!) when PTSD had recently been added to the DSM) putting PTSO on the board and explaining that when you consider trauma, it seems more reasonable to look at the symptoms as in fact an “orderly” response to such events! It’s people who have no disturbing symptoms following trauma that indicate “disorder”. Therefore, I prefer calling it PTSI referring to it as an injury that can and does heal (with treatment of course) and therein lies the need for it to be listed in the DSM for our medical/healthcare systems like the VA to serve our warfighters who suffer from the symptoms.
Thank you again for your thoughtful and articulate articles on important but very challenging issues!
All my best to you and Will! I love you guys!
I don't think a clinical model for moral injury is inappropriate.
It's one thing to bring yourself to medical care after a lifetime of self-neglect, and it's another thing to bring a healthy body to medical care after it has undergone trauma.
I myself had a very severe trauma as a child that led to depression, anxiety, and multiple personality disorder. I have spent decades in recovery— I would not in any way characterize it as “bouncing back,” but after decades of wrestling with symptom after symptom and roadblock after roadblock, I am healthier than I have been since I was two years old.
Also, in your essay you speak about one kind of moral injury in which a person does not live up to their ideals. Does this include witnessing other people doing actions that you cannot control rather than committing deeds about which you are ashamed?
How about a multidisciplinary approach? Clinical, humanities, spiritual?
Hi Kathleen! Michael and I landed at the same place as you: moral injury deserves, and requires, and multidisciplinary approach. After all, it is an injury of the mind, body, AND soul.
And yes, moral injury can absolutely be incurred just by watching someone commit an act over which you have some engagement, but no actual control. Afghanistan’s veterans are a great example of this. They couldn’t alter the government’s decision to withdraw, but felt it was a deep and personal injury to their own moral compass.
I found your comments really enlightening and I’m so glad you shared!