Moral Injury and Life Balance

Moral injury is a relatively new term many people still find hard to understand. Moral injury is a type of psychological injury that often accompanies PTSD and other more understood psychological injuries sustained from workplace violence based trauma, violence and the threat of death. Moral injury is a psychological wound sustained at the core of a person’s deeply held values and ethics. Moral injury strikes at the heart of the persons' moral compass, beliefs and sense of right and wrong. Understanding the relationship between traditional, trauma based psychological injury (fear of harm/ death based) and moral injury (shame, transgression and moral disorientation) can help those affected by moral injury- and those that love them - find better support.

Loss of Life Balance and personal functionality can be caused by Moral Injury

What Is Moral Injury?

Moral injury occurs in situations where people recognize they have betrayed their own personally held code of values and ethical standards and/ or have witnessed others violating these same beliefs. Unlike post-traumatic stress disorder (PTSD), which is linked to fear and survival, moral injury centers on the damage to one’s conscience from moral transgressions where the person failed to act to stop (or prevent) the morally wrong incident, observed others in transgression and/ or was a victim of the moral transgression itself. When someone experiences, ignores or participates in actions that break their deeply held moral beliefs, it can often lead to intense feelings of self condemnation. Personnel whom have been forced to make impossible choices within their service delivery during a work environment crisis might develop a moral injury. Persons whom have been the subject of moral transgressions inherent to workplace violence (including systemic betrayals) often develop moral injury as they lose trust and are stigmatized by censure by the systemic community when they reach out to for help. The persons' Life Balance and self care bears the marks of imbalance when a moral injury has been sustained.

Harvard University has recently announced that it's work in the area of moral injury and the subsequent 2025 APA acknowledgement of moral injury under it's own code within the DSM. https://hsph.harvard.edu/news/moral-injury-officially-recognized-as-mental-health-condition/

Workplace Violence based Moral Injury

Moral injury can arise in many different settings and can be sustained in any workplace community. Moral injury is a conscience wound in the sufferer.

Some common workplace examples include:

• Military service: Actions during war that conflict with personal ethics.

• Healthcare decisions: Making life-and-death choices under resourced.

• Law enforcement: Observing or participating in inherent workplace violence

• Workplace Conflict: Pressured or coerced to act against one’s values and established patterns of integrity

• Workplace Violence: Observing or participating in workplace violence incidents

• Interpersonal relationships: Betrayal or harm caused to those meant to be protected from harm.

Each of these situations (the list is not exhaustive) can create a morally based psychological injury when a person feels they have violated their own moral code and/ or when the systemically held conduct of right vs. wrong is transgressed.

Signs and Symptoms of Moral Injury

People experiencing moral injury often struggle with emotions and thoughts that differ from typical trauma responses. Some signs include:

• Impairment to function and relationships at work and in other life areas,

• Feelings of betrayal of self and others

• Loss of faith, spiritual and existential crisis

• Loss of trust in people or institutions

• Difficulty forgiving others and/ or oneself

• Self condemnation, persistent regret, remorse, guilt or shame over actions or inactions

• Moral distress, loss of purpose or meaning in life

• Disillusionment, resentfulness, retribution and anger

• Difficulty in reconciliation with others effected by the transgression incident.

  
  

These symptoms can affect daily life, relationships, and overall well-being. Moral injury may not respond well to treatments focused solely on PTSD based therapies.

Moral injury can lead to serious mental health challenges. Research shows it often coexists with PTSD and psychological injury. The difference is that moral injury’s root lies in ethical conflict and the shame created by the transgression against the person's deeply held values about good vs evil. A moral injury can prevent sufferers from seeking help or sharing their experiences due to the depth of the transgression itself and the stigma that will follow their acknowledgement.

Moral injury erodes a person’s sense of identity and purpose and requires more than traditional trauma therapy to overcome. Due to the soul damage that is inherent to moral injury, treatments based in belief, faith and spirituality as well as those secular treatments geared towards forgiveness and reconciliation are necessary for healing.

Faith based groups can assist and many are already in place to help in person and online.

Example Craig Groeschel,   Here is the link: https://www.youtube.com/watch?v=IVCLj-F9X7c&t=669s

Next Steps

The Workplace Community can assist their workers through the development and promotion of Psychological Health and Safety policy and practice alongside their existing Occupational Health and Safety plans. Through the development of psychological health and safety policy and practices, education, training and learning about moral injury, the workplace community can champion awareness and prevention of workplace violence, promote appropriate performance expectations, and reduce incidents that result in moral injury.

Achieving a functional life balance is essential for personal, relationship and professional growth and is a protective factor in maintaining positive psychological health. Supporting your workplace community employees to develop individualized Life Balance plans can be a part of psychological health and safety initiatives and an additional benefit offered by your workplace. In addition, a QC L4L Life Balance plan can function as an important gage in understanding and achieving workplace performance and expectations. Prevention of psychological injury is possible.

Championing a safe and healthy workplace environment through policy and supported practice is achievable!

Start by taking the first step and ask about Psychological Health and Safety in the Workplace at QuintessenceConsultation@gmail.com

Quintessence Consultation provides Free (Social Impact) L4L Life Balance planning support for those affected by workplace violence and living with Moral Injury.