War’s invisible injury:
From PTSD to moral injury

moral injury by andy warner

Illustration by Andy Warner | Symbolia

There’s something that happens to a lot of people who fight in wars that is as old as war itself. But we’re still just beginning to understand it.

Researchers working with the Marine Corps, the Navy and the Department of Veterans Affairs are exploring this thing — call it a condition, maybe — they’re calling it “moral injury.”  It’s the thing that lingers for many veterans who were a part of something awful: specifically, something that they feel violated their own moral or ethical codes.

Moral injury can happen when “there is a betrayal of what’s right by someone who holds legitimate authority in a high-stakes situation,” says psychiatrist Jonathan Shay, one of the pioneers studying the condition. It’s not as clear-cut as a diagnosis of post-traumatic stress disorder (which any doctor would tell you is far from clean-cut itself). It’s less about being the receiver of an attack as it is about being the cause of something that conflicts with what one believes is right.

The Public Insight Network is working with Boston’s WBUR logo  and symbolia-wordmark_WEB magazine to report on how veterans experience moral injury, and what leaders in the field are beginning to understand about it.


 

 

Symbolia: Moral Injury

PART 1 [published June 21, 2013]

Invisible injury: Beyond PTSD (illustrated story)
Moral Injury: It’s the thing that lingers for many veterans who were a part of something awful in the midst of war, something that they feel violated their own moral or ethical codes.

Symbolia WBUR

 

 

PART 2 [published June 24, 2013]

One Marine’s struggle to define his injury
There’s growing interest in studying moral injury — the wounds to a veteran’s soul from events that “transgress deeply held moral beliefs and expectations.” The concept has helped Tyler Boudreau better understand what years of PTSD treatment have never fully addressed.

 

 

Symbolia: Moral InjuryPART 3 [published June 25, 2013]

“Moral injury” still controversial
One betrays his or her sense of what’s right, under orders, in a high-stakes situation. By the mid-1990s, psychologist Jonathan Shay called the condition that results “moral injury.” The idea is gaining traction among researchers, veterans and the military — but not everyone is embracing the idea.

 

 

Tom's story

PART 4 [published June 26, 2013]

“Tom’s story: A crisis of compassion in the chaos of war
During his second deployment to Iraq with the U.S. Army, ‘Tom’ found himself losing his sense of compassion amid the chaos of war. As hard as he tried, he had trouble holding on to his moral compass. And then: Reality hit, in the form of a local Iraqi resident’s dog.

 

 


‘Moral injury’ gaining traction, but still controversial

One betrays his or her sense of what’s right, under orders, in a high-stakes situation. By the mid-1990s, psychologist Jonathan Shay called the condition that results “moral injury.” The idea is gaining traction among researchers, veterans and the military — but not everyone is embracing the idea.

Read more →

Beyond PTSD to “moral injury”

For service members returning home from combat, PTSD diagnoses are commonplace and extensive. But one VA psychologist argues that the complications of PTSD compound to create a 'moral injury' -- one that requires a community, not a clinic, in order to heal.

Read more →