.svg)
What actually happens in a first session
Most people arrive at the first appointment carrying two things: whatever brought them, and the worry that they will not know how to say it. Here is the whole hour, in plain terms, so one of those can be put down before you walk in.
Navigating Moral Injury: How Therapy Can Help
Most people arrive at the first appointment carrying two things: whatever brought them, and the worry that they will not know how to say it. Here is the whole hour, in plain terms, so one of those can be put down before you walk in.
Moral injury is a term that has gained traction in recent years, particularly within the context of those who have served in the military. A moral injury refers to the psychological distress experienced when someone feels they have violated their moral beliefs or ethical standards. Going beyond the battlefield, moral injury can manifest in various contexts, including emergency response, healthcare, social work, and even everyday life. Understanding moral injury and engaging in therapy can be instrumental in the healing process.
What is Moral Injury?
Moral injury often occurs when individuals confront situations that challenge their moral compass. This could involve witnessing actions that conflict with their values, feeling powerless to prevent harm, or being compelled to act against their ethical beliefs. Unlike Post-Traumatic Stress Disorder (PTSD), which can trigger fear-based responses, moral injury is characterized by feelings of guilt, shame, and betrayal regarding a particular event. However, it is common to see much overlap between PTSD and moral injury.
The impacts of moral injury can lead to a range of symptoms, including:
- Depression
- Anxiety
- Irritability
- Isolation
- Difficulty forming or maintaining relationships
- Loss of identity
- Loss of trust in self and others
- Feelings of anger, guilt, betrayal, shame
- Negative beliefs towards self, others, or the world.
The Therapeutic Path to Healing
Therapy can play an important role in addressing the emotional and psychological challenges associated with moral injury. Here are several ways in which therapy can help:
1. Creating a Safe Space: One of the first steps in therapy is establishing a safe and supportive environment. This space allows you to express your feelings without judgment and invites open discussions about your experiences and emotions.
2. Processing Emotions & Beliefs: Various therapeutic modalities can help you explore and process the emotions tied to your moral injury. Techniques such as Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing Therapy (EMDR), and Narrative Therapy have been proven to help identify and reframe negative thoughts and beliefs that contribute to feelings of guilt and shame.
3. Strengthening Self-Compassion: Self-compassion plays a significant role in the healing process. Therapy can teach the importance of self-compassion by helping you be kinder to yourself as you navigate your moral distress.
4. Building Resilience: Therapy can help develop coping strategies that foster resilience through skill-building exercises. These might include stress management techniques, emotional regulation strategies, mindfulness practices, and ways to increase social support.
5. Addressing Systemic Issues: Sometimes, moral injury is rooted in systemic issues, such as workplace policies or societal norms. A therapist can help you understand these broader contexts and identify the impact they may have had on your experience.
Conclusion
Moral injury can be a profound source of distress, impacting individuals across various professions and life experiences. However, therapy offers a pathway toward healing and a better understanding of your experiences. Therapy can play a vital role in the recovery journey by creating a safe space for exploration, helping you process your emotions, and fostering resilience. If you or someone you know is struggling with moral injury, seeking therapeutic support can be an essential step toward healing. Through therapy, you can begin to find acceptance, compassion, and peace within yourself and your experiences.
Abby Ajvaz
Abby specializes in trauma-focused therapy, supporting individuals navigating anxiety, PTSD, complex trauma, and relationship challenges. Her collaborative, mind-body approach incorporates IFS, EMDR, mindfulness, and self-compassion to support healing, resilience, and meaningful growth. She also offers clinical supervision for social workers and social service workers, with a focus on trauma-informed and somatic practices.