Moral Injury beyond the battlefield
Why Moral Injury is impacting our service members away from the front lines and why the DoD is so slow to address it.
It took me more than a year to connect the dots of my mental health therapy and the phenomenon of moral injury. The term Moral Injury (MI) was one I was not familiar with until one of my Foundation’s advisors, after having read On Deaf Ears, sent me a link to Syracuse’s Moral Injury Project website. On the site, MI is defined as:
“the damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct.”-Moral Injury Project
The Department of Veterans Affairs (VA) published an article on their website on Moral Injury. In it, they describe some of the main causes of MI, typically occurring when “people may perpetrate, fail to prevent, or witness events that contradict deeply held moral beliefs and expectations. Individuals may also experience betrayal from leadership, others in positions of power or peers that can result in adverse outcomes.”
“Moral injury is the distressing psychological, behavioral, social, and sometimes spiritual aftermath of exposure to such events. A moral injury can occur in response to acting or witnessing behaviors that go against an individual’s values and moral beliefs. In order for moral injury to occur, the individual must feel like a transgression occurred and that they or someone else crossed a line with respect to their moral beliefs. Guilt, shame, disgust and anger are some of the hallmark reactions of moral injury, as is the impact to one’s spiritual beliefs.”– Department of Veterans Affairs
I would go beyond that to say how it also impacts how one approaches others and relationships, fundamentally shifting that as well.
Most of the VA article relates moral injury to events from the battlefield. In this respect, I believe they are overlooking a more pervasive yet insidious source of MI: injury which results from workplace abuse. Re-reading the VA excerpt, there is one important sentence that jumps out at me: “…individuals may also experience betrayal from leadership…”. Unfortunately, the VA, in making the link between MI and PTSD, mostly omits another likely cause of MI in the military: workplace abuse. I find that to be somewhat disappointing since MI is an adversary that will always be present – in wartime as well as peace, on the battlefield as well as back at home base. The missing link in the article is reflective of the DoD’s weak grasp on the psychological and emotional toll that their failing or failed avenues of recourse (IG, EO, chain of command) are having on the wellness of the force. Likewise, members of the military, I submit, are suffering from MI at much higher rates than detected primarily because they don’t know what it is they are suffering from. Much like in my personal reprisal case, I knew I was angry, frustrated, and felt betrayed, but I couldn’t quite ascertain what the root psychological injury was until my mental health care journey was complete.
In just over a year since I established my Foundation, I would estimate I’ve engaged in some form of advisement capacity with approximately 300 service members. Anecdotally, I submit that the majority suffered, or are suffering, from the effects of moral injury; many due to the fact that they, as the VA cited, experienced “betrayal from leadership.” Many of these service members are suffering from MI because they retained firmly-held beliefs about our military, its leadership, and the notion that members of the military would be protected from things such as retaliation and reprisal. They also believed that if they did suffer those abuses, justice would be served. Sadly, with every person I advise, several, if not all of these beliefs have been shaken, if not shattered. It’s difficult to convey in words what MI is and what it feels like. It’s difficult to convey constantly feeling frustrated, even angry, questioning everyone and everything and trusting no one and nothing. It is a fundamental shift – in how you think, how you feel, how you approach others and how you approach life. In the article cited above recounting my year in therapy, I was quoted as saying “I began to not recognizing the person I was becoming.” And that’s exactly how I felt.
“Just the work of some disgruntled attachés”
I submit that there are a few reasons why MI outside the war zone is not as widely accepted and treated as the battlefield-related flavor. The first has to do with the quote above, which several witnesses attributed to the Director of the Defense Attaché Service the day after his inept management of the division was highlighted in the national press. In response to that Wall Street Journal article, he attempted to counter the damning narrative by writing it off as a collusion of a few former attachés (yours truly included, obviously). But this futile attempt to explain away years of abuses also highlighted what many victims suffering MI from the workplace go through: ostracism, retaliation, and slander. I assume this is due to the fact that our military culture sees certain things as tough/sexy/brave/patriotic like getting shot at, and shooting back; and other things like whistleblowing as something for whiners. Thusly, the victim of MI is treated differently in the military depending on the type of the event that caused it. This is unfortunately another symptom of the seething hypocrisy in the DoD at-large regarding whistleblowing where instead of being recognized and protected, they are retaliated against. But the problem goes deeper because those victims suffer the same traumas after-the-fact as their battlefield counterparts. I have several advisees who are in psychiatric care, have had suicidal ideations, attempted suicide…some multiple times. And those wounds are not from the battlefield, rather from the proverbial cubicle farm.
Another factor which plays a role, I submit, is the insidious nature of MI. When I look at IG cases, for example, that plod along for literally years, many overlook the human toll that takes on the complainant, or subject. Day after day, week after week, month after month, these people are left in limbo, no justice and, perhaps more importantly, no closure and no ability to move on. This results in a veritable psychological Chinese water torture effect – drip by drip, their mental health erodes away, no one usually taking notice until its perhaps too late. I recently read an article in the Navy Times about the USS George Washington suicides in April 2022. The report concluded that sailors were reluctant to come to their leadership to discuss mental health issues. This made me wonder what else they were not comfortable discussing with their leadership; if they felt they couldn’t go to another avenue like the chain or IG or EO with issues such as their living and working conditions. I pose this question not to speculate about the events surrounding the Washington, but to draw a parallel to mine and others’ cases which beg the question: if we had healthy and functioning avenues of redress free from corruption, would that not also have mental health benefits for the military? I say the answer is an unequivocal yes. I also say the DoD has not made that mental leap. It needs to.