The Many Tentacles of Moral Injury

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While the term moral injury (MI) was originally envisioned to address the gap between PTSD and what Vietnam veterans were experiencing after returning from the war, our understanding of the phenomenon has grown (Shay, 2014). Due to recent scholarly work in the fields of servicewomen, healthcare, social work, and many others, we now know that moral injury can appear in many domains. The precursor of MI can be a wide variety of things, such as combat, sexual assault, having to choose who lives or dies in a healthcare setting, being forced to operate in a high stakes environment without needed resources, bullying, hazing, and all forms of injustice.

Given that moral injury refers to the trauma that occurs when one’s sense of moral rightness is violated, MI’s tentacles are everywhere and there is virtually no industry where one could not put together a viable research project on moral injury and gather important data. In other words, there is no human endeavor on this planet where moral injury does not have a chance of occurring.

Moral injury can not only do damage to those who are the direct victims of trauma, but it can affect others who are simply trying to help survivors. Chaplains, social workers, psychiatrists, nurses, physicians, and first responders of all kinds can suffer the consequences of moral injury through secondary trauma.

The tentacles of moral injury can spread even further. One could make the case that whole communities, even nations can be affected by MI. Might one draw the conclusion that non-white ethnic communities in many Western nations are suffering from moral injury due to perceived racial injustices?

MI damages the body, soul and mind. It can lead to long term health effects, psychosis, and even suicide. Many survivors cannot maintain meaningful relationships with others and are prone to substance abuse and homelessness.

MI is such a complex phenomenon that there is no universally agreed upon definition and scholars are still working to define the borders of moral injury. There is years worth of work to be done. One way that Moral Injury Support Network for Servicewomen, Inc. is attacking the problem is through the 2021 Comprehensive Moral Injury Conference (CMIC).

The 2023 Comprehensive Moral Injury Conference, sponsored by Great Philosophical Problems Think Tank and taking place June 6-8 in Atlanta, will provide important information from researchers, thought leaders, and practitioners on the subject of moral injury in a wide range of domains and settings, including military and first responders, healthcare, women veterans, social justice, and chaplaincy. Presenters represent a variety of fields, including chaplaincy, psychology, medicine, community health, and others. The conference offers, workshops, and panels on assessment tools, interventions, and new research to deepen attendees’ understanding of moral injury and introduce ways of helping those suffering from moral injury.

When one begins to think deeply about moral injury and discuss it with others, it does not take long to realize that MI cuts across every discipline and is probably the source of most people’s deep pain. Because moral injury is so pervasive and the information is so important, we are offering access to the recordings, slides, and handouts from the conference. Many disciplines, including psychology, social work, chaplaincy, occupational and physical therapy, and counseling can benefit from the knowledge in the recordings.


Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182-191.

6 thoughts on “The Many Tentacles of Moral Injury

  1. My good father wanted to serve in WWII. He was rejected due to scars in his lungs from childhood tuberculosis in Texas. When I was 4 years old, I heard him sobbing to another family man was listening to what Dad witnessed. Dad’s younger brother Jimmy was blown up in a pipeline explosion. Looking at Jimmy’s burns as he was dying in the hospital was likely the cause of the moral injury many people in our family and outside our family. I was only 4 years old when my father’s sobbing and self-blame kept me awake all night. It is no exaggeration to say that moral injury destroyed the mental health of generations of my family. Now that I have found your website, I will tap into your knowledge as a form of understanding and comfort. A lifetime of extreme PTSD+C has been exhausting. The good news is that in the past 10 years I have established helpful therapeutic relationships with my mind specialists: A psychiatrist and a Jungian psychoanalyst. My spiritual leaders of multiple faiths have been lifesavers over the 35 years that I needed to release the fear an hatred of injustice. Thank you for listening.

    On Facebook as,
    Ripley Wolf

    1. Thank you for taking the time to tell your story. Moral injury and the wars that cause it are devastating. I am glad that you have been able to get the help you need. Praise the Lord! Let us know if we can support you further.

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