Releasing the Burden of Moral Injury
An interview with Dr. Brandon Griffin on moral pain and resilience.
Posted April 23, 2019 | Reviewed by Abigail Fagan
Today we continue in the series of interviews with experts on how resilience —one of the major themes of my book, A Walking Disaster: What Surviving Katrina and Cancer Taught Me About Faith and Resilience —connects to their area of study.
This interview is on the subject of moral injury and resilience with Brandon J. Griffin, Ph.D., who is a Research Health Science Specialist at the San Francisco Veterans Affairs Health Care System and affiliate of the University of California, San Francisco. Dr. Griffin’s current work aims to promote resilience in combat veterans who were exposed to military-related traumatic events.
JA: How do you personally define moral injury?
BG: Scholars only recently began to scientifically study moral injury, and they have not yet agreed on a consensus definition. I think about moral injury as persistent and pervasive moral pain—in other words, transgression-related psychological and emotional conflicts (and, in some cases, relationship and religious/ spiritual problems) that occur over extended periods of time and interfere with multiple areas of a person’s life such as marriage , parenting , friendships, work or school, leisure and recreation, and self-care.
Moral pain may be attributed to an event or series of events that a person views as a gross transgression of his or her moral beliefs and values, such as when we violate our own values by what we did or failed to do as well as when we witness or are harmed by another person’s wrongful actions. Although not everyone who experiences moral pain develops a moral injury, the burden can be immense for those who do.
JA: How did you first get interested in studying moral injury?
BG: As a clinical and research psychologist who works with military service members and veterans, my patients sometimes describe experiences in which they faced challenging moral dilemmas while they were deployed. The right thing to do is not clear in many cases, and there is often little time or information to make important decisions. For example, a veteran could have done everything right, such as following orders and adhering to the rules of engagement, but still feel as if he or she did something wrong if a fellow service member or innocent civilian was harmed.
In situations like these, people may think what they have done is unforgivable or that they could never forgive what someone else did to them. As a clinician and researcher with a background in trauma and forgiveness , working with American military service members and veterans who present with these kinds of concerns is a privilege.
JA: Who is most at risk for experiencing moral injury?
BG: Moral pain occurs all the time when we are exposed to things that violate our beliefs and values. This could include feelings like guilt and shame linked to our own wrongdoings and failures, or feelings like anger and disgust that we feel in response to others’ wrongful actions. The best-case scenario is that moral pain motivates repatriation and then resolves, such as when we give or receive an apology after minor wrongdoings.
In some cases, however, people who are exposed to more severe transgressions or who believe that reparation is impossible may experience a more lasting and pervasive moral pain that characterizes a moral injury. Such moral injuries are associated with an array of problems, including condemning thoughts and emotions, destructive behaviors like substance use and self-harm , social isolation , and in some cases religious/spiritual struggles like feeling abandoned by God or without purpose in life.
JA: What is the connection between moral injury and resilience?
BG: What’s more inevitable than dealing with our own and others’ wrongdoings and failures? It’s part of being human. Resilience shows up in a lot of different ways after a transgressive event occurs. Having empathy toward others whose wrongful actions may have negatively affected us and empathy toward ourselves to appreciate that we have value despite our limitations can contribute to resilience.
Also, humility to ask for help when we need it, and openness to new and creative ways to facilitate moral repair by spending our time reinforcing our connections to the things that are important to us.
JA: What are some ways people might work through struggles associated with moral injury?
BG: I believe forgiving ourselves and others is a critical step toward recovery from moral injury. This does not mean condoning or excusing a transgression. Forgiveness entails that we make a decision to acknowledge our own or others’ responsibility for what happened coupled with an emotional release of the burden that is condemnation toward ourselves or others. It also doesn’t require that repair with others who were involved in a transgression is always possible, prudent, or safe. Sometimes we forgive “in our own skin” without reconciling a ruptured relationship.
Sharing your experience with a trusted and benevolent family member, friend, religious/spiritual director, or mental healthcare professional can be a first step to validate your feelings as well as see things from a more forgiving perspective.
JA: Any advice for how we might support a friend or loved struggling with moral injury?
BG: Moral beliefs and values are almost always imbued with social or religious/spiritual significance. You might have internalized standards of right and wrong from close others (e.g., family members, friends, religious/spiritual organizations), and it is consequently easy to feel like you might be rejected by other people for the very thing you already condemn yourself for. Also, when we witness or are harmed by others’ wrongful actions, it can feel like putting ourselves at risk for another betrayal by being open with other people again.
When a friend or loved one struggling with a moral injury chooses to share about their experience, acknowledge how difficult it can be to disclose that experience, listen with compassion, and ask them how you can aid their process of recovery and repair.
JA: What are you working on these days related to moral injury?
BG: Although clinicians and scholars have repeatedly acknowledged the relevance of forgiving ourselves and others to moral injury, studies about forgiveness and moral injury have proliferated mostly independent of one another. For this reason, I am working on a series of studies to support a model of moral injury that identifies specific moral beliefs and values violated by transgressive events, conceptualizes forgiveness as a way to meaningfully interpret moral pain and release condemning emotions toward ourselves and others, and explores important health outcomes related to forgiveness such as lower cardiovascular and suicide risk.
Note: The opinions expressed in this article are Dr. Griffin’s and do not necessarily reflect the official positions of the United States Government, academic affiliates, or funding partners with whom Dr. Griffin collaborates.
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Jamie Aten , Ph.D. , is the founder and executive director of the Humanitarian Disaster Institute at Wheaton College.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.