MORAL INJURY - Introduction

INTRODUCTION

As an ordained Presbyterian minister I qualified to become an Army Chaplain in early 2008. At that time I began work as a Reservist (part time) and started working fulltime in early 2013. Immediately I began rubbing shoulders with individuals suffering from ‘problems’, some of which are now being labelled as Moral Injury. I got to interact with doctors, Mental Health nurses and various psychologists. What could a Presbyterian Minister such as myself have to say about mental health issues? Says Sarah Gibson,

Moral injury is not just a ‘mental health’ issue because it relates to much more than the mind. Moral injury is also a state of the heart and a condition of the spirit. As a chaplain I know something about these things and believe my chaplain colleagues have something worthwhile to contribute as we discharge our overarching duty of care.[1]   

Moral Injury pertains to having ones view of the world violated resulting in an adverse effect of feeling guilt and shame. A worldview is that aspect of our humanity that focuses on things in the world that are (in our own personal opinion) right or wrong, and true or false. Thus morals relate to who we are as a person. Therefore morals are the personal apparatus which we use as individuals to determine, judge or deem what measures up or fails to measure up to our own set of moral standards.

Moral standards vary from individual to individual. In other words some individuals have a high moral standard and some have a low moral standard. But who gets to judge whether a moral standard is high or low? Upon what does one base ones morals? The tendency might be to posit “Common Sense” as the answer. However, this approach is to take too much for granted.

Morals are rules. They are a set of laws by which we police the world in which we live. They govern our interactions with others and our behaviour towards them and they determine how we perceive the interactions between others, whether as individuals or in groups.

Moral Injury occurs when as individuals we go against our own set of moral values and cause harm. It is important to note that this harm may or may not involve other parties (whether human, animal, objects or anything else). The bottom line is that Moral Injury is an injury to self! And, because morals vary from individual to individual it would be wrong to say that morals are simply the application of “Common Sense” to life issues. Says Tom Frame,

The term moral injury gained currency from the late 2000s among researchers in the United States who believed that something distinct, and perhaps new, was adversely affecting American service personnel returning from combat operations… Sufferers of moral injury struggle to discern good and bad, right and wrong in personal morality and social conventions after being somewhere when the norms of civilised society were collapsing, or after engaging with a people displaying little or no regard for basic human rights and entitlements… The health of a person’s soul and state of their moral being are not the privileged possessions of behavioural scientists.[2]

Moral Injury is self-inflicted! It is caused when you as an individual do not measure up to or have violated your own code of ethics and your conscience accuses you with regular reminders (usually in the wee small hours of the night) resulting in you experiencing feelings of guilt and shame.

       Guilt is one of the most powerfully paralysing forces to the human spirit.[3]

Human beings demonstrably are moral agents. But where do our morals come from? From our parents? Our community? Thin air? If morals are really just applied “Common Sense” then why, no matter how low they are, do none of us ever live up to our own moral standards? And why then do we judge the conduct of others to be wanting at times?

In the following we shall argue that morals are spiritual. By spiritual we mean that morals reside in the innermost being of humans, i.e., the conscience so-called, and as such, morals are invisible to the naked eye. The individual’s conscience is injured when the conscience refuses to excuse his/her thoughts and/or words and/or deeds.

Our actions (whether thought/word/deed) have consequences, moral consequences, i.e., spiritual consequences. Thus Moral Injury is a spiritual problem.

Sarah Gibson underlines the need for theological input into the Moral Injury question,

I can readily understand why a healthcare professional can look at a religious practitioner or spiritual counsellor and wonder who they are encountering and what the patient or client might be getting from them. But I also note that healthcare professionals are not generally educated in the nuances of existential thought, they are not trained to deal with spiritual questions and moral dilemmas. They will have their own opinions, of course. But they have not been required to immerse themselves in the history of ideas, to become familiar with philosophy’s response to enduring questions of identity and destiny, to recognise and respond to the heart’s yearnings for point and purpose in life. These are existential matters in which healthcare professionals cannot generally claim any expertise.[4]

Theology[5] is the study of God as He has revealed Himself in His creation and in His written Word. The Bible teaches us about God, His creation and ourselves as human beings. It teaches us about what is wrong with us and what God has done, is doing and will do about our problem. Therefore, Moral Injury: Toward a Theology will help us to understand why Moral Injury exists and how it can be cured in terms of the Bible.

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[1] Sarah Gibson, Moral Injury: Unseen Wounds in an Age of Barbarism, (Edited by Tom Frame), University of New South Wales Press Ltd, p. 234, 2015

[2] Tom Frame, Moral Injury: Unseen Wounds in an Age of Barbarism, (Edited by Tom Frame), University of New South Wales Press Ltd, p. 2, 2015.

[3] RC Sproul

[4] Sarah Gibson, Moral Injury: Unseen Wounds in an Age of Barbarism, (Edited by Tom Frame), University of New South Wales Press Ltd, p. 230, 2015

[5] The author writes from a Biblically Reformed theological perspective commonly known as “Covenant Theology.”