"The concept of *Moral Injury was introduced by Jonathan Shay. It refers to an injury to an individual's moral conscience resulting from an act of moral transgression which produces profound emotional shame.  The concept of moral injury emphasizes the psychological, cultural, and spiritual aspects of trauma.  Distinct from pathology, moral injury is a normal human response to an abnormal event. 


The concept is currently used in literature on the mental health of military veterans who have witnessed or perpetrated a morally transgressive act in combat.  (But it can also apply to a myriad of other non-combat, outside of the military related injuries such as child physical and sexual abuse, spousal/partner abuse, severe poverty and its effects on children, racial discrimination and intolerance, bullying, solitary confinement as punishment, and physical or psychological torture, to name but a few possible examples.)


Brett Litz and colleagues can be credited for major developments in the psychological perspective on moral injury. They define moral injury as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.”  Litz and colleagues focus on the cognitive, behavioral, and emotional aspects of moral injury in a preliminary conceptual model. This model posits that cognitive dissonance occurs after a perceived moral transgression resulting in stable internal global attributions of blame, followed by the experience of shame, guilt, or anxiety, causing the individual to withdraw from others.  The result is increased risk of suicide due to demoralization, self-harming, and self-handicapping behaviors.


Johnathan Shays defines moral injury as stemming from the “betrayal of ‘what’s right’ in a high-stakes situation by someone who holds power.”  The process of recovery, according to Shay, should consist of “purification” through the "communalization of trauma." Shay places special importance on communication through artistic means of expression. Moral injury can only be absolved when “the trauma survivor… is permitted and empowered to voice his or her experience….”  For this to occur, there needs to be openness on the part of civilians to hear the veterans’ experiences without prejudice. Fully coming “home” means integration into a culture where one is accepted, valued and respected, has a sense of place, purpose, and social support.


Major developments in the spiritual perspective on moral injury can be credited to Rita Nakashima Brock and Gabriella Lettini. They emphasize moral injury as “…souls in anguish, not a psychological disorder.”  This occurs when veterans struggle with a lost sense of humanity after transgressing deeply held moral beliefs.  The Soul Repair Center at Brite Divinity School is dedicated to addressing moral injury from this spiritual perspective.”


*Material was lifted verbatim from Wikipedia http://en.wikipedia.org/wiki/Moral_injury with the exception of the parenthetical italicized comment in the second paragraph. https://creativecommons.org/licenses/by-sa/3.0/

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