Moral injury: Exploring the consequences of a wounded conscience

A Vietnam veteran was once asked about his struggle to make eye contact with others since returning from war.

“I can’t look anyone in the eye for fear that they will see the stain on my soul for what I’ve done in Vietnam,” he replied.

This powerful statement summarizes the experience of many veterans and military members. And, in large part, it summarizes what it means to suffer a moral injury.

A moral injury occurs when a person has to witness, fails to prevent, or engages in an event that violates their personal moral beliefs. For example, military members may encounter situations or be forced to make choices that conflict with their own ethical standards.

Exposure to morally injurious situations has been linked to adverse outcomes, including post-traumatic stress disorder (PTSD). The concept of moral injury in relation to PTSD has emerged in the past decade and has been identified as a vital area of study for mental health researchers – particularly those working with military members and veterans.

Currently we have a very limited understanding of how the brain and body respond to moral injury, but one HRI Scientist is looking for answers.

Finding answers through innovative research

“We can only understand how to treat moral injury if we understand the mechanisms underlying it,” says Ruth Lanius, MD, PhD and HRI Associate Clinical Scientist.

Dr. Lanius is Professor of Psychiatry, Director of the PTSD Research Unit and the Harris-Woodman Chair in Mind-Body Medicine at the Schulich School of Medicine and Dentistry at Western University. Her research interests focus on the neurobiology of PTSD and the development of new treatments.

In collaboration with colleagues Chantelle Lloyd, Charlene O’Connor and Dr. Margaret McKinnon, Dr. Lanius is leading groundbreaking research that uses neuroimaging to explore how the brain processes morally injurious events.

“PTSD is often thought to be the primary mental health concern for individuals returning from war,” says Dr. Lanius.

“But moral injury is an emerging and highly important consideration. Moral injury brings profound shame, anguish and guilt that can severely disrupt quality of life and daily function. We need to better understand how moral injury develops and how our bodies process moral injury in order to help people recover successfully.”

Still in its early stages, Dr. Lanius’s research aims to do just that: gain insight into the wounded conscience and learn how to treat those wounds.

To learn more as Dr. Lanius’s research develops, subscribe to HRI Connects or follow HRI on Twitter, Facebook and LinkedIn.

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