Academic journal article Organisational and Social Dynamics

Beyond the Battlefield: "Moral Injury" and Moral Defence in the Psychic Life of the Soldier, the Military, and the Nation

Academic journal article Organisational and Social Dynamics

Beyond the Battlefield: "Moral Injury" and Moral Defence in the Psychic Life of the Soldier, the Military, and the Nation

Article excerpt

MORAL INJURY

The idea of "moral injury" has gained currency in clinical circles, academic literatures, and the popular press. It refers to a psychological or spiritual wound suffered by soldiers, medical officers, or others exposed to combat or disaster zones (see e.g., Currier et al., 2014; Litz et al., 2009; Nash & Litz, 2013; Shay, 2012, 2014). Several prominent researchers associated with the psychiatric treatment of soldiers and veterans now claim that although "moral injury is not officially recognized by the Defense Department [nor the DSM] . . . it is moral injury, not PTSD, that is increasingly acknowledged as the signature wound of this generation of veterans: a bruise on the soul, akin to grief or sorrow, with lasting impact on the individuals and on their families" (Wood, 2014).

Morally injurious events, or "MIEs" as they are sometimes called, have been distinguished from psychic traumas, although not always for clear reasons. The most frequent explanation for differentiating the two constructs is that moral injury, unlike the traumas that qualify for PTSD (post traumatic stress disorder) diagnoses, do not necessarily involve the survival of life-threatening events. Other differences include presentations of guilt and anger, rather than fear, and the apparent absence of nightmares or intrusive memories of the event (Currier et al., 2014, p. 2).

Operational definitions of "moral injury" are vague and varied. Most, however, rely on the notion that sufferers have done, witnessed, or in some way experienced things that "violate their own sense of who they are, their own sense of right and wrong, their own sort of moral compass" (Wood, 2014). In a widely-cited study, Litz and colleagues define moral injury as "perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations" (2009, p. 700). Currier and colleagues understand moral injury to be "the constellation of inappropriate guilt, shame, anger, self-handicapping behaviors, relational and spiritual/existential problems, and social alienation that emerges after witnessing and/or participating in warzone events that challenge one's basic sense of humanity" (2014, pp. 1-2).

The authors of the recently-developed Moral Injury Questionnaire- Military Version (MIQ-M) characterise moral injury as covering "several different types of betrayals (i.e., by peers, leadership, trusted civilians, or self), acts of disproportionate violence in the warzone, . . . incidents involving death/harm to civilians, acts of violence committed within military ranks, . . . inability to prevent death/suffering, and ethical dilemmas or moral conflicts from deployment-related decisions/actions" (Currier et al., 2014, p. 2). Common examples of moral injury therefore include "losing a loved comrade" (Wood, 2014), "handling or uncovering human remains" (Litz et al., 2009), the experience of "loss of meaning" (Currier et al., 2014, p. 3), witnessing a "poor decision made by those in charge" (Wood, 2014); and, perhaps most commonly, the act of killing another human being, particularly a child (Shay, 2012, 2014).

Former US Marine Stephen Canty, who shot and killed a middleaged man dragged into his outpost, explains how "morals start to degrade". Describing the scene, Canty recalls:

I just lit him up . . . One of the bullets bounced off his spinal cord and came out his eyeball, and he's laying there in a wheelbarrow clinging to the last seconds of his life, and he's looking up at me with one of his eyes and just pulp in the other. And I was like twenty years old at the time. I just stared down at him . . . and walked away. And I will . . . never feel anything about that. I literally just don't care whatsoever . . . You learn to kill, and you kill people, and it's like, I don't care. I've seen people get shot, I've seen little kids get shot. You see a kid and his father sitting together and he gets shot and I give a zero fuck. …

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