tom associated with moral injury (Kutz, 2019). Given
the many challenges involved in successfully treating
military-related PTSD, clinicians are often so focused
on PTSD symptoms and comorbid disorders (mood
disorders, substance abuse, risk of suicide, etc.) that
they fail to recognize underlying moral injuries that
may be driving these disorders. Failure to recognize
and address moral injury may impair successful treatment
of PTSD, at least partly explaining why PTSD
outcomes are so poor.
Moral injury must be acknowledged in the same way
that we acknowledge the physical and mental costs of
traumas experienced in war and other places of danger.
Trauma that causes PTSD will most likely cause moral
injury, too. This does not mean treating PTSD will
“treat” moral injury, nor vice versa. With something as
complicated as moral injury, vigorous research is now
taking place as clinicians and researchers
are developing tools that
can be used to test the efficacy of
the treatment interventions that are
currently being studied to address
moral injury (Pearce et al, 2019).
At some point, the precipitating
incident(s) must be shared
and looked at reflectively. Therapists
and clergy are often at the
front lines, however, the larger
community can also take part.
Consider that moral injury affects
and is affected by the moral
codes across a community, healing
is based on setting oneself
right with their moral conviction and the community.
It is asked that the community become aware and
listen deeply with an open heart and without judgment.
Such sharing and listening to moral injury
outside the confines of a clinical setting can be a
way to break the silence that so often surrounds this
unrecognized invisible wound.
In my work with post 9/11 veterans throughout the
state as well as with those within the Beaufort/Bluffton
area, I see many who are struggling with Moral Injury.
It is through finding peace with their past, reconnecting
with their faith and being willing to connect with
others in the community that allow for healing and
purpose to take place. This in turn allows the veteran
to begin to thrive rather than just survive in their
Article courtesy of
Kim Bradley, RN, BSN
Semper Fi Fund Nurse
& Co-Founder of