Moral Injury

Moral injury is a deep psychological, emotional, and spiritual wound that occurs when someone is exposed to or participates situations that violate their deeply held moral values or sense of what is right.

Unlike PTSD, which is primarily rooted in fear and threat, moral injury is rooted in values, conscience, and meaning.

A simple way to understand it

Moral injury happens when a person thinks, “This should never have happened,” or “This goes against who I am.”

It often involves:

  • Doing something that conflicts with one’s values

  • Witnessing harm and being unable to prevent it

  • Being betrayed by leaders, systems, or institutions that were trusted

Common experiences of moral injury

People experiencing moral injury may struggle with:

  • Persistent guilt or shame

  • Anger, bitterness, or moral outrage

  • A sense of loss of integrity or identity

  • Feeling disconnected from others, purpose, or meaning

  • Harsh self-judgment or self-blame

  • Spiritual or existential distress (“Who am I now?”)

These feelings can linger even when someone knows intellectually that they “did the best they could.”

Who is most affected

Moral injury is especially common among:

  • Healthcare workers forced to make impossible choices

  • First responders exposed to preventable suffering

  • Military veterans

  • Humanitarian workers

  • Anyone working within systems that create ethical dilemmas under pressure

Moral injury speaks to the human cost of caring in broken systems.

Moral injury vs. PTSD

While they often overlap, they are not the same:

  • PTSD: “I wasn’t safe.”

  • Moral Injury: “What happened violated my values.”

Someone can have moral injury without PTSD, PTSD without moral injury, or both.

Healing moral injury

Healing often involves:

  • Being witnessed without judgment

  • Making meaning of what happened

  • Reconnecting with values, compassion, and humanity

  • Repairing a relationship with oneself

  • Restoring a sense of integrity and belonging

  • Forgiving yourself and learning to live with what happened

Therapeutic approaches like EMDR, IFS, ketamine assisted EMDR, somatic therapies, and meaning-centered or spiritually integrated work can be especially supportive and healing.

A final note

Moral injury is not a personal failure. It is often a sign of deep care, conscience, and humanity in situations that asked too much of a person.

You’ve carried enough alone. I would consider it an honor to partner with you as you work toward regaining your joy, increasing your health, and finding more peace.  Please use the contact form below to reach out.