When addressing moral injury, there is a need to help patients learn to compartmentalize their experiences. But it doesn’t stop there. Patients then need to be able to step back and see all the pieces of themselves in order to move forward.
Post-Traumatic Stress Disorder (PTSD) among Service members and Veterans receives a lot of well-deserved attention. That said, it was not until 1992, that the term Moral Injury was coined by Dr. Jonathan Shay to describe the devastating impacts of an event or experience that violates one’s personal ideals, ethics, moral expectations, conscience, or attachments. Since moral expectations are at the core of who we are as humans, moral injury describes a fracture to one’s deepest sense of being. The result of this moral violation can lead to guilt, existential crisis, and loss of trust (Jinkerson, 2016).
The weekly Research Update contains the latest news, journal articles, useful links from around the web. As part of PTSD Awareness month, we've got a handful of specific PTSD-related topics and more! Some of this week's topics include:
● Causes of Excess Mortality in Veterans Treated for Posttraumatic Stress Disorder.
● Examining the relation between PTSD and insomnia on aggression.
● The Impact of Negative Attributions on the Link Between Observed Partner Social Support and Posttraumatic Stress Disorder Symptom Severity.
● “You’re Missing Out on Something Great”: Patient and Provider Perspectives on Increasing the Use of Cognitive Behavioral Therapy for Insomnia.
During my recent research on Post-Traumatic Stress Disorder (PTSD) treatments, I have been spending more time reading about moral injury and reflecting on therapeutic practices that incorporate tools such as forgiveness and spirituality into the healing process. I have worked with clients of different faith backgrounds and different spiritual practices. I am careful to ask questions in order to assess what this means to the individual, as I know my own faith expression and experience may be very different from their own. I have worked with clients who are Buddhist, Islamic, Jewish, Wiccan and all have taught me a great deal and we have worked well together. If a client tells me their faith is important to them and wishes we integrate it into treatment, we work on this.
Let’s take a look at a specific model of CBT to treat anger. The premise of this treatment model is that anger develops from unmet expectations. Norman Cotterell, Ph.D., Clinical Coordinator, Beck Institute, puts it this way: “We expect people to treat us fairly and they don’t. We expect children to respect the wishes of their elders and they don’t. We expect the government to have our needs at heart and it doesn’t. Each time there is a gap between expectation and reality, anger is more than willing to fill in that gap. We may decline. We may accept. But it’s important to know that it’s a choice we are making” *. Perceived loss of control for getting important values met causes anger.