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(preprint available)
Moral Injury
Abstract
Moral injury is a specific kind of trauma caused by violations of deeply internalised moral values. It has been particularly studied in the United States from the ’90s of the last century among Vietnam veterans, but it may appear in a variety of contexts, from healthcare to educational and organisational ones. In the latest text revision of the DSM-5 it is not recognised as a distinct disorder; however, it should be distinguished from the classic post-traumatic stress disorder (PTSD), as a careful analysis of its nosology and aetiology reveals different characteristics. Although PTSD and moral injury can coexist, the specific symptoms of the latter do not focus on terror linked to violence and death, but on emotions and moral cognitions, such as shame, anguish, attributions of guilt, and loss of existential meaning, which are associated with dysfunctional internalising and externalising behaviours, according to the cases. Such a collapse of the integrity of the individual’s moral identity cannot be addressed through the traditional tools used in the treatment of PTSD, which focus on the extinction of fear and avoidance reactions, and the habituation to memories related to traumatic events through physiological relaxation. Rather, moral injury can be soothed thanks to a reconstruction of meaning that reinstates the moral character of the person and restores a solid link between I and Self, leveraging recovery of trust in others, conscious self-observation, compassionate acceptance, forgiveness and reconciliation, and development of a renewed life project. Psychosynthesis is well suited to provide tools aimed at this kind of transformation, in that it promotes a syncretic approach to the bio-psycho-spiritual dimensions of the human being. Offering wide recognition of ethical and transpersonal instances, Psychosynthesis promises the possibility of rejoining the components of the personality fragmented by the moral injury, facilitating motion toward a possible and personalised “ideal model” capable of integrating the moral values that support the fullest actualisation of the individual’s authentic Self.






