Latest / Love, Happiness and Success with Dr. Lisa Marie Bobby / Moral Injury: How to Stop Punishing Yourself for the Past | Happiness | E549

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Moral Injury: How to Stop Punishing Yourself for the Past | Happiness | E549 · Love, Happiness and Success with Dr. Lisa Marie Bobby

0:00
Speaker 1: If you are feeling haunted by a regrettable incident that
0:05
Speaker 1: happened in the past, maybe you did something, maybe you
0:09
Speaker 1: didn't do something, Maybe you participated in something that now
0:13
Speaker 1: you deeply, deeply regret. It can be really hard to
0:19
Speaker 1: not to shake that off but actually heal from it.
0:34
Speaker 2: Maybe they bullied somebody as a kid, and then they
0:38
Speaker 2: see later that person's alive, but maybe they wonder how
0:42
Speaker 2: much that affected the person or how they got through it.
0:45
Speaker 2: It could be an affair or a way that you
0:49
Speaker 2: betrayed your partner, or you weren't honest with somebody you love.
0:53
Speaker 2: So it doesn't have to be this life threat or
0:55
Speaker 2: threat to body integrity.
1:02
Speaker 1: We're talking about a moral injury. That's, believe it or not,
1:07
Speaker 1: a very specific and often one of the deepest types
1:11
Speaker 1: of psychological trauma. And this is a dark topic, but
1:16
Speaker 1: I really wanted to talk about this today on the Love, Happiness,
1:19
Speaker 1: and Success podcast because it's not uncommon and there are
1:24
Speaker 1: so many of us walking around carrying these kinds of
1:27
Speaker 1: wounds that often go unrecognized with others and sometimes even ourselves.
1:33
Speaker 2: A lot of times it does have to do with
1:34
Speaker 2: how we respond maybe in that fight or flight mode
1:38
Speaker 2: that didn't line up with how we would respond if
1:40
Speaker 2: we had time to think about it. That can be
1:42
Speaker 2: a morally injurious event.
1:44
Speaker 1: And so today we're going there with a very special guest,
1:49
Speaker 1: my friend and colleague, doctor Jamie Lusk. Doctor Lusk is
1:52
Speaker 1: a psychologist. She's also a Marine Corps veteran and one
1:56
Speaker 1: of the country's leading experts.
1:58
Speaker 2: On moral injury, military first responders, and healthcare. They did
2:03
Speaker 2: a screening with moral injury, and those who screened for
2:05
Speaker 2: moral injury were six times more likely to attempt suicide
2:09
Speaker 2: in a lifetime after controlling for all the other variables.
2:12
Speaker 1: She spent over fifteen years in the VA system doing
2:15
Speaker 1: some of the hardest and most important healing work there is,
2:19
Speaker 1: and she has a gift for making it relatable, making
2:24
Speaker 1: it bearable, and making it better.
2:27
Speaker 2: Moral injury is not a diagnosis, and somebody could be
2:31
Speaker 2: out there in the world struggling and maybe not get
2:35
Speaker 2: care covered because it's not actually a diagnosable condition.
2:44
Speaker 1: So Jamie, I'm so happy to connect with you today.
2:47
Speaker 1: I've been looking forward to this me too.
2:50
Speaker 2: Doctor Lisa is my mentor in learning how to be
2:54
Speaker 2: a coach, so I'm a board certified coach thanks to her,
2:58
Speaker 2: and that's been able to help me span my reage.
3:01
Speaker 3: Justice and aside.
3:03
Speaker 1: I thought that moral injury now was a DSM diagnosis.
3:06
Speaker 1: I thought I saw something that had been factored into
3:10
Speaker 1: the treatable codes.
3:12
Speaker 2: No, it is a Z code. They added moral to
3:16
Speaker 2: the spiritual and religious problems. So now it's religious moral,
3:21
Speaker 2: religious and spiritual problems. So we have a way to
3:24
Speaker 2: code it as a problem as a Z code starting
3:27
Speaker 2: September twenty two, thousand and twenty five. But no, not
3:31
Speaker 2: a diagnosis.
3:32
Speaker 1: Yeah yeah, So doctor Jamie, just to jump right into this,
3:38
Speaker 1: I would love it if you could tell our friends
3:41
Speaker 1: here listening with us, what a moral injury is and
3:48
Speaker 1: how this type of trauma impacts people.
3:53
Speaker 2: So it's not the event itself, it's how the event
3:57
Speaker 2: is continuing to impact us. So you can have a
4:00
Speaker 2: potentially morally injurious events.
4:03
Speaker 3: What give us an example?
4:05
Speaker 2: So I work a lot with veterans, healthcare providers, journalists.
4:09
Speaker 2: It could be something that maybe somebody failed to help
4:14
Speaker 2: somebody and there's injury or even death. It could be
4:17
Speaker 2: that in a situation that of value is going to
4:22
Speaker 2: be potentially violated. So I guess maybe I'll get more specific.
4:25
Speaker 2: In healthcare, a lot of times it has to do
4:27
Speaker 2: with not being able to treat someone the way that
4:31
Speaker 2: you wanted to treat them, or not being able to
4:33
Speaker 2: save someone's life, or perhaps within the health care system
4:37
Speaker 2: there are compromises being made that violate your values. Perhaps
4:41
Speaker 2: it has to do with the corporatevisation of care and
4:44
Speaker 2: the ways that you're participating in that. So in the
4:47
Speaker 2: veteran community, a lot of times it has to do
4:49
Speaker 2: with death and how those deaths occurred. It could be
4:53
Speaker 2: death of innocent or death of a fellow service member.
4:57
Speaker 2: It could be that you made a leadership mistake, or
5:01
Speaker 2: perhaps in heat of the moment, reacted in a way
5:06
Speaker 2: that violated your values. A lot of times it does
5:09
Speaker 2: have to do with how we respond maybe in that
5:12
Speaker 2: fight or flight mode that didn't line up with how
5:14
Speaker 2: we would respond if we had time to think about it.
5:17
Speaker 2: That can be a morally injurious event.
5:19
Speaker 1: So situations where there's chaos, stuff going on, fog of war,
5:24
Speaker 1: so to speak, and regrettable things happen so quickly and
5:27
Speaker 1: people get activated and things happen fast, and then you're like, oh, no,
5:31
Speaker 1: what have eyeslash we done? Like that kind of thing.
5:35
Speaker 2: Absolutely, yeah, And so that event may affect people very differently.
5:39
Speaker 2: Some people may not be affected, some people, like you said,
5:42
Speaker 2: might be haunted for years to come. So it moves
5:47
Speaker 2: to a moral injury when that moral distress. Like you said,
5:50
Speaker 2: those haunted feelings could be fear, anger, horror, disgust, guilt, shame.
5:57
Speaker 2: When we try to escape and avoid those, we don't
6:00
Speaker 2: actually find out what's underneath the hood there, but we
6:02
Speaker 2: escape and avoid them and we end up in a cycle.
6:05
Speaker 2: So that cycle could be short term survival strategies that
6:09
Speaker 2: then actually even kick up more and moral distress. So
6:13
Speaker 2: common ones could be substance use or isolating or overworking
6:18
Speaker 2: or going on some superhero mission to really fix the world,
6:24
Speaker 2: or maybe completely shutting down and sort of leaning into
6:27
Speaker 2: a side of you that's frankly not lining up with
6:31
Speaker 2: your values. So the moral injury is that functional impairment.
6:34
Speaker 2: That way that we get stuck in that cycle, and
6:37
Speaker 2: as you said in the introduction, this could last for years.
6:42
Speaker 1: Something happens and it's really this deep psychological wound because
6:49
Speaker 1: somebody is horrified about what happens because they do care,
6:53
Speaker 1: but it almost gets internalized into this thing that feels
6:58
Speaker 1: so overwhelming that then they're that classic trauma response, really
7:02
Speaker 1: that avoidance or a reactivity that is actually then pretty
7:10
Speaker 1: destructive to somebody's life going forward. But you can see,
7:13
Speaker 1: like looking back on the timeline, this moral injury catalyst
7:18
Speaker 1: event is really when it started.
7:20
Speaker 2: And there is overlap with PTSD, they are distinct doo.
7:24
Speaker 2: We have a criterion a event, so there needed to
7:27
Speaker 2: be life threat or serious threat to body integrity or
7:33
Speaker 2: you could have witnessed that on the job. And with
7:35
Speaker 2: moral injury it can be a lot more subtle and
7:38
Speaker 2: it doesn't have to be that event. It could be,
7:41
Speaker 2: as you know, an affair or a way that you
7:45
Speaker 2: betrayed your partner or you weren't honest with somebody you love,
7:48
Speaker 2: so it doesn't have to be this life threat or
7:51
Speaker 2: threat to body integrity.
7:53
Speaker 1: So you're saying that with a moral injury, there can
7:56
Speaker 1: be a trauma that's incurred even just from participating in
8:01
Speaker 1: a regrettable act, even if nobody dies in the process,
8:05
Speaker 1: or there was an actual injury and perhaps even a
8:08
Speaker 1: regrettable act that in the moment you participated in. But
8:12
Speaker 1: then looking back, there's that what's the word gosh, you
8:16
Speaker 1: would probably have a better word than I would, but
8:19
Speaker 1: almost like a horror like horror have I done?
8:22
Speaker 2: Yeah, Yeah, I have people who come to me with
8:26
Speaker 2: maybe they bullied somebody as a kid. Oh, and then
8:29
Speaker 2: they see later that person's alive, but maybe they wonder
8:33
Speaker 2: how much that affected the person or how they got
8:36
Speaker 2: through it. So yeah, it doesn't have to be the
8:39
Speaker 2: level of a criterion a trauma, and the flavor is
8:41
Speaker 2: a little different with PTSD, it's very much coming from
8:45
Speaker 2: that fear response. This horrible thing happened. I got to
8:48
Speaker 2: make sure that saying never happens again. So I'm very
8:51
Speaker 2: much avoiding any reminders of it because that feels dangerous,
8:56
Speaker 2: whereas a lot of times with moral injury, it's almost
9:00
Speaker 2: like I feel contaminated. So there is a little bit
9:03
Speaker 2: of a disagreement in the field right now of how
9:06
Speaker 2: to measure moral injury and what it includes. And one
9:08
Speaker 2: of the big arguments is do we include betrayal. So
9:12
Speaker 2: an important group of researchers is saying no, let's make
9:15
Speaker 2: betrayal a separate thing, and then another important group of
9:18
Speaker 2: researchers like, no, we want we want to put these
9:21
Speaker 2: together because it's not always that clear, and I see
9:24
Speaker 2: both sides. So in my work, I have done original
9:27
Speaker 2: research and moral injury, and I've also created and implemented
9:32
Speaker 2: some interventions both in the US and Canada. And what
9:35
Speaker 2: I saw is it's messy. So some people are It's
9:38
Speaker 2: almost how we've talked about internalizing and externalizing. Some people
9:43
Speaker 2: are very much same event, feeling very guilty. Some people
9:48
Speaker 2: same event are feeling very angry at other people, and
9:50
Speaker 2: then other people are oscillating. So I think it's messy
9:54
Speaker 2: to separate.
9:56
Speaker 1: It's always messy. Would you really get into it?
9:58
Speaker 2: Is it?
9:59
Speaker 3: And you know?
10:00
Speaker 1: So one of the things that I'm really so eager
10:02
Speaker 1: to do, Jamie, is to give you the opportunity to
10:05
Speaker 1: really take us into this and so not just what
10:08
Speaker 1: it is, not just how it impacts people, but what
10:11
Speaker 1: the process of healing looks like. And the reason why
10:15
Speaker 1: I'm I feel like this is so important is, as
10:19
Speaker 1: you've been describing, one of the hallmarks of this type
10:22
Speaker 1: of thing, feeling contaminated, feeling like a bad person, right,
10:28
Speaker 1: running off and hiding or this like all kinds of
10:31
Speaker 1: different avoidance things.
10:32
Speaker 3: I'm going to put a mountain between me and.
10:34
Speaker 1: Whatever this was right and I think in that this
10:39
Speaker 1: is the type of injury that can so easily either
10:44
Speaker 1: become hidden from others, oftentimes hidden from the self, or
10:50
Speaker 1: if people do know about it, could it be interpreted
10:54
Speaker 1: as Oh, that's a really bad person, or people feel like, oh,
10:59
Speaker 1: I'm a really bad part.
11:00
Speaker 3: Therefore I need to conceal this whole thing.
11:03
Speaker 1: And so for all of these reasons, I would imagine,
11:06
Speaker 1: and maybe this is a question, but that this is
11:10
Speaker 1: one of the hardest things to get people in the
11:13
Speaker 1: door to get help with. Is that a correct assumption.
11:18
Speaker 2: Absolutely? So. There's a group I created with this the
11:22
Speaker 2: first Buddhist chaplain in the VA. She's really my best friend,
11:25
Speaker 2: a really cool lady, And it's an Act for Moral
11:28
Speaker 2: Injury group, And we have a betrayal version.
11:30
Speaker 1: Acceptance and commitment therapy for our friends who are not
11:33
Speaker 1: familiar with but a breakdown the lingo here doctor gavey okay.
11:36
Speaker 2: Got so yes, this acceptance and commitment therapy group. And
11:40
Speaker 2: we've developed two versions, a betrayal one and a transgression one.
11:46
Speaker 2: And we do about five betrayal groups for every one
11:50
Speaker 2: transgression one. So that speaks to you know, not a
11:54
Speaker 2: lot of people raising their hand to be like, you know,
11:55
Speaker 2: what I want to talk about in group is the
11:57
Speaker 2: thing I did that I feel horror about and feel
12:01
Speaker 2: like a terrible person about. And yeah, those groups can
12:03
Speaker 2: be some of the most powerful, and there's almost a
12:07
Speaker 2: felt sense of like almost the okay corral moment where
12:11
Speaker 2: which direction is this gonna go? Or people gonna take
12:14
Speaker 2: that risk to be vulnerable and really share from their
12:18
Speaker 2: heart about some of that horror and guilt and shame,
12:21
Speaker 2: or are they gonna sort of be a fly on
12:24
Speaker 2: the wall and sort of keep it So it's really beautiful.
12:26
Speaker 2: As you know, we do a lot of compassion work,
12:29
Speaker 2: you and I, and that compassion just can't happen in
12:34
Speaker 2: that secrecy and judgment and silence. It really has to
12:39
Speaker 2: come out, so lots of compassion can happen. But you
12:43
Speaker 2: know that ratio of five groups for everyone, I think
12:47
Speaker 2: speaks to what you're talking about.
12:48
Speaker 1: Well, okay, and so then let's actually just pause here
12:51
Speaker 1: because it's also highly likely that our friend listening to
12:55
Speaker 1: this right now, doctor Jamie, might not even be the
12:58
Speaker 1: person who needs to hear this converse. Maybe it is
13:01
Speaker 1: the spouse, the partner, the kid, the parent of somebody,
13:06
Speaker 1: the best friend, of somebody who is going through this,
13:09
Speaker 1: and so maybe one takeaway from this podcast educate yourself
13:13
Speaker 1: on what's going on, how to recognize and have compassion
13:16
Speaker 1: for what might be happening inside of your loved one,
13:19
Speaker 1: and forward this podcast to that person with a Hey,
13:24
Speaker 1: this made me think about some of the things you
13:27
Speaker 1: went through back in Afghanistan or whatever.
13:31
Speaker 3: Might want to give it a listen.
13:33
Speaker 1: Would you advise something like that or would that be
13:35
Speaker 1: shut down?
13:36
Speaker 3: Do you think I want to?
13:38
Speaker 2: I think we all know deep down when we have
13:44
Speaker 2: a sliver or a piece of shrapnel that's in there, yeah,
13:48
Speaker 2: and we got to get it out. And I think
13:50
Speaker 2: this is for people who maybe just are considering addressing
13:56
Speaker 2: this could be a warm up. And again I do
13:58
Speaker 2: think sometimes we need a formal therapist to really sit
14:03
Speaker 2: with us. Oh yeah, but this is that chance to
14:06
Speaker 2: just start to acknowledge that this shrapnels stuck in there
14:09
Speaker 2: and it ain't gone away.
14:10
Speaker 1: Oh, and that in any way, shape or form to say,
14:12
Speaker 1: because listening to this podcast is going to make it
14:14
Speaker 1: all better. It is like a oh, there's a name
14:17
Speaker 1: for what I'm experiencing. There is a path to help
14:21
Speaker 1: me feel better. And so then just to pause for
14:25
Speaker 1: a moment. How would one of our friends here with
14:28
Speaker 1: us today, listening to this conversation, recognize that someone they
14:34
Speaker 1: care about might be struggling with a moral injury. What
14:38
Speaker 1: does it look like to an observer?
14:42
Speaker 2: It might look like there is a pulling away, a defensiveness.
14:48
Speaker 2: Sometimes someone might I don't really like the self sabotage
14:54
Speaker 2: because I think it fails to recognize the purpose of it.
14:57
Speaker 3: Intentional sabotage.
14:58
Speaker 2: Okay, this person doesn't I feel they deserve goodness or
15:02
Speaker 2: fun or joy or connection. So there's a way that
15:05
Speaker 2: they get in the way of that. It could be
15:07
Speaker 2: that you've maybe you knew this person before, and then
15:11
Speaker 2: you start to see some of these ways that they've
15:13
Speaker 2: become more prickly or difficult to experience joy with, experience
15:19
Speaker 2: compassion with. There could be more drinking, there could be
15:22
Speaker 2: more substance use, reckless behavior, and then you might see
15:27
Speaker 2: their body language or you might pick up on that shame.
15:29
Speaker 2: There's a real shutdown and maybe a hiding that's happening.
15:33
Speaker 1: I would imagine the immediate responses avoidance, rejection, dismissal, denial.
15:39
Speaker 1: They do not want to engage in this and that's
15:42
Speaker 1: really hard to broach. It takes a lot of courage.
15:46
Speaker 2: Yeah, I think that we can offer our observation. I
15:49
Speaker 2: see a heaviness, I see you struggling. You don't have
15:53
Speaker 2: to talk to me about it, but I want you
15:55
Speaker 2: to know I see it, and if you want me
15:58
Speaker 2: to help you, I'll get you to You know, I
16:01
Speaker 2: heard this podcast. I was thinking that might be applied
16:03
Speaker 2: to you. There's a time, one time when I, oh,
16:07
Speaker 2: I might also mention Yeah, suicidality, thank.
16:12
Speaker 3: You, And why did I not ask about that?
16:14
Speaker 1: Right?
16:14
Speaker 2: It's actually crazy. A study came out with military first
16:17
Speaker 2: responders and healthcare and moral injury screening. They did a
16:23
Speaker 2: screening with moral injury, and those who screened for moral
16:26
Speaker 2: injury were six times more likely to attempt suicide in
16:29
Speaker 2: a lifetime after controlling for all the other variables. So
16:33
Speaker 2: this is a significant factor for suicidality. So I had
16:37
Speaker 2: this person I knew one time, and I just had
16:40
Speaker 2: this sort of I hadn't talked to him in ten years,
16:42
Speaker 2: but I just had this, you know, one of those
16:44
Speaker 2: intuitive moments, and I thought to myself, I hope that
16:47
Speaker 2: guy never kills himself. So I actually called him. I
16:50
Speaker 2: hadn't talked to him in ten years, and I said, Hey,
16:52
Speaker 2: I just want you to know I thought about you
16:54
Speaker 2: today and I thought, I hope you never kill yourself.
16:56
Speaker 2: The world would be a worse place without you. And
16:58
Speaker 2: he said, I attend to this morning holy craps like, ah, you're.
17:04
Speaker 1: A witch now we know, But you know what, that's
17:07
Speaker 1: just as a't aside. I did a remarkable podcast interview
17:12
Speaker 1: that I would encourage anyone to listen to with my
17:14
Speaker 1: friend Steve Kramer. You guys, scroll back through my feed,
17:18
Speaker 1: and it was actually talking more about the male emotional
17:23
Speaker 1: experience and how some of these dark experiences can look
17:27
Speaker 1: different in male psychology. And so Steve did such a
17:30
Speaker 1: great job of describing this. But he actually shared a
17:32
Speaker 1: story where he like had been going through a hard
17:37
Speaker 1: time and out of the blue, as does happen sometimes
17:42
Speaker 1: these intrusive thoughts like just be done, went ahead and
17:46
Speaker 1: ordered the rope on Amazon, like to hang himself and
17:49
Speaker 1: was very deeply into the preparation phase, you know, gonna
17:53
Speaker 1: do it, and a friend that he hadn't talked to
17:56
Speaker 1: in years, who had been a close friend previously, called
17:59
Speaker 1: out of the blue and said, Hi, I know we
18:02
Speaker 1: haven't talked in a while, but I just needed to
18:05
Speaker 1: call you today because I felt really worried about you.
18:08
Speaker 3: What's going on?
18:09
Speaker 1: And he told her everything and groped down, and you
18:13
Speaker 1: know that that was the start of the pivot that
18:16
Speaker 1: honestly saved his life. And so just one takeaway from
18:19
Speaker 1: this podcast. If you get a random thought that bubbles
18:23
Speaker 1: up into your mind, like an intuition that you need
18:25
Speaker 1: to call and check on someone, you go ahead and
18:27
Speaker 1: do that.
18:28
Speaker 3: Worst case scenario. They're like, oh, yeah, it's.
18:31
Speaker 1: Up, and you know it's nothing, but yeah, you've lost nothing.
18:37
Speaker 2: I do think a lot of times people end up
18:39
Speaker 2: working with me on Marlandrey because of something like that.
18:42
Speaker 2: Somebody said something like, hey, you aren't yourself. You aren't
18:45
Speaker 2: who you used to be. I don't see you showing
18:47
Speaker 2: up for the things that used to matter to you.
18:50
Speaker 2: And those are the comments, are the things that stick
18:52
Speaker 2: on that make him think I got to do something.
18:54
Speaker 1: Yeah, yeah, Okay, So let's take a quick break here, Jamie.
18:58
Speaker 1: We need to pause for a whatever our valued sponsors
19:03
Speaker 1: who helps make this show possible, so we'll give there
19:05
Speaker 1: a little bit of space.
19:06
Speaker 3: But then on the.
19:07
Speaker 1: Other side, i'd love to hear you talk more about
19:12
Speaker 1: what it looks like when we drive the golf cart
19:15
Speaker 1: into the darkness and start dealing with this stuff directly,
19:19
Speaker 1: and what the path of healing can involve, so that
19:22
Speaker 1: someone listening to this can understand how this can be better,
19:28
Speaker 1: that there is actually a process that they don't have
19:31
Speaker 1: to hold on to this forever.
19:32
Speaker 3: Is that okay?
19:33
Speaker 2: Sounds great?
19:50
Speaker 1: You guys were back with doctor Jamie Lusk. She is
19:53
Speaker 1: a psychologist, a Marine Corps veteran VA psychologist, and a
19:59
Speaker 1: leading expert on the subject of moral injury, what it
20:04
Speaker 1: is and how to heal it. So doctor Jamie, welcome back.
20:08
Speaker 1: So just before we pause for the break, I invited
20:11
Speaker 1: you to in this next segment take us into.
20:18
Speaker 3: How this gets better. We can't.
20:21
Speaker 1: We don't have a time machine. You can't go back
20:23
Speaker 1: into the past and do something differently. So I think
20:26
Speaker 1: it can feel so.
20:29
Speaker 3: Just true, like.
20:31
Speaker 1: There's no hope for this. Where do you even begin
20:35
Speaker 1: to help someone?
20:36
Speaker 2: I'll tell you. I first want to right size the
20:40
Speaker 2: guilt and shame based on the facts. Okay, So if
20:43
Speaker 2: there's an actual capital T trauma like life threat or died,
20:49
Speaker 2: somebody died, or somebody got sexually assaulted or somebody got
20:52
Speaker 2: beat up. Then I'm going to start with an evidence
20:55
Speaker 2: based PTSD treatment. I should clarify, and you're having re
20:59
Speaker 2: excs experiencing symptoms about those events, you're having nightmares and
21:03
Speaker 2: trusive memories, then I'm going to start with one of
21:06
Speaker 2: our evidence based PTSD treatments. That's really because we know
21:10
Speaker 2: a lot about really addressing that index, that trauma that
21:14
Speaker 2: you having re experiencing symptoms. We can lower those symptoms significantly.
21:18
Speaker 1: If there's actual PTSD involved. Why do you need to
21:21
Speaker 1: treat those symptoms first? And generally speaking, those would be
21:25
Speaker 1: symptoms of avoidance, try to numb it out out and
21:28
Speaker 1: not experience things, or having a lot of intrusive symptoms
21:32
Speaker 1: like dreams, nightmares, and trusive thoughts like that hypervigilant.
21:35
Speaker 3: So why do we need to.
21:36
Speaker 4: Do that first?
21:37
Speaker 2: Well, those intrusive symptoms are trying to tell you, hey,
21:40
Speaker 2: this needs to be looked at. There's something about this
21:42
Speaker 2: that you're not looking at, and they're coming into your
21:45
Speaker 2: mind unbidden, un wanted because you're still trying to keep
21:50
Speaker 2: those things at bay. But there's wisdom we need to
21:53
Speaker 2: mind from that situation. So when there's an incident where
21:57
Speaker 2: somebody feels a deep guilt and a lot of times
22:01
Speaker 2: they're telling themselves, I shouldn't have, I should have the
22:07
Speaker 2: thing I did was wrong. So we really need to
22:09
Speaker 2: look at Okay, let's look at what actually happened. And
22:12
Speaker 2: like I said, I'd want them to do that based
22:15
Speaker 2: on the three treatments we know work the best from research,
22:19
Speaker 2: and those treatments are prolonged exposure, cognitive processing therapy or EMDR.
22:25
Speaker 2: So let's get back there and look at what actually happened,
22:29
Speaker 2: and let's really look at specifically, what are you telling yourself,
22:34
Speaker 2: For instance, you should have known, and let's see if
22:37
Speaker 2: it was actually possible for you to know. So I'll
22:39
Speaker 2: give you an example. This is a composite person. But
22:43
Speaker 2: let's say somebody was driving along in a neighborhood and
22:46
Speaker 2: ran over a kid. The kid ran right in front
22:49
Speaker 2: of them. Horrible life changing experience. Okay, so let's really
22:54
Speaker 2: look at what you knew at the time. So what
22:56
Speaker 2: was happening. How fast were you driving, what were you
23:00
Speaker 2: doing while you were driving? Were you multitasking where you're
23:04
Speaker 2: talking to someone? Where's your hands on ten and two?
23:07
Speaker 2: How when did you see this kid. And then there's
23:11
Speaker 2: a million dollar question that I'm taking from traum informed
23:15
Speaker 2: Guilt Reduction, which is a really excellent, elegant treatment for
23:21
Speaker 2: guilt and shame. There's actually a self help version. The
23:25
Speaker 2: book is called Transforming Your Guilt and Shame by doctor Allard,
23:29
Speaker 2: highly recommend So this million dollar question is if you
23:33
Speaker 2: knew for certain that was going to happen, what would
23:36
Speaker 2: you have done that day? Or how would you have
23:38
Speaker 2: done things different? And a lot of times people really
23:41
Speaker 2: recognize why I didn't know. If we're a certain kid
23:43
Speaker 2: who's going to run out, of course, I wouldn't have
23:44
Speaker 2: been driving on that street. So we're certain starting to
23:47
Speaker 2: loosen up some of the things I've been telling themselves,
23:49
Speaker 2: but also shrinking that gap between what they thought should
23:53
Speaker 2: happen and what did happen. It's not so big as
23:57
Speaker 2: we start to look at it.
23:58
Speaker 1: I get that, you know, Can I just share if
24:00
Speaker 1: this is okay to share? A teenage family member of
24:03
Speaker 1: my not my kid. Another family member had a bunch
24:07
Speaker 1: of other goofball fifteen year olds over at their house
24:12
Speaker 1: not too long ago, playing with fire in the garage.
24:16
Speaker 1: I don't know what they were thinking, but one of
24:17
Speaker 1: the kids got burned, had to go to the emergency room.
24:20
Speaker 1: And it's not, you know, maybe as big as some
24:23
Speaker 1: of the stuff you're talking about, But my my family
24:26
Speaker 1: member felt so bad, did not want to come out
24:29
Speaker 1: of his room and was just like really like beating
24:32
Speaker 1: himself up and going through all these things. I think
24:35
Speaker 1: that instinctively, maybe I did a little bit of that.
24:38
Speaker 1: I got him to talk to me. We were talking
24:40
Speaker 1: about what happened, and he was like, it was all
24:42
Speaker 1: my flah blah blah blah.
24:43
Speaker 3: And I was like, did you make the kid do this?
24:45
Speaker 2: And he's like no.
24:46
Speaker 3: I was like, did you throw a cocktail out him?
24:49
Speaker 1: And he was like no, no, you know what I mean.
24:51
Speaker 1: But it's like, what is the choice? What is the agency?
24:54
Speaker 1: Would you have done that on purpose? It was like no,
24:57
Speaker 1: And so I hear what you're saying, like kind of
24:59
Speaker 1: making it smaller and helping people see what did I
25:02
Speaker 1: do exactly? You know that contributed to that? Was that
25:07
Speaker 1: a sign of me being a horrible person or maybe
25:11
Speaker 1: just not like thinking that one all the way through
25:13
Speaker 1: in the event of a fifteen year old kid. But
25:16
Speaker 1: I think for so much of this, there's like a
25:18
Speaker 1: true accident.
25:21
Speaker 3: Especially if people and I'm thinking about.
25:23
Speaker 1: First responders or a military where it's heavy, people are
25:28
Speaker 1: flooded and your brain really isn't I don't want to say,
25:34
Speaker 1: isn't working. Our cognitive abilities diminish when we become very
25:38
Speaker 1: activated and flooded, and so much of what happens, I
25:41
Speaker 1: would think is in that context or an er doctor
25:45
Speaker 1: and there's like chaos and blood and people running around and.
25:48
Speaker 2: Yeah, so I wanted you actually did use a few
25:51
Speaker 2: trigger skills. So that's traumend forum guilt reduction. So I
25:54
Speaker 2: want to point out your victory there. You really looked
25:58
Speaker 2: at percent responsibility. So it's all my falls what this
26:01
Speaker 2: kid was saying. But then you sort of asked in
26:03
Speaker 2: questions to see, you know, how much of this kid
26:07
Speaker 2: is responsibility? You know how much of these other kids
26:10
Speaker 2: you know, is a responsibility, these other killies.
26:12
Speaker 3: This was a group effort.
26:13
Speaker 1: I think I said that out loud as well, like
26:16
Speaker 1: you guys did this together, right anyway, go ahead?
26:18
Speaker 2: Sorry? Well that I think you nailed it. And then
26:21
Speaker 2: I think the other piece there is maybe you got at, well,
26:23
Speaker 2: what were you intending to do? What values were you honoring?
26:27
Speaker 2: It sounds like they're having fun. Fire is awesome, the
26:32
Speaker 2: you know, playing with their friends. They weren't intending harm.
26:35
Speaker 2: He didn't throw the malt cocktails on me, So really
26:38
Speaker 2: getting out intent and a lot of times that these
26:41
Speaker 2: things there's a values clash, right, they had the value
26:44
Speaker 2: of having fun together, and frankly, playing with fire is
26:47
Speaker 2: better than a lot of other things fifteen year olds
26:49
Speaker 2: are doing.
26:49
Speaker 1: I mean, so much stuff is flammable that you wouldn't
26:52
Speaker 1: even think is flammable, and there's on fire.
26:55
Speaker 2: The things be doing so okay, you're having this fun.
27:00
Speaker 2: The elements in the garage solve it all right, good job.
27:05
Speaker 2: And then I think the other piece that you mentioned
27:08
Speaker 2: is what options were really available at the time. So
27:11
Speaker 2: when you went to first responders or even my person
27:14
Speaker 2: that's driving the car and hit the kid, what options
27:17
Speaker 2: were you presented with? And so a lot of times
27:20
Speaker 2: of veterans, for instance, this one veteran I worked with,
27:24
Speaker 2: there's a convoy that went out. He was supposed to
27:26
Speaker 2: go on the convoy. He didn't go on the convoy.
27:29
Speaker 2: The convoy got hit. So he had all these options
27:32
Speaker 2: he was holding against himself that weren't actual options, Like well,
27:35
Speaker 2: I should have been on the convoy. Okay, Well how
27:38
Speaker 2: come you weren't because my commander said I couldn't be Okay,
27:41
Speaker 2: so what were you gonna say to your commander? Fu,
27:44
Speaker 2: I'm gonna do it anyways, Okay, what would have happened?
27:46
Speaker 2: So like when we actually played out that scenario, it
27:49
Speaker 2: was a non option. His commander was not going to
27:51
Speaker 2: let him go on this convoy. So he was holding
27:54
Speaker 2: something against himself that wasn't even possible. And then he
27:57
Speaker 2: also had another one, well I shouldn't have joined the
27:59
Speaker 2: army again, that was available at the time. The thing
28:02
Speaker 2: that happened was the only option he was presented with.
28:07
Speaker 2: So all that to say that those are interventions from
28:10
Speaker 2: trum inform guilt reduction and all of our evidence based
28:14
Speaker 2: PTSD treatments attempt to really explore this, But that doesn't
28:19
Speaker 2: mean we're not left with something. Right, there's a gap.
28:21
Speaker 2: So for me, I think with therapists we always do
28:25
Speaker 2: things partly because of our own history. I joined I
28:28
Speaker 2: went to the Naval Academy, and I joined the Marine
28:30
Speaker 2: Corps in May two thousand and one. So before we
28:33
Speaker 2: got involved in Iraq, before nine to eleven, and very
28:40
Speaker 2: early on, I was not interested in the conflict. I
28:44
Speaker 2: did not think we had justification. We have not declared war.
28:49
Speaker 2: Congress has not declared war in this country against an
28:53
Speaker 2: enemy since nineteen forty two. So I'm not interested in
28:57
Speaker 2: fighting wars that are not declared by Congress that we
29:01
Speaker 2: have not agreed are threatening our nation. But had to
29:05
Speaker 2: renig on my commitment. So there's a real values conflict,
29:09
Speaker 2: and I suffered a lot from it. It was a
29:11
Speaker 2: hard time. I had a hard choice. I wasn't confident
29:14
Speaker 2: I made the right choice. And there's nothing that's going
29:18
Speaker 2: to take that away from me. Like you said in
29:19
Speaker 2: the beginning, you hurt because you care. There's something I
29:23
Speaker 2: care about that was violated. So when we've gone through
29:27
Speaker 2: and really right sized what happened versus what we think
29:30
Speaker 2: should happen, there's still a gap sometimes so for me,
29:33
Speaker 2: like a gap of care, a gap of justice, a
29:37
Speaker 2: gap of I think righteous foreign policy in my case.
29:41
Speaker 2: So then we have to help somebody honor those violated values.
29:46
Speaker 2: So I can't go fix Iraq. That's not something I
29:49
Speaker 2: get to do. But I did get to do this
29:51
Speaker 2: really cool project where I always wear this bracelet, and
29:55
Speaker 2: this is actually a part of a bomb that we
29:58
Speaker 2: dropped on Lao. So we also, as you know, didn't
30:02
Speaker 2: declare war in Vietnam. That was never war, and we
30:05
Speaker 2: never even admitted we were in Lao. But that is
30:08
Speaker 2: one of the most bombed countries per capita in the
30:10
Speaker 2: whole world. So it'll take another one hundred and fifty
30:13
Speaker 2: years to remove all the bombs that we dropped on
30:16
Speaker 2: them at the rate they're going into Even now, villagers
30:21
Speaker 2: can find these little bomblets from cluster bombs, and if
30:24
Speaker 2: they handle them in properly, they get blown up. So
30:28
Speaker 2: this still happens.
30:29
Speaker 3: In low gosh.
30:30
Speaker 2: There's a group called the Mind Advisory Group that's training
30:33
Speaker 2: people to get these out in safe ways. And so
30:37
Speaker 2: this is actually there's a village that takes all the
30:39
Speaker 2: extra stuff. It's called Spoon Village takes all the extra
30:43
Speaker 2: bombs that they remove safely and they make jewelry out
30:46
Speaker 2: of it. So it's a little token of something I
30:50
Speaker 2: got to participate in that wasn't maybe repairing for my war,
30:54
Speaker 2: but it was repairing another war. So that was the
30:57
Speaker 2: way I could honor that value.
31:00
Speaker 1: Oh my gosh, Okay, so what I'm here, there's a
31:03
Speaker 1: lot here, Doctor Jamie.
31:05
Speaker 3: But so what I'm hearing are a couple of big things.
31:07
Speaker 1: And I'm just gonna restate this very clearly that even
31:13
Speaker 1: if you are telling yourself you are a terrible person
31:17
Speaker 1: for having participated in whatever, or made the mistakes, whatever
31:20
Speaker 1: it was, actually the fact that you are feeling as
31:25
Speaker 1: badly as you are is direct evidence of the fact
31:29
Speaker 1: that you are a caring person with a very clear
31:33
Speaker 1: moral center. If you didn't have that, this wouldn't bother
31:38
Speaker 1: you at all.
31:39
Speaker 3: So to hold on to that part.
31:42
Speaker 1: But then additionally, and maybe we could talk about this
31:45
Speaker 1: on the other side of the next break, Jamie, is
31:47
Speaker 1: that I'm hearing that perhaps part of this process, maybe
31:51
Speaker 1: even further out, is this not just the repair, not
31:54
Speaker 1: just the healing and the different relationship that you have
31:57
Speaker 1: with the event and the way you showed up in that,
32:00
Speaker 1: but that longer term there is a almost like a redemption,
32:04
Speaker 1: like how can I become aligned, realigned with my moral
32:09
Speaker 1: compass in a way that helps me feel like a
32:14
Speaker 1: force of good in the world. Again, is that the
32:17
Speaker 1: right way to say it.
32:18
Speaker 2: There's a Vietnam that he wrote a book called at
32:21
Speaker 2: Hill's Gate, and he stood something really similar to you,
32:24
Speaker 2: He said, what could I do about the lives I've taken?
32:27
Speaker 2: I can't undo them, I can't bring them back to life.
32:30
Speaker 2: But I've realized that the world doesn't work by a
32:33
Speaker 2: simple math equation. I for an eye, tooth for a tooth,
32:36
Speaker 2: bridge for a bridge, I can I have taken life,
32:39
Speaker 2: and now I get to commit to giving life. So
32:41
Speaker 2: that guy, he's traveled around the world as a mendicant
32:44
Speaker 2: monk to wartron villages. He's actually going to be in
32:47
Speaker 2: the Ukraine in August. His name is Claude anshent Thomas.
32:51
Speaker 2: So he's still living his Amend's work in a way
32:55
Speaker 2: that's pretty powerful.
32:56
Speaker 1: Well that's interesting though, and I think I've just been
32:58
Speaker 1: talking with you.
32:59
Speaker 3: I'm understand this in a different way.
33:01
Speaker 1: There's the sort of darkness part that's internalized and sort
33:05
Speaker 1: of self destructive and right, but then if you can
33:09
Speaker 1: almost flip it through this healing process, there's a lot
33:12
Speaker 1: of regenerative power.
33:14
Speaker 3: Almost that comes out of it.
33:16
Speaker 2: Absolutely.
33:16
Speaker 3: Yeah, yeah, all.
33:18
Speaker 1: Right, Okay, we need to take another quick break. Jamie
33:21
Speaker 1: on the other side, let's keep going. I'd love to
33:24
Speaker 1: hear more about how this all works and your advice
33:27
Speaker 1: for how people who would like to engage in this
33:31
Speaker 1: kind of process, like how they would even get started,
33:35
Speaker 1: who they look forward.
33:35
Speaker 3: The first steps are just so that there's.
33:37
Speaker 4: Something actionable that people can do after this is done.
33:55
Speaker 1: You guys were back with doctor Jamie Lesk, a Marine
33:59
Speaker 1: Corps veteran and a VA psychologist here with us today
34:02
Speaker 1: to unpack, demystify, and also light the way forward around
34:08
Speaker 1: moral injury, what it is and how to repair it.
34:11
Speaker 1: And so, Jamie, just before the break, you were sharing
34:14
Speaker 1: some really helpful interventions and ideas and resources that can
34:20
Speaker 1: help reorient people and change the relationship with what happened.
34:26
Speaker 1: But so I'd really like to spend the last third
34:29
Speaker 1: of our time here together talking about what you know
34:33
Speaker 1: around what to do, where to go, where to get
34:36
Speaker 1: the right kind of help. Because we were just chatting
34:39
Speaker 1: during the break and I mentioned that my biggest fear
34:41
Speaker 1: of somebody listening to this is going to sign up
34:44
Speaker 1: for a Better Help subscription, right, because I think that
34:47
Speaker 1: the narrative in our culture is like therapy is therapy, right,
34:51
Speaker 1: And no, that is not even a little bit true.
34:52
Speaker 1: And it is so easy to get connected, and no
34:56
Speaker 1: shade on Better Help or any of the therapists that
34:58
Speaker 1: work for them, but like are highly specialized spaces in
35:03
Speaker 1: our shared profession, and you are one of the world's
35:06
Speaker 1: leading experts on this. At the twenty twenty six APA
35:10
Speaker 1: convention that we're all going to be attending, you are
35:12
Speaker 1: actually hosting this whole training on trigger the trauma informed
35:18
Speaker 1: guilt reduction is that the acronym there, so like you
35:22
Speaker 1: are the person and I really want you to share
35:24
Speaker 1: your knowledge of if you want to make this better,
35:28
Speaker 1: what to do, but also like what not to do,
35:31
Speaker 1: because it's such a wasted opportunity. I think if people
35:34
Speaker 1: show up for therapy thinking that it's going to help
35:36
Speaker 1: them and they could connect with the ROM provider not
35:39
Speaker 1: even knowing it, and I'm like, never doing that again,
35:41
Speaker 1: you know, So let's not do that.
35:42
Speaker 3: What should they do instead?
35:44
Speaker 2: So the VA has led both the understanding of moral
35:49
Speaker 2: injury and the treatment so trauma and forum guilt reduction
35:52
Speaker 2: that I'm presenting on I'm a fangirl. I've been using
35:55
Speaker 2: it since twenty sixteen. The developers are actually from the
35:58
Speaker 2: San Diego Via so doctors Allard and doctor Norman and
36:03
Speaker 2: many others. And then there's some other treatments ACT for
36:07
Speaker 2: moral injury. There's a few different people within the VA,
36:10
Speaker 2: including me, that have developed interventions and act for moral injury.
36:14
Speaker 2: So you might look for a former VA psychologist or
36:19
Speaker 2: mental health provider who's been trained. The VA is an
36:21
Speaker 2: excellent place to get trained in evidence based PTSD treatments
36:25
Speaker 2: and to understand and really study moral injury. So that
36:29
Speaker 2: could be an option. Look for somebody who's former VA.
36:31
Speaker 2: I could help you find someone. I'm licensed in three states, Oregon, California,
36:36
Speaker 2: and Idaho, but I'm connected nationwide to former VA providers
36:41
Speaker 2: who have really good training in both evidence based PTSD
36:45
Speaker 2: and moral injury treatment.
36:47
Speaker 1: And can I just say for the record that VA
36:50
Speaker 1: psychologists they're like a breed onto themselves. You guys are
36:54
Speaker 1: even among psychologists.
36:56
Speaker 3: You have your own vibe. Let's say, is I love it? Honestly?
37:00
Speaker 3: I don't know.
37:01
Speaker 1: You're a lot of fun to hang out with, honestly,
37:03
Speaker 1: but okay. But so reading through people's bios looking for
37:06
Speaker 1: that type of pedigree a VA psychologist, but also then
37:11
Speaker 1: a training specifically in moral injury. But also wait rewinding
37:15
Speaker 1: just a second, you said that frequently the first order
37:18
Speaker 1: of business is actually to get trauma treatment like treatment
37:22
Speaker 1: for PTSD first, and I would imagine that it's much
37:27
Speaker 1: easier to find evidence based treatment provider who can do standard.
37:32
Speaker 1: PTSD is so prevalent that you can typically go a
37:35
Speaker 1: lot of places for that, whereas the moral injury stuff
37:39
Speaker 1: is more specific.
37:40
Speaker 3: But what would somebody look.
37:42
Speaker 1: For even when seeking out trauma treatment.
37:46
Speaker 2: Well, there's a great resource called Decision Aid on the
37:50
Speaker 2: National Center for PTSD that's a research hub with the VA,
37:55
Speaker 2: and the VAS poured a ton of research into PTSD
37:58
Speaker 2: and moral injury treatments. So you could actually go through
38:01
Speaker 2: the Decision Aid and learn about the different treatments and
38:03
Speaker 2: see what fits for you, what you think sounds the best.
38:07
Speaker 2: I just actually got a new client and had them
38:10
Speaker 2: run through it, and they told me one of them, hellmo,
38:13
Speaker 2: that sounds terrible. Okay, we're not doing that one.
38:16
Speaker 3: Which one did they cross off? The bingo? I don't
38:18
Speaker 3: want you to, Okay.
38:20
Speaker 2: So I don't want to hurt its feelings. But the
38:22
Speaker 2: point is another person's doing that treatment with me right now,
38:25
Speaker 2: So people get to decide, and we also we also
38:30
Speaker 2: are still doing research. Among those three treatments, corgment and
38:33
Speaker 2: processing therapy prolonged exposure in the NBR to see what
38:37
Speaker 2: works best in what situation. And since we don't know,
38:40
Speaker 2: we really let the person decide for themselves what sounds
38:44
Speaker 2: best for them, so that could be a resource.
38:47
Speaker 1: Sorry interrupt you kind of just random questions. How do
38:50
Speaker 1: you feel about psychedelic therapies?
38:53
Speaker 2: I love it, love the potential. Do this work first,
38:57
Speaker 2: we're throwing It's one of my guys in the life
39:00
Speaker 2: enforcement says, it's like doing a forced entry, and a
39:04
Speaker 2: lot of these people are doing forced entries amateurs that
39:07
Speaker 2: have no clue how to clear a room. So I
39:10
Speaker 2: like totally.
39:11
Speaker 1: See that, like sitting in a tpe some yeah, like
39:14
Speaker 1: college sophomore, right and eating a bunch of bushes.
39:16
Speaker 4: Do that?
39:17
Speaker 2: Okay, you really need skills to integrate whatever happened in psycho.
39:22
Speaker 3: So that the foundational stuff.
39:25
Speaker 1: Do more conventional evidence based PTSD treatment first, then like stabilization,
39:31
Speaker 1: then go ahead, have a little visit with God that
39:34
Speaker 1: can help too, and then the moral injury work.
39:38
Speaker 2: Yeah, okay, we're still researching. So there's a lab here
39:41
Speaker 2: in Portland that's about to do a study. This hasn't
39:44
Speaker 2: been done before, so they've been doing all the psychedelic research,
39:47
Speaker 2: but nobody's research. What happens when we combine psychedelics with
39:51
Speaker 2: an evidence based PTSD t so, and it irritates me.
39:58
Speaker 3: It's very obvious, but okay obvious.
40:00
Speaker 2: The actual protocol for MDMA for PTSD takes eighty four
40:05
Speaker 2: clinical hours and CPT, that's my secret favorite of the
40:10
Speaker 2: three horses winning the race, takes twelve clinical processing, So
40:15
Speaker 2: twelve clinical hours and the results are better with CPT.
40:20
Speaker 2: I mean, they haven't been head to head, but to me,
40:23
Speaker 2: it's like, do I'll start there. It took way more resources,
40:27
Speaker 2: didn't turn out as well. Don't tell me that's the
40:30
Speaker 2: place to start.
40:31
Speaker 3: I mean, would you argue with that?
40:32
Speaker 1: We could go rehash all those horrible memories and re
40:36
Speaker 1: experience them, or go take some of DMA.
40:39
Speaker 2: Like absolutely, Actually, even this treatment that I love that
40:43
Speaker 2: I told you there's this American Life Order actually does
40:48
Speaker 2: prolonged or I mean a cognitive processing therapy.
40:50
Speaker 3: I didn't hear that one.
40:51
Speaker 2: So you get to hear her treatment, you get to
40:53
Speaker 2: hear parts of recession, and at some point she's mad,
40:56
Speaker 2: She's like, why are these stupid work sheets helping me
40:59
Speaker 2: with something that's been around for fifteen years this is stupid.
41:03
Speaker 2: I can't believe it's even helping me.
41:05
Speaker 1: So yeah, okay, And so then doctor Jamie, before we
41:09
Speaker 1: let you go, I certainly want to give you some airtime.
41:12
Speaker 1: I mean, you're such a wealth of information. You mentioned
41:15
Speaker 1: the VA center associated with San Diego. There was a
41:18
Speaker 1: website that goes into two different trauma treatments. But I'd
41:22
Speaker 1: also like, you know, you so kindly mentioned just get
41:25
Speaker 1: in touch with me, and if I can't help you personally,
41:28
Speaker 1: I could recommend you.
41:29
Speaker 3: And I'd love for you to talk a little bit
41:31
Speaker 3: about your practice, because you.
41:33
Speaker 1: Are not just doing moral injury work with people. You
41:38
Speaker 1: are helping the toughest.
41:40
Speaker 3: Of the cookies.
41:41
Speaker 1: I think I was talking to you one time and
41:44
Speaker 1: you were talking about military psychologists, like psyops types that
41:48
Speaker 1: had been associated with psychological torture construction at Guantan, like
41:53
Speaker 1: that kind of thing.
41:54
Speaker 3: You're like, those are my people.
41:55
Speaker 1: So tell us more about your gifts and how you
42:01
Speaker 1: use them.
42:02
Speaker 2: Well, So, I have been a clinician in the VA
42:05
Speaker 2: for fifteen years. I'll be leaving in December. So I've
42:08
Speaker 2: been able to build a private practice over the last
42:10
Speaker 2: couple of years that's really specializing in PTSD, moral injury
42:14
Speaker 2: and loss, and so people in high stake situations. I
42:18
Speaker 2: work with all sorts of people, including journalists, healthcare providers,
42:23
Speaker 2: people in cybersecurity, RST veterans.
42:28
Speaker 3: Cyber security. That's interesting.
42:29
Speaker 1: I wouldn't have tossed that one into the Sorry not
42:32
Speaker 1: to digress, but okay.
42:34
Speaker 2: Think if I much these a lot of times very
42:37
Speaker 2: fastidious people who really care about their job, and then
42:41
Speaker 2: constant bad actors trying to break into the system, and
42:45
Speaker 2: lots of non adaptive guilt if there's a brief Yeah,
42:49
Speaker 2: so people have to be twenty four to seven, and
42:51
Speaker 2: then of course now they're stuck with guilt if anything happens,
42:56
Speaker 2: even if their client wasn't paying for the level of
42:59
Speaker 2: security that will have prevented it. Even if this is
43:02
Speaker 2: a new special hack that nobody's ever done before, it
43:05
Speaker 2: doesn't matter. They take that on lots of overestement of
43:09
Speaker 2: responsibility in that job. So many other jobs are similar.
43:13
Speaker 2: If somebody is not ready for therapy and they're just
43:16
Speaker 2: ready to do something, I do have a free course
43:19
Speaker 2: on my website that is Acceptance and Commitment Therapy for
43:22
Speaker 2: Moral Distress, so you can play with some of those concepts.
43:25
Speaker 2: And see if they fit for you and see if
43:27
Speaker 2: that is something you'd want to pursue.
43:29
Speaker 3: Therapy and mentioned your website.
43:32
Speaker 2: Oh, doctor Jamie Lusk dot com. You have spell my
43:35
Speaker 2: name right? I have two eyes O.
43:37
Speaker 3: J I E.
43:39
Speaker 1: L Usk dot com Doctor Jamie Lusk dot com. Okay,
43:43
Speaker 1: So there's that free acceptance and commit.
43:47
Speaker 2: And then I also if guilt is in the mix
43:49
Speaker 2: for you, guilt and chain, I love there's selfhaul. Books
43:54
Speaker 2: are mostly not evidence based. It's mostly a person that
43:56
Speaker 2: just writes a book. But this one, Transforming your Guart
44:00
Speaker 2: Guilt and Shame is directly based on that trauma and
44:03
Speaker 2: form guilt reduction. So this book Transforming Your Guilt and
44:07
Speaker 2: Shame very well written, lots of activities by doctor Allard,
44:12
Speaker 2: highly recommend if you're really stuck in that guilt and
44:15
Speaker 2: shame from a moral injury.
44:17
Speaker 1: Yeah. And is that the cave that you're talking about
44:21
Speaker 1: people that are really stuck. I've heard you say I
44:24
Speaker 1: go into the cave to find the person, drag him out.
44:28
Speaker 1: How could somebody listening be an ally like you?
44:31
Speaker 3: What is that involved? What are we talking about right now?
44:34
Speaker 1: Well?
44:34
Speaker 2: I think we go back to how you worked with
44:36
Speaker 2: your family member. You know when somebody's stuck. He was
44:39
Speaker 2: literally stuck in his room, so.
44:41
Speaker 3: You know that he would not come out of his room.
44:44
Speaker 2: So you know, if there's somebody you love, that's I
44:48
Speaker 2: think it's fair on the Love, Happiness and Success podcast
44:52
Speaker 2: that we believe people were born for joy and connection
44:56
Speaker 2: and if you see somebody that absolutely is avoiding it
44:59
Speaker 2: at all costs, there's a barrier. And one of the
45:02
Speaker 2: biggest barriers is shame. Yeah, so how about you.
45:07
Speaker 1: Go for yeah, no seriously, but and not to make
45:11
Speaker 1: light of it. And obviously we don't be overly a
45:14
Speaker 1: truce that could cause new problems. But actually, maybe there
45:17
Speaker 1: does need to be somebody who cares enough and who
45:20
Speaker 1: is brave enough to say hi, to call out of
45:23
Speaker 1: the blue and say hello, I know you're.
45:26
Speaker 3: Not okay, and here I am, and I know you
45:29
Speaker 3: don't want to be helpful. I'm going to do it anyway.
45:30
Speaker 1: So here's a book, here's a podcast, here's doctor Jamie
45:32
Speaker 1: Losk's website, and that somebody might actually need that, because,
45:36
Speaker 1: as you mentioned earlier in this conversation, you know, sometimes
45:41
Speaker 1: a life can actually be on the line, like not uncommonly,
45:45
Speaker 1: So go ahead and embarrass yourself. Seriously good any last
45:49
Speaker 1: words to share, doctor Jamie.
45:51
Speaker 2: No, I'm excited I get to hang out with doctor
45:54
Speaker 2: Lisa at the APA conference time. Yeah, I get to
45:57
Speaker 2: celebrate all that she's doing. I love this podcast and.
46:02
Speaker 1: Help me shoot my t shirt cannon.
46:04
Speaker 3: That such a good time.
46:06
Speaker 2: I'm gonna try to have some of your joy.
46:09
Speaker 3: Take it out, Doctor Jamie Lusk.
46:12
Speaker 1: It was such a pleasure to hang out with you
46:15
Speaker 1: as always, and thank you so much just for sharing
46:17
Speaker 1: your insight and expertise here with our audience. And so
46:20
Speaker 1: you guys, I'm sure listening to this like I need
46:22
Speaker 1: more doctor Jamie in my life.
46:24
Speaker 3: So or again.
46:24
Speaker 1: The website is doctor Jamie Lusk dot com and.
46:28
Speaker 2: You're on I'm LinkedIn. I'm trying to figure out Instagram
46:32
Speaker 2: and I'll tell you I tell you one thing about
46:35
Speaker 2: So I got involved with a group. It's nonpartisan, but
46:40
Speaker 2: it's a bunch of veterans who have moral distress and
46:43
Speaker 2: moral injury.
46:44
Speaker 1: Are these the ones you took surfing?
46:45
Speaker 2: But I do take veterans surfing a lot, But these
46:47
Speaker 2: are veterans for public lands. So they started a nonprofit
46:51
Speaker 2: to start trying to protect public lands. So as you know,
46:54
Speaker 2: there's public Lands under threat and it's a really cool
46:57
Speaker 2: group and that it kind of goes back to my
46:59
Speaker 2: bracelet here veterans who fought for our country and want
47:03
Speaker 2: to protect what they love best, which is public lands.
47:08
Speaker 2: So I've been pretty inspired by that group, and I
47:10
Speaker 2: think that's why I'm trying to figure out Instagram because
47:13
Speaker 2: I'm doing my own posts, but I'm like lasting some
47:16
Speaker 2: of the Veterans for public Lands. Okay, if you're an
47:19
Speaker 2: Instagram person, then you got tips. I could learn a
47:22
Speaker 2: few things.
47:23
Speaker 3: Me too, Jamie, me too. I'm like, I don't even
47:25
Speaker 3: know what this is about.
47:26
Speaker 1: Okay, so veterans for public Lands, but what a wonderful
47:29
Speaker 1: place to land. And I think full circle, right, is
47:31
Speaker 1: that the end of the story, the end of this journey,
47:34
Speaker 1: is one of redemption. There are many different ways to
47:39
Speaker 1: foster that type of energy. Some people find it spiritually,
47:42
Speaker 1: some people find it through these acts of service, are
47:45
Speaker 1: getting involved with organizations that are intentionally making the world
47:49
Speaker 1: a better place, our country literally the land itself a
47:52
Speaker 1: better place, and that's what lies ahead. So thank you,
48:08
Speaker 1: thank you so much for spending this time with me today,
48:11
Speaker 1: And if you have found this episode helpful, do your
48:16
Speaker 1: good deed for the day, pass it on, pay it forward,
48:21
Speaker 1: Share this episode with someone you care about who might
48:26
Speaker 1: need to hear what you just heard today.
48:29
Speaker 3: Close your eyes, think about.
48:30
Speaker 1: Who that is, and then boop hits end. Now. As
48:34
Speaker 1: for you, if you are feeling inspired by what we
48:39
Speaker 1: talked about today, if you're ready to go deeper, whether
48:42
Speaker 1: it's in your relationship, your own personal development, or maybe
48:46
Speaker 1: even your bigger sense of purpose, I would love to
48:49
Speaker 1: help you. Come visit me at growing self dot com.
48:54
Speaker 1: I have so many free resources for you, but you
48:57
Speaker 1: can also schedule a free consultation with one of the
49:01
Speaker 1: amazing licensed therapists on my team, who, like me, specialize
49:06
Speaker 1: in evidence based coaching psychology.
49:09
Speaker 3: You can do that.
49:10
Speaker 1: You can also explore the programs that we have designed
49:16
Speaker 1: for you to create real and lasting change in your
49:19
Speaker 1: life in a structured, step by step way, and do
49:23
Speaker 1: not forget to go into my blog and podcast, my
49:26
Speaker 1: content collections where you can find exactly what you need
49:32
Speaker 1: to support your journey of growth. And hey, let's also
49:37
Speaker 1: stay connected. If we're not already connected, come track me down.
49:41
Speaker 1: I am on Instagram periodically and would love to hear
49:45
Speaker 1: from you. Or if you have a question or comment
49:48
Speaker 1: about the show, just email me, get in touch hello.
49:51
Speaker 3: At growingself dot com.
49:53
Speaker 1: All Right, until next time, you take care and keep
49:57
Speaker 1: growing about
50:04
Speaker 4: About