Latest / Hardiness with Dr Paul Taylor / Mojo Monday: Healing Moral Injury with Acceptance and Commitment Therapy with Carly Taylor

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Mojo Monday: Healing Moral Injury with Acceptance and Commitment Therapy with Carly Taylor · Hardiness with Dr Paul Taylor

• 0:08
  Speaker 1: Welcome back to Mojo Monday. I'm Krli and today I'm
• 0:13
  Speaker 1: going to dive into a concept that I was introduced
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  Speaker 1: to this week through a client. It's something called moral injury,
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  Speaker 1: and I had never heard of it, but I was
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  Speaker 1: really intrigued by it. So when I first heard this term,
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  Speaker 1: it really didn't sit well with me, Like that was
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  Speaker 1: my automatic response, and it's the word injury that doesn't
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  Speaker 1: sit well. So being morally injured implies when something violates
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  Speaker 1: our moral code, which makes me wonder is the language
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  Speaker 1: of being injured appropriate or maybe there's a different perspective
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  Speaker 1: and a more effective way to address these feelings of
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  Speaker 1: betrayal or conflict. So before I dive into that, let's
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  Speaker 1: look at what moral injury actually is. So it was
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  Speaker 1: first termed by doctor Jonathan Shay in the nineties, and
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  Speaker 1: he was a psychiatrist who worked with Vietnam veterans. And
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  Speaker 1: what happened was he recognized that there was something happening
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  Speaker 1: beyond just PTSD. So while PTSD usually results from life
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  Speaker 1: threatening experiences the trigger fear and hypervigilance, moral injury is
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  Speaker 1: a bit different. It arises when there's a betrayal of
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  Speaker 1: deeply held values or what we made term as virtues,
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  Speaker 1: things like justice, loyalty, fairness, particularly by somebody in authority
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  Speaker 1: and in a high stakes situation. So it's not about
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  Speaker 1: feeling physically unsafe, but about having your ethical compass thrown
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  Speaker 1: off course. And it could happen when you're forced to
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  Speaker 1: act in a way that goes against your moral code,
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  Speaker 1: or when someone else's actions deeply violate what you believe
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  Speaker 1: is right. We're probably all been in those situations. But
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  Speaker 1: moral injury isn't just emotional burnout or frustration. It can
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  Speaker 1: change the way you see the world and yourself, and
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  Speaker 1: it often leads to feelings of shame and guilt or
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  Speaker 1: anger or resentment. And I find this so interesting because
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  Speaker 1: moral injury isn't currently recognized as a mental disorder. It
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  Speaker 1: doesn't appear in the diagnostic and statistical manual. But it's
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  Speaker 1: emotional impact things like depression, anxiety, or that hurt that
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  Speaker 1: comes through loss of loss of trust is very real,
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  Speaker 1: and these emotions can run very deep and erode how
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  Speaker 1: we feel about ourselves and also how we relate to others.
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  Speaker 1: So when I heard this term, it really struck me
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  Speaker 1: that calling it an injury might lead us towards focusing
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  Speaker 1: on fixing something like reducing our symptoms. But I thought
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  Speaker 1: there could be a more effective approach here, and that's
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  Speaker 1: when acceptance and commitment therapy, or what we call ACT,
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  Speaker 1: could come in. So ACT doesn't focus on symptom reduction
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  Speaker 1: in the traditional sense. It's about learning to sit or
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  Speaker 1: make room for your moral pain, those feelings of shame
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  Speaker 1: or anger or betrayal, while taking actions or behaviors that
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  Speaker 1: align with your values. So rather than framing moral injury
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  Speaker 1: as something to heal or escape from, ACT what ACT does.
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  Speaker 1: It invites us to acknowledge that pain is part of
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  Speaker 1: the human experience and the real work is in choosing
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  Speaker 1: how we respond to it. And so I did a
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  Speaker 1: bit of a search. I came across a research paper
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  Speaker 1: that really aligns with this perspective. So I was pretty
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  Speaker 1: excited about that and what it does. It discusses how
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  Speaker 1: moral injury doesn't need to be seen as a collection
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  Speaker 1: of symptoms that we have to eliminate. Instead, it can
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  Speaker 1: be understood as the behaviors we engage in to avoid
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  Speaker 1: or control moral pain. So whether it's withdrawing from relationships,
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  Speaker 1: becoming isolated, or ruminating on the event, or just focusing
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  Speaker 1: on that and then neglecting other areas of your life.
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  Speaker 1: These behaviors can often keep us very stuck. The term
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  Speaker 1: often comes up in the context of healthcare and military service,
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  Speaker 1: and even corporate settings, where people might experience betrayal or
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  Speaker 1: they have to actually do something in their job that
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  Speaker 1: doesn't align with their values, but they have these external
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  Speaker 1: pressures to do so. So I'll take an example that
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  Speaker 1: was from the paper. So, say you're a health care
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  Speaker 1: provider who promised to be there for a patient in
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  Speaker 1: their final moments, but due to external pressures or something
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  Speaker 1: going on that something else that they had to do,
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  Speaker 1: you couldn't actually be there. So you might feel intense
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  Speaker 1: guilt and shame or anger because this act goes against
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  Speaker 1: your deeply held values of providing compassionate care. So labeling
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  Speaker 1: this situation as a moral injury might lead you to
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  Speaker 1: focus on healing the guilt or trying to get rid
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  Speaker 1: of the pain. But as the paper suggests, this doesn't
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  Speaker 1: help long term, and what does help is or is
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  Speaker 1: more is maybe more effective, is acknowledging that this pain
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  Speaker 1: exists because it's part of your commitment to your values
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  Speaker 1: and it is part of the human experience. It's a
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  Speaker 1: normal response to a really stressful situation. So painful, yes,
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  Speaker 1: but also deeply tired to what we care about the most.
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  Speaker 1: So it's almost like there's two sides to a coin here,
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  Speaker 1: and the question to ask is how can I live
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  Speaker 1: my values? How can I live aligned with what is
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  Speaker 1: deeply important to me now in the presence of this pain.
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  Speaker 1: So for anyone who feels like they've been injured in
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  Speaker 1: the moral sense, and I say injured in inverted commas,
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  Speaker 1: I really encourage you to shift your perspective. So rather
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  Speaker 1: than focusing or eliminate trying to eliminate the pain, explore
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  Speaker 1: what it's telling you about your values, because there's a
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  Speaker 1: message in that, and then think about how you could
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  Speaker 1: move forward towards those values in what you do. So
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  Speaker 1: your behavior and your actions is even when the moral
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  Speaker 1: pain is present. Well, that's it for today's Mojo Monday.
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  Speaker 1: I hope that you have got value out of this,
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  Speaker 1: especially if you have experienced or are experienced what feels
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  Speaker 1: like a moral injury. I really hope that this has helped.
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  Speaker 1: And I think it's important to remember that pain can
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  Speaker 1: coexist with purpose. It's what we choose to do. It's
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  Speaker 1: how we respond to that pain that really matters. Have
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  Speaker 1: a great week everyone, and I will catch you next week.