The daughter of a U.S. Marine veteran didn’t understand why her father kept hiding his Honorable Discharge in a drawer. “He earned it on Guadalcanal” she said. “He’s a hero.” Her father had been known in the community for helping people in need for forty years. But with his daughter in the other room he whispered, “I’m a fake. Everybody thinks I’m good, but they don’t know what I did.”

The U.S. Marine veteran could be suffering from Moral Injury. Moral Injury occurs when a person acts in a way that they think is wrong, watches someone else commit wrongdoing, or fails to prevent a wrong.

Looking out the window at some unseen thing a thousand yards away, the marine remembered: “One night I was separated from my squad. To stay alive, I fired on anything that moved.” After pausing he continued, “There were other marines in the jungle.”

No evidence exists that he harmed anyone, friend or foe. But with a moral injury it isn’t evidence that matters, it is belief. The marine believed he had harmed or killed other marines. And he believed that doing so was unforgivable. Once home, he had tried to sweep away his guilt and shame by helping other people. Those he helped told him he was the nicest person they ever met. At times he almost believed them. Until the sun dipped, shadowing a bush like Guadalcanal. And he remembered the other marines in the jungle.

Common symptoms of moral injury are:

  • Reliving the event when something triggers the memory.
  • Experiencing disruptive feelings like guilt, shame, fear, anger, and anxiety.
  • Avoiding situations and places that resemble the person, place, or experience.
  • Having trust issues.
  • Substance abuse—which can either be long term, or occasional benders.

If someone you care about has these symptoms once a month or once a year, they may have a moral injury—even if they didn’t go to war: training accidents and illegal orders happen in times of peace. You don’t have to be a veteran either—law enforcement, first responders, first receivers, and corrections staff, are all at risk for moral injury every time they go to work.

Moral injuries hurt. Beliefs about bearing pain in silence, about suffering being part of atonement, and thinking that what someone experienced “wasn’t that bad” can cause the injured to deny treatment. They may think that they aren’t injured. But symptoms don’t lie. You don’t have to live with moral pain.

Life can get better, much better. With help, you or your loved one can learn how to respond to negative thoughts and emotions. You can learn what to do when painful or troubling memories disrupt the peace. There are ways of coping that don’t involve passing out in a puddle of vomit, having a screaming fight, or quitting your job.

Moral anguish disrupts a person’s narrative and blurs the sense of self. Healing starts with the injured exploring their beliefs about who they are, and what they believe about the world they live in. The Center for Mental Health is here to help.

The Center for Mental Health has several professionals on staff who have been specially trained in effective treatments for moral injury, as well as PTSD. Call us at 970.252.3200 to find a provider or email info@centermh.org and we will reach out to you directly.