There is an interrogative technique often used in psychology and business called The 5 Whys. The technique is simple. You ask a question and then ask ‘Why?’ five times. It’s a remarkably simple technique which really causes the statement-holder to get to root of their reasoning. (Either that, or they shout, ‘What are you, three years old? Stop asking why!’)

Although not universal, I am witnessing beneath many discussions around vaccines and governing measures lays a heartfelt ethical and moral personal concern for many. Several private discussions and intentional ‘whys’ beneath the myriad of medical debates have revealed core moral and ethical beliefs underpinning many preferences and biases we all hold. Let’s face it, as with political views, we can all find objective information and reasoning to support our subjective internalised moral and ethical convictions.

But what happens when we are feel forced, coerced or penalised for holding and acting upon certain convictions? What happens when we witness others suffer under these kind of measures?

What we do know from research is that this deep human desire for safety, security and freedom within all of us is subject to injury and trauma. The medical and military community have been using the term Moral Injury for decades. I dare say, moral injury is what people on all corners of the global debate are experiencing now in varying degrees.

Williamson et. al define moral injury as ‘the profound psychological distress which results from actions, or the lack of them, which violate one’s moral or ethical code’ (2020)[1]. War Veteran recovery specialist Dr Edward Tick regards moral injury as a deeply spiritual trauma.

Symptoms of moral injury include:

• Self-destructive impulses
• loss of religiousness, faith, or hope
• Guilt or shame
• Feelings of betrayal
• Loss of trust
• Lack of purpose
• Self-blame
• Anxiety or depression
• Sleep problems
• Substance abuse [2]

Although moral injury is not a mental illness like PTSD, it can lead to negative thoughts about oneself and others as well as feelings of guilt, shame or disgust. If we look at the academic research from the past 18 months, it suggests that moral injury is finding its way into many homes and workplaces. For example, moral injury reached the essential worker community in the US early in the pandemic [3]. It has reached world leaders trying to make equitable decisions [4]. It has reached parents trying to make good decisions regarding their child’s wellbeing [5]. It has reached religious communities, sparking debates among some Jewish and Evangelical Christian communities [6] .

When it comes to healing moral injuries, military support organisations often focus on three things when working with defence veterans. Note that these recovery actions start with the individual. Not policies, funding, or apologies:

1. Rebuild trust with important relationships.
2. Find forgiveness through mental flexibility.
3. Reconnect to your core purpose and share it.

Here’s what I believe we can all be mindful of at this time:
No doubt, a lot of us are feeling the effects of collective moral injuries. Whether you are for, against or in-between all that has been suggested, imposed and withheld, we each have a responsibility to tend to our own moral wounds.

If it is true that hurt people, hurt people, then the unknown long-term effects of our medical action may be pale when compared to the harm our lack of self-awareness is causing others. If we don’t take personal stock of our own moral injuries and attend to them in a healthy way, God knows the road back to our better selves will take more than a double dose.

Much love

Dave

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[1] Victoria Williamson, Dominic Murphy, and Neil Greenberg, ‘COVID-19 and Experiences of Moral Injury in Frontline Key Workers’, Occupational Medicine, 70.5 (2020), 317–19
[2] CHAMP, ‘Help Your Relationship Recover from PTSD, TBI, and Other Invisible Injuries for Military Wellness’, 2021.
[3] Joanna Gaitens and others, ‘Covid-19 and Essential Workers: A Narrative Review of Health Outcomes and Moral Injury’, International Journal of Environmental Research and Public Health, 18.4 (2021), 1–16
[4] F Tahzib, ‘Moral Distress and Moral Injury in the Public Health Community in Times of COVID-19’, European Journal of Public Health, 31.Supplement_3 (2021), 2021
[5] Jordan Luttrell-Freeman, Timothy J. Bungum, and Jennifer R. Pharr, ‘A Systematic Review of the Rationale for Vaccine Hesitancy among American Parents’, Global Journal of Health Science, 13.8 (2021), 77
[6] Ben Kasstan, ‘“A Free People, Controlled Only by God”: Circulating and Converting Criticism of Vaccination in Jerusalem’, Culture, Medicine and Psychiatry, 2021