Moral Injury – Revisited

Have compassion on me, Lord, for I am weak. Heal me, Lord, for my bones are in agony. Psalm 6:2 NLT

Every day, our dedicated law enforcement personnel, firefighters, and medical responders confront the harsh realities of their environment. As first responders, we are reminded of the challenges we face and often feel the impact of that difficult journey. Our dedication to protecting and serving our communities shows our strength and resilience in overcoming challenges. Our actions and experiences sometimes challenge our moral compass, making us feel guilty, ashamed, or isolated.

There are times when training may hold you back and other times when policies and procedures prevent you from making the best choice. We often make tough and quick decisions that can significantly impact the lives of others. While we strive to get it right every time, sometimes things don’t go as planned. Navigating these situations can be challenging. When our actions conflict with our ethics, even when they align with laws, policies, and procedures, they can lead to psychological harm. Understanding the concept of moral injury and its impact is essential for effectively tackling this issue.

Moral injury is a concept that describes extreme and unprecedented experiences that can significantly impact individuals. It refers to the damaging effects on a person’s conscience and spirit when their actions or circumstances violate deeply held moral values or ethical principles.

Moral injury involves a non-physical wound caused by the breach of fundamental moral beliefs and ethical convictions, whether through one’s actions or those of others. This often stems from traumatic experiences related to personal circumstances, the world, or even God. Unlike immediate trauma, moral injury typically develops gradually; it may surface days after an event, and in some cases, it can take years to become apparent.

Research shows that when people experience more morally injurious events, they often struggle with feelings like guilt, frustration, depression, self-harm, shame, and even a loss of spirituality or a sense of belonging. It’s also been found that there’s a noticeable connection between moral injury and adverse psychological effects. Understanding this can help us support those going through tough times.

While most research on moral injury focuses on veterans, it can affect anyone. When we fail to act, do not meet our standards or ideals, or take part in actions we never thought we would, we become vulnerable to this type of psychological injury. Violations related to moral injury can result in feelings of shame and guilt, making it difficult to trust ourselves, others, or even the goodness of God and the world around us.

Moral injury can profoundly impact your emotional well-being, leading to feelings of shame, guilt, brokenness, and isolation. It poses a significant threat to your inner self. This experience can damage relationships and may serve as a gateway to alcohol and drug abuse. Additionally, individuals might resort to risky, thrill-seeking behaviors to gain attention. The harm done to your moral compass can create a profound sense of hopelessness, leading to suicidal ideation.^[1]

Moral Injury and Post-Traumatic Stress injury

While Moral Injury and PTSi can coexist, each has unique elements that make them different from each other, with some symptoms overlapping. According to the Veterans Administration, PTSi is “a mental disorder that requires a diagnosis,” while Moral Injury is considered “a dimensional problem” with no definable threshold for its presence.^[2]

In the field of psychology, some experts consider moral injury to be either a precursor to or a symptom of post-traumatic stress injury (PTSi). Dr. Jonathan Shay, known for his work with Vietnam veterans, argued that moral injury is often associated with various symptoms of PTSi. This includes triggering events, re-experiencing traumatic memories, and patterns of avoidance or emotional numbing.

It is not an enemy who taunts me— I could bear that.
It is not my foes who so arrogantly insult me— I could have hidden from them.
Instead, it is you—my equal, my companion and close friend.
Psalm 55:12-13 NLT

Betrayal: The Hidden Cause of Moral Injury in First Responders

One of the main attractions of becoming a First Responder is the opportunity to be part of a supportive community, often referred to as the First Responder family. The pride that comes from knowing our partners have our backs provides us with a profound sense of honor. However, this comforting feeling can quickly diminish if any of our partners betray us. Experiencing betrayal can be incredibly challenging and often leads to painful emotions such as guilt, shame, and disillusionment, which can profoundly affect our emotional well-being. Betrayal can take many forms, whether personal, within the organization, or in social settings.

Administrative and organizational betrayal can manifest as silent leadership, lack of support, and undermining behaviors. When a superior officer engages in administrative betrayal, it can hurt trust and morale. A betrayal leads us to doubt our agency, friends, or community as reliable sources of support.

When people in our organizations or personal lives disappoint us, we feel a sense of personal betrayal. The nationwide “summer of love” riots at the start of this decade serve as a prime example of community betrayal.

Recovery After the Injury

Post-traumatic and psychological injuries do not have to last a lifetime. Experiencing tragic events, causing harm to others, or feeling powerless to prevent someone else’s trauma can lead to moral injury. These experiences can have lasting psychological and physical effects that might stay with us for many years.

Post-traumatic growth is a recovery process from trauma in which personal development exceeds the impact of moral injury. Moral injury can lead to significant personal growth, improved abilities, and heightened resilience. First published in 1995, Post-Traumatic Growth (PTG) can be defined as “life-changing psychological shifts in thinking and relating to the world that contribute to a personal process of change that is deeply meaningful.”^[3]

In their book “Facilitating Post-Traumatic Growth,” researchers Richard Tedeschi, Ph.D., and Lawrence Calhoun, Ph.D., wrote, “Post-traumatic growth is the positive change that the individual experiences as a result of the struggle with a traumatic event.” Tedeschi and Calhoun have identified five aspects of Post Traumatic Growth to reflect on:

• • Spiritual Changes
  • Personal Strength
  • Relating to others
  • Appreciation of life
  • New possibilities

Some Christian researchers suggest that “spiritual changes” can draw people closer to God, fostering a belief in His divine presence. Studies show that the spiritual aspect of faith significantly contributes to healing and promotes post-traumatic growth. Additionally, individuals who are more engaged in religious practices are more likely to experience personal growth after facing trauma.

The blood of Jesus Christ, our Savior, cleanses our conscience and sins and cleanses us from immorality and Moral Injury. It’s a spiritual solution. The only true way to eradicate Moral Injury is through the restoration of all things, the restoration of the law of God! It’s the removal of sin and the installation of a new way of doing things. It’s a spiritual solution. It’s a return to holiness.^[4]

As First Responders, we have sworn to protect the good and fight against evil. However, many have lost sight of their priorities and placed their jobs above all else. If you are feeling a diminished sense of self-worth, depression, misplaced guilt, difficulty remembering or discussing trauma, emotional numbness, dissociation (being unaware of the present moment), disconnection from your daily life, hyper-arousal and constant vigilance for danger, irritability or unexplained anger, feelings of jitteriness, or trouble concentrating on tasks, as well as anxiety disorders like panic or intense distress, it’s essential to talk to someone and seek help. Always put God first, family second, and career last.

IF YOU HAVE THOUGHTS OF SUICIDE – GET HELP NOW

Law Enforcement – COPLINE (800)COPLINE (267-5463)

Firefighters / Medics – FIRE/EMS HELPLINE (800) 731-FIRE (3473)

“We don’t allow ourselves to become mired down in the difficulty of life, because we understand that we were created for something so much bigger than the challenges we are facing today.”
(Jeremy Stalnecker, CEO – Mighty Oaks)

1. Konstantinos Papazoglou PhD, “Moral Injury in Police Work, Law Enforcement Bulletin, https://leb.fbi.gov/articles/featured-articles/moral-injury-in-police-work, accessed 03/10/2025 ↑
2. “Moral Injury,” DAV (website), https://www.dav.org/veterans/resources./moral-injury, accessed 03/10/2025 ↑
3. Tedeschi, R. G. PhD., & Calhoun, L. G. PhD (1995). Trauma & transformation: Growing in the aftermath of suffering. Sage Publications, Inc. https://doi.org/10.4135/9781483326931 ↑
4. Peter Eddington, “Fixing Moral Injury,” United Church of God, https://www.ucg.org/members/united-news/fixing-moral-injury, accessed 11/19/2019 ↑