New York Avenue Presbyterian Church continues its discussion on moral injury

Dr. Rita Nakashima Brock delivers the second of her McClendon Scholar-in-Residence lectures

by Mike Ferguson | Presbyterian News Service

Photo by Jacob Bentzinger via Unsplash

LOUISVILLE — Dr. Rita Nakashima Brock, an author and scholar and the senior vice president for moral injury programs at Volunteers of America, continued her discussion on moral injury on Saturday at New York Avenue Presbyterian Church in Washington, D.C., by emphasizing the church’s role in moral injury recovery through ritual.

Brock, this summer’s McClendon Scholar-in-Residence at the downtown Washington, D.C., church, spoke last month on moral injury. Read a report of that talk here. She also preached Sunday at the church that President Lincoln attended regularly during the Civil War.

Brock traced moral injury in veterans back to the 1700s, when it was labeled “nostalgia” or “homesickness.” By Lincoln’s time in the White House, moral injury was being called “soldier’s heart,” and throughout both world wars it was commonly known as “shellshock” or “combat stress reaction.” Clinicians identified it “Post-Vietnam Syndrome” until 1980, and post-traumatic stress disorder entered the Diagnostic and Statistical Manual of Mental Health Disorders in 1980. The fifth edition of the DSM revised it to “stressor-related disorder.”

“Your brain over-functions in its fear mode,” Brock said of moral injury’s effects. Moral injury “is not a mental health disorder. It’s a function of our being born moral,” and has three levels of severity: moral discomfort, moral distress and moral injury, which she noted is “the biggest factor for suicide among veterans” and is, as Rabbi David Blumenthal has pointed out, “a sign of mental and moral health.”

“People can seem OK. They can get on with their lives, but it will need to be processed at some point,” Brock told an audience listening both in-person at the historic downtown church and online. “It is crucial for the church to figure out how to help people with moral injury.”

“We may feel broken individually,” Brock said, “but we recover collectively.”

She said that human beings are “social animals. We need friends, and there’s an epidemic of loneliness right now that’s bad for your health.”

Both our meaning systems and our moral behavior are social, and they’re reinforced through ritual, Brock noted. Parents and caregivers tell their 2-year-olds to say they’re sorry when they need to, “and eventually they get it … Most of us are moral by habit. We just are nice to people and do our thing because we have been habitually trained in that behavior. Rituals are crucial to that process.”

In church, those are shared, repeated processes that “occur in liminal space and time.” It can be as simple as a hospital chaplain asking a patient, “May I pray with you?”

“If the patient says yes, a ritual has begun,” she said. Churches “are that kind of space, and so is the outdoors. You don’t have to build it. You just have to say, ‘This is the space.’”

“It’s counterintuitive for Protestants to go on and on about ritual,” Brock said. “The Protestant attitude was ritual is superstition … Protestants focus on personal faith and subjectivity, and rituals are understood to be an expression of your personal faith.”

But in many cultures, that’s the minority opinion, Brock said. “You do the ritual because it’s the ritual. They don’t care about your own beliefs.” If belief in God makes you a better person, go ahead and believe in God, those communities might say. “It’s the ritual that’s effective,” such as tai-chi or mindfulness.

Dr. Rita Nakashima Brock

Even worship rituals many Christians consider innocuous enough, such as the passing of the peace, have been called hypocritical by some people. Brock pushed back on that: “You want a community where people who don’t like each other can greet one another,” Brock said.

Ritual can “pull you up out of the misery of your own feelings. You get to process your inner world with imagination and with empathy for others, and that relativizes how miserable you feel,” Brock said. We attend a friend or loved one’s memorial service “because you feel terrible that someone died who you cared about, knowing you will feel better in the end. You listen and trust, sing songs and listen to scripture and prayers, and you’re surprised sometimes how much better you feel.” Sometimes it doesn’t work, “but it helps people handle the fierce forces in life that otherwise would destroy you.”

Rituals work for many people, she said, because they engage people’s imagination. There’s movement and often group singing, both of which are “good for people. Rituals turn attention to the present time, focus perception and connect people.”

In fact, recovery from moral injury is like another ritual symbol for many Christians: a labyrinth, Brock said. “You keep moving.”

She offered a number of online resources for people who are helping others, including this and this, a six-part podcast called “Soul Repair: After Moral Injury,” which Brock did with Dr. Susan Diamond.