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The PC(USA)’s Connecting the Dots webinar suggests congregations can support veterans dealing with combat-related trauma

‘Moral injury’ differs from PTSD but is still prevalent for servicemen, servicewomen

by Scott O’Neill | Presbyterian News Service

A webinar on Militarism and Moral Injury is the most recent installment in the Connecting the Dots series. (Screenshot)

LOUISVILLE — Most of us are familiar with Post-Traumatic Stress Disorder (PTSD), which is commonly associated with combat military service but covers a wide swath of trauma-inducing events.

Unlike PTSD, which deals with fear-based symptoms, moral injury focuses on symptoms related to the guilt and shame one feels from performing duties related to combat. A recent Connecting the Dots: Militarism and Moral Injury webinar brought together several panelists, including active and retired military to health counseling professionals, to discuss moral injury in the context of ministering to military members and how faith communities can support them in dealing with its symptoms.

The term “moral injury,” coined in the 1990s, can be defined as “the effects that occur in response to acting or witnessing behaviors that go against an individual’s values and/or moral beliefs.”

The Rev. Joshua Morris, currently Assistant Director of Spiritual Services at Children’s Mercy Hospital in Kansas City, Missouri, and a U.S. Army Reserve chaplain, spoke about his experience as a caregiver.

“Moral injury has always been helpful to me because when I’m providing counseling to soldiers or family members it helps them to feel seen sometimes when they may feel missed. They don’t have PTSD but there’s still a sense of experiencing something like shame or betrayal,” he said. “Moral injury enables them to feel covered by something, and that’s an entryway to healing.”

The Rev. Dave Terrinoni, an ordained PC(USA) chaplain in the U.S. Air Force and retired colonel with 31 years of service, including eight deployments, noted that military members — both enlisted and officer corps — all bear the sins and scars of war. He poignantly shared his experience with one pilot who told him: “How do I explain to my pastor that if we’re going to drop a nuclear bomb I would do it?”

“How does one deal with that?” said Terrinoni. “That’s a definite moral collision course.”

In a phenomenon that dates back two centuries to Napoleon’s army, research shows that fewer than 25% of the soldiers in World War II shot their weapons at the enemy. It seems that human beings, except for psychopaths, have an aversion to killing each other, according to panelist Bill Galvin, a counseling coordinator at the Center on Conscience & War. As a result of this research the military is training soldiers to kill reflexively in order to override one’s conscience.

“But the problem is you still have a conscience, and that’s where moral injury comes in, because folks in the heat of battle will do what’s necessary for their survival but have to reflect and live with that they’ve done,” said Galvin.

In addition to defining moral injury and how it manifests itself, the seven panelists and moderator Ryan White, PC(USA) mission co-worker/co-regional liaison for Northern and Central Europe, addressed three overarching questions around moral injury:

  • How to use the term without being accusatory or diminishing one’s sense of integrity.
  • Are marginalized communities overrepresented in the military? If so, are these communities impacted differently?
  • How might communities or churches exacerbate moral injury, or conversely, offer support and solidarity to facilitate recovery?

From the perspective of Lt. Christopher Hansen, an active U.S. Navy chaplain currently working at the Naval Medical Center San Diego, it’s important to note each story is unique and to listen to the language used in the telling of that story.

“The first step is having the mindset that moral injury itself is this conflict or violation of values of what’s right, but it doesn’t necessarily say who did what was wrong — meaning that it could be an act perpetrated by the member, or it could be something done to them, or it could something done to them by the larger institution,” said Hansen.

“The mindset we have to approach it from is to realize we don’t really know what’s going until we hear their story. Each story is unique, and I listen for language such as ‘I did something.’ Are they using language of I feel guilty, or I feel bad because of something, or language such as ‘I’m not myself; I lost myself and I’ll never be the same.’”

The Rev. Dr. Brian Powers, an ordained minister in the PC(USA), expanded on Hansen’s point.

“Moral injury carries some helpful and unhelpful connotations. Positively, it speaks to something that someone suffered and from which something one can recover. Negatively, it implies something is wrong with someone and that it’s only wrong with the person suffering and I don’t think that’s necessarily true. Moral injury — as opposed to PTSD — is not a disorder. It’s important to emphasize there’s nothing wrong with someone who is morally injured.”

On the question of impact to marginalized communities, Powers noted that 85% of the United Kingdom’s military comes from the poorer northern communities in the UK. Marginalized persons may suffer moral injuries at a higher rate before they even get to the military, Powers said.

From the U.S. military perspective, Hansen believes the issue is more complex.

“Currently the military is still more than 50% white racially but at the lower ranks there is a disproportionate representation of minority communities,” Hansen said. “However, over the last 10 years, the military has become more diverse at higher ranks to try to be more proportionate to the civilian world and corporate America.”

“Active-duty military is currently more than 1.4 million people,” Hansen said, “and most of those will never see combat and never go to war.”

He also noted that in the military, one has access to resources that one might not necessarily have outside of service, including universal health care, marriage and family life counselors, psychologists, psychiatrists and hospital social workers.

So how can faith communities and congregations support those suffering from moral injury?

The Rev. Dr. Carrie Doehring, a PC(USA) minister and professor of pastoral care at Iliff School of Theology in Denver, highlighted some research that points to when and how spiritual practices and religious beliefs and values help in the recovery from moral injury.

“Spiritual practices have an amazing potential to ground people and experiencing their bodies as good, even in experiencing the traumatic response of their body as good when they can pause that automatic alarm system that goes off that makes every situation feel morally threatening,” said Doehring. “We know Buddhist practices help, meditation and yoga help, and there’s more research that Christian and Jewish meditation practices help.”

Morris, from a reservist perspective, asked what it would look like for religious communities to lead and be able to nurture the veteran community in a way that doesn’t tokenize their experience.

“We’re all implicated in this, so if we can eliminate the ‘us versus them,’ the military and civilian divide, which is very real, I think religious communities can be healing — if there can be space to listen to stories.”


The Connecting the Dots webinar series will continue in 2023. Scheduled topics include:

  • The effects of militarism on women and children from a global perspective
  • Militarism in the economy and the military industrial complex
  • Peace Church.

The “Connecting the Dots” webinar series examines militarism from a variety of intersectional perspectives through the lens of the Christian faith. Organized by the PC(USA)’s Militarism Working Group, a recording of this webinar and its resources, as well as previous webinars in the series, will be made available here. It is also available in Spanish and Korean.

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