Dr. William Nash Discusses Moral Injury Beyond the Military Context

The emerging issue of moral injury has been most often associated with returning military personnel. However, Volunteers of America believes this construct extends beyond the military setting, requiring more investigation into how to identify and treat moral injury among diverse populations. In that vein, Volunteers of America, The Soul Repair Center, and The Braxton Institute came together to hold a seminar titled, "Moral Injury and Collective Healing," an advanced training session for professionals in multiple fields, including theology, psychology, corrections, the arts, ministry, and more. Experts came together in this collective effort and this video highlights an interview with Dr. William P. Nash, speaking on the subject. Questions and inquiries regarding this video's content may be made to Dr. Rita Nakashima Brock at RBrock@voa.org.


Dr. Nash:
Moral injury is damage to a person from experiencing something that violates deeply our moral expectations, and moral expectations are something that although ministers, and theologian, and philosophers have been interested in for a long, long time, it's a new thing for health care professionals and other caregivers to consider. They're really ... Moral expectations are right at the very core of who we are as people, and who we are as societies, it's what we build our lives on. It's what matters, it's what we value, it's what we love, it's our system of love. We love the things that we look up to, and work toward, are willing to serve, and in some cases die for.

I think there's good evidence that we are all hardwired from before birth to try to embody goodness, morality, love, compassion, empathy, caring. We all know that those are the right things, well all ... They give us joy, and if life were lived somewhere other than here on this very earthly planet, maybe we could pull that off for a lifetime. But of course nobody can, of course life brings us to our knees over and over again because we can't always meet our own moral expectations, and others can't always meet our moral expectations.

Then the challenge is okay, now what? Now what? How do we make sense out of that? How do we regroup after that? How do we go on? A lot of moral injuries are just little bruises, twinges. I did something, or somebody did something to me and you get angry about it for a while, and then you shrug it off, and it's just life. But then there are others, other moral injuries that are profound and devastating, and having conversations about moral injury that's important for people to be aware that there is that spectrum.

As somebody whose served with the Marine Corp in war zones and in the aftermath of that, as others who've served in prisons are aware, there are significant numbers of people who've had these profound moral injuries and that's a real challenge of how to rebuild. Rita Nakashima Brock, who is one of the leaders of this great training seminar uses the term rebuilding the house as a metaphor for recovering, repairing after moral injury. I think it's a really good metaphor.

One of the things this training here, this seminar is built on is the awareness that moral injury is part of the human condition, it's something all people experience, it is not a medical thing, it's not a health care thing, it's not a religious thing, it's not a spiritual thing, it's not a literary thing, an artistic thing, or a poetic thing, but it's all of those things. And that humanness is defined by all those different perspectives, and through all those different lens, and I will fight for the rest of my career to not let health care professionals, even though I am one, not let health care professionals try to co-opt this moral injury thing as a health care issue because that will be ... That will not do any of us any good.

That the people who I have met and talked to over the years who had the best outcomes after a sever moral injury, who've come through that hero's journey, come out of the wilderness with this new wisdom that they bring to others, it's almost always because of relationships because somebody listened to them, really listened, was able to hear sometimes some pretty horrible horrific truths without becoming disgusted, without judging, without turning away, and then giving the person who spoke the greatest gift that we can offer and that is to say, "I hear you, I believe you, but I still love you." And to ... For the person to believe that, it can't really be a helping professional like me who's paid to come in and give you 50 minutes of an hour.

Sometimes people can suspend disbelief about genuine love and caring, and I believe I genuinely do love and care for the people I serve. But how much easier when there's already a relationship and they already know that this person they're talking to really does care about them? You don't need to have any special skill to provide this service, and we've been doing it forever, we just haven't had the language, we just haven't had the words to communalize these experiences and then to study, to research and find out were really what works and what doesn't, and that's where we're at now finally this is exploding worldwide, and it's changing people's attitudes about so many things because there's this realization, this acknowledgement even among our senior military leaders, which are just so delighted about, that moral injury is real. It is a ... One of the things that can happen to people in bad situations.

And in the military, if we're going to create bad situations by prosecuting wars, by deploying into ugly situations even if its humanitarian missions, we have to do it with our eyes open knowing that we're going to be putting people in positions where they're going to be vulnerable to and at risk for moral injury. And it's our duty ... It is our duty to do what we can to prevent that, to recognize it, to help people move on, rebuild, heal, to create goodness where we have created evil.

So I think one of the really hopeful things to me about this ... These last three days here, is that there's so many different voices, poetic voices, and song, and music, and art, and literature, and philosophy, and religion, theology, and a little bit of psychiatry. It's very encouraging for me, and I think this is the kind of conversations we need to have more of with inclusion, and seeing the big picture so we can ... That's the other thing about moral injury as a concept that's made me very proud actually to be part of this conversation is that it's become a linking concept. It has created ... It's drawn a circle in which all these different points of view, these different walks of life can converge and say this is our common ground, this is our common space. That's exciting, and we need more conversations like this.