Introducing The Shay Moral Injury Center at Volunteers of America
Under the direction of Rev. Rita Nakashima Brock, Ph.D. and named for Jonathan Shay, the Shay Moral Injury Center at Volunteers of America aims to deepen understanding about moral injury in the many populations who experience it. The center builds on Volunteers of America’s work, spanning more than a century, of helping veterans and others who live with this emotional trauma.
Dr. Jonathan Shay: My definition of moral injury is when there is a betrayal of what's right. Now, the definitions of what's praiseworthy and blameworthy in every place that human beings are is located in the local culture, so the understanding of what's praiseworthy and blameworthy is culture. The second part of the definition is betrayal of what's right by someone who holds legitimate authority. All societies, the anthropologists tell us and the sociologists tell us, all societies have some understanding of legitimacy in the exercise of social power, so betrayal of what's right in the culture by someone who holds legitimate authority, and then the third component is in me in a high stakes situation. I am the person who has a stake in it. It may be something as obvious as my stake in my bodily integrity, that I don't want to spend the rest of my life trying to get around on one leg, for example. Of course, in war, weapons do terrible harm to the human body, so the betrayal of what's right by someone who holds legitimate authority in a high stakes situation.
When all three are present, I assert, I believe with some justification that moral injury is present. I also observe that when moral injury is present, the body reacts massively in the same way that the body reacts if somebody is coming at you with a knife, the massive adrenal and autonomic reaction to physical danger, so painfully, but I think accurately, there you have the whole human critter involved with brain and body, physical brain and physical body, with mind, with social system, and with culture.
Dr. Rita Brock: But then the task you have coming out of that is how do you then build a moral identity again that doesn't deny what happened, but will give you the strength to move forward. So moral injury is not one thing. Everybody has a different culture and value system, and we share those with the people we know and grow up with and live with, but even if you share the same value system with someone, you can be disturbed by something that doesn't bother somebody else.
Mike King, Volunteers of America CEO: So it really relates to really everything we do. You know, virtually every service we provide at Volunteers of America, from both our caregiver side, our 16,000 member family that I think are the best caregivers in the world, our caregivers as well as the people they're caregiving for. Most have experienced some form of moral injury, so nothing could be more congruent with who we are and what we do than to learn more about this particular term, more about this concept, and more about how to deal with it.