by Susan Sganga, Public Health Specialist
This is a community of practice aimed at helping people to recover their sense of self-worth. The goal is for practitioners to talk, ask questions, interact, and help each other to learn and grow. With a subscription cost of $25 per month, participants receive 2 books, CEUs, and a free pass to the 2023 Comprehensive Moral Injury Conference in Atlanta.
The learning objectives are these:
1. Define moral injury
2. Describe how moral injury affects people’s self-esteem
3. Explain ways chaplains, psychologists, social workers, and other caregivers can help a person rebuild their self-esteem
Moral injury is caused by a traumatic event that profoundly disturbs one’s sense of what is right. It is a betrayal of one’s core values. Let’s say Charlie is ordered to attack a building in a war-time situation. When he assesses the damage, he finds dead women and children. He is consumed by guilt. Let’s say Susie is raped by her boss while on a business meeting. She feels shame, guilt, anger, and betrayal. Moral injury is an ancient problem, as old as Cain and Abel, but as a research field, it is a new phenomenon. It involves one human deeply wronging another human being. It also occurs when a perpetrator, a murderer or rapist, morally injures himself by his own actions.
Charlie’s commanding officer lied to him, as did many other officers in combat situations. Charlie realized that he and his teammates drank so much after deployments due to their guilt, although they didn’t understand that at the time. Witnessing wrongful acts and doing nothing because one felt powerless also leads to moral injury. The perpetrators, victims, and witnesses to immoral acts have each suffered moral injury. Medical personnel without adequate resources also face moral injury, as do those harmed by racism.
Religious people experience moral injury, as do atheists. Deeply held moral beliefs can come from religious teachings, but also from family teachings, codes of ethics, and laws.
Self-esteem is lowered when people don’t feel valued, or worthy of the good things in life. They may feel that they can’t be redeemed because of the bad things they have done, that others have done to them, or they have witnessed. These thoughts can lead to depression, anxiety, and suicide. Prison chaplains say that even criminals feel they have done morally injurious things (i.e., they are not hardened psychopaths).
Most people have a low sense of self-esteem or worth. Even high performers are often motivated to prove their worth, and when they fail, they feel they are just “garbage.” Not all, but many, instances of low self-esteem are the result of moral injury.
How can we help to rebuild self-esteem, or our own evaluation of our worth as a human being? We all tend to link our value to our performance, or behavior. But we must delink our self-esteem from our behavior. How can we do that? As a Christian, my value or self-worth comes from God. I was created as a unique individual, and if I sin (behave wrongly), I can be forgiven. So, I see 3 ways to rebuild someone’s self-esteem.
- Establish a source of value that does not shift. Either that comes from being created in the image of God, or being unique, irreplaceable, or knowing I matter in the world. Caregivers must listen for clues, as people don’t see their problems as being rooted in their self-esteem. A person with high self-esteem doesn’t hesitate to seek help, but a person with low self-esteem doesn’t feel he is worthy of your time.
- Help the person to see that everyone deserves a chance for redemption. Mistakes do not mar his value. When a morally injurious act occurred, often the person acted on limited information. Charlie received an illegal order in the fog of war. Susie was raped but felt she should have been able to prevent it. The practitioner’s role is to help her to see that she was not empowered at the time. She trusted an untrustworthy person. We need help on the journey to be able to reframe and change our perspective.
- Helping the person to establish a new self-image means to rehumanize them. Daily affirmations can help them to reprogram their brains by choosing to believe they are valuable. Reading books and blogs is a useful strategy. Multiple sessions are often needed, with reiterations and remembering what has been learned in a trusting therapeutic relationship.
Chaplains aim to uplift soldiers. While the world doesn’t affirm our value, and people often visit their own pain on others, we as caregivers should be sending the message that each person is valuable and of great worth.
Next month’s meeting will be on Revitalizing the Disempowered.
Subscribe and join us live on December 7th at 7:oo pm ET.