1 00:00:08,920 --> 00:00:13,360 Speaker 1: Welcome back to Mojo Monday. I'm Krli and today I'm 2 00:00:13,400 --> 00:00:16,480 Speaker 1: going to dive into a concept that I was introduced 3 00:00:16,520 --> 00:00:20,960 Speaker 1: to this week through a client. It's something called moral injury, 4 00:00:21,079 --> 00:00:23,400 Speaker 1: and I had never heard of it, but I was 5 00:00:23,480 --> 00:00:28,280 Speaker 1: really intrigued by it. So when I first heard this term, 6 00:00:28,600 --> 00:00:31,319 Speaker 1: it really didn't sit well with me, Like that was 7 00:00:31,320 --> 00:00:35,800 Speaker 1: my automatic response, and it's the word injury that doesn't 8 00:00:35,840 --> 00:00:41,960 Speaker 1: sit well. So being morally injured implies when something violates 9 00:00:42,000 --> 00:00:46,640 Speaker 1: our moral code, which makes me wonder is the language 10 00:00:46,880 --> 00:00:51,760 Speaker 1: of being injured appropriate or maybe there's a different perspective 11 00:00:51,920 --> 00:00:54,840 Speaker 1: and a more effective way to address these feelings of 12 00:00:54,920 --> 00:01:00,440 Speaker 1: betrayal or conflict. So before I dive into that, let's 13 00:01:00,440 --> 00:01:04,000 Speaker 1: look at what moral injury actually is. So it was 14 00:01:04,040 --> 00:01:08,880 Speaker 1: first termed by doctor Jonathan Shay in the nineties, and 15 00:01:08,920 --> 00:01:12,720 Speaker 1: he was a psychiatrist who worked with Vietnam veterans. And 16 00:01:12,800 --> 00:01:16,520 Speaker 1: what happened was he recognized that there was something happening 17 00:01:16,600 --> 00:01:23,080 Speaker 1: beyond just PTSD. So while PTSD usually results from life 18 00:01:23,120 --> 00:01:29,120 Speaker 1: threatening experiences the trigger fear and hypervigilance, moral injury is 19 00:01:29,200 --> 00:01:33,360 Speaker 1: a bit different. It arises when there's a betrayal of 20 00:01:33,520 --> 00:01:37,520 Speaker 1: deeply held values or what we made term as virtues, 21 00:01:38,240 --> 00:01:44,880 Speaker 1: things like justice, loyalty, fairness, particularly by somebody in authority 22 00:01:45,480 --> 00:01:49,600 Speaker 1: and in a high stakes situation. So it's not about 23 00:01:49,720 --> 00:01:56,040 Speaker 1: feeling physically unsafe, but about having your ethical compass thrown 24 00:01:56,080 --> 00:02:00,040 Speaker 1: off course. And it could happen when you're forced to 25 00:02:00,080 --> 00:02:02,720 Speaker 1: act in a way that goes against your moral code, 26 00:02:02,920 --> 00:02:07,360 Speaker 1: or when someone else's actions deeply violate what you believe 27 00:02:07,480 --> 00:02:11,760 Speaker 1: is right. We're probably all been in those situations. But 28 00:02:11,919 --> 00:02:16,959 Speaker 1: moral injury isn't just emotional burnout or frustration. It can 29 00:02:17,120 --> 00:02:21,120 Speaker 1: change the way you see the world and yourself, and 30 00:02:21,160 --> 00:02:24,600 Speaker 1: it often leads to feelings of shame and guilt or 31 00:02:24,639 --> 00:02:29,280 Speaker 1: anger or resentment. And I find this so interesting because 32 00:02:29,720 --> 00:02:34,640 Speaker 1: moral injury isn't currently recognized as a mental disorder. It 33 00:02:34,680 --> 00:02:39,119 Speaker 1: doesn't appear in the diagnostic and statistical manual. But it's 34 00:02:39,200 --> 00:02:45,120 Speaker 1: emotional impact things like depression, anxiety, or that hurt that 35 00:02:45,240 --> 00:02:48,480 Speaker 1: comes through loss of loss of trust is very real, 36 00:02:49,320 --> 00:02:53,679 Speaker 1: and these emotions can run very deep and erode how 37 00:02:53,720 --> 00:02:58,560 Speaker 1: we feel about ourselves and also how we relate to others. 38 00:02:59,440 --> 00:03:02,280 Speaker 1: So when I heard this term, it really struck me 39 00:03:02,480 --> 00:03:07,240 Speaker 1: that calling it an injury might lead us towards focusing 40 00:03:07,280 --> 00:03:12,240 Speaker 1: on fixing something like reducing our symptoms. But I thought 41 00:03:12,280 --> 00:03:15,920 Speaker 1: there could be a more effective approach here, and that's 42 00:03:15,960 --> 00:03:19,000 Speaker 1: when acceptance and commitment therapy, or what we call ACT, 43 00:03:20,080 --> 00:03:23,919 Speaker 1: could come in. So ACT doesn't focus on symptom reduction 44 00:03:24,160 --> 00:03:28,960 Speaker 1: in the traditional sense. It's about learning to sit or 45 00:03:29,000 --> 00:03:33,079 Speaker 1: make room for your moral pain, those feelings of shame 46 00:03:33,200 --> 00:03:38,320 Speaker 1: or anger or betrayal, while taking actions or behaviors that 47 00:03:38,560 --> 00:03:43,240 Speaker 1: align with your values. So rather than framing moral injury 48 00:03:43,320 --> 00:03:47,960 Speaker 1: as something to heal or escape from, ACT what ACT does. 49 00:03:48,000 --> 00:03:51,080 Speaker 1: It invites us to acknowledge that pain is part of 50 00:03:51,120 --> 00:03:55,080 Speaker 1: the human experience and the real work is in choosing 51 00:03:55,320 --> 00:03:58,920 Speaker 1: how we respond to it. And so I did a 52 00:03:58,960 --> 00:04:02,120 Speaker 1: bit of a search. I came across a research paper 53 00:04:02,520 --> 00:04:05,520 Speaker 1: that really aligns with this perspective. So I was pretty 54 00:04:05,520 --> 00:04:08,720 Speaker 1: excited about that and what it does. It discusses how 55 00:04:09,120 --> 00:04:12,640 Speaker 1: moral injury doesn't need to be seen as a collection 56 00:04:12,760 --> 00:04:16,760 Speaker 1: of symptoms that we have to eliminate. Instead, it can 57 00:04:17,040 --> 00:04:21,120 Speaker 1: be understood as the behaviors we engage in to avoid 58 00:04:21,279 --> 00:04:26,520 Speaker 1: or control moral pain. So whether it's withdrawing from relationships, 59 00:04:26,600 --> 00:04:34,200 Speaker 1: becoming isolated, or ruminating on the event, or just focusing 60 00:04:34,240 --> 00:04:36,760 Speaker 1: on that and then neglecting other areas of your life. 61 00:04:37,440 --> 00:04:41,800 Speaker 1: These behaviors can often keep us very stuck. The term 62 00:04:42,040 --> 00:04:46,480 Speaker 1: often comes up in the context of healthcare and military service, 63 00:04:46,600 --> 00:04:52,839 Speaker 1: and even corporate settings, where people might experience betrayal or 64 00:04:52,920 --> 00:04:56,440 Speaker 1: they have to actually do something in their job that 65 00:04:56,560 --> 00:05:00,560 Speaker 1: doesn't align with their values, but they have these external 66 00:05:00,640 --> 00:05:03,520 Speaker 1: pressures to do so. So I'll take an example that 67 00:05:03,640 --> 00:05:07,119 Speaker 1: was from the paper. So, say you're a health care 68 00:05:07,320 --> 00:05:10,440 Speaker 1: provider who promised to be there for a patient in 69 00:05:10,480 --> 00:05:14,719 Speaker 1: their final moments, but due to external pressures or something 70 00:05:14,760 --> 00:05:17,200 Speaker 1: going on that something else that they had to do, 71 00:05:17,240 --> 00:05:20,720 Speaker 1: you couldn't actually be there. So you might feel intense 72 00:05:20,800 --> 00:05:24,599 Speaker 1: guilt and shame or anger because this act goes against 73 00:05:24,680 --> 00:05:29,880 Speaker 1: your deeply held values of providing compassionate care. So labeling 74 00:05:29,960 --> 00:05:33,680 Speaker 1: this situation as a moral injury might lead you to 75 00:05:33,920 --> 00:05:36,880 Speaker 1: focus on healing the guilt or trying to get rid 76 00:05:36,920 --> 00:05:41,200 Speaker 1: of the pain. But as the paper suggests, this doesn't 77 00:05:41,240 --> 00:05:45,680 Speaker 1: help long term, and what does help is or is 78 00:05:45,720 --> 00:05:49,400 Speaker 1: more is maybe more effective, is acknowledging that this pain 79 00:05:49,520 --> 00:05:53,680 Speaker 1: exists because it's part of your commitment to your values 80 00:05:54,320 --> 00:05:56,919 Speaker 1: and it is part of the human experience. It's a 81 00:05:57,080 --> 00:06:02,960 Speaker 1: normal response to a really stressful situation. So painful, yes, 82 00:06:03,760 --> 00:06:07,839 Speaker 1: but also deeply tired to what we care about the most. 83 00:06:08,880 --> 00:06:11,520 Speaker 1: So it's almost like there's two sides to a coin here, 84 00:06:12,320 --> 00:06:14,840 Speaker 1: and the question to ask is how can I live 85 00:06:14,920 --> 00:06:18,560 Speaker 1: my values? How can I live aligned with what is 86 00:06:18,640 --> 00:06:23,920 Speaker 1: deeply important to me now in the presence of this pain. 87 00:06:24,200 --> 00:06:28,720 Speaker 1: So for anyone who feels like they've been injured in 88 00:06:28,839 --> 00:06:32,040 Speaker 1: the moral sense, and I say injured in inverted commas, 89 00:06:33,080 --> 00:06:38,159 Speaker 1: I really encourage you to shift your perspective. So rather 90 00:06:38,240 --> 00:06:44,159 Speaker 1: than focusing or eliminate trying to eliminate the pain, explore 91 00:06:44,279 --> 00:06:48,680 Speaker 1: what it's telling you about your values, because there's a 92 00:06:48,800 --> 00:06:53,239 Speaker 1: message in that, and then think about how you could 93 00:06:53,279 --> 00:06:57,680 Speaker 1: move forward towards those values in what you do. So 94 00:06:57,760 --> 00:07:01,720 Speaker 1: your behavior and your actions is even when the moral 95 00:07:01,880 --> 00:07:06,200 Speaker 1: pain is present. Well, that's it for today's Mojo Monday. 96 00:07:06,520 --> 00:07:09,800 Speaker 1: I hope that you have got value out of this, 97 00:07:09,960 --> 00:07:14,000 Speaker 1: especially if you have experienced or are experienced what feels 98 00:07:14,160 --> 00:07:18,440 Speaker 1: like a moral injury. I really hope that this has helped. 99 00:07:19,480 --> 00:07:22,760 Speaker 1: And I think it's important to remember that pain can 100 00:07:22,920 --> 00:07:27,320 Speaker 1: coexist with purpose. It's what we choose to do. It's 101 00:07:27,360 --> 00:07:31,480 Speaker 1: how we respond to that pain that really matters. Have 102 00:07:31,560 --> 00:07:34,720 Speaker 1: a great week everyone, and I will catch you next week.