Forgiveness: A Key Component of Healing From Moral Injury?

Abstract

Service members and veterans can be exposed to potentially traumatic and morally injurious experiences (PMIEs) including participating in, witnessing, or failing to prevent an act(s) that transgresses their core beliefs. Violation of one's deeply held morals and values can be profoundly distressing and shatter one's sense of self at the deepest level. Relationships with self, others, the world, and for some, the Sacred, can also be fractured. Post-Traumatic Stress Disorder (PTSD) and/or Moral Injury (MI) can result. Left unresolved, MI can leave individuals struggling with guilt, shame, cognitive dissonance, and negative self-attributions. A holistic approach that addresses the psychological and spiritual harm associated with MI is warranted. We wonder if forgiveness can help individuals struggling with MI to address the harm caused by actions or inactions, release negative emotions, and mend relationships. Commonly used by Spiritual/Religious (S/R) Leaders, forgiveness practices are increasingly being explored by Mental Health Professionals as a complement to evidence-based treatment approaches. This article provides case examples that illustrate the use of forgiveness practices that promote recovery and identifies programs used in clinical practice that incorporate forgiveness. Research is yet needed to better understand the importance of forgiveness in the treatment and healing of PTSD and/or MI. This requires an interdisciplinary discourse between Mental Health Professionals and S/R Leaders working in the field of MI. Such engagement and integrated use of forgiveness practices may yield improved outcomes not only for service members and veterans, but for all those struggling as a result of PTSD and/or MI.

The impact of moral injury on suicide risk among recently discharged Israeli veterans: A longitudinal moderated mediation model of trauma-related guilt and self-forgiveness.

“…First, Litz et al (2009) suggested the notion of “forgiveness support”—the aid that some veterans receive which may support and help them forgive themselves for their PMIEs. Thus, self-forgiveness might obviate self-condemnation, guilt, and shame (Brémault-Phillips et al, 2022) but also increase veterans’ feelings of being supported, even following what they consider morally flawed decisions and acts. Second, following the assumptions of Joiner’s interpersonal theory of suicide, some studies found that perceived burdensomeness and thwarted belongingness (Shapiro et al, 2022) and entrapment (Levi-Belz & Zerach, 2018) were subsequently associated with high levels of SIB and suicide risk.…”

“…Importantly, compared with military personnel with no SIB history, those with a history of SIB reported lower levels of self-forgiveness (Bryan et al, 2015). Notably, few scholars suggested that self-forgiveness might serve a crucial role in recovering from MI by obviating self-condemnation, guilt, and shame and as a vehicle for corrective action (Brémault-Phillips et al, 2022). They also recommended administering a targeted forgiveness intervention for veterans dealing with MI (Burkman et al, 2022).…”

All the King’s Horses and All the King’s Men: Falling Into Moral Injury, During the COVID-19 Pandemic

“…It is also important to highlight the benefits of forgiveness, by current health care workers, as they interact with their administrations, as part of the healing from moral injury. One of the most effective tools to recover from moral injury is forgiveness according to Brémault-Phillips et al 16 An important part of moral injury is that you feel you are the guilty person but circumstances forced you to do to things that you regret, as well as those things that happened to you. It is important to start by forgiving yourself and understand that you did the best that you could, given the circumstances.…”

Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

“…Mediators include lack of social support, negative cognitions, and meaning-making. Self-compassion and forgiveness, pre-deployment mental health, education, and mindfulness are reported moderators [ 412 , 424 ]. Organizational, environmental, cultural, individual, and relational factors also need to be considered.…”