Shame, betrayal, guilt, anger. As social animals, humans are wired to have moral emotions that bind us to our groups. When we experience a transgression against our moral values, we might experience Moral Injury. Moral injury is a normal human response to a violation of our strongly held moral beliefs, and it can have a deep impact on people’s lives, making it difficult to move forward. In this episode, Debbie interviews two psychologists who are researching moral injury with veterans, Dr. Lauren Borges, and Dr. Jacob Farnsworth, about this cutting-edge and important topic in psychology.

In this episode you’ll learn:

What moral injury is, and types of situations in which people might experience morally injurious events.How moral injury can impact people’s lives.Why we have moral emotions like guilt and shame.How PTSD and moral injury are related, and how they are different.How Acceptance and Commitment Therapy might be a helpful approach for working with people who are struggling with moral injury.

Resources:

A seminal paper by Litz on Moral Injury: Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology ReviewLauren’s case study: A Service Member's experience of Acceptance and Commitment Therapy for Moral Injury (ACT-MI) via telehealth: Learning to accept my pain and injury by reconnecting with my values and starting to live a meaningful life. ) Journal of Contextual Behavioral Science.Papers by Dr. Borges, Dr. Farnsworth, and their research team: Temporal Associations Between Moral Injury and Posttraumatic Stress Disorder Symptom Clusters in Military Veterans. Journal of Traumatic Stress.Is and Ought: Descriptive and Prescriptive Cognitions in Military‐Related Moral Injury. Journal of Traumatic Stress.A functional approach to understanding and treating military-related moral injury. Journal of Contextual Behavioral SciencePhysicians aren’t ‘burning out.’ They’re suffering from moral injury Stat Sebastian Junger’s documentary films on Moral Injury in war: RestrepoKorengal

Dr. Lauren M. Borges is a clinical research psychologist at the Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) for suicide prevention. She holds an academic appointment of assistant professor in the Department of Psychiatry at the University of Colorado School of Medicine. Dr. Borges’ primary line of research concerns the use of contextual behavioral interventions to help Veterans approach emotions like guilt and shame more flexibly. She is a principal investigator on a federally funded study focused on investigating the acceptability and feasibility of Acceptance and Commitment Therapy for Moral Injury (ACT-MI). She is also interested in using skills from Dialectical Behavior Therapy (e.g., the chain analysis skill) to help Veterans identify and intervene on their suicidal behavior. Beyond her focus on interventional research, Dr. Borges is developing and validating novel approaches to measuring facets of responding to guilt and shame.

Dr. Jacob Farnsworth is currently a staff psychologist at the VA Eastern Colorado Health Care System. Jacob's primary research interest is in the area of military-related moral injury. His most recent efforts have focused on the further development of the construct’s definition, assessment approaches and comparing existing and novel intervention approaches for moral injury. He is a co-author of the Expressions of Moral Injury Scale-Military Version.