Broken Trust: The Profound Consequences of Moral Injury

The psychiatrist Jonathan Shay and his colleagues introduced the term “moral injury” in the 1990’s to describe on others when there is a “betrayal of ‘what’s right’ in a high-stakes situation by someone who holds power.” There are no bandages, casts or crutches to see, but the invisible wounding is very real.

Think of the soldier who witnesses a commanding officer slaughter innocent civilians, committing war crimes and violating rules of engagement. What happens to such a soldier? Or consider, as did some early studies of “moral distress,” the effects on nurses “when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action.” You aren’t doing what you know is right or you are witnessing what you know to be wrong without the ability to stop or interrupt it.

What are the effects of moral injury?

According to the International Centre for Moral Injury, moral injury “involves a profound sense of broken trust in ourselves, our leaders, governments and institutions to act in just and morally ‘good’ ways” and the experience of “sustained and enduring negative moral emotions – guilt, shame, contempt and anger – that results from the betrayal, violation or suppression of deeply held or shared moral values.” (emphasis added)

Americans now live — amid the Trump Presidency — in a perpetual and relentless state of “moral injury.” It’s neither a one-off nor an ambiguous case, but constant violation of the norms that define decency, civilized behavior and morality. It is day after day after day. The examples of Donald Trump, someone who holds power by virtue of his election to office, “betraying what is morally right in high-stakes situations” are mounting up as fast as the national debt, pegged just this week at forty trillion dollars.

Whether it’s pardoning those who violently attacked police, selling Presidential pardons, politicizing the justice system for personal vendettas, self-enriching crypto schemes, insider trading, extorting foreign governments and their officials, shaking down corporations, starting and waging an illegal war or simply the firehose of daily lies and insults . . . it never stops, never lets up but only keeps coming.

For those suffering moral injury the possible effects are many. Numbing is one. You stop feeling in order to protect yourself. You numb yourself by abusing the usual options, booze, drugs, food. Other effects include living with and in a constant state of guilt, shame and anxiety, emotions that cause people to withdraw and cut them off socially. Self-harm and suicide also result from moral injury. Theologians call it “soul anguish” or spiritual brokenness.

These effects not only happen, invisibly, on people’s insides, they manifest outwardly as well. They happen among us. They come to plague, and degrade, a society.

In her recent column at the Wall Street Journal on Trump’s unbridled corruption, “The Art of the Self-Deal,” Peggy Noonan writes of the effects of this corruption and deceit on America and Americans. “The larger threat of government corruption is that it hurts public morale, its [the public’s] sense of seeing itself as a moral actor to whom politicians have to answer.”

“Our entire system of government,” continues Noonan, “assumes a citizenry that polices its politicians, that says, ‘You can’t do that.’ ‘This office isn’t yours, your powers were lent to you for public purposes.’ If the public shrugs and looks the other . way, Americans will lose the habit of thinking of themselves as entitled to a clean government.

“Citizens have a certain dignity from believing that we enforce the rules. It reminds them of who’s in charge: them. You’re giving up a lot when you give up that.”

The effects of living with the steady stream of moral injury? Morale is degraded, losing a sense of yourself as a moral actor, the surrender of expectations of fairness and decency, the sacrifice of your own dignity as a human being created in the image of God. As Noonan says, “You’re giving up a lot when you give up that.”

Much has been said and written in recent years of “a loneliness epidemic,” of a “mental health crisis,” of a society in a “spiritual crisis,” of an America that has “lost its confidence.” All of this and more may have a lot to do with living day after day after day with moral injury, of living with a constant “betrayal of ‘what’s right’ in a high-stakes situation by someone who holds power.”

This degradation of our norms, of a basic sense of right and wrong, the denial of a moral order and of our sense of ourselves as moral people — this constant moral injury — is taking a toll, a very large toll on us all. You can see it in our eyes, hear it in our voices, feel it in your heart.