moral injury

Moral Injury Part Two: Self-care Strategies for Clinicians (and their clients)

In a previous blog, Moral Injury Part One, we discussed the differences between workplace burnout and moral injury. While often used interchangeably, the two are markedly different and require a differing approach to addressing and coping with them.

Burnout is the result of chronic workplace stress. It’s not a medical diagnosis, but if left unaddressed could potentially lead to physical and mental health concerns. For more information on burnout including common symptoms read Moral Injury Part One: Are You Experiencing Burnout or Moral Injury?

Moral injury, on the other hand, refers to psychological, behavioral, social and/or spiritual distress that is experienced by individuals who are performing, asked to perform, or exposed to actions that contradict their moral values and personal ethics. Moral injury is being recognized in frontline and healthcare workers of the COVID-19 pandemic.

Symptoms of moral injury could be acute or appear slowly months or years after the event. Symptoms can include:
• Feelings of guilt, shame, disgust, anger
• Self-blame, self-sabotage
• Feeling unworthy
• Feeling detached from sense of self

Note: If you’re feeling severe symptoms such as those related to PTSD, depression, anxiety or substance use issues, it’s important to see a behavioral healthcare provider as soon as you can.

Everyone has individual experiences and may require different strategies to cope with moral injury. What may work for one person may not work for another, and that’s okay. Consider the following:

Lean on existing support systems. Seek support from family, friends, colleagues, and spiritual leaders. Be vulnerable and express your feelings. Often, having a listener is helpful in relieving the burden of our feelings. Also consider reaching out to other support groups locally or even virtually for a place to share your thoughts, feelings, and help others by supporting them.

Create a stress management system. You know yourself best and know what strategies work for you. Common techniques include focusing on proper sleep, a consistent exercise routine, incorporating healthy foods, and a mindfulness practice. Would it be helpful to have an accountability partner? Ask someone from your support system if they will walk around the neighborhood with you a couple times a week. Or discover a new recipe with nutritious ingredients. Consider cooking the meal as a form of mindfulness and allow yourself to get lost in the process.

Slow down. Recognize that you may be in a vulnerable and raw emotional and spiritual place. Remind yourself that this is okay. We all go through traumatic events, witness unethical practices, or are asked to perform duties that go against our very nature. Allow yourself to slow down, feel and process your feelings. Take all the time you need. Healing yourself isn’t a race.

Attend therapy. If you don’t yet attend, we suggest that you start. As a behavioral healthcare provider, you know first-hand the benefits of scheduled therapy sessions. Additionally, it’s likely that your provider will be sympathetic to the effects of moral injury as they may have experienced it before themselves.

Take action. Experiencing moral injury has the potential to detract us from our sense of self. What we believe in, our ethics, our values. Reunite with your inner self by remembering what it is that you believe in. Take time to reflect inwardly on what strengthens your sense of self, your morals and your beliefs. Then take action! Maybe it’s in the form of activism for a cause you care deeply about or volunteering in your community. Determine what’s important to your deepest self, what reinforces your core beliefs, and then, reconnect with it.





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