“A Stain on the Soul”: Why Moral Injury Requires A Different Treatment Plan Than PTSD
with Bessel van der Kolk, MD; Judith Herman, MD; Rachel Yehuda, PhD; Ruth Lanius, MD, PhD; Matt Gray, PhD; Wyatt Evans, PhD; Bill Nash, MD; Megan Schmidt, PsyD; Ruth Buczynski, PhD
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12-step groups are one model for atonement, making amends that work for so many people!! Underestimated gifts from 12 involvement!!!
Really informative thank you. Have lots of clients where this approach would fit well, in particular a military veteran I’m working with and also a client whose neglectful childhood has left her with serious damage. Lots of learning here, many thanks
Helping define morality, help people name their core values & how to realign with them through small changes
“how to realign with them”. Yes, I think their MI has caused something like a split in personality, the person they had thought they were, and the person that their action would otherwise suggest. So our job is to bring those two back together
Thank you for the new information. I am a first year MSW student. I can see application with people in my life and podcasts I have listened to. Thank for you these great sessions.
* Unfortunately I had the wrong time zone. I thought it started at 11pm CT, but now I believe it would be 10am CT for the next module. Please confirm if possible.
What I got most importantly out of attending this webinar, to me, is how to work with shame & pain of a moral injury by using various volunteer sites to spread the word with the community etc., who could benefit from using the moral injury, that is very painful & traumatic, to help the community get educated or become involved with voluntary work to avoid staying stuck where they are. This can reduce the shame & pain for others.
I’ve personally & professionally experienced EMDR to be a very helpful when used prior to a talk therapy session. I would
(Verifying that the Therapist is credentialed or trained in EMDR is very imortant. Many therapist present themselve as everything shift in one’s perception and helps clients who may have a difficult time moving forward. They can obtain clarity of what was is & what /how they perceive the moral injury. It reduces shame & brings a purpose to what they had to endure.
I look forward to next Wednesday’s webinar. I thank all the presenters and others who put all this together for Counselors.
It seems many of these suggestions for dealing with MI and PTSD has clients needlessly reliving their trauma over-and-over when it is not necessary for heeling to take place. Most of these suggestions seem to merely extend the length of the therapy sessions time-frame and cost — again, needlessly. Why not integrate a proven brief therapy ie: Accelerated Resolution Therapy (ART) or RRT – an get people back to living life and not merely “surviving” for years, or a life-time, in unresolved pain.
I enjoyed the broadcast, and took four pages of notes, which I have since expanded into six pages.
I found myself wondering if any of the insights of Zen Buddhism might help morally injured clients. (??)
Certainly, at least two of the speakers spoke favourably of the value of mindfulness to morally injured individuals. (And some spoke of discussing values in counselling and therapy with morally injured clients).
And at the end of writing my six pages of notes, I came back to this:
1. When a morally injured individual comes to therapy, this is a bit like a repentant individual going to confession.
2. There is no intention of denying the moral transgression. It is a confession of wrongdoing. (If it is inappropriate guilt or shame, the therapist must be able to identify that difference, and instead of compassion and pardoning, they need to promote clarification of the distinction between appropriate and inappropriate guilt and shame!)
3. There is encouragement to own up to moral culpability; but it has to be combined with regret; remorse; and a commitment to be a morally good person in the future.
4. Then the counsellor/psychotherapist indicates that the past offence is forgivable, in the context of remorse and a commitment to not repeat the offence, and perhaps also a “penance”, or form of offered recompense or repair, “payback”. The counsellors lovingkindness communicates the purifying of the offence, to the client, in the context of remorse! 🙂
~~~
1 and 2 – yes I would agree but there is a danger that, in 3 and 4, you are adding to the client’s woes?! They feel the moral culpability only too keenly; the regret and remorse have already impacted their lives too much and for too long. They are ALREADY ‘a morally good person’ – they need something closer to self-compassion and any (optional) ‘payback’ must come from strength, love and purpose and not from any sense of atoning otherwise it will simply magnify in their minds the horror of what they did.
I disagree, Richard. Human beings are social beings, and we have innate and socially shaped “moral emoitons” – of guilt, shame and remorse, etc. Those moral emoitons are very important guides to action, and we must not do anything to undermine those moral emotions. Of course, it is important to distinguish between “appropriate” and “inappropriate” shame; but Moral Injury very often results from “apropriate shame”, and that has to be expiated in order to resolve the sense of self-rejection or denigration.
Hi,
My name is Valerie and I live in Israel that is currently in war. Two weeks ago there was a big massacre of citizens.
There were citizens that survived while others around them were gruesomely killed.
Now they feel guilty that they survived, and think about how could’ve do more to save, feel guilty that they were hiding and running instead of helping.
My question is if that indicates of moral injury?
Thank you,
I think that survivor guilt that you talk about must surely be an element of moral injury. What do you think?
I’m so sorry to hear about your experience & extend love& prayers to your family & country. I was also thinking if the war, but whether intances of incorrect relataliation and further civilian injuries in palestine would cause further moral injury and harm to the people of Israel.
My name is Gila and live in Israel too.
Possibly survivors guilt is mayby not automatically equivalent to moral injury. Maybe that depends on choices or actions that saved them while leaving others behind or unintentionally harming their loved ones or someone they were responsible for or just another human being…
We should definitely be aware of the extra layer of moral injury on top of the ptsd…
I agree 100% that survivors’ guilt is not the same as MI; in fact it is often the opposite. MI arises out of what I did (unwillingly, unwittingly, or weakly) but survivors’ guilt is almost sadness at what I could have done if the opportunity had presented itself, eg I would have given my life for theirs if I had known.
I think we need to think about it but I suspect survivors’ guilt is a particularly sharp form of PTSD
Hi Valerie,
When constantly threatened with annihilation by evil, then surviving yet another onslaught when loved ones didn’t must be one of the most horrific traumas ever. It just doesn’t fit neatly in any box.
I am with you in your grief and quest for relief.
Hi Valerie,
It’s an interesting question you ask. I’m not sure what the right label for this feeling is. I sense that this is a form of grief. It has a kernel of hope that one could of or should have done something, …an “if only..” type of wish. Whether it’s moral injury would depend on whether the person actually could have done something and whether they did or omitted to do something which made them go against their own deeply held values. In most of the situations that your question alludes to, the survivor COULD NOT do anything. Please note, the survivor is still able to help others because they survived. Maybe focusing on what they can do now can help them and others around them. I’d give them support and encouragement to do whatever they still can.
( I speak from experience. My parents were Holocaust survivors and they coped by helping others. They both became doctors after the war.)
My heart is with you. Éva
Case studies were especially valuable . The current events in the U.S. re Trump and the insurrection and complicity of politicians, journalists, and those enabling disinformation, also. events in Israel and Palestine will undoubtedly have a legacy of PTSD and/or Moral Injury and understanding the differences in treatment will assist in treating the survivors and their families
I have wondered about moral injury and politicians.
For those who are acting against their own values and morals for expediency, power, or some other goal, I have wondered if they will, or perhaps already are suffering moral injury. This could include those who vote with their group when the values & motivations for doing so are in conflict with other values they hold.
For those who do not suffer moral injury we might wonder about narcissism or psychopathy. Same may be said for prisoners. Remorse, regret, shame and guilt seem to be important distinguishing features for identifying moral injury.
I heard one of the speakers, the psychologist specializing in the treatment of moral injury and providing advice to the UN on this topic, suggest that doctors are concerned about their patients’ well-being, while technicians tend to be in and out of a room without forming as caring a relationship with their patients. I’d like to propose that technicians often spend more time with their patients than doctors, which allows them to build deeper and more intimate connections due to the extended time and the nature of the care they provide. Consequently, technicians tend to have a profound concern for their patients. I believe that making a broad statement implying that technicians don’t care about their patients is uninformed and potentially harmful, especially when it comes from a psychologist, let alone one in the role of an expert.
Agree. I thought the same things when I heard the “expert” think in this manner about technicians vs doctors. (If he is talking to the UN, my guess he is in Big Pharma’s back pocket.) The current Western “Medical” model (fast, furious, 15 minute appointments to note symptoms = pharma… is not “healing” core issues, teaching real nutrition (even at the cellular level), etc. and just lacks so much. That “expert” exemplified that point … knowingly or not. (Western medicine is better for emergency care and only “needed” surgery (which many surgeries are not) and not “health” care.
I agree re technicians, doctors, Pharmaceutical companies and my own profession “psychology”. We need more humility, more recognition of our clients and students as their own authority and to be accountable for injuries inflicted even if unintentional. Physician heal thyself. Health Service providers address your/our own PTSD and moral injury before offering “help” to others.
The overlap between Ptsd and moral injury is so pronounced ,whether it is Military Trauma and or Sexual trauma/Rape and Incest ,Dealing with deep’ Self Loathing ‘ can also discombobulate the therapist. Dr. Ruth Lanius approach to the patient who realized she was failing to save her younger siblings is an eye opener-that it is a normal human state- and not wrong to feel that way.
Listening to other Trauma expert about cognitive Restructuring and ‘letting Guilt in’ is very new to me and not jump in to dismiss patient’s experience too soon; Instead go to ACT and Mindfulness to bring in self compassion.
Thanks .I will buy the Golden Pakge. to listen to this particular module again and again .
Thank you, NICABM, for addressing this issue of true guilt. I am wondering how therapists should interact with clergy about both moral injury and moral violations against the client. I have been reading about the issues of boundaries and forgiveness and still don’t believe that I have a solid grasp on how these should interact, especially when the violation is ongoing, multilayered, or current triggering is unavoidable.
I too was surprised that there was no mention of boundaries. I suspect that ‘boundary issues’ might be indicative of MI rather than PTSD. PTSD events overwhelm boundaries in ways that even the client can understand. What the MI client has a much greater problem with is whether they were complicit in the overcoming of their own boundaries (even the soldier wonders whether he should have been a pacifist objector etc). MI requires understanding and self-forgiveness, whereas one might almost say that PTSD requires understanding and other-forgiveness
Thought provoking….
Personally, I am appreciating moral wounds as a health care provider. The behavioural activation tool resonates well for application in mindfully re-engaging with compassion in a couple of areas of my life.
Thank you.
Thanks again for offering this great series on moral injury and trauma. just understanding the differences in approaches with moral injury and PTSD was helpful and what works and doesn’t work with moral injury. I liked the use of symbolic amends, values exploration, realigning with their values, encouraging the importance of community family and connection, the use of exposure based therapy and if course the importance of attachment, love, trust, self esteem, A,,C,T etc.
The differentiation between moral injury and PTSD and what has been said about it seems important to me and my future work with new clients. Especially in the first sessions and in short term therapies for assessment and diagnostic purposes. My background is not BCT and I do not work in a programm based way, but I am always looking for getting a good evidence based dynamic diagnostic. The notion of moral injury seems helpful also for working with people who are or are not directed and to which extent towards religious or spiritual beliefs.
This episode about moral injury was especially valuable for me, as a non (or not yet?) practitioner: in my personal life. My younger brother is agressive towards me, I recognized that it is an extreme kind of self-defence but I never completely understood why. I even interpreted it as the same narcissistic empathy lacking character as our father. It regularly hurt me deeply, even more so as there was absolutely no way to talk about it, as he would only get MORE defensive and thereby hurtful, even spiteful. To protect me from his verbal injuries I felt I had no other choice than cut contact.
And now I had the enlightening understanding of how terribly he is struggling with guilt of not standing up for his sister (me) when he was a boy. He has that self-hate of a moral injury from a time in his life when he was too young to do anything else than hiding under his bed. While to me it never ever occurred to me to hold him in ANY way responsible for not defending me, he was a boy of 6 to 10 years, a child. But what I do holdnhim responsible for is his verbal transgressions as an adult, who can appear oit of the blue.
I hope I will find the right way of approaching this with him, so that contact will be possible again.
Thank you for these series. I learn so much, and today I found such an important piece of my own life’s puzzle.
Empaths have a tendency to find compassion for and “forgive” others too easily (even when the other is not authentically seeking it). He MAY or may NOT be struggling with guilt. You don’t know unless he expresses that … other wise it’s an assumption on your part. With a dad w strong narc behaviors – your brother may also be a narc. If he was a true empath vs narc, he would not saying such hurtful things to you.
I agree that this may or may not be MI – it does sound as if your younger brother (by how many years?) was too young to intervene on your behalf, ie too young to be complicit in any injury to you (and therefore any MI to him). You need to be careful of accepting any and all shame that is floating around the family!!
This was a well informed discussion of the differences between PTSD and Moral Injury. In assessing the difference the clinician must be attuned to intense feelings of guilt, shame, self-loathing/disgust and self contempt in the client. What the program failed to address was, how, in some religious individuals, the moral injury is rooted in primitive theological beliefs in a punitive, judgmental or sadistic concept of God. I worked with a person with severe OCD who obsessed about his sinfulness and God’s inability to forgive him for sexual transgressions in thoughts, words and actions. (He was raised is a strict, sex negative Roman Catholic culture). When these erroneous theological beliefs are fueling Moral Injury it’s essential that the clinician, who may not share these beliefs, or is hostile to organized religions, makes an appropriate referral to trained clergy persons with certification in pastoral counseling.
Why refer them back into the system that has created so much pain? Not following that logic. Everything up until then made sense. I’ve seen more damage done via “pastoral” counselors. (ie: Abused women encouraged to stay with abusive malignant narcissist, etc.).
I have a client who visited a live volcano, with her small kids, and when lava blob flew up high above them, she thought it was going to hit them and ran in panic -instead of throwing herself on top of the kids. The feels intense guilt at the thought her limbic brain/body chose to save herself, instead of shielding her kids. She is also tormented by the thought that in a Jewish cattle car situation, that she might be the kind of person who could scrabble over others” to get air just for herself – contrbuting to others’ deaths. This broadcast opens the door to the idea to just directly do EMDR on the feelings of intense guilt and shame. But what of the “self-sacrificing script” that seems to underlie her moral torment?
You make a very, very insightful point – but what matters surely is the client discovering or rediscovering or even redefining their own core moral values. If their moral values are self-preservation, then they did the right thing (ie not MI). If their core moral values are self-sacrifice, then they did the ‘wrong’ thing (ie yes MI). But it may well be that the volcano incident unearthed moral values that, at an even more ‘core’ level, they now wish to change – ie they had operated on bequeathed moral values whereas they now wish to espouse their own. These things are not easy – we sometimes ‘try out’ several sets of moral values until we find those that we feel most comfortable with
I understand much better what this type of trauma entails and what can best serve the client with this condition. I appreciate it very much because I feel more prepared and confident to contribute something valuable to these people.
Thank you for this distinction. However I belive there are many cases that overlap, as trauma especially early in life place individuals at risk of engaging in activities that they don’t feel they can control, or even doing something wrong because they need to have some control on life.
You must be right, indeed absolutely spot on, in wanting to distinguish between events which clients ‘don’t feel they can control’ (PTSD not MI) and those which they know they could have controlled (ie MI), or yet even (to make things difficult but which I think might be the knife-edge distinction you are making) ‘doing something wrong because they NEED to have some control on life’.
In the case of the latter, I think we must be guided not by our own morality but by an intuitive feel for whether the client themselves feels they need ‘absolution from MI’ or ‘recovery from PTSD’ – and by that I mean that the client might be seeing themselves as doubly guilty of MI or alternatively whether the sense of ‘control’ that they thought they had was in fact part of the horror of the PTSD they suffered. In either case, our aim is not itself moralistic but simply to identify what will bring the client the relief from the agonising pain they carry.
Our job is to restore human beings to their own humanity whether it is the same as our humanity or not!?
I have been following NICABM since it’s inception and have always found it to be insightful, engaging and informational. I am not a practicing professional but always had an interest in psychology and methods of finding a path to healing. Having experienced a dysfunctional childhood, abandonment, familial mental illness, and self-hatred the programs of NICABM have interested me and continue to lead me to answers that I have always been seeking.
I can’t thank you enough for all you do to move humanity to a better, more understandable place.
Harriet Porto
I found this presentation really helpful. Thank you to all the contributors. There can be a pastiche of therapy which presents it as accepting any behaviour with Unconditional Positve Regard and which, in doing so, underestimates the importance of a person’s moral code as an aspect of their well-being. The examples highlighted the moral seriousness of what we do, and the devastating effects of human fallibility on a person’s sense of self and gave helpful practical guidance about how to adapt well-known protocols to work with this.
HI Catherine,
I liked your comment because so many counsellors have been “liberated” by Carl Rogers into “Unconditionally” Postiively Regarding themselves. And Albert Ellis took a similar stance with his creation of “Unconditional” Self Acceptance. In rejecting both of those amoral positions, I have developed my own principle of “One-conditional” Self Acceptance; and that “one condition” is that I, and my clients, must be committed to being moral individuals, following the Golden Rule, or some similar system of moral guidance. (I frequentlhy discuss moral values with my clients, when and if that is appropriate.) Thanks for sharing.
With respect I would disagree. We are not called to being “committed to being moral individuals, following the Golden Rule, or some similar system of moral guidance”.
We are called to helping individual clients ‘find themselves’ whether we like what they are or not. And if we then want to try to persuade them to be more like us, then that is a conversation between healed individuals, not between therapist and client
Forgive me if I have misunderstood you
Thank all of you who presented today. As always I must reflect on what I heard and how it relates to me, and the clients I work with. I had some challenges yesterday with a client, who first refused to see me and dismissed me. I said, oh I won’t be long, I have errands to run, we did a quick session and by the end she was holding my hand and thanking me for showing up.
I THANK EVERYONE FOR SHOWING UP.
A moral injury I’ve come across working as a School Social Worker is teens who have been groomed into sharing explicit photos of themselves, then feel trapped into supplying more or even recruiting others for the perpetrator. They often feel and believe the only escape for themselves is self-harm or suicide. Elements of Acceptance and Commitment Therapy, especially the cultivation of self-compassion, have been essential for their maintaining a therapeutic connection and eventually, a healing.
Your comments are very poignant because they are typical of the MI caused by sexual abuse – there is not only the abuse itself but there is also the subtle insinuation that any thought of ‘abuse’ is itself ill founded and – dare one say it – a form of abuse against the abuser – truly evil, if evil exists
Today class was very helpful for the ones that don’t have hope, in our countries we live violence every day and alotre of this information is not abálenle, thank you very much to allow people with no recourses to participate.
Blessings🙏🌷🌷
Very disappointed to see your inclusion of Judith Hermann here considering her profound betrayal, and outright denial, of both male AND female victims of female sexual offenders in her latest book. Nice trick, Dr. Herman: you made a huge chunk of trauma survivors not only disappear, but accused them and their treatment providers of lying and exaggerating.
That’s a pretty profound ‘moral injury’ right there, on the part of both her and NICABM. A moral injury too far (much too far), if you ask me. Surprised Ruth Lanius (thank heaven’s for Ruth Lanius) even agreed to be on the same panel.
I have NO axe to grind but I am concerned – please elaborate
Very much valued the clarification between Moral Injury and PTSD which will add confidence to my choice of interventions.
more check, differentiate and work to ameliorate moral injury and fear-based trauma injury, Thank you
As a therapist I have a client who cannot connect with her Mother. Her mother has paranoia schziophrenia, has been living on the streets and is presently in a room but hasn’t been able to pay rent for 2 months. In the past my client helped her financially but the money went into a black hole (with the mother buying products/clothes that she didn’t return yet never used, or took out of the box). When my client does contact her mother over the phone, the conversations are agressive and manipulative and bring my client to anger or intense sadness. Over the years, my client has come to the conclusion that she cannot help her mother and is even considering breaking any contact with her for her own mental health (which is affecting how she is mothering her own children). However experiencing extreme guilt, due to the moral injury, keeps her in intensely dysfunctional relationship with her mother. I would like to ask, how would you, as therapists, help my client with the feelings of guilt? She clearly needs those feelings to maintain her sense of morality, she is also in a situation where she has to chose between an action that will cause her moral injury, or to stay in a situation that will cause her psychological injury. I just don’t know how to help her.
Hi Julia,
Your client is definitely in a difficult situation. No one can help anyone else if their own mental health is destroyed so self preservation is a must. Our attachment to our parents doesn’t depend on whether they have been good or bad to us. It’s inborn.
A lot of questions come out of her conundrum. For instance, how does her guilt help her? How can she actually be of help to her mom? Should she help her mom? etc.,
Definitely speak to your supervisor about this one. Maybe he or she can give some insights.
I think you have answered the key question when you write “my client has come to the conclusion that she cannot HELP her mother”. That has clearly not been an easy decision. Perpetuating something which “is affecting how she is mothering her own children” means, potentially, putting her own speculative MI above what might actually become their very real PTSD.
When you speak of her “intensely dysfunctional relationship with her mother”, we are not talking about MI, or even PTSD but of mother wounds (of neglect/abandonment or trauma). Your client is not meant to be paying for her mother’s mistakes or failings. What is, clinically, of significant interest is how one person’s PTSD can be forced on that person as their own MI
One approach is to have her clarify the various values she is currently holding. So a value about maintaining a relationship with her mother may be one, and a value about the quality of mothering she wants to provide her own children could be another. It sounds like she could benefit from help to identify and prioritize her values, and resolve inconsistencies or conflicts consciously through a facilitated process with you. Developing this clarity may reduce or eliminate actual or potential moral injury. More to it than that but perhaps this could be a helpful direction.
Thanks for identifying moral injury as separate from other traumatic injuries. I also appreciate the last strategic intervention discussed – of helping a person with behavioral activation to realign their lives with the morals and values that defined them prior to the moral injury. The example given was the person who was drunk and drove into a van of students, killing them all. He eventually became a presenter to schools advocating never to drink and drive. Finally, I like the notion that when we help someone heal from trauma, we change the course of human civilzation. In other words we help change the world.
This webinar was so informative. I am not in this professional space. I am an HR professional. This information has opened my eyes to opportunities to support employees who might have moral injury, especially in the area of being overworked.
There are still employers who want employees to separate their personal life from their professional life. I do not believe this is possible. If an employee is dealing with an emotional issue the employer is now affected by it. An employer, to some degree, is involved in an employees life. New births, birthdays, marriage anniversaries are all acknowledged and celebrated.
I actually found relevant information that if an employee feels that they are being overworked and have made this complaint to their employer and nothing is done, the employee files a lawsuit. Unfortunately, I don’t have numbers to share for success or failure rate but I feel the information that was shared today is a wonderful tool to help prevent such actions. Not in the sense of offering intern
It was a very helpful session on moral injury with my voluntary work with the people who suffer homelessness and depression in my town. It will help me to take more time to explore the meaning and perception of people’s experiences and trauma. It is particularly helpful to make that distinction between Moral Injury and PTSD.
so grateful to be able to listen to this exceptional presentation. 🙌
Thank you so much for this and all the invaluable expert sharing about this condition of moral injury – i recognise this presentation in many of my patients and I can now differentiate this from PTSD – so my biggest take away is in being able to ask appropriate questions that help to discern discern what is happening for my patient and how to intervene in an appropriate and healing way – in helping them to re align to their moral compass.
Great presentation!! Much needed and appreciated!!!
Great insights, and plan to become familiar with Moral Injury Workbook, which may be appropriate for some clients
Thank you! My take-away is encouraging patients to engage in activities in order to prevent possible future harm. As well as behavioral activations in order to live values driven life with the shame/guilt in it. Thank you once again for what you do!
Thank you for this presentation. I found this information to be very enlightening and it has given me other ways to look at my assessment process and my intervention toolbox. I am a big believer in values clarification with all of my clients and this is especially true in this case of moral injury for trauma survivors. I look forward to practicing and implementing some of these techniques described today.
Wondering if there is a role for psychedelic theraphy with moral injury
Good question !
Not as an automatic ‘Yes’ (as if PAP sorts everything) but because ‘integration with the whole’ can lead to that ever so crucial self- compassion
But I’m not an expert in this
I work as a critical incident responder for a national health benefits service provider and have spent the last three years with cases within medical facilities. I must always use a specific process that is slightly helpful sometimes, but since I am almost always facing staff dealing with moral injury my response is less than I wish it could be.
Thanks for helping me frame this experience in its difference from PTSD, and also in how I can move within the required process to push out the corners with things that are appropriate.
New client who knows abuse was not her fault. This is wonderful timing as I was wondering about how to approach this case. Thank you. Moral injury is definite present. Very familiar with moral injury with veterans. Civilians not so much. The case presentation was very helpful regarding the young woman.
I think the tricky thing with MI is that the abuse both is, and is not, her fault. She feels that it is her fault but, within the currency of survival, she did absolutely what she needed to in order to survive. It is not for us to dump our ‘adult’ values on her in her circumstances – why should she prefer annihilation to some ‘alteration’ of what she had started out believing?
loved hearing differences between moral & ptsd! ty.
Thank you for pointing out the differences in therapies. I now understand that therapies have to be specific to moral injury.
I just want to thank you for all the work you do in informing and educating people about trauma informed best practice. These seminars you offer continue to ripple out and you are responsible for fostering healing in this world on a grand scale. THANK YOU!
As a Registered-Play Therapist Supervisor, I will screen for moral injury with the parents/caregivers of my child/youth clients. They are critical to supporting the child in their healing and they will have their own response to trauma or familial or community stressors that also need support. Thank you for a great session today!
Can’t wait to learn more
Grateful for getting knowledge of this type of trauma, which wasn’t aware of before.
I’m eager to use this knowledge in assessment, especially in cases that present somewhat like trauma (shame, profound life stuckness, self-hatred) but the dots aren’t connecting. Thank you!
Very helpful—well done. Thanks for the insights.
thank you 🙂
to review on a more compassionate approach and likely to learn about the core values of the individual as part of the discussion on what could be done
Thank you for this, very informative