We feel psychological distress when we are compelled to act against, witness, or fail to prevent actions that conflict with our moral beliefs. Therapists Robin Stern and Marc Brackett share their advice on how to navigate the struggle.
Q. I find myself struggling emotionally and ethically in today’s polarised world. I have a job in healthcare and often find myself in situations where I have to act in ways that go against my values, whether it’s due to hospital policies or the general state of our healthcare system. How do I navigate this?
A. This question from one of our clients may resonate with many who feel caught between their values and the realities of their environment. This distress has a name: It is called moral injury - psychological distress that arises when we are compelled to act against, witness, or fail to prevent actions that conflict with our moral beliefs.
Originally studied in military contexts, the concept of moral injury has expanded to encompass various personal and professional settings. It is prevalent in healthcare, education, law enforcement and other professions where individuals’ personal values frequently clash with systemic realities. While moral injury is not classified as a mental health diagnosis such as post-traumatic stress disorder (PTSD), or depression, it often coexists with these conditions, and healthcare workers like our client face this challenge daily.
But it’s important to recognise that moral injury isn’t just emotional - it can manifest as physical symptoms and as problems in our daily lives. Research shows that those suffering from moral injury report disrupted sleep patterns, persistent fatigue, headaches, and difficulty concentrating. People might notice changes in their eating habits, experience unexplained aches, or feel constantly tense. These symptoms can be especially pronounced during periods of heightened stress.