The December 2022 issue of the Scientific American features an article by Elisabeth Svoboda on Moral Injury: “Moral Injury is an Invisible Epidemic that Affects Millions.” The article defines Moral Injury as a “specific trauma that arises when people face situations that deeply violate their conscience or threaten their core values.” It presents recent examples from the health care setting, where ethically challenging dilemmas are part of the everyday scenario.
The article reviews literature that first identified Moral Injury in the military setting, to its working definition for everyday life and clinical practice. It provides several examples that require a therapeutic approach that goes beyond traditional cognitive behavioral therapy (CBT), since the distress is genuine and not the product of distorted thinking. The article asserts that Moral Injury is different from Post Traumatic Stress Disorder (PTSD). It does not respond well to conventional trauma treatments, and it requires a more “spiritual approach” that considers the whole of the person.
Proposed models for the treatment of Moral Injury share the emphasis on the search for meaning to overcome its effects. The article reflects on the role of Viktor Frankl’s Logotherapy and Existential Analysis (LTEA) for the management of Moral Injury. This approach “bolsters a clients’ sense of purpose.” It validates the reality of values transgressions, and helps to find meaning in line with core values as guiding principles. LTEA can be applied alone, or as a complement to other treatment modalities currently employed in the treatment of Moral Injury.
The book, “Logotherapy and Existential Analysis for the Management of Moral Injury,” by Edward Marshall and Maria Marshall, published through the Ottawa Institute of Logotherapy in 2021, reviews the history of the conceptualization of Moral Injury, the development of tools for its assessment, and a review of the treatment modalities proposed for its management. In developing the case for the application of LTEA, the book reviews the evidence base of LTEA, and provides practically relevant principles and methods based on LTEA that can be useful for clinicians when treating individuals affected by Moral Injury.
On March 31, 2022, Professor Edward Marshall offered a workshop with over 120 participants on the application of Logotherapy and Existential Analysis for the management of Moral Injury at the Royal Ottawa Mental Health Centre, Canadian Centre of Excellence on PTSD.
Awareness of Moral Injury is increasing as examples locally, and globally amount. Validation for the use of LTEA as an evidence-based method for addressing the symptoms arising from moral injury is a welcome sign that the scientific community embraces LTEA to offer a purposeful and meaningful contribution to the treatment of moral injury, one that puts humanity at the forefront of responding to suffering arising from values transgressions.
On March 23-24, 2023, Professor Edward Marshall is offering a two-day workshop at the Royal Ottawa Mental Health Centre that will focus specifically on the methods and applications of Viktor Frankl’s Logotherapy and Existential Analysis. This event is tailored toward health professionals and students who would like to deepen their knowledge and understanding of the uses of this modality in their clinical practice. Registration Page.