Military Moral Injury: An Evidence-Based and Intercultural Approach to Spiritual Care

How can spiritual care help veterans struggling with military moral injury? An evidence-based, intercultural approach to spiritual care is proposed. Evidence-based care uses research on military moral injury and religious and spiritual struggles to understand when religious and spiritual practices, beliefs, and values are helping or harming veterans. Intercultural spiritual care recognizes the complex, distinctive ways veterans’ values, beliefs, coping, and spiritual practices are shaped by interacting cultural systems, especially military training and cultures. Pastoral theologian Larry Graham’s (Sacred Spaces: The E-Journal of the American Association of Pastoral Counselors 5, 146–171, 2017) writing on moral injury and lamentation is used to develop two spiritual care strategies: sharing anguish and interrogating suffering. Spiritual care begins with lamenting the shared anguish of moral injury using intrinsically meaningful spiritual practices to help veterans compassionately accept the emotions arising from moral injury so intensely felt in their bodies. The second strategy is sharing the lament of interrogating suffering through exploring values, beliefs, and coping arising from moral injury. A literary case study of a young female veteran based on Cara Hoffman’s (2014) novel Be Safe, I Love You illustrates this evidence-based intercultural approach to spiritual care of military moral injury.

     

Prayer: A Helpful Aid in Recovery from Depression

Depression is a growing issue within the field of medicine. It negatively impacts individuals’ lives and the people they are most connected to. For decades, medical professionals have been searching for solutions to assist those who are suffering from this illness. The use of drugs has not been a sufficient means of treatment to alleviate depression and its symptoms. There is a dire need to expand therapeutic interventions that can attribute meaningful recovery for victims of depression. One means of positive treatment is the use of prayer. Prayer, one of the most ancient forms of meditation, aligns and relaxes the mental state of the mind. The uses of drugs are limited by physiological focus, but prayer is a mechanism that brings human beings into a unique state of oneness. Oneness comprises the holistic nature of a human being and asserts the triad of well-being: mind, body, and spirit. As the emergence of humanities and holism continues in medicine, centering/meditative prayer and similar practices like mindfulness-based cognitive therapy can be useful therapeutic interventions specifically for major depressed patients.     

The Role of Political Practices in Moral Injury: A Study of Afghanistan Veterans

While much research has been conducted on military trauma, conceptualizations of deployment‐related suffering have been predominantly approached through a medical, individual‐focused lens. Since the military is an instrument of the state, it is crucial to expand the conceptual scope to include political processes, particularly for the fast‐growing literature on “moral injury,” which refers to the emotional impact of perpetrating, witnessing, or falling victim to perceived wrongdoing. This article examines the role of political practices in the onset of moral injury as well as the micropolitical responses of morally injured veterans. A study of the Dutch mission in Uruzgan, Afghanistan, shows that decisions and frames at the political level helped create distressing quandaries on the ground and that in all the ways the political leadership acknowledged the problems that veterans subsequently developed, it also maintained a silence on its direct contribution to these problems, as such perpetuating them. Consequently, veterans tried to make the political leadership take a material and symbolic share in their burden. Clearly, moral conflict may exist both in the veteran and between the veteran and the political domain, and therefore, experiences of institutional betrayal and a resultant search for reparations should be included in theory on moral injury.     

The Spiritual Recovery Manual: Vedic Knowledge and Yogic Techniques to Accelerate Recovery

Patrick Gresham Williams (2002). The Spiritual Recovery Manual: Vedic Knowledge and Yogic Techniques to Accelerate Recovery.     

Generation to Generation: Passing on Religious and Spiritual Beliefs and Practices

Many families face difficulties in maintaining healthy relationships. Past research has identified that religious and/or spiritual beliefs and practices can enhance family well-being. Research has also shown that religious and/or beliefs and practices can shape the aging process. Yet there exists little information on the methods through which religious and/or spiritual beliefs are passed on to future generations. This study utilized Eriksonian conceptual ideas, and grounded theory methods to conduct interviews with 13 older adults on the process through which religious and/or spiritual beliefs are passed on to children and grandchildren. Ideas are discussed for practitioners based on study findings.     

Religious and Spiritual Practices Used by Children and Adolescents to Cope with Cancer

Journal of Religion and Health - This study consists of an integrative review of the scientific literature that aimed to know the religious and spiritual practices used by children and adolescents...     

Moral Injury,Spiritual Care and the Role of Chaplains: An Exploratory Scoping Review of Literature and Resources

This scoping review considered the role of chaplains with regard to ‘moral injury’. Moral injury is gaining increasing notoriety. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions and afflictions than just physiological or psychological harm, for there may also be wounds affecting the ‘soul’ that are far more difficult to heal—if at all. As part of a larger research program exploring moral injury, a scoping review of literature and other resources was implemented utilising Arksey and O’Malley’s scoping method (Int J Soc Res Methodol 8(1):19–32, 2005) to focus upon moral injury, spirituality (including religion) and chaplaincy. Of the total number of articles and/or resources noting the term ‘moral injury’ in relation to spiritual/religious issues (n = 482), the results revealed 60 resources that specifically noted moral injury and chaplains (or other similar bestowed title). The majority of these resources were clearly positive about the role (or the potential role) of chaplains with regard to mental health issues and/or moral injury. The World Health Organization International Classification of Diseases: Australian Modification of Health Interventions to the International Statistical Classification of Diseases and related Health problems (10th revision, vol 3—WHO ICD-10-AM, Geneva, 2002), was utilised as a coding framework to classify and identify distinct chaplaincy roles and interventions with regard to assisting people with moral injury. Several recommendations are made concerning moral injury and chaplaincy, most particularly the need for greater research to be conducted.     

Introduction to the Special Issue on Military Moral Injury

Pastoral Psychology -     

The Recovery of Religious and Spiritual Significance in American Psychiatry

This paper reviews a body of data that identifies underlying influences that have contributed to an evolving change in American Psychiatry toward a more positive and receptive stance toward religion and spirituality over the past three decades. This development, surprising in light of the remedicalization of psychiatry and its predominantly neuro-biological orientation, is attributed to five foundational ideas that have helped to leverage this change. These are significance of culture, creative power of ritual, psychic function of belief, neuro-biology of spirituality, and relevance of recovery narratives. The impact of these factors for psychiatric assessment and treatment is described, as well as the contribution of the Oskar Pfister legacy and award to the ongoing dialogue between religion and psychiatry. Adapted from the American Psychiatric Association's 2011 Oskar Pfister Lecture in Religion and Psychiatry.     

Correction to: Religious and Spiritual Practices Used by Children and Adolescents to Cope with Cancer

Journal of Religion and Health -     

从道德情感走向道德自由

道德情感是人所具有的高级社会性情感,是与人的道德认识相伴而生的,是人产生善的道德行为的力量和源泉。本文在对道德情感进行伦理分析的基础上,对道德情感与道德理性的相通性进行了阐释,并针对今天人类道德生活中的情感缺失问题指出,道德自由的境界是道德情感与道德理性和谐统一的境界,人类要走向道德自由的理想王国就必须将道德情感还原于人的生活世界中去,给予道德情感应有的地位。     

A Self-Attribution-Reactance Model of Recovery from Injury in Type A Individuals1

A self-attribution-reactance model of Type A behavior and medical recovery is introduced. The model proposes that Type As' bias to view themselves as causal for all outcomes makes them sensitive to events (illness, injury, or treatment) that reduce their personal control. Consequently, Type As are more likely than Type Bs to respond to such events with reactant behavior (noncompliance with treatment) in order to restore their perceptions of control and freedom. In a test of the model, 32 patients being treated for running-related injuries were assessed for Type A behavior, preference for control over and involvement with treatment, and attributions for and reactions to their injury at the beginning of treatment. The physician's ratings of progress through treatment made at the conclusion of the study served as the measure of recovery. Results supported the model in that extreme Type As were more likely than moderate Type As and Type Bs to be judged as exhibiting poor recovery. Moreover, Type As judged to have made poor progress made more extreme self-attributions and were more angry about their injuries than were Type A and B patients judged to have made good progress. The implications of the findings for promoting compliance are discussed.     

Insights into Moral Injury and Soul Repair from Classical Jewish Texts

Pastoral Psychology - This article explores how Jewish biblical, rabbinic, and liturgical texts can be used to broaden and deepen an understanding of moral injury. To date, the literature on moral...     

彰显道德韧性：应对疫情中的道德创伤

道德韧性是成功应对道德逆境的高尚道德操守。面对新型冠状病毒感染的肺炎疫情,中华民族的道德韧性得以彰显,有效地遏制了道德创伤的发生;但社会个体道德韧性的缺失,也使得部分道德创伤不容忽视,如果任其恣意蔓延必将消解和冲击人们抗击疫情的道德情感和道德意志。抵御疫情中的道德创伤,必须在坚定文化自信中传承道德韧性,在应对道德逆境中塑造道德韧性,在探寻生命意义中升华道德韧性,在领导和权威人士履职尽责中激发道德韧性。     

Varieties of Spiritual Experience in Support of Recovery From Cocaine Dependence

A case study is presented that examines 3 spiritual experiences, each of which played a critical role in a client's recovery from cocaine dependence. These experiences, categorized as subtle, synchronistic, and sudden, are described. The effect of the client's disclosures on the therapist's practice of counseling is also discussed.     

Oppression and Responsibility: a Wittgensteinian Approach to Social Practices and Moral Theory

Book reviewed:
O'Connor, Peg, Oppression and Responsibility: a Wittgensteinian Approach to Social Practices and Moral Theory , The Pennsylvania State University Press, 2002, 151 pp., ISBN 0-271-02202-7.     

Hidden Treasures in Theological Education: The Writing Tutor,the Spiritual Director,and Practices of Academic and Spiritual Mentoring

Mentoring is an important but often overlooked resource in theological education and students' academic and spiritual formation. This essay profiles the mentoring practices and postures of the writing tutor and the spiritual director as exemplars of academic and spiritual mentoring. An extended probe of this analogy affirms the integration of academic and spiritual formation as a core value in theological education; identifies mentoring in theological education as a hidden treasure fostering this integration and warranting attention as a theological practice; and re‐envisions the theological practice of mentoring under the traditional rubric of the “care of souls,” embracing the relational, educational, formational, spiritual, and rhetorical dimensions of this practice.     

Patterns of Spiritual and Moral Development in Religious and Public Schools in Chicago

This article draws attention to the different approaches adopted in 21 Chicago schools towards the education of pupils in relation to beliefs and values. It presents the findings of the first stage of an ongoing research project, which explores models of religious, spiritual and moral education in American schools. The dangers of omitting an open and critical study of religion in the curriculum are considered.     

当代道德教育指向:从道德顺从到道德选择的理路

我国的道德教育有着悠久的历史,其主体流质是道德顺从教育,原因有:伦理本位的思想传统;群体本位的教育倾向和道德教育的政治统治功能强化。当代道德教育的时代背景的变迁即社会结构的转型和多元化社会的形成以及当代道德教育人本倾向和生活世界的实践回归,标示着道德选择教育成为了道德教育的内在要求和指向。