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Moral Injury: The War Inside

What is Moral Injury?

Moral Injury is a relatively recent term used to describe a crisis that soldiers have faced for centuries, the internal suffering that results from breaking your own moral code. It's a wound of the conscience, and it's not just military members who struggle. Anyone can experience Moral Injury.

As one of the nation's thought leaders in the #Moralinjury field, we dedicate our efforts in helping individuals who are battling with moral injury to overcome #TheWarInside

The War Inside


At Volunteers of America, we’re prioritizing Moral Injury research and your donation today can help support our injury repair initiatives and increase our capacity to serve veterans and other Americans at risk of suicide.


Effects of Moral Injury

Moral Injury breaks the spirit. It makes people question their ability to do the right thing and leaves them contaminated with the feeling that they're "bad," "disgusting," or "beyond redemption." They may feel that they have an evil twin lurking inside. Moral Injury often leads to self-harm. People turn to alcohol, drugs, and self-isolation to avoid the pain of their feelings. The War Inside may leave some emotionally dead.

Imagine a soldier who takes a life in the line of duty. No matter how much good he does, he believes he’s a bad person. He hates himself, hurts himself. He lives with Moral Injury.

Imagine a nurse who blames herself for losing a patient. She questions her own self-worth and abuses pain killers to numb the constant emotional struggle. She lives with Moral Injury.

Imagine a defense attorney who wins a trial for a guilty client. He did his job, but he sees himself as a villain. Even when he leaves the profession, he drinks to forget. He’s one of the many who struggle with Moral Injury. At Volunteers of America, we can help him find peace.

Imagine a school bus driver who falls asleep at the wheel. She blames herself for every injury, every life, and every day, she considers taking her own. She lives with Moral Injury.

Imagine a struggling single mother who neglects her child to work the night-shift. She regrets every second he’s alone in an empty apartment. She lives with Moral Injury.


Hope for Moral Injury

Resilience Strength Training or RST: A New Program for Military Veterans

RST is a program that helps military veterans process moral injury and other difficult life experiences that interfere with their ability to thrive and have satisfying lives. The evidence-based pilot project, funded by a grant from Bristol-Myers Squibb Foundation, processed a total of 95 veterans in Los Angeles and New York City. The first group met in early November 2017 and the last group took its last survey at the end of October 2019. Research results will be published in 2020.

RST goals include:

    • Reducing individual isolation;
    • Restoring capacities to form relationship bonds;
    • Enhancing inner self-knowledge and emotional awareness;
    • Lowering moral injury distress and self-destructive coping;
    • Increasing habits of self-care and self-esteem;
    • Learning emotional sharing and compassionate listening;
    • Avoiding high-risk behaviors;
    • Creating new meaning together that can integrate traumatic memories;
    • Reestablishing connections to families and communities;
    • Reintegrating with anticipation, curiosity, and hope.

The RST accomplishes these goals by:

    • Providing information about moral injury and self-care;
    • Creating groups with strong bonds and ethical practices;
    • Teaching ways to attend to inner emotions and manage strong emotions through body-awareness and spiritual practices such as yoga, mindfulness, and TRE (Trauma Release Exercises);
    • Offer ritual times for expressing and processing grief and moral emotions;
    • Focused writing and art-making to express and process traumatic memories;
    • Enhancing capacities for empathy and offering emotional support through deep, focused listening;
    • Encouraging examination of beliefs, meaning, and moral identity and resolution of conflicted relationships with the past; and
    • Increasing self-awareness and behavioral control to sustain long-term, satisfying relationships.

Currently, RST groups for veterans are being regularly offered via the Volunteers of America Florida Affiliate. Contact Pat Norstedt, pnorstedt@voa-fla.org, for more information.

In addition, the Shay Moral Injury Center has teams of facilitators and program staff who are available to contract to operate groups, if your organization is interested in trying the RST program with veterans in your area. Contact Rita Brock, rbrock@voa.org, if you are interested.

Plans are underway to expand the use of RST to new populations and, as funding is secured, we will announce new plans via our newsletter.

The Shay Moral Injury Center

Named for Dr. Jonathan Shay, the Shay Moral Injury Center at Volunteers of America conducts research on and promotes deeper understanding of moral injury in the many populations who experience it. Through our education and training programs, we offer effective strategies and processes that support healing. Under the direction of Rev. Rita Nakashima Brock, Ph.D., the center builds on Volunteers of America's work, spanning more than a century, of helping veterans and others who live with the burden of moral injury.

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    Personal Stories of Moral Injury

    Read "The Momentum of Hope," a collection of real experiences with Moral Injury. See how Moral Injury has impacted so many people from veterans to caregivers, including Dr. Rita Nakashima Brock and our Chief Executive Office, Mike King.

    View Stories
  • Shay.jpeg

    The Shay Moral Injury Center

    Named for Dr. Jonathan Shay, the Shay Moral Injury Center at Volunteers of America conducts research on and promotes deeper understanding of moral injury in the many populations who experience it. Through our education and training programs, we offer effective strategies and processes that support healing. Under the direction of Rev. Rita Nakashima Brock, Ph.D., the center builds on Volunteers of America's work, spanning more than a century, of helping veterans and others who live with the burden of moral injury.

    Learn More
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    Meet Dr. Rita Nakashima Brock

    Rev. Rita Nakashima Brock, Ph.D., is the Senior Vice President of Moral Injury and the Director of the Shay Moral Injury Center. She leads the organization's efforts to deepen the understanding of Moral Injury and the many populations who experience it. Learn more about her impact.

    Learn More