Healing Veteran Moral Injury

“Moral injury always occurs in a relational context. As such, it cannot be healed in a vacuum; rather, the presence of safe, supportive, and—importantly—benevolent relationships where acceptance, forgiveness, and repair can occur are essential. Marrying their vast knowledge of moral injury and the use of metaphors in psychotherapy, the authors have created a unique text to illuminate the sometimes long and windy road to recovery from potentially morally injurious events. Pernicano and Haynes offer mental health clinicians, Veterans, family members, and individuals touched by MI a roadmap for understanding the multi-layered impact of potentially morally injurious events. They do so by utilizing the amazing power of metaphor—a tool with a long history in psychotherapy and increasingly recognized as invaluable in working with trauma. In helping individuals re-story their experiences, metaphors serve as a conduit of human connection and a vehicle of change. This book is as enlightening as it is practical, and a must-read for anyone whose life has been impacted by moral injury.” Valentina Stoycheva, PhD, co-author of The Unconscious: Theory, Research, and Clinical Implications, co-chair, Moral Injury Special Interest Group, International Society for Traumatic Stress Studies “Years ago, I volunteered as a hospital chaplain near Atlanta, Georgia. One day I visited a World War II veteran facing a dire physical diagnosis. He was near death, but the elderly man asked a profoundly moral question. He pleaded “Will God forgive me for what I did during the war?” He revealed a secret that had tormented him for decades. The pain on his face was evident as his stoic features softened. He said he had killed a surrendering German sailor. He had obeyed orders but now carried a moral injury from what he had done as a frightened young soldier.I was an untrained, recent seminary graduate and new pastor. I was unequipped to help him other than recite my confessional and Scriptural beliefs. I had no tools to offer him comfort. I needed this book then; it is what I wish I could have provided to that unnamed man decades ago. I am so thankful for this new but ancient way of bringing healing to moral injury. Ray Woolridge, brigadier general, US Army (retired) and co-author of Escaping Enemy Mode: How Our Brains Unite or Divide Us “As a combat veteran, woman, Latina, and sexual-assault survivor, I saw myself throughout the pages and walked away awe-struck by the realness of it all. In many ways, this book parallels my journey to wellness from trauma and moral injury. The authors authentically describe real veteran experiences, acknowledge, and affirm our struggle and resilience; most importantly, they provide a pathway towards healing. I saw my healing journey play out countless times in each veteran story. The metaphor, stories, art, and writing brought me back from a dark saturated type of emotional and physical pain into a fuller life in the light.” Lisa Carrington Firmin, colonel, US Air Force (retired), and award-winning author of Stories from the Front: Pain, Betrayal, and Resilience on the MST Battlefield and Latina Warrior “The authors, drawing on vivid personal stories from veterans and their extensive professional experience, offer readers a wealth of useful strategies such as storytelling, imagination, and collective engagement to support recovery from moral injury.” Rita Nakashima Brock, PhD, senior vice president for moral injury recovery programs, Volunteers of America “This book is an up-to-date overview of the field and a guide for treating moral injury through group therapy, writing, and art-making. The authors’ compassion and clinical rigor shine through from page one as they draw on decades of moral injury research and treatment. In addition to providing a thorough understanding of moral injury, the innovative treatment techniques developed by the authors comprise a proven step-by-step process for helping veterans heal. Dozens of gripping veteran testimonials offer a rare insight into the realities of combat and military service and describe many of the ways that those who serve can suffer life-long trauma. This is a valuable and thought-provoking resource for seasoned practitioners, lay persons, and students alike.” Scott Sinkler, director of the documentary Absolutions: War and Moral Injury “Healing Veteran Moral Injury delivers an innovative and impactful recipe for healing that supports, educates, instills hope and dignity, and offers a path to forgiveness for those struggling with moral injury. Pernicano and Haynes use captivating examples that connect the reader to the introduced concepts while honoring veteran stories. This book provides a voice that academic texts and treatment manuals often lack.” Ashley Casto, PsyD, HSP, licensed clinical psychologist “Building on their combined decades of clinical experience in mental health care and chaplaincy, Pernicano and Haynes offer an approach that integrates forgiveness and acceptance with storytelling in various forms to address the suffering of moral injury, pointing the way to what is possible when mental health and spiritual care professionals collaborate.” Keith G. Meador, MD, ThM, MPH, Anne Geddes Stahlman Professor of Medical Ethics and professor of psychiatry and behavioral sciences at Vanderbilt University and professor of ethics and society at Vanderbilt Divinity School