scholarly journals Untold Stories of Moral Injury: What We Are Learning—And Not Learning—From Military Veterans in Transition

2020 ◽  
Vol 5 ◽  
Author(s):  
Barton David Buechner

Despite increases in technical capacities for communication, contemporary society struggles with a persistent inability to effectively engage in collective action around a growing number of existential challenges manifesting in local, national, and global contexts. Confronted with environmental deterioration, economic disruptions, wars, and civil unrest, we are challenged to engage in coherent conversations that could lead to collective action, based on a shared understanding. Instead, we are enmeshed in polarized narratives, competing agendas, and emotional conflict. The uneven response to the global COVID-19 pandemic is but the most recent example of this lack of unity. As we seek to find our way in this increasingly complex social landscape, one of the best potential sources for learning about social systems and communication in conflict has gone largely unexamined. For nearly two decades, Military veterans of many nations have struggled while returning from wartime service in Afghanistan and Iraq. Despite best efforts to welcome these service members home and provide access to educational and health benefits, many of them report a difficulty in relating to fellow citizens and institutions upon their return. One indicator of this sense of alienation is the growing number of suicides among this population, now exceeding the number of casualties of combat service itself. Thwarted ability to communicate with others outside of the military and veterans community, and therefore participate in post-service social life, is increasingly recognized as a significant risk factor for suicide. It has never been easy for military veterans to talk about combat experiences. However, the levels of social isolation we are seeing now points toward a deeper and more systemic issue that is not necessarily connected to specific experiences of combat trauma, but instead rooted in real or perceived cultural and moral misalignments associated with difficult experiences in both service and post-serve transition. The longer term effects of thwarted communication and social isolation of veterans, or the feeling of not fitting in can lead to further damage to the underlying moral structures, manifesting as moral conflict (Pearce and Littlejohn, 1997) or moral injuries (Shay, 2014). These moral injuries may include perceived personal failings or culpability based on specific combat experiences, or more generally, a sense of futility in the political limitations of military missions, or perceived betrayals of trust by those in authority. Additionally, stressors and misalignments in the transition process around homecoming are likely as much of a factor as combat experience in creating moral injuries. Many veterans point to a lack of shared values and principles among citizens, and within social institutions and media, as one reason for the difficulty of post-service reintegration. Moral injuries in this sense have further existential implications, with important (but often unheard) messages for our entire society. These are not simple issues that can be addressed by our current array of social work or clinical interventions, or by altering narratives and messages. Rather, they demand a full and interdisciplinary engagement in collective assessment and meaning-making at the society level. As a way of inviting communication scholars into this conversation, I present several models drawn from the Coordinated Management of Meaning (CMM) Theory (Pearce, 2007) to look at the way that moral conflict and moral injuries are made or socially constructed in misaligned communication between returning service members and families, institutions, and others at both the population level and in community settings. Mental health implications are drawn Adlerian psychology, a body of psychological theory that is intersubjectively oriented, and shares a relational or social constructionist orientation with CMM. I then discuss the significance of these intersections in communication and mental health theory and practice, and implications for looking more closely at social connections and communication as key components of well-being and coherence.

2018 ◽  
Vol 24 (3) ◽  
pp. 228-235 ◽  
Author(s):  
Justin T. McDaniel ◽  
Kate H. Thomas ◽  
David L. Albright ◽  
Kari L. Fletcher ◽  
Margaret M. Shields

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.


Sign in / Sign up

Export Citation Format

Share Document