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The uncharted waters of moral injury

Turns out, the internal storm we’re weathering has a name

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Giulia Neri for the Deseret News

I stopped leaving my phone in the bedroom at night a few months ago. After reading time and time again that rolling over and beginning a new day with a runaway scroll through messages, notifications and news is a bad idea, I put a charger in the kitchen and resolved to have more than a few mere inches between my unconscious brain and everything I can’t control during my resting hours.

But I still wake up some days, listlessly examine the walls of the room, and feel ambiguously doomed.

There’s the war. There’s the financial strife. There’s the pandemic. There’s the politics. There’s the drought and wildfires. There are the everyday heartaches of life that march on regardless of social, political, natural or economic stability. And, of course, there’s a bottomless chasm of information about it all just a few clicks away. The reasons why so many people are collectively feeling levels of grief in their day-to-day lives are apparent. But what do we call this feeling?

Generally speaking on a practical level, I have no reason to feel threatened by a sludgey cloud of hovering melancholy. I have a home that I feel secure in. More than enough food to eat. Good health. Two very cute dogs. Family and friends who are supportive (and still on this earth). An exercise routine. A career. Outdoor spaces that are welcoming and safe. Access to information and opportunity. I am very privileged. But a few times over the past couple of years, it — whatever “it” is — has floated in and loomed around.

I know I’m not the only one. Recently, a poem by Mari Andrew was widely shared online. As I saw it make the rounds on social media and in podcasts, a few lines struck me as very relatable — a way to say that this low-level grief and anxiety was far-reaching. “I am washing my face before bed while a country is on fire,” the poem opens. “It feels dumb to wash my face, and dumb not to. It has never been this way, and it has always been this way.”

It gave words to something I was feeling, others are feeling, and maybe you’re feeling.

In the Harvard Business Review, David Kessler, co-author of “On Grief and Grieving” with Dr. Elisabeth Kübler-Ross, described collective grief as one phenomenon we’ve been experiencing. For more than two years, there has been a widespread loss of safety, normalcy, financial security, relationships, imagined futures and loved ones. And what connects each loss is a fear of whether all will one day be OK. On top of that, we’re exposed to tangible evidence of the losses of millions of other people, global conflict and crises every day.

That’s a heavy weight to carry as we still attempt to get up, get out, log on and carry out daily responsibilities. It’s not rocket science that all of this together leads to something that is more than just stress or grief.  

“On top of the grief and the fear is a sense of trauma,” says Anna Darbonne, a licensed clinical psychologist who specializes in grief and bereavement. “We’ve been exposed to frequent and persistent distressing images and stories both directly and indirectly. ... For some, that results in sadness and discomfort; for others, it can cause vicarious trauma.”

The outcome? Many of us feel helpless and, to some degree, hopeless. And that malaise, Darbonne says, is borne from a specific type of trauma that has a name: moral injury.

“We’re scared of our own heavy feelings associated with grief … so we often push away from our feelings.” —Anna Darbonne

The term refers to the emotional, psychological, behavioral and even spiritual aftermath that can happen after a violation of our ethics code and moral beliefs, Darbonne explains. Moral injuries occur when an experience shatters our perception of the world, people and life.

“The pandemic and its waves of variants divided and contentious sociopolitical situations, and global conflicts all occurring simultaneously shattered most people’s perceptions of safety, community and peace. We don’t know who to trust, how to make it better and how best to protect ourselves and others.”

And although you can find nearly anything you want (and everything you don’t) on the internet, it can’t give us these answers. Google “how best to protect ourselves and others,” and you’ll end up with a lot of advice about washing your hands. Andrew was right when she said that thing about how it has always — and never — been this way.

Civilization has been exposed to calamity and devastation through the ages, whether via narrow or wide lenses, past or present tenses. Plague struck Athens in 430 B.C. amid the (equally horrific) Peloponnesian War and killed between 25-30 percent of Athenians. The epidemic was documented by ancient Greek historian Thucydides while he witnessed the crumbling of his community and suffered the disease himself. In A.D. 79, the eruption of Vesuvius was reported by Roman author Pliny the Younger, who watched the certainly terror-inducing detonation of a mountain ablaze and fled from fire, ash and horror that enveloped his city and killed his uncle.

After studying the documentation of these two archaic gents, researchers found conclusions that eerily parallel how we’re dealing with catastrophes today. “The victims of these disasters were plunged into confusion and uncertainty about what to do to survive,” the study, published in the book “Forces of Nature and Cultural Responses,” reads. “In many cases, social cohesion dissolved, and individuals broke norms and traditions. Some sought help from the gods, and others felt there were no gods.”

Both empires eventually dusted off and moved on, led by what study author and former professor of history J. Donald Hughes surmises as leaders “responding with measures intended to help people, restore the body politic, and rebuild.” And although “frustrated by physical and social barriers, they achieved a degree of success.”

As we can see in the stories, records, and Greek and Roman myths that followed, a collective memory was passed down to mourn, make sense of disasters and remember the mistakes made — together — to reduce moral injury.

Learning from the past and encouraging communal grieving are things other societies seem to have on American culture. “As Western societies, particularly the United States, move away from the direct experience of a mourner, the rites and customs of other cultures offer valuable lessons,” Daniel Wojcik and Robert Dobler, both professors of folklore, co-wrote in The Conversation.

But those valuable lessons are yet to be embraced. We are a moral injury-averse society, says Darbonne. “We’re scared of our own heavy feelings associated with grief — like longing, despair, helplessness, being out of control — so we often push away from our feelings. In that vein, we don’t want to hear about anyone else’s grief, fear and trauma because we don’t know how to respond to them — like what to say or do.”

It doesn’t help that the term “moral injury” isn’t really used in the everyday American lexicon. Other cultures have had words to describe what these morose-y, malaise-y, I’m-not-OK feelings are.

Once while staying in a ridiculous mansion in Jackson Hole, Wyoming, under circumstances in which I was the guest of friends of friends and felt a little out of place, I thumbed through the pages of a book titled “Lost in Translation.” The too-long subtitle said something about words from around the world that are untranslatable, but according to the pages, they were illustratable.

There was saudade, a Portuguese word describing “a vague, constant desire for something that does not and probably cannot exist, a nostalgic longing for someone or something loved and then lost.” Maybe right now there is a little collective longing for the rose-colored “good old days.”

Then I found Hi Fun Kou Gai (ひふんこうがい), a Japanese description for a specific righteous anger over a situation that is terrible but cannot be changed. Yup, that checks out, too.

There’s​​ ghoseh ( غصه), a Farsi word that, by some English-speaking translator’s definition, describes having sadness, but in an embodied sense. One Farsi speaker defined it as having emptiness, or “to practice holding sadness.”

When a culture doesn’t have the right words to express what people are feeling, it keeps a distance between experiencing those feelings and understanding them. That’s a problem in our psychological culture, Darbonne says, and can lead to normal human reactions being maligned as medical conditions. “The DSM-5 (the diagnostic manual for mental health providers) just pathologized grief that lasts longer than a year,” she explains. “The inclusion of the diagnosis turned a very normal and necessary reaction into one that can now be medicated and medicalized.”

When a culture doesn’t have the right words to express what people are feeling, it keeps a distance between experiencing those feelings and understanding them.

So what to do with our moral injuries, big and small?

We have the history to learn from, even though we’ve heard ad nauseam that these times are indeed unprecedented. World Wars I and II provided amplified exposure to suffering and sad news, which may have felt similarly overwhelming to our current stream of incoming global information. And — thanks to science — we now know that the more we expose ourselves to news, the higher our anxiety becomes and the more likely we are to catastrophize the future.

Besides ending the daily doomscroll, Darbonne gently reminds us that acknowledging our negative feelings about what we can’t control is critical in being able to find joy in what we can control. How we deal with it is personal, but acknowledging it should be more common.

“In some ways, it creates greater openness for folks to say that they’re struggling — which is beautiful and exactly what our society needs,” Darbonne says. “There is still a lot of work to be done to acknowledge that ... we all respond to those feelings differently, that those feelings impact how we view and interact with the world, and that we need each other to heal individually and collectively.

“Folks have such different reactions,” she adds. “Some feel solace knowing that others feel the same as them or struggle in similar ways to them. Others feel deep despair when they realize that so many other people are suffering. A lot of people feel scared to burden others with their grief. ... There are also pragmatic grievers who feel their grief and then move forward without a hiccup. It’s important that we make space for everyone to grieve the way that they need to without comparing.”

So whether the term “moral injury” ever catches on or not, calling our feelings as we see them (or feel them, rather) is one step toward lifting the shroud of uncertainty that surrounds the moments or days that feel tough. And while saudade is a much more elegant way of describing a certain sadness that’s tough to put a finger on, the next time my partner asks me how I’m doing on a day that I’m not doing so great, I’m probably going to respond with the (less-dignified) untranslatable word that continues to make the most sense for me: blah. 

This story appears in the October issue of Deseret MagazineLearn more about how to subscribe.