Moral Injury and Pathways to Recovery

Los Angeles, California
Wednesday, May 29, 2019
This conference is the most comprehensive and largest event on moral injury in the nation.

Leading researchers and teachers on moral injury will be present throughout the entire conference to offer plenary talks and intensive seminars to help everyone understand its impact and to offer strategies for recovery. 

Description of Plenaries (May 29)

Plenary 1—Moral Injury: Definitions, New Research, and Clinical and Spiritual Approaches

William P. Nash, M.D. & Rita N. Brock, Ph.D

Psychiatrist William Nash will present a range of definitions and current research about moral injury.  Theologian Rita Brock will offer a view of its spiritual/community dimensions. Then they will engage in a dialogue about how their various approaches intersect and differ and what they offer each other. There will also be time for a conversation with the audience.

Plenary 2—Narrative Practices for Processing Moral Injury

Joanne Braxton, Ph.D & Cynda Hylton-Rushton, Ph.D

Humanities Scholar and minister Joannae Braxton and Medical Ethicist Cynda Hylton-Rushton will discuss moral injury in relation to healthcare and trauma and describe strategies for processing it in care-givers and those they care for.

Plenary 3—Arts & Healing

Ping Ho, MPH

This plenary will enable participants to use the arts in managing trauma and moral injury and explore how the language of non-judgment in arts-work can enhance engagement and dialogue with clients. It will demonstrate experientially how the arts can facilitate self-expression, stress reduction, positive emotions, and connection to others in an interactive hour of art making, movement, music making, and writing.

Plenary 4—Care for Caregivers

Carrie Doehring, Ph.D & Ramsay, Ph.D

Pastoral theologian and licensed psychologist Carrie Doehring and pastoral theologian and director of the Soul Repair Center Nancy Ramsay will discuss moral distress and moral injury in caregivers both professional and familial and offer strategies for self-care in diverse populations.

Plenary 5—Spiritual/Community Responses to Moral Injury

De Hong, Ph.D; Amir Hussain, Ph.D; Cori Williams, MDiv.; & Belva Brown Jordan


A panel with theologian of trauma psychologist and priest De Hong, professor of theological studies Amir Hussain, pastoral theologian Cori Williams, and associate professor of ministry Belva Brown Jordan will discuss how different communities and traditions understand and address moral injury.


Description of Seminars (May 30-31)

All seminars are 10 hours, unless noted.

1. “Leaving Prison Before You Get Out”: Deep Transformation with Incarcerated Populations—Healing trauma, developing emotional intelligence, cultivating mindfulness and understanding victim impact.  

Upumoni S. Ama & Jacques Verduin, MA 

This seminar will introduce the GRIP program (Guiding Rage Into Power). The GRIP methodology is a transformational re-education modality that commits the members to a process of deep self-inquiry. Violence and suffering are transformed into gateways for healing and learning as participants heal the moral injury that drove them to lash out.  The program examines the origins of criminogenic conduct, especially early trauma, and undoes destructive behavioral patterns that lead to transgressions. Participants graduate from offenders into servants. We will have a unique opportunity to study video footage of the work in action in San Quentin. What is learned about the work of staring down our demons in the trenches of our prisons? How are we all doing time? 

In addition to learning about how to do transformative work with prisoners, the seminar will guide participants in strategies for radical ownership of any experience of personal reactivity and how "leaving prison before getting out,” works, whether that is a physical prison or the space between our ears.  In learning about how to sit in the fire of trauma pain and dissolving the hold that traumas have over lives, participants will learn about ‘Q-TIP’ (Quit Taking It Personally), how to unlearn self-blaming and blaming others, how to process feelings vs. medicating them, how to purge shame and how to achieve forgiveness of self and others.

2. Transforming Moral Injury Across the Professions: Cultivating Moral Resilience Through Reflective Writing and Contemplative Practice

Joanne Braxton, Ph.D, MDiv & Cynda Hylton Rushton, Ph.D, RN, FAAN

“Transforming Moral Injury Across the Professions” is an experiential track designed for clinicians, war-fighters, chaplains, social workers, emergency workers, community organizers, VOA ministers and anyone interested in cultivating practical tools for sustainable self-care. This Track is relevant to anyone struggling with or seeking to understand any form of moral injury and critical incident stress, or anyone who works with others who experience or have experienced moral injury or critical incident stress. The skills learned help the healer heal the self, not by diminishing or minimizing moral adversity, but by naming it and addressing it. 

Under the guidance of two seasoned teachers with a strong background in health and well-being, participants will learn the fine art of witnessing our own and others’ experience and extending compassion to ourselves and those we serve.  How do we come to understand the contours of integrity in a situation where there were no good outcomes possible? How do we transform that experience of moral stress, distress or injury, once we have named it, through reflection and contemplation? Using case studies and personal experience, we name where we find ourselves on the continuum of moral anguish and moral suffering, and then begin to learn to transform it. Participants learn practices such as journaling, spiritual life writing, walking the labyrinth, sitting meditation and other forms of exploration and meaning-making that realistically support recovery from moral adversity and the building of moral resilience.

3. Resilience Strength Training (RST) for Veterans

Rita Nakashima Brock, Ph.D, MA & Timothy M. Barth, Ph.D.

RST is a peer-facilitated, sixty-hour program for military veterans who are interested in strengthening their capacities to process moral injury and other inner struggles, improve relationships, and bounce back from adversity. The pilot program, created by an expert design team and funded by a grant from Bristol, Meyers, Squibb Foundation, has been tested for eighteen months in Los Angeles and New York City and shown very positive results in post-traumatic growth and greater life satisfaction for participants.

Seminar participants will first hear from veterans in Los Angeles who have completed the program. They will discuss the impact it has had on their lives and what it was like to go through the program. Then the project director will explain the design and peer facilitators will describe how they were trained and what they did in the program. The facilitators will lead participants through some of the activities used in the program. In addition, the seminar includes an hour of introduction to Trauma Release Exercises (TRE), which is one of the forms of spiritual exercises used to support other activities. TRE releases stress or trauma stored in the body so it can be processed and accompanies other practices like mindfulness. Copies of the facilitator and participant manuals will be available for examination.

4. Insights into Moral Injury and Soul Repair from Classical and Contemporary Jewish Texts

Rabbi Kim Geringer, MSW & Rabbi Nancy Wiener, D.Min

Jewish literature and languages, such as Hebrew and Aramaic, have always recognized the existence of soul wounds and the need for soul repair. In this seminar we will explore Jewish biblical, rabbinic, and liturgical texts to broaden and deepen an understanding of the contemporary field of Moral Injury and Soul Repair.  To date, the vast majority of literature on Moral Injury has been written from psychological, secular, Christian and Muslim perspectives.  Our research and teaching have focused on finding concepts and language that can speak to Moral Injury in a uniquely Jewish vernacular and context so all committed to the field can enhance their clinical work and/or find new tools to promote their own healing and self-care and those they serve. We will begin with an overview of core Jewish teachings that sets the backdrop and context for the texts, rituals, liturgies, and case studies we will study and discuss them throughout the seminar.

5. Social Emotional Arts on a Shoestring for Individuals & Groups in Any Setting

Ping Ho, MA, MPH

In this 10-hour training, you will experience activities in art, movement, music and writing developed by UCLArts & Healing and its team of creative arts therapists. This curriculum offers general guidelines on the use of each art form in therapeutic contexts, communication techniques for creating rapport and preventing resistance, and containment strategies for managing stress responses.

Ongoing assessments of the program have shown that this curriculum achieves its intended goals of helping to build connection, evoke positive emotions, bolster resilience, decrease stress and pain, facilitate verbal and nonverbal communication, strengthen the creative vs. illness narrative, and manage grief and loss. The training enables sustainable delivery in settings with limited resources, including hospitals, nursing homes, schools, shelters, and community clinics.

6. War-Related Moral Injury: Theory, Research, and Clinical Care

William P. Nash, M.D.

In this seminar, moral injury will be examined through the lens of medical science, continuing the work of the psychiatrist Jonathan Shay, who developed the concept of moral injury in his clinical care of Vietnam veterans at the Boston VA Medical Center in the 1980s and 90s.  Through a mixture of lectures, guided discussions, and large group exercises, participants will formulate answers to the following questions of relevance to moral injury as a public health challenge:

1. How did the scientific concept of moral injury develop and gain traction?  What health-related problems did it solve?
2. What are the existing empirical measures relevant to moral injury?
3. What types of events are known to result in moral injury?
4. What are the adverse health and social outcomes that correlate with exposure to potentially morally injurious events?
5. What is the nature of moral injury?  How does it differ from normal moral development?
6. What, exactly, is injured in moral injury in a person or community?
7. What is the relationship between moral injury and PTSD or grief?
8. What is the nature of moral repair?  What work does it require?
9. What clinical treatments have been tried for moral injury?  What are their logic models and what is the evidence they work?
10. What are the most burning questions moral injury science must tackle today and in the future?

Participants can expect to gain actionable knowledge about moral injury as a form of psychological harm that affects all domains of life, and skill in the use of a number of emerging clinical and research tools for assessment and treatment.  No prior medical or scientific knowledge or skill is required to participate in this seminar.

7. Transforming Spiritual Impasse:  Thinking Theologically about Moral Injury

Rebecca Parker, D.Min & Michael Yandell, M.Div

Participants will gain insight and skills for accompanying people as they engage the spiritual, religious, and theological crises that often are present in moral injury as “spiritual impasse.”  Spiritual impasse occurs when a person’s core beliefs confront life experiences for which their belief system is not adequate; deeply held beliefs may shatter and the person enters a “dark night of the soul.” Within the experiences of isolation, guilt, regret, broken-heartedness, and failure, it is possible to detect theological perspectives at work—core frameworks of meaning relating to themes such as sacrifice, atonement, redemption, belonging, purification, punishment, suffering, and forgiveness. The human capacity for profound evil, betrayal, and dehumanizing acts also comes into play.

When experiencing spiritual impasse, people often make one of three choices: they deny their experience and hold onto their beliefs; they accept their experience and abandon their beliefs; or they transform their established framework of meaning in light of their lived experience---they become creators of spiritual, theological and ethical insight that restores meaning and purpose to their lives.

We will explore this third option as a pathway of healing from moral injury, drawing on the work of theologians and spiritual teachers whose life experience has included moral injury, and considering a diversity of spiritual perspectives and practices from among the world’s religious traditions.

1. Evidence-based intercultural spiritual care for caregivers experiencing moral stress and injuries

(This seminar is 5 hours)-Morning session Only!

Carrie Doehring, Ph.D

Moral stress was first described by healthcare professionals worried about not providing adequate care. Moral stress of caregivers arises from the shame and fear of causing harm through not putting core values into practice, like protecting life. Negative health outcomes arise for those who do not get specific help with religious, spiritual and moral struggles at the heart of moral stress. This seminar provides an intercultural, evidence-based approach to spiritual care of moral stress experienced by caregivers. The seminar draws upon research on spiritual struggles, moral injury, spiritual integration and wholeness. It aims to help caregivers find intrinsically meaningful spiritual practices that can shift them from (1) the shame of moral injury/stress into embodied self-compassion and goodness, and from (2) life limiting shame-based values and beliefs around suffering to life giving compassion-based values and beliefs.

2. “Basically, I look at it like combat”: Moral injury among child-welfare involved parents, professionals and youth

(This seminar is 5 hours)

Wendy Haight, Ph.D

We will focus on empirical research addressing moral injury among professionals, parents and youth involved in the public child welfare system. We administered a modified version of the Moral Injury Events Scale (MIES) to participants and then conducted in-depth, semi-structured, audio-recorded individual interviews with them to elaborate their MIES responses. Participants described harm to themselves occurring through under-resourced systems, problematic professionals, unfair laws and policies, child maltreatment, an adversarial system, systemic biases, harm to children by the system and poor-quality services. They also communicated feelings such as anger, sadness, emotional numbing, guilt and shame. Many also described troubling, existential issues. 

For example, professionals questioned their ability to function in a moral manner within a system they viewed as deeply flawed, and in an unsupportive working environment steeped in human misery. Parents and youth described a loss of trust in professionals and resulting inability to engage fully in potentially helpful services. Participants described coping through a variety of resources available in their everyday lives including: stress reducing and meaning-making activities, self-reflection and forgiveness; social support and corrective experiences; engagement in advocacy and social programs to support other parents and professionals; and spiritual engagement. If involvement in child welfare places professionals, parents and youth at increased risk of moral injury, then moral injury is a critically important construct to understand and address to conduct effective, ethical child welfare practice. Identifying potential models of successful coping with moral injury in everyday life can help identify viable targets for formal prevention and intervention efforts.

3. Spiritual Care for Veterans and their Families: Resources and Practices for Religious Leaders and Chaplains

(This seminar is 5 hours.)

Nancy Ramsay, Ph.D

This 5 hour interactive seminar will equip religious leaders in faith communities and in specialized settings to respond to those affected by military moral injury and their families.  We will frame moral injury through the lens of loss and grief. We will draw on resources from the Abrahamic traditions and theoretical resources such as Pauline Boss’ theory of “ambiguous loss” (2006) and ritual practice (Anderson and Foley, 1998) to propose and illustrate practices of care that enhance resilience and hope for veterans and their families. The seminar will focus on strategies for spiritual care with persons who find a religious tradition helpful, those participating in faith communities, and those residing in specialized contexts such as hospitals, assisted living, and hospice. Because the consequences of Moral injury are not only personal but also relational, systemic, and generational, we will develop guidelines for effective responses to veterans and their partners and families. We will also consider how to sensitize and equip a community of faith for effectively supporting veterans and their family members. We will consider factors preceding military service that may influence an individual’s response to war such as earlier experiences of marginalization and trauma, value for and understanding of religious resources relevant for framing the violence of war, and relational resources.

4. Spiritual and Community Responses to Moral Injury 

(This seminar is 5 hours.)

De Hong, Ph.D & Cori Williams, M.Div

Faith communities and their leaders have the potential to play significant roles in helping to prevent and significantly reduce trauma that can lead to Moral injury within their communities. This seminar is designed to assist faith leaders, lay leaders, community organizers, and concerned citizens with better understandings of the dynamics of trauma and the effects trauma can have upon individuals, families, and communities. 

Participants will learn how to employ effective faith practices to help break the silence of Moral Injury- related trauma. The diverse faculty team from across the United States will explore the power of ritual, spiritual practices, and community development for healing and restoration of individuals and their communities. Information and practice will be offered on the effectiveness of Buddhist Mindfulness mediation practices and the dynamic of using Mindfulness as a moral compass to deal with stress, mental clarity and recognition of traumas. Other presentations will include Pastoral Care and the use of empathic listening, as well as how to apply practical faith methods to better reach, engage, support, and empower individuals and the communities we serve.


 

Contact Information

  • Sophie Barry

    Phone: 703-341-5083

© 2019
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