1. Treating Moral Injury in the Real World
Sheila Frankfurt, PhD
Postdoctoral Research Fellow
VISN 17 Center of Excellence for Research on Returning War Veterans
Instructor, Texas A&M University

2. Acknowledgements
This work is supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Central Texas Veterans Health Care System, and the VISN 17 Center of Excellence for Research on Returning War Veterans.
Disclaimers: The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. The artwork contained in this presentation is copyright protected and not free for dissemination.

3. Overview Introduction & Background What is Moral Injury
How to Treat Moral Injury

4. Background Community Engagement VISN 17 Center of Excellence
Develop Assessments of Moral Injury
DOD: Walter Reed Army Institute of Research
Moral Injury across Deployment Cycle
Community Engagement
Fort Hood Chaplains
Heart of Texas Veterans One Stop
TexVet Initiative, Texas A&M University
Military Officers of America Association, Waco

5. Model of Moral Injury
Transgressive Act
Moral Dilemma
Moral Injury

6. Working definition of “morals”
DEFINITION: Commonly accepted standards of proper and improper behavior, such as is mutually expected or is an interpersonal demand
Context and role dependent
Working definition of “morals”

7. Cultural Worldview of Military
Military Trains Character Values…
Cultural Worldview of Military

8. Cultural Worldview of Military
Moral Obligations
The impact of law (UCMJ), politics, tribunals, & treaties
Cultural Worldview of Military

9. Model of Moral Injury
Transgressive Act
Moral Dilemma
Moral Injury

10. Cultural Worldview of Military
Moral Obligations
Rules of Engagement
that often create
Double-Binds
Cultural Worldview of Military

11. Moral Dilemma
Moral Injury

12. Transgressive Act
Moral Injury

13. Transgressive Act
Moral Dilemma

14. How to Treat Moral Injury?
Reconnect with Cultural Worldview and Community
Communicate with Trusted Others
Give Back

15. Reconnection through Talking
Communalize Wounds
Open and Drain Wound to Heal

16. Whom to Talk To?
Battle Buddies
Veterans
Spouses?

17. Talking about Moral Injury
Prepare yourself to hear combat stories involving gruesome, troubling violence or failings WITHOUT comforting or repulsing
Look for opportunities to build genuine self-empathy, self-compassion, and trust

18. Talking Points Self-empathy Trust Self-compassion Self-forgiveness
Specifically for objectively transgressive acts
Cannot rely on exposure alone

19. Reconnection through Giving Back
Volunteering
Active coping > Passive Coping
Prosocial Behaviors Treat Depression
Community Building
Veterans Organizations
Peace Groups
Politics
Religious or Spiritual Institutions

20. Thank You!
Please be in touch!