Moral Injury can be thought of as being under the umbrella of trauma related disorders (Kanojia, 2025). The National Center for PTSD encapsulates this as, Moral Injury occurs when individuals are exposed to traumatic or highly stressful events that violate their deeply held moral beliefs, either through actions they take (acts of commission), actions they fail to take (acts of omission), or through betrayal by leaders or others in positions of power (Norman and Maguen, 2025). Additionally, this exposure can lead to significant psychological, behavioral, social, and sometimes spiritual distress, particularly when individuals act in, or witness, behaviors that conflict with their personal values (Norman and Maguen, 2025). This shows frequently in populations who are exposed to war, people who work in healthcare systems and policing, and in the realms of religious institutions and social injustice.

Why is this so important? One might think this is just another label for trauma, but it really is not. For years, many people in healthcare, particularly nurses, have been experiencing something greater than burnout. Dr. Keith Corl, a physician at a Las Vegas hospital and an assistant professor of medicine at Brown University, notes that there is a growing number of physicians, nurses, social workers, and other clinicians who use the phrase “moral injury” to describe their inner struggles at work (Corl, as cited in Bailey, 2020). In Canada, we can already see the cracks forming within our political and healthcare climate. Stories shared and voiced by clinicians echo these struggles, long before the COVID-19 pandemic.

The idea behind moral injury is that it occurs when an individual is forced to act in a way they have no control over or ability to change (Kanojia, 2025). Essentially, it creates a numbing pain of shame and guilt, often leading to a loss of meaning in one’s work. It is commonly experienced as social withdrawal and has a high comorbidity with depression, PTSD, and anxiety. Studies have also found that moral injury is correlated with increased substance use and elevated suicidality scores (Nieuwsma et al., 2021).

What can we do about it? Having community, social support, and spaces to talk openly are meaningful places to start. Beyond that, having someone who can hold space, someone who helps you feel, understand, and reintroduce meaning, can support movement through these experiences. This process can expand an individual’s moral cognition, spiritual grounding, and sense of self- belief. It also reminds us that healing does not happen in isolation but through relationships. Allowing compassion and grace creates room to process, reflect, and lament the past in a way that feels both humane and restorative.

Therapists who offer modalities such as Cognitive Processing Therapy (CPT), Acceptance and Commitment Therapy (ACT), Narrative Therapy, or Grief Counselling can walk alongside individuals as they navigate various aspects of moral injury. These approaches create space for individuals to name their pain, examine deeply held beliefs, and gently reconnect with values that may have been disrupted through difficult experiences. Through this process, healing is not rushed, but held with care, allowing meaning, self-compassion, and a renewed sense of integrity, one’s sense of self, purpose, and connection to others.

— Joshua Basil, Psychotherapist Intern, MA (candidate), BA