Moral Injury

By:  Dr. Jennifer M. Williams, PhD, DACM, L.Ac

Pain comes in many forms.  The consequences to physical, emotional, and psychological traumas have distinct associated pathologies and recognized therapies, with the exception of an injury to one’s morality.  Being ordered to inflict harm on another under a directive of authority in the context of war, business, or medical advancement has chronic consequences that Western medicine has only recently started to recognize.  This may be largely due to the culture of suppression that made speaking out on moral issues taboo in many industries.

On September 11, 2001, a phone call from a dear friend and previous military colleague, indicated that there appeared to be a missile lodged close to her office at the Pentagon and that a gag order had promptly been issued.  She was one of the most decorated and devoted Soldiers I had ever met.  In that moment, her world changed completely, and it took at least 10 years for her mind to function clearly again.  The betrayal she experienced and the inability for her to speak to a mental health professional weighed on her until she cracked.  Physical deterioration and chronic illness followed.

In Chinese medical theory, the breadth of emotional suffering is almost always a factor in chronic conditions.  The associated pathological pathway is just as one might suspect; a gut level weakening facilitating pathological rheum with concurrent insufficiency.  Western medicine does not recognize these pathological processes or resulting factors, but there is an acknowledgement of moral injury that is not limited to patients.  Moral injury to physicians in the United States was outlined by Dr. Wendy Dean and Dr. Simon Talbot.  It is not a mystery as to why many physicians feel more part of the problem than the solution in the rapidly changing paradigm of healthcare.  Although, this is shifting within many Veteran’s Administration (VA) Medical Centers where conversation of moral injury is becoming more transparent, especially in the wake of the VA Whole Health initiative.

Whole Health is a biopsychosocial model that was signed into existence through executive order in 2018.  While this model is systematically being rolled out, being part of a design facility has been illuminating.  While performing acupuncture, the subject of moral injury was brought up by a Vietnam era veteran who had suffered significant chronic pain for decades.  He recalled how, for so many years, he was consumed by anger until he was informed that he had suffered a moral injury.  That conversation changed him and his path.  He ended his cycle of destruction and started a journey of healing.  No longer wheelchair bound or emotionally confined, the veteran journals daily about his gratitude for the services offered under Whole Health; a biomedical paradigm designed to address many facades of chronic pain.

About the Author:  

Dr. Jennifer M. Williams, PhD, DACM, L.Ac is a Doctor of Acupuncture at the James H Quillen V.A. Medical Center in Johnson City, Tennessee where she is helping to shape the Whole Health initiative.  She also serves a local community at her private clinic and farm in Green Mountain, North Carolina.  She completed her B.S. in Information Technology, M.S. and Doctorate in Traditional and Classical Chinese Medicine in California, and her PhD in Counseling Studies. She also completed an Internship at the Red Cross Hospital in Huaihua, China and teaches advanced diagnosis and acupuncture techniques for pain and comorbidities.

Dr. Williams is a U.S. Army veteran, spouse of a recent active duty retiree, and has worked with the military and VA for over 20 years.  She shifted away from Internal Medicine after her son was born significantly premature, about 20 years ago, she sought a more progressive model of medicine.  After substantial success, Dr. Williams pursued Chinese medicine.

Dr. Jennifer M. Williams previously taught for the Pacific College of Oriental Medicine Doctoral program.