7/26/2016 TalkingSpiritualaboutMoralInjuryVeteransHealthAdministration

TalkingSpiritualaboutMoralInjury

ArmyVeteranMarianelaLantigua,ArmyVeteran,servedasaTruckDriverinIraqandChaplainJohn
Schultz.

ByClaudieBenjamin,VANYHarborHealthcareSystem
Tuesday,July26,2016

Hi.ImChaplainJohn.Wouldyouliketotalk?MostpatientssaySure,saysChaplainResident
SchultzdescribingthepracticetomeetwithpatientsshortlyaftertheyareadmittedtoVAsSt.
Albanscampus,aresidentialfacility.

WhileSchultzisCatholic,HarborsChaplaincyClinicalEducationProgramisinterdenominational,
includingfulltime,residents,mentalhealthchaplainfellowsandinternchaplains,chaplainsmeet
withpatientsofallfaithsunlessapatientspecificallyaskstotalkwithsomeoneofaspecificfaith.
VAchaplains,hesays,arepartofaninterdisciplinaryteamthatmayincludeapsychiatrist,
psychologist,socialworkers,nurses,physicians,physicaltherapist,dietitianandothers,whomeet
regularlytocoordinatepatientscare.Likeothercliniciansontheteam,chaplainscocontributeto
patientoutcomes.

ThepathfromMoralInjurytomoralrepairislongandrequirescourage.

Chaplainsexploreapatientsspiritualwellbeingandprovidespiritualcomfortandcareinthe
momentandaspartofalongertermcareplanwithotherclinicians.Theuniqueroleofthechaplain

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7/26/2016 TalkingSpiritualaboutMoralInjuryVeteransHealthAdministration

istoassistpatientswithconnectingtheirspiritualresourceswiththeirspiritual/religiousneeds.One
areaaVeteranmaybestrugglingwithismoralinjury.

MoralinjurycancomeaboutwhenaVeteranexperiencesperpetrating,failingtoprevent,bearing
witnessto,orlearningaboutactsthattransgressdeeplyheldmoralbeliefs.Forinstance,asoldier
mayhavekilledanenemycombatantinbattle.

Ivenevertoldanyonethis.

ThewayChaplainSchultzdescribesmoralisamatterofought.Achaplainmaybeabletohelpa
Veteranaddressthethoughtstheymaybeaskingthemselvesaboutwhattheydidincombatthat
mayconflictwithwhattheynowthinktheyoughttohavedone.

Theseexperiences,ChaplainSchultzsaysareoftenkeptinsideandcompartmentalized.Ive
nevertoldanyonethisarewordschaplainsandothercliniciansmayhear.Becausethesethoughts
remainpushedawayandavoided,saysChaplainSchultz.Veteranskeepreplayingpastincidents
andmayhavenightmaresorsleeplessnights,andcanexperiencemanyotherdestructive
symptomsincludingwithdrawal,addictionissues,selfsabatoging,selfharmingandself
condemnation.Thesepatientscanviewdrugsandalcoholastheonlyescape.Overtime,though,
theseattemptsatcopingbreakdown.

Memoriesthatarediscarded,shamed,somehowtheymaycomebackindifferentways,
disguised,perhapsseekinganotheroutlet.,saysChaplainSchultz,referringtoaquotefromElie
Weisel,HolocaustSurvivorandteacheroftoleranceandNobelLaureate,whorecentlypassed.

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7/26/2016 TalkingSpiritualaboutMoralInjuryVeteransHealthAdministration

ChaplainJohnSchultz

ChaplainSchultzalsotalksabouttheneedforallhumanstospeakaboutandprocesstheir
feelings.HenotesacomparableintheBookofLamentationsintheBiblewhichdetailsindividual
lamentsofdespairthatoftenendinrenewedfaithandhopeafterexpression.

Bothchaplainsandpsychologistsareconvincedthatbringingtheissuesintotheopenand
processingandreflectingonthemwithguidancefromsupportivecliniciansinathoughtfulplanof
careisthebestwaytotreatmoralinjury.

ManyVeteransareSeekingForgiveness

ChaplainsfirstapproachVeteransbyengaginginconversationandattimesaskingthemto
completeabriefspiritualselfassessmentthatasksstraightforwardquestionsaboutlevelsofguilt,
shame,anger,anxietyandgeneralspiritualwellbeing.Spiritualityreferstoaquestformeaning
andpurposeandconnection.WhileformanyGodispartofthatcontext,spiritualityappliesto
believersandatheistsalike.

WithmoralinjurywheretheVeteranblameshimself/herself,shameandguiltcanbe
overwhelming.ManyVeteransareseekingforgiveness.Fromwhom?Fromamoralauthority.For
eachpersonthismoralauthoritycanbedifferent.ForsomeitisGod,forsomeitispeersand
familyultimatelyeachcanstrugglewithforgivingthemselves.

Achaplaincanmodelthisforgivenessforapatient,perhapshelpingthemexperienceGods
forgiveness.MostimportantisconnectiontheVeteranisnotalone.ImaytellaVeteran,Iforgive
you.Iamasguiltyasyou.Iamacitizenofthisnationwhichsentyouintocombat.Weareall
complicit.

Thepathfrommoralinjurytomoralrepairislongandrequirescourage.FortheseVeteransthe
returnhomefromthebattlefieldisonlythefirststep.Moreworkisneededforrecoverybutinthat
workthereareotherswhocare,thereishopeandthereisrecoveryandrenewal.

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