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Guilt and Shame: The "Messy" Part of Moral Injury
Photo by ISAF Media
by
Dr. Lisa Finlay
on
July 20, 2015
| Stress & Burnout | Trauma & Critical Incidents | First Responders |

I became interested in moral injury a few years ago when I worked with military veterans who were struggling to make peace with things they had seen or done, sometimes more than 40 years after the fact. Moral injury (which Jim has blogged about here) is defined as the lasting impact of participating in, witnessing, or failing to prevent something that goes against deeply held beliefs and values. People who are helping others during an emergency or after a disaster don’t have the same experiences as those who go to war, but the nature of this work can bring people face to face with human suffering and tragic outcomes. An emergency responder might be haunted by a life that could not be saved, or an accident that could have been prevented.

Two emotions frequently paired with moral injury are guilt and shame. These are most common when someone can identify something they should have done differently during a critical incident, although it can be more complicated than that (e.g., sometimes people feel guilty for a private thought or feeling they’ve had, or for a long list of behaviors they regret). I call guilt and shame messy emotions not just because they’re uncomfortable and can stay with us for a long time but because they’re complicated.

The truth is that being exposed to injustice and suffering changes most people. Facing unexpected danger, random loss, or human cruelty tends to disrupt the way we see the world (including God, if you believe in God), other people, and ourselves. We can’t just go back to an old perspective once it’s been uprooted. And we usually can’t simply adopt someone else’s perspective, either--even when it seems reasonable or wise. You may have had the experience of sharing something you felt guilty or ashamed about with someone, and then they told you why you shouldn’t feel bad about it, and you could hear what they were saying but you couldn’t fully believe it for yourself. Guilt and shame can be surprisingly persistent. I don’t bring this up to be discouraging but to encourage you to be patient with yourself as you try to understand what you have been through and what it means. 

Another part of what make guilt and shame complicated is that, like many emotions, they are shaped by our social groups and by cultural values. Although typically viewed as “negative” emotions (because they are unpleasant), there is research that demonstrates that guilt and shame have inherent value as well. For instance, people who rate themselves higher on guilt feelings after an interaction in which they offended someone also score higher on measures of empathy. Societies known as “high shame” cultures tend to be places where group cooperation and collective wellbeing are prioritized. So in some ways these emotions are instructive: they can teach us what kind of person we would like to be in the world. I don’t mean to say that we should never try to find relief from guilt and shame, but there are reasons to believe that “sitting with” these emotions can be beneficial. 

By “sitting with” the emotions, I mean exploring them, rather than avoiding or ruminating. The difference is this: exploring an emotion allows you to feel the emotion long enough to figure out why it’s there and what you should do about it. Dr. Brené Brown, who studies guilt and shame, says “The ability to hold something we’ve done or failed to do up against who we want to be is incredibly adaptive. It’s uncomfortable but it’s adaptive.”

Here are some questions to help you in the “sitting with” part.

What is the event or circumstance that I feel guilty or ashamed about? Who was hurt by me? What was my role?

What personal, communal, or traditional value did I not live up to?

What were the environmental or contextual factors that influenced my behavior? (e.g., Did I have time to plan my response? Was I tired? Was I offended?)

What things can I do in order to act differently in the future?

What things can I do in order to seek repair? (e.g., confession, apology, cleansing, etc.)

Sometimes we also need input on how we answer these questions, and what other questions to consider. This is one reason that it can be tremendously helpful to talk about guilt and shame with people you trust—friends, family members, a spiritual leader, or a counselor. Deciding who to talk to and when can be complex and is really important in and of itself! I will focus on that in the next post on moral injury.

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