In the wake of recent events in Israel and rising antisemitism worldwide, many are grappling with complex emotions. In this Q&A, Milwaukee psychiatrist Dr. Hillel Moffic explores the concept of moral injury — what it is, how it may affect us, and how we might begin to heal.
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Q: What is moral injury?
Moffic: With varying intensity, it is a violation of one’s moral values. Typical symptoms are shame, anger, mistrust, and guilt, especially survivor’s guilt. It can be caused by bearing witness to suffering, feeling complicit, a direct violation of one’s morals, and feeling betrayed by trusted leaders.
Given the inevitability that everyone will experience some of these causative situations, everyone will experience moral injuries to some degree over time.
Q: Does it relate to the rise in antisemitism, that the horrors of Oct. 7 took place, the actions Israel took in the war, or a feeling that Jews don’t have worth in the world?
Moffic: Is it OK to answer “yes” to all of the above? Actually, the connection to antisemitism may be from the existence of antisemitism, the world’s oldest hatred, since Biblical times. Being the perennial target of such hatred can’t help but make one wonder at times if the hatred is deserved and that one did something morally wrong, or even that the religion had ethical failings. The current rise in antisemitism only makes the moral injuries potentially worse and more explicit.
There have been two factions in Israel in regard to prioritizing the hostages or the defeat of Hamas. And there is Israel’s internal political divisiveness, right before the invasion by Hamas, that led to increased vulnerability to attack. We in the diaspora seem to have similar conflicting moral opinions about how the war was conducted, especially with regards to the deaths and physical injuries to children. We also seemed to have underestimated the extent and risk of rising antisemitism over recent years before the invasion.
Whether moral injuries relate to our worth in the world may be a paradox. Given that in modern times we have done so much to improve the world, all of which indicate great moral strengths and accomplishments, the problem may be that we can be seen as providing too much worth as “chosen” people, connected with envy, jealousy, scapegoating and cultish conspiracy theories.
Q: Could moral injury remain present, even as the conflict may be over, and there are 20 living hostages home, or will it linger with time? Does the trade of 2,000 Palestinian prisoners for 20 hostages, followed by Hamas executing Palestinians in the streets, show that we, the Jewish people, just wanted our people back, while yearning to prioritize human life in a very complicated world?
Moffic: These are natural questions for us to struggle with. For sure, as of this Q&A and historic ceasefire lull in late October, moral injury is still present and will be for some time. Even with the return of the last living hostages, that can’t make up for the moral anguish about those who were not rescued in time. Then there are the bodies, still not returned, may their memory be a blessing. The Israeli government did prioritize receiving 20 living hostages over the risk of releasing about 2,000 Palestinian prisoners. At some point, extensive analysis of what made Israel so vulnerable to such an invasion, as well as other possible military alternatives, will be necessary for moral consideration and clarity.
Q: Are we wrong if we feel moral injury today even as we may feel cautiously optimistic? How do we help ourselves with this emotional complexity?
Moffic: Not at all! Our emotional reactions to the conflict can naturally be complex. Forgiveness of oneself and others when practical and indicated can be therapeutic. Moreover, if the optimism holds up, that improvement can be a mental salve to the moral distress and injuries.
Q: Is there a way to look at it all that’s healthy?
Moffic: Yes, there is. First, avoid what is unhealthy in the long run. That would be denying or ignoring these moral wounds. That may be necessary for a brief time in a crisis, but not long term. Even too much resilience has its drawbacks in avoiding the need to address and reduce the causations. Our traditional reliance on education is healthy, and necessary for this newly prominent and challenging subject matter, so let’s provide more of it to the community, as we did at Congregation Shalom for our annual Yom Kippur Study Session, which this year was on moral injuries. I have processed my own moral anguish in multiple daily columns and videos for Psychiatric Times.
In case the ceasefire backfires, this lull can help us anticipate and prepare for such a possibility, which may challenge us again morally. When the moral wounds persist despite these interventions, personal discussion with clergy or psychotherapists can be helpful.
We all have our personal and denominational moral approaches. We have the Torah and later Rabbinic literature. Much intense, deep discussion has been processed by our people. We have been able to recover and move forward after so many moments of major trauma, loss, and moral challenges. We will do so again.
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What is moral injury?
Moral injury is the emotional pain that arises when someone feels they’ve violated their own moral code or witnessed others doing so. It’s not a clinical diagnosis, but it can lead to shame, guilt, anger, mistrust, and survivor’s guilt.
It can result from:
- Witnessing suffering or injustice
- Being betrayed by trusted leaders or institutions
- Surviving when others did not
Healing begins with acknowledging the injury, seeking support from community or professionals, and engaging in reflection and education. Forgiveness — of self and others — can also be part of the process.
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