This chapter conceptually analyzes the post-traumatic stress injuries called moral injury, moral fatigue or exhaustion, and broken spirit. It then identifies two puzzles. First, soldiers sometimes sustain moral injury even from doing right actions. Second, they experience moral exhaustion from making decisions even where the morally right choice is so obvious that it shouldn’t be stressful to make it; and even where rightness of decision is so murky that no decision could be morally faulted. The injuries result of mistaken (...) moral self-evaluation. Methods of preventing and treating these injuries are defended, including training in self-forgiveness, moral off-loading of actions and decisions to persons and devices less likely to feel inappropriate guilt, and the use of drugs to prevent such guilt. The foregoing has been about moral injury erroneously resulting from the non-violation of a correct moral code. But the chapter then introduces the concept of moral pseudo-injury—felt moral injury that has in reality resulted from violation of a false moral code, so that no one has really been morally injured. This can be used as a method in warfighting. And since the injuries it produces are illusory, this would be morally superior to physical violence. For it causes less injury to its victims, and should cause less guilt in those who must inflict it. Historical precedents are considered. Finally, our enemies often use moral pseudo-injury against us, in the form of terrorist violence against civilians. Terrorism causes comparatively few harms, yet we mistakenly see it as more morally horrific than conventional combat that causes much worse loss of life among armed forces members. Here we need the nuancing and clarifying power of philosophy to restore a sense of proportion, thence to prevent or therapize the moral pseudo-injury we may experience from these sorts of attacks. (This is a pre-penultimate version of the published version, available from OUP at the external link, which contains minor variances. The paper was earlier known as "PTSD Weaponized: A Theory of Moral Injury"; that now superseded version is archived under "past conferences" on the Center for Ethics and the Rule of Law website.). (shrink)

This is a paper on the philosophical clinical psychology of PTSD. How best to improve our treatment plans for the disorder is the primary imperative in the clinical literature. Our failure to properly treat those suffering from PTSD up until now could be either the result of merely a problem in practice or, more seriously, a problem in principle. In this essay, I explore three possible accounts consistent with the supposition that what we have here is a (...) problem in principle. I call the first the “Somatic” hypothesis; the second, the “Memorial”; and the third, a “Rilkean” hypothesis of PTSD, which is inspired by the recent work of M. Rowlands. The first two have been more-or-less articulated previously; the third is introduced here for the first time. The primary argument of this essay is abductive: I argue in favor of a Rilkean Memory hypothesis of PTSD by comparing it to the other two accounts and showing that it possesses greater theoretical virtue than they do. I then conclude the essay by noting certain limitations with the account here sketched, nonetheless suggesting that this hypothesis can open up new avenues of clinical research and treatment options for the disorder. (shrink)