When your values clash with your actions, it can cause deep emotional distress. Photo / 123RF
When your values clash with your actions, it can cause deep emotional distress. Photo / 123RF
We feel psychological distress when we are compelled to act against, witness, or fail to prevent actions that conflict with our moral beliefs. Therapists Robin Stern and Marc Brackett share their advice on how to navigate the struggle.
Q. I find myself struggling emotionally and ethically in today’spolarised world. I have a job in healthcare and often find myself in situations where I have to act in ways that go against my values, whether it’s due to hospital policies or the general state of our healthcare system. How do I navigate this?
A. This question from one of our clients may resonate with many who feel caught between their values and the realities of their environment. This distress has a name: It is called moral injury - psychological distress that arises when we are compelled to act against, witness, or fail to prevent actions that conflict with our moral beliefs.
Originally studied in military contexts, the concept of moral injury has expanded to encompass various personal and professional settings. It is prevalent in healthcare, education, law enforcement and other professions where individuals’ personal values frequently clash with systemic realities. While moral injury is not classified as a mental health diagnosis such as post-traumatic stress disorder (PTSD), or depression, it often coexists with these conditions, and healthcare workers like our client face this challenge daily.
But it’s important to recognise that moral injury isn’t just emotional - it can manifest as physical symptoms and as problems in our daily lives. Research shows that those suffering from moral injury report disrupted sleep patterns, persistent fatigue, headaches, and difficulty concentrating. People might notice changes in their eating habits, experience unexplained aches, or feel constantly tense. These symptoms can be especially pronounced during periods of heightened stress.
Over time, some people develop a kind of resigned adaptation, as moral injury becomes woven into the fabric of their daily life. While this adaptation might make the experience feel less acute, it speaks to a deeper reality: We have learned to function in a world where values misaligned with our own have become normalised.
Moral injury isn’t a mental health diagnosis, but it often coexists with conditions like PTSD and depression. Photo / 123RF
Recognising physical and emotional manifestations is crucial because they often serve as early warning signs to prioritise our wellbeing.
And in a pluralistic society, while one person may experience moral injury now, another may face it at a different time, and it’s up to us to use our understanding to cultivate greater empathy. Recognising that moral injury is a universal human experience can help us move beyond judgment to find opportunities to collaborate on meaningful solutions.
Moral injury can be exhausting, and sometimes (and justifiably) you feel pushed to the point where you choose to leave the organisation, relationship or community. But for many, financial, lifestyle or familial needs make it impossible to leave. Whether you choose to stay or leave, here are some practical approaches that can help you navigate and manage its impact:
Validate your emotions
Acknowledge that feelings of guilt, anger, sadness or disillusionment are valid. These emotions often stem from a deep sense of care and commitment to your values. Allow yourself to recognise and process these feelings without judgment.
Focus on agency
While you can’t control every issue, identify areas where you can take meaningful action. These might include volunteering, advocating for systemic change, or engaging in local governance. Aligning parts of your life with your values can help restore a sense of purpose and agency.
Even small acts, like volunteering or advocacy, can help restore a sense of purpose. Photo / 123RF
Build compassion
Recognise that others may be grappling with their own moral complexities, even if their beliefs may differ from yours. Practising compassion doesn’t mean agreeing with them, but it can reduce the alienation that fuels distress and foster more constructive dialogues.
Connect with like-minded communities
Finding a community of individuals who share your concerns can provide solidarity and amplify efforts toward change. Whether through professional organisations, support groups or local advocacy networks, these connections can help combat feelings of isolation.
Community support plays a crucial role in managing moral injury. Photo / 123RF
Practise self-care
Maintaining your mental and physical health is critical. Practices such as mindfulness, regular exercise and nurturing social relationships can help you build resilience and cope with stressful situations.
Moral injury can also serve as a catalyst for growth and change. By staying grounded in your values and taking constructive action, you can transform emotional distress into meaningful dialogue, education or activism. While navigating these challenges isn’t easy, they hold the potential to inspire progress - for yourself, your profession, and the world around you.
Robin Stern, PhD, is the co-founder and senior adviser to the director of the Yale Center for Emotional Intelligence, a psychoanalyst in private practice, the author of The Gaslight Effect and the host of The Gaslight Effect podcast.
Marc Brackett, PhD, is the founding director of the Yale Center for Emotional Intelligence, a professor in the Child Study Center at Yale, lead developer of RULER, an evidence-based approach to social and emotional learning, and the author of Permission to Feel.
