When a client experiences a moral injury, the guilt, sadness, and shame that come with it can be debilitating. It can create a deep wound at the center of a person’s identity.
So how can you help a client who’s suffering from a moral injury begin to heal?
In the video below, Ruth Lanius, MD, PhD will walk you through the approach she used with a first responder to help him process his actions at the scene of a car accident. Have a look.
This week, we’ll take a deeper look at how to work effectively with trauma-induced shame – including moral injury – in the Advanced Master Program on the Treatment of Trauma.
We’ll also discuss four defenses clients use to manage shame, get into how cognitive approaches to shame may backfire, and share a question that can help you address shame when the client doesn’t think it’s a problem.
It’s free to watch the broadcast – just sign up here.
Now we’d like to hear from you – what approaches have you found useful when working with moral injury? What do you find helpful for working with shame? Please let us know by leaving a comment.
Hello! My name is Nikki Smith and I am a MSW student at Salisbury University. I posted a comment on FB about Dr. Bessel Van Der Kolk’s book Body Keeps The Score and I got put in FB jail twice, now. It says I posted against their sexual, nudity agreement. I just really want to let Dr. Van Der Kolk know about this.
Sincerely, Nicole Smith
Dear Ruth, you are my favorite on this program. I did not yet saw this part of the training but I would like to share my experience with last night session with my therapist. I am psychologist myself and I am on self-development training – doing my own psychotherapy. I told her that I start using the model IFS and I do things at home alone- discovering my firefighters and managers and I think I done great job for a week. More parts start popping up like popcorns. I am still wondering should I continue doing it alone or it is not so safe like this. I wanted to tell her this and address some difficult issue. The last few months my therapist shouted and screamed at me unpredictable during session and this scared me so much. And I have trauma history and this is my save place and you can imagine my arosal and my fight and flee mode that I am getting in. After that I was planning to address the screaming issue but she was fast – she said that I do the model alone because she scared my exile. She means when she screamed at me. I told her that first time she screamed at me I did not know what to do. She did not done nothing later either. Then the story repeated again – I asked her to stop. Then she screamed again and I screamed at her back so she feels how I feel. This happened for a period of 6 months – from time to time. And I quite her for a while. Then when I returned back, she done it again. Yesterday I told her that I was thinking why she is doing this and that I think she has an exile that I am triggering. Then the fighherfihter comes and she screams at me but this is not professional. She agreed it is not professional. I asked her to tell me what exactly triggering her – she said I need to think and find it myself for next time although I do not have any idea about her. She only mentioned that I am bluffing. I was shocked. She said I am in pain inside – I do not hide it but to her I look so strong and clear – I said I feel both and I am not bluffing. This apparently is making her angry. What you think? How I should solve this problem? She makes a lot of mistakes but she knows things about IFS model – I would like to use her knowledge and years of experience (she is around 60) but she is not trained in it I think. I do not know if I really need to quite her and if not can I solve this problem somehow?
Hi Nadia
I my opinion a therapist should never shout at a client! If she is being triggered she needs to address that in her own supervision or therapy.
If you do not feel safe there then why stay?
In act you could report her if you wanted to.
Act for your own best interest!
This is one of my biggest takeaways from attending these webinars on trauma. The issue of integration of different parts of self as a vehicle for healing.
Dr Ruth Lanois to helped me a great deal with her interpretation about the dilemma of first responder.
I am a Holocaust educated and was asked recently about the silence of the survivors for decades about their experiences.
The answer was given in her approach.When one is in survival mode, empathy even toward self is dormant.All psychic energy has to focus on just simply making it everyday.
Many thanks
I talk about the concept of integration with my clients, and the importance of integrating all parts of oneself. I like to approach it that it isn’t all one way (e.g. all bad or all good) but that, as humans, we are part of a collective whole- working to recognize, acknowledge, and respect all parts of ourselves, understanding that each part plays an important role.
How interesting to acknowledge thet we have different parts of “self” that can be in oposition with one another in difficult situations. Thanks for the oportunity to learn more.