Tuesday 16 July 2024

Moral Injury

Apparently this is a thing. It was identified by an activist on behalf of US Army vets. He said it was: betrayal of 'what's right' in a high-stakes situation by someone who holds power. Puts the blame squarely on management. I heard about it during this YT video.

One day someone will do a study of the sad career of this concept, and psychologists and their kind will hang their heads in shame.

A more recent definition is “the inability to contextualize or justify personal actions or the actions of others and the unsuccessful accommodation of these . . . experiences into pre-existing moral schemas”. This polysyllabic neo-gibberish appears to put the blame squarely on the injured person, since it is their “failure to contextualise other people’s actions into pre-existing moral schemas” - in other words, management didn’t do anything wrong, you just don’t understand why what they did was right.

Any idea that can be so easily turned on its head has something wrong with it. The mistake (which I have just recognised after many abandoned words) is to go in search of what’s wrong and try to explain or rectify it. Because it won’t affect the underlying insight.

Which is that some people can be severely shaken and lose faith in the institutions within which they are working, when they see some ghastly event happen as a result of yet one more incomprehensibly dumb management decision.

They can also lose faith and respect for themselves for going along with that decision, for fear of a Court Martial, the sack, a poor performance review, and otherwise having their career screwed. The relevant phrase comes from a Sunday Times journalist after Rupert Murdoch bought it: it is an unpleasant experience to discover that the size of one’s soul is just less than the size of one’s mortgage.

Even civilian life can inflict sufficient insults, disappointments, refusals, rejections, broken promises, incomprehensible bureaucratic decisions, below-inflation pay rises, increased prices for decreased quality and quantity, zero-hours contracts, redundancies, offshoring, increased taxes for policies no-one agrees with, long waiting lists, cancelled operations, unavailable GPs, LTN schemes appearing out of thin air… to reduce even the strongest to despair and self-doubt.

The concern is that this will affect the functioning of our society and economy. Trust feels like something nice and warm that we should have in our leaders and institutions. But we don’t, because that’s not how it works.

We just need to know that the law or institutional practice says that if we competently follow our leader’s instructions, we are absolved of any liability, if anything goes wrong as a result. Which is why we should always get everything in writing. The deal is that we will not question their dumb and self-serving decisions, and they will protect us from the consequences of following those dumb and self-serving decisions.

It’s when that deal is broken that all hell breaks loose amongst the ranks. Management that goes looking for low-level scapegoats is tarred and feathered in the press, should the story get that far. And management finds out that “staff goodwill” is a real thing, especially when it vanishes.

Most of what is covered by “moral injury” (front-line warfare and NHS treatment of whistleblowers excepted) is what used to be considered a “welcome the real world” moment, in which one’s delusions and were rudely broken, and one’s un-informed expectations were properly informed. It was regarded as a moment in which one added additional adult maturity to one’s character. People who could not handle the disappointment or shock were regarded as a little short of moral fortitude. Back in the day, women who couldn’t handle the shock were offered a move to (name some gentler place off the serious career track here). Men just sucked it up.

“Moral injury” suggests that our delusions and unrealistic expectations are in fact precious possessions, and their loss in the face of reality is to be regarded as a blow to the integrity of our character from which we may never recover. The truth is no longer learning, but injury.

We are supposed to be shocked as our delusions are dispersed, and then build the character needed to carry on doing good work despite being in a world we now know is far-from-perfect. Being cynical is not good enough, and nor is running away in shock.

It may be that the only way to do good work is to do the same job somewhere else. Nothing wrong with that: there’s no obligation to stay in a dysfunctional institution run by a**holes. Apply for a job elsewhere, and speak so well of the place you’re leaving that everyone wonders why you are leaving. Except they will know, and appreciate your willingness to play the game.

(Edited 24/7) It may be you are not cut out for nursing / surgery / sales / customer service / (enter some other activity here). That’s how it used to be said. Nothing wrong with that. Find another occupation, preferably that you don’t have high-flown illusions about. Yes, sometimes management or the enemy do something so egregious that not to react to it would be inhuman, and to regard it as an opportunity for growth would be obscene. Then we could talk about “injury”. But that happens to very few people outside a war zone, or the NHS.

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