Trauma changes the brain, but so does healing

A personal look at moral injury and what helps us heal

By Sue Boquist, GCC Member

Watching the news today is more than depressing. It's profoundly distressing. It’s painful to witness how easily some people can inflict harm, whether physical or verbal, distort the truth, and show a chilling disregard for the sanctity of human life. Mass shootings, COVID deaths, war, famine, genocide—the list feels endless. If you have witnessed or been involved in any of these horrific events, you may have experienced moral trauma. Even seeing these events unfold on television or social media can trigger it. Symptoms may include depression, guilt or shame, a loss of trust in yourself or others, deep sorrow, grief, or a diminished sense of meaning. But what exactly is moral trauma, or moral injury?

On Thursday, November 20th, I attended a presentation aimed at helping participants understand this very issue. Greg Young—chaplain for the Germantown Police Department, pastor at Our Savior’s United Church of Christ, and owner of Resilient Response—explained the clinical definitions and shared experiences from his work responding to tragedies around the globe. Alexandra Hahnfeld, therapist and owner of Grey Area Consulting, offered a range of strategies to help attendees recognize their emotions and begin healing from moral trauma.

Moral trauma, or moral injury, is a shame-based reaction to a moral transgression—an internal crisis that results from events violating your deeply held moral beliefs and values. It shares some similarities with PTSD, but they are not the same. PTSD often develops after exposure to life-threatening events and is marked by fear, hypervigilance, paranoia, flashbacks, memory loss, and an exaggerated startle response. Moral trauma, by contrast, stems from events that contradict personal values and typically manifests as grief, shame, regret, alienation, and a collapse of one’s moral framework. Both conditions can lead to anxiety, depression, insomnia, substance use, anger, nightmares, and suicidality. Both are recognized by the American Psychiatric Association and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

My own story: In 2011, Act 10 became law in Wisconsin, stripping educators like me of collective bargaining rights. Having entered the field at a time when unions were just gaining strength, this felt devastating. Then, in December 2012, the Sandy Hook mass shooting occurred. My work at the time centered on first graders. Though I was not there that day, the event affected me profoundly. I spent more than a year in a depression I didn’t recognize until my former therapist pointed it out. She suggested I was grieving, and after some reflection I realized she was right. I was grieving the loss of the world as I had known it: schools as safe spaces for children and staff, and teaching as a respected, valued profession.

I didn’t have the term “moral trauma” then, but I now believe that is exactly what I experienced. I returned to therapy to work through the helplessness I felt—my inability to change what happened at Sandy Hook, to prevent the rise of active-shooter drills, or to influence gun laws. Those were outside my circle of control.

What I could do was focus on my circle of influence: voting for local, state, and federal representatives whose values aligned with mine. And within my circle of control, I could take care of myself. I realized that wine and chips are not a healthy dinner, and that I needed to tend to both my physical health and my emotional well-being. Exercise, spending time with positive and like-minded people, and taking real or imagined vacations all helped me move through the depression. Now, with a clearer understanding of moral trauma, I feel better prepared to protect myself from falling into that dark place again.

One of the most powerful insights from the presentation was that although trauma changes the brain, healing changes it too. There are ways to reduce distress and anxiety, set healthier boundaries, and lessen guilt and shame. Some strategies that may help include:

1. Focusing on your circle of control.

2. Identifying and living by your personal values.

3. Working to reduce guilt and shame.

4. Seeking support from a therapist through resources such as Psychology Today or One Path Collective.