The Neuroscience of Being Human

The Neuroscience of Moral Injury

When the wound is not what happened to you but what you did, what the brain does with guilt that cannot be resolved, and why moral injury requires a fundamentally different kind of healing from fear-based trauma

The Neuroscience of Moral Injury

1,498-word article with 8 Harvard references.

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Moral injury is what happens when a person perpetrates, witnesses, or fails to prevent an act that violates their deeply held moral beliefs. It is not the same as PTS, though the two frequently coexist. PTS is a disorder of fear circuitry. Moral injury is a disorder of the self. The person is not haunted by what was done to them. They are haunted by what they did, or by what they failed to do, or by what they were made to witness. This article examines the neuroscience of moral injury: how the brain processes guilt versus fear, why the default mode network and the self-referential processing system become sites of suffering, how moral violation activates the anterior insula and the ventromedial prefrontal cortex in ways that resemble physical disgust, and why conventional trauma therapies that target fear extinction are insufficient for a wound that is fundamentally about identity.

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