Introduction to Moral Injury: A Spiritual Look for First Responders

By Bruce Lacillade

This book focuses on the internal conflict, i.e., moral injury, of occupational stress injuries. Written in a readable style, it offers the First Responder a quick reference and a starting point, to coping with the moral injury they may acquire as a result of their continued exposure to traumatic events.
The book introduces and briefly explain PTSD and Moral Injury. Followed by basic information on human make up, trauma-focused psychotherapies, antidepressants, and peer support.

• Language: English
• Publisher: WestBow Press
• Release date: Jan 25, 2022
• ISBN: 9781664251717

Bruce Lacillade

Over the past decade Bruce has facilitated a variety of seminars and training programs dealing with several different topics, including Moral Injury/PTSD, Spiritual and Faith issues, Health and Safety, and Fire Protection. He was a keynote speaker at the 2019 Canadian Critical Incident Stress Foundation Annual Conference in Niagara Falls, Ontario, where he spoke on Moral Injury in First Responders.

Book preview

Copyright © 2022 Bruce Lacillade.

All rights reserved. No part of this book may be used or reproduced by

any means, graphic, electronic, or mechanical, including photocopying,

recording, taping or by any information storage retrieval system

without the written permission of the author except in the case of

brief quotations embodied in critical articles and reviews.

This book is a work of non-fiction. Unless otherwise noted, the author

and the publisher make no explicit guarantees as to the accuracy of

the information contained in this book and in some cases, names of

people and places have been altered to protect their privacy.

WestBow Press

A Division of Thomas Nelson & Zondervan

1663 Liberty Drive

Bloomington, IN 47403

www.westbowpress.com

844-714-3454

Because of the dynamic nature of the Internet, any web addresses or

links contained in this book may have changed since publication and

may no longer be valid. The views expressed in this work are solely those

of the author and do not necessarily reflect the views of the publisher,

and the publisher hereby disclaims any responsibility for them.

Any people depicted in stock imagery provided by Getty Images are

models, and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Interior Image Credit: MEGAN BENNETT

[Scripture quotations are] from the New Revised Standard Version

Bible, copyright © 1989 the Division of Christian Education of

the National Council of the Churches of Christ in the United

States of America. Used by permission. All rights reserved.

ISBN: 978-1-6642-5169-4 (sc)

ISBN: 978-1-6642-5170-0 (hc)

ISBN: 978-1-6642-5171-7 (e)

Library of Congress Control Number: 2021924423

WestBow Press rev. date: 01/12/2022

CONTENTS

Acknowledgments

Introduction

Chapter 1 The Issues at Hand

Chapter 2 Human Makeup

Chapter 3 Treatment/Growing Through It

Chapter 4 Moving Forward

Conclusion

Appendix A

Appendix B

Appendix C

Appendix D

Index of Specific References

Index of References

ACKNOWLEDGMENTS

When stopping to reflect on the people in our lives who have influenced us, we should come to realize that we actually achieved little on our own. Please understand that I am not intending to diminish or understate the value of individual achievement. I am merely pointing out that as living creatures, we are interconnected and interdependent with all other life on the planet.

When we stop to consider all those who have impacted our lives, we will discover a vast number of people and a variety of relationships. For me, this starts with my grandparents who raised me and then to my great-aunts and great-uncles, a certain girlfriend’s father, teachers, and fire chiefs and clergy. The list of those influencing me is indeed long. I am grateful for each one of them, and I can only mention a few here as it would take volumes to mention them all.

I cannot go any further without thanking Christ, Jesus. I thank Him first for His actual being and then for Him providing me the opportunities to meet, learn from, and be inspired by a vast number of people in my life. For I did not get here by myself, far from it.

Next, I thank Fr. Brian Bevan for bringing me back home to the Catholic faith and encouraging me to enter the Diaconate. Fr. Brian was not only my pastor but a good friend and mentor as well. Further, I owe a debt of gratitude to Fr. Paul McNeil for helping me develop my hands-on ministerial skills and for encouraging me to develop my writing.

Being blessed to be a county chaplain with the American Legion for twenty-plus years, I need to acknowledge and thank a number of brothers, Gary, Chuck, Rene, Robert, Dirk, Sgt. Bunny, and many more. This we’ll defend! Semper fi!

I would be remiss if I failed to give significant credit to Sue Turner, an editor who took a chance on me back in 2010. And now four books later, I have to tell you that you have been a great guide. Thank you, Sue.

Having had a career as a first responder, I am grateful to Warren Corp, the fire chief who believed in me. I also thank Bill and Lynne Rusk as well as others at Badge of Life Canada. They and their organization have contributed greatly to my survival of and growth through PTSD. I cannot thank them enough for helping me and the work they do in our first responder community.

Pharmacotherapeutic assistance came from friend, Dr. C. Karnis, who helped me navigate the world of antidepressants. Practical theological assistance and insight came from Fr. Rico Passero, a good and faithful priest. I am both grateful and blessed for his leadership and wisdom.

Last, but certainly not least, a big thank you to Megan Bennett for her beautiful artwork and her beautiful spirit. When feeling discouraged near the end of this project, Megan was not only a bright light and source of encouragement to me, but to the entire community. Thank you, Megs, for your love and support.

Of course, I am eternally grateful for the love and patience of my wife and soulmate, Vicki. Love you forever.

Thank you, everyone. I could not have done this without your help.

INTRODUCTION

Okay, so you’ve picked up this book. I thank you, my publisher thanks you, and my debtors thank you. If you’re reading this, more than likely you’re a first responder or you love a first responder, who is wondering about some stuff going on inside or around them. This is good, as it means you’re human and aware that there is too much stuff going on in the world.

As we journey through life, we celebrate, struggle, laugh, and cry. Sometimes we need support. Add to this is the fact that all too often we fail to pause to reflect and remember who we really are. I have written this book in the hope of providing a simple guide to assist you on your journey through the struggles and tears and to help you better understand moral injury. But please understand that I do not have all the answers. I just wanted you to know that and for you to know that I know I don’t have all the answers, far from it. I am merely passing on some of what I have learned on my journey. During my time in the military and my fire service career, I experienced some nasty stuff, maybe more or perhaps less than you. That doesn’t matter as we are all in this together, and if we support and share with each other, we can grow through the nasty stuff and come out the other side reasonably intact and with a wisdom that the sheltered will never know.

Although focusing on what is called the Trinitarian Pastoral Model of counseling in my work with veterans and first responders, I do, however, also use an integration of psychology and theology. Having studied both, I believe that both disciplines provide tools for us to use in our continued growth through life. While some may argue that one is science and the other is not, I ask you to consider the following.

Psychologists and theologians both study human behavior, values, interpersonal relationships, attitudes, beliefs, pathology, anthropology, marriage, the family, and helping others. So, one can see that their interest and goals tend to overlap. Oh yes, I also had to study a certain amount of math, statistics, physics, and other sciences along the way.

Most Christian counselors, as do I, believe that a number of biological, psychosocial, and emotional factors contribute to psychological problems. They, again as I, also believe that a number of these psychological problems result from the evil embedded in our human nature and our culture.

I do, however, use a certain amount of caution in this integration as there is no unified (one) psychology and no unified (one) theology. Instead, there are psychologies and theological systems (plural) that are at play. Enough said about that, as that is not the topic of this work.

Now we want to believe that we are an advanced society, and many may tell you we are greatly developed. But the stuff we deal with as first responders and veterans causes me to wonder if this is truly the case. Yes, we have made tremendous strides in technology and the sciences in the last few centuries. Yet in most of these advances, the human person seems to have been left behind. And that is a major problem. As Pope Saint John Paul II stated in his 1979 encyclical Redemptor Hominis,

The man of today seems ever to be under threat from what he produces, that is to say from the result of the work of his hands and, even more so, of the work of his intellect and the tendencies of his will. All too soon, and often in an unforeseeable way, what this manifold activity of man yields is not only subjected to alienation, in the sense that it is simply taken away from the person who produces it, but rather it turns against man himself, at least in part, through the indirect consequences of its effects returning on himself. It is or can be directed against him.

Wow! Reread that and let it sink in. Are we ignoring the role of the individual’s contribution to society’s progress? Are we losing our humanity? I fear the answer is yes. In our fast-paced electronic culture of sound bites and Instagram, many of us fail to actually stop to look at ourselves and check the pace of our life or the state of life around us or even how we have achieved the success we have.

Instead, we are led to believe that it is the quantity of life that matters. However, this misinterpretation of life attempts to replace quality with quantity and in turn actually devalues life. This push for quantity of life has eroded the foundations upon which most civilizations were built.

According to Will Durant,¹ civilization has not really changed since Plato’s² time. Our means and our instrumentalities have changed, but our motives and ends remain the same. Durant states that the first biological lesson of history is that life is competition. In the competition for food, mates, or power, some organisms succeed and others fail. So the motive of competition for food, mates, and power has not changed.

The second lesson of history is that life is selection. Durant goes on to say, hereditary inequalities breed social and artificial inequities; every new invention or discovery is seized by the exceptional individual, and makes the strong stronger and the weak weaker, than before. Isn’t that what Pope Saint John Paul II was saying in Redemptor Hominis previously?

I believe that the same holds true, although unintentionally, for issues surrounding mental health. Post-traumatic stress has developed too much into a business for researchers and therapists while too often failing to actually treat the whole person. Sadly, post-traumatic stress disorder (PTSD) is managed and controlled with little concern for actual healing.

For years, many veterans, first responders, and their loved ones have complained that the contemporary diagnosis of PTSD and its treatment was actually inadequate to truly express their condition. I too can attest to this from my personal experience with purely secular mental health professionals.

Psychology is too often attempting to give secular answers to spiritual questions. It appears now that everyone who had experienced a trauma, a difficulty, or something they needed to repent for went to a therapist. While current psychotherapies are, for the most part, excellent in their treatment and management of post-traumatic stress, I believe that we should consider other viable options.

As in the past, psychology has failed to adequately capture and address the moral dimension of first responder trauma, which is vital to the healing process. There are spiritual answers to many of life’s difficult questions that may cause psychological discomfort. We should not fear examining our spiritual side.

Too often the moral injury component of PTSD is never identified, and only the diagnosis of PTSD was treated. Or when it is identified, the secular approach tends to treat moral injury as neuroses or psychic disorders that inhibit self-actualization and interfere with authentic urges and feelings. They then prescribe antidepressants while ignoring the soul.

We must acknowledge the soul and recognize the signs of moral injury if we are to successfully heal the soul. Moral injury, or internal conflict, as some call it, is best addressed and healed through a holistic and spiritual approach. Opening up a dialogue around the concepts of right and wrong, along with appropriate assistance and relationships, can greatly improve one’s level of functioning, quality of life, and well-being.

Accordingly, this short book will focus on the more holistic approaches by looking at the person and human relationships, not just a group of symptoms. In all reality, the basic issue of moral injury revolves around injured relationships with God, yourself, and others.

Now, just to be clear, I am a chaplain certified in CISM. An important part of chaplaincy, as in any relationship, is to just be there and to actively listen. Further, I am not a psychiatrist, psychologist, or sociologist. So there will be no human developmental charts from the likes of Jean Piaget, Lawrence Kohlberg, or Erik Erikson. Nor will there be anthropological discussions about how we got to this point. You’re welcome.

As a chaplain, I do believe that some psychological problems result from the evil embedded in human nature and our culture. I am also one who has had boots on the ground and degrees in social sciences and a doctorate in pastoral care. So as a chaplain, I will speak of the traditional teachings of philosophy, spirituality, and religion. I will mention Homer’s classics, The Iliad and The Odyssey. I will also mention the Bible and specifically the psalms. The lessons found in these teachings never grow old, dear friends. Their lessons are timeless.

I have mentioned relationships twice in the last few paragraphs. Relationships are vital. They enable us to experience and meet our needs for connection, belonging, acceptance, and love. But I have just a word here about relationships. As we all know, relationships can be rather messy. As humans, we are a rather messy species. And while this book is not intended to be gender-specific, I do, however, believe that, on the whole, it is more natural for women than men to focus on relationships. Good or bad, men have a different view of relationships than women. As a guy and as with most guys, my first instinct is to solve problems, come up with strategies, and do things with people. Women, however, want to acknowledge problems, offer concern and sympathy, and be with people. This is something that guys need to work on. However, the good thing is that men and women are naturally made different so to have a complementarity effect on each other.

Again, I do not profess to have all the answers, if any. However, please accept that it is possible to grow through PTSD and moral injury.

What I am is a U.S. Navy veteran, retired from a twenty-five-year fire service career, and a Catholic chaplain, and I am proud of all three. In all three of these, I have participated in and/or been witness to a variety of traumatic events. Again, by no means am I saying my experiences are any worse or any less than yours. What I am saying is that I too have had boots on the ground. Therefore, I will attempt to speak to you, my brothers and sisters, with the love, understanding, and respect you deserve. But please bear in mind that I struggle with PTSD and moral injury, so now and then, I might fail in meeting your expectations in this book. For this, I do not apologize, as I am doing the best I can and am now doing much better now than a few years ago.

As a chaplain, I will, however, speak about God in this work. Further, as a chaplain, please understand that I am not called to bring great visions or dreams. Chaplains are called to loosen the tightness in one’s chest that restricts their breathing, allowing their lungs to gratefully expand of their own accord. And specifically, as a chaplain working with veterans and first responders, my task is to help you open yourself, your soul, so you may create a new relationship with yourself, God, and others, a relationship