Service Workers and Moral Injury

Work occupies a huge share of our time, attention, and energy. What we might call “work stress” or “burnout,” therefore, can be a much bigger issue than these terms suggest. I have worked with clients in all kinds of occupations, and find that work issues can be just as personal, and just as important, as anything else to approach in counseling.

I love listening to clients who work in public service fields like:

• Education

• Health care

• Social services

• Emergency response

• Law enforcement and corrections

• The military

• Any other public-facing service work

I have trained in the psychosocial phenomenon of moral injury: the pain of witnessing, or even participating in, situations that go against a person’s sense of right and wrong. In the context of work, research shows that service workers experience moral injury when factors out of our control undermine our mission to help people.

Moral injury may arise from:

• Seeing people in distress and feeling powerless to help

• Being mistreated at work, or seeing others mistreated

• Working with inadequate resources or in unsafe conditions

• Causing physical or emotional harm to others in the course of your job

• Feeling stuck in a broken system

I share the concept of moral injury because I feel it conveys the depth and the seriousness of distress endured by so many working people.

Is it "burnout"? Or moral injury?

Comparing the two concepts may help answer this question for you.

• Burnout feels like your workload is unmanageable or unsustainable. Moral injury feels like you're doing something at work that is wrong, or watching harm take place.

• Burnout refers to exhaustion, detachment, or negative emotions toward work. Moral injury is a deeper suffering, and can affect identity, trust, relationships, and meaning. Fatigue may not even be present.

• Burnout affects us in real time. Moral injury can emerge after the events that triggered it--sometimes even by years or decades.

• Burnout is supposed to be alleviated with rest, self-care, and managing expectations. Moral injury may not be helped at all by doing these things.

If work is an oppressive presence in our lives, then even naming the toll it takes is empowering. Counseling can help in reclaiming our workers’ humanity, and in seeking more sustainable ways of life.

Readings on Work and on Moral Injury