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How to cope with moral injury in the workplace

Take care of feelings of moral injury by not denying it, finding support and creating a self-care ritual, writes LaRae Quy.

10 min read


moral injury

Parradee Kietsirikul/Getty Images

LaRae Quy

As an undercover FBI agent, I had to learn how to lie to people. Which is ironic because if an agent is less than honest in their investigations or in their behavior toward others, it’s a legitimate reason to be fired from the FBI.

I’d been raised to be honest with people and treat them with integrity. In part, those values persuaded me that a career as an FBI agent was my path forward. I knew I would need to work past the guilt I felt when misrepresenting myself to the subject of my investigation because deception is required in undercover work.

I didn’t know how to process my conflicting emotions at the time because I didn’t have the language to express it. As a result, I was experiencing moral injury, which happens when we face situations that violate our core values. Moral injury happens when there is a disconnect between the ethical principles we live by and the reality of what is required of us or what we are experiencing. 

Moral injury is common in high-stake situations, like those encountered by health care workers and soldiers, but it’s become more prevalent in the workforce as well. Moral injury is more widespread than people realize. It also extends to social workers, educators and lawyers.

Employees are tired of hearing, “Do whatever it takes to get the job done,” from their supervisors. It doesn’t feel good to manipulate and lie to people, whether it’s customers, clients, students, patients or colleagues. 

Moral injury is a young and growing field of study for clinicians. Psychologists agree that it’s not as traumatic as PTSD or depression (although there are overlaps). The pandemic and the resulting upheaval in the workplace have turned the spotlight on how companies run their business. As a result, employees are revolting against unethical behavior, mistreatment, injustice, betrayal by supervisors and incompetence in leadership, especially if it’s at the expense of their values and integrity.

Moral injury in health care providers

During the COVID -19 pandemic, health care providers experienced moral injury because of the constant, gut-wrenching decisions that had to be made. For example, during the height of COVID-19, a patient with suspected colon cancer would show up bleeding in the ER, but because there were no beds left, the patient was sent home.

Relationships broke down as unvaccinated COVID-19 patients walked into exam rooms maskless, against hospital policy. They cursed nurses and doctors for telling them that they had the virus and could spread it. They didn’t care if they made others sick. The callousness with which they treated life, when health care providers place so much value on life, caused serious moral injury for many who worked in hospitals. 

This explains why those in the health care industry are leaving in droves. Like health care providers, when confronted with moral injury many of us wonder if we’ve failed our calling. Are we failures?

What leaders can do

Employees need to know they and their work matter and that you genuinely care about their needs. Of course, this means you have to take the time to try to understand their needs. Only then can you develop solutions together to meet those needs. When you propose simplistic solutions to painful situations, employees will feel dismissed, insulted and their needs invalidated. You’d be better off doing nothing than doing something that worsens the injury.

How did I continue to work undercover, even if it meant lying to people? These are some of the strategies I learned in order to cope with moral injury:

1. Look toward the greater good

As an honest person, I had to take a longer look at the greater good before I accepted the undercover assignment. I needed to be very clear-headed about what I was doing and why I was doing it. Sure, I would be deceiving the target of my investigation, but I would be able to identify and possibly recruit a foreign spy who wanted to harm the US. 

Not all moral conflicts lead to moral injury. If a soldier kills someone on the battlefield and feels justified in doing so, they have no reason to feel moral injury. I felt justified in my deception because my job was about more than me. My undercover job was to identify and recruit foreign spies sent to the US to steal classified or proprietary information. I saw myself performing on moral high ground to preserve the interests of the US.

What you can do now:

  • Ask yourself how your job and career contribute to something for the greater good. What is your part in it?
  • Was your moral injury initiated by something you did or something that was imposed upon you?
  • Can you delineate between what a perfect response from you would have looked like and how reality made it messy?
  • Be specific about what was out of your control. Identify how the system created a response that was less than perfect.

2. Build community

Every undercover agent is assigned a case agent to meet with regularly. The deeper the undercover assignment, the more vital it is for continual contact between the two. For me, this was essential because I needed a tether to remind myself why I was working undercover in the first place. I didn’t want to feel the isolation that can come from moral struggles, and the disconnect between the way I saw myself and the image I projected to the target. 

Community can take many shapes. Perhaps all that is needed is another person to whom you can be honest and vulnerable. If something sucks, it’s dangerous to keep those emotions bottled up because one day, it will explode. The result is moral injury which can lead to depression or PTSD.

The openness of my case agent built a bond that helped me navigate even further into the deception that was my life. Moral injury is basically a break in a relationship, either with patients, clients, students or colleagues. In my case, it was with a foreign spy because the relationship was not authentic. As a result, I needed another, different relationship to sustain and guide me in this situation, someone with a different set of eyes. My case agent fit the bill perfectly!

Ironically, I barked at myself, “Do whatever it takes to get the job done.” I knew at the time I was flirting with compromising my values and belief systems but when I got caught up in the minutia of the job, I responded by pushing myself harder. When other people reminded me of why I was doing this job, it allowed me to reflect on the bigger question: what is the greater good?

What you can do now:

  • Find a community where you can share stories about your situation. 
  • Find ways to forgive yourself. 
  • Define your value system and identify when those barriers have been (or are about to be) compromised.

3. Avoid denial

Self-awareness is always the place to start. If we’re honest with ourselves, we can feel truth in our gut. We don’t do ourselves any favors when we pretend things are all right when, in reality, we’re stuck and feel ourselves sinking deeper into our own personal hell. Denial can be an easy way to cope and endure. But over time, that begins to look a little like Stockholm Syndrome, where we actually bond with our abusive environment, dismissing its harmful effects. We suppress pain signals like anxiety, sadness, guilt and self-doubt.

Moral reckoning becomes very important. We need to evaluate our situation and accept what happened. Often, this can often lead to uncomfortable truths but the best way to heal is to face moral conflicts head-on rather than deny them. We have a choice: develop strategies for making amends and pursue closure. This can be messy because it means we need face the truth and own our part in it. Our ego usually puts up a hissy-fit about this time because it always wants to be either right, or blame someone else for our situation.

Many times systemic solutions are needed to address moral injury, whether it be hospitals, schools or businesses. System-wide conversations about ways people can do their job are more effective that relying on outside programs to assume they know what you need. While wellness solutions like massages and meditation are great, don’t rely on them to move the needle. When we face something serious like moral injury, the last thing we need to hear is “eat well, get 8 hours of sleep and do yoga.” That’s like putting a Band-Aid on cancer. 

What you can do now:

  • Encourage conversations where people can share what they feel is wrong or has caused their suffering.
  • Focus on the specific acts during your day that led to something good and productive. 
  • Remind yourself that you did the best you could in the circumstances.
  • If you are a leader, initiate frank internal assessments that will benefit workers and those they serve.

4. Engage in soul care

One of my favorite books is Man’s Search For Meaning by Viktor Frankl. He was caught up in the Holocaust and lost his entire family in various Nazi concentration camps. He wrote, “Everything can be taken from a man but one thing, the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.” 

After his liberation in 1945, Frankl refined a treatment approach called logotherapy, which states that a sense of purpose can help people endure the gravest suffering. The essential question we face when confronted with moral injury is the same one that Frankl confronted: In the midst of what has happened and what is still happening, how can I find meaning in life?

Moral injury is often described as wounded soul-care. This is very different from self-care which can quickly devolve into pathetic attempts to indulge ourselves or shield ourselves from the world’s unpleasantness. Self-care has also morphed into a wimpiness that gets people offended at everything that doesn’t fit into their sensitivities.

First, effective moral injury requires us to process and identify the moment when you see things for what they really are. Second, look at how you can break it down into something more meaningful. And finally, it becomes a spiritual approach where we find ways to renew our soul

What you can do now:

  • Be honest with yourself.
  • Carefully examine each aspect of your pain.
  • Re-evaluate your personal values and compare them to the values of your organization.
  • Does your organization have a culture that nips moral injury in the bud before it rears its ugly head?
  • Discover what makes you so vulnerable and what you can do to stop it.


LaRae Quy was an FBI undercover and counterintelligence agent for 24 years, during which she exposed and recruited foreign spies and developed the mental toughness to survive in environments of risk, uncertainty and deception. Find out if you’re mentally tough with Quy’s FREE, evidence-based Mental Toughness Assessment. Quy’s new book is “Secrets of a Strong Mind (2nd edition): How To Build Inner Strength To Overcome Life’s Obstacles.” Follow her on TwitterFacebookInstagram and LinkedIn.

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