205 | Moral and Spiritual Injury: Therapeutic Approaches for Addressing Guilt, Shame, Anxiety, and Compulsive Behaviors

Moral and spiritual injury describes the lasting psychological, emotional, and spiritual distress that can occur when individuals act, fail to act, witness, or are victim of events that violate deeply held moral beliefs or spiritual values. Initially identified in military personnel following combat, these injuries are now recognized in first responders, healthcare providers, clergy, and civilians exposed to trauma or moral conflict. In January 2025, the American Psychiatric Association (APA) formally recognized “Moral Problems” within the Spiritual and Religious Problems Z-code category of the DSM-5-TR, providing a standardized framework for diagnosing and addressing moral and spiritual struggles. The resulting guilt, shame, and loss of meaning can intensify anxiety, disrupt relationships, and impair overall well-being. In some cases, these unresolved emotions contribute to maladaptive coping, including compulsive behaviors, as individuals attempt to avoid or numb emotional pain. This session equips mental health professionals, chaplains, clergy, and Christian counselors with evidence-based and spiritually integrated strategies to assess and treat moral and spiritual injury. Practical approaches will address moral repair, emotional regulation, restoration of identity, and service to others that will help clients move toward lasting healing, meaning, and purpose.