Moral Wounds - Healing with Games

Two RPG professionals (one with a background in game design and peace studies and the other in health psychology and medical ethics) seek critical assessment and feedback for the design and execution of a project designed to assist veterans in processing moral injuries from their military service. Moral injury can result whenever someone operating in the context of a military (or other) hierarchy is asked or ordered to do something they consider immoral and are left with significant unprocessed moral distress about their participation in an event they deemed immoral. It was first described in the 1990s by psychiatrist James Monroe, who worked with veterans as part of his practice in the Veterans Administration in Boston, Massachusetts. The “gold standard” treatment for such moral injuries is similar to interventions designed to address post traumatic stress disorder (PTSD) and includes exposure therapy combined with resiliency and strength training (so-called RST, as developed by Monroe and colleagues). Therapeutically designed RPGs have been increasingly used to help people with a number of psychological challenges. Thus, our hypothesis is that veterans with PTSD who exhibit signs of “moral injury” may benefit from intentional role playing games that provide both exposure therapy and “narrative repair” for moral injuries. One of us is a disabled veteran with experience running intercultural dialogue programs designed to reduce division within the United States. The other had a father from the Vietnam era who experienced both moral injury and PTSD as a result of his front-line service as an infantryman in Vietnam during the Tet Offensive. We hope this workshop will be instructive as well as interactive in terms of providing critical assessment and feedback to the project designers in terms of identifying potential funding sources and avoiding pitfalls associated with the project goals and design. Help us help veterans to whom we owe a debt for their service overcome moral injuries sustained from their military service.

Objectives:

·     Describe what moral injury is in the context of military service.

·     Analyze how therapeutically applied RPGs can uniquely assist veterans in processing moral injuries.

·     Provide feedback to two RPG professionals on the design and execution of a work-in-progress project designed to use therapeutic RPGs to assist veterans in processing harms from moral injuries as a result of their military service.

·     Critically assess feedback provided above by engaging in facilitated dialogue lead by the workshop leaders.

References:

·     Currier, J. M., Farnsworth, J. K., Drescher, K. D., McDermott, R. C., Sims, B. M., & Albright, D. L. (2018). Expressions of moral injury scale--military version. PsycTESTS Dataset. doi:10.1037/t74298-000

·     Koenig, H. G., Youssef, N. A., & Pearce, M. (2019). Assessment of Moral Injury in Veterans and Active Duty Military Personnel With PTSD: A Review. Frontiers in psychiatry, 10, 443. https://doi.org/10.3389/fpsyt.2019.00443

·     Koenig, H. G., & Al Zaben, F. (2021). Moral Injury: An Increasingly Recognized and Widespread Syndrome. Journal of religion and health, 60(5), 2989–3011. https://doi.org/10.1007/s10943-021-01328-0

·     Barth, T. M., Lord, C. G., Thakkar, V. J., & Brock, R. N. (2020). Effects of resilience strength training on constructs associated with moral injury among veterans.