When Self-Blame Is Rational and Appropriate: The Limited Utility of Socratic Questioning in the Context of Moral Injury: Commentary on Wachen et al. (2016). Issue 4 (November 2017)

• Record Type: Journal Article
• Authors: Gray, Matt J.; Nash, William P.; Litz, Brett T.
• Is Part Of: Cognitive and behavioral practice. Volume 24:Issue 4(2017)
• Page Start: 383
• Page End: 387
• Publication Date: 2017-11
• Subjects: moral injury -- guilt -- shame -- treatment; Behavior therapy -- Periodicals; Cognitive therapy -- Periodicals; Behavior Therapy -- Periodicals; Cognitive Therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.cbpra.2017.03.001
• Languages: English
• ISSNs: 1077-7229

Abstract

Abstract: In this commentary, we argue that a generally sound therapeutic technique—Socratic questioning—is ill-suited to address a common variant of combat-related emotional and psychological distress. Specifically, moral injury is a term used to describe a syndrome of shame, self-handicapping, anger, and demoralization that occurs when deeply held beliefs and expectations about moral and ethical conduct are transgressed. Importantly, moral injury can and often does result from instances of intentional perpetration. We contend that challenging the accuracy of self-blame in such cases is conceptually problematic and potentially harmful. Such an approach is based on a questionable premise—i.e., that self-blame and resulting guilt are inherently illogical or inaccurate. Though this is often the case, it is not invariably so. We briefly describe an alternate approach—Adaptive Disclosure—that allows for accurate and legitimate self-blame when warranted but also promotes the possibilities of self-forgiveness, compassion, and moral reparation.