Draft:Soul Injury

Soul Injury

A Soul Injury is a wound that separates a person from their real self. Soul Injuries often corrode a person’s self-worth with feelings of being “not good enough,” “less than,” “lost,” “empty,” “defective,” or other similar self-descriptors.

Soul Injuries occur across all populations. Soul Injuries may include childhood wounds caused by neglect, physical and emotional abuse, foster care and other institutional situations, bullying. A significant other who makes a child feel “not good enough” can impact a person’s life throughout their adulthood. Marginalized populations – populations that are made to feel “less than” because of their race, gender, religion, or sexual orientation can experience Soul Injury. The aftermath of trauma such as in military service or crisis-related healthcare work, might develop into a Soul Injury if the trauma causes the person to become separated from their sense of self. Sexual trauma is especially effective in causing a sense of self to disappear. Elderly people are not immune from Soul Injuries if they start to feel “invisible” due to society’s loss of respect or value for them. Significant loss of health or the death of a loved one are other common losses that may evolve into a Soul Injury. Soul Injuries are often at the heart of addictions and other unhealthy coping strategies.

Acquiring a Soul Injury

The dictionary defines the word “soul” as the “total self that includes the immaterial animating essence of an individual.” This non-religious dictionary definition captures the meaning of “soul” as it is used in the term “Soul Injury.” The “total self” is not an idealized, perfect inner space that has no flaws or failures. Rather, for various reasons, the self gets divided into scattered pieces; these pieces are just as “real” as the larger whole that they are comprising. Restoring “wholeness” requires bringing consciousness to all the scattered pieces that comprise the self, including unwanted parts hidden in a person’s “shadow.”

There are primarily three barriers that cause people to become separated from their sense of self:

·       Un-mourned loss and hurt

·       Unforgiven guilt and shame

·       Fear of helplessness and loss of control

Soul Injuries can occur in the aftermath of trauma if the trauma separates a person from their sense of self. However, Soul Injuries more often occur insidiously. The dictionary defines the word “insidious” as:

·       Developing so gradually as to be well established before becoming apparent

·       Harmful but enticing

·       Awaiting a chance to entrap

The insidious nature of Soul Injuries makes them difficult to identify. If they are not recognized, the wound might fester. For this reason, insidiously-acquired Soul Injuries might do more harm than Soul Injuries acquired after trauma. A traumatic experience often receives the attention, understanding, and resources that it deserves. Insidious Soul Injuries, on the other hand, seem benign so they are often dismissed, minimized, or trivialized.

Whether acquired insidiously after a seemingly insignificant event or suddenly after a traumatic event, if a person loses their sense of self then they forget who they are. Loss, guilt, shame, or helplessness can lead to a separation from their personhood. Boxing up emotional pain can cause a person’s personhood, vitality, and passion to become boxed up as well.

Responding to Soul Injury

Research by Grassman and colleagues has demonstrated that addressing Soul Injuries helps people move from numbing their pain to mourning their pain, hiding their guilt to using their guilt to learn how to forgive themselves and others, being ashamed of not being “good enough” to releasing their fear of who they are and who they are not, and controlling things they have no control over to feeling their helplessness and loss of control so they can cultivate the courage to “let it be.”

Mourning losses and forgiving hurts release emotional log jams so that people are no longer stuck in the past. Grieving and forgiving can free a person to enter fresh into the present moment without un-mourned loss and unforgiven guilt and shame weighing them down. Learning how to recognize helplessness, name it, talk about it, and feel it when a person has no control over something, helps them to “let it BE.” Rather than learning how to let go of barriers, people are often encouraged to overcome them – to “be more resilient,” to be the “best version” of themselves – implying that they need to be stronger, be better, and be more. These kinds of messages sometimes burden people with seeds of self-doubt that grow into a Soul Injury that threaten self-identity.

Responding to Soul Injuries is not an infusion process that somehow imbues strength and resilience. Neither is it a process designed to “cure.” Addressing Soul Injuries is an uncovering process that recovers wholeness by consciously connecting the person with their brave self that has been unconsciously holding the wound for them all along. Recovering from Soul Injury requires teaching the ego how to let down its defenses and expand to embrace scattered pieces of self that have been banished into unconsciousness; it involves waking up to one's “total self.” As a result, they discover that they can be whole and wounded at the same time. They learn how to stop numbing their pain and instead let themselves feel it. They tell their ego to stop covering their pain up with anger, fear, and shame. They talk to the part of self carrying the pain. They learn how to comfort that part of self without using numbing agents. They tell a trusted other person about their pain.

Wounds of Suffering: PTSD, Moral Injury, and Soul Injury

Soul Injury is different from Posttraumatic Stress Disorder (PTSD) or Moral Injury. Posttraumatic Stress Disorder (PTSD) is well defined with diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders. “Moral injury” is a term used by the Department of Veterans Administration, the Department of Defense, and others to identify a violation of deeply-held beliefs that often occurs during military service or during other acts of betrayal or abuse. Although there is some overlap of symptoms, the distinctions between Soul Injury, PTSD, and Moral Injury are important to recognize; they each have causative factors that require different approaches to maximize effectiveness of treatment. Soul Injury, PTSD, and moral injury may exist simultaneously but require different treatments.

History of the Soul Injury Grassroots Movement

Opus Peace is a 501(c)3 non-profit organization with a stated mission to “provide a meaningful experience through Soul Injury educational programs that help people heal the relationship they have with themselves.” It was founded in 2013 by five Veterans Administration (VA) hospice nurses who had taken care of 10,000 dying veterans and their families. The nurses learned lessons about how to attain personal peace from veterans who had been trained for war but put to the ultimate peace-seeking test.

These nurses observed that moral injuries surfaced on a regular basis as veterans were getting ready to “meet their Maker” in hospice. However, some veterans expressed how the moral injury caused another problem – it caused them to become separated from their “real self,” which required a different course of action than only addressing the moral injury itself. Once the nurses started using the term “Soul Injury” with patients, meaningful conversations quickly ensued, and the patients were able to come to peace with the trauma in their past, make peace with what they were currently going through, and experience peace with their death that was looming in the future. The nurses noticed that there was an underlying theme causing the Soul Injury: un-mourned loss/hurt, unforgiven guilt/shame, and fear of helplessness and loss of control. That’s when the nurses realized that Soul Injury was a concept with universal application for people who were not veterans and people who were not dying.

In the 11 years since the Opus Peace organization was formed, numerous news programs, podcasts, Ted Talks, and keynote conference presentations have brought Soul Injury to the public arena. Colleges are providing Soul Injury workshops. Continuing Education credits for Soul Injury education have been granted by professional healthcare boards such as the American Nursing Credentialing Center and the National Association of Social Workers. The National Hospice and Palliative Care Organization maintains a Soul Injury webpage on their We Honor Veterans website. Non-hospice companies use Soul Injury materials for their clients as well as their employee health programs. An online learning program, MasterPEACE, brings the Soul Injury message to a global market. Opus Peace Institute for Soul Injury Leadership had developed an internship program to deliver Soul Injury education. Six textbooks and more than 20 journal articles have featured the concept of Soul Injury and its treatment. Two books published by Vandamere Press highlight the foundational elements of Soul Injury. Four documentary films feature Soul Injury: 1) Go in Peace.(2014), Van Vuuren Productions; 2) Frozen in War (2015), LeBaron Productions; 3) Soul Injury: Liberating Unmourned Loss and Unforgiven Guilt (2017), Hospice Foundation of America; 4) Liberating Unmourned Loss: Restoring Wholeness after Soul Injury (2018), Hospice Foundation of America.

Another research project published in the Journal of Hospice & Palliative Nursing studied 12 tools and interventions used with people impacted by Soul Injury. This two-part investigation included an on-line survey of 91 healthcare professionals who had attended a 4-day Soul Injury Institute Leadership training and a post-Institute narrative inquiry conducted in structured interviews. Qualitative data collected in virtual interviews with 15 research participants demonstrated the power of one of the self-help tools, the “Write/Tell Your Story” technique in which storied narratives facilitate integration of the Soul Injury experience. As a result of this research study, Opus Peace Press was created.

Opus Peace Press publishes stories written by people who use the Soul Injury self-help tools to heal the relationship they have with themselves. Understanding one’s own story helps a person connect with scattered pieces of self so they become more conscious. Writing about their brave journey into the wilderness of the soul means that their suffering is not wasted, but rather it inspires others to risk trekking into their own wilderness to discover personal wholeness. There is community with one another as stories are shared with others. Thus, a Soul Injury community (common unity) has been created to provide hope and strength as people explore self-discovery together.

News Broadcasts, Film Productions, & Publications Featuring Soul Injury NEWS BROADCASTS & MEDIA PRODUCTIONS   Go in Peace. (2014) Van Vuuren Productions. Documentary film Frozen in War. LeBaron Productions. Documentary film on Veteran Suicide. 2015.   (2017) www.fox13news.com/news/program-helps-veterans-families-deal-with-soul-injuries   Soul Injury: Liberating Unmourned Loss and Unforgiven Guilt. (2017) Hospice Foundation of America.   TEDx Ocala. (2019). TEDx speech on Soul Injury.   Liberating Unmourned Loss: Restoring Wholeness after Soul Injury. (2018) Hospice Foundation of America.   Soul Injury: Dare to Forgive (2023). Opus Peace Productions. CHAPTERS IN TEXTBOOKS:   Military Medicine: From Pre-Deployment to Post Separation (2013). Routledge. Chapter in Care for Veterans at the End of Life.   Veterans and End-of-Life Care. (2013). Hospice Foundation of America. Two Chapters: Military Culture, and Forgiveness: Restoring Wholeness at the End of Life.   Oxford Textbook on Palliative Care Nursing (2015). Oxford Press.   Aging America. (2019). Hospice Foundation of America. Two Chapters: Aging: Redeeming the Destiny We Were Born to Fulfill, and Practice Tips of Elderly Veterans at the End of Life.   Grassman, Deborah (2019). Special Patient Populations: Veterans. Oxford Text of Palliative Nursing. Grassman, D., Kemp, K. (2021). Identifying the Unique Needs of Veterans that Influence End-of-Life Care, in Caring for Veterans and Their Families: A Guide for Nurses and Other Healthcare Professionals. Ed: D'Aoust, R., Rossiter, A. Jones & Bartlett. Burlington, MA. PRINT PUBLICATIONS   Tampa Bay Times. October 16, 2014. Soul Injury Ceremony Aims to Ease the Pains of Veterans, Others.   Boston Globe. June 22, 2015. Help PTSD Sufferers Heal from ‘Soul Injury.’   Dying Healed: What we can learn about ending our lives in peace, from those who were trained for war. (Summer 2015) Wise Publishing. Belonging: An Increasingly Lost Reality. (Fall 2015) Wise Publishing.   On Being Unfaithful: Have you cheated yourself out of the real experience of growing older? (Spring 2016) Wise Publishing.   Grassman, Deborah (2017). PTSD and Soul Injury: The Aftermath of War that Complicates Peaceful Dying. Journal of Arizona Geriatrics Society, Vol. 24 (2).   Grassman, Deborah (2019). Aging: Redeeming the Destiny We Were Born to Fulfill and Practice Tips: Supporting Elderly Veterans at the End of Life. Aging America Coping with Loss, Dying, and Death in Later Life by Hospice Foundation of America.   Grassman, D., Katz, A., Conforti-Brown, L., Wilson, J.F. (2021). Validation of the Soul Injury Self-awareness Inventory. Journal of Hospice & Palliative Nursing, Vol. 23(6), 564-570.   Grassman, D., Katz, A., Wilson, J.F., Conforti-Brown, L., (2021). Identifying Soul Injury: A Self-Awareness Inventory, in Caring for Veterans and Their Families: A Guide for Nurses and Other Healthcare Professionals. Ed: D'Aoust, R., Rossiter, A. Jones & Bartlett. Burlington, MA.   Grassman, D., Katz, A., Wilson, J.F., Conforti-Brown, L., Snyder, A. (2024) Responding to Soul Injury: Tools for Hope and Healing. Journal of Hospice & Palliative Nursing, Vol. 26 (3), 166-171.