Building Resilience in Times of Moral Distress and Moral Injury
Many people who dedicate their lives to creating healthier and safer communities—educators, healthcare workers, social workers, community organizers, advocates, and volunteers—carry extraordinary emotional and ethical burdens. They show up every day to care deeply for others, often with limited resources and in environments filled with uncertainty and rapid change. In recent years, the strain has intensified. As communities face ongoing conflicts, divisive public conversations, and systems stretched past capacity, the gap between what helpers know should be done and what they can do has grown.
Most people in helping professions or community work realize that this work can take a toll: secondary trauma, the emotional stress of witnessing or hearing about others’ suffering, and compassion fatigue, the emotional exhaustion that comes from prolonged caregiving, are common risks. Fewer people know about the risks of moral distress and moral injury—the inner conflict and lasting impact that occur when our actions, or our inability to act, violate our core values. That gap can take a profound toll on your physical and mental health.
Moral Distress vs. Moral Injury
These two terms are often used interchangeably, but they describe different experiences:
Moral Distress occurs when a person knows the right thing to do, but external barriers—policies, hierarchy, legal constraints, lack of resources—prevent them from acting according to their values.
For example: a nurse who knows a patient needs more time and attention but is caring for too many patients at once.
Moral Injury is deeper and more lasting. It occurs when someone feels they have been part of, witnessed, or could not prevent an event that violates their core moral beliefs. It may lead to feelings of guilt, shame, betrayal, or disconnection.
For example: someone working in community safety who sees ongoing preventable harm yet feels powerless to stop it.
Both experiences are common among those trying to make the world a kinder and more just place. But when this kind of negative emotion accumulates without healing or community support, it can lead to burnout, emotional numbness, post-traumatic stress, depression, and physical exhaustion.
The Weight of Care
If you support others—whether through formal professions or informal community roles— you might frequently feel pressure to keep pushing, even when you are depleted. Maybe you feel that others have it worse, or that stepping back would be selfish. But caring work is relational: it requires connection, perspective, and renewal. In my book The Resilient Teen, I discuss how building resilience involves balancing different types of restoration. Many readers (including adults) have told me that graphic in the book that describes four components to build a healthy routine—focusing on mind, body, relationships, and purpose—has been a particularly useful way to build a tailored wellbeing plan. A resilience routine draws from each area over time—not perfection every day, but small, intentional actions that help us stay connected to the values that brought us into the work. In times where headlines shift daily, where the future feels uncertain, and where many are stretched thin, these practices aren’t luxuries. They are essential acts of sustainability.
Two Practices to Begin Rebalancing
Exercise 1: Reconnecting to Community
Brainstorming ways to renew connection and purpose
Take 5 minutes and write freely in response to each prompt:
What originally called me into this work or level of caring?
Who in my community gives me energy, perspective, or humor?
What is one small action I can take this week that reconnects me to meaning or joy?
Examples: send a thank-you note, attend a mutual support group, help a neighbor, join a creative or movement group, participate in community art or storytelling.
Choose one to commit to this week. Put it in your calendar like any other appointment.
Exercise 2: Caring for the Body That Carries the Work
Grounding practices for the nervous system
Try one or more of the following micro-restoration tools:
Box Breathing
Inhale for 4 counts
Hold for 4 counts
Exhale for 4 counts
Hold for 4 counts
Repeat 4–6 rounds.
Other quick physiological resets:
Shoulder release: Lift shoulders up to ears, squeeze, drop sharply. Repeat 5 times.
Grounding scan: Sit and press both feet into the floor for 10 seconds, noticing strength and stability.
Tension shake: Gently shake arms or legs to release muscle bracing.
Baroreflex Hand Warming: Rub your hands together briskly to generate warmth, then place both warm palms gently over your cheeks and breath.
You don’t need perfection or an hour-long routine. You need tiny, repeated moments that tell your body: I am safe enough right now to breathe.
Closing Thought: Recognizing and Treating Moral Injury
Resilience is not about being endlessly strong. It is about remaining connected—to ourselves, our values, and our communities—even when the world feels heavy. We can’t pour from an empty cup, but we also can’t fill it alone. When we nurture our own well-being, we strengthen our capacity to care for others with patience and love. Healing is a collective practice. May we build spaces where those who hold others are also held.
