The Moral Injury Experience Wheel

Moral pain is more than guilt, shame, and anger. It’s remorse, vengeance, disgust, disillusion and many more emotions found on the wheel.

For many, the vocabulary used to describe moral pain is confined to terms like “anger,” “guilt,” and “shame.” A lack of precise language and an inability to differentiate feelings in the context of moral stress may lead to global appraisals and misattributions (e.g., “People suck,” “I’m a monster,” “I’m a pawn,” “It’s all a big joke”). Such distortions can leave a person feeling bitter, hopeless, and stuck without a means of responding adaptively to morally perplexing circumstances (Barrett et al., 2001; Cameron et al., 2013).

A lack of conceptual understanding regarding the operation and function of moral injury may also generate suffering. Not knowing why one feels guilty or angry, or how to process and resolve a moral violation, or whether the experience is a normal human response is likely to perpetuate the painful dissonance and alienation of MI (Molendijk, 2018).

In response to this need for language and insight, clinicians may now benefit from the Moral Injury Experience Wheel. The infographic tool visually indexes moral emotions and depicts their relationship with precipitating (morally injurious) events through spatial and semantic proximity (Fleming in J Relig Health 62(1):194–227, 2023 https://www.researchgate.net/profile/Wes-Fleming). Rooted in definitional and empirical research and based on Plutchik’s “Wheel of Emotions” (Plutchik, 1982), the circumplex model is designed to elicit adaptive psychological processes (e.g., emotion differentiation) that lead to a reduction in distress and dysregulated behavior. A manual of best practices for using the MIEW, offered through this website, provides educational scripts and exercises that provide:

 

  1. A conceptual understanding of moral injury in multiple contexts
  2. The ability to identify moral injury in clients/patients and staff personnel
  3. The capacity to articulate moral pain and grasp the origin, context, and function of MI with precision
  4. Effective appraisal and acceptance processing (flexible thinking)
  5. Adaptive grief processes that address losses related to moral injury
  6. Value clarification and movement toward committed action (agency/self-efficacy)
  7. Means to adapt the MIEW to meet the needs of multiple populations in various clinical settings.

Barrett, L. F., Gross, J., Christensen, T. C., & Benvenuto, M. (2001). Knowing what you’re feeling and knowing what to do about it: Mapping the relation between emotion differentiation and emotion regulation. Cognition & Emotion, 15(6), 713-724. https://doi.org/10.1080/02699930143000239

Cameron, C. D., Payne, B. K., & Doris, J. M. (2013). Morality in High Definition: Emotion differentiation calibrates the influence of incidental disgust on moral judgments. Journal of Experimental Social Psychology, 49(4), 719-725. https://doi.org/10.1016/j.jesp.2013.02.014

Fleming W. H. (2023). The Moral Injury Experience Wheel: An Instrument for Identifying Moral Emotions and Conceptualizing the Mechanisms of Moral Injury. Journal of Religion and Health, 62(1), 194–227. https://doi.org/10.1007/s10943-022-01676-5

Molendijk, T. (2018). Toward an Interdisciplinary Conceptualization of Moral Injury: From unequivocal guilt and anger to moral conflict and disorientation. New Ideas in Psychology, 51, 1–8. https://doi.org/10.1016/j.newideapsych.2018.04.006

Plutchik, R. (1982). A Psychoevolutionary Theory of Emotions. Social Science Information, 21(4–5), 529–553. https://doi.org/10.1177/053901882021004003