Moral Injury (MI) is often described as a wound of conscience that shakes our sense of identity, values, belonging and spirit. As a child of environmental failure, I spent the first fifteen years experiencing abuse of every persuasion, then another thirty years unpacking it. As a peer worker walking alongside people with developmental and complex trauma, I wrestle on multiple fronts with the silence of those with ‘lived ‘and ‘living’ experience of family-based distress.

Children who experience environmental failure often lack the developmental cognition to attribute accountability beyond positioning themselves as the source of dysfunction. In these contexts, the wound is internalised - appropriated as personal fault and most typically, pathologized later in life via a cascade of diagnoses and interventions that obscure the original injury.

Within this disparity, the symptomology between CPTSD and Moral Injury align; suicidality, shame, survivor guilt, substance abuse, rage, annihilation. It follows, that if family as ‘institution’ causes harm on a population that biologically and developmentally lacks the cognition and language to recognise its impact, should moral injury frameworks be expanded to re-cognise morality as instinctive and innate? Or is the complexity too much for clinical care systems increasingly aligned with notions of ‘recovery’.
To tease out this provocation, I advocate the common ground between developmental trauma and moral injury. From an ethnographic and qualitative perspective, I also share some practice observations across two mental health care models operating in South Australia. Both attempt to redress the impacts of moral injury beyond the boundaries of its more familial contexts – one through a clinical framework, the other a strictly relational approach. While their collective intentions align, their response and outcomes vary significantly.

Moral Injury and its Cousins is an examination of the actors and institutions with/in family that contribute to an aggressive disregard of the ‘self’. Fundamentally however, this paper is a call to action toward re-framing ecosystems of relationship, dis/comfort and change.