The Opposite of "Letting It Go"

Last week’s post was about moral injury in addiction treatment. Earlier in my career I did not yet have this term to describe my distress, but I recognized that the system I worked in devalued my clients’ lives and ignored their wishes. Today we’re picking up where that post left off, on the only advice I ever got: I was told not to care so much, to “let it go.” And not only did I get this instruction from supervisors and more experienced clinicians. I also heard it from my own therapist when I tried to discuss collective issues that affected others more than my (privileged) self. Then as my solo practice began drawing clients who work in service fields, particularly in health care, they told me they heard exactly the same thing whenever they brought up systemic barriers to doing their jobs properly.

You read it here first: this advice is now retired! And not a moment too soon.

Why enter a “helping profession” only to be told not to think too hard about actually being helpful? And why would a “helping professional” encourage clients to ignore systemic problems or the pain of seeing others suffer? Our culture does enough to desensitize us. A certain amount of desensitization is necessary just to get through the day in these catastrophic times. So when moral injury breaks through our mental armor—when we come across something wrong that we simply can’t let go—this should be affirmed and embraced. It is not “venting” or an irrational “hangup” about something beyond our control. It is a precious sign of humanity in an inhumane climate.    

Here are some of the things I have done with my moral injury, in rough chronological order, instead of “letting it go:”

·       Became more and more outspoken while working in addiction treatment agencies

·       Began talking to the many health care workers in my personal life about moral injury

·       Participated in a Maine DHHS listening session on “behavioral health” needs in the state

·       Quit working for treatment agencies to open my solo practice, where I make less money

·       Read books on moral injury

·       Trained in moral injury with ministers and chaplains at the Shay Moral Injury Center

·       Taught a Continuing Education class on moral injury

·       Began telling my clients about moral injury when they brought up relevant experiences

·       Made moral injury a stated focus in my therapy practice

·       Trained intensively to work with military members and veterans (the population in whom moral injury was first identified as a clinical issue)

·       Started writing a book on addiction treatment from a moral perspective

·       Submitted a paper on moral injury in addiction treatment to an academic social work journal

·       Joined the Psychotherapy Action Network, the Drug Policy Alliance, and the Institute for the Development of Human Arts

·       Started this newsletter

The point is not about what specifically one should do—or even what I am doing, which has all been improvised. The point is for each of us to find a way to keep going after heartbreak and disillusionment. We can lean into caring more, not less. This goes for anyone experiencing any kind of moral injury, but I feel especially strongly about health care and other kinds of care workers.

When my clients express distress about systemic problems or world events, I validate it every time. And the more strongly they feel about a particular issue, the more I encourage thinking about actions they might take, or identifying who is already in the fight. We need more like them.

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