Draft:Soul Injury

• Comment: You have not changed the prose of the article after the previous decline. Please adhere to the WP:TONE. Pygos (talk) 03:09, 12 November 2024 (UTC)

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A Soul Injury is defined as a wound that separates a person from their real self. Soul Injuries corrode a person's self-worth with feelings of inadequacy. 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." Symptoms of Soul Injury include: hiding or masking personal thoughts and feelings, ignoring one’s inner goodness, feeling empty or inadequate, desiring to be someone else, and using numbing agents to avoid shameful or guilty feelings.

Although Soul Injury was first identified in Veterans receiving hospice care, 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, or bullying. A significant other who makes a child feel "not good enough" can impact a person's life throughout their adulthood. Marginalized 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 can also cause a person's sense of self to disappear. Elderly people can develop a Soul Injury if they start to feel "invisible." 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

Soul Injuries can occur in the aftermath of trauma if the trauma separates a person from their sense of self. However, Soul Injuries can also occur insidiously, making them difficult to identify. Insidiously-acquired Soul Injuries can 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, a person with a Soul Injury loses their sense of self. 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.

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 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 and the Department of Defense to identify a violation of deeply held moral beliefs that occurs during military service or during other acts of betrayal or abuse. Although there is some overlap of symptoms, the causative factors associated with Soul Injury, PTSD, and Moral Injury require different treatment. Soul Injury, PTSD, and moral injury may exist simultaneously but require different treatments.

Like moral injury, Soul Injury is not listed in the Diagnostic and Statistical Manual of Mental Disorders. The distinguishing criteria that characterize Soul Injury is when the trauma or the moral injury compromises a person’s sense of self, stifling their full potential. If the trauma or moral injury does not threaten their self-identity, then a Soul Injury does not emerge.

Identifying Soul Injury

The Soul Injury Inventory was designed to identify unresolved losses and hurts that threaten a sense of self.  The Soul Injury Inventory is a brief, 8-item instrument that counseling professionals use with patients and clients. It offers an opportunity to reflect on Soul Injury and consider its relevance in a broader life context.

The Soul Injury Inventory, developed by Grassman, Katz, and Conforti-Brown, is comprised of eight items that use a 1 - 4 Likert Scale to measure responses that range from “always true” to “never true.” The lower the score, the more likely there are issues of unresolved loss, hurt, grief, guilt, and shame. These issues often reflect unfinished attachments that can complicate peaceful dying or interfere with a person reaching their full potential. Scores of 16 or below indicate that the respondent can benefit from consulting a professional who specializes in loss, grief, forgiveness, and self-compassion. This scale is available online, with automated scoring, at the Opus Peace website: https://opuspeace.org/soul-injury-inventory/. Opus Peace is a 501(c)3 non-profit organization that is dedicated to raising awareness about Soul Injury, its causes and consequences.

In an analysis of de-identified data from 400 healthcare professionals and caregivers, the Soul Injury Inventory was demonstrated to be a psychometrically sound tool in which all questions contributed significantly to a single factor characterized as soul injury. In receiver operating characteristic (ROC) analyses, scores below 23.5 were shown to be indicative of soul injury with optimal sensitivity and specificity. A second study demonstrated that the Soul Injury Inventory has excellent test-retest reliability and strong internal consistency. These two validation studies, taken together, demonstrate that the Soul Injury Inventory is an excellent measure of soul injury.

Responding to Soul Injury

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, a person with Soul Injury discovers that they can stop covering their pain up with anger, fear, and shame. They learn how to comfort that part of self without using numbing agents.

Numerous news programs, podcasts, and keynote conference presentations have brought Soul Injury to the public arena. Continuing Education credits for Soul Injury education have been granted by 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. Five textbooks 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.

News Broadcasts, Film Productions, & Publications Featuring Soul Injury NEWS BROADCASTS & MEDIA PRODUCTIONS  Go in Peace (2014), Van Vuuren Productions. Documentary film Frozen in War (2015), LeBaron Productions. Documentary film on Veteran Suicide  www.fox13news.com/news/program-helps-veterans-families-deal-with-soul-injuries (2017)  Soul Injury: Liberating Unmourned Loss and Unforgiven Guilt (2017), Hospice Foundation of America.   Liberating Unmourned Loss: Restoring Wholeness after Soul Injury (2018), Hospice Foundation of America. TEDx Ocala (2019). TEDx speech on Soul Injury.   Soul Injury: Dare to Forgive (2023). Opus Peace Productions. CHAPTERS IN TEXTBOOKS  Military Medicine: From Pre-Deployment to Post Separation. Chapter in Care for Veterans at the End of Life (2013), Routledge. Military Culture. Chapter in Veterans and End-of-Life Care (2013), Hospice Foundation of America. Forgiveness: Restoring Wholeness at the End of Life. Chapter in Veterans and End-of-Life Care (2013), Hospice Foundation of America. Special Patient Populations: Veterans. Chapter in Oxford Textbook on Palliative Care Nursing (2015), Oxford Press. Aging: Redeeming the Destiny We Were Born to Fulfill. Chapter in Aging America (2019), Hospice Foundation of America. Practice Tips of Elderly Veterans at the End of Life. Chapter in Aging America (2019), Hospice Foundation of America. Identifying the Unique Needs of Veterans that Influence End-of-Life Care. Chapter in Caring for Veterans and Their Families: A Guide for Nurses and Other Healthcare Professionals (2021), Jones & Bartlett. 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, 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.