Research
Trauma, Spirituality and Ethics, and Creative Arts Therapies
What I’m Passionate About Exploring
When I was young, I spent the entirety of my life intentionally ignoring death. Funerals, no. Horror movies, definitely not. Thoughts of heaven or hell — wasn’t going there. For a few years, when I was really young, even “Breaking News” sent me fleeing from the television to my private bunker beneath the stairs, where a Strawberry Shortcake sleeping bag, a few favorite books, some snacks, and a flashlight could delude me into thinking that all would be okay — always.
Who was it that said, “What we resist, persists?”
Strangely (or not), I’ve always been drawn to life’s “big,” existential questions. Likewise, I’ve been fascinated by the fundamental human desires (like meaning, purpose, value, connection, resilience, and transcendence) that all the world’s wisdom traditions — both spiritual and secular — help people to satisfy, each in their own way.
My first foire into academic research was to explore how individuals leverage their beliefs and principles, rituals and practices, and identity and community to help buttress themselves in times of challenge and uplift them when things are good. I also spent a great deal of time looking at how people and groups take these most important aspects of human existence to their extreme — contorting them into an excuse for otherizing and other unhealthy or abhorrent behavior.
An embarrassing amount of heart attacks by the time you’re 33-years old (such as I’ve had) has a way of doubling-down on the whole knife-edge of life, awareness-of-death “thing.” Post HAs, my clinical training and practice led me to work in what I’ll call “edge experience” therapy and clinical ethics. It was there I learned about the burgeoning field of trauma research called moral injury.
Moral injury is commonly understood as a violation of a person’s core moral foundations in high-stakes situations that recasts how they see themselves, others, and the world. Such violations could result from a person’s own actions, actions they witnessed (including betrayal) or were made to do against their will, or things they couldn’t prevent.
For reasons that could (and may someday) fill a book, moral injury (and moral distress, a related condition, and resilience) became my home. My current research explores whether there is a somatic dimension to moral injury and moral distress that isn’t being adequately addressed by extant therapies — which, to date, have proven inefficacious. Low and behold, my research found that there may very well be such a dimension. Until now, the felt sense or somatic experience of moral injury has been largely ignored in both research and treatment, instead favoring cognitive-behavioral applications.
Out of this research, I developed a writing therapy (WT), specifically for moral trauma called Embodied Disclosure Therapy. While it’s a great tool for therapists or other mental health professionals, I have adapted it into an online, self-directed course for individuals. It’s entitled “ResilientU: Healing Writing for Cultivating Moral Resilience.” For more information, check out our Soul Console Community. We're also developing a new course called, “The Write Way to Heal” that’s targeted more generally for meaningful change, challenge, crisis, and lost innocence.
My blog “Soul Console” for Psychology Today features my and others’ research on moral injury and moral distress and resilience.
About Embodied Disclosure Therapy (EDT)
Embodied disclosure therapy (EDT) is a new therapeutic approach to healing moral injury that integrates body awareness into the writing process, something that appears to have not been used in other writing therapies or as a primary mode of treatment for moral injury. EDT was purposefully developed to overcome the challenges of expressive writing and other exposure-based writing therapies that use fast-paced, explosive, “let-it-all-go” writing, which have been shown to cause agitation, overwhelm, or retraumatization in certain populations. EDT is adapted from somatic therapy/Somatic Experiencing© (Levine, 2012) and other writing therapies, such as written disclosure therapy (WET; Sloan & Marx, 2017).
Conceptually, EDT stems from my belief that there may be a somatic dimension of moral injury not addressed by extant evidenced-based frontline therapies or novel cognitive approaches but possibly amenable to access through felt senses or other somatic modalities. Until now, the felt sense or somatic experience of moral injury has been largely ignored in both research and treatment, instead favoring cognitive-behavioral applications, despite low efficacy rates. Also, from my belief that writing may be especially valuable for people with moral injury given its nonverbal nature. EDT is a brief six-session intervention that is cost-efficient and requires little clinical intervention compared with other therapeutic approaches.
The original EDT project was part of my dissertation research. This allowed me the time to develop the approach, write a treatment guide and script, and conduct both pilot studies and a broader controlled study. Positive initial results of these studies suggest that EDT may be an innovative and effective therapy for moral injury. If so, it could expand access to care for those suffering with moral injury and reduce cost to providers given the brief number of sessions.
Resources
Levine, P. A. (1997). Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences. North Atlantic Books.
Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.
Sloan, D. M., Marx, B. P., Bovin, M. J., Feinstein, B. A., & Gallagher, M. W. (2012). Written exposure as an intervention for PTSD: A randomized clinical trial with motor vehicle accident survivors, Behaviour Research and Therapy, 50(10), 627–635. https://doi.org/10.1016/j.brat.2012.07.001
Research: Embodied Disclosure Therapy: Writing From a Place of Safety and Connection: A Novel Approach to Moral Injury.