Donald Trump has won a second term in office as president of the United States. Soon, he’ll be one of the most powerful men in the world – again.

As an American who’s lived in the UK for over 20 years, I read the news alert on my phone through bleary eyes immediately after I woke up. I quickly realised that my worst fears for my home country were coming true. With everything that Trump has said and done over the years (including but not limited to earning the title of convicted felon and being the man to “kill Roe v Wade”), his win is terrifying.

After reading the news, and processing it in the days that followed, I began to realise that what I was feeling was more than just fear and disappointment. This felt all-consuming – my hope for the future, my sense of identity and my faith in humanity went into total freefall. I drifted around my house like a ghost, trying to figure out how there could be a point to anything when something like this was possible.

Then I read about ‘moral injury’ and something clicked. Could this be why I’ve been feeling so dreadful?

Moral injury is a term used to describe the deep emotional and psychological distress caused by being a witness to (or even perpetrating) events that go against one’s strongly held morals. Events like a man who’s got an entire Wikipedia page dedicated to the allegations of sexual misconduct against him winning a second term in office as president, for example. “Moral injury can lead to a profound loss of meaning or trust in religious, moral or societal frameworks,” integrative counsellor and psychotherapist Anna Lewandowska-Bernat tells me. “American psychiatrist Jonathan Shay was among the first to describe it while working with Vietnam veterans experiencing PTSD.”

Dr Sheethal Rajashanker, a consultant psychiatrist based at Priory Hospital Cheadle Royal in Manchester, says that while the term moral injury is “increasingly recognised in healthcare settings, including the NHS”, moral injury isn’t as widely established as other conditions such as depression or PTSD yet. She adds: “In psychological and medical circles, there is still some debate over whether moral injury should be classified as a separate condition or treated as part of other established mental health diagnoses. Research into it is ongoing, and while there is increasing awareness, standardised treatment pathways are yet to be developed.”

With that in mind, how would someone know they’re suffering from moral injury or something like it? Lewandowska-Bernat says that symptoms can often manifest as anger, disgust, self-isolation, reduced empathy and loss of faith. Dr Rajashanker adds that symptoms can range from guilt and eroded trust in society to depression, anxiety and even existential crisis.

There’s still plenty left to learn about this relatively new psychological experience, as current research focuses primarily on people who regularly face high-stakes ethical dilemmas in their work. For instance, people with jobs in the military, healthcare, education and social services. There’s also a notable number of refugees who’ve experienced it. This lack of research into other causes of moral injuries makes getting an official diagnosis a challenge for people who don’t face these dilemmas in their workplace, but that doesn’t mean we can’t still get treatment for the symptoms. “For it to become a recognised medical term, the same symptoms need to be observed in a large enough group of people under similar conditions. There haven’t been other significant events that would allow us to observe this phenomenon in civilians,” says Lewandowska-Bernat. “Of course, this may change quickly as ideological shifts occur around us. I think if you went to a GP saying you had a moral injury, they would likely refer you to talking therapies or counselling to work through it, and perhaps offer anxiety medication if your anxiety levels were high.” 

It’s still early days, Lewandowska-Bernat stresses, but she thinks there’s a chance that the US election could have caused moral injuries – even here in the UK. “We live in deeply uncertain times,” she says. “In the modern world, we’ve come to believe in the possibility of a good, happy life, surrounded by like-minded people. But recent events – pandemics, economic crises, wars – have disrupted this view of the world. The stressors of the past few years have been immense. It’s essential to recognise that, in this state, we are more vulnerable to additional stressors.”

On top of that, British and American culture often overlaps in a big way, and this can stretch into politics, too. “Historically, political ideologies have always had the potential to migrate across borders, influencing others,” Lewandowska-Bernat adds. “In today’s interconnected economies, where countries impact one another, the effects of events like US elections understandably raise concerns.”

Dr Rajashanker agrees: “Feeling a sense of threat to one’s identity, self-esteem or relationship with the world due to the results of a foreign election can seem surprising. But it’s quite understandable when considering the interconnected nature of the world today.” She points to the US’s role as a major global power, how closely the world is connected via the internet and social media, and the emotional intensity of the election as potential psychological flashpoints for us. “The influence of a powerful country like the US, combined with the global exchange of information and shared human concerns can make distant events feel profoundly personal and threatening,” she explains. “When a foreign election result feels like a challenge to one’s sense of what is right or safe in the world, it can lead to anxiety or fear, moral injury and loss of trust.”

Even though getting an official diagnosis might be tricky, there are steps you can take to help yourself begin to process everything going on and take steps to heal if you relate to feeling morally injured.

1. Acknowledge your pain. Lewandowska-Bernat says that just knowing about the concept of moral injury can help you better understand the symptoms, distance yourself from them and find healthier ways to cope. This way, there’s a chance you could even prevent a full-blown moral injury from happening in the first place.
2. Seek support. Lewandowska-Bernat also stresses that it’s important not to just diagnose yourself with a moral injury and leave it at that. If you suspect you or someone you care about might be going through this, getting further treatment for the symptoms is really important. Talk to your GP or find a counsellor, psychotherapist or clinical psychologist who can offer support and help you find a way to address your feelings.
3. Understand it will take time. “It’s often a non-linear journey, with progress and setbacks,” adds Dr Rajashanker. “It requires patience, a willingness to engage with painful emotions and the right support network. There is no one-size-fits-all solution. People must find what works best for them to reconcile their experiences and move forward.”

Images: Getty