Re-thinking/embodying Pastoral Theology: Ritual in the Care of Moral Injury in Veterans Open Access

Choi, Johann (Summer 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/xp68kg30k?locale=en
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Abstract

The purpose of this dissertation is to understand moral injury and discern an appropriate  response to it from a distinctly pastoral theological perspective. The definitions of moral injury that ground most explorations of the topic today arise from doctors and psychologists, the very community that formulated this construct. In turn, chaplains and pastoral theologians have almost wholly taken over these definitions from the clinical world. That I approach these topics from a fundamentally pastoral theological perspective is one of the novelties of this study.

 

In the course of this exploration I reconsider the strengths of ritual as a form of pastoral care. Clinicians and theologians alike have lamented the lack of rituals today for warriors returning from combat, intuiting that such practices would be appropriate in addressing moral injury. In pursuing this line of thinking, this study answers the questions: Why might ritual be a fitting pastoral response to moral injury? And, what kind of ritual would be most appropriate? Drawing from the Christian tradition, I demonstrate that liturgical rites, particularly those grounded in the Eucharist, offer a fitting pastoral theological response to the particular needs of moral injury. Thus, this form of trauma provides an ideal test case for highlighting the importance of ritual in pastoral care.

 

The study begins by redefining moral injury in pastoral theological terms by grounding it in the language of sin. Next, I highlight the particular challenges that moral injury poses to conventional approaches to pastoral care, arguing that rituals better attend to some of the complexities of this form of trauma. I then summarize previous research conducted in the areas of both moral injury and the use of ritual in pastoral care. Upon assessing these two fields of inquiry, I propose three principles that should undergird ritual approaches to pastoral care. This leads to a commentary of an ancient Christian penitential rite used for military veterans that incorporates the insights of current research on moral injury, trauma, and liturgical studies. Through this commentary of St. Gregory’s rite, I illustrate the principles proposed above and the pastoral potential of non-humanistic rituals in addressing the needs of the morally injured.

Table of Contents

Introduction ………………………………………………………………………………… 1

Chapter 1       Moral Injury as a Pastoral Theological Construct ...…………………… 12

1.1 Introduction …………………………………………………………………………….. 12

1.2 Veterans’ Issues and Trauma as Significant Pastoral Concerns ..……………………… 14

1.3 Moral Injury: A Review of Definitions ………………………………………………… 23

1.4 The Relationship between PTSD and Moral Injury ……………………………………. 36

1.5 Arriving at a Pastoral Theological Definition of Moral Injury……...………………….. 40

1.6 Conclusion ……………………………………………………………………………… 52

Chapter 2       Ritual and the Problem of Moral Injury ………………………………… 54

2.1 Introduction …………………………………………………………………………….. 54

2.2 Defining Ritual for Ritual Care ………………………………………………………… 55

2.3 Challenges that Moral Injury Poses for Pastoral Care …………………………….…… 58

2.3.1 The Problem of Sin …………………………………...……………………………… 58

2.3.2 The Problem of the Body …………………………………………………………….. 62

2.3.3 The Problem of Ambiguity and Ineffability ………………………………………….. 67

2.4 Ritual’s Answer to Moral Injury’s Challenges …………...……………………………. 71

2.4.1 An Answer to Sin …………………………………………………………………….. 71

2.4.2 An Answer to the Body ………………………………………………………………. 75

2.4.3 An Answer for Ambiguity and Ineffability …………………………………………... 78

2.5 Conclusion ……………………………………………………………………………… 83

Chapter 3       Contributions from Moral Injury (MI) and Ritual Care Literature for a Pastoral Theological Approach to Moral Injury ………………………………………... 84

3.1 Introduction …………………………………………………………………………….. 84

3.2 Moral Injury Treatment Literature ……………………………………………………... 85

3.3 Ritual Care Literature …………………………………………………………………... 97

3.4 Three Principles of Ritual Care ……………………………………………………….. 104

3.4.1 The Primacy of Worship in Ritual Care …………………………………………….. 105

3.4.2 The Centrality of the Eucharist ………………………………………………...…… 106

3.4.3 Pastoral Ritual Hermeneutics …………………………………………………….…. 108

3.5 Conclusion …………………………………………………………………………….. 120

Chapter 4       Non-humanistic Ritual Care for MI: A Pastoral Theological Commentary ..……………………………………………………………………………………………. 121

4.1 Introduction …………………………………………………………………………… 121

4.2 The Ancient Graded Penitential Discipline and the Ritual Care of Veterans ………… 122

4.3 Pastoral Theological Commentary on the Graded Penitential Rite …………...………. 130

4.3.1 Confession: The Danger of Disclosure ……………………………………………... 131

4.3.2 Grade of Weeping: Grieving and Discipline ………………………………………... 134

4.3.3 Grade of Audience: Faith and Solidarity ……………………………………………. 148

4.3.4 Grade of Submission: A Pastoral Ritual Interpretation ……………………………... 162

4.3.5 Grade of Standing With: Ritual Narrativity in Care ………………………...……… 167

4.3.6 Grade of Participation: Trauma Recovery and Ritual ………………………………. 179

4.4 Conclusion …………………………………………………………………………….. 191

Chapter 5       Concluding Thoughts: Implications for Further Research …………… 197

5.1 Introduction …………………………………………………………………………… 197

5.2 Sin and Pastoral Theology …………………………………………………………….. 197

5.3 Ritual and Pastoral Theology …………………………………………………………. 201

Appendices ……………………………………………………………………………….. 205

Bibliography ……………………………………………………………………………... 220

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