Moral Injury Matters: Why This is Important for Clinicians Understanding Religious Trauma
Moral injury has finally entered the clinical vocabulary in a meaningful way. As of September of 2025, the DSM now recognizes moral injury under the category of “Moral, Religious, or Spiritual Problem.” We’re watching the field take a step toward acknowledging the kinds of wounds that don’t show up on scans but shape a person’s entire sense of self. It’s overdue, and it seriously matters. (DSM stands for Diagnostic and Statistical Manual of Mental Disorders. It is the primary manual clinicians use to classify and describe mental health conditions. DSM-5-TR Update is the edition I’m referring to.)
But there’s a parallel story here, one that still hasn’t been given the same legitimacy. Religious trauma continues to sit outside formal diagnostic language, even though its patterns are consistent, research is now available, its impacts are measurable, and its survivors are sitting in therapy rooms, online support groups and devouring related books every day trying to make sense of what happened to them.
For clinicians, understanding the relationship between moral injury and religious trauma isn’t just academically interesting. It’s essential. These two experiences often overlap, inform one another, and show up in ways that can be misread if you don’t know what you’re looking at.
Understanding Moral Injury
Moral injury happens when a person’s core values are violated - by their own actions, by what they were forced to participate in, or by the betrayal of someone they trusted. It’s the kind of wound that shakes a person’s internal compass. People often describe it as a rupture in who they believed themselves to be, or who they believed others were.
It’s not simply guilt. It’s not simply shame. It’s the disorientation that comes when the world stops making moral sense.
Understanding Religious Trauma
Religious trauma grows in environments where fear, control, shame, or authoritarianism are woven into the spiritual fabric. It can come from leaders who misuse their power, doctrines that frame the world through threat, or communities that punish questions, autonomy, or identity.
For many survivors, the harm wasn’t a single event. It was the air they breathed. It shaped their development, their relationships, their bodies, their sense of safety, and their understanding of themselves.
And because religious beliefs or leaders often claims moral authority, the harm is not just emotional or psychological—it’s moral, existential, and deeply personal.
Religious Trauma has been defined as: The deep psychological and spiritual injuries that arise from overwhelming experiences, relationships, abuses, or systemic issues within a religious context, leading to lasting adverse effects on an individual's mental, emotional, and social well-being.
This trauma disrupts one's core beliefs and sense of safety, often resulting in a painful process of deconstructing and rebuilding one's identity and worldview. Religious trauma is the result of a spiritually abusive situation, system, person, experience or belief system.
Where These Two Experiences Meet
When you listen closely to survivors, the overlap becomes clear.
Both moral injury and religious trauma involve a fracture in a person’s meaning‑making system. Both involve betrayal—sometimes by leaders, sometimes by institutions, sometimes by the very beliefs that were supposed to guide and protect them. Both can leave people questioning their goodness, their identity, and their place in the world.
And both can leave survivors carrying burdens that were never theirs to hold.
Many people who grew up in high‑control religious environments experience moral injury without having language for it. They were taught that obedience was morality. They were conditioned to believe that fear was faithfulness. They were told that their own instincts were sinful or untrustworthy. When they eventually step away, or are pushed out, they often feel like they’ve violated something sacred, even when what they violated was the system that harmed them.
That is moral injury wrapped inside religious trauma.
The Trifecta - Why Moral Injury Hits Differently for Neurodivergent People
Emerging studies combined with lived experience show that when moral injury and religious trauma compound in the life of a neurodivergent person, the impact is often deeper because the harm strikes at the very structures they rely on to navigate the world. It’s common for neurodivergent individuals to have a very strong sense of justice and internal moral code. Many neurodivergent people build their sense of safety around consistency, clarity, and trustworthy patterns. High‑control religious systems often mimic those structures at first - offering rules, routines, and a sense of belonging - only to weaponize them later through shame, coercion, or spiritualized fear. When the same system that promised (or gave) stability becomes the source of betrayal, the injury cuts through multiple layers at once: moral, relational, sensory, and existential. The person isn’t just questioning what happened; they’re questioning the reliability of their own internal compass, because the system taught them to override it. For neurodivergent survivors, the collapse of a trusted framework can feel like the collapse of the entire scaffolding that helped them interpret meaning, safety, and identity. This is why the combination of moral injury and religious trauma doesn’t just wound, it destabilizes the very mechanisms that once helped them survive.
Why This Matters for Clinicians
When moral injury was recognized in the DSM‑5‑TR, it signaled something important: that the field is ready to acknowledge wounds that are ethical, existential, and relational—not just behavioral or symptomatic.
Religious trauma belongs in that same conversation.
Clinicians need to understand that religious trauma is not simply “church hurt,” and it’s not a matter of disagreement or deconversion. It is a trauma pattern with predictable impacts on the nervous system, identity formation, attachment, sexuality, and moral development.
When therapists don’t have language for religious trauma, survivors often get misdiagnosed—or worse, dismissed. Their symptoms get treated, but the source of the wound remains unnamed.
Naming matters. It gives survivors a framework that makes sense of their experience. It gives clinicians a path toward appropriate care. And it gives the field a chance to catch up to what survivors have been saying for decades.
Moving Forward
The recognition of moral injury is a step in the right direction. But it also highlights the gap that remains. Religious trauma deserves the same clarity, the same legitimacy, and the same clinical attention.
My hope is that as more clinicians understand the connection between these two experiences, the field will move toward formally recognizing religious trauma—not as a niche concern, but as a legitimate and significant category of harm.
Survivors deserve nothing less.
Note: Therapy has been an important part of my own healing. Learning psychological concepts, understanding basic neuroscience, and working with clinicians who genuinely care has been invaluable. It’s a step on the journey I often recommend.
At the same time, I want to name that the DSM‑5 is a tool and not the final authority on a person’s life or wellbeing. There are multiple frameworks for understanding human pain, and there’s a meaningful conversation happening in the field about how diagnostic systems can sometimes pathologize normal struggle, reflect cultural biases, or carry more power than intended. I’m aware of those critiques and take them seriously.
Even so, the growing recognition of moral injury within mainstream psychology gives me hope. It suggests the field is continuing to expand its lens and becoming more responsive to the kinds of harm survivors have been naming for a long time.
This article is not intended to treat or diagnose any condition.
Rebekah is not a licensed therapist or clinician. Any thoughts, opinions or resources given on this site are strictly her own observation and insights based on personal experiences and study. It should in no way take the place of professional assistance.