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A Phenomenological Exploration of Moral Injury Among Female Operation Enduring Freedom/Operation Iraqi Freedom Veterans

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A Phenomenological Exploration of Moral Injury Among Female Operation Enduring Freedom/Operation Iraqi Freedom Veterans University of Northern Colorado Scholarship & Creative Works @ Digital UNC Dissertations Student Research 8-2019 A Phenomenological Exploration of Moral Injury Among Female Operation Enduring Freedom/Operation Iraqi Freedom Veterans Tricia Mercaldi Steeves Follow this and additional works at: https://digscholarship.unco.edu/dissertations Recommended Citation Steeves, Tricia Mercaldi, "A Phenomenological Exploration of Moral Injury Among Female Operation Enduring Freedom/Operation Iraqi Freedom Veterans" (2019). Dissertations. 586. https://digscholarship.unco.edu/dissertations/586 This Text is brought to you for free and open access by the Student Research at Scholarship & Creative Works @ Digital UNC. It has been accepted for inclusion in Dissertations by an authorized administrator of Scholarship & Creative Works @ Digital UNC. For more information, please contact [email protected]. © 2019 TRICIA MERCALDI STEEVES ALL RIGHTS RESERVED UNIVERSITY OF NORTHERN COLORADO Greeley, Colorado The Graduate School A PHENOMENOLOGICAL EXPLORATION OF MORAL INJURY AMONG FEMALE OPERATION ENDURING FREEDOM/OPERATION IRAQI FREEDOM VETERANS A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Tricia Mercaldi Steeves College of Education and Behavioral Sciences Department of Applied Psychology and Counselor Education Counseling Psychology August 2019 This Dissertation by: Tricia Mercaldi Steeves Entitled: A Phenomenological Exploration of Moral Injury among Female Operation Enduring Freedom/Operation Iraqi Freedom Veterans has been approved as meeting the requirements for the Degree of Doctor of Philosophy in the College of Education and Behavioral Sciences in the Department of Applied Psychology and Counselor Education, Program of Counseling Psychology Accepted by the Doctoral Committee Jeffrey A. Rings, Ph.D., Research Advisor Brian Johnson, Ph.D., Committee Member Jennifer Murdock-Bishop, Ph.D., Committee Member Lory Clukey, Ph.D., Psy.D., RN, Faculty Representative Date of Dissertation Defense: _____________________________________ Accepted by the Graduate School Linda L. Black, Ed.D. Associate Provost and Dean Graduate School and International Admissions Research and Sponsored Projects ABSTRACT Steeves, Tricia Mercaldi. A Phenomenological Exploration of Moral Injury among Female Operation Enduring Freedom/Operation Iraqi Freedom Veterans. Published Doctor of Philosophy dissertation, University of Northern Colorado, 2019 The purpose of this transcendental phenomenological qualitative study was to investigate the construct of moral injury among a female Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veteran sample. Moral injury has been defined as the “lasting psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply-held moral beliefs and expectations” (Litz et al., 2009, p. 697). Moral injury also includes experiences of feeling betrayed by others (e.g., leaders and/or peers) while serving in high-stakes situations such as theater (Drescher et al., 2011; Litz, Leslie, Gray, & Nash, 2015; Shay, 1994). A total of 11 female OEF/OIF veterans were ultimately recruited and interviewed before saturation was reached. Data were analyzed using Moustakas three phase horizontalization approach (Moustakas, 1994). Demographic information and qualitative information from the Moral Injury Questionnaire – Military Version screening measure (Currier, Holland, Drescher, & Foy, 2015) were collected to provide additional understanding of the sample. Five composite themes emerged from participant interviews: Feeling Betrayed by Organizational Leaders: “Senior leadership wasn't taking care of us”; Feeling Minimized and Disrespected Through Cultural Norms: “We have to have this emotional exoskeleton”; Various Experiences of Violence: “I don’t iii always feel good about how we treated them”; Struggling with Relationships: “It’s still the greatest betrayal of my life”; and The Emotional and Psychological Impact of Moral Injury: “Once you're that tortured it's pretty hard to recover.” Further, the clinical and research implications for counseling psychologists were identified, along with ideas for future research. The implications of this study include the recognition that female veterans have had unique morally injurious experiences during their military careers when compare to the experiences of male veterans. These unique experiences include: gender discrimination, sexual harassment, stresses that accompany being a part of a skewed minority group, and having to live and work within a traditionally misogynistic military culture. Further, female veterans experienced military sexual trauma as a morally injurious experience in part because of the ways that they felt betrayed by those who had assaulted them, and also because of the ways that their military leaders had responded to their attempts to report the trauma. Next, that female veterans are likely to have experience combat-related morally injurious experiences even when they did not serve in a traditional combat role during deployment. Further, that female veterans are likely to have morally injurious experiences related to their veteran identity due to the fact that female veterans are not considered the norm within the United States culture. Overall, this study highlighted the need for researchers to continue studying the causes of moral injury within female veteran samples. A new definition of moral injury is offered here to be more inclusive of their experiences. Keywords: FEMALE VETERANS, OEF/OIF VETERANS. MORAL INJURY, QUALITATIVE STUDY, TRANSCENDENTAL PHENOMENOLOGY iv ACKNOWLEDGMENTS First and foremost, I am incredibly grateful for the constant love and support of Peter Steeves, my amazing husband. He has selflessly postponed his own professional goals and dreams in order to allow me the opportunity to become a doctor. He is a wonderful, encouraging, optimistic, and loving husband, and I am so darn lucky every day to have him in my life. I also want to thank my mother, Terry Bonadonna. It was not an easy journey for me to begin an undergraduate career as an adult, and without her support I would never have made it this far. I would also like to acknowledge my father, Anthony Mercaldi, who held a life-long love of academia. I know that he would be incredibly proud to know that I made it to the finish line. I was also fortunate to have the most amazing ‘dream team’ serve as my dissertation committee. To begin, I want to thank Dr. Jeffrey Rings, the professor who made me want to come to UNC in the first place. I appreciate his humor, his constant encouragement, his amazing pep talks, and above all else his patience and his humanness. I am so grateful for all that he has done for me. I also want to thank Dr. Brian Johnson for his support, his encouragement, and his hilarious sense of humor. He was an incredible mentor in all things cognitive, and did much to shape me as a clinician and a clinical supervisor. Next, I would like to thank Dr. Jennifer Murdock-Bishop for her willingness to serve on my committee despite her incredibly busy schedule. She was an amazing source of support and always seemed to be v seeing the best in me; thus, helping me to see the best in myself. I also want to express my thanks to Dr. Lory Clukey for her guidance with the qualitative aspects of this research. She also offered an invaluable perspective on the experience of veterans, and told some pretty great stories along the way. vi TABLE OF CONTENTS CHAPTER I INTRODUCTION ......................................................................................... 1 Review of the Literature ...................................................................................................... 4 Study Rationale ................................................................................................................. 13 Statement of Purpose ......................................................................................................... 15 Research Questions ........................................................................................................... 16 Limitations of the Study .................................................................................................... 16 Definitions ......................................................................................................................... 18 CHAPTER II REVIEW OF THE LITERATURE ............................................................ 20 Morality ............................................................................................................................. 22 What is Morality? .......................................................................................................... 22 Theories of Moral Development ................................................................................... 28 Moral Injury ....................................................................................................................... 37 Atrocities of War ........................................................................................................... 38 Pre-Construct Literature on the Affects of Wartime Atrocities .................................... 39 Guilt and Shame in Veteran Population ........................................................................ 48 Shay’s Theory of Moral Injury .....................................................................................
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