Consider these scenarios:

1. A child grows up with emotionally unavailable parents who never teach them how to regulate emotions or form secure attachments.
2. A soldier witnesses an explosion that kills their comrades and now experiences panic attacks when hearing loud noises.
3. A mid-level manager slowly realizes that everyone in their company is lying about productivity, that the metrics are meaningless, and that showing too much integrity will end their career.

These are fundamentally different experiences, yet our therapeutic culture increasingly groups them all under "trauma."

Taxonomy of Trauma: A Shell Game

Cluster 1: Problems of socio-emotional development

This is what developmental psychologists and attachment theorists study. Children need appropriate emotional mirroring, consistency, and support to develop healthy emotional regulation and social skills. When these are absent or disturbed, people develop maladaptive patterns that resemble what many call "complex PTSD."

Cluster 2: Conditioned fear responses

This is "classic" PTSD. Someone experiences a threat to physical safety, and their nervous system forms powerful associations that trigger fight-or-flight responses to similar stimuli later. This is the domain of exposure therapy, and it's relatively straightforward (though not easy to treat).

Cluster 3: Moral injury

This is the category we lack adequate language for. It happens when you're forced to recognize that your social environment operates on corrupt principles that you can't escape. The injury occurs when you internalize the message that upholding moral standards is for suckers, yet you can't fully extinguish your sense that those standards matter. In short, moral injury is received (and overgeneralized) evidence for the unjust world hypothesis.

The contemporary discourse around "trauma” in effect constitutes an epistemological coverup by conflating these three distinct phenomena. Much of the excitement around PTSD and C-PTSD is precisely because they are conflations of mundane, relatively apolitical and self-limiting problems, with the self-replicating emergency of pervasive moral injury.

The history of this conflation is itself revealing.

It started with "shell shock" during World War I. "Shell shock" was an euphemism for getting messed up by noticing that your whole society including your accepted moral authorities with a duty of care towards you were demanding that you do something bad for yourself and others. It wasn't simply fear conditioning (Cluster 2); it was also moral injury (Cluster 3).

When academics formalized PTSD in the DSM-III after Vietnam, they emphasized the fear-based symptoms while downplaying the moral dimensions. As Jonathan Shay documented in "Achilles in Vietnam," what actually broke soldiers wasn't just fear but betrayal by leadership and the collapse of moral certainty.

When clinicians later noticed that some trauma victims had symptoms that didn't fit the PTSD model, they invented "complex PTSD" — but instead of clearly distinguishing moral injury, they conflated it with developmental problems (Cluster 1).

Result: People who try to draw attention to moral injury by using well-established, canonical terms end up redirecting people to focus on either conditioned fear ("your amygdala is dysregulated") or developmental neglect ("your attachment style is disorganized"). Both miss the profound moral dimension. Critics who spot the incoherence but not the pattern often go one step too far and deny the underlying phenomenon entirely.

While “betrayal blindness” is closer to what I’m describing, it gracefully omits the element of active complicity, and the compulsion to inflict the injury on others.

Wickedness Studies

Let's talk about moral injury in depth, because it's the part we're worst at recognizing.

The clearest fictional portrayal is in Ayn Rand's novels, particularly The Fountainhead and Atlas Shrugged. Whatever you think of Rand's politics, she captured something essential: the psychological damage that occurs when you're forced to choose between integrity and recognition.

Doris Lessing's Nobel Prize-winning novel The Golden Notebook provides a more subtle treatment.¹ The protagonist, Anna, constantly finds herself subtly undermining others or engaging in petty power struggles, only gradually becoming conscious of this pattern. This behavior fits easily into her social context (British intellectual circles), suggesting her moral injury is culturally normal.

Robert Jackall's sociological study Moral Mazes offers perhaps the clearest non-fiction account, documenting how corporate managers systematically learn to abandon naïve moral intuitions in favor of loyalty-signaling in order to succeed in bureaucracies.

The pattern looks like this:

• You witness or participate in corruption that's treated as normal
• You realize speaking out will result in punishment
• You gradually internalize the idea that "criminals are winners"
• You begin engaging in similar behaviors to demonstrate loyalty
• You develop a persistent sense of shame and cynicism
• You become distrustful of genuine moral standards

This creates a particular constellation of symptoms: difficulty calling out dishonesty even when it would be advantageous; assuming hidden corrupt motives behind seemingly good actions; experiencing intense anxiety around moral judgment; and engaging in self-sabotage to confirm the belief that integrity doesn't pay.

I could name quite a few people from the Effective Altruism and Rationality / LessWrong communities who would probably vouch for me that I'm exceptionally willing to criticize, but even so I'm doing a lot less criticizing, and more fighting-freezing-fleeing-or-being-polite, than makes sense given my situation & incentives. It is extremely stressful for me to call people out on their bullshit, even in situations where there is no upside to prolonging polite engagement unless they change their behavior, even though doing so empirically has strong upside. This is one way moral injury manifests in me.

Wrong is Wrong

You might say: "This is just putting a fancy name on the common experience of disillusionment."

That understates the severity of the problem. Moral injury isn't just disappointment that the world isn't perfect. At best, it's the active internalization of corrupt values while maintaining enough awareness to experience persistent internal conflict. At worst, it's resolving that internal conflict by simply siding with corruption. (See Guilt, Shame, and Depravity.)

Or you might say: "This just pathologizes political disagreement. One person's 'corruption' is another's pragmatism."

But moral injury typically involves violations of widely endorsed moral intuitions. Lying about productivity, covering up harm to customers, and betraying explicit commitments may or may not be pragmatic, but they are wrong, harmful, and erode trust.

Why does this matter?

Because we're experiencing a crisis of moral injury on a societal scale. From the replication crisis in science to a financial regime oriented around creating patronage jobs, from nonprofit pyramid schemes to notionally for-profit capital allocators that are just trying to be likeable, people are surrounded by systems that reward corruption and punish integrity.

The therapeutic response has been to pathologize the resulting distress as either a fear problem (PTSD) or a developmental problem (complex PTSD), rather than addressing the legitimate moral dimensions.

Consider someone who experiences moral injury in a corrupt workplace. Treating them with exposure therapy (for PTSD) or attachment-focused therapy (for complex PTSD) while sending them back to the same environment is like treating someone for smoke inhalation and sending them back into a burning building. Or, more to the point, like responding to a vampire infestation by sending an ambulance.

1. The Golden Notebook is a more difficult read because it's written as a first-person account by someone gradually becoming conscious of their orientation (which makes it a subtle and fine-grained character study). Rand's novels are clearer because they take the 3rd person omniscient perspective of someone who already has a clear theory of the problem, rather than showing off her subtle, perceptive, and sensitive empathy for wickedness like Lessing. Lessing is showing off her sensitivity, perceptiveness, and capacity to empathize with wickedness, which is why The Golden Notebook won a Nobel prize, and Ayn Rand's books never did. ↩︎