Moral Health, Not Just Mental Health

The hardest wounds to name are the ones that whisper you’re not good. We sit down with a VA chaplain, Army veteran, and moral health scholar to explore moral injury as a shame-rooted fracture of identity—not just a cluster of symptoms. Together we draw a clear line between fear-based PTSD and the moral injuries that follow betrayal, military sexual trauma, and violations of conscience, and we examine why the path to repair runs through truth, presence, and belonging.

We dig into a four-part model of moral health—belief, identity, integrity, responsibility—and show how trauma can collapse trust, autonomy, and competence until isolation takes over. From the debate around DSM recognition and compensation to the reality that loneliness is a massive suicide risk factor, we challenge systems that only pay for diagnoses while missing the person. The conversation turns practical: how to create spaces where survivors can be believed without pressure, how moral truth-telling restores voice, and why clinicians and chaplains should be trained to see the ethical dimension of trauma.

We also step outside. The chaplain shares insights from Healing in the Wild, where nature becomes a clinic without walls. No checklists, no judgment—just presence that helps people shift from performance to awareness so the nervous system can settle and the story can be told honestly. For women veterans, caregivers, and anyone living in the aftermath of moral harm, this episode offers language, tools, and hope: healing isn’t forgetting; it’s remembering differently in community. If moral injury has touched your life or your work, you’ll leave with a deeper map and immediate steps to support moral repair.

If this conversation moved you, subscribe, share with a friend who needs it, and leave a review telling us what moral health means to you.

Chapters

• 1:08 Welcome And Guest Introduction
• 3:06 Defining Moral Injury Versus PTSD
• 5:40 The Four Dimensions Of Moral Health
• 11:29 Media, Meaning, And Bystander Distress
• 16:26 Betrayal, MST, And Systemic Harms
• 24:44 Compensation, DSM Codes, And Ethics
• 33:14 Suicide Risk, Loneliness, And Repair
• 40:46 Why Worthiness Predicts Resilience
• 47:34 Presence Over Prescriptions In Healing
• 56:02 Healing In The Wild: The Book

Transcript

SPEAKER_00: 0:34

Uh hey, good day. Welcome to the Moral Injury Support Network Podcast. I'm Dr. Danny Roberts, President and CEO of Moral Injury Support Network for Service Women Incorporated. Today we have a great uh guest with us, Dr. Carter Check, who is a board certified clinical chaplain with the Suicide Prevention Specialty and an associate professor of moral health at Roberts, Oral Roberts University. A U.S. Army veteran and national voice on moral injury, moral health, and meaning-centered care, he is helping reimagine how trauma, recovery, and ethics intersect in both clinical and faith-based settings. Dr. Check's work reframes healing as an act of moral repair, restoring integrity, identity, and belonging where trauma has fractured the self. His research and teaching at probably saying this wrong, DeKesney University and within the Department of Veteran Affairs integrate theology, philosophy, and clinical ethics to create new pathways of care that reach beyond diagnosis towards moral and spiritual wholeness. He is the author of the Amazon bestseller Healing in the Wild and the forthcoming care confrontation, the Translution Chaplaincy Model for Ethical Leadership and Moral Resilience. Within the VA, he co-authored the peer-reviewed Real, Reclaiming Experiences in Loss, and UMI, Understanding Moral Injury Group Interventions, both now nationally uh recognized models for moral injury healing. Dr. Check, great to have thanks for coming on the podcast. It's great to have you today.

SPEAKER_01: 2:14

And I really appreciate being here. It's always a good opportunity to get out and have these types of conversations that I think really hit home for a lot of people.

SPEAKER_00: 2:24

So uh the one thing that I'm really that I really want to get into early on is this term moral health. But before we do that, what's the difference between moral injury and other forms of trauma like PTSD or burnout that we find in the medical profession?

SPEAKER_01: 2:43

Yeah, that's a great question. So PTSD is it's it's fear-based, where moral injury is more shame-based. It's it's more identity-driven, not something from the outside, right? Um and so moral injury really happens. Where PTSD would say, I'm not safe, Daniel, moral injury would say you're not good. Yeah. That would be a major difference, right? And moral injury really happens when someone violates that core sense of right and wrong within themselves, right? Um, maybe something you did or didn't do, maybe it's something you failed to do. Um, maybe it was something done to you. It's a wound to your, I'm gonna say your moral core, because we say moral injury, well, what's that an injury to? And and we will unpack this a little bit more, but I would argue that that's whatever you conceptualize as being morally healthy, right? And I think the danger in the academic realm around these types of terms, Daniel, is that if you take morality and you always include religion as a core component in it, well, then you miss half the people. Just like taking the word spirituality and immediately attaching religion to that, right? So what it means is you don't just need treatment, you need truth and presence and reconciliation and um community involvement for an injury like moral injury, because um it breaks. I say there's four dimensions to moral health, and this isn't difficult. There's belief, identity, integrity, and responsibility. I think anybody who's moral would agree that those would be maybe not the only like main components, but these would be very important components, right? Belief. What you know is good and right. That could contain a religious belief structure, that could contain some type of other ideology, but at the core of you, there should be that belief that you know what's right and good. I would think that would be a great part of morality. And then what you believe yourself to be, that's super important. Do you have purpose in your life? Like, do you feel like you have a calling? Do you have a space? Is there is there a belief of what you know to be right and good? And who do you believe that you are? And that feeds right into your integrity. How you live in alignment with those values, how you live in alignment with those things you believe. This is a morally healthy person, right? Because then it carries you to responsibility. When all of those things line up, then you carry and you protect and you steward friendships, community, others, right? It's just kind of that part of you. You can be an atheist and be moral, okay? So in my arena, I really look at moral health like someone would look at mental health. Because here's the human capacities that are really lost when someone suffers a moral injury. Trust. They lose trust, whether it's in self or in others or in institutions. Maybe it's lost trust in God, okay? That's a big one. Number one, someone suffers a morally injurious event. Well, what is that? It's a violation of what's right to you. That's a moral injury. I'm not trying to simplify it. That's just the subjectivity of it makes it just that. It's a violation of what's right to you, right? And it affects your autonomy. The like my choices no longer matter because I'm not worthy of making choices. Maybe I'm not even worthy of living because I've done something that really fractured my moral code. And now my competence is gone. If I would, if I were good or capable, you know, this wouldn't happen to me. So, you know, this only happens to me because this is my curse in this world. You know, you start to go because the worst risk factors, Daniel, are isolation and loneliness. And those type of mindsets, they push you into that isolation. Why? Because moral injury disrupts both your moral architecture and the human capacity for meaning and belonging.

SPEAKER_00: 7:15

Yeah, no, I there's tons of great stuff there, and I I agree with you. Every person has a sense of what's right and wrong for them. So uh you may you may get that from you may have gotten it uh some of it from your religion. I mean, religious influences can be extremely powerful. Uh, family, culture, like there's a lot of different forces that sort of provide influence on what is right and wrong. And then, but it but you don't have to be religious. Like you said, you can be you could be the most you can even be the most atheistic and heathenistic person on the planet. You still have some sense of I think this is right. Even if you think, even if you say, well, might is right, that's still a sense of like there's a right way and a wrong way for uh for me to behave in the world or for people to behave towards me. And when that's a violated in a very traumatic way, right? Because we all, I mean, every day all you gotta do is flip on the news and you'll see like stuff that violates your morality. But yeah, that when it invite it like um violates it in a very traumatic way, in that it's you know, and this is where and this is where um we still more need more research in into the moral injury field, but to what degree, you know, and I I work with a a group of scholars and we're working on a book and things like that, but you know, we discuss this a lot. Like what to what degree um how do you measure the degree of violation so that it's goes from like moral conflict to moral injury and these kind of like different permutations of moral violation.

SPEAKER_01: 9:08

But the but the big point is like you said, it's yeah, I can bring let me bring a really kind of a I would call it a current event, and I can show you just through this current event how moral injury would be measured. So you remember just recently the girl in North Carolina that got stabbed to death on the subway. She got stabbed in the neck by a perpetrator who was sitting behind her. I'm not here to have a conversation about who that was. I'm just the scenario, right? Because I work in crisis care. I teach in the university in crisis care. So this is my this is my area of expertise, if you could say. And please, whoever's listening, do not take my words as cockiness, take them as confidence. I've been a suicide prevention chaplain for 10 years, and I have had thousands of cases where I have had direct crisis care. I also have lost quite a few, too. So hear my heart. Um in that situation, Daniel, we could do a whole nother podcast on the impacts of people just being able to scroll through their phone and see these types of things, right? Right, right. Let's come back to like the conversation at hand, right? Because that's a that's an important conversation, too. You know, veterans like yourself who signed their name on the line and went to combat and saw things that most natural civilians would never see, right? Especially American civilians. Um it you did it, and there's that warrior piece to it. When you when you experience things like that when you're in purpose, man, it's a lot easier to handle than when you just don't have purpose and it happens, right? Um, and sometimes you just scroll through and you see someone shot in the neck and you see someone stabbed to death, and you see someone blown up, it's it's or beheaded, right? So, in this particular story with the girl in the subway, when I watched that, I was morally distressed because what I saw didn't align with my beliefs and my integrity and my responsibility as a human being, right? When I saw no one go to her aid, I'm not just talking about the individual, you know, stabbing her. I'm talking about the fact that there were five people around her and nobody went to aid her after the violent person had left. That to me really was disturbing. Now, did that morally injure me? No. I didn't come away from watching that thinking, Carter, you're a bad person. Right. Right? Um, I did come away with that realizing that the meaning-making system inside of every single one of us, that's that inner compass that connects conscious purpose and belonging within us. Now, Daniel, I'm a Christian chaplain. I would never deny that. But you talk to any of my colleagues in my day space, and they would say they know I'm a Christian, but not because I teach it to them, not because I share scriptures, not because of my social media post, right? Um, they know that when I encounter veterans in our inclusive workspace, one of the first things I ask them is, hey, look, I don't have some predetermined journey I think you need to go on. I just want to meet you where you are and hopefully walk with you where you need to go. How does that sound? Every single one of them says, yeah. Atheist, Buddhist, Muslim, Christian, whatever. Now, none of that care for them is gonna change my faith belief, right? Right. But as an but as a professor and a and a doctor in the space, I need to be able to get into some other conversations, research level conversations about this type of care. So I couldn't just stay completely in the theological lane in school structure. I had to go into the research healthcare ethics lane, number one, because I believe moral injury is an ethical issue. Okay. Um, and that's the realm of morality. So when your belief and your identity and your integrity and your responsibility are in a line, you'll watch things like that happen on that subway and it won't sit well with you. Right. Okay. Now, some people call that the conscience. Uh, some religious Christians might call that the witness of the Holy Spirit. You know, there's all types of words we can display to that. What it is, is it's it's an alignment of something because when moral health fractures in an individual, and then it can become systemic, there is loss of trust and belonging. There is erosion of purpose and hope in that individual and in the system that they're in. There's a lot of times some type of spiritual abandonment or isolation where they feel like either God's abandoned them or they just don't know what their place is in the world, right? And when that happens, self-condemnation can easily set on somebody and drive them to suicidal ideations. You show me. Think of the people in your life, Daniel, who have purpose. And then think of the ones that don't have purpose. Which side of those are usually the ones that are constantly communicating with you about some type of chaos or conflict in their lives? Right. Right? Do you think there's I don't believe there's a mystery to that. I believe that that is an area when shame can come into someone's life and influence them in such a way to make them believe you're not worthy of love and belonging, you are in a serious spot. Do you agree with that?

SPEAKER_00: 15:03

Yeah, I think there's a lot to that. I I think one of the one of the things I want to explore with you a little bit as we talk about I'm not good. So that makes total sense when you're when you're thinking about someone who does something, but when in in the context of something happening to them, sure, yeah, a betrayal, right? You know, yeah, where there's uh, you know, in my work with women veterans, not all for sure, but many of them sexual trauma. Sexual assault is uh military sexual trauma is a major component. And so um it was something that happened to them. Now they often they often like you hear a lot of I should have done something else, I shouldn't have, you know, because in society we we're still blaming the victim, not not the perpetrator. And so yeah, um, you know, how how does that uh align or or another example would be uh people deployed in in those environments where like look think about the Afghanistan pullout? I mean, it wasn't their fault, they but they had to watch people uh being killed in horrible ways, they weren't able to, they were forbidden from doing anything about it, so it's a betrayal by the military leadership and so on. Does that still, in terms of moral injury, is it still like is there still that I'm no good, I'm garbage piece, or is that something different because it clearly wasn't their fault?

SPEAKER_01: 16:37

Yeah, great question. And it doesn't have to be their fault. Um, because moral injury definitely has different faces, right? You've got that. Here's the the the reason that we hear more about the one, Daniel, is if you even go back to like 08, 09 when research started to happen and we start seeing the word moral injury in academic literature, it's always connected to male combat zone deployed veterans. Yep, yep, absolutely. So my research. Yep. So the research and all the data is centered around male combat zone deployed veterans. And so it doesn't even hit, well, it does hit for male sexual trauma, right? But it doesn't hit for what you're talking about. So here's what I can tell you. Betrayal, I'm I really appreciate the fact that Jonathan Shea started writing about this piece of it because this is what led me to really understand mine uh in a very quick um because we could camp here all day. My first duty station was uh Camp Casey, South Korea. Um, I got there, my uh my company was in the field. So I got in, got unpacked, and went straight to the field, and I was in the field for two months with them as we were opposition forces for the training that was going on. So, what a great way for a private to just get fully introduced into being a Cab Scout, right? And so that's what I did for two months. And you can imagine just in that two month period, the types of relationships that I built with the people in my platoon. We come back, uh, we come back to base. My platoon sergeant is ETSing. We have a big party, and outside of Camp Casey is a huge area. Just think Mardi Gras, right? Everybody who's anybody in any of the outside bases, if they have some type of weekend pass or something, they're coming to that area of the country to just hang out and fellowship and then party. There's a bunch of bars. You already know what I'm talking about. Okay. So we're walking down the road and a car comes zipping down the road, Daniel, on a road that is not supposed to have cars zipping down it, right? They've been blocked off pedestrian roads by the Korean police from there. Car almost hits us. My battle buddy gets into an argument. Five guys surround us, one pulls a knife. I take out the guy that pulls the knife because he's in my battle buddy's blind side. Three of those five end up in the hospital. I end up at the main gate with the MPs because two of these guys were trying to hold me back, so I couldn't get across the gate at 3 a.m. MPs had to come out and club the guys off of me, take me in, but the Korean police grabbed my battle buddy. So while I'm sitting waiting for my LT, he's at the police station getting a little worn out uh by the Korean police officers. Long story. Division offered us up because one of the one of the boys of those three was the son of a Korean dignitary. Oh, wow. And they offered us up for political reasons to be prosecuted for assault and battery, which was a life sentence in prison, and we have three counts. Wow. Daniel, the first nine months of my service, I was in American uniform, protecting my country, protecting their country, doing my job, going out into the field, doing op four, doing all of that. And then one day a month, I'd have to get in my dress greens, go down to Seoul International to the court, and listen to a language that I didn't know about wanting to put me in prison for life. Wow. At the end of the nine months, the jury found us guilty. Oh. And I'm pretty sure you're a football fan, Daniel. Yeah, yeah. So you ever been watching? Have you ever been watching your team and it's the last seconds, and the field goal goes up and it goes through the uprights, and you're you're just ecstatic, right? But then everybody realizes there's a flag on the field. Yeah, yeah. Right? Okay. So as this verdict is going up, it's all in Korean. I can't understand anything, but I can understand tone and and I have discernment, right? So I'm sitting there and I realize, well, if that side is is, you know, if the field goal is going through, that's why they're so excited, right? Yeah. I mean, they're not gonna be excited if I'm getting, you know, off or dismissed or no charges. Well, I look at I look over at Olin and I'm like, bro, that's not good. I mean, just in my eyes. Like, you know, he's my he was my battle buddy, he was my sniper partner. I mean, you know, you you there's two, there's usually two relationships that you can communicate without words. Yeah, it's a relationship like that that you develop in the foxhole, and it's your usually your spouse, right? You got that communication, you just get a look. So, and then immediately the judge starts talking in English, Daniel, and the flag was thrown. What I didn't know is that judges in that judicial system can change a verdict. And so he started talking, and he changed the verdict, and he banned us from ever coming back to South Korea after we PCS. And so me and Olin actually huge difference. Oh my gosh. Yes, and and you know what? And it and the day that that happened, then uh my because I broke my wrist in that in that altercation, right? Um all of that became a training incident. And so I came back stateside. The here's the really bad part, Daniel, and and I really haven't even got in. You know, I bet you're thinking, like, man, that's a betrayal, that's a moral injury. It's part of it. But it wasn't like the main thing. Because what ended up happening when I broke my scaffold, I had to have a cast for six months. First it was up my elbow, so I couldn't twist it, right? Then it was here for two months, then it was here for two months, and I was always like, hey, just keep my trigger fingers loose, Doc. You know, just do that part. Well, can you imagine the atrophy in my wrist after six months in a cast? Yeah. This elite, calf scout, PT master, push-ups, crazy, all of that. I couldn't even do a push-up. So I was on a profile that whole next year of my service, because remember, I did two years plus training. That whole next year, when I came back to Fort Stewart, I was on a profile and I had a uh platoon sergeant that just saw me as a negative blip on his patient. Right? Yeah. And and he began to haze me and give me guard and burn barrels and everything you could think, which really led me to the point where I didn't even want to be in the army anymore. Yeah. So I didn't I didn't realist. That is a smidget of the type of betrayal that someone experiences when they are sexually assaulted. Because usually that's compounding, Daniel. Usually that is heavy PTSD and the moral injury. And and I think you really have to have an all hands on deck for that. What has been super successful for me and my team is we really come at moral injury through the lens of loss, because loss is the common denominator. It's like it doesn't matter a traumatic experience, loss is connected to it. So there's a grief, right? What did you lose? And I really appreciate the fact that just in September, the committees that decide what goes into the diagnostic systems manual, they actually put moral problems in the DSM, now like spiritual or religious problems. Now they're not disorders. They are what we call Z-codes uh that expand um definitions a little bit, but but now they're recognizing moral distress and moral injury in the DSM V. I don't believe that that will ever become a disorder, just like spiritual problems hasn't become a disorder, religious problems hasn't become a disorder. Because should moral or spiritual suffering be coded as mental illness?

SPEAKER_00: 25:06

Yeah, it's a tricky one. I think I think you know, I've gotten into this debate with a number of folks, and uh, one of the one of the issues that I think is a is a key part of this is just from a practical standpoint of um do people deserve to be compensated for what they suffered in the military? And um, if you're you know, PTSD has a very, very specific diagnosis. We need more specificity for moral injury for it to be a diagnosis, but there are there are many cases where PTSD may not be there, but we do have moral injury. It was the fault of the military, it was caused by the person. They deserve to be compensated, and they're not. So, so one argument for it to be it's not a disorder, it's a normal reaction to a very immoral, traumatic event. But at the same time, like how do we compensate people, especially the especially women, because that's the main population that I'm serving, that were violated, their career was destroyed, it was shortened, all that from some very bad actors, and not just bad actors, but a system that allows it to happen and perpetuates it. Um they should be compensated for that. And one way to do that is for it to be a diagnosis. So that's to me a very strong argument. The other, the other argument for it is there's a lot more potential. There's funding for research, funding for intervention techniques, and all that, because all of us, most of us working in the moral injury field. Um I don't want to say most, I haven't surveyed it, but a lot of people working in the moral injury field, like myself, are have limited resources when it comes to funding. When we're asking for grants and funding and all that, we can't you we can throw moral injury in there, but it has to be part of so many other things that foundations recognize as a term, yeah. Or that granting or the government recognize the VA recognized as a term, but they don't fund uh research and that kind of thing for people outside the VA. So there's a funding issue that that also, if it's in the DSM 5, it's recognized and more than just a problem. There's a good chance that changes too.

SPEAKER_01: 27:35

Well, I think that this addition of this code then now adds, I think it adds a little bit more weight to those grant proposals. Now, what I need to clarify something. As a VA employee, I need to specify that my points and my views are mine and my alone. And in no way am I representing the VA today. Let me say this. Um, for all intents and purposes, Daniel, I am a missionary to the VA. That's that's what I do. Um, it's not just as to go and take Jesus Christ to the veterans. I do that as they welcome it. In the other sense, it's for me to just go and help uh care for anybody, regardless of what they feel or think. All right. And and I've dedicated my life specifically to work around suicide prevention and moral injury because I believe moral injury takes more of our brothers and sisters out in the world. And I'm not just talking about our military brothers and sisters, I'm talking about just in general, right? Right. So I do have, I'm not gonna say it's an opinion, but because I come up against this question a lot, I'm gonna answer it in the most non-prescriptive or advisory way that I possibly can. So can we compensate veterans for moral injury? We can acknowledge it, we can we can honor it and we can accompany it, but we can't compensate it in the traditional sense, and I'll tell you why. Moral injury is about loss of function, it's about loss of meaning. It's it's not a wound that the VA can rate in percentages. It's a fracture to your identity, your integrity, who you who and what you believe, right? The very core of what makes you human. And so while benefits and recognition are essential acts of justice, right, we they need to be compensated, right? Helping rebuild state safety and stability and trust, they don't touch the moral code of the wound. So compensation can restore fairness, but not wholeness. And don't let me don't hear me say there shouldn't be compensation. I'm not saying that. I think the wholeness is the most important part because when moral, moral repair requires something no check can buy, no grant can get, it requires presence, truth, and belonging, right? 100%. When I did my uh when I did my dissertation from Vanderbilt on using outdoor recreation as upstream suicide prevention, what I found, I did a meta-analysis on 94 different research projects that connected suicidality to loneliness. Okay. Isolation and loneliness are the worst risk factors. Whether you're looking at diagnostic side, anxiety, sexual trauma, PTSD, all these things we're talking about found in the DSM. That's the diagnostic side, right? There's screeners, there's measures, there's reports, right? But the non-diagnostic side, how do we measure helplessness? Hopelessness, unworthiness. Now, I would put those against anything on the diagnostic side. And I would say that those three that I just listed right there, and we can expand this, right? But just those three cause more people to eat a bullet in the sense of suicide, right? Than any of the things over here. Now, these things over here will lead to this, right? So that means the system's responsibility isn't just financial. It is financial, also, Daniel. But even more, it's relational. We we compensate moral injury by creating spaces where veterans or people can tell the truth without judgment, by training clinicians and chaplains to understand that moral dimension of trauma and by restoring the sense of what was broken in war can be healed in community. Now, so I I don't you can't compensate someone for a loss of innocence, but you can honor it. You can't, you can stand with them as they rebuild meaning. I do it daily in my day job, and that's what moral repair looks like. Not payment, but presence. Now, I said all that to say this. Yes, there needs to be a way to be compensated for something that isn't necessarily found in the DSM 5 because it is affecting people's lives. But the problem is the system. How do you create percentages and all of that for something that isn't? So the sad part, Daniel, and and this is the part that that bothers me about the conversation if one thing does. That journey to try and find compensation will force moral injury academically, clinically, into a box that it doesn't need to be in. Uh, because that's kind of how what happens, you know, with PTSD and others, they could throw money at it and grants, and you got all these programs, right? And here's the problem, and this is what bothers my heart. When everything is so symptom-driven, you miss the person. I don't want to miss the person. I feel like if if we if we don't miss the person, then all the symptoms that individual can then learn to co-regulate. Whatever that looks like for them, because it's different for everybody, right? What works for me won't necessarily work for you. But I can tell you this. You know, they always say, you know, it's it's impossible to find a needle in the haystack. Okay. I I would agree with that. It's it's nearly impossible. But one thing I can tell you to make it guaranteed impossible is you never even look for the needle. Yeah, right? That's the type of care we're going after here, I believe. That's the type of work you're doing with this podcast, with this exposure, is you're going after the needle in the haystack because the needle means something. The needle means one life saved. And here's the thing: one of the worst statistics I've ever heard is that suicide survivors, those that are left living after someone has decided to die by suicide, they are 175% more likely to die by suicide. So when you can effectively stop one, you can, you're, you're, you're actually mitigating generations of suicide. And and that's the I think that's the key and the most important part about the conversation is we can keep standing in the way of people dying, Daniel, but if we don't show them reasons to live, then they're then we're just going to keep stopping them from dying. So my, and and I would love for your organizations to jump on this. The reason that I'm pursuing the PhD in healthcare ethics is one major reason. There is no statistical data that shows when people have been flagged high risk for suicide and they're still living. Why are they living? What have you been doing year one, year two, year five, year 10? You are gonna blow your brains out. Now, hear me. We need the data that leads up to suicide death, even though it's always two years late when we get it. Yeah. But don't you think we would get better information on how to live from people who have actually been living? Like, where's that statistical data on the resilience and the protective factors that these people have been developed along the way, right? Because we have to show that suicide is not just about standing in the way of the death. It's about helping revive the reason to live within someone. And I really think that moral health is a great conversation, a great uh healthcare model to get into that important conversation on a daily basis without people saying, you're you're you know, overriding my religious freedom, you're doing this or that. Because it's because that's a part of it, but that's not the whole of it.

SPEAKER_00: 35:51

Yeah, yeah. I think you make a very valuable point when you think about um how many of women veterans um went through suicidal ideation because of sexual assault or something else. They're they're still alive. They're they're living in many ways a very meager existence um without, you know, you're talking about the isolation, um, very extremely low incomes, um, just really living hand to mouth. I I mean, um, I I love this debate about well, people just need to get jobs, they're lazy, and all this stuff. It's like that's not any of the people I work with. The women veterans I work with, they are they are not living on this meager income that the government provides because they're lazy, it's because they're disabled and this other stuff. But it's like, but there so it'd be a great, a great thing to look at of okay, how did you even at the level that you're living, because we can I I've I've interviewed plenty of women who are thriving now in many ways after some very traumatic experiences. Yes. I understand how I I understand like there's some very common threads about how they were able to overcome and so on, and a lot of it, a huge bit of it, and I think this is a real key is self-talk, you know. And I think uh unfortunately, self-talk often has been relegated to a silly kind of notion, people make fun of it and all that stuff. But I'm a very, very big believer in self-talk, and so um I I've interviewed too many women who are who are not getting rich off a scheme or whatever, they are telling their story and they physically they survived, literally survived physically, mentally, um, you know, through some horrible diseases, suicidal ideation, all that other stuff through self-talk of just determining the will to live and then talking themselves into health. And I would love to like I haven't done this research, but then look at the other side. The women that did survive, they're still continuing on, but not with a lot of things going their way, right? With struggling every single day. We interviewed some spouses, military spouses of service members with PTSD. They're in some really, really dire situations, family-wise. And literally every single day is just survival. And there's just something about the human drive to survive. They they continue to survive each day, even though every day is chaotic. They're not sure if their service member, their veteran, is going to commit, uh, is going to die by suicide. Many of them have. Um, they have children to worry about, finances, and all this stuff. Nothing seems to be going their way. Yet they manage to somehow, uh, with very little mental health support because they don't have time for it, or the VA doesn't have the capacity, or whatever, they continue to like go on with their lives. Um, and and when you interview them, you talk to them, they don't have a lot of hope. They're not uh with with some exceptions, they're not highly encouraged or optimistic or anything like that. They're just getting getting by one bit one day for the next. And I've always had this question about a lot of different things, um, a lot of different situations, but to that deeper question of like, what is the difference between someone who goes through very horrible childhood or trauma, whatever, whatever version of trauma it is, and goes on to succeed or thrive or do whatever, and another person who goes through similar circumstances, maybe even less, uh, dies by suicide or ends up extremely in just one horrific, like you know, homeless and all this stuff. Like, what is the real, real difference mentally, internally, soul-wise, or whatever, between those two people?

SPEAKER_01: 40:01

Um this is gonna sound too simple, Daniel. It's gonna sound way too simple, okay? The belief that they are worthy of love and belonging. It really comes down to that. Do they believe that they're worth living? It's not something external, it's something internal. I I was I've been thinking, and I I'm gonna cover, I'm gonna cover some of that. When people are sexually assaulted, before anything else, the person needs to be safe. Like before they can start processing anything. There's a that it, you know, whether that includes like uh immediate medical care or for some forensic options or anything like that, right? Safety isn't just physical, it's emotional and it's spiritual. Like the survivor needs to have spaces where they won't be pressured to disclose or talk or forgive. I'm preaching to the choir here. I know you already know this, right? And then the thing is, they really because because sexual assault is such a complex assault, right? Um, they need to be believed and accompanied. And so moral injury after sexual assault, it often sounds like I should have done something. Yeah, yeah. It was it it was it was my fault. Where was God? Why did God allow this, right? And so words, what I've learned uh working with those who have been sexually assaulted through our moral injury clinic, words alone rarely reach that place. What heals, and this is why I love what you're doing, okay, with these women, what heals is presence. To be present with people. It's not about what pill you feed them, although I'm okay with medication. Sometimes people need it, right? But when someone, when there's someone who can sit in the truth with you without judgment and help you restore your voice and your agency, um, and the name and and naming the injustice clearly, that this is not your fault, right? That's moral truth telling, and that's a part of moral care. And that is something that I believe folks like you and I, we we don't necessarily have to be taught to do that. It's instinctual, right? It's like when you see a copper head on the ground, you don't think, oh, should I go pick that up with my bare hand? No, it's like, right? And so sexual assault, it's it's so complex, it it fractures the moral code of a person, their core, right? That sense of dignity, safety, identity in their own body, it just destroys that. And so moral repair begins when the survivor can reclaim their truth and their voice and especially their worth, right? And so there's ways to get into that. I, you know, um we we just uh hunt therapy, right? Nature-based and bodied therapies, equine, archery, moot, you know, rituals of remembrance. There's all types of great tools to do that, but you got to get into that place where that injury is, right? And so I would say this sexual assault is not only an assault on the body, it's an assault on your soul. It's an assault on the spirit, spiritual part of you, right? Um, and healing means restoring dignity where it was stolen, voice where it had been silenced, and presence where shame tried to isolate you, right? You need you need community. Daniel, I want to say something and I want to make sure that this is loud and clear. When people have been suffering from moral injuries for 30, 40 years, like especially some of our Vietnam vets, right? Um, and I'm just speaking specifically to them at the moment, you please realize that the reason you're suffering is not a uh a highlight of the weakness of you. It's actually a highlight of the best part of you. Because if you didn't have morals, you wouldn't care. Right. So the reason it's affecting you, the reason you're a morally injury is is you care. And and you're still here for a purpose, and I hope that you completely find out what that is. Healing is not forgetting, it's remembering differently, right? Um and I hope that that is what you'll lean into. I know for me that there was a there was a point in mind, Daniel, where I had been living with my trauma, my PTSD, my moral injury in a way where every time it came around, I had a big bat and I was just gonna wear it out. You gonna come around me? Well, I've got faith. I had scriptures, I have, you know, community, friends, and I'm stronger than you. And what I realized is trying to forget is a lot like remembering, although it's worse. Not only do you deal with the anxiety of remembering, you're dealing with the anxiety that you're trying to forget. So I made one little movement. And so instead of encountering my trauma like it was, like it was never gonna go away, I started encountering it like it would always be here. And that reframes something for me, where I was able to now um kind of take it to task a little bit than it taking me to task, right? Um and moral repair really begins when we can tell the truth without fear and judgment, and being in community is the only place you can do that. You gotta be around people, right?

SPEAKER_00: 46:05

Yeah, no, I I agree with you. Um so we're we're just just about out of time, but I wanted to Okay. This this is some great um this is some great you know discussion that uh we could. I mean, there's so many different avenues we could get into that I would enjoy that with you. Uh, but let's end on this note. You mentioned uh healing in the wild. That's a book uh that's available on Amazon. Just give us a couple minutes, tell us about that book, who it's for, what's in it, that kind of thing.

SPEAKER_01: 46:40

Yeah. So I get asked a lot, you know, what does it mean to heal in the wild, and why do you take people outside to heal what's broken inside? And um, Daniel, I'm gonna ask you a question as I as I as I share this. I know you've lived life long enough to have had plenty of leaders, whether military or out, right? You've had leaders that have sat right across the desk from you and talked to you, and you've had leaders who have come around the desk and sat with you. Which leaders did you prefer?

SPEAKER_00: 47:14

Yeah, I I mean, in a basics, I I would say it like this. The the leaders, the best leaders were the ones that um I mean, without uh without getting like complicated, like I had a commander, uh brigade commander was a great leader. He never really sat down with me, but what I loved about him was uh you know, he knew everything that was happening, he was he was a real optimist, and he was very much like, you tell me what needs to happen, I'll get the money, we'll make it happen, that kind of thing. Yeah, but then you appreciate the ones. They laugh with you, they yeah, they're you know, when you screw up big time, they're like, I'm gonna take care of you, I'm gonna help you, it's gonna be okay. Like that's um yeah, but but you know, but they're leaders, they also have been where you want to go and that kind of thing.

SPEAKER_01: 48:15

So and did you appreciate the fact that they wanted to deposit something into you outside of just performance, right? The the leaders that came from out behind their desks, they were more relational. And so I said all that to say this nature is honest, nature meets you wherever you go. All you have to do is go into nature, right? It doesn't judge, it doesn't diagnose you, nature just receives you. So when we step into the wild, we step out of performance and into presence. And so healing in the wild, um, it it's a it isn't about escaping. It's about remembering. It's about reconnecting with the, I'm gonna say the rhythms God built into creation to heal us, stillness, movement, ritual, relationship. And so the wild becomes a mirror that reflects who we are without all the noise, right? You know it. Where's that place you like to sit in the wild? Maybe it's your favorite cup of coffee or a cup of tea or or a specific place you like to see a sunrise, right? You can think about it right now. I mean, I you you have that place, where is it?

SPEAKER_00: 49:36

You know, uh I actually for me it's um you know, um you would think I would have it right in front of my face, but I I end up you know, I uh for me, I always loved a because I grew up in Colorado, I grew up in the mountains. I love a place in the mountains, in the surrounded in the woods, and the it's a nice time and just sitting on a rock or sitting on a looking out over a huge draw. Um and just you know, especially if there's a little bit of a sunset. Um just feels like the world just feels so vast. Um at the same time, it's just um, you know, you're out there. We had this place in Colorado where we always went deer hunting, but you could just sit on this rock, look over this valley that was 300, 400 yards wide, and you could just feel like everything's right here because nature is just doing its thing, right? It's yes, it knows what to do and how to do, and you can hear some birds, and you got all these, and you're just like, I could I it and what's interesting about this is is that sometimes I'll be driving along and just you know, um, here in North Carolina, this part of North Carolina where I live, we don't have mountains, but we love going to the mountains in Tennessee and and all that. But I'll just be driving along and sometimes on my way to Charlotte, I'll go through URA forest, and I just want to pull over. Um, there's a there's a great parking spot and just go in the forest. Go in the woods and sit for a while. Like whatever else I'm doing, I just think wouldn't it be great if I just camped out for a couple days in the woods? I would love it.

SPEAKER_01: 51:43

Well, what everything you just described, Daniel, is presence. See, a lot of times people think presence, you have to be with someone, but you forget you are with someone or something even when you're alone, right? And so that view, that awe, that what that is, when you see that sunrise, right? When you see that sunset, presence gives people back their dignity. When someone's in pain, what they need most is an advice. It's someone who won't look away, it's someone who won't be judgmental, it's someone who won't try to fix it, right? Presence says you still matter right here, no matter what you're going through, even in this pain. And what does, when you get into nature, it rehumanizes the person and creates space for their own truth to surface. So when we think healing comes from fixing, but it actually comes from being with. Because presence is what love looks like when it when it stays, right? And so the the beauty of really healing in the wild uses nature as a sacred place where presence replaces performance. And in the wild, there's no masks, there's no clocks, there's no cell phones, hopefully. There's no clinical checklist, right? There's only honesty. And when someone steps into that space, they step out of survival mode and into awareness. All those things you just talked about, Daniel, the birds, the wind, the trees, the sun on the hill, right? Presence in the wild means slowing down enough to feel again. And that's what's important because in those moments, people start telling the truth that they've never been able to stay indoors. And they discover where that there's still love, they're still worthy, they're still here, and that's where healing begins, right? So for me, healing in the wild wasn't about treatment, it's about reconnection. Reconnection to self, reconnection to others, reconnection to God if you're a person of theistic faith, right? Or even to creation, because presence doesn't work. Presence does the work because presence is what trauma stole. And that's healing in the wild. And if you wanted to find it, um, you can find it on Amazon, Healing in the Wild, Dr. CarterCheck. You can go to drkartercheck.com. Um, and the book is also on Audible. So if my voice hasn't annoyed you during this podcast, man, get it on Audible. If it has, you probably don't want to listen to me for four hours.

SPEAKER_00: 54:22

Well, I you have a great voice. You actually remind me of a really good friend of mine who is a chaplain for many years. Um just uh it's similar accent, tone, everything. Uh but anyway, uh Car, it's been great talking to you. I think um uh there's I know that you're doing a lot of good for a lot of people in your in your practice and and through your writing and your research, the different things you're doing. But really appreciate it. Uh, I'm excited about getting this podcast out to people. Um, and and so we'll just close by we'll uh Dr. Cardi he gave you his information, you heard it, but also we'll put it in the show notes of the podcast so you can go get his book. I highly recommend his book. Um, especially, you know, if you're if you're a person that works with people that are morally injured, if you work with veterans, um, and and I'm guessing too that this doesn't have to be veterans. If you're working to help heal people who have been through trauma and they have those wounds at the core, um, and and they're losing that sense of they've lost that sense of identity, that sense of rightness, that sense of purpose, like this would be a great book to to really for for you. So thank you so much. It's been great having you, Carter, and uh I look forward to to watching from there. Um, and uh have a great day.

SPEAKER_01: 55:51

Thank you so much. It was my pleasure.