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Matthew Ikenoyama (matthew.ikenoyama@gmail.com) is a chaplain candidate in the BYU Religious Education chaplaincy program and a US Navy ensign. He plans to apply for active duty after he graduates in the spring of 2021.

Jared W. Ludlow (jared_ludlow@byu.edu) is the ��Ӱֱ�� publications director.

Matthew Ikenoyama’s chaplaincy project shows the positive impact of BYU’s Inspiring Learning emphasis and faculty mentoring. He partnered with Dr. Marc-Charles Ingerson, an affiliated scholar at the Wheatley Institution, whose expertise is in behavioral ethics. Matthew’s research emphasis is “Moral Injury in the Public at Large and in the Military: A Meta-Analytic Review from 2010 to 2020.” Since his project was defended, Matt has done additional research to make his topic a comprehensive review. The gist of the research reported is that moral injury can be addressed by turning to the source of moral values in someone’s life.

Background

I was raised in Ridgecrest, California, a little spit of dirt about two hours east of Bakersfield. When I was growing up, my father was the only member of The Church of Jesus Christ of Latter-day Saints in our family, but he was inactive when I was a kid. And it really wasn’t until I expressed interest in joining the navy when I was in high school and I left for boot camp that he went back to the Church. So I was gone for about six years, and four of those were spent overseas. When I came home, I saw the difference that the Church made in his life. It was like looking at a completely different person. Not to say that my father was a bad person when I was growing up, but there were noticeable, marked differences in his demeanor and the way he carried himself when he came back to the Church. That’s really where the path started for me to come to the Church because I wasn’t a member at that point yet.

My calling to the chaplaincy began when my father invited me to the priesthood session of general conference in 2016. I didn’t know at the time, but I was receiving a prompting to become a navy chaplain, and the more I pushed that thought away, the harder it persisted, to the point where I said to myself, “Ok, fine. I’ll look into this chaplaincy thing. I’ll follow this thought, and we’ll see where it leads.” And so when the session was over, this was kind of that moment that flipped the switch on for me—after I had received that prompting and I started looking into chaplaincy. What did I need to do to become a navy chaplain? I saw that BYU had a program specifically for chaplains. And then, I mean that kind of hit me. I was like, “Holy cow.” I mean something like that just doesn’t pop up out of coincidence, you know. And so that night I knelt down and prayed about it. I said, “Heavenly Father, if this is the path that you want me to follow, let me know, and make sure that it’s really prominent because I don’t want to miss it.” And so that night I received revelation that that was the path that I was supposed to follow. And so the next day I woke up and told my dad, “Hey, I need to get baptized.” And he was like, “Wait, what?” He’s like, “You need to talk to the missionaries first, and you need to go through the lessons.” And I said, “OK, why don’t we do that?”

So in 2016 I got baptized, went to BYU–Idaho, got my bachelor’s in psychology, came to BYU (Provo), applied for the chaplaincy, got in in 2020, and that’s how I ended up here at BYU in the chaplaincy program. I will graduate in April of next year, but I started this project a year ahead of my graduation. They had us at least start thinking about topics at the beginning of our time here at BYU so we could slowly work over them the next couple years. But with an impending mobilization that I had to go on, I didn’t want to come back and have to deal with the project on top of everything else.

Project

The reason for my project topic on moral injury came from Blake Boatright, who asked me in one of our meetings, “I’ve got a potential topic for your project if you are interested.” And I said, “I’m open to anything really.” And so he says, “How would you feel about doing a literature review on moral injury?” And I said, “I have no idea what moral injury is, but if I look into it and come back to you in a couple days would that be OK?” And he said, “Absolutely.” So I looked into it, and my project on moral injury started with a literature review covering the past ten years. During this time, both Brother Boatright and Brother Ingerson were instrumental in guiding and mentoring me every step of the way. I really cannot emphasize enough just how pivotal they both were in setting me up for success. They were very open about adjustments I needed to make during my project and shared their personal insights with me that deepened my perspective.

As a segue, let me explain what moral injury is. The short answer is that it’s a betrayal of personal moral values. And the ways that we’ve seen it manifest itself at least in the military is very complex. It’s very different from something like PTSD with its psychological trauma. Whereas with moral injury, some researchers call it a spiritual or a soul wound because it’s something that deeply transgresses beliefs or values that people hold within them. It sometimes results from being asked to do things that normally you wouldn’t do, like if you have to shoot somebody or something. Sometimes it is because maybe you make some choices while you’re out in a high-stress situation that maybe you wouldn’t have done if you were back home in a normal environment. It’s complex because it can be tied to military responsibilities and actions, actions more on a personal level, or a bit of both. It manifests itself differently in different people in the different ways that they perceive these events, these experiences. For example, you could have somebody who is in charge of a group of soldiers, and they have this sense of responsibility that these are my soldiers and I need to take care of them. But what happens if some of them get killed in combat? Then they have that weigh on their soul that they couldn’t keep their soldiers alive.

On the other hand, there’s other instances that I’ve read about, traumatic experiences from not just US soldiers but from British, German, or Canadian soldiers who are deployed to Iraq or Afghanistan. Insurgents would use kids and would strap bombs to them and force them to walk up to these checkpoints where the soldiers were, and so these soldiers have to make a decision. “It’s a kid, but they have a bomb strapped to them, and if we don’t shoot this kid, we are all going to die.” And so it’s instances like that that drive the moral injuries. It’s not because they intentionally put themselves in these situations. They had to make a choice between bad and worse.

The difference between moral injury and PTSD is the former is tied to one’s own set of values. In a sense, it’s their perception of how to act in a particular situation. I read an example of a squad of soldiers at a checkpoint. One of them had to shoot a teenager, and the other soldiers at that checkpoint didn’t develop any sense of moral injury. Only that soldier did. They were all at the same place at the same time seeing the same thing, but he was the only one that suffered from moral injury. PTSD is like a bomb that goes off. It affects everyone in the blast radius. Moral injury is much more selective or dependent on the individuals and what their values are and how that experience violates their moral values. One thing that we found in the research is that it’s the individual perception that really tells you if they are suffering from moral injury or not. Like you could go to a psychiatrist or a psychologist or a counselor if you have PTSD, and they can diagnose you with PTSD because they will see the signs and symptoms and say, “Yes, you’ve suffered from this traumatic experience. You’ve got PTSD.” But with moral injury, if the person doesn’t feel like their values have been violated, then they’re not going to have moral injury. But if that person does feel that their moral values have been violated, they’ve got moral injury.

Chaplain Help for Moral Injury

The difficulty with moral injury is there are intense feelings of guilt, shame, and anger associated with it, so a lot of times these stories don’t want to be told. But the one good thing about military chaplains is that they have 100 percent confidentiality with those that they talk with. And so that has been very helpful in the military, with these soldiers being able to unburden themselves of the traumatic experiences that they have had, while at the same time knowing that these stories won’t be retold to anyone else without their permission. That’s one way that I think chaplains can really stand at the forefront in helping our service members deal with moral injury that they have suffered.

Due in large part to the efforts of Brother Boatright, I was asked to share part of this information to a group of military chaplains and other military leaders in July 2021 over several days to make them more aware of this issue. I’m not exaggerating, if it weren’t for Brother Boatright’s acting as our point of contact with the command, the presentations never would have happened. I felt humbled and privileged to accompany Brother Boatright, Brother Ingerson, and others during that presentation, which included my own research. I think a large part of it was the research project that I did covering a ten-year timespan with over 220 research articles that I had to meticulously go through. I was able to compile and water it down for someone who doesn’t have the time to read through 220 research articles. I could tell them what the research says and about x, y, and z as it relates to moral injury. So that’s really why they brought me on board—I had all this knowledge from researchers that have done tremendous work already in the field of moral injury in the military. Again, thanks to the guidance and mentorship of Brother Boatright and Brother Ingerson, I was able to draw out what the research was telling me as it related to moral injury in the military.

The biggest thing that I found is building awareness because one of the issues with moral injury is that it’s got some similarity with PTSD. So when people treat PTSD, they go through the therapy sessions where they relive that incident to try to build up that exposure. But with moral injury, that’s essentially reliving the worst moment of their lives. And so being able to differentiate the two and know that you can’t treat moral injury the same way you can treat PTSD, I think that really is the biggest thing that we’re trying to do, is to help show people that, and also to help show them that our service members aren’t stupid. They know when something is wrong with them, when something is off. It is valuable to be able to sit down and identify what it is that’s bothering them, what it is that has been troubling them all these years and say, “Oh, moral injury. That’s what I’ve been dealing with this whole time.” That’s been very helpful because now it’s not some unknown entity. They can actually pinpoint it and say, “OK, this is what I’m dealing with.” And then they can formulate a plan to identify how they are going to work through this.

Part of the treatment is just to recognize it and being aware of it and learn how to manage it. In a lot of ways, it was helpful to know that they weren’t just dealing with an unknown entity.

But that wasn’t the be-all and end-all of resolving moral injury. One thing that Brother Boatright brought up at the training was that the source of values can also be the source of healing. If you can identify what the value that was violated came from, you can identify a source of healing from that same venue. For example, all of us learned our values from our parents, who learned them from our grandparents, and so on and so forth. But if you look far enough down your family history, you will be able to find that our values have been steeped in religious tradition. And so, like for us, as members of The Church of Jesus Christ of Latter-day Saints, we have a path toward forgiveness, toward redemption, toward repentance. Same thing for Catholics, same thing for Muslims, same thing for Jews. All religious faiths have some way of providing healing for their followers. And so that was an insight that Brother Boatright had that we believe was guided by the Spirit.

Personal Benefit

For me, doing this project really validates how essential chaplains are for the military. The amount of spiritual support that chaplains can provide to service members who are suffering from moral injury is, in my mind, a resource that has been severely undervalued and underutilized. I know within our secular culture the value of religion has been downplayed over the years, but I think regardless of what religious background you follow, chaplains are able to provide spiritual care and spiritual support. It’s really validated again that this is the path that I’m supposed to be on and that the Lord has indeed called me to be a chaplain.

I am currently finishing my next-to-last semester, and then I will do two-year postgrad work, a residency somewhere to gain ministerial experience. Because unlike the army or air force, who have supervisors over them, if you are a navy chaplain and you are sent to a cruiser and you are the only chaplain, guess what? You are the only chaplain. So they expect you to know what you are doing to a certain extent. When I’m done with residency, I intend to apply for active duty.

I think the topic of moral injury is something that will be up and coming in the next few years if it isn’t already. As I’ve told some of the members of my cohort, moral injuries are our generation’s PTSD. In the same way that the previous generation really felt awareness of PTSD to the point of where everybody knows what it is, I think that’s going to be our call with moral injury for our generation. It’s amazing that five years ago none of this was on my radar: the Church, BYU, chaplaincy, moral injury. None of that was really on my radar, yet here I am today.