By Ashley Schumacher, MS, LAPC

I have been thinking about moral injury in relation to something from the Thomistic tradition that may offer another way of understanding both the wound and the possibility of healing: synderesis.

In the Thomistic tradition, synderesis refers to a natural habit of the practical intellect concerning the first principles of human action. It is associated with the foundational recognition that good is to be pursued and evil avoided (Aquinas, 1947; Repuyan, 2021). It is not the same thing as conscience. Conscience involves the application of moral knowledge to a particular situation, while synderesis concerns the more foundational principles upon which moral reasoning proceeds (Aquinas, 1947).

This distinction may offer an interesting way of thinking about moral injury.

Moral injury is not yet understood through one universally accepted definition or theory. Contemporary scholarship describes it in terms of disruptions involving moral emotions, beliefs, behaviors, identity, meaning, purpose, trust, and one's understanding of goodness and right and wrong (Litz & Walker, 2025; VanderWeele et al., 2025). Other scholars have emphasized that moral injury cannot be fully understood apart from the relational, spiritual, existential, organizational, and social contexts in which moral violations occur (Molendijk et al., 2022).

But what if part of what makes moral injury so painful is not simply that we believe something was wrong, but that something within us remains oriented toward what is good—and encounters a reality that contradicts it? 

That question becomes especially interesting when we consider how our earliest experiences of relationship shape the developing person.

A young child may not yet have the language or developed moral reasoning to say, This is unjust. But the child can encounter being protected or frightened, welcomed or rejected, listened to or silenced, treated as worthy or made to feel as though they do not matter.

The experience may be registered before it can be explained.

The body may register something before the mind can name it. The relational experience may precede the story about it. And the sense that something is not as it should be may precede the ability to articulate why.

Recent work has begun explicitly considering moral injury in people who have been victims of abuse or adverse childhood experiences, expanding moral injury beyond the more familiar contexts of perpetrators and witnesses, particularly in military settings (VanderWeele et al., 2025). This does not establish that preverbal children experience moral injury in the same way that adults consciously recognize and describe it. But it does create space for an important question: Could some moral injuries have an embodied, sensory-perceptual, and relational beginning before they become an explicitly understood moral experience?

I am not suggesting that a preverbal child necessarily experiences moral injury in the same way an adult might consciously recognize and describe one. Rather, I am exploring whether some moral injuries may begin in experience before they become explicitly understood as moral.

This possibility matters because our earliest relationships are not separate from our developing moral lives. Through repeated experiences of being responded to or ignored, protected or frightened, welcomed or rejected, children begin developing expectations about themselves, other people, and the world. These experiences occur within the broader development of moral understanding, conscience, and the capacity to discern what is good.

Aquinas himself distinguishes between the natural possession of first principles and the ability to make use of them. In discussing the natural law, he notes that a child may possess the habit of understanding principles without yet being able to make full use of it because of developmental limitations (Aquinas, 1947). This does not establish a theory of preverbal moral injury, but it is philosophically interesting in light of the possibility that a foundational orientation toward the good may precede the person's capacity to articulate or reason explicitly about particular moral situations.

If this is the case, then an early relational injury may affect more than attachment alone. It may also shape the landscape within which later moral discernment occurs.

A person may grow up knowing, at some level, that something was wrong, while simultaneously learning not to trust that perception.

They may recognize injustice but doubt their right to protest it.

They may long for goodness while expecting betrayal.

They may know that relationships should be different but have difficulty imagining what “different” could look like.

They may have learned that belonging requires self-abandonment, that authority cannot be questioned, or that obedience means suppressing their own conscience.

I am not suggesting that synderesis itself is necessarily damaged by moral injury. From a Thomistic perspective, it may be more accurate to think about the possibility that a person's foundational orientation toward the good becomes obscured, distorted, or difficult to trust in its expression because of what they have experienced.

This creates an interesting tension.

Something within the person remains oriented toward the good, while their lived experience may have taught them to expect something very different.

Perhaps this is part of what makes moral injury so disorienting. The person is not simply struggling with an idea. They may be experiencing a painful dissonance between what they encounter and what they intuitively recognize ought to be true.

This fits with contemporary descriptions of moral injury as involving disruptions in moral beliefs and emotions, one's understanding of humanity, and one's sense of meaning and purpose (Litz & Walker, 2025). It also fits with broader interdisciplinary work emphasizing that moral injury can involve spiritual and existential disorientation, loss of trust, and the violation of moral expectations within particular relational and social contexts (Molendijk et al., 2022).

And this brings me to moral imagination.

Moral imagination is not simply the ability to think about morality abstractly. It involves the capacity to perceive possibilities for goodness, relationship, responsibility, and action that may not yet be immediately visible within a particular situation.

There is already scholarship connecting moral injury and moral imagination. Buechner (2020), for example, argues that moral imagination can help create space for recontextualizing troubling experiences and imagining alternative possibilities. His work also emphasizes that moral injury cannot be reduced to individual psychology because the meanings through which people understand themselves and their moral worlds are shaped within relationships and broader social contexts.

There is also scholarship explicitly connecting synderesis and moral imagination. Repuyan (2021) examines how the Thomistic habit of synderesis, understood in relation to the first principles of natural law, can be brought into conversation with moral imagination and prudential moral development.

What I find particularly interesting is the possibility of bringing these conversations together.

Perhaps synderesis and moral imagination represent two different but related dimensions of our relationship to the good.

Synderesis points toward the foundational orientation itself; moral imagination may help us perceive how that orientation could take shape within the particular circumstances of our lives.

This is my own synthesis rather than a distinction proposed by Aquinas himself.

Trauma can narrow that field of vision.

If a person has repeatedly experienced authority as controlling, they may have difficulty imagining authority that protects rather than controls.

If belonging has required self-abandonment, they may struggle to imagine belonging that allows them to remain fully themselves.

If obedience has been associated with suppressing conscience, they may have difficulty imagining obedience that strengthens rather than diminishes freedom.

If relationships have repeatedly involved betrayal, they may have difficulty imagining trust that does not require surrendering discernment.

Moral injury can therefore affect not only what a person believes, but what they are able to perceive as possible.

This is where moral imagination may become clinically meaningful.

It does not require us to deny what happened. It does not ask us to reinterpret injustice as good. And it is not simply positive thinking.

Instead, it can create room for questions such as:

What would a trustworthy relationship look like?

What would authority look like if it protected rather than controlled?

What would obedience look like if it strengthened rather than diminished freedom?

What would it mean to belong without having to abandon myself?

What if what happened to me does not have to determine what I believe is possible?

These questions do not erase the past. They begin to loosen the possibility that the past must become the final horizon for the future.

This also suggests why moral imagination should not be treated simply as a technique for generating more positive thoughts. If moral injury is embedded within particular relationships, communities, institutions, and systems of meaning, then healing may require more than changing an individual's interpretation. It may involve encountering relationships and contexts that make alternative ways of being genuinely possible (Buechner, 2020; Litz & Walker, 2025; Molendijk et al., 2022).

Perhaps, then, one aspect of healing from moral injury involves not creating a new moral vision from nothing, but learning to recognize and trust what has remained.

“This was not right” may reflect an enduring orientation toward justice.

“I should not have been treated this way” may reflect an awareness of human dignity.

“I want to be able to disagree without losing the relationship” may point toward a longing for truthful relationship.

“I want to know what I actually believe rather than simply believing what I was told” may reflect a desire to recover genuine moral discernment.

From a Thomistic perspective, the underlying orientation toward the good is not something we simply manufacture for ourselves. And clinically, this means we do not necessarily need to begin by telling someone what the good should look like.

Sometimes healing may begin by making space for the person to discover what they already find themselves reaching toward.

What do I still long for?

What feels worth protecting?

What feels unjust?

What kind of relationship do I want?

What kind of person do I want to become?

What goodness have I been taught to distrust?

Perhaps the pain of moral injury can sometimes reveal something that the injury did not destroy: an enduring orientation toward the good.

Healing may involve learning to trust that orientation again—not blindly, and not without discernment, but with increasing freedom to encounter, question, imagine, and choose.

Moral imagination can help widen the field of what the person is able to perceive as possible. It can help make visible forms of goodness, relationship, freedom, vocation, and dignity that once seemed impossible or unsafe. In this sense, moral imagination may not create the person's orientation toward the good so much as help the person perceive how that orientation might be lived within the reality of their particular life (Buechner, 2020; Repuyan, 2021).

Perhaps we do not begin healing by creating a new moral vision from nothing.

Perhaps we begin by making room for something that has remained within us to become visible again.

The orientation toward the good may be wounded in its expression, but not erased. And moral imagination may help us begin to see where that orientation can lead us now.

Sometimes, this begins simply by identifying and naming the good we still find ourselves oriented toward.

References

Aquinas, T. (1947). Summa theologica (Fathers of the English Dominican Province, Trans.). Benziger Brothers. (Original work published 1265–1274).

Buechner, B. D. (2020). Untold stories of moral injury: What we are learning—and not learning—from military veterans in transition. Frontiers in Communication, 5, Article 599301. https://doi.org/10.3389/fcomm.2020.599301

Litz, B. T., & Walker, H. E. (2025). Moral injury: An overview of conceptual, definitional, assessment, and treatment issues. Annual Review of Clinical Psychology, 21, 251–277. https://doi.org/10.1146/annurev-clinpsy-081423-022604

Molendijk, T., Verkoren, W., Drogendijk, A., Elands, M., Kramer, E.-H., Smit, A., & Verweij, D. (2022). Contextual dimensions of moral injury: An interdisciplinary review. Military Psychology, 34(6), 742–753. https://doi.org/10.1080/08995605.2022.2035643

Repuyan, P. dela Cruz. (2021). On “Synderesis” and moral imagination: An inquiry into the beneficence of “imaginative prudence” in moral development via the first principles of natural law of Saint Thomas Aquinas and the Imagination Ethic Theory of Darcia Narvaez [Doctoral dissertation, The University of Notre Dame Australia]. ResearchOnline. https://researchonline.nd.edu.au/theses/330

VanderWeele, T. J., Wortham, J. S., Carey, L. B., Case, B. W., Cowden, R. G., Duffee, C., Jackson-Meyer, K., Lu, F., Mattson, S. A., Padgett, R. N., Peteet, J. R., Rutledge, J., Symons, X., & Koenig, H. G. (2025). Moral trauma, moral distress, moral injury, and moral injury disorder: Definitions and assessments. Frontiers in Psychology, 16, Article 1422441. https://doi.org/10.3389/fpsyg.2025.1422441