Psychiatrist, Department of Veterans Affairs Outpatient Clinic, Boston
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Philosophic conclusions from work with psychologically and morally injured combat veterans: brain, mind, society, and culture are co-evolved. The four encompass the complete human phenomenon, but are not reducible to the physical brain. None of the four is ontologically prior to the others. All four are each other’s environments with obligatory cross boundary flows, each with each in both directions. Rigorous, but non-reductionist interdisciplinary research in the vein of “EvoDevo” in embryology is called for in the study of the human phenomenon. Moral injury is present when the following three things are present: Betrayal of what’s right (according to the local culture) by someone who holds legitimate authority (in the social system) in a high stakes situation (the stakes are held and their changed condition anticipated and appraised in the mind). The body (mainly run by the brain) codes moral injury as physical attack and responds accordingly.