Freud, Lacan, Russell, and the Ethics of Care in Treating Moral Injury

The concept of moral injury—a profound rupture in an individual’s ethical or spiritual framework following catastrophic events—has gained increasing attention in psychoanalysis, trauma studies, and philosophy. While the term is relatively recent, its foundational elements appear in Sigmund Freud’s early reflections on war trauma, Jacques Lacan’s reformulation of ethics as a confrontation with desire and the Real, and Jared Russell’s extension of sublimation as a means of engaging with moral conflicts embedded in the social and cultural unconscious. Each of these perspectives contributes to our understanding of moral injury, yet none, on their own, provide a sufficient framework for addressing it in a clinical setting.

Freud’s insights into war neuroses demonstrate how moral injury involves more than simple trauma; it is a conflict between the superego’s ethical imperatives and the survival-driven actions required by war. Lacan deepens Freud’s analysis by situating moral injury within the structural limitations of the symbolic order, arguing that such injuries result from an encounter with the Real—a dimension of experience that resists signification. Jared Russell’s engagement with sublimation and the superego further extends these insights by showing how cultural ideals, much like unconscious desires, operate in ways that shape ethical subjectivity before the subject fully understands them.

Bringing these frameworks into conversation with contemporary psychoanalytic approaches to moral injury, this essay argues that an ethics of care—one that neither pathologizes moral suffering nor remains trapped in theoretical abstraction—must be built upon three key principles: recognition of moral pain as real and non-negotiable, therapeutic techniques that support symbolic re-narration, and a pragmatic embrace of sublimation as a means of restoring moral agency. Without these elements, psychoanalysis risks either reinforcing the patient’s guilt through an overactive superego or leaving them in a state of ethical paralysis, where no clear path to reparation or ethical reintegration is available.

Freud and War Trauma: The Birth of Moral Injury

War Neuroses and the Collapse of Meaning

Freud’s wartime writings, particularly Thoughts for the Times on War and Death (1915), provide an early psychoanalytic account of moral injury. He observed that many returning soldiers suffered from nightmares, flashbacks, and relentless anxiety—what he classified as “war neuroses.” However, he also noted that many of these men were not simply traumatized by war’s brutality; they were haunted by what they had done. Guilt, shame, and a profound sense of moral dislocation distinguished these cases from those of soldiers whose symptoms aligned more closely with a fear of death or physical harm.

Freud recognized that traditional psychoanalytic explanations of neurosis, which emphasized childhood sexual conflict, failed to fully account for the unique moral and ethical conflicts that emerged in war. Instead, he noted how the battlefield upended a soldier’s sense of right and wrong, forcing them to participate in acts that, under any other circumstances, would be considered unforgivable. Many soldiers struggled to reconcile their actions with the ethical principles they had internalized before the war. Freud’s early reflections on this phenomenon prefigure what we now understand as moral injury: a psychological wound that emerges not only from suffering, but from a betrayal of one’s deeply held moral convictions.

The Superego’s Role in Moral Injury

Freud’s structural model of the psyche—the id, ego, and superego—clarifies why moral injury is so uniquely destructive. The superego, as the internalized moral authority, dictates ethical behavior and punishes transgressions with guilt and self-reproach. Under normal circumstances, the superego provides a regulatory function, ensuring that the individual conforms to socially and ethically acceptable behavior. However, in wartime, moral codes are radically restructured. Soldiers are not merely permitted to kill; they are expected to do so as part of their duty.

This transformation produces a profound psychic contradiction. The same ethical system that once forbade violence now commands it. In some cases, the superego adjusts accordingly, suspending guilt in the name of necessity. But for many soldiers, the superego remains active, continuing to punish the ego even after the war has ended. The result is an unrelenting sense of guilt and moral alienation. The problem is not simply that the soldier has done something “bad,” but that they no longer know how to position themselves in relation to their own moral framework.

Freud recognized the punitive force of the superego in cases of war neurosis, but he did not provide a clear therapeutic strategy for addressing it. While he developed techniques for helping patients “remember and repeat” traumatic experiences, he did not articulate a method for reconfiguring the patient’s symbolic moral world. This is where Lacan’s insights into ethics and the Real provide a further avenue for understanding how moral injury functions at the structural level of subjectivity.

Lacan’s Seminar VII: Ethics and the Real of Moral Injury

I. Beyond Freud: The Ethics of Psychoanalysis

In Seminar VII: The Ethics of Psychoanalysis (1959–1960), Jacques Lacan redefines ethics in a radical way that departs from both classical morality (centered on conformity to established laws or norms) and Freud’s focus on internalized prohibitions (the superego). Lacan posits that ethics ultimately concerns our relationship to desire and the Real. Whereas Freud analyzes how guilt arises from conflicts between instinctual drives and the superego, Lacan pushes further, asking how these conflicts point to something that eludes our standard ways of making sense of the world.

From a Freudian standpoint, the superego is a moral agency internalized from parental and cultural authority, punishing us whenever we transgress. Lacan integrates this idea into his broader theory of subject formation, highlighting that what we call “moral law” is also knotted up with unconscious desires, anxieties, and fantasies. For Lacan, the crucial task is less about obeying or disobeying specific moral codes than about confronting the places where our desire clashes with the limits of symbolization—the Real.

II. The Three Registers: Imaginary, Symbolic, and Real

To grasp why moral injury can be seen as an encounter with the Real, it helps to recall Lacan’s tripartite framework of the Imaginary, Symbolic, and Real:

Imaginary: This register is tied to images, identifications, and illusions of wholeness. It includes the ways we see ourselves and others, shaped by mirrors, social comparisons, and idealized self-images.
Symbolic: This register is the realm of language, law, culture, and social norms—the “big Other” that structures our reality. It includes the moral codes, religious precepts, and societal taboos we inherit.
Real: This register is that which cannot be symbolized or neatly represented. It resists language and meaning-making, remaining outside the Symbolic. Traumatic experiences, profound losses, or unspeakable actions often relate to the Real because they do not fit neatly into the narratives, codes, or laws that structure everyday life.

In this schema, an individual typically navigates everyday life through the Imaginary and Symbolic, maintaining a working sense of identity and moral orientation. However, certain experiences—especially extreme or violent ones—may confront the subject with the Real in a way that destabilizes or collapses the usual supports of language and social norms. This collapse can yield moral injury.

III. Understanding the Real in Seminar VII

In Seminar VII, Lacan suggests that ethics is bound up with the subject’s willingness (or refusal) to come face to face with the Real. Traditional moral systems tend to revolve around prescriptions and prohibitions—“Thou shalt” or “Thou shalt not.” Yet for Lacan, a more fundamental ethical question is: Can we endure encountering what disrupts our symbolically ordered world?

Desire and the Real: Lacan emphasizes that desire itself is never fully graspable. Part of it always lies beyond symbolic expression. It is oriented toward something that we cannot reduce to conscious goals or social demands. When confronted with moral crises—such as having killed in combat—one may discover that the usual narratives (“I did what had to be done,” “I was following orders,” “It was me or the enemy”) fail to capture the full weight of the experience. This excess, which language cannot contain, is the Real.
Ethical Experience as Rupture: In war, or in other dire moral contexts, the subject can be forced to enact or witness atrocities that break all prior moral frameworks. Lacan’s notion of an ethical encounter is not about establishing new moral norms; it is about acknowledging that one faces a dimension of human experience that defies assimilation into the usual symbolic categories of “heroism,” “evil,” or “duty.”

IV. The Real as the Core of Moral Injury

Moral injury, in the context of war, can be framed as an unassimilable experience that resists our capacity to reconcile it with established moral or cultural codes. If the symbolic order is the network of culturally approved meanings—such as “Thou shalt not kill” or “we fight for a just cause”—the Real is what emerges when these codes collapse or contradict each other in the face of lived reality.

Encounter with the Unspeakable: The soldier who has participated in combat, taking a life or witnessing horrific violence, may find that any attempt to narrate or justify the act comes up short. The usual language of patriotism, necessity, or survival might ring hollow, failing to capture the magnitude of guilt or horror. That indescribable residue is a hallmark of the Real.
Impossible Space: Lacan’s approach clarifies why moral injury feels so unresolvable. The soldier has done something that was legally or institutionally sanctioned (the “justified by military necessity” aspect) but personally experienced as morally devastating. The superego, which internalizes moral prohibitions against murder, condemns the soldier’s actions, intensifying guilt and shame. Meanwhile, the soldier’s efforts to symbolize the act—telling stories, rationalizing it, or slotting it into official narratives—may fail because the act surpasses conventional frameworks of meaning. The soldier is thus caught in a paradoxical space: the act is “justifiable” and “unjustifiable” at the same time.
Trauma and the Real: For Lacan, trauma is often the intrusion of the Real upon a subject unprepared to face it. In war, the Real emerges not only as the threat of death but also as the subject’s own capacity for violence—a dimension that might be disavowed in ordinary peacetime life. Moral injury is, in this sense, the traumatic discovery that one is capable of acts that violate deeply ingrained moral convictions, revealing an internal contradiction the Symbolic cannot easily paper over.

V. The Role of the Superego and Guilt

While Lacan departs from Freud on many points, he still recognizes the significance of the superego. In Freudian terms, the superego is the internalized voice of authority that both commands and punishes. Lacan extends this concept by suggesting that the superego is not merely a moral policeman; it is also entangled with the subject’s desire. The superego’s injunction can be paradoxical—what Lacan terms the “obscene and ferocious superego”—because it sometimes pushes the subject to transgress (e.g., “Enjoy!”) at the very moment it forbids certain enjoyments.

In the context of moral injury, the soldier’s superego might lash out with particularly devastating force:

It condemns the soldier for having committed acts incompatible with moral beliefs (“You killed someone—this is unforgivable”).
It may simultaneously offer no path toward redemption, because the Real of the violent act cannot be undone or fully assimilated.

This traps the individual in an endless cycle of guilt and self-recrimination, contributing to the sense that moral injury is inescapable.

VI. Why Moral Injury Cannot Simply Be “Talked Through”

One of the central insights from Lacan’s perspective is that the Real cannot be integrated simply by talk therapy or by adopting a new cognitive framework. Although language (the Symbolic) and identification (the Imaginary) are crucial tools for processing experience, they always leave a remainder when it comes to the Real. The soldier may try to discuss the moral dimensions of killing in war, seeking relief from guilt, but the core of moral injury remains precisely in that realm where words fail.

This is not to say that therapy is futile. Rather, it means that an approach informed by Lacan acknowledges a limit to symbolic resolution. The aim is not for the soldier to find a perfect rationalization but to negotiate a new orientation toward the unspeakable. The therapeutic space can offer possibilities for “traversing the fantasy” that underlies moral codes and personal ideals, opening the path for a different relationship to one’s guilt, shame, and responsibility.

VII. Relevance to Contemporary Clinical Practice

Although Lacan wrote Seminar VII in a very different historical context, its implications for understanding moral injury in modern warfare (and other scenarios of ethical catastrophe) remain potent:

Ethical Confrontation: Clinicians who work with moral injury may find Lacan’s emphasis on confronting the Real helpful in moving beyond simplistic absolution or condemnation. Instead of trying to forcibly reconcile the patient’s actions with a stable moral order, therapy can encourage an acknowledgment of the fundamental rupture the soldier has experienced.
Listening to the Unspeakable: Lacanian-informed therapy often focuses on the patient’s speech, noting where language breaks down, stutters, or falters. These moments can be entry points to the Real. The therapist recognizes that moral injury is not merely a “cognitive distortion” but an actual collision with a dimension that is intrinsically un-narratable.
Reconfiguring Desire: Ultimately, in Lacanian psychoanalysis, healing is not about a tidy closure but about rearranging one’s desire and symbolic coordinates in a way that can accommodate the traumatic Real. The soldier might come to accept the irreconcilability of certain experiences yet find a way to live with that contradiction rather than be perpetually undone by it.

VIII. Intersection with Other Theorists

Freud’s Superego: The Freudian superego sets the stage for understanding the soldier’s intense guilt, yet Freud often frames moral conflict as an intra-psychic struggle without fully exploring the dimension of the Real that Lacan emphasizes.
Jared Russell on Sublimation: Drawing on Lacan and Laplanche, Russell sees moral injury as a breakdown in the cultural codes that shape subjectivity at an unconscious level. Russell’s insight dovetails with Lacan’s notion that moral injury reveals a gaping hole where cultural signifiers fail to hold. Sublimation may help redirect the aftermath, but it does not erase the Real.
Levinas and Ethics of the Other: While not a direct influence on Lacan’s Seminar VII, Levinas’s work also addresses encounters with otherness that escape standard moral codes. This resonates with Lacan’s Real, emphasizing an ethical demand that cannot be reduced to pre-established norms.

IX. Concluding Reflections

In sum, Lacan’s redefinition of ethics in Seminar VII makes moral injury comprehensible as a collision with an aspect of experience—the Real—that symbolic frameworks (cultural laws, communal rituals, personal beliefs) cannot fully tame. Particularly in wartime situations, individuals commit acts that split open the protective envelope of language and ideology, exposing them to the stark fact that they have done something that was both demanded and forbidden.

This paradox tears at the fabric of moral subjectivity, leaving the soldier (or anyone in a similarly agonizing predicament) with a haunting sense that something in reality forever eludes justification, forgiveness, or even coherent explanation. Lacan’s ethics asks: How does one confront this irreparable gap while refusing either to disavow it or to drown in guilt? The moral task, from a Lacanian angle, is not to patch the hole in the symbolic order, but to develop a new, perhaps humbler, stance toward a Real that can neither be undone nor fully understood.

By focusing on the place where language fails—where the logic of “right” and “wrong” collapses—Lacan’s Seminar VII offers a potent lens through which we can interpret and respond to moral injury. The “ethics of psychoanalysis” thus becomes less about imposing external standards and more about acknowledging an internal, often unbearable confrontation with something that shatters the known world, calling the subject to find ways of bearing this shattering without succumbing entirely to despair or self-annihilation.

In this way, Lacan’s concept of the Real deepens our grasp of why moral injury can be so devastating—and so resistant to neat solutions. By recognizing the dimension of experience that evades symbolic capture, clinicians and theorists alike can approach moral injury with greater nuance and respect for its gravity. Rather than seeking to eliminate guilt entirely or rationalize away traumatic actions, a Lacanian perspective points toward an ongoing, never fully resolvable negotiation with the Real, challenging the individual to forge an ethical stance amid the ruins of a shattered moral order.

Russell on Sublimation and Cultural Codes

Jared Russell’s study of sublimation and the superego—in Sublimation and Superego: Psychoanalysis Between Two Deaths—represents a thorough rethinking of how cultural norms and ethical injunctions come to shape our subjectivity at the deepest, often unconscious, levels. He extends earlier psychoanalytic theories, notably those of Freud, Lacan, and Laplanche, by arguing that moral injury can be most fruitfully understood as a breakdown or failure of the process by which cultural imperatives are symbolically mediated within the psyche.

Sublimation, Morality, and the Cultural Unconscious

Central to Russell’s argument is the idea that cultural ideals and moral codes function far less like rational guidelines that individuals choose to follow than like unconscious imperatives that shape our ethical being from within. Drawing on Freud’s notion of sublimation—the transformation of base or potentially destructive drives into socially acceptable or constructive forms—Russell highlights how moral and cultural values are absorbed and internalized long before a person consciously reflects on them. Indeed, we typically view ethical codes as sets of rules to be followed or broken, but Russell, building on Laplanche, emphasizes the more enigmatic way these codes infiltrate our inner world. We do not merely learn them the way one might memorize a legal statute; rather, they imprint themselves on our desires, inhibitions, and sense of self at a level beneath immediate awareness.

In this light, sublimation is never just an individual’s private capacity to redirect drives; it is profoundly interwoven with communal, historical, and cultural contexts. What a culture deems “sublime” or “noble” directly influences how individuals interpret and channel their instincts. The superego, as Freud posited, polices any deviation from these internalized standards through guilt, shame, or a sense of moral failing. Russell shows that these processes—sublimation and superego regulation—are not merely personal psychological mechanisms. Instead, they are also vehicles for enforcing and perpetuating cultural codes.

Unconscious Imperatives and Symbolic Mediation

When Russell speaks of a “failure of symbolic mediation,” he refers to moments or contexts in which the normally hidden workings of these cultural imperatives become painfully exposed or untenable. Under typical circumstances, an individual manages to organize contradictory moral directives into something akin to a coherent ethical self-image. But in extreme situations, the very signifiers that have structured the moral domain—prohibitions like “Thou shalt not kill”—are turned upside down. The result is an acute crisis: the subject discovers that the very culture that nurtured them and instilled its moral commandments can also suspend or invert those commandments under certain conditions.

Why call this a crisis of symbolic mediation rather than just a cognitive contradiction? According to Russell, the difference lies in how these moral precepts are not purely rational. They have become part of the individual’s deepest psychic life, occupying an ontological status that defines who they are or believe themselves to be. Thus, a breach in these codes is no trivial matter. It is not simply disobeying a rule or changing one’s opinion; it is a radical disturbance in the foundational structures that give a person’s life meaning and coherence.

The Double Bind of War

Russell’s analysis is particularly vivid when examining the context of war, which exemplifies this breakdown with startling clarity. A soldier might grow up in a society that stresses the sanctity of human life and enshrines “Thou shalt not kill” as a central moral tenet. This ethic is instilled from childhood, woven into cultural narratives about heroism, justice, and compassion. Yet, when called to arms, that same soldier finds that the cultural machinery now insists on violating this moral law: killing the “enemy” becomes not just permissible but necessary, even valorized.

The soldier is thus caught in a double bind. On the one hand, he has internalized the prohibition against killing as a core moral belief—an internal law policed by the superego, which triggers intense guilt or shame whenever that boundary is crossed. On the other hand, he must carry out lethal actions in the name of duty, patriotism, or group survival. The war condition effectively suspends the old law while simultaneously commanding the soldier to remain loyal to the larger cultural order. The contradiction here is not merely intellectual or emotional; it is ontological, as Russell would describe it, because it attacks the bedrock of who the soldier is as an ethical being.

From Contradiction to Ontological Crisis

This dissonance—the culture saying “do not kill” in normal times and “you must kill” in war—is more than a hypothetical puzzle. It places the subject in a predicament where the internal architecture of ethical identity is shattered. After all, these moral codes are not just rules that can be turned off and on at will; they are deeply internalized, affect-laden imperatives that shape every dimension of self-experience. When the soldier returns from war, these contradictory signifiers remain deeply engraved in the unconscious, setting the stage for guilt, shame, nightmares, and the persistent fear that one has irrevocably transgressed something sacred.

For Russell, moral injury arises precisely when these cultural codes—absorbed as unconscious imperatives—collapse under contradictory demands. The soldier’s moral identity, rooted in that intangible “do not kill” command, clashes with the actions demanded by war. This leads to a psychic disruption far more devastating than a simple logical inconsistency could explain. The subject’s ethical self is compromised, and no easy cognitive reframing can resolve the new chasm that has opened up between who the soldier believed they were and what the soldier has done.

Russell’s Unique Contribution

What distinguishes Russell’s perspective from other psychoanalytic or theoretical approaches is his emphasis on the ongoing, ever-evolving relationship between individual drives (as harnessed by sublimation) and the cultural environment that defines acceptable or heroic forms of expression. He compels us to see that moral codes are not stable or purely rational structures. Instead, they are mutable signifiers that carry profound affective weight, shifting across different historical or political contexts.

This view helps clarify why moral injury can be so difficult to treat through purely cognitive or behavioral interventions: the problem is not simply a lack of information or a maladaptive belief, but a fundamental crisis in how the individual’s desires, values, and identity have been formed by cultural expectations that later prove contradictory or impossible to uphold.

Implications for Clinicians and Social Theorists

Therapeutic Work: Clinicians must recognize that what initially appears to be an individual’s “irrational guilt” often reflects a collapse in the cultural signifiers they had trusted to guide ethical life. Therapy must therefore address the broader symbolic matrix—the cultural stories, communal rituals, and inherited moral traditions—if it hopes to restore or reconstruct an individual’s shattered ethical framework.
Collective Dimensions: Russell’s focus on cultural codes underscores that moral injury is never purely “personal” or “subjective.” It is also about a social community that sets forth conflicting moral imperatives and then disavows the psychic toll of those contradictions on its members.
Revisiting Sublimation: By placing sublimation in the context of cultural codes, Russell invites us to consider new possibilities for redirecting destructive impulses. Art, political activism, or communal acts of remembrance can serve as channels for working through the anguish of having committed—or been compelled to commit—ethical violations that once seemed unthinkable.

In sum, Russell’s analysis of sublimation and cultural codes offers a profound explanation of why moral injury manifests as an ontological crisis rather than merely a moral disagreement. When a society’s deepest imperatives are reversed under pressure—particularly in wartime—the subject who embodies both the prohibition and its suspension suffers a catastrophic breakdown in ethical identity. Russell thus provides both a diagnostic framework for understanding how and why moral injury happens, and a theoretical basis for imagining ways to restore coherence—whether through new forms of sublimation, communal acknowledgment, or the gradual re-symbolization of shattered moral imperatives.

Toward a Pragmatic Ethics of Care

Moral injury can be understood as a failure of symbolic mediation: an individual’s inner moral framework shatters in the face of actions or events that cannot be reconciled with previously held ethical codes. Whether it occurs in wartime, in settings of institutional violence, or in everyday life when moral norms are violated in extreme ways, the aftereffects include profound guilt, shame, and an existential sense of having betrayed oneself or others. Traditional psychoanalytic approaches, from Freud to Lacan, offer conceptual tools but often lack a concrete, “pragmatic” pathway for restoring the individual’s sense of ethical coherence. Hence, contemporary clinicians must weave together insights from these foundational theories with emerging ideas—such as Jared Russell’s nuanced approach to sublimation—to help patients navigate the difficult process of moral repair.

If moral injury arises from a breakdown of the subject’s capacity to symbolically organize or process moral conflict, then treatment must address more than fear responses or defensive structures. It must aim to rebuild the very architecture of the patient’s moral world. Neither a purely intrapsychic model (as Freud’s early focus on libido and superego alone might suggest) nor a purely structural one (as in Lacanian theory, which can sometimes veer toward abstraction) is sufficient. Instead, clinicians can use a threefold strategy: sublimation, which provides a channel for reworking destructive drives into constructive or creative expressions; symbolic re-narration, which offers a new narrative matrix for the patient’s shattered worldview; and communal support, which recognizes that moral frameworks are rooted in shared social bonds and cultural signifiers.

The following key therapeutic principles build on these overlapping insights. They illustrate how an ethics of care—grounded in psychoanalytic understanding yet open to communal and creative dimensions—can address moral injury in a thorough, integrated way.