We like to tell children who are despairing in darkness that there is no such thing as ghosts, that they are merely figments of our imagination. As a trauma researcher, writer, and therapist, I’ve come see that ghosts do very much exist—they exist when there is a concern that’s unresolved or a story left to be told. These ghosts indeed have a spectral presence: they whisper in our ears or appear in the dark corner of our eyes. They walk on our chest and tug on our conscience, begging not to be forgotten. And yet, sometimes all we want to do is forget these ghosts, because they are simply more than we can bear.

The number of “ghost stories” that have been shared with me over decades working in the field of moral injury is extraordinary. People who have betrayed their core values and sacred beliefs—whether intentionally, unintentionally, or unavoidably—felt great pain or harm, even devastation. They were racked with guilt, decaying from shame, questioning their goodness or self-worth, burying their ghost story in a shallow grave, swallowing the awful, suffering in silence, afraid to tell others of the “monster” they became or have become. For many people with moral injury, there is a profound feeling of being divided in their soul, which alienates them from life-sustaining relationships.

This is the experience of self-induced moral injury. Moral injury happens when a person’s core moral foundations are violated in high-stakes situations. This violation recasts the way they see themselves, others, and the world, and can cause changes in behavior that signal a loss of trust, connection, self-worth, and meaning. There is agreement that moral injury is multidimensional in nature—psychological, emotional, biological, social, behavioral, relational, and spiritual—and so, requires an interdisciplinary, integrated approach to healing.

Forgiveness generally, and self-forgiveness specifically, has been identified as an important component of healing moral injury. Forgiveness is a complex neurocognitive, affective, and spiritual process that has received much attention across disciplines and has been shown to have positive benefits for all aspects of health (Bremault-Phillips et al., 2022; Haikola, 2023). While past research has centered on studying other-related forgiveness, less has focused on self-forgiveness. As of this writing, no program for self-forgiveness exists that fully addresses the multidimensional, embodied nature of moral injury.

Introducing the 6-fold path for self-forgiveness

To fill this gap, I developed the 6-fold path to self-forgiveness (6-FPSF; DeMarco, 2024), an interdisciplinary, narrative-based healing writing process for the treatment of moral injury, particularly self-induced moral injury. The protocol draws upon theoretical literature, evidence-based psychological interventions, spiritual-oriented practices, creative arts, and somatic exercises for mental health counseling and spiritual/religious ministration. Among these include embodied disclosure therapy (EDT; DeMarco, 2022), adaptive disclosure therapy (ADT; Litz et al., 2016), narrative therapy (Freedman & Combs, 1996; White & Epstein, 1990) somatic experiencing (SE; Levine, 2010), and psychedelic integration models (Frymann et al., 2022; Siegel, 2010).

The purpose of the 6-FPSF is to transform self-condemnation, self-rejection, and self-estrangement that result from self-induced moral injury into self-worth, self-integration, and moral resilience.

The 6-FPSF is comprised of two phases, each with three components and goals:

Phase 1: Coming Into Awareness

1. Reckoning: Reckoning is a cognitive process of examining one’s conscience. The transgressor (or person looking for self-forgiveness) confronts, acknowledges, and takes account of the harm caused, openly, kindly, and with benevolent honesty. They also assess their part in the transgression, admit wrongdoing, and accept responsibility. Reckoning is an intentional move toward self-forgiveness by the person understanding what their own moral identity uniquely looks like.
2. Remorse: Remorse is an emotionally driven process of honest grieving, whereby a person metabolizes difficult truths; allows for and accepts unpleasant feelings, emotions, and sensations; appreciates the impact of the harm caused and values violated; acknowledges perspective shifts and relationship changes or fractures; and affirms that the pain they feel is actually a sign that their core values are still intact. They also bring awareness to “core wounds”.
3. Reconcile: Reconcile is a psychospiritual process that brings an end to hostility towards oneself and brings the person into harmony with others and the world. To reconcile, the person addresses internal dissonance (that is, feeling fractured), overcomes self-deception, acknowledges and accepts the limits of responsibility, honors the past, integrates painful memories into life’s larger story, and makes themselves available to a “moment of grace.” Reconcile requires dynamic balance, that is, maintaining a flexible, open, and accepting posture, and restoring a bond of trust, self-worth, and meaning.

Phase 2: Soul Remaking

1. Rectify: Rectify is a behavioral (action-oriented) process that works to fix what’s been broken and restore right relationships. Here, a person gives voice to the nature of transgression (as it is safe to do so), receives the response with benevolent honesty, makes amends if possible (and if not, makes a gift or ritual), finds new purpose, recommits to values, and explores harmful attitudes and beliefs. They also determine steps to avoid future harm and implement new boundaries. Rectify requires positive intention, that is acknowledging that the person is “acting in good faith”—with honest desire, pure motives, and goodwill—doing the best they can. Good faith is a mark of moral integrity.
2. Re-creation: Re-creation is an embodied process of integrating painful experiences as sources of wisdom and guidance and creating a new and coherent narrative. The person moves from self-estrangement to being “at home” in the world. They also embrace self-acceptance and self-compassion, pursue self-mastery and self-expression, and advocate for integrity and authenticity. Attending to personal growth and honoring their intrinsic self-worth is essential for Re-creation. Re-creation is akin to the Japanese art of Kintsugi.
3. Remain: Remain is also an embodied process, one that engages self-forgiveness as a “way of being.” It is more than an attitude, mood, or set of behaviors. Rather, it is a holistic felt sense and ongoing process of moral resilience (Rushton, 2016)—one that does not culminate as a final point on a spectrum, but abides sustainably in conscience, character, choice, commitment, community, and contribution.

As moral injury continues to gain attention, researchers and practitioners are increasingly calling for effective treatments that differ from those commonly used with PTSD, particularly those that overcome barriers to cost, accessibility, and stigma and directly address the self-blame, self-condemnation, and negative emotions that accompany moral injury. This is especially important given that research (Corona et al., 2019) has shown that perpetrating moral violations is associated with increased suicide attempts.

The 6-FPSF fills this vital need by addressing the multidimensional concerns of moral injury and the intra- and interpersonal aspects necessary to foster moral repair and moral resilience. The 6-FPSF was designed to facilitate self-forgiveness among those with moral injury and may be a valuable tool for re-establishing a person’s essential bonds of self-worth, trust, and life-sustaining relationships.