The Wound of Knowing: Scientists Propose Epistemic Moral Injury as New Trauma Category

For more than a decade, researchers studying moral injury have organized the field around three canonical pathways: perpetration, in which a person participates in an act that violates their deepest moral commitments; witnessing, in which a person observes such an act and fails to prevent it; and betrayal, in which a trusted leader or institution fails them in a high-stakes moment. A newly published theoretical article in Pastoral Psychology argues that this triad, while indispensable, may be incomplete. Andres Boaz Munoz Mosquera, a chaplain at Beverly Hospital and doctoral-affiliated scholar at Boston College, proposes a candidate fourth category he calls epistemic moral injury: a wound produced not by what a professional does or sees, but by what that professional is required to understand with intimacy in order to do the job.

The article, grounded in the author’s prior service as a counter-intelligence officer as well as in the scholarly literature on moral injury, moral distress and secondary traumatization, makes a deliberately modest but consequential claim. Existing typologies, the author writes, are necessary but insufficient. Some workers—intelligence officers, chaplains, clinicians, forensic investigators, journalists who must absorb atrocity at close analytical range—are structurally required to build deep cognitive and empathic models of harmful people and harmful systems. They must enter, mentally and relationally, into the logic of evil in order to anticipate it, contain it or report on it. That sustained cognitive intimacy, the paper argues, may injure conscience in ways that do not map cleanly onto perpetration, witnessing or betrayal.

Technically, the argument rests on a distinction between exposure and comprehension. Vicarious traumatization research, pioneered in the 1990s by McCann and Pearlman, described how clinicians’ cognitive schemas about safety, trust and intimacy shift after sustained contact with victims’ trauma narratives. Compassion fatigue, a term popularized by Charles Figley, captured the emotional depletion of caregivers. Moral distress research in healthcare, notably the work of Epstein and Hamric on moral residue and the crescendo effect, documented how repeated ethical constraints leave cumulative residue in clinicians. Epistemic moral injury, as Munoz Mosquera frames it, sits at the intersection of these literatures but is not reducible to any of them: the injury is not exhaustion, not schema disruption alone, and not the residue of blocked moral action, but the corrosive effect of being professionally mandated to know evil intimately while remaining unable to act on that knowledge in ordinary moral ways.

The paper develops four candidate mechanisms through which this injury might be produced. The first is instrumentalized empathy, in which empathic and relational capacities—the very capacities ethics requires people to preserve—are conscripted as tools of the mission. An intelligence professional who deploys what the literature on negotiation calls tactical empathy is, in a sense, weaponizing a moral capacity, and the author suggests that this instrumentalization may itself degrade the self. The second mechanism is sustained cognitive intimacy with evil: the long, deliberate study of cruel actors, which risks normalizing the logic of cruelty from the inside. The third is mandatory compassion suppression, in which institutions require workers to switch compassion off in circumstances where it would naturally arise, producing a rupture between professional identity and moral character. The fourth is relational duplicity under moral mandate: maintaining false relationships, cover identities or strategic deceptions for extended periods, which strains the truth-telling virtues that moral traditions from Aristotle to Aquinas have treated as constitutive of integrity.

What gives the article its distinctive texture is the way it frames these mechanisms theologically, through what the author calls pastoral inversion. Drawing on Emmanuel Levinas’s philosophy, particularly the concepts of le visage (the face) and le tiers (the third party), Munoz Mosquera argues that ethics traditionally begins in the encounter with the face of the Other, which commands a response. In professions that require knowing evil intimately, this structure is inverted: the professional must study the face of the perpetrator analytically while remaining obligated, simultaneously, to the third party—the victims, the public, those the work is meant to protect. This double obligation, held under conditions of secrecy and operational constraint, generates what the author identifies as a specific moral geometry of harm, one that pastoral caregivers need new vocabulary to address.

To anchor that vocabulary historically, the paper reaches into Christian intellectual traditions. It invokes the Thomistic concept of veracitas, the virtue of truthfulness associated with Thomas Aquinas, to analyze what sustained professional deception does to a person ordered toward truth. It draws on the ascetical and confessional precedents of the tradition, including the Spiritual Exercises of Ignatius of Loyola and the apophatic mysticism represented by The Cloud of Unknowing and analyzed by scholars such as Denys Turner and Andrew Louth, to construct what the author calls a structure-over-content model of care. The insight is elegantly practical: when a trauma survivor cannot disclose the content of what they know—because of classification requirements, legal exposure or protection of others—caregivers can still work with the structure of the wound, using apophatic, or negative, approaches that attend to what cannot be said rather than demanding that it be said.

The article does not stop at theory. It offers a five-domain taxonomy intended to organize the phenomenology of epistemic moral injury for future empirical work, along with four-step interim guidance for clinicians and chaplains who may already be encountering cases that fit the pattern. It also lays out a research agenda: the field now needs psychometric instruments capable of distinguishing epistemic moral injury from perpetration-based and betrayal-based presentations, validation studies across occupational groups, and intervention trials that test whether structure-over-content pastoral approaches outperform disclosure-dependent models for populations bound by secrecy. The author is explicit that these are proposals, not findings; the paper is a conceptual and theoretical contribution, written from the author’s personal professional experience and published literature, without primary data collection.

The broader significance of the proposal lies in how it repositions the boundary of trauma science. Post-traumatic stress disorder centers on fear-based fear circuitry and life threat; moral injury, as developed by Jonathan Shay, Brett Litz, Shira Maguen and colleagues in the military mental health literature, centers on transgression—of one’s own morals, or of others’ morals toward oneself. The Moral Injury Outcome Scale Consortium’s 2022 work in Frontiers in Psychiatry consolidated the syndrome around feelings like guilt, shame, betrayal and spiritual struggle. If Munoz Mosquera is right, a subset of suffering professionals experiences none of these pathways yet still presents with the hallmark cluster: alienation, loss of trust, meaning collapse and spiritual dislocation. Naming their wound would matter clinically, because interventions built around processing perpetration-related guilt may fail people whose guilt is epistemic—guilt about what they know, understand and can never unknow.

The paper also carries an implicit institutional challenge. If epistemic moral injury proves to be a real and distinct phenomenon, then intelligence agencies, courts, hospitals, media organizations and faith communities bear responsibility for the moral formation of the people they task with dark knowledge. Structured chaplain interventions for moral injury in veterans, already tested in trials by Koenig, Ames, Antal, Cenkner and their colleagues, suggest one template; the paper implies that similar structures—supervision that treats the knower as morally exposed, rotation practices, confession-adjacent safe spaces, and care models that do not require disclosure—should be designed for secret-keeping professions. The wound of knowing, the argument concludes, is real precisely because knowing is never morally neutral: to understand evil with intimacy is to let it touch the self, and a science of trauma that ignores that touch is describing only part of the human cost.

Subject of Research: Epistemic moral injury as a proposed fourth category of moral injury arising from mandated professional knowledge

Article Title: Epistemic Moral Injury: The Wound of Knowing

Article References: Munoz Mosquera, A. B. (2026). Epistemic Moral Injury: The Wound of Knowing. Pastoral Psychology. https://doi.org/10.1007/s11089-026-01369-w

Image Credits: AI Generated

DOI: 10.1007/s11089-026-01369-w

Keywords: moral injury, epistemic moral injury, trauma psychology, pastoral care, Levinas, apophatic theology, compassion fatigue, vicarious trauma, moral distress, chaplains, counter-intelligence, empathy