Disrupted Moral Order: A Conceptual Framework for Differentiating Reactions to Loss and Trauma

Abstract

To discern what turns a child victim of war into a patient, categories relevant to a disrupted moral dimension were applied to play sessions of two groups of children. Both groups had experienced familial loss in the context of war but differed in their clinical status: 7 children (all boys), aged 3 to 10 years, had been referred for psychological consultation and 15 community-based children (9 boys), aged 4 to 6 years, had not been so referred. Both groups exhibited vulnerability and vigilance. Whereas community-based children re-enacted scenarios of parental loss, the loss of a rule-governed universe characterised the play of referred children. Roles of perpetrator, victim, and witness shifted rapidly as moral ambiguities permeated fragmented scenes. Retaliation fantasies were intense but attribution of blame uncertain. Ambiguity and secrecy distinguished parents' narratives in the referred group. The concept of disruption in the moral order as well as the social order was useful as a framework in distinguishing children of differing clinical status.