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To Your Health: Stress, anxiety and 'moral injury' among fishermen

The Maine lobster industry has a long history of sustainability practices and an ongoing commitment to right whale protections. When these practices and commitments are called into question, it’s not just a lobsterman’s business that is impacted — lobstermen are being harmed as well.

Over the past year, the Maine Coast Fishermen’s Association has been part of a partnership working on a podcast called Fishing Forward. Fishing Forward is inspired by fishermen, for fishermen, with a focus on health, safety, and staying shipshape in the commercial fishing industry. It is funded by the Northeast Center for Occupational Health and Safety and produced by the team at Coastal Routes Radio at the University of Guelph and Dalhousie University in Canada. Episodes include topics like sleep and nutrition and feature guests from organizations such as the Texas Shrimp Association and Newport Fishermen’s Wives Association.

While working on this project, I have learned many new things about both commercial fishing and health. One episode in particular has stuck with me more than all the others — Episode 11: Stress, Anxiety, and Moral Injury. Moral injury refers to the intense psychological distress which can follow actions, or the lack of them, which strongly clash with someone’s moral and ethical code.

Monique Coombs is director of community programs at the Maine Coast Fishermen's Association. M. Coombs photo.

For example, very often when people become doctors it is because they want to help other people. Unfortunately, though, over time doctors (and nurses and physician assistants) find themselves in situations when their desire to do the right thing is restricted by institutional or systemic constraints that force them to act in a way that is in conflict with what they feel is morally right. For example, being unable to provide someone the medication they need because of cost, being unable to spend as much time with a patient as they see fit because of scheduling requirements, or spending more time on paperwork than on important research can cause intense stress.

Since the 1980s, the term moral injury has been used to describe “an injury to an individual’s moral conscience and values resulting from an act of perceived moral transgression, which produces emotional guilt and shame, and in some cases a sense of betrayal and anger.” So, if a doctor is unable to do what they think best for a patient because of bureaucratic restrictions, they might suffer moral injury, especially when it happens repeatedly.

In Episode 11, Dr. Travis Hall, a New York clinical psychologist, explains how certain medical diagnoses like Post Traumatic Stress Disorder or generalized anxiety disorder reduce a person’s experience to a medical category, thereby negating their personal experiences and even alienating them. This limits how we understand someone’s suffering, and makes it seem as though the problem is because of the individual rather than the system in which the person exists.

The other thing that is important to note about moral injury, as Hannah Harrison, Fishing Forward podcast co-host, points out is that it “tends to be greatest in circumstances where a person has the least amount of power over the conditions in which they work.”

One way that fishermen exert control over their surroundings is to work harder. Hall talks about his experience working with the farming community: “Something breaks down, something goes wrong, you might have a week without sleep, but you know your work ethic and resilience and determination will get you through it. However, with the advent of issues that the farmer exerts no control over, working harder is no longer a viable solution, and in some ways contributes to the suffering," he said.

To be clear, I am not a therapist or psychologist, nor have I studied moral injury beyond research for my own understanding. When I first heard about moral injury, and then continued to read about it, however, its pertinence to the commercial fishing industry was obvious to me.

In a 2019 video from the Maine Lobster Marketing Collaborative, lobsterman Dwight Carver says, “None of us want to harm a right whale. That would be one of the saddest days of my life to come upon that.” Despite many lobstermen feeling similarly, and despite the Maine lobster fishery’s minimal risk to right whales, NMFS’s ten-year whale plan requires the Maine lobster fishery to reduce its risk by 98%, an untenable goal The plan will end the Maine lobster fishery but won’t save right whales.

Many Maine lobstermen say they are feeling burnt out about this issue, but it is not burnout. Burnout implies that a person feels overwhelmed because of their position and actions taken about a topic. Moral injury shifts the focus: the system is the issue.

Reframing this issue is important for the health and well-being of Maine lobstermen who care about marine species, who value a strong work ethic, and who have for generations been successfully conserving the lobster resource. Being a fisherman for most is not just a career but a way of life, fundamental to their identity. The right whale issue creates stress and a toxic atmosphere for fishermen who feel scapegoated and vilified, despite their lifelong dedication and commitment to the sea.

It’s hard to identify a solution to this problem. The commercial fishing industry is the seventh most regulated industry in the United States, with 13,218 restrictions as of 2014. That’s more than oil and gas extraction (11,955 restrictions) and pharmaceutical and medicine manufacturing (11,505 restrictions). Thinking about further restrictions is incredibly overwhelming to lobstermen. The reactions and emotions Maine lobstermen are having are completely valid and, as pointed out in the Fishing Forward podcast, are not going to be managed away with deep breathing and yoga.

Yet as Hall noted “Understanding that these events have a name — moral injuries — and that they can deeply affect fishermen seems like a good first step in addressing them.”

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