Psychiatry, Moral Worry, and the Moral Emotions

There has been increased philosophical, psychological, and, more recently, psychiatric interest in the moral emotions, most specifically the emotions of guilt, shame, regret, and remorse. Interest in these emotions has not been in their role as symptoms of a particular mental illness, but in their presence in everyday life and in their importance in defining our character and our very humanity. Moral emotions are those emotions that arise in the context of life experiences and daily choices that bear upon our perceptions of the rightness or wrongness of particular actions or inactions. Human beings have a moral scanner that constantly provides both a cognitive judgment and a feeling tone of ease or unease in the moral evaluation of life's moment-to-moment activities. This paper discusses the intersection of psychiatry and the moral emotions, providing case examples and a review of empirical studies to illustrate the relevance of patients' concerns about their moral choices to psychiatric evaluation and practice.