Moral injury in dementia caregiving: Unrepresented fields and the aesthetic formation of moral experience

This paper develops a psychoanalytically informed account of moral injury in dementia caregiving, conceptualized as a disturbance of moral experience arising within emotionally saturated care relations rather than from discrete ethical failures or traumatic events. Drawing on post-Bionian field theory, moral philosophy, and dementia-care scholarship, it argues that family carers’ suffering is shaped by the erosion of a sustaining ego ideal under conditions of compressed agency, diminished mutual return, and weakened symbolic recognition. As dementia advances, carers are repeatedly required to adapt in ways that undermine their capacity to recognize themselves within the moral image that has previously oriented their lives. These pressures often accumulate as unrepresented experience rather than as a reflective narrative. Moral injury is thus understood as a failure of symbolization within a complex social and institutional ecology of care. In this context, reparation depends on receptive attention to the carer’s aesthetic experience: the atmospheres, rhythms, scenes, and affective forms through which suffering first becomes perceptible and through which symbolic capacity may gradually re-emerge in support of a liveable moral position.