Category Archives: Post-Traumatic Stress Disorder

When someone you love suffers from PTSD?


Has anyone read this book? The full title is: When Someone You Love Suffers from Posttraumatic Stress: What to Expect and What you Can Do  (By Claudia Zayfert and Jason DeViva (Guilford Press).

If so, any thoughts on it? I do not yet have it in my possession. One of the areas I found wanting re: PTSD is a good book for spouses of survivors of sexual abuse. There was a book that I would use but is no longer in print. Some do read “Stop Walking on Eggshells”, a book about living with Borderline Personality Disorder. While there are relational behaviors commonly seen in people with either complex PTSD or BPD, the two problems are different and sadly, those with complex trauma reactions get stigmatized with the BPD label.

So, if anyone has seen this and wants to lend their comments, I would welcome them here.

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Filed under Abuse, Post-Traumatic Stress Disorder, Psychology, ptsd, Uncategorized

Safe churches for sufferers of PTSD?


A friend recently asked me about the characteristics of the kind of church someone with PTSD should seek out in looking for a safe place to heal. I’d like to ask that of my readers. What special characteristics might someone look for as a good church family when they suffer from hidden damage? If YOU were looking for a church and wanted to find a safe, compassionate, sensitive church, what would you look for? What characteristics would tell you that the church was what you wanted?

Preaching and teaching? Interpersonal characteristics? Resources? Characteristics of leadership?

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Filed under Abuse, pastors and pastoring, Post-Traumatic Stress Disorder, Psychology

Heal thyself? Do we have the capacity?


Those who follow the Christian faith wholeheartedly believe that God is the “great physician” and eschew the belief that humans heal themselves. As a result of this belief, Christians sometimes react rather strongly to humanistic language of “self-healing.”

But before you do, consider this: if we assume that God is indeed the creator of all things, then we must also assume he puts into place the many corrective features found in the body. The liver and kidneys remove toxins from the body; blood clots when we cut ourselves; we sneeze to get rid of irritants; we sleep to rejuvenate what has become run down. In better words, Richard Mollica says,

This force, called self-healing, is one of the human organism’s natural responses to psychological illness and injury. The elaborate process of self-repair is clearly seen in the way physical wounds heal. At the moment of injury, blood vessels contract to staunch bleeding. Chemical messengers pour into the tissue, signalling a multitude of specialized cells to begin the inflammation process. White blood cells migrate into the wound within twenty-four hours, killing bacteria and triggering a process of cleansing and tissue repair. A matrix of connective tissue collagen is then laid down, knitting together the ragged edges of the wound in a repair that may not be perfect but is highly functional. (p. 94)

He goes on to say,

The healing of the emotional wounds inflicted on mind and spirit by severe violence is also a natural process.

I find his writing on this subject rather helpful. Sometimes we look passively to God to resolve our traumas, as if it were entirely up to Him. Other times we either resist what we can do or attempt what is not healthy for us. Dr. Mollica (an MD) provides many examples in his book of how the body naturally tries to heal/respond to trauma (e.g., DHEA counteracts toxicity of too much cortisol), where the system goes wrong, and what we can do about it from a therapeutic standpoint.

Dr. Mollica is right in that our bodies are designed to respond well to traumatic experiences. However, I’m pretty sure he also agrees that we are not designed to do this unassisted. The community must participate in the process. We are social beings and thus our healing must be socially situated.

Two Toxins: Emotional Memory and Poor Storytelling

Part of the problem, says Dr. Mollica, is the emotional memory system. When we experience a trauma, our cortex forms declarative memories of the event. These are where we store the “facts” (where we were, what we felt, and how these events connect to previous experiences). But there is another memory system, one he calls “emotional memory” (p. 96). Declarative memory involves the cortex and hippocampus while emotional memory involves the amygdala.

The amygdala is the fear-response command center of the brain, and it does not wait around for the conscious mind, located in the cortex, to decide if a threat is real or not. The amygdala can activate an emergency response throughout the body within milliseconds by calling the stress-response system into play.  (p. 96)

Unfortunately, traumatic events can create emotional memories in the amygdala that keep on replaying and are difficult to extinguish over time. (p. 97)

Another toxin is the re-telling of the trauma story in a way that retraumatizes the victim. Dr. Mollica, in chapter 5, describes the problem of poor storytelling. Poor storytelling evokes only the trauma, the shame, the degradation experienced. Storytelling should cause us to form images in the teller and listener’s minds. These images need to symbolize the whole person/story and not only the most damaging details. The problem is we tend to tell stories that fixate on the intense emotions and thus elicit toxic emotions and maintain the experience that the trauma is still ongoing.

Many traumatized persons are plagued by the two poles of humiliation–sadness and despair on one side, and anger and revenge on the other. (p. 122)

Assisted Self-healing?

Mollica says, “A proper clinical approach to emotional memory avoids triggering the emotions stored in the amygdala and enables the cortex to assert conscious control over the recollection of traumatic events. (p. 97)

How do you do this? With the help of a storytelling coach, a person tells their story in a factual, direct, but not grotesque way that would cause the listener to turn away. Why does this matter? Because part of the healing process is to be heard, seen, and empathized with. Fixating on the most grotesque details only enhances the emotional memory system and pushes others away. Good storytelling still tells the truth but does so in a way that reconnects people with the world, enables them to feel sadness but in community with others, and helps them see that their lives are not solely defined by the traumatic events. Further, good storytelling points to larger values that are still held and not lost due to the evil done by others. Surely trauma does shape and change us. Recovery and healing to the point of living as if the event did not happen would be to live in a world of denial and self-deception. But good storytelling reminds us that we are not ONLY defined by and/or limited to being victims. And good storytelling reminds us of God’s sustaining power that is greater than those who can only destroy bodies.

Dr. Mollica summarizes this chapter this way,

Strong emotions comprise the traumatic memories that are imprinted in the survivor’s brain. One of the mind’s key tasks after trauma is to take these strong emotions and gradually reduce them over time through good storytelling. A poor storyteller tells a toxic trauma story, unhealthy to mind and body with its focus on facts and high expressed emotions. In our society situations that demonstrate this type of storytelling are common, including superficial, sensational media reporting of tragedies and debriefing therapy by misguided mental health workers. In contrast a good storyteller is able to express tragic emotions with the artfulness of a musician playing an instrument, engaging the listener’s interest and involvement. (p. 133)

I commend to you the book. He discusses both good and bad dreams, the role of “social instruments” of healing and a call to health. Very helpful book if you are interested in international trauma recovery.

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Filed under Abuse, counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd, Uncategorized

Whose shame do you carry?


Diane Langberg and I talked recently about the concept of shame. She mentioned reading an interesting mystery that had a couple of lines about shame that might be powerful imagery for some. The novel, C.J. Sansom’s Sovereign, is about a hunchbacked lawyer. About 200 pages in the lawyer has an encounter with King Henry the 8th. The King scorns the lawyer publicly for his hunch (at which everyone laughed).

His first reaction?

“Now I had met him. I felt for a second that he shown me what I was, an unworthy creature, a beetle crawling on the earth.” (p. 221)

Then anger arises in the lawyer. Why? for he recognizes the weight on him is not his own shame, but that of the king.

Whose shame do you carry? Most often we carry either the clear shame of our own misdeeds OR the shame foisted on us by the misdeeds of others. And it seems that the shame put upon us by abuse and maltreatment weighs us down the most. Often those who mistreat us do so in ways to make us believe that in fact we are worthy of shame or that they are righteous in their treatment of us.

What would happen if you saw it not as your own but thrust upon you by those who mistreated you? If you could hand it back (metaphorically), would your own back straighten? Would you feel less dirty and self-negating? If you suffer from shame due to mistreatment, try to imagine that the feelings are not yours but in fact the abusers.  Imagine what life might be like if you were to shed that shame that does not belong to you.

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Filed under Abuse, christian counseling, christian psychology, Christianity, counseling, Meditations, Post-Traumatic Stress Disorder

Listening to trauma


Those interested in trauma recovery work in international settings where rape is used as a tool of war will find this article on CNN to be of interest. WARNING: Not for those who are easily triggered by trauma stories!

Here’s a couple of reasons to read the article.

1. Why do this work?

They believe that listening is acknowledgement — and that acknowledgment is a kind of apology. Listening, they say, is the least the world owes.

2. Impact of this work?

You will experience secondary trauma. Don’t think you won’t.

3. How to do this work?

Start with an open question: Tell me about your experience. Look them in the eye. Don’t look at your notepad. If they say, “No, I don’t want to talk,” then leave. If they say, “Yes,” and tell you horrible things, wipe the emotion from your face. Get over being surprised they would tell a stranger, you, such intimate violations.

Know they are telling you because they need to tell someone, for whatever reason. And bearing that in mind, make no promises. Different victims want different things — revenge, financial compensation, asylum, prosecution of their attackers. Tell them that you can only listen, and do only that.

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Must Read: Diane Langberg on “Trauma as a Mission Field”


My supervisor, mentor, and colleague, Dr. Diane Langberg has been telling us for some time that “trauma is the mission field of our time.” Recently, however, a few Christian NGO/Missions leaders have heard this line in one of her talks and have become electrified by it. I cited it last week in a board meeting at Biblical as I was trying to make the case that developing postgraduate trauma training at Biblical fits our mission: following Jesus into the world.

But, some of you have not heard her give one of these talks. For you, I point you to the World Reformed Fellowship website so you can read a report she made on June 5 regarding the problem of trauma and the opportunity of the church to have a hand in healing this man-made scourge. Below is an excerpt of that short report. Do go to the WRF link and read it in its entirety. The report is not long but it is powerful and includes a couple of specific comments from two leaders in Africa.

We are the church. That means we are the body of Jesus Christ and He is our Head. In the physical realm, a body that does not follow its head is a sick body. That is also true in the spiritual realm. We are His people and I believe with all my heart He has called us to go out of ourselves and follow Him into the suffering of this world bearing both His character and His Word. And we do go – we send missionaries and the Scriptures; we provide food, clean water, education and jobs for many. And we should. We have rarely, however, seen trauma as a place of service. If we think carefully about the extensive natural disasters in our time such as earthquakes, hurricanes and tsunamis and combine those victims with the many manmade disasters – the violent inner cities, wars, genocides, trafficking, rapes, and child abuse we would have a staggering number. I believe that if we would stop and look out on suffering humanity we would begin to realize that trauma is perhaps the greatest mission field of the 21st century.

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Filed under Abuse, christian counseling, christian psychology, Christianity, Congo, counseling, counseling skills, Diane Langberg, Great Quotes, missional, Missional Church, Post-Traumatic Stress Disorder, Rwanda

Healing, recovery, restoration and other words for “getting better”


Recovered. Healed. Better. Restored. Resolved. Whole. What words do you use when describing positive change regarding traumatic events like abuse, the pain of adultery, or other like experiences? And more importantly, what do those words convey to yourself and others?

Why am I thinking about this? Soon, I will begin teaching an on-line summer class called “Healing Trauma in International Settings.” To be honest, I’m a little uncomfortable with the title I chose. Words matter and “Healing” conveys a message. Imagine replacing “healing trauma” with

Trauma treatment

Trauma recovery

Trauma care

Now, maybe I’m being overly sensitive but consider some of these other kinds of problems we face

  • You break your tibia during an aggressive move on the basketball court. Your leg heals and you go back to your basketball playing. Here we use healing to denote that you regained your former capacity to play sports. You are back to normal or near normal.
  • You cut your finger while slicing vegetables. You go to the hospital to get stitches. While you have a scar, your finger heals and you use it again. In time you have only a slight scar to remind you of that day.
  • Your house sustains a fire. You lose belongings. Your insurance company restores your house and replaces your possessions.
  • Your car is stolen. The police recover it and return it to you (with fuzzy dice attached)
  • You have a protracted conflict with a family member. At some point, you have a heart to heart and resolve your differences.

My examples all convey a resolution of a problem where the problem recedes, maybe even disappears. But what about trauma? Is there a form of resolution and healing of rape or sexual abuse or domestic violence where the memories disappear? Should there be? Wouldn’t forgetting these experiences place the person in danger of living in unreality and, in some cases, at risk of re-injury? Here are some important questions:

  • What does healing from an affair look like? How do you know you have “recovered”? What symptoms or experiences would remain?
  • What does healing from a rape look like? What would be expected if you “pretty well recovered”? What is to be expected to not change?

As a counselor I do not want to under or over-sell the recovery process. Victims do find tremendous healing but to assume all vestiges of a traumatic experience go away would be false. Unfortunately, we who have not been traumatized sometimes expect the kind of recovery where victims go back to a way of life and thinking as if the trauma never happened.

If we are honest, we wish to live in a world without lasting consequences from sin and suffering.

We want people to “get over” their pain and go back to a way of life as if it never happened. It would be like asking a person who lost a leg to hope they will run exactly like they did before losing the leg. Indeed, they may run again. But never as fast and never as easy. There will be a stump to care for, a hip to learn new motion, phantom pains to re-interpret, and limits to accept.

This world of limits is one God wants us to live in and one we detest. Our first parents saw the limits of their wisdom and desired to get wisdom on their own. We too love the happily ever after story where humans obtain health and healing apart from limitations. We tell the stories of miraculous healing as if we no longer live in a broken world.

Let us endeavor to tell true stories of healing that glorify God and remind us that we depend upon him for every breath.

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Filed under Abuse, adultery, biblical counseling, christian counseling, christian psychology, Christianity, counseling, Post-Traumatic Stress Disorder, Uncategorized

Last Reminder! Sign up now for our Sex Trafficking and Sexual Abuse Conference


Biblical Seminary’s March 17-19 conference on sex trafficking and sexual abuse in Christian communities is filling up. We have space for only 400 attendees. You do NOT want to miss a chance to interact with Dr. Diane Langberg, Bethany Hoang (IJM), Pearl Kim (ADA of Delaware Cty), and Robert Morrison (founder of FREE). If you have been thinking about attending this conference, sign up now. All the information you need about who, what, when, and where is found here. Registration is free and those who would also like academic credit or CEs can see what additional costs and work are required can use the previous link to get more information.

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Filed under Abuse, Biblical Seminary, christian counseling, Christianity, Post-Traumatic Stress Disorder

Additional information on the March 2011 sex trafficking and abuse conference at Biblical Seminary


I’ve mentioned the conference before here on this site. But here is additional information for those considering the conference in order to acquire either graduate academic or continuing education credit.

NOTE:

  • Conference dates: March 17-19
  • The conference is free for all attendees, only those who want CEs or grad credit will have to pay a fee
  • A PDF of the information below is available here: Please pass on to anyone who might be interested.

Continuing Education at Biblical Seminary

March 17-19, 2011

The Biblical Call: A Christian Response to Human Trafficking and Sexual Abuse[i]

Mental health professionals and clergy interested in attending this seminar may be able to acquire 10 contact hours of continuing education by attending this conference. Biblical Seminary is an accredited graduate institution and thus is qualified as a pre-approved provider of continuing education in the form of graduate coursework by Pennsylvania’s State Board of Social Workers, Marriage and Family Therapists, and Professional Counselors47-49.36) and Pennsylvania’s State Board Of Psychology41.59). (Attendees who wish to receive academic credit should follow directions in the footnote below.)

While Biblical Seminary provides verification of attendance and a transcript showing completion of the CE course, attendees are responsible to verify acceptance of these hours by their particular licensing boards prior to registering and paying for CEU credits.

The following information may be used to apply for approval to your licensing body.

Speakers:

Diane Langberg, PhD; Bethany Hoang, MDiv; Pearl Kim, JD; Robert Morrison, MBA; Philip G. Monroe, PsyD

Seminar Overview:

This conference continues the “Conversations on Christianity and Culture” series focusing on sexual violence and injustices in a variety of contexts: domestic and international settings and sexual abuse in Christian communities. Attendees will explore these issues from biblical, psychological, legal, and sociological perspectives. The conference will conclude with a focus on practical intervention and prevention strategies.

COST:

The conference is free for all attendees. Register here. Those who wish to receive CE credits will be charged $20.00 per CE unit (0-9 credits) or $180.00 for all 10 CE units. Attendees will be billed following the conference and certificate of attendance will be held until payment is received.

Educational Objectives:

  1. Become familiar with the psychological and sociological data regarding domestic and international trafficking phenomena and also sexual violence within Christian settings
  2. Describe common community and individual consequences resulting from these sexual traumas
  3. Consider biblical and theological factors relating to sexual violence
  4. Identify effective and practical interventions as well as preventative actions to treat and stop sexual slavery and sexual violence

Tentative Schedule:

Thursday, March 17

Speaker Title Time length
B. Hoang Biblical Call: Response to Violence (obj. 3) 1:15
D. Langberg Biblical Call: Global Violence against Women and Children (obj. 1-3) 1:15

Friday, March 18

Speaker Title Time length
B. Hoang International Human Trafficking (obj. 1) 1:15
D. Langberg Domestic Human Trafficking (obj. 1) 1:15
Breakout Sessions (choose two as each session is repeated; total length: 2:30)
B. Hoang Follow up from morning session (obj. 3) 1:15
D. Langberg Follow up from morning session (obj. 1-3) 1:15
P. Kim Spiritual Warfare and Criminal Prosecution (obj. 3) 1:15
R. Morrison Mobilizing all Christians in Effective Action Against Human Trafficking (obj. 4) 1:15

Saturday March 19

Speaker Title Time length
D. Langberg Sexual Abuse in Christian Organizations (obj. 1-4) 1:00
Panel (all speakers) Panel Discussion (obj. 1-4) 1:30

[i] This course is also available for one (1) academic credit. Credit students will be required to complete additional readings and coursework after the seminar. Those interested should view the course syllabus on our school’s website and complete a brief, online non-degree application. Cost for a one credit course is $447.

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Filed under Abuse, Biblical Seminary, christian counseling, christian psychology, counseling, counseling science, counseling skills, Post-Traumatic Stress Disorder

Edna Foa and prolonged exposure therapy


Happy New Year everyone!

Check out the Philly Inquirer today (Sunday) for a lengthy piece on Dr. Edna Foa and her creation of prolonged exposure therapy for PTSD victims. It gives nice background info on her and how she came to transition from work with children to adults with anxiety disorders. This is the treatment that is used at UPenn in their treatment of war vets. While this treatment won’t work for everyone, many with OCD and PTSD could be vastly helped with this treatment.

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Filed under Anxiety, Post-Traumatic Stress Disorder, ptsd