Category Archives: Psychology

Reading the bible through the lens of trauma?


What if you read the bible through the lens of trauma? Some are quite obvious–catastrophes are all throughout the bible. But are these stories of trauma in the bible merely keeping a record of it or attempts to deal with the trauma, to put the world back proper perspective after chaos?

Consider this 2015 video by Rev. Dr. Robert Schreiter entitled: Trauma in The Biblical Record. He gives some background about this newer way to read the bible through this lens and then ends with 3 examples. I’ve just ordered this book on the subject, but those wanting to jump ahead may wish to know about it as well.

 

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Filed under Abuse, American Bible Society, counseling, Doctrine/Theology, Post-Traumatic Stress Disorder, Psychology, ptsd, trauma

Can Mental Health Practitioners Predict Future Violence?


Yesterday, a gunmen killed five and wounded at least eight others at the baggage claim for a Florida airport. Initial news reports allege the shooter had recently experienced psychotic-like symptoms. I am sure that in the coming days we will learn more details about the shooting and about the recent history of the shooter. Among the details there will be plenty of questions. Did anyone know this might happen? Could someone—especially in positions of power (FBI? Mental Health?)—have prevented it by reporting or removing access to guns?

Of course, it is easy to ask these questions and develop opinions after the fact. And yet we need to ask them if there are possibilities to learn from possible mistakes. What follows attempts to give the public a brief but better understanding of risk assessment when mental illness and violence combine. (NOTE: this is not a comment on the above sad situation or those cases where violence is unrelated to mental health.)

A little history of predicting future violence

Violence risk assessment is part of the sub-division of forensic psychology and psychiatry. Expert witnesses are used in court proceedings to report on the existence of mental illness, the probability of imminent dangerous behavior, and the options for most effective/least restrictive treatment required to reduce illness and increase safety.

How do clinicians make these opinions? In the not-too-distant past, expert witnesses usually used their wisdom shaped by years of experience. Much to the chagrin of experts, it turns out that clinical intuition isn’t all that effective. For some professionals, it is little better than chance! (Interested readers can check out Monahan’s 1984 oft-quoted research quoted in this rebuttal article.) Other options include actuarial methods (collecting risk factors just like an insurance company does to determine how much to charge your 18 year old son for car insurance) and test data. Both of these methods seek to eliminate feelings in the decision-making process. Actuarial data can certainly help us. Knowing someone has a history of violence and criminal behavior helps us predict future behavior. Knowing someone has schizophrenia may slightly increase risk of violence, but no more than it would for those who have problems managing impulses. And this would not be a reason to lock someone up (though it may be a reason to limit access to handguns). Assessment tools filled out by the person suspected of violence have a couple of problems with them but the main one is that very few of the most violent have been identified in treatment as possibly benefiting from assessment. And when we do give these assessments, the data rarely is clear—this kind of response means they will be violent, this one means they will not. We’re far better at identifying “faking good” or “faking bad” results than we are in determining whether the results mean future violence.

The best assessment to date requires that we have adequate history, survey of known risk factors, interviews, and test data. But as I said above, if the person suspected has not been in treatment or has done well to present as being merely disturbed but not dangerous, what can be done?

One More Complication

In our current society, we believe deeply that individuals have the right to self-determination. This means they have the right to refuse treatment. This right trumps nearly every other value. It doesn’t matter if the treatment would really help. The person is permitted to refuse. The only exceptions are involuntary commitments to address imminent danger to self or other. And as soon as the danger passes, the treatment can be refused again even if the treatment might avoid a relapse.

Bottom line for Practitioners

We can do better in responding to risk factors that might lead some to violence. We can learn more about these factors. We can equally promote confidentiality and privacy for our most distressed clients and yet be quick to warn others when signs of imminent violence are present. We can ask better questions. We can use non-cognitive approaches to get a better picture of their internal experiences. And yet, we can only work with the information we have. Contrary to popular belief, we are not prophets. In addition, most of our outpatient clients are not even remotely dangerous (in 27 years of clinical work, I have only needed to report two clients for imminent risk to others).

What we can do is assert the need for better and more available treatment options.

Family members are really the frontline of help for most distressed individuals. They are more likely to hear the murmurings that might indicate violence. This requires greater public education about the nature of mental illness and violence risk assessment and the kinds of ways to respond. Church leaders can also be better educated as to what kinds of options are available for those parishioners who are struggling with similar kinds of emotional distress. Let us be willing to lead the way in educating our communities and churches about mental health challenges and healthy responses. If we did a better job surrounding those with severe mental illness (and isolating them less) we would likely have less mental health induced violence.

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Filed under counseling, counseling science, counseling skills, News and politics, Psychology, teaching counseling, Training, Uncategorized, Violence

Is your empathy really self-serving?


Empathy, or feelings of understanding or identification with another, seems to be a primary vehicle of human expression of love and compassion. In the world of therapy, empathy seems the foundation for all good counselor work. Sure, we can act in kind, compassionate, yet robotic ways but knowing that someone gets you and helps you is better.

But this begs two questions: Are empathy and altruism connected and parallel? And, is our empathy really self-serving? Taking the second question further, could our empathic responses be destructive to the very people with whom we want to help? Psychologist Paul Bloom thinks so (short video of his contra empathy point of view). While I think his argument against empathy is seriously flawed and really merely an argument against naïve, superficial, and self-serving do-gooderism–a significant problem in our society where we solve problems on emotion and often without taking the time to understand either cause or consequence–the bigger question is whether or not we ever really have concern for others outside of self-interest. And if we discover that all empathy is self-serving, does that deny the Christian virtue of self-denial and voluntary submission to others?

What is at the heart of our empathic, altruistic behavior?

We all have numerous instances where we have witnessed self-sacrificing behavior. The reason these instances stand out in our memories is that they are unusual and somewhat rare experiences. But consider the more run-of-the-mill expressions of empathy. You see a GoFundMe page for a friend in need and you give. Your church is seeking donations for Thanksgiving baskets and you buy groceries. Your neighbor is sick and you mow her lawn. Do we do these behaviors for them? Or do we do it, in large part, for ourselves?

Josh Litman’s paper “Is Empathy Ultimately Just Narcissism?” seeks to summarize the research literature about whether empathy and altruism are positively correlated and whether empathy is really about the other or about self-interest. His answer? Empathy and altruism may not be all that connected. Empathy is better understood as feelings of “oneness” or connectedness to the other. When I identify more with someone, I’m more likely to feel empathy and do self-sacrificial for them.

In conclusion, this paper defends a non-altruistic, egoistic strain of empathic concern. It might be heavy-handed to call it narcissism, but evidence has shown that empathic concern is certainly motivated by self-interested factors rather than selflessness.

Could this be the reason why more people changed their Facebook profile images to a French flag after the Paris bombings and far fewer chose a Turkish flag after the most recent airport bombing? Do we more closely identify with one group over another and thus feel more empathy and make more statements of support and care?

Does this proclivity to more strongly identify with some more than others reveal self-interest and self-concern? If so, does that make our caring of others all about ourselves and cause us to suspect the warmth and empathy we get from others?

So you, too, must show love to foreigners, for you yourselves were once foreigners in the land of Egypt. (Deut 10:19, NLT)

Oneness and love in the created and the Creator

I think empathy can be self-serving (I care for you because I want to be cared for) but I do not think it must be this way. Rather, I would argue that we have been designed to understand our world by means of our experiences. Because I understand what it could feel like to lose my home to a flood I am moved to donate time and talent to help rebuild a home. Because I see your humanness, I am able to empathize with your losses and then consider what possible ways I might respond.

Oneness does help us empathize. But empathy is not the same thing as love. True love, as an action verb, requires a willingness to expend self for the sake of another. True love enlarges the population you are one with. So, straight people find themselves in the experiences of gay people; Christians in the experience of Muslims; liberals in the experience of conservatives. True love moves beyond simplistic understandingfile-nov-02-12-21-19-pms with oneness and best reflects the character of God who self-sacrificially loves beyond measure, choosing to take up our infirmities as his own.

In your relationships with one another, have the same mindset as Christ Jesus: Who, being in very nature God, did not consider equality with God something to be used to his own advantage; rather, he made himself nothing by taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself by becoming obedient to death—even death on a cross! (Phil 2:5-8, NIV)

For we do not have a high priest who is unable to empathize with our weaknesses, but we have one who has been tempted in every way, just as we are—yet he did not sin.(Heb 4:15, NIV)

 

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Filed under counseling, counseling skills, love, Psychology, Uncategorized

3 negative consequences of having too many options


I prefer having choices to make over not having the option to choose how I spend my time. And yet, just like any medication you might take, the freedom to choose brings with it some potentially dangerous side effects. I’d like you to think about 3 and then consider a couple of modifications about how you make choices.

Consider the differences between choosing a mate today versus 50 years ago. According to Daniel Jones (listen at the 17 minute mark), in previous generations people chose mates from close proximity–from their block, building, or neighborhood. Now, we have endless choices if we are willing to use the Internet.  Consider the differences in choosing professions. In the past, your father was a farmer, you became a farmer. Now, not only can you pursue any career, you have to choose from endless post-secondary educational schools on your way to that career.

How can having choices/options lead to negative consequences?

  • Dissatisfied. You are always wondering if there is something better out there. Again, consider Daniel Jones as he discusses online dating sites,

“…it turns you into a flaky person who is always looking for something better, that can become a kind of mania…if you have a moment of boredom, you think there are 12 more possibilities in your inbox…”

Later in the same interview, Jones tells us that the issue of today is “not labeling relationships. Based on his college student interviews, many young people today are loathe to identify someone as their partner or lover. They tend to resist labeling someone as a boy or girlfriend. The failure to accept normal labels not only lead to potential of chronic dissatisfaction but also confusion–if you don’t know when a relationship begins, ends or what it is founded upon. It would seem that commitment to a relationship would suffer if it never is named as such.

Dissatisfaction leads to comparing self against others and both lead to depression.

  • Anxious. Coupled with the tendency towards feeling dissatisfied with life, more choices lead many to anxiety. What if I made the wrong decision? What if the next person I meet would make a better spouse? What if I’m missing out on something important? Continual choice and/or rumination over choices increases the sense of importance for the choices we have.

Anxiety leads to chronic stress and chronic stress begins to break down our immune system.

  • Fatigued (cognitive and emotional). We find ways to simplify life. A colleague of mine has a system to know what to wear each day so as to avoid the “What am I going to wear today” question. We (try to) put our keys in the same place to avoid the stress of looking for them every time we leave the house. When we live with too many open choices and options, we burn more glucose and our brains become less efficient. We numb our feelings or we become edgy.

Fatigue leads to poor decision-making (impulsive, reactive, unthinking). This is why we blow diets more at 10 pm than we do at 9 am. This is why those with addictions are more likely to use later in the day than early in the morning. When we are emotionally and cognitively fatigued, we are prone to feel greater anxiety and dissatisfaction. The “gift” of choice continues to give.

Can We Do Anything About This?

Now, rest assured that I am not advocating for life to return to a place of no choice (arranged marriage, one career path, etc.). Choice has enabled me to learn about myself and given me many wonderful experiences that as a boy growing up in Vermont I never imagined. But are there ways we can minimize the common negative consequences of too many choices?

  1. Examine your view of God’s will. I meet many people who fear making a choice God does not want them to make. They fear they will somehow end up on plan B of life as punishment from God. While there are many very black and white decisions (should I cheat on my taxes? Is it okay to kill my annoying neighbor?) most decisions are not that clear. What if most of your decisions are neither right nor wrong? Whether you go to university A or B, marry person A or B is less of concern for God than we might think. Typically God seems more interested in our motives than some of our daily choices. Consider seeing God’s will as guardrails on a road rather than a pinpoint decision.
  2. Limit your decision-making time. It can be a habit of some to mull over future decisions long before the decision needs to be made. Do you find yourself worrying about the challenges of next week? While it might seem wise to think through your decisions in a thorough way, anxious rumination is not helpful. Limit when you think about big ticket future decisions. For example, if you are considering a career change, set a specific time during the week to search out available options. Then, when you find your mind mulling over options outside that set time, you can say to yourself, “I’m going to think about that during the scheduled time, not now!” When you do make a decision, use the same technique to limit when you review/evaluate that decision, thereby limiting time for “what ifs.”
  3. Challenge post decision “if only” regrets. I made a major career decision 17 years ago. I chose to become a seminary professor over an Ivy League appointment. For the first few months at Biblical Seminary I found myself wondering if I had made the right choice. I imagine this was the result of financial struggles (the other job paid double) and the overwhelming stress of creating grad courses from scratch (the other job was something I had ample experience to do). So, I could easily see that I chose the harder job for less pay. That became the truth I believed for a bit. But, the real truth is that I chose a job that had immense freedom and opportunity for growth. I would not have been able to travel the world as I do now. Of course, I couldn’t know all that then. So, work to challenge your assumptions about the future. Yes, like me, you will grieve when doors close. But remember, God is at work in providing a future for you, even in tough locations and times.

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Filed under Anxiety, biblical counseling, counseling, counseling science, Psychology, Uncategorized

Alternative to talk or pharmacological therapies for depression?


For many of my clients, medications are necessary for their moderate to severe depression. With SSRIs or mood stabilizers, they are able to function at home and at work and can better benefit from talk therapy. But in every case my clients report side effects from their meds. It is always a bit of art-form to balance benefits and side effects. That is the world we live in and the best we can do now. One of the key problems with all psychopharmacological interventions is that drugs provide a systemic solution when often we may need a targeted approach. Consider a person with ADHD who takes a stimulant that will help them focus in class yet must deal with increased blood pressure, heart rate and potential for insomnia. The stimulant does not just target the frontal lobe but impacts the whole body.

Wouldn’t it be great if we could target an intervention to a particular part of the brain?

“The brain is not a bowl of soup and you add the chemical and you stir,” she says. “Chemicals work within networks, within systems, within pathways. And where in the brain a chemical may be working is as important as knowing what chemical you should use.”

I read the above quote in this news item about the problem of rumination in treatment resistant depression. Helen Mayberg, author of the above quote, is researching Broadman Area 25 and its connection to the problem of rumination–where a person struggles to turn off negative thoughts about self and the world. She and other researchers are wondering why some people do well with talk therapy while others seem not to benefit. Instead of looking at the possibility of a less helpful form of talk therapy, they wondered whether the problem is that the person cannot get away from their negative thoughts enough to engage in the work of counseling.

One of the interventions being tried is to practice disconnecting from ruminations by paying attention to what is going on in the present. To help with the learning of this skill one researcher is testing whether 5 sessions of having an electrode on your wrist create an itching sensation while the patient practices paying attention to a decreasing amount of electrical stimulation.

Sound crazy? It just might be. I am always wary of any “5 sessions or less” advertisement. But before we toss out the idea, if a targeted treatment could help turn down the volume on a rumination, wouldn’t that be a help to many?

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Filed under Depression, news, Psychiatric Medications, Psychology, Uncategorized

Useful Book on Narcissism


Craig Malkin of Harvard Medical School has written a popular, easy to read book on the topic of narcissism and its opposite end of the spectrum, “echoists.” Rethinking Narcissism: The Bad–And Surprisingly Good–About Feeling Special (Harper, 2015) is worth your read if you think you might be on the spectrum or if you live with someone who does.

In the beginning he sets out to destroy the myth that narcissism is always destructive and that all narcissists act the same. To help describe the continuum of egocentrism Malkin defines the low side as “echoists,” those who have too little of it who feel special in becoming invisible to others only known for the help they offer to others. Further, he also describes narcissism as something that may ebb and flow, rather than a consistent trait. Malkin describes the continuum well with many real life examples. With a better understanding of the spectrum, it may help us look more closely at less pathological forms of egocentrism and be less likely to lump everyone together.

Worried that you might be a narcissist? Want to see where you fall on the spectrum? Try out his assessment tool.

In his book he describes the root causes and the experience of being around subtle and extreme forms. Unlike other researchers, he outlines ways that egocentric people can grow empathy toward others. This idea flies in the face of conventional wisdom that a narcissist can never change,

The problem is we’ve all had it drummed into our heads that narcissist can’t change. They think they’re perfect just the way they are, the argument goes, so why should they even try? But unquestioningly accepting this idea backs us into an impossibly tight corner….We’ll fall silent or vent our anger, or…we’ll try a little of each. And none of these reactions will make the relationship any healthier

When we withdraw, by swallowing our words or walking on eggshells, we only strengthen people’s narcissism. In fact, echoists and narcissists often pair up to create a “love” that’s toxic to them both.

What can we do? For those who are not extreme narcissists, one way to encourage growth is to validate their experiences even while we say “ouch” letting them know we are hurt. Too often our anger or our silence is the primary response. While validation and pointing out our pain is not a guaranteed solution, combining validation plus vulnerability can enable some to experience compassion for self and other at the same time.

Check out the book!

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Filed under personality, Psychology, Uncategorized

Thinking about offering SKYPE counseling? Think twice!


There has been a lot of focus on telepsychology over the last decade. What started out being about counseling over the phone has morphed to counseling via the video chat, text chat, instant message, social media, and even in virtual settings with avatars.

At times it seems like the wild west, that anything goes without regulation.

But now, more counseling related associations have developed standards for telehealthcare delivery. And licensing boards are also beginning to restrict who can offer telecounseling. Did you know that Georgia only allows Georgia licensed mental health providers to provide telecounseling to its citizens?

Ken Pope has an excellent website listing many resources you will need as you consider what you might be allowed to do. He lists standards of care, recent professional articles, and links to state boards who are beginning to regulate telepsychology. I encourage anyone who currently practices “Skype” counseling (BTW, SKYPE is not HIPPA compliant), to become informed.

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Filed under christian psychology, counseling, Psychology

PTSD “A Disease of Time”


David Davies, part of the staff of “Fresh Air” on NPR, has conducted an 35 minute interview with David Morris, a journalist who was embedded in a unit in Iraq and who suffers from PTSD resulting from an explosion he survived. David has written a book, The Evil Hours: A Biography Of Post-Traumatic Stress Disorder. If you want to better understand the experience of PTSD and its impact on a person, you should listen to this show (or read the transcript). For therapists, Morris discusses his experiences with Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). He also describes the use of propranolol when repeating trauma stories.

Here’s a couple of my take-aways:

  • PTSD is a disease of time.

“…in some ways, PTSD is a disease of time. And a lot of people – PTSD is many things, but one of the things it is a failure to live fully in the present. And I think what happens a lot of times with traumatic – survivors of trauma is they have these compulsive returns to awful events, and they are unable to live in the now.”

  • The best treatment never removes all symptoms of PTSD

“The best we can do is work to contain the pain. Draw a line around it. Name it. Domesticate it, and try to transform what lays on the other side of that line into a kind of knowledge, a knowledge of the mechanics of loss that might be put to use for future generations.”

  • Honest reflections of the impact of PE and CPT (and why so many dropout from PE treatment)
  • Honest admission about the most common “treatment” of PTSD–alcohol (and evidence why so many end up abusing it!)
  • War traumatizes far too many but rape is 5x more traumatizing

[in discussing how helplessness/lack of control is a significant factor in the development of PTSD] “Yeah, the helplessness is one of the main predictors of who’s going to end up with PTSD and who doesn’t. And the idea that you have absolutely no control over your environment is very hard for people to deal with because, you know, you are basically completely helpless and unable to control your destiny and your survival….and that’s one thing I discovered in the book is I thought – you know, we sort of assume that PTSD is sort of the realm of soldiers and veterans, when in fact, the most common and most toxic form of trauma is rape.

…a soldier may have some control over his or her environment. They have a weapon with them; they can move; they can take cover. But oftentimes in the cases of rape, the victim is completely overwhelmed and trapped and cornered. And from the moment the attack begins, they are rendered almost completely helpless, which is interesting. And you see that in the diagnosable rates of who gets PTSD and who doesn’t. Rape survivors tend to have it almost 50 percent of the time, whereas your average war veteran – particularly for Iraq and Afghanistan veterans – the rate of PTSD diagnosis is more around 10 to 12 percent. So a rape victim – rape is, in a manner of speaking, five times more traumatic than combat.”

 

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How labels we use reveal self-deception


 

Someone sent me one of Ken Pope’s summaries of a recent essay about the differences in research findings when asking men if they have ever used force and held someone down during sex versus asking them if they had ever raped another person. You can read the original research he was discussing here, which is by some researchers at the University of North Dakota.

No, I’m not a rapist, but I have used force to make someone to have sex.

Let that previous line sink in a bit.  We’ll discuss it in a minute. But first, you might not want to read the article so let me tell you what the authors were interested in knowing. They wanted to know if there were differences between men who are hostile towards women and accept the label of rape and those who have used force but deny the label.

This allows us to test whether there are differences in men who do not identify with the “rape” label on sexual aggression surveys, although they have committed acts that would be defined as rape. Men who admit intentions to force women to have sexual intercourse only, but do not believe that this act constitutes rape, might not be primarily motivated by a desire to retaliate and overpower women. Their behavior could be guided by other factors in line with stereotypically masculine gender roles such as having a high desire for sexual activity, viewing sexuality as a competition and a way to gain respect among peers, and lacking consideration for women or viewing them as sexual objects. Therefore, we hypothesize that men do not endorse any intentions for sexual aggression will differ from the other two groups of men primarily on a dimension characterized by hostility toward women as the strongest loading factor. (emphasis mine)

What did they find?

As hypothesized, a sizable number of participants indicated that they might use force to obtain intercourse, but would not rape a woman. Men who indicate intentions to use force but deny intentions to rape exhibit a unique disposition featuring an inverse construct of hostility toward women but high levels of callous sexual attitudes (Check 1985). Given that hostility toward women involves resentment, bitterness, rejection sensitivity, and paranoia about women’s motives, we consider the inverse of hostility toward women in men that intend to use force to be indicative of an affable, trusting, and nonreactive affect toward women. When combined with callous sexual attitudes, we interpret this function as representing personality characteristics that might lend themselves to allowing men to not perceive his actions as rape and may even view the forced intercourse as an achievement. The primary motivation in this case could be sexual gratification, accomplishment, and/or perceived compliance with stereotypical masculine gender norms. The use of force in these cases might be seen as an acceptable mean to reach one’s goal, or the woman’s “no” is perceived as a token resistance consistent with stereotypical gender norms. While the ultimate outcome of either act constitutes rape, this pattern of results suggests that there might be different types of offenders with potential differences in underlying motivation, cognition, and/or personality traits.

So, not every rapist does so for the same motives (and therefore our interventions will need to be different). Some knowingly rape and are not self-deceived about their actions. Others who are willing to acknowledge “forceful intercourse” group reveal deceptions  (probably both in view of self and other) that enable rape to be considered something less than it really is.

Labels and what they may reveal

What labels do you use and what do they reveal about yourself and your proclivity to self-deceive? Here are some examples

  • I exercise (once in a great while)
  • I stand up for myself (I attack anyone who disagrees with me)
  • I used to struggle with porn (well, I look about once a month but I don’t think I will do it again)
  • I eat healthy (I’m obsessed with food labels)
  • I am good at doing my taxes (I underreport income)
  • I’m a Christian (I go to church but never really talk to God)
  • Let’s just call it sin rather than abuse (because I won’t accept my actions are abusive)
  • I need (I want/demand)

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Filed under Abuse, counseling science, deception, Psychology, Rape

Institutional betrayal: Secret ingredient to PTSD


We live in the world where human frailty and pathology is viewed in individual terms. When we see sickness we imagine that the person must have some weakness in biology, faith, or behavior. Rarely do we think about the role the system or community has played in the development of that person’s pathology. This is true when we think about a person diagnosed with PTSD. We therapists hypothesize about individual factors (personality factors, early childhood experiences (a slight nod to external causes) and neurobiological risk factors) and situation factors (the frequency, duration, and intensity of overwhelming trauma events) when we try to answer the “why” of the development of PTSD in a person.

The problem with this kind of thinking is that it fails to take into consideration of known research that suggests that environmental response to an individual’s trauma experiences may be a determining factor in whether PTSD or chronic traumatic reactions form.

In the most recent American Psychologist (2014, 69:6, 575-587), Carly Parnitzke Smith and Jennifer Freyd write about the concept of institutional betrayal. Traumatologists recognize Freyd’s name as the researcher who developed “betrayal trauma theory”, pointing to the especially toxic form of PTSD caused by those who were supposed to be safe and protective. These begin to examine “institutional action and inaction that exacerbate the impact of traumatic experiences…”

How can an institution betray a victim?

When a person trusts that a system designed to defend, respond, protect, or seek justice will do its job after an interpersonal trauma, and when that system either chooses not to respond (omission) or worse, chooses to lay blame at the feet of the victim (commission), institutional betrayal occurs. Examples include law enforcement accusing rape victims of “asking for it” with their clothing, church leaders allowing offender clergy to “leave with their reputations” or refusal to investigate a case of date rape when the reported offender is an important leader in the community.

In summarizing a couple of studies, Smith and Freyd point out that institutional betrayal after a trauma experience leads to higher rates of dissociation, sexual problems, and health difficulties. This is even more likely when the trauma takes place in an environment where protection of the members is trumpeted (i.e., church or military).

What are the common characteristics of betraying institutions?

Smith and Freyd note several characteristics found in institutions at greater risk for betraying members.

  • membership requirements to define in group identity. This produces a need for members to act in ways to maintain such an identity
  • Prestige (both leaders and institutions). Prestige produces both trust and fear, dependency and power
  • Priorities. “Institutional betrayal may remain unchecked when performance or reputation is valued over, or divorced from the well-being of members.” As the authors note, maintaining reputation as a priority will lead to neglect or attack of those who challenge reputation
  • Institutional denial. Blame a few bad apples, avoid institutional blame or responsibility

Those institutions that do make efforts to prevent abuse within its community may still yet fail to respond well. They may fail to use adequate screening procedures, normalize abuse, fail to utilize or follow appropriate response procedures, punish whistleblowers, and aid cover-ups.

What to do?

Smith and Freyd argue that transparency (about past actions/failures to act as well as power structures) and priority to protect the well-being of all members will move institutions away from the risk of betraying individual members. I would argue that the shift to protect moves from the institution as a whole to protection of the most vulnerable.

Let me recommend a few resources that have appeared here in the past:

  1. Diane Langberg’s 5 part video about narcissistic leaders and the institutions they lead. She too describes systemic narcissism.
  2. Why some spiritual leaders abuse (and systems allow it)
  3. Narcissistic systems
  4. Resources to combat narcissism one person at a time

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Filed under Abuse, personality, Post-Traumatic Stress Disorder, Psychology