Over at the faculty blog at www.biblical.edu I have this first post of two on the topic of how our bodies influence our behavior. I raise two questions:
1. Can our bodies cause us to sin?
2. If so, are we responsible or culpable?
Category Archives: Psychology
Can your body make you sin? Post on www.biblical.edu
Filed under biblical counseling, Biblical Seminary, counseling, Psychology
Depression and your internet usage?
Have you seen news articles suggesting that one might be able to predict depression on the basis of how you use the Internet? If not, read about it here in a very brief essay. Bottom line, the study may find that depressed college students use more P2P (peer-to-peer) file sharing than their non-depressed counterparts. The depressed group may also do far more application switching (e.g., check email, look up sports scores, open other apps, etc.) suggesting an appearance of bored surfing for something to stimulate them out of their negative mood.
On the one hand, these possible results make some sense. Depressed people may be looking for stimulus and social connection to raise their mood. They may have less focus on more mindless activity on the net. However, as this essay reminds us, there are a number of problems with the research that show up in many of the “newsy” items that show up on the Internet or on television news.
Despite the caveats we must place on such “news”, it does provide a great opportunity for each of us to evaluate our Internet habits.
What are we doing on-line…really? What do our habits say about what we are looking for, desiring, etc.? What are we avoiding while we are on-line? What are we trying to fill?I can tell you that my usage, at times, tells me I am not wanting to engage some bit of work that I have on my plate. Far better to check email than to write a difficult section of an upcoming lecture. Far better to read an important blog than to go talk to my kids about something that I’ve been avoiding. Or…so it seems at the moment.
What does your Internet usage tell you about you?
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Filed under counseling, counseling science, Depression, Psychology
Psychology and the Sandusky trial: Assessing Histrionic Personality Disorder
A short news article (found here) tells that Jerry Sandusky is to be evaluated for a personality disorder today by a prosecution psychologist. Jerry is on trial for some 50 counts of child sexual abuse. The article says that the defense team plans to argue that Jerry has Histrionic Personality Disorder and that explains his verbal and written behavior with the boys who are accusing him of abuse–rather than see those same behaviors as attempts to groom the boys.
Just how will a psychologist go about determining the presence of HPD? In a non-forensic setting, a psychologist would attempt to determine the presence of a personality disorder by gathering several kinds of data
- clinical interviews (including the Structured Clinical Interview for DSM Disorders (SCID-II))
- Review of prior records (if any exist)
- Possible interviews with significant others
- Personality tests such as the MMPI-II and the Millon Clinical Multiaxial Inventory-III
However, there is a problem with the forensic (criminal court) setting. The problem is this: if the defense believes such a diagnosis will help their case, it stands to reason that they could easily coach their client to answer questions (whether interview or objective testing) in such a way as to ensure a positive diagnosis. It doesn’t take a rocket scientist to figure out how to present or which questions need to be answered in a particular way to meet the criteria for HPD, or any other diagnosis.
So, what is a forensic psychologist to do? Check for malingering. Some who try to fake a particular diagnosis tend to overdo the fake. The MMPI-II, for example, has some capacity to assess for those who answer in a particular way in an attempt to fake mental illness. There are a few other tests that work very hard in assessing malingering. Even so, it will be one psychologist’s clinical judgment against another’s.
Does it matter?
Not really. What is on trial is whether Sandusky committed acts of child sexual abuse. Either he did or didn’t. The only way the HPD diagnosis will work is if the jurors believe that Sandusky is only misunderstood–that he never touched a child in a sexual way but was over-emotional in his attempts to garner the kids attention. It is possible that Sandusky does meet criteria for HPD and abused the boys. The diagnosis will not protect him from the consequences of crimes he may have committed.
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Filed under Abuse, Psychology
2 Reasons Why Every Church Needs an Abuse Response Plan
We all know that we shouldn’t wait until our house is on fire to purchase insurance on our home. We all know that a will is necessary before we die. But, do you know that most churches do not have any plan to deal with an allegation of child or adult abuse? While no plan is foolproof and almost every abuse allegation contains unique features requiring difficult decision-making, a basic plan usually contains directions for who will make sure plans are carried out and how the church will handle both victim and offender.
Why Don’t Churches Have a Plan?
Maybe one of the reasons many churches fail to have a plan is that they aren’t really convinced a plan is central to the work of the Gospel–as central as a doctrinal statement or the preaching of the Word. Maybe such a plan is seen as a necessary evil like unto car insurance, something you know you should have but are annoyed to pay such a large bill even though you haven’t needed to use the benefit.
2 Better Reasons!
Read my faculty post here over at www.biblical.edu for 2 Gospel reasons why every Christian organization needs an abuse response plan.
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Do your labels help or hurt?
I have a post over at the Seminary’s faculty blog today. You can find it here.
Counselors label all the time. Even when we don’t offer official DSM diagnoses, we label things as good, bad, healthy, unhealthy, dysfunctional, sinful, etc. The key question counselors face is WHEN and HOW to share their views on a subject. Just because we can see something is wrong doesn’t mean we ought to share it yet. While you may wish your family doctor to share suspicions of Lyme’s disease with you on the first visit, your counselor may need to earn the right to say, “I think you have become embittered over your husband’s insensitivity.”
If you are in a position of authority (parent, teacher, boss, counselor, leader, etc.) consider how quickly you use labels and whether or not they invite dialogue and action. If the result of our labeling is increased passivity in the one being labeled, then maybe we need to consider that our labeling is part of the problem.
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Validating your client’s distrust of you
Ever had a person tell you they can’t trust you when you know they can? What was your response? if you are like most people, you notice the tendency to want to defend yourself. No, really, you can trust me. Why don’t you give me a chance? Or maybe your response isn’t one to beg but to back away and treat the person with a cool demeanor.
What should counselors do when a client doesn’t or won’t trust their intentions or motivations?Janina Fisher (see previous post) reminds us that the right responses is…acceptance validation. Especially with clients who experienced invalidation in violence and abuse. Notice that the effort to press a client to trust you or distancing from them sends the exact same message: your feelings and experiences are wrong and something to be rejected. Not surprisingly, clients feel invalidated once again.
What does validation look like?
You are right. You don’t know if you can trust me. Trusting important people meant that you got hurt in the past. So, not trusting me is understandable. So…what should we do? Validation doesn’t mean that we agree with whatever our clients say but that we find the truth and we underline it. Further, it means that we give the power back to our clients since many of them experienced being controlled.
Too often we think we know what is best for our clients and we try to indoctrinate them to our wisdom. Even when we are right, our efforts may unwittingly re-enact the stealing of power to set proper boundaries. Even when our clients want us to convince them that we are okay and worthy of trust, we ought to be careful. In everyday life we have to trust others, live with the possibility that our trust may be violated…and that we will need to respond to such violations with grace and truth. Promises to always be trustworthy perpetuate the myth that protection from all pain is possible in this life.
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eye contact and amygdala stimulation?
I’m in the midst of a CE training by Janina Fisher–Traumatic Attachment & Affect Dysregulation–and here is something she just said (not quote…my recollection),
When you make eye contact with another, you stimulate the amgydala. The arousal of this part of the brain arouses emotions, especially those connected with desire for or fear of intimacy. The point is that eye contact stimulates the attachment system which in turn plays on our feelings about being in relationship with others.
Later, she quoted someone (named Benjamin), “To be known or recognized is immediately to experience the other’s power. The other becomes the one who can give or withhold recognition: who can see what is hidden; who can reach, conceivably even violate, the core self.”
Thus, some clients (those who are ambivalent) find our “seeing them” (via empathy) as anxiety provoking. Counselors do well to help the client notice these reactions without over-stimulating reactions (which likely would trigger fight/flight reaction).
How you feel about making eye-contact with another depends largely on (a) how you feel about that person, or (b) how you feel about yourself. Both feelings depend on prior experiences and perceptions of self and other.
Try out a few moments of eye contact, either with someone you have authority over (supervisee, child, student) or someone who has power in your life (spouse, boss, teacher). What reactions did you have? Reactions in your body, thoughts, feelings? What impulses did you have? What does this tell you about how your brain works in regard to knowing and being known?
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Filed under counseling, counseling science, Psychology, Uncategorized
Why is some trauma complex? A helpful distinction from Judith Herman
Counselors talk about trauma as if all traumas lead to traumatic reactions. They do not. Some people have significant distress from what might be considered slight traumatic experiences (surely an oxymoron!) while others appear not have any negative or ongoing reactions to very large distressing events.
There’s another problem. We sometimes talk as if all traumatic reactions are the same. This is also not the case. While the symptoms of posttraumatic stress disorder (PTSD) are well-known to many (i.e., intrusive re-experiencing of trauma experiences, emotional numbing and other attempts of avoiding memories or triggers, and hypervigilance), you can find counseling students and practitioners who are less aware of a cousin of PTSD: Complex Trauma.
Defining Complex Trauma
I’m reading Treating complex Traumatic Stress Disorders: An Evidence-Based Guide, edited by Christine Courtois and Julian Ford (Guilford Press, 2009). This is an excellent text if you are interested in exploring the symptoms, neurobiology, and treatment protocols for complex trauma. In the foreword, Judith Herman helps the reader clarify the main difference between regular and complex trauma
These days, when I teach about complex PTSD, I always begin with the social ecology of prolonged and repeated interpersonal trauma. There are two main points to grasp here. The first is that such trauma is always embedded in a social structure that permits the abuse and exploitation of a subordinate group… The second point is that such trauma is always relational. It takes place when the victim is in a state of captivity, under the control and domination of the perpetrator. (xiv, emphases mine).
For trauma to become complex one needs to experience the trauma at the hands of those who are most perceived to control a social unit (family, community, etc.). It needs to be repeated and woven into the fabric of distorted relationships. You can see that prolonged abuses experienced as a child prior to development of an understanding of the world and of the self would have more devastating impact than an unfortunate and distressing event that happens as an adult. If I experience a horrific accident and an unexpected attack by a stranger, I would not, usually, begin to feel unsafe amongst friends and family. I would likely continue to trust them even as I might not trust the larger community. However, if I experience repeated abuse by a teacher, a parent, a relative, a church leader as a young child, I do not have the prior experiences of safety to rely on and thus, I am likely to experience all of the symptoms of PTSD and then some more.
What More Symptoms?
Courtois and Ford give a cursory description of complex trauma on the first page of the book,
…involving traumatic stressors that (1) are repetitive or prolonged; (2) involve direct harm and/or neglect and abandonment by caregivers or ostensibly responsible adults; (3) occur at developmentally vulnerable times in the victim’s life, such as early childhood; and (4) have great potential to compromise severely a child’s development.
Adding to the typical symptoms of PTSD, complex trauma victims also struggle to regulate emotions, impulses, somatic experiences, consciousness, and evidence significant distortions in views of the self and others leading to difficulty forming trust relationships and finding meaning in life and faith.
Those interested in learning more about the current thinking on complex trauma conceptualization and treatment may find this book useful. Others may wish to check out the latest articles at www.traumacenter.org, one of the leading centers in the country focused on the problem of trauma.
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3 important goals for trauma recovery
In the last week we have been discussing the best words used to describe the process of trauma recovery (see related post below). While words are important and carry much meaning, it may be more helpful to consider what recovery goals are in order for trauma victims. While we know recovery road can be long and arduous, it helps to know when we make progress and a general sense of the direction we are headed. In the days before GPS, if you went on a long car trip you probably consulted a map on several occasions in order to make sure you were headed in the right direction. So also, when you are working to get better after a traumatic experience, you want some sense you are still working on good goals. This need is especially great if the traumatic symptoms are complex and the treatment not brief (think war, genocide, child sexual abuse, etc.)
What three goals?
Esad Boskailo, as noted on p. 94 in his memoir (written and reported by Julie Lieblich) works toward these three goals that in turn support the ultimate goal: thriving (notice that the goal is not being free of symptoms, free of triggers, or back to life as if the trauma did not happen).
- Acknowledge losses
- Foster resiliency (i.e., build the capacity to use current coping resources)
- Find meaning in life again
I think these do function well as helpful signposts or intermediate goals in the process of recovery from traumatic experiences. Now, I don’t believe these goals are necessarily in sequence. For some clients, they stumble on something that gives new meaning to life and thus are better able to acknowledge losses. Others get to work on building better coping mechanisms (e.g., a vet puts away items that cause him or her to dissociate, an adult victim of CSA stops cutting and develops acceptance strategies, etc.) and then can acknowledge losses.
So, in the murky water of therapy (and it surely is murky!), the trauma victim can find some comfort in activities pointing to these intermediate goals. Each day they reject self-condemnation for not being who they used to be before the trauma, they are moving toward thriving. Each day they embrace available coping resources (e.g., a friend who will call or pray), they are moving toward thriving. Each day they find one meaningful experience, they are moving toward thriving.
the how we meet these goals is, of course, the 64,000 dollar question…and not something we can set in stone. I will write on some general activities that are common in most treatment modalities in the coming days.
Related articles
- Trauma recovery? Healing? Integration? Which words communicate a good outcome to you? (wisecounsel.wordpress.com)
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In Counseling, Who is the Teacher?
Most counselors and therapists get into the field of counseling because they want to help people. This is a good thing! Imagine if they only wanted to make money or to be the center of attention. But, underneath the goal of wanting to help people lurks an insidious goal:
being seen as wise.
Being seen as wise (notice the difference between being wise and being seen as wise) tempts us to become the teacher, the teller, the obnoxious sage. Teaching, telling, training are all activities that may happen in counseling, but only when necessary. Truth be told, we counselors resort to teaching and telling because it gives us a job to do and makes us feel good. This is especially true when we work with the most severely traumatized people. Here someone is hurting in front of us. We can see that they are stuck. Who wouldn’t want to pull them out of the mud? Now, there may well be important teaching moments–gently instructing someone on the symptoms of trauma and/or the physiology of trauma. This might be important for the client who believes that the symptoms are really signs they are sinning and that they can just choose to stop being triggered.
In Counseling, Who is the Teacher?
“The patient is the ultimate teacher about trauma, and a good therapist is a good listener.” (Boskailo, p. 81)
While the counselor has much to offer in regard to teaching, training, and goal setting, we must remember that the client is the one teaching us about their trauma experiences and how much they can deal with at a given time. For example, Boskailo reminds us (see above link for book) that while telling the trauma story is an important part of the healing process, the “how” of telling (and the “how much”) is something each client will need to teach us. One client may need to tell and re-tell the same story each week. Another may be better helped by drawing. Still another may tell once and never again.
We counselors are the student in these kinds of matters. It is our job to listen well and learn well!
Musings on Faith and Psychology 