Category Archives: ptsd

PTSD: A New Theory? An Old Treatment


Researchers Liberzon and Abelson at the University of Michigan have published an essay articulating a new way of conceptualizing what is happening in the brains of those with Posttraumatic Stress Disorder. While you can’t read their essay for free, you can read this good summary here.

What is their new theory? the neurobiological problem of PTSD is “disrupted context processing.” In simple terms, I fail to respond to the “stimulus” in its proper context when I am triggered by old experiences in a new setting. Even more simply, when I wake up on full alert in the middle of the night after smelling wood-smoke in my sleep I initially fail to recognize the context (my neighbor burns wood) and immediately think my house is on fire (as it once was). Thankfully, the alertness is less than it used to be and I don’t always get up to check on my house.

The authors suggest that 3 separate and current brain models are inadequate in their scope of understanding the brain’s activities in PTSD. From their perspective the “fear model” (Fight/flight learning), the “overactive threat detection model” and the “executive functioning model” work best when integrated into one unified theory with their new label. And, in true humble researcher fashion, they request help in testing this model to see if indeed it can carry the freight.

An Old But Essential Treatment?

It is good to have a better handle on what is happening in the brain when someone experiences PTSD. Neurobiological research is growing by leaps and bounds. It is hard, frankly, to keep up. And yet, let us not forget an old but essential part of PTSD treatment, the person of the therapist. Humans are designed to be in relationship. PTSD has a way of shattering connections with others and thus the treatment must reverse the disconnect. Being present and bearing witness to trauma will always be the first and primary intervention every therapist must learn. Our temptation is that we want to move beyond the bearing witness phase into change phases. While this is understandable (we want others to get better as fast as possible), we sometimes want this for our own reasons–to avoid the pain we experience in sitting with traumatic experiences of others.

Let us remember that we therapists (and pastors, friends, etc.) are the primary intervention when we are present with those who suffer, when we become a student of their suffering. All other treatment activities stem from this foundation. To use a different analogy, consider Dr. Diane Langberg’s meditation, “Translators for God” (Day 26 of In our Lives First). In this meditation she describes the experience of being translated in a seminar. The translator must fully understand both languages in order to accurately communicate the speaker’s words into the heart language of the hearers. Counselors are translators for God and for healing. And yet, if they do not deeply learn the heart language (pain and trauma experience) of the client, they will not be able to connect the client to healing and to the God who heals.

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Filed under christian counseling, counseling science, Post-Traumatic Stress Disorder, ptsd, trauma, Uncategorized

4 Reasons I Promote Scripture-Based Trauma Healing


[Note: broken link fixed. If anyone is interested in taking this course with me this summer, see here.]

As a psychologist I have had a front row seat to observe the destruction that traumatic experiences have on individuals and families. And as a professor training future counselors I see the necessity of passing on best practices for treating those with symptoms of posttraumatic stress disorder (PTSD). New understandings of trauma’s impact on bodies, minds, souls, and relationships appear on the pages of our academic and clinical journals. As a result, I read daily about innovative attempts to hasten trauma recovery for individuals and even whole communities.

With a world filled with trauma, it is clear to me we need an army of psychologists and mental health practitioners. How else could we address problems faced by 60 million displaced peoples in the world at present? How else could we address the scourge of sexual abuse, where worldwide 1:4 women and 1:6 men have experienced sexual violation before they reach the age of 18?

So, given the needs I have just mentioned, why would I spend considerable time and effort to promote a bible-based trauma healing training program? Let me tell you four key reasons I think this program is essential to address the world-wide problem of trauma. [Note, this is NOT a paid advertisement.]

Trauma disrupts faith and identity. The church must be at the center of the response

While many practitioners recognize the physical and psychological symptoms of PTSD, fewer have noticed that trauma disrupts and disables faith and connection to faith practices. Just now the scientific community is beginning to track this problem and acknowledge the role faith plays in the recovery process. Some are brave enough to suggest that failing to utilize faith practices and communities in the recovery process is tantamount to unethical practice! But most mental health practitioners have had zero training and experience engaging faith questions as part of treatment. The field of psychology is waking up from more than 100 years of training practitioners to ignore, even reject, faith as essential to healthy personhood. If faith is essential to most people on the planet then any intervention must engage faith and spiritual practices if it is going to consider the whole person.

Dr. Diane Langberg recently reminded a world gathering of national Bible Society leaders that trauma needs in the world are far too large for any government to handle. The only “organization” in the world situated to respond to at both a micro and a macro level is the Church. But is the church prepared? We need the church willing to understand the nature of trauma and participate in supporting faith and Bible-based healing responses. These responses include practices the church has not always been known for: validating, supporting and comforting victims, speaking up about injustice, inviting individual and corporate lament, re-connecting oppressed people to God. We need the church to be a safe community for victims.

The Healing the Wounds of Trauma (HWT) program fills this void. It offers basic trauma education, illustrates how God responds to traumatized peoples and provides simple yet effective care responses average believers can enact without being professional caregivers.HWT_USA_2014

While I believe we psychologists with specialized skill sets are essential to trauma recovery, much of what we do can be done by every day individuals. I tell my students that most of counseling is not rocket-science. Being present, listening well, building trust, validating, asking good questions, and walking with someone in pain is largely what helps counselees get better. With a little training, the church can be at the forefront of the trauma healing.

But we need an army…of capable trainers who reproduce

There are approximately 2.2 Billion Christians in the world today. If we decided (and I am not suggesting this AT ALL!) to only serve traumatized Christians, we do not have enough capable practitioners to serve those in need. The ONLY way we would be able to serve this population is to train up capable trainers (wise, able to work well with others, understand group dynamics, know when to be quiet, etc.) who are then able to reproduce themselves and make even more trainers who subsequently serve ever increasing populations. This creates a cascade effect—1 trains another who each, in turn, trains others. Conservatively speaking, one training of 35 future trainers could reach up to 15,000 traumatized people in 3 training generations.

To maintain quality, the program must be able to be delivered and passed on in a consistent manner. The HWT program is designed not merely to educate participants regarding trauma symptoms and good care/healing practices but how to pass on such knowledge and skill to others. The facilitator (trainer) handbook provides a wealth of information to ensure that the quality does not erode as the information is passed on.

Experiential learning trumps lectures every time

In the West, we cherish academic lectures as the primary training mode. Lectures enable a speaker to give a large amount of information in a short period of time, with minimal interruption. A good lecture casts vision, identifies problems, and points to effective responses. But a lecture cannot produce skilled practitioners. Any academic mental health program worth attending will require practicums where head knowledge is put into repeated practice.

Consider this scenario. My father is capable of building a house. He sits me down and he spends hours gong over the steps to building an addition to my house. I listen, take notes, and even handle the tools that will be used. Am I prepared now to build the addition? No! If I am to build a proper addition, I will need to do so under his close supervision. In fact, most of the hours of lectures are not necessary at all. What will be more effective is his teaching me as we build together.

The HWT program is all about experiential learning. Participants learn as they experience trauma and trauma healing through story, dialogue, and practice. First applied to self and then in consideration of others. This is in stark contrast to most continuing education programs that amount to little more than monologues and passive audiences. While the monologue may give more information, it is highly unlikely that participants can in turn teach what they heard to others. The HWT program is not designed to deliver large amounts of new academic information. And yet, what participants get via experience and practice will be far more easily passed on when they become the teacher. There will be no army of trainers if we cannot quickly get experience and practice and pass on what we learn in simple everyday language.

Good training hinges on contextualization

If trauma is universal, then it might be thought easy to deliver trauma healing training across cultures. This is not so. If I prepare a lecture or training on trauma in my context (the megalopolis of the Northeastern seaboard of the United States) but deliver it on a different continent, my training may be of minimal value. The reason it is sure to fail is that what I had to offer didn’t fit the context; it didn’t speak to the heart of that audience. Good training must be contextualized so that participants immediately recognize trauma in their settings and that interventions make sense. Imagine if I deliver a talk on good conflict skills to a hierarchical society but emphasize the need to speak in “I” language (I need, I feel, I would like)? Such interventions will rightly be rejected as inappropriate. And if experience holds, whatever else I say will also be rejected.

The HWT program is founded on contextualization. Not only has it been translated into many different heart languages, the central stories and illustrations are also contextualized so that the participants can see themselves in the stories and interventions. At heart of each lesson, participants are asked about their own culture’s take on the particular problem. In dialogue, they compare responses to that of biblical passages highlighting trauma, grief, loss, and pastoral care. Nearly every major training point addresses context and encourages participants to develop creative interventions in keeping with key biblical and psychological foundations.

Is the HWT program all a traumatized person needs? No, it doesn’t assume this. Is the HWT program perfect? Of course not. I continue to make suggestions for improvement and the authors and developers are some of the most flexible I know, always looking for ways to improve the materials and training program. There are many other solid programs out there, but few programs I know have refined the content and delivery systems to be able to scale out across the globe. I’m grateful for the opportunity to serve the Mission: Trauma Healing team at the American Bible Society as co-chair of their advisory council and occasional trainer.

For a more visual exposure to this training, see this downloadable documentary.

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Filed under Abuse, Christianity: Leaders and Leadership, counseling, Missional Church, Post-Traumatic Stress Disorder, ptsd, teaching counseling, trauma, Uncategorized

So, you want to support trauma recovery?


In recent years I have witnessed significant growth in public discussions of posttraumatic stress (PTS) and trauma. This is a good thing. We want to care well for victims of natural disasters and political and ethnic conflict. We want to care well for ex-combatants. While we work to stop the worldwide disaster of child sexual abuse and domestic violence we also want to care well for those we couldn’t protect.

What do I need to know to be able to help?

When we want to help solve a problem we look for solutions. Students in my counseling and global trauma programs see the problem (individuals and communities experiencing trauma symptoms) and come looking for solutions. They want to know which intervention strategies will be most effective in reducing or eliminating the problem of PTSD. It is a good thing to be skilled; skilled in diagnostics as well as treatment application.

However, knowledge and skills are not enough. Yes, a helper will necessarily need to know how to listen to trauma stories, how to speak and how to be silent. A helper will need to know him or herself in such a way as to recognize blind spots and other factors that may hinder the capacity to walk with a survivor. But even more importantly, the helper will need to recognize, and participate in the following trajectory of memorializing trauma while moving to recovery.¹

The trajectory of memory and recovery

  • The [trauma] Event took place: One must speak.

Having experienced trauma (the Event), speaking of trauma is a necessity if recovery is to take place. How one speaks and what is spoken will differ from person to person (thus, NEVER force someone to speak beyond what they want to speak). But whatever is spoken always leads back (explicitly or implicitly) to the Event. Nothing can be spoken without the Event in view. And resolution is really not possible. How does one resolve a genocide? A sexual assault. Rather, there is before…and after. The victim, as Brown says, “does not have the privilege of such a resolution…again and again” (p. 23). We listeners cannot fully understand, but we can listen and repeat what we have heard.

  • The Event defies description: One cannot speak.

When speaking, victims soon realize, “having tried to speak, they discover that attempts to speak of this Event are doomed” (p. 23). Brown notes that this places the messenger and listener into a double bind. It cannot be adequately spoken and understood. Normal language cannot do justice to what was experienced. If not, then the  trauma would cease to be evil, horrific and devastating but normal and inconsequential. The double bind is this: to not speak is a betrayal of the experience and to speak is a betrayal since words will always fail to do justice to what has been experienced.

Words must minimize the event to some extent. Consider 6 million Jews slaughtered or 1 million Rwandans. It is easy to speak those facts but in doing so we must minimize what those numbers mean. We cannot imagine unless we are there.

If we are going to recover and if we are going to support that recovery, we must sit with the fact that we cannot make sense of trauma. The human attempt to do so is normal…but impossible. Helpers need to avoid all attempts to answer the question of why even as we acknowledge that is is always on our lips.

  • The Event suggests an alternative: One could choose silence.

It must be recognized that victims can choose silence. In fact, silence can heighten our understanding of the unspeakableness of trauma. This is a silence that is chosen in an effort to highlight what is also being told. Consider Beethoven’s 5th symphony that has a rest just after the first four notes (dit dit dit dah [rest]). As Brown points out, the rest accentuates what has just been “spoken.”

One could (ought?) also to choose silence when descriptions of trauma will be used to critique the character of the victim. Too often when tales of trauma are told, listeners look for ways to minimize or explain away the events. “It wasn’t that bad…he didn’t mean it…it could have been worse…you’re fine now.” So, in light of these common experiences, victims and helpers have to wrestle with how and when to be silent.

But of course, silence may be the right choice for victims, it never is for observers. As Brown so starkly puts it,

Silence is no virtue; it is vice twice-compounded: indifference toward the victims, complicity with the executioners. (p. 36)

  • The Event precludes silence: One must become a messenger.

…speech betrays so we must forswear speech, but silence also betrays so we must forsake silence. (p. 36)

Per Wiesel and Brown survival by itself is insufficient. Survival must include testimony to those who live. They call it being a messenger from the dead to (and for) the living. The messenger’s job is to disturb and to awaken those who would rather not see or know of the trauma. Truth must be brought to light and wrongs ought to be acknowledged without explanations or reasons given. These things happened, period.

The messenger (and the helper) do not just speak truth to the rest of humanity but also to God. Like Job, like Jeremiah, like David, we contend with God through our questions and our laments. In the Christian world we tend to try to speak for God. But what if our time was spent raising our questions and our complaints to God? Such complaints do not have to be about our anger but rather because we cannot make sense of both the senseless–God and evil in the world.

  • The Event suggests a certain kind of messenger: A teller of tales.

If trauma presses the messengers (victim and helper) to speak and yet makes in next to impossible to effectively communicate what has happened, then the telling will have to be done in analogies. Brown suggests that storytelling is one way to bring victim and listener together. Consider how Nathan uses story to confront David. Such a story, per Brown, bridges two worlds and uses one (the story) to challenge or confront the other. Confrontations may be as direct as Nathan (You are that man!) but just as frequently these “confrontations” are affective and subtle. This is what happens when you find yourself crying during a movie that has tugged on your heart in ways you never expected. The story enables you to connect with feelings and experiences that may have just moments before, been distant and protected.

Why tell stories? Not just to have a feeling (Brown calls that merely an indulgence). Tell stories to change people; to call to action; to demand acknowledgement of injustice and movement to right wrongs.

A final thought: standing on sacred ground

This trajectory (struggle to voice, necessity of silence, becoming messengers and storytellers to call the world to action) does not often happen in a linear fashion. Rather, it happens in fits and starts; in quiet and rageful voices. But if you see evidences of someone attempting to speak about a trauma you are witnessing the Spirit speaking,

Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words. 27 And he who searches hearts knows what is the mind of the Spirit, because the Spirit intercedes for the saints according to the will of God. (Rom 8:26-7)

When you see those groanings be silent. You are standing on sacred ground.

___

¹This trajectory of remembering trauma and becoming a messenger can be found in Robert McAfee Brown’s Elie Wiesel: Messenger to all Humanity, Rev ed. This book is a kind of commentary on Wiesel’s work and so this trajectory intersperses Wiesel’s quotes and thoughts with the authors. These five points are made by Brown on pages 20-49 in much greater clarity and artistry than I can in this space.

 

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What does recovery look like after traumatic experiences


After trauma, what does recovery look like? Is it possible to “move on?” How can you when you can never unsee or unremember what happened to you? 

Is it possible to experience joy rather than emotional pain when remembering past or ongoing hurts? If so, just what does that look and feel like for the victim? What can be expected if I am “healed”? Can I be free from the typical experience of trauma (e.g., Hopelessness, despair, anxiety, confusion, shame, anger, loss of identity, feeling stuck but the demand to act as if the trauma did not take place, and spiritual angst over the goodness and love of God)?

As Diane Langberg has so aptly reminded us, “Trauma is the mission field of this century.” Around the world there is much openness to talk about the impact of trauma and to use spiritual practices as part of the recovery process. In Christian language, we talk about healing the wounds of the heart and one of the best programs out there is the Trauma Healing Institute’s, Healing the Wounds of Trauma. This program is based on the strong Christian belief that God, through the work of the Holy Spirit and the Scriptures,  is in the business of healing wounded hearts. At the heart of this belief sits two important passages:

Isa 61:1-4 The Spirit of the Lord Yahweh is upon me, because Yahweh has anointed me, he has sent me to bring good news to the oppressed, to bind up the brokenhearted, to proclaim release to the captives and liberation to those who are bound, to proclaim the year of Yahweh’s favor, and our God’s day of vengeance, to comfort all those in mourning, to give for those in mourning in Zion, to give them a head wrap instead of ashes, the oil of joy instead of mourning, a garment of praise instead of a faint spirit. 

2 Cor 4: 16-18 Therefore we do not lose heart, but even if our outer person is being destroyed, yet our inner person is being renewed day after day. For our momentary light affliction is producing in us an eternal weight of glory beyond all measure and proportion, because we are not looking at what is seen, but what is not seen. For what is seen is temporary, but what is not seen is eternal.  

These two beautiful passages present a picture of recovery. Good news, release, favor, comfort, joy and beauty in place of mourning and oppression. Renewal in the face of affliction. But what does this mean in real life? Does a “double portion” instead of shame feel like to a victim of sexual trauma? What does renewal and release feel like after a natural disaster? 

Prognosis for Complete Recovery?

If you suffer a serious knee injury requiring surgery, you will need time for rehabilitation. But rehab does not necessarily mean you will recover the full range of motion you once had, or that  your knee will be entirely pain free when you are finished with physical therapy. Your prognosis for recovery depends on many factors such as age, extent of injury, physical health prior to the accident, and availability of quality care. Even with the best care provided to top athletes, recovery may not lead to return to top form. For example, an Olympic skier may be able to ski again but not at a quality that allows for competitive skiing. 

What about the prognosis for spiritual and emotional recovery? Of course, just as in the knee injury example, the answer must be “it depends.” Still, considering the two passages above, words like liberation, joy, release, and renewal shape our imagination for recovery. Do we imagine complete recovery to top spiritual and emotional form, without pain and limitation? It appears to me that we sometimes imagine emotional and spiritual healing without taking consideration the reality of broken bodies and a fallen world. We are not guaranteed a pain free life or faith without distressing questions. In fact, Paul’s beautiful words in 2 Corinthians bear this out. afflicted in every way, persecuted, perplexed, persecuted, struck down, always carrying around death, burdened, groaning and more. Yes, he also says not crushed, not despairing, not destroyed, but alive. But both must be considered together at the same time if we are indeed to imagine our prognosis. Recovery means comfort and lament, joy in mourning, perplexed while trusting, dying yet alive. 

Sprouts of Justice and Recovery?

Isaiah describes sprouts of justice and righteousness beginning in the recovery of the oppressed (Isa 61:11). As a gardener, I see sprouts as the beginning of hope. After planting seeds, the tiny sprouts give me hope for a later harvest but that hope is still tempered with the knowledge of the challenge of getting sprouts to develop into fruited plants. I have to be vigilant about bugs, weeds, and drought. I need to cultivate and fertilize or my sprouts will not turn into much. And even if I do everything right, the seed may be weak or the weather may mean I only have spindly or stunted plants that cannot bear much fruit. Yet, the sight of sprouts brings the hope that empowers us to keep at the gardening work. 

So, what are these sprouts of justice and recovery that victims of trauma may first see that encourage hope and further empowerment? Consider some of these: 

  • Capacity to Name Truth and Justice

Recovery begins when oppressed people find words to name injustices done to self and other. For example, a victim of domestic violence may become well aware of the subtle signs of verbal and emotional coercion, long before any physical violence. They become the canary in the mine, aware of poison that others may not yet sense. 

As this capacity grows beyond a mere sprout, the person may be able to speak the truth aloud, even with courage to say it to leaders. 

As naming capacity grows, it moves from awareness of personal risk to capacity to notice and care for the injustices others experience

  • Accepting weaknesses without hopelessness

Part of recovery requires honest reflection of the damage done. Signs of recovery include the ability to recognize limitations and working within capacity without self-hatred (though there may be lament for losses of previously held abilities). When we truly accept the “new normal” we then can stop evaluating daily life from the perspective of who we used to be

As we accept our limits, we can then begin to see the opportunities we do have even within our limitations

  • Identify resilience and new capacities in the midst of struggle

There may be new capacities we never observed before (e.g., the capacity to speak up to power, the ability to withstand rejection, increased empathy for the pain of others). We now notice these resiliences and growth as they stand on their own

Though we will not call the suffering good, we will be able to identify blessings that we have received in spite of and as a result of the trauma experienced 

Be Careful Not to Damage the Sprouts

For those who are not attempting the impossible, to “move on” from trauma and abuse, it is good to remember that sprouts are tender and can be easily damaged with too much interference. You may need to leave a few weeds you see near the fledgling plants so as not to disturb their roots or bruise the green shoots. How do we do this to the sprouts of recovery? We may unintentional limit growth by questioning why the person learning to speak the truth isn’t doing it in a even-tempered manner. Sadly, too often those in domestically violent marriages are told to stop being so dramatic and to calm down when they begin to speak about the truth of the violence they have experienced. Or, we can point out the sins of the victim as if somehow their responsive sins eliminate their right to speak up about the trauma they experienced. Or, we can hear someone accepting brokenness and accuse them of not trusting God for complete healing. 

Nurture recovery as you would a tender plant. It is a scandalous act of grace! By paying attention to safety needs, by bearing witness to trauma, by being willing to lament and to stay connected, we provide a greenhouse for such plants to grow into levels of recovery never before dreamed of. 

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Filed under Abuse, biblical counseling, christian counseling, christian psychology, Christianity, counseling skills, pastors and pastoring, Post-Traumatic Stress Disorder, ptsd

Brooks on journaling about emotions


Friend Jeff McMullen pointed out a recent David Brooks op ed in the New York Times. (Read it here). While I’m not sure I agree fully with his journaling/not journaling point he says something very important about the timing of writing one’s emotions after a traumatic event. He says,

When people examine themselves from too close, they often end up ruminating or oversimplifying. Rumination is like that middle-of-the-night thinking — when the rest of the world is hidden by darkness and the mind descends into a spiral of endless reaction to itself. People have repetitive thoughts, but don’t take action. Depressed ruminators end up making themselves more depressed.

Then later, this important distinction between immediate processing of emotions and later processing,

We are better self-perceivers if we can create distance and see the general contours of our emergent system selves — rather than trying to unpack constituent parts. This can be done in several ways.

First, you can distance yourself by time. A program called Critical Incident Stress Debriefing had victims of trauma write down their emotions right after the event. (The idea was they shouldn’t bottle up their feelings.) But people who did so suffered more post-traumatic stress and were more depressed in the ensuing weeks. Their intimate reflections impeded healing and froze the pain. But people who write about trauma later on can place a broader perspective on things. Their lives are improved by the exercise.

David points to some research that exists that suggest CISD is unhelpful for some participants. Some are made worse. Yet, narrating one’s trauma in the broader context of a life tend to see a reduction of symptoms. The difference seems to be whether the focus in on life or mostly on the trauma. Trauma in perspective is the goal. Just reviewing trauma may in fact strengthen the traumatic reaction rather than weaken it.

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Military trauma and traumatic brain injury: Challenges and Opportunities


Colleague and veteran Steve Smith has let me know about this web article regarding the state of PTSD/TBI injury among active duty military personnel. The essay points to some very startling numbers:

  • 59% report no improvement or worsened symptoms after undergoing treatment for PTSD and TBI
  • 30% dropped out before treatment was complete
  • A large portion of patients are on up to 10 meds at a time

The news item goes on to summarize presentations made a few days ago at the American Legion symposium on care for TBI and PTSD veterans. What makes this worth reading is that the actual slides from the presentations are provided in links at the end of the piece. I encourage you to go and read up. You can see what is being done using complementary treatments, the numbers of veterans with head injuries (interestingly, 80% are NOT received during combat) and/or PTSD, what services are available and what recommendations are made to DoD and the VA system to improve patient care.

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Does yoga decrease PTSD symptoms?


The lead article in the most recent issue of Journal of Traumatic Stress (27:2, 2014) presents a small randomized control trial pitting yoga interventions (12 sessions) against “assessment control” (i.e. assessment plus no treatment). The authors suggest this is the first randomized control trial for yoga interventions, something needed since there is significant anecdotal and quasi-research evidence that yoga reduces trauma symptoms. It is purported to work for several reasons: improved breath-control, improved mind-body awareness/mindfulness, and improved stress resiliency.

What did they find?

The answer to the title question: yes, but not more than controls. Some improvement is noted in the Yoga intervention group: reduction of re-experiencing symptoms and reduction of hyperarousal symptoms. However, the same reductions are also noted in the assessment control group. You might wonder why. The authors suggest that the control group found benefit in tracking their symptoms each week. Thus, self-monitoring may help improve well-being, especially if the person also is accepting and normalizing symptom expression of PTSD. Thus, both groups may have received the same intervention: self-awareness, self-monitoring, and self-acceptance.

Now, this trial was rather small, just 38 in total. With a larger study, researchers might find more power to their intervention. Why keep trying? Yoga is (a) low-cost, (b) not particularly taxing from an emotional standpoint (thus few drop-outs when compared to something like Prolonged Exposure), and (c) something that helps sufferers stay attuned to their body.

 

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Urban trauma or bad kids?


Psychiatrist Michael Lyles gives an excellent presentation on the nature of urban trauma at the 2014 ABS Community of Practice. He points out how much of what gets labeled as uncaring violence is better seen through the lens of urban trauma reactions. In addition, he discusses the response of the church. Not to be missed!

Michael Lyles – COP 2014 from American Bible Society on Vimeo.

After his presentation, Police chaplain and urban pastor Rev. Luis Centano gave this response regarding trauma in the city of Philadelphia.

Rev. Luis Centeno – COP 2014 from American Bible Society on Vimeo.

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Mapping urban domestic trauma


Our community of practice continues with a presentation by Michael Lyles, MD who presented on the problem of trauma in urban settings. He pointed out how we often think about violence and the connection with trauma in international settings but fail to connect the two in American urban settings. We see angry young men and women who seem calloused and do not value life. Yet, often what is happening is that we have hypervigilant individuals who choose to manage their trauma reactions by being alert and on edge and ready to attack before being attacked. When you bring together poverty, violence and a traumatized population, you develop a chronically meeting most criteria for PTSD but never getting diagnosed.

One study mentioned a few statistics about violence prevalence. 55% of urban children have experienced sexual abuse (compare that to 15 to 15% of US population); 39% have witnessed domestic violence. 27% experienced physical abuse.

To highlight the problem he pointed out a 2o12 Philly Magazine report on trauma in our city. Between 2001 and 2012, more than 18,000 people were shot. During that time some 3800 murders. He noted that suicide rates run about 20% and that number goes even higher when you include “academic suicide”–dropping out of life. In addition, he pointed to the connections between trauma and adrenal overload, hypertension, diabetes, and other physical illness. He also pointed to the scarring that takes place in the amygdala.

He noted a good book to consider: John Rich, MD (Drexel University) Wrong Place, Wrong Time: Trauma and Violence in Lives of Young Black Men.

He ended his presentation considering the role of “Chief Musician” as found in the Psalms. These are folks who listen to the story, don’t debate it, set it to words/music that are appropriate.

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Mapping Global Trauma


This week I am participating in the American Bible Society sponsored Community of Practice for trauma healing interventionists. The audience represents many organizations, Exile International, Wycliffe, SIL, the Seed Company, Food for the Hungry, as well as many bible societies. Attendees come from places such as Sri Lanka, Nigeria, South Sudan, CAR, Rwanda, Uganda plus several more.

Today, we heard from successes and challenges in several specific areas. Then, Dr. Matthew Stanford (Baylor) gave us an overview of trauma around the world. When we look at armed conflict, we see much on the continent of Africa. Natural disasters take even more of the globe. Trafficking, HIV and sexual violence cover the rest. While some 50% of the US population are exposed to traumatic events, only about 8% will meet criteria for PTSD during their lifetime. In other parts of the world, 90% are exposed to trauma and 40% will meet criteria for PTSD during their lifetime. One of the challenges missionary/humanitarian efforts face is learning about the symptoms and impact of trauma on populations. Too often people either neglect trauma or only focus on a few symptoms. We can try to work on one problem (domestic violence) but without addressing the deeper roots of trauma, it is likely not to be very effective.

After Matt, Rebecca Deng spoke of the experience of being a refugee (South Sudan) and coming to the US as a refugee. Some 42 million refugees worldwide. Some 25 million internally displaced (IDPs) on the continent of Africa. She told a bit of her story of loss and struggle even as she came to the US as an unaccompanied youth. She spoke this very important question

You can grow food, purify water, but who can clean the wounds of the heart?

We ended the morning session with a presentation from Bethany Haley of Exile International. Dr. Haley spoke about the impact of trauma on children. (Exile has work in the DRC and Uganda.) She reviewed the many sources of trauma (armed violence, sexual violence, trafficking, child labor, orphans, recruitment into armed gangs) and how it commonly impacts capacity to develop well and learn. We know that trauma changes brain structure and function. She pointed us to the work of Karyn Purvis at Texas Christian University who has done work on the effects of trauma on developing brains. In addition, she pointed us to Unicef materials available to teach about child trafficking around the world.

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Filed under Africa, Post-Traumatic Stress Disorder, Psychology, ptsd, suffering