
Category Archives: trauma
Lessons learned in the Middle East
I traveled to Jordan in early November to do trauma recovery training/equipping work for Jordan Bible Society as a volunteer representative of the Trauma Healing Institute. Today, I posted a blog on the BTS faculty blog page on some of the lessons I learned there. I encourage you to check out those insights. The title of the post says, “5 Lessons Learned…” but in fact there are 6. Consider it your Christmas bonus (wink).
Filed under Christianity, trauma
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.
Filed under Abuse, Post-Traumatic Stress Disorder, ptsd, trauma, Uncategorized
What can we do about the refugee crisis?
If you have any connection to the outside world you know that the Middle East, North Africa, and Europe is undergoing a refugee crisis of massive proportions. Syrian and Iraqi refugees are finding their way to Europe to try to escape the violence, hunger, and lack of basic resources resulting from ongoing conflicts in both countries. For years, Lebanon, Jordan, and Turkey have borne most of the brunt of the burdan from the crisis, but now refugees are risking their lives crossing the Mediterranean to Europe. What was a regional conflict is now a wider political and economic challenge.
If you are like me you read the stories, see the pictures, dig into the complexities of the problem and end up feeling helpless or hopeless. Someone has to do something. But what? Is there anything you and I can do to help? We know we can pray and we know we can give money to aid organizations. However, I suspect we often fail to do either of these things because will my prayers or fifty dollars do anything, realluy?
Can we do anything else? Here are a few things I think merit consideration as doing our part. They may not do anything at all in the big picture, but then again, they may help you take one more step, even if only helping you to pray more pointedly and persistently.
- Choose to be continuously educated. It is easy to make sweeping generalizations about those who are fleeing violence, about those in host countries, about the various armed militias. Sometimes we are right but far too often we develop simplistic formulas for the problem and solutions. Read outside of your normal news sources. If you are in the U.S., check out the stories by BBC and Al Jazeera news corps. Especially look for news stories about the refugees, who they are and what they are looking for. Many journalists in this area tweet out their stories/blogs. Find them and read them. Don’t allow hopeless feelings keep you from bearing witness to the tragedies nor from calling on God to intervene.
- Study the Scriptures regarding the God who loves refugees, hears their cries (think Exodus) and his son who was himself a refugee (check out Matthew 2). What is God’s mind on caring for those who have nothing and who will cost us something if we do care for them? Too often we can become consumed with political and economic realities and forget that God’s word calls us to love immigrant and outsider among us. In doing so, challenge your common assumptions about how we should relate to Muslim outsiders.
- Learn a lay-counselor trauma training model. The American Bible Society has a program, Healing Wounds of Trauma. This program is Scripture-engaged, dialogical, lay-oriented, and cascade oriented. You can get trained by attending a low-cost equipping session (4-5 days) and then train others (hence the cascade effect). You do not need to be a counselor but plenty of counselors love this model because it is so easily transferrable. Translated and contextualized into many languages, you can teach in English and the participants can teach in their own communities in their own language. Wait, you migh think, I don’t know any refugees in my community. While there may not be any Syrian refugees (then again, there many well be!), immigrants and refugees are all around us. Find out who is serving them (e.g., Lutheran Social Services, World Relief, etc.) and see if you can use this materials with them. This particular program isn’t the only one out there but it is effective and budget friendly.
- Of course, give and pray. Once you get connected to local refugee serving organizations, you will have a better sense of who is serving in your community and how your time, talent, and treasure could be used.
Filed under counseling, Justice, news, News and politics, Training, trauma, Violence
How childhood trauma could be mistaken for ADHD
This article: (http://acestoohigh.com/2014/07/07/how-childhood-trauma-could-be-mistaken-for-adhd/) was sent to me by a GTRI student (Thanks Charity!). Worth the read to consider how we may mistake hyperactivity as evidence of ADHD vs. evidence of hypervigilance and PTSD. Given the high prevelance of ADHD diagnoses in areas where there is also much trauma (urban and impoverished settings), it stands to reason that there could be significant misdiagnoses. I began to understand this problem some 17 years ago during my pre and post doc experience in small town Concord, New Hampshire. We saw all sorts of boys first diagnosed with ADHD, then diagnosed (and heavily drugged) with bipolar disorder. Back then we called them emotionally-dysregulated. Nearly all had been subject to domestic violence and had witnessed their mothers abused by boyfriends. A large number had seen their mothers had guns held to their heads. Such experiences shape a child and so it stands to reason that a brain bathed in the hormones released during terror and horror would have an impact. It is also true that in this same population there was a high incidence of tobacco use, also known to be highly correlated with ADHD diagnosed children.
My suspicion is that one day we will find syndromes that encompass both diagnoses but that will not be until we have better understanding and technology to assess what is happening in the brain during an episode of “hyperactivity.”
Check out the above article and if you are a clinician, consider alternative explanations for ADHD diagnosed children. Do you see signs of emotion dysregulation? And if so, how might that be more central feature of the treatment plan?
Online Trauma-related (Cheap!) Continuing Education at BTS
[Note: the video-based training described below is available to anyone for free. The information below is for those interested in purchasing continuing education credits after watching the video. If any of the titles interest you, click the link below and start watching right away!
BTS is an NBCC approved continuing education provider. Just in time for those looking for last-minute CEs before renewing their LCSW or LPC this month, please check out our new online offerings. We offer three new trainings:
- Narcissism and the System it Breeds, By Diane Langberg, PhD
- Understanding and Responding to Dissociation, By Diane Langberg, PhD
- Making the Church a Safe Place for Trauma Victims, By Philip Monroe, PsyD
The videos are free for anyone to watch. If you desire CE certificate, the cost is quite nominal in comparison to the usual going rate. Check out the abstract and objectives and follow the links to pay for your CE quiz. Watch the videos, complete the quiz, and we will email you a certificate you can use to claim on your license renewal form.
Filed under Biblical Seminary, continuing education, counseling, Counselors, trauma
Knowledge vs. information: When trauma stories change you
Last night in our Advanced Global Trauma Recovery Institute (GTRI) course web conference, we were discussing the weight of listening to trauma stories. This conversation spawned from our delving rather deeply into the systemic torture, trauma, and loss of identity occurring in post-WWII eastern Europe (specifically in Romania). We considered the question
What should we do when we are overwhelmed with the weight of trauma stories around the world? Especially, what are we to do when we can do little to nothing about the new stories we hear every day? How do we respond to temptations to despair?
Knowing or just information?
During the web conference, Diane Langberg pointed out the common phenomenon that sometimes we hear of atrocities but do not really know about them. We hear information on the news about various tragedies (e.g., ISIS, Boko Haram, shootings, suicides, etc.) and sometimes fail to process it. One of our students reminded us of a bit of dialogue in Hotel Rwanda between the hotel manager and an American journalist,
Paul Rusesabagina: I am glad that you have shot this footage and that the world will see it. It is the only way we have a chance that people might intervene.
Jack: Yeah and if no one intervenes, is it still a good thing to show?
Paul Rusesabagina: How can they not intervene when they witness such atrocities?
Jack: I think if people see this footage they’ll say, “oh my God that’s horrible,” and then go on eating their dinners.
Not far from the truth, right? However, when someone takes the time to really listen to trauma stories, something changes in that person; they are no longer able to go about their life as the did in the past. When we choose to sit with stories of pain, we gain knowledge that changes our view of the world. For example, when we take new individuals to Rwanda, we often hear, “I remember hearing about the genocide….but I didn’t know. I knew but I didn’t know what I know now.” The same thing happens when individuals are willing to learn about racism, domestic violence, gender based sexual violence and the like.
When you see something in detail, you can’t unsee it. You will be changed.
I know…now what?
Once you know, really know, the depth of suffering of a community, you are changed. That knowing often creates deep pain, especially when we can do nearly nothing about it. So, now what? What can we do? Here are a few things that may be overlooked as insignificant
- Listen. Wait, didn’t we already do that? What good is hearing more about the story if I can’t do anything about it? No, listening is part of the solution. Individuals and communities who are enabled to tell their trauma story benefit from repeated truth-telling. They benefit from “being seen and heard.” It matters that those from outside cared enough to come and hear of the pain. Do not underestimate how such listening may empower a trauma survivor to move towards healing.
- Lament. Laments are conversations with God about the brokenness before you. Whether done in private or in public, these laments help us to communicate to God what we find intolerable, to ask God to do what is impossible, and to look closely for his response. Laments hand the problem back to God. “Do something Lord!” Laments also tell victims that their pain is real and not merely an emotional weakness on their part.
- Look for seeds of healing. If you are hearing a story of tragedy, then you are also hearing a story of survival. While being careful not to dismiss losses and pain, we can also point out signs of life, of resistance, of resilience. These seeds do not deny the damage being experienced. Jeremiah’s plaintive sigh, “Yet this I call to mind and therefore have hope: because of the Lord’s great love we are not consumed…” does not undo his previous tears, “I remember my affliction and my wandering, the bitterness and the gall. I well remember them, and my soul is downcast within me.”
- Do one thing. If you are in direct contact with the person who is suffering, you can check in with them, find out what would be helpful. If you are not in direct contact, then do any number of “one things.” You can pray daily. Ask not only for restoration and justice but also for God to direct your response. You can tell one person about what you have learned. You can look for ways to identify how the seeds of the same tragedy might be in your own environment and not just “over there.” You can give an alternative points of view when you hear someone speaking naively about the situation. Start a conversation with friends.
- Remember. Look to find God’s view of the situation. How does He feel about injustice, whether minute forms in us or the massive ones we see on television? What reason might God have for waiting to bring all things under his control?
Join me in Brazil, March 23-27, 2015!
UPDATE: Conference registration cut in half! Now only costs $250 instead of $500.
I will be attending and speaking at the 2015 General Assembly of the World Reformed Fellowship in Sao Paulo, Brazil (March 23-27, 2015) on the topic of recovery from child sexual abuse. Boz Tchividjian, Diane Langberg, Jim Gamble (N. Ireland) and Beatri Kruger (S. Africa) will also be covering topics such as preventing child abuse, sex trafficking and counseling.
These conversations are important everywhere, but this audience will be representing Reformed church communities worldwide, and that makes it very important conversation since churches worldwide need to keep talking about abuse that takes place within Christian environments. ! If trauma and abuse aren’t your cup of tea, there are parallel tracks covering everything from transdenominational ministry, Islam, church ministry and sexuality, church planting, and prosperity gospel.
See WRF GA Assembly for more information about the conference program and how to register for the conference.
Filed under Abuse, conferences, trauma
Thoughts on Gary Haugen’s “The Locust Effect”
Over 2 billion people live on less than 2 dollars a day. If you doubled the population of the United States you would have the number of people who live on less than a dollar a day. As Gary Haugen points out, if you are reading The Locust Effect: Why the End of Poverty Requires the End of Violence (Oxford, 2013) or are reading this blog, you are not likely to be a member of the extreme poor. And if you aren’t a member of the extreme poor you probably wish you could do something to improve the lives of the most impoverished. The poor need clean water, food, housing, jobs, affordable healthcare, and education among other things.
But Haugen says all of those needs pale to a greater need: the need to stop the plague of “lawless violence.”
Opportunities for education, jobs, healthcare, quality food and water will evaporate or will not be accessed if poor do not have protection from violent forces–security, law enforcement, and a just judiciary.
The book challenges the reader to stay with the problem of poverty and violence as it travels across the globe to recount story after story of vulnerable men, women, and children whose governments fail to (a) protect them from sexual violence, bonded labor, property theft, and (b) defend them or seek justice after becoming prey. Frankly, it would be easy to either turn away from this problem since it is too large for anyone to solve or to just keep offering some form of help (food, water, job creation–all of which are needed and good!) without confronting the epidemic of violence.
Sexual Violence
There are many forms of violence a poor person can face. Their livelihood, home, and communities can be destroyed. But sexual violence doesn’t just take those things but also eviscerates the soul. Haugen recounts that in some locations as many as 68 percent of girls report experiences of sexual abuse. Some 6 to 11 million individuals are trapped in the sex trafficking industry. Some 1 billion women are known victims of sexual abuse. For most readers, this is not new news.
But consider for a minute that somewhere’s between 6 and 50 million people (Haugen tells us to read that as MEN) pay for sex each day. Remember that buying sex is likely supporting violence (pimps, prior sexual abuse, etc.). Look at the problem of sexual violence a different way–the percentage of men who have EVER paid for sex ranges from 15 percent to 85 percent (depending upon the country).
Sit with that number for a bit. You want to stop sexual violence? Yes, we need law enforcement willing to investigate and charge sex offenders. Yes, we need a judiciary system willing to provide justice through convictions and sentencing. But, if we really want to stop sexual violence, we have to deal with demand side of the equation.
Trauma the Multiplier of Violence and Poverty
Gary’s book addresses some of the colonial roots of violence in the developing world (i.e., government and law enforcement built for the ruling/colonial class, not for the local population). While I have not finished the book, I’m wondering about how he sees the impact of trauma on this whole problem. As most recognize, traumatized people tend towards learned helplessness and thus are much more vulnerable to future violent acts against them. And Haugen acknowledges this problem, if briefly (pp 105-106). He identifies the fact that “unrestrained violence” leads to traumatic reactions that will hinder the capacities to take advantage of available resources.
While all true, the problem of trauma is likely causing problems not just for the vulnerable poor but also effecting the entire system (police, judiciary, and government). Trauma often causes individuals to stop thinking of the future. Instead, individuals make impulsive, self-protective decisions that may hinder future opportunities (e.g., drug use stops triggers but harms future health). The same can be true of systems (bribery to survive now, but destructive to safety and stability.
The book ends with a number of ways to address the problem of global violence so make sure you read to the end. But I encourage you to think about ways to respond to BOTH trauma and faith deficits. Check out the work the Trauma Healing Institute as an example of grassroots, lay level response to these two problems.
GTRI 2014: Day 9 Muhanga
July 9, 2014
Wednesday morning. We had our last lovely breakfast at Solace guest house, packed our things and left to travel a little over an hour south to Centre Saint Andre, a retreat and conference facility. We arrived in time to get our rooms to put our things away and get to the start of the conference. This Community of Practice conference, run by the Bible Society of Rwanda, is their first ever such meeting of trauma healing facilitators and is designed to raise the level of skills and knowledge of the facilitators as well as share best practices among them. Our role at the conference is threefold: lead some of the teaching sessions, listen and respond to case consultations and, best of all, get to know the facilitators and share experiences. The room was set with tables for 6 with 4 Rwandans and 2 Americans each.
The conference began with a bible study by the secretariat of the Bible Society. He spoke of the necessity of having the right names for things. He noted the significant difference in naming Rwanda a country healing from genocide instead of Rwanda a genocide country. Each table then discussed successes and challenges. At my table we heard of many good stories of healing (Success) but also that the
facilitators feel much guilt for not helping more (Challenge). They struggle with feeling worn out and impoverished helping others. Some noted how their own families and marriages were suffering given that they found it hard to say no to tangible needs of those they were trying to help. They noted that many of the recipients did want to have tangible gifts in order to take time to be in a healing group.
Next, Diane Langberg presented on the topic of shame. She defined guilt as a response to what we do but shame as a response to what we perceive we are or have become. She noted there are different types of shame but all result in a loss of “glory.” Some religious traditions believe that blood (honor killings) is the only way to cleanse the family of shame. She pointed out that while this is gravely distorted view of shame/honor, blood IS the only cleansing of shame–Jesus’ death and resurrection. She explored how Jesus did not run from the shame, that the image of God is one who runs after the shamed, who clothes them, who brings them his honor.
In response, the table groups considered three questions: What is considered shameful in Rwanda? What does the church say is shameful? Which of these are false sources of shame per the Scriptures? Consider some of the items mentioned,
- To be pregnant without a husband, yet a man is proud
- To divorce or separate
- To be impotent or barren
- To be a victim of rape
- To be drunk (if woman); only shameful for a man if he does something wrong when drunk
- To engage in open conflict; to talk openly of problems
- To be in need/impoverished
- For a woman to talk about domestic violence; to be a man beaten by his wife
- to have disobedient children
- To be albino
- To commit adultery (church endorsed shame); to be HIV+
Interestingly, it was not always agreed upon which items should not be considered shameful.
We ended our training day with a teaching/group interaction I did regarding addictions (the nature of addictions, what the Scriptures say, and how these facilitators can help improve commitment to sobriety in those they seek to help). I think most Americans and Rwandans felt the beginnings of connections forming as personal stories were told to us and we received them for what they were, treasures.
Filed under christian counseling, Rwanda, trauma

