Category Archives: Uncategorized

November 27, 2013 · 5:27 am

Singing for Justice? Hymns that Flesh Out Micah 6:8?


On Sunday, I was visiting my parents’ church, Goodwins Mills Advent Christian Church. During the service we sang a hymn I had never heard sung before. The hymn, “We Are Called to Be God’s People,” (WORDS: Thomas A. Jackson, 1973; TUNE: Hayden, Austrian Hymn) took my breath away as I couldn’t recall ever singing a hymn with that clear a call to work for justice and to bring evil into the light.

Listen to the third and final stanza:

We are called to be God’s prophets, speaking for the truth and right,
standing firm for godly justice, bringing evil things to light.
Let us seek the courage needed, our high calling to fulfill,
that the world may know the blessing of the doing of God’s will.

We rightly sing of God’s grace. We praise him and laud him for being God. We sing songs to call ourselves to love God with all that we have. But when do we sing songs to remind us to work for justice, to have courage, to speak for truth and for right?

Can you think of one that speaks of our call to do justice?

[Listen to a Youtube rendition. See PDF for entire hymn.]

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November 6, 2013 · 10:19 pm

Philly Friends: Check out the ISTSS Conference


Starting tomorrow, the International Society for Traumatic Stress Studies is having their annual meeting at the Marriott in downtown Philadelphia. Anyone interested in hearing the leading researchers and clinicians on the topic of PTSD and trauma (whether domestic or international, treatment of veterans or sexual abuse) should plan to drop by. There are 1300 plus registrants but room for more. 

If you come, check out Biblical’s Global Trauma Recovery Institute exhibit. I will be at the table on Friday and Saturday. 

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November 5, 2013 · 2:05 pm

Does the DSM 5 define pedophilia as a sexual orientation?


In recent weeks I have read a couple of postings suggesting that the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) has taken Pedophilia out of the realm of (psycho)pathology and made it equivalent to sexual orientation (e.g., gay, straight, bisexual, transgendered, etc.). These postings propose that the publisher, The American Psychiatric Association, has decided to normalize pedophilia–something that some believe is mere politics and a sign of further loosening of social mores. Usually, these writers point to the fact that the APA depathologized homosexuality in previous editions and now are going steps further to normalize pedophilia.

But, is this rumor true?

The facts from DSM 5

Pedophilia, or Pedophilic Disorder still exists and is considered a disorder in the family of paraphilias (patterns of abnormal sexual desire or activity). To be diagnosed with Pedophilia, one must meet 3 criteria (summarized)

  • Have sexual fantasies, urges, or behaviors for prepubescent children
  • Either urges cause marked distress, interpersonal difficulty OR the adult has acted on the urges with children
  • Must be at least 16 and seeking those who are at least 5 years younger

So, why the rumors?

Okay, so pedophilia is still a disorder. So, where is the confusion? After listing the criterion, the DSM offers some commentary to further describe the disorder. Here’s where some confusion may enter in as they describe the person who has intense pedophilic urges but who has not acted on them:

“However, if they report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both), and their self-reported and legally recorded histories indicate that they have never acted on their impulses, then these individuals have a pedophilic sexual orientation but not pedophilic disorder.” (p. 698)

Meaning?

Unfortunately, “pedophilic sexual orientation” is not defined. By the way, neither do they define any other sexual orientation. The point being that since sexual orientation is outside the purview of  a catalog of psychopathology, it need not be discussed. So, my read of the DSM 5 intent regarding pedophilic urges is this

  • Pedophilia is NOT equated with sexual orientation when the person is acting on the urges or is troubled by them, BUT
  • Those who have these attractions, yet feel no shame about them, function in society to protect children, and have not acted to harm children are not pedophiles but can be listed in a new nonpathology category: pedophilic sexual orientation. thereby, 
  • Opening the door for some to self-identify in a nonpathological manner

Is this cause for alarm?

Short answer. No, this nor the removal of homosexuality as pathology is not evidence of APA’s moral degradation.

Longer answer. this addition/change will create confusion. It does open the door for some crazy thinking and adding the “orientation” language is wrongheaded and may harm the good research being done about sexual orientation. Further, never underestimate the power of some to use this for evil intent.

Remember, the DSM is a catalog of psychopathology, not social pathology, moral pathology or the like. So, if it is possible (and there is evidence to support this) that gay and lesbian people do not experience psychopathology solely as result of their sexual feelings, then it would be right to remove homosexuality as a psychological disorder (no matter how you classify it in terms of morality).

There is another DSM feature that may be more of issue in this debate. As of now, diagnoses are locked into using the criterion, “causes marked distress” as a way of determining the floor for a pathology. Thus, you could possibly experience recurrent and persistent obsessional thoughts and images but not have them cause “marked distress…or significantly interfere with normal routine, social activities…” and therefore NOT be diagnosed with OCD. So, if it is possible to determine that a person with sexual feelings for little children is able to be not disturbed by them AND not act on them, then you wouldn’t give the diagnosis.

See the problem?  Here’s an analogy of sorts: if all 80 year old men have cancer cells in their prostate but never have any symptoms, seek no treatment, and die of other causes, should they be diagnosed with prostate cancer? Denying the existence of the cells doesn’t seem to be the answer even if no treatment is necessary.

To the point: Is there movement in redefining pedophilia?

Not in the mainstream.

It appears that there is an effort to better understand those who are being charged and convicted of child sex offenses. I see a growing research beginning to differentiate between three types of people who commit sex crimes: contact sex offenders (those who directly abuse actual children), internet offenders (those who use or send child pornography), and solicitation offenders (those who use technology to communicate with minors for sexual purposes).  The idea is that there may be differences between these three types and thus arguments for different punishments and treatments. It seems, thus far, that contact sex offenders have far more distortions in empathy for victims, cognitive distortions about self and children while the other two categories seem to have some features that might protect them from becoming contact offenders. NOTE: the data is small at this point and we can’t predict who will and who will not become contact offenders.

Go ahead and worry some

If one could really argue that child porn viewers are not statistically more likely to become offenders against actual children, you can easily imagine someone arguing that virtual child porn (i.e., digital created images of children having sex) harm no one and ought to be legal for the pedophilic orientation individuals. On recent report stated that at any given moment in time there are 750,000 individuals accessing and viewing child porn. And that is with it being a crime. Do we really want to open this door to normalization? No. We want to understand, empathize, restrict, and intervene.

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November 1, 2013 · 3:37 pm

Trauma Healing Equipping Week: February 2014


Biblical’s Global Trauma Recovery Institute is sponsoring the American Bible Society’s Trauma Healing Equipping seminar set for the Philadelphia area late February 2014. This is a week-long seminar that gives participants hands-on experience with the Healing Wounds of Trauma material. If you are local and would like to have experience with this Scripture engagement material (excellent for use in churches or lay counseling contexts) that explores both content and means to teach others, I highly recommend you check out this 2014-02 Equip PA Flier.

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September 25, 2013 · 11:58 am

Pastoral Counseling for Sex Offenders: 3 Dos and 3 Don’ts


As the church does a better job in understanding the epidemic of sexual victimization (1:3 women, 1:5 men report unwanted sexual contact by age 18), the church also faces the challenge of understanding how to care for sex offenders in the community. Gone (hopefully!) should be the days where a congregation just ignores offenders and acts as if their sins are in the past needing no further follow-up. And we don’t want to swing to the other extreme of making it impossible for sex offenders to be part of the church community. Rather, the church will best represent Christ to victims AND offenders when it exemplifies the grace of limits to offenders.

The local pastoral counselor (whether in the church or in a para-church organization) will be called upon to participate in the care and counsel of a sex offender. In preparation for this eventuality, every pastoral counselor should embark on their own continuing education. Read books (start with the difficult book Predators by Anna Salter), meet your local ADA who prosecutes sex crimes and find out what is required of offenders after they leave prison, find local clinicians who specialize in treating the various kinds of offenders (e.g., adolescents, adults, Internet based, those who have been incarcerated, etc.)

Dos and Don’ts

After improving your understanding of the nature of sexual offending and the available resources, consider these three dos and don’ts in order to avoid some serious pitfalls

  • Do treat them as fully bearing the image of God, just as you would a victim of a sex crime. Your relationship with the offender should not be a barrier to their ongoing growth and sanctification. Do you share the same mercy and grace as you would to someone you may feel more compassion? Do you see them as less human? Your compassion should lead you away from an adversarial or judgmental approach to them (this does not mean you won’t be firm or even skeptical!). Accusations, no matter how accurate, rarely lead to transformation in another. Instead validate their feelings and experiences. They will have lost much: friends, family, finances, standing. While it came at their own hand, you surely want to validate this experience.
  • Don’t treat all sex offenders the same. Recognize differences between adolescent and adult offenders, Internet only offenders and direct contact offenders. You do not want to have a one-size-fits-all approach for supposed fairness reasons. If you don’t have training in understanding these differences, do not assume you already know how to counsel these individuals. Get training, supervision, and consider referrals.
  • Do assess on a continual basis. As with all clients, a competent counselor never stops assessing for treatment readiness, commitment to change and growth, commitment to the grace of restriction, insight and more. Does your client show a growing evidence of empathy towards victims and the community? Does your client evidence a thirst for community supports and accountability (vs. passive acceptance)? Does your client give evidence of being solely focused on personal experience; give evidence of resistance and bitterness that others do not offer blanket trust?
  • Don’t use words, time, or other factors in determining growth and repentance. Far too frequently, churches use the right words, a few tears, and the passage of time to indicate when they reduce oversight over an offender. These are not good indicators of change! In addition, do not confuse repentance with a requirement for reconciliation. Do not neglect the matter of restitution but do not hold requirements of victims to return to a former level of intimacy with the offender. Not all that is broken in this life can be fixed in this life. Do not fall prey to the fantasy that all things are restored and reconnected in this life. Yes, our God can work miracles, but he also gives grace to us to continue with our thorns in the flesh.
  • Do set specific goals. Whenever we provide counseling for chronic issues, it helps to set goals that can be evaluated even as there may be a long road still to go. A competent counselor agrees upon goals with a client. Some of these goals might include (a) growing in empathy for others, being able to sit with the experience of others without bringing up one’s own, (b) deepening Gospel understanding about sin and impact of evil without either despair or superficial repentance, and (c) accepting limits and little trust as a way of life.
  • Don’t be caught off guard by common concerns of the offender. In my experience, offenders often have these questions that repeat on a fairly regular basis: Where can I worship? When can I come to church? Why can’t I worship with my family? When will I be done and be treated like anyone else? Doesn’t [victim] bear some blame? Why does [victim] get to make decisions about my worship? Why am I treated as a leper?  These questions are important and being prepared for them means the counselor can more likely respond with compassion and clarity. This can only better serve the offender and reduce the bitterness that comes from unanswered questions.

 

Additional links to check out:

1. Church Ministry to Sex Offenders 

2. Sex offenders vs. Sex Abusers?

3. Search “sex offender” in search box in the upper left for more blogs on this topic

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August 14, 2013 · 1:43 pm

When trauma isn’t “post”?


Over the last year or so I have been doing some thinking about those experiencing ongoing trauma. We talk of PTSD, Post-traumatic Stress Disorder, as a set of symptoms experienced after a traumatic event or time. But some people continue to live in ongoing trauma. I’m reading James Fergusson’s The World’s Most Dangerous Place: Inside the Outlaw State of Somalia. Early in the book, he talks of seeing “Sister Mary, a warm-hearted big-bosomed Ugandan in combat fatigues, dispensing medicines from a table in the ruins of the villa’s kitchen.” (p. 45). Sister Mary explains that there are two medical problems she sees. The one she treats most often is diarrhea. But, she says, the other problem she could not treat,

The people here are stressed, she explained. They are traumatized. They do not know where to turn.

You talk a lot in the West about PTSD-Post-Traumatic Stress Disorder…but for these people there is no “post”. The trauma never ends.

What can people do when trauma isn’t post? Do they have to wait until the traumatic experience is in the past in order to deal with it? What can we do for others who remain in precarious and life-threatening situations? A friend raised this question when working with a group of refugees in a UN temporary camp. Some of the suggestions that were given this friend

1. Helping refugees find some way to hang on to small measures of empowerment: set up classes for children, build huts for those who are just arriving, develop “positions” for adults to fill so the camp runs smoothly and has a modicum of safety.

2. Reinstate religious and cultural traditions where possible

3. Practice corporate lament along with other worship activities

4. Allow people to tell as much story as they wish, whether by voice or artistic rendering

Notice that these are finding ways to cope by (a) making the moment better and (b) bearing witness, even if they can do nothing about the crisis. When a person feels some level of ability to respond to a difficult situation, that person often experiences less trauma than those who are unable to express any agency. Further, when they feel that they matter to others (someone listened to whatever they had to say), they tend to have less long-lasting PTSD symptoms.

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August 1, 2013 · 5:08 am

Some additional thoughts I had after Rwanda


Over at the Seminary faculty blog, I’ve posted this short musing about Rwanda and some of the stories of loss and redemption we heard during the conference. Check it out and see one picture of a small group activity where we heard many of these stories. In truth, listening to these stories on the banks of exquisite Lake Kivu made for a surreal experience!

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July 30, 2013 · 11:11 am

How do trauma symptoms pass to the next generation?


As a clinician, I have had anecdotal experiences that the trauma experienced by a parent is passed on to a child who presents with many trauma symptoms despite not having experienced the initial trauma. We have witnessed what looks like this kind of transmission in places like Rwanda where children born after the genocide seem to experience many of the same symptoms of their parents.

Thus far, the data about generational transmission has been mixed. Looking at 2nd and 3rd generations of holocaust survivors, some research indicates that later generations can be affected; some research indicates no secondary traumatization. The problem with this research is that much is focused on the content of transmitted symptoms rather than the process. In the latest issue of Psychological Trauma (v. 5:4, 384-391), Lotem Giladi and Terece Bell have published a study looking at both content and process of trauma symptom transmission (“Protective Factors for Intergenerational Transmission of Trauma Among Second and Third Generation Holocaust Survivors”). The authors hope to have a clearer picture of risk and protector factors. As they say,

“The research question was not whether 2G and 3G experienced greater psychopathology than controls, but rather why some of them still carry some Holocaust-related psychological distress whereas others do not.” (384)

These researchers tested whether psychological concepts of differentiation of self (a Bowen concept indicating the ability to balance need for connectedness with family and need for being a separate self) and family communication (a previous study indicated that 2G holocaust survivors suppressed communication of negative emotion around their parents).

What did they find? 2G and 3G both showed greater levels of secondary trauma than controls (though all amounts of STS were in normal range) and surprisingly, the 3G group did not show less secondary trauma than did the 2G group. Indeed, greater differentiation of the self and better family communication among the generations of holocaust survivors positively correlated with  few secondary trauma symptoms.

So, how do trauma symptoms get transmitted to the next generation? We do not really know yet but one possible answer is that trauma tends to influence emotion regulation, anxiety regulation, and thus decreased self-soothing behaviors. This may get passed on to the next generation via suppressed negative feelings (children who do not want to make matters worse) and identification with the parent’s distress (and partially responsible for it).

For those readers who might wonder if their own trauma is causing secondary trauma in children, consider these things:

  • Most of the 2G and 3G holocaust survivor families are not terribly harmed. Most do well. So, it is not a given that your family is being harmed by your trauma symptoms
  • Open communication about the trauma symptoms and impact on family (without laying blame!) is likely helpful. Also communicate how coping with trauma symptoms can also teach a family some positive lessons as well (patience, gentleness, boundaries, etc.)

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July 26, 2013 · 9:39 am

Remember the “crack babies”? Results you might not expect


My local paper ran this essay this week: “Crack Baby” Study Ends With Unexpected But Clear Result. After 23 years, the study is over and the results might interest you. Turns out, cocaine is not the worst thing for you. It did not create underdeveloped children, mentally retarded children, emotionally disturbed children. Researchers found no evidence that cocaine accounted for clinically significant differences between exposed children and non-exposed children.

The Clear Result?

The clear result is not that cocaine has no negative impact (it does contribute to premature births and some other problems, but it doesn’t appear to contribute to life long problems in children born at full term.

The clear result is that both controls and exposed children were from the same environment: urban, minority, poor communities. The clear result is that POVERTY and VIOLENCE are significant contributers to things such as low IQ, exposure to traumatic experiences, etc.

Listen to some of these stats:

  • At age 4, control group average IQ: 81.9; exposed children average IQ: 79.0 (both significantly lower than average IQ of national population of children same aged
  • At age 6, 25% of kids in each group scored in abnormal range in math and letter/word recognition
  • By age 7, 81% had seen someone arrested, 35% had seen someone shot, 19% had seen a dead body outside
  • Drug use did not differ between groups: 42% had used pot (as young adults)

But some stats that astounded me:

Of the 224 kids, the researchers have kept track of 110. Here’s some additional data:

  • 2 dead, 3 in prison
  • 6 have college degrees, 6 on the way to getting a degree (these are the ones who they kept in touch with! I expect the percentage of college degrees to not would go down!)
  • and this one: 60 children born to the 110 participants (remember the ages of the participants must be between 23 and 26!)

Mix poverty with failing schools, fractured families, and you get folks who have few options to make it. Without much hope for a future, it is easy to give in to any pleasure or comfort for the moment. Thus, you see higher drug use and babies.

Good to remember that when we see a simple equation between problem and cause, we probably have it somewhat wrong.

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July 22, 2013 · 5:38 am

Belief System Supports for Spiritual Abuse


We continue our survey of some of the issues regarding spiritual abuse. You can see these links at the end of this post for prior blogs and also check out Carolyn Custis James’ thoughts on the same topic: www.whitbyforum.com. In this post I want to consider some of the beliefs that may support the ongoing presence of spiritual abuse among people of faith.

Beliefs of those who abuse

In my recent trip to Rwanda, we got into a discussion with some Rwandans about husbands and wives and the “right” husbands had to demand sex. In Rwanda, the groom pays a dowry for his bride. He pays it to her family. They set a price of “cows” that she is worth. This is an old custom but one that continues even in modern Rwanda where the “cows” are kept at the bank. In some people’s minds, a man has a right to demand sex at any time because he paid for her. She is property. Sure, he treats her as a prized possession but still, he has the right to have sex whenever he wants. Here, you can see, is a considerable belief system held by those in power about their right to use others. Does something similar exist in evangelical Christianity that enables a person in power to abuse another using spiritual tactics?

  1. The leader should not be questioned. He is ordained by God and therefore speaks for God. While evangelicals and fundamentalists are not papists, they appear to maintain a similar belief that ordination means the leader speaks for truth and for God. And if someone should bring a charge against a leader, it will not be entertained without multiple witnesses. Too bad that most abuse takes place in private, without witnesses. A corollary to this belief is that when a leader abuses a less valued person in the community, it is likely the less valued person’s fault for the abuse.
  2. Important rules must be fenced/protected. The bible speaks against divorce but not in all cases. Thus, we should protect against the abuse of divorce by refusing biblical divorces for those who have the right to them and demanding reconciliation. The bible indicates ordination of men (this is how it is read in many circles). So, in order to protect against women teaching or preaching, we won’t let them have any leadership outside of Sunday School for children. Fencing the law is legitimated in order to protect against the appearance of wrongdoing.
  3. The organization is more important than the individual. If one person does bring a credible charge against leader(s), some orgs will attempt to restore the leader and push the victim on to another church.
  4. Chronic weaknesses (e.g., mental illness) are signs of spiritual flaws and are deserving of rebuke. If a parishioner struggles with chronic anxiety, depression, or bipolar disorder, some leaders are prone to make it clear that the primary problem is not mental illness but a lack of faith and obedience. And in light of this ongoing rebellion, the person with mental illness (and their family) are not given the same kind of care as those with physical weaknesses.
  5. Thinking is less biased than feeling. When an allegation of abuse is brought against a leader, the merits of the case are sometimes decided in favor of the leader’s logic and against the victim’s emotional arguments. It is assumed that cognitions are less impaired by sin nature than feelings/emotions. Similar to this belief is the one that says that men are more logical and accurate than women or children.

Those who are abused also maintain many of these same belief system. They feel that they are not in a position to know truth, that their feelings are distorted more than others, that their needs do not merit help, that the preservation of the institution is more important, and that they are the cause of the problems they experience.

What other beliefs have you noticed that support the acceptance and continuation of spiritual abuse?

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