Category Archives: Uncategorized

Complex Trauma: Going Deeper, By Diane Langberg


As part of our staff meeting today we watched this video by Diane Langberg. It reviews the 3 stages of typical trauma recovery process plus focuses on the impact of the work on the counselor. Self-care is a common conversation these days. However, a few lines stuck out to me:

Unless we take care of ourselves, we will not be able to bear witness…. Vicarious trauma is not something done to us but a consequence of having empathy…. Evil and suffering also provide an opportunity to expose the weak places in [the counselor]…. Seek out the antidotes to the poison that you sit with…[these antidotes] are not just good coping mechanisms but part and parcel to living the life obedient to God.

1 Comment

Filed under counseling, counseling skills, Counselors, Diane Langberg, Post-Traumatic Stress Disorder, suffering, trauma, Uncategorized

What does resilience look like in the face of traumatic experiences?


Does a resilient individual appear as if stress and trauma has not lasting impact? Does it mean we bounce back as if it never happened? Are there better ways to think about resilience in real life?

In 2014 I gave a presentation reviewing the topic of resilience (definition, examples, threats to, and helps) at our annual Trauma Healing Community of Practice hosted by the American Bible Society.

Sometimes we consider only resilience as an individual trait. I spend a bit of time talking about community resilience. Video is 25 minutes and associated slides (not embedded in the video) can be found here: 2014 COP Resilience.

1 Comment

Filed under "phil monroe", American Bible Society, continuing education, counseling, Post-Traumatic Stress Disorder, ptsd, Training, Uncategorized

Diane Langberg on Shame


A few years ago, Dr. Diane Langberg presented on the topic of shame at the 2014 Community of Practice hosted by the American Bible Society. She describes the toxicity of shame as a distinct part of trauma, especially betrayal trauma. You will learn about the cognitive phase of shame, kinds of shame experienced and how the response to shame takes one of 4 common forms (i.e., withdraw, avoid, attack self, attack others).

Make sure you watch to the end as she shares some insights to how God understands and responds to our problem of shame. See how Jesus enters in to our shame.

1 Comment

Filed under Abuse, Post-Traumatic Stress Disorder, sexual abuse, trauma, Uncategorized

Why we need a theology of trauma


[Previously published April 2015 at http://www.biblical.edu. The faculty blog no longer exists there thus re-posting here]

We live in a world shaped by violence and trauma. This week that I write 147 Christian Kenyan university students were killed because of their faith. Such horrific forms of violence shock us. But they shouldn’t given that in our own country violence and trauma are everyday occurrences. While some of our local brothers and sisters face actual death, all of our communities are shaped by soul-crushing abuse and family violence. Take the most conservative numbers we have—1:6 males and 1:4 females have experienced sexual assault before age 18—and realize that a large portion of your friends and acquaintances have traumatic experiences.

In a congregation of 100, 20 of your fellow church members are walking around with invisible wounds of sexual violence on their bodies and souls. And that number says nothing about those walking around with other invisible wounds, such as caused by domestic violence, racial prejudice, sexism, bullying and the like. Were we to include these forms of interpersonal violence the number would likely reach 70!

As my friend Boz Tchividjian asks, what would the sermons and conversations look like if 20 of our mythical congregation of 100 had just lost a house in a fire or a child to premature death? Wouldn’t we be working to build a better understanding of God’s activity in the midst of brokenness rather than passing over pain as a mere hiccup of normal life?

Yet, we continue to imagine trauma as some sort of abnormal state.

Ruard Ganzevoort[1] tells us that, “When one looks at issues like these, we must conclude that our western societies are to no less degree defined by violence and trauma, even if everyday life is in many ways much more comfortable” (p. 13). Thus, Ganzevoort continues, we must “take trauma and violence not as the strange exceptions to an otherwise ‘nice’ world” (ibid, emphasis mine). He concludes that while we have a strong theology for sinners, we have a less articulated theology for victims.

What if we were to read the Bible in such a way to build a theology of trauma for victims? What would it look like? I would suggest that Diane Langberg’s maxim sets the stage quite nicely: the cross is where trauma and God meet. Jesus cries out due to the pain of abandonment by the Father. Since we do have a high priest who understands our trauma (Hebrews 4:15), we can read the entire canon from the frame of trauma—from the trauma of the first sin and death to the trauma of the cross to the trauma just prior to the coming new heavens and earth.

Key Themes in a Theology of Trauma

Reading the Bible through the lens of trauma highlights a few key themes beyond the foundation of a God who Himself knows trauma firsthand in the unjust torture and death of Jesus:

Anguish is the norm and leads most frequently to questions

When more than 40% of the Psalms are laments (and that doesn’t count the primary themes of the prophets!) we must recognize that anguish is most appropriate forms of communication to God and with each other. But we are not alone in the feelings of anguish. God expresses it as well. Notice God expresses his anguish over the idolatry of Israel (Eze 6:9) and Jesus expresses his when lamenting over Israel (Luke 13:34) and cries out in questions when abandoned by the Father (by quoting—fulfilling—Psalm 22).

Despised and rejected, a man of sorrows, acquainted with grief.

Peace happens…in context of chaos

Psalm 23 comes to the lips of many during times of trouble as it expresses peace and rest during times of intense trouble. Shadows of death yet comfort; enemies around yet feasts. Peace happens but rarely outside of chaos and distress. Consider Jeremiah 29:11, frequently quoted to those going through hardship to remind them that God has a plan. He does have one, but recall that the plan was to live in exile among those who see the Israelites as foreigners and second-class citizens!

The kingdom of God in the present does not promise protection of bodies

Try reading Psalm 121 aloud among those who have survived genocide or been raped repeatedly by soldiers. “The Lord will keep you from all harm.” Really? You lost 70 family members? You cannot maintain your bladder continence due to traumatic injury to your bladder? Where was your protection? Our theology of God’s care must take into consideration that He does not eliminate disaster on those he loves. Recall again the trauma wrought on those God chose to be his remnant. They were the ones ripped from families and enslaved by the Babylonians.

God and his people are in the business of trauma prevention, justice, and mercy responses

The kingdom of God is not for those who have pure beliefs. The kingdom of God is for the poor in Spirit, the persecuted, those who provide mercy and those who hunger for justice (Matthew 5). True or pure religion is practiced by those who care for the most vulnerable among us (James 1:27). Jesus himself is the fulfillment of healing as he claims Isaiah 61 as fulfilled in his personhood and mission (Luke 4:18-21). We his people are the hands and feet to carry out that binding up and release from oppression.

Recovery and renewal during and after trauma likely will not eliminate the consequences of violence until the final return of Jesus Christ

Despite our call to heal the broken and free those enslaved, we are given no promise that the consequences of violence are fully removed until the final judgment. Rarely do we expect lost limbs to grow back or traumatic brain injuries to be erased upon recovery from an accident. Yet sometimes we assume that traumatic reactions such as startle responses, flashbacks, or overwhelming panic should evaporate if the person has recovered. A robust theology of trauma recognizes we have no promise of recovery in this life. What we do have is theology of presence. God is with us and will strengthen us guiding us to serve him and participate in his mission to glory.

There is much more to say about a theology of trauma for victims. We can discuss things like theodicy, forgiveness, restorative justice, and reconciliation. But for now, let us be patient with those who are hurting as they represent the norm and not the exception. And may we build a missional theology of trauma, not only for victims, but also for all.

[1] Ganzeboort, R. Ruard (2008). Teaching that Matters: A Course on Trauma and Theology. Journal of Adult Theological Education, 5:1, 8-19.

10 Comments

Filed under Abuse, biblical counseling, christian counseling, counseling, counseling skills, Counselors, Doctrine/Theology, Post-Traumatic Stress Disorder, teaching counseling, Uncategorized

Trauma and the Church presentation this Friday night


This weekend, Foundations Christian Counseling is hosting a 2 day conference, Counsel From the Cross at Spruce Lake Retreat. I will be speaking Friday night (8 pm) on “The Cross, the Church, and Trauma: Making the Church a Safe Place for Victims of Trauma.” Use the 2nd link above to register for the day or the weekend.

2 Comments

Filed under "phil monroe", Abuse, Christianity, counseling, Counselors, Post-Traumatic Stress Disorder, ptsd, trauma, Uncategorized

Watch live stream presentations on power that harms or heals


Starting Tuesday, The Mission: Trauma Healing ministry of the American Bible Society will livestream its 2017 Community of Practice. You can link up here. Conference begins at 8:30AM EDT.

Here are a few of the notable plenaries

  • Tuesday 11 AM: The Good, Bad, and Ugly of Trauma, By Diane Langberg, with Phil Monroe
  • Wednesday 9 AM: The Exploitation of Power in Cultures, By Sherwood and Judith Lingenfelter
  • Wednesday 3:30 PM: Your Power as Facilitator, By Phil Monroe with Diane Langberg
  • Thursday, 9 AM: How to Empower People who have Lost Their Power, By Michael Lyles, MD
  • Thursday, 11 AM Power in Trauma and Healing in Rwanda, By Baraka Paulette

There are other presentations but these are some of the key presentations on the topic of power. Hope you can make it online.

 

Leave a comment

Filed under Abuse, Post-Traumatic Stress Disorder, Training, trauma, Uncategorized

Rumination and Reframing Mistakes: A Podcast


I participated in my colleague Heather Drew’s Life in the Whirlwind’s podcast. Check it out!

Phil Monroe joins me for a conversation on meeting rumination with stillness & acceptance, on reframing mistakes, addressing shame head-on, and other things to contemplate and practice. Come join the conversation.

Leave a comment

Filed under Uncategorized

A Cancer Within Evangelical Christianity


There is a serious problem within protestant evangelical Christianity. We love right preaching and teaching more than we love right living. We love power and authority more than sacrifice and submission. We love honor over humility. We love being led by popular leaders who make us feel good more than following the despised and rejected One—who has no “beauty or majesty to attract us to him.” (Isa 53)

We want King Saul over young David.

Of course I do not accuse all protestant Christians nor all leaders with this charge. And yet, we must all own this problem together. It is not merely the Catholic Church that has covered up abuse or used power to protect itself. While the system of the Catholic Church enables a wider and deeper cover-up, we have all of the same issues on a (slightly) smaller scale.

A picture of a true leader of God’s church…and the opposite

Leaders of the church are to be representatives of Jesus, individuals set apart to be under-shepherds. They are to care for the flock. And what do we need? We need teaching, encouragement, comfort, and rebuke in their proper times and measures. But most of all we need our leaders to be images/examples of our true Shepherd.

Quite simply, the good shepherd is one who lays down his life for the sheep (John 10:11) and who feeds, carries, and gently leads (Isa 40:11). Of course this is a picture of a powerful leader. Only one with power who knows right and wrong can choose to sacrifice rights and become smaller for the purpose of care of the most vulnerable.

But we have a pattern of enabling self-promoting leaders of the flock. These want to be listened to, respected and followed for their own sake. Sure, they may speak of the Gospel of grace, but how do they live it? How do they treat the ones who have the least power? How do they handle criticism? Do they even have a Paul (wise older leader with a track record of being willing to encourage and also say hard things) to speak to them as he did to Timothy? Or would they tolerate one who spoke to them as Paul did to Peter when he acted out of accord with the Gospel (Gal 2:11f)?

It seems that when we do see brokenness in our leaders we tend to excuse it, especially when their gifts are attractive and the ones revealing these flaws are expendable.

Consider this warning

What makes Jesus angry? The New Testament records a few instances of expressed anger: Money changers, self-righteous religious leaders, hindering children, and the pain of death (Lazarus). We see it most clearly in his language toward the religious leaders when he calls them “brood of vipers…white washed tombs…hypocrites.”

What are these leaders doing that evoke Jesus’ just anger? Matthew 23 provides some answers.

  • Everything they do is for show to receive the praise and honor of followers
  • They seek power and control. They (try to) decide who can be in the kingdom; they seek converts who will work for their interests
  • They develop special rules that support their apparent position of authority
  • They makes a show of sacrifice yet forget the most important values: justice, mercy, and faith/submission to God
  • Their public and private selves do not match—the outside looks great but inside is abominable

It does not matter if they deliver well-crafted and biblically sound sermons. It does not matter if many flock to their ministries. If their motive, efforts, and tactics (public and private) do not match God’s character of a good shepherd, their good human gifts of are no value. Even worse, they deserve rebuke (Ezekiel 34; Jeremiah 23) and even removal from speaking for God anymore (Ezekiel 44).

The true problem?

There have always been false shepherds. There always will be false shepherds. But, what enables them to stay in positions of power is that we allow it. G. Campbell Morgan minces no words when he highlights the problem of false shepherds.

Now the false in religion stands revealed in Christ’s contemplation of these men [described in Matthew 23], not only in the case of the men themselves, but in the case of the people who are under the influence of such men. The false in religion in the case of the people is due to failure to discriminate between the human and the divine; and consists of submission to unauthorized authority.

Morgan, Gospel According to Matthew, p. 273†

Why do we fail to discriminate between human and divine? We overlook “foibles” because we know our own hidden sins. We fear being ostracized and losing our position in the inner-ring of power. We ignore the words of victims in order to maintain the appearance of health in the system. We love the image of redemption (the happily ever after restoration) more than the long slog of obedience. In short, false shepherds cannot maintain or increase power unless we protect and enable them.

The beginning of a solution

Let us repent of these our sins. Let us study anew what we and our leaders are to be like. Let us listen to the ones we call expendable when they speak about abuse of power. In the words of my former pastor, let us pray to God for better leaders than we deserve and to be the kinds of undershepherds we are called to be in God’s wide kingdom.

Consider these previous posts on related topics:

To avoid spiritual abuse church leaders should do this

Evaluating the Character of a Leader?

Restoring fallen leaders? Possible or Impossible?

Spiritual Abuse: What it is and Why it Hurts

† My thanks to Dr. Diane Langberg for pointing me to this quote in Morgan’s commentary.

 

3 Comments

Filed under Abuse, Christianity: Leaders and Leadership, church and culture, Evangelicals, Uncategorized

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.

6 Comments

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

Can Mental Health Practitioners Predict Future Violence?


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

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

A little history of predicting future violence

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

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

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

One More Complication

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

Bottom line for Practitioners

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

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

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

2 Comments

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