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.
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.
Free Screening of Unchained: a documentary about generational trauma and healing in African American families
Come early if you want a seat. Local church leaders are featured in the documentary.
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.
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:
† My thanks to Dr. Diane Langberg for pointing me to this quote in Morgan’s commentary.
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.
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.
There have been a number of popular books about living a particular way for the year. AJ Jacobs’ book about living Biblically or Rachel Held Evan’s book on living biblical womanhood may be the most well known but I think my favorite title in this genre is a The Year of Living Danishly. Maybe it is all that hygge (cozy living) they enjoy. I hope to find out soon in my trip there in January.
This post details a similar genre, though entirely involuntarily so.
On December 31 2015 I found myself being tested, stuck, and interviewed at my local ER. I had been more tired than usual since my trip to Amman Jordan the previous month. I chalked it up to a heavy travel schedule and the end of semester fatigue. I would soon be 50. Was I slowing down? But on that day in the ER, I was having trouble moving my muscles to go up and down stairs. Standing for more than 5 minutes was out of the question. Larger muscles seemed to all want to twitch with a mind of their own. Having traveled to Brazil, DR Congo, Rwanda (twice), and Jordan, the doctors thought I must have contracted something exotic and interesting.
I spent the month of January and February teaching from a stool and spending a lot of time in bed…or at various specialists. The results all came back negative. I didn’t have a known exotic infection. Neurology didn’t turn up anything that would explain my fatigue. I was able to keep working but exercise and basic exertion was next to impossible. I had felt tired before but didn’t know that fatigue makes things like raising your hands or even chewing food to be a chore…or that fatigue makes sleep even more difficult.
After 6 months of seeking mainstream answers and getting nothing, I turned to integrative medicine and began a regimen of massive supplements and treatment for a possible chronic lyme infection. Certainly, my level of fatigue has dropped considerably even if I cannot walk long without fatigue. I can teach for 3 hours and only need to sit from time to time.
So, what have I learned during the last 12 months?
- Fatigue colors everything. Sleep is non-existent. Eating is tiring. Even thinking is a challenge. Memory, mood, and libido are seriously disrupted. Fatigue of this level is all-encompassing and cannot be escaped.
- Planning is nearly impossible. What will I be able to do next month, next week, the next day? Should I cancel that speaking engagment? Should we cancel family vacation? I wouldn’t know how I was going to feel in the afternoon even when I felt great in the morning. I realized how little ability I had to predict my energy, especially last winter.
- Fatigue messes with identity. For 50 years I have done what I wanted to when I wanted to. I have been able to push (even over-extend) my body with little seeming consequence. Fatigue, on the other hand changes how you see yourself and how you relate to your loved ones. Once used to being the one to do things for others, you become the helped. When you feel 80 but you think you should feel like 50, it begins to change your sense of yourself and your place in life. At times I wondered if my career was about to be over. If you make your identity what you can do, fatigue will soon remind you that such an identity is certainly fragile and soon lost.
- Unknown causes of suffering is its own form of suffering. During the months of testing, I regularly had to consider what to do have the next round of “negative” results. Should I keep digging? Even after accepting an “equivocal” chronic lyme infection diagnosis, the treatment consists of medicines/supplements that are not fully supported by mainstream medicine (i.e., double-blind study results). Is it working? (Or better, what part of it is causing the positive results?) Should I continue?
- There is a secret fraternity among fell0w sufferers. Over the last year I have come to know many invisible sufferers. Individuals with chronic pain, fatigue, and/or disease states that limit capacity are quick to empathize. They offer support and help with ease but also with the knowledge that there isn’t a magic bullet to solve the problem. I have felt loved and cared for by many but those who know are the best at understanding.
- Weakness offers an opportunity to trust God anew and to see life with new eyes. When you can only trust God (and not your own strength) you see mercy and grace you might not have seen before. When you can do what you want, you are filled with gratitude.
I would love to say that on December 31 2016 I was able to learn all I needed to learn from my year of fatigue and revert to my former physically capable self. While I am not back to where I was, I am happy to report that I am much improved over last year. I can walk further, stand for as long as I need to, and travel internationally as I have opportunity. And I hope I continue to be more prayerful as I steward what resources I have been given.
Advent and the end of the year provide opportunities for some self-reflection in preparation for the start of the coming year. So…how are you doing? Are you taking care of yourself? This is especially important if you are a service provider such as a counselor or caregiver.
Last October, a meta analysis of healthcare providers’ self-care (or lack thereof) and its relationship to quality of service indicates a clear negative relationship: lack of self-care leads to great likelihood of harm to patients.
Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = −0.26, 95 % CI [−0.29, −0.23]) and safety (r = −0.23, 95 % CI [−0.28, −0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients.
What is even more telling is that patients can tell and do perceive when we are burned out. You think your bitterness, your lack of sleep, your losing your first love of helping isn’t showing? It is.
Now, there are many reasons why we don’t steward ourselves (hearts, bodies, and minds) well. Sometimes we are in systems that actively discourage taking care of the self. In Christian settings, focusing on the self doesn’t seem to comport with “being poured out like a drink offering.” Others of us never learned how. Still others struggle with guilt. How can I take care of me if others have less help than I do? Yet others don’t take time to pour back in to self because it isn’t comfortable. Serving others is easier and provides more immediate rewards.
What is your reason?
If you were going to do something on a consistent basis to recognize your need to be cared for, what would you do? For your spiritual needs? Professional growth? Physical needs? Relational needs? See if you can come up with one thing for each arena–things you can do on a consistent basis. For example, you might decide to read Diane Langberg’s daily devotional for the next 40 days, In Our Lives First, as a means to do something for both your ministry skills growth and spiritual vitality.
Don’t over-think it. What is just one thing you can do (or stop doing if it isn’t helping) to make your self a bit more refreshed?