Tuza 2.0: Day Three


[June 25, 2013: Kigali to Kibuye]

Our day started with devotions with IJM staff at their office in Kigali. After devotions we met with the social work staff on a beautiful balcony overlooking the city to hear about their work with victims, the process of getting information to determine View from IJMif they could take the legal case and the counseling they could offer. IJM offers TF-CBT informed therapy for parents and child victims. You could hear the heartache as the counselors can only offer counseling to those whose cases IJM agrees to investigate and work for prosecution. They do what they can in those cases where abuse has happened but lack necessary evidence for courts. Unfortunately, there are few options for referral.

After IJM we proceeded to go to Ndera Psychiatric Hospital. As the ONLY psychiatric inpatient facility in the country of 11 million people, they about 350 beds. Do the math! About half of their patients are those with serious seizure disorders. Those in the crisis units have severe psychotic and disruptive behaviors. We saw one man who was stark naked. When asked about census, we discovered that while they have 60 or so beds for men in crisis, their current census is 78. Meaning, men share cots for sleeping!

We visited the stabilization units for men and women, the pharmacy, and kids ward [Picture below is of the daily schedule for kids in picture form]. It seemed that the hospital has a fewkid schedule more medications available to use since our last visit in 2009. Then, they only had access to Haldol. Now, they have some atypicals like Risperadone. Most stay at the hospital for about 3 weeks, though we were told that someone was in the crisis unit since 2001!

After the hospital, we intended to take a trip to one of the church memorials in Nyamata. However, we were running late so we returned to Solace for lunch and discussions with Bishop Alexis, an Anglican Bishop. Bishop has been engaging with us since 2009 for counseling help. He suggested that we come next time with a plan to engage key principles for a country-wide  response so that we avoid overlap.

By 3pm, we were on our way to Centre Bethanie on Lake Kivu in Kibuye. Our bus was packed with people and luggage. The road from Kigali to Kibuye has more twists, turns and vistas than you can possibly imagine. Lovely drive, though long. Finally, we arrived 3 hours later (after dark) to the conference center. Dinner was served in the restaurant (open sides to the lake!).

Today was a full day in many ways. One fun item: I received an African shirt from other team members. Wore it with pride today. One serious item: on our trip to Kibuye, I sat next to a man who told me his genocide story. Lost wife and 2 children. Survived hiding in the reeds for over a month. He told me how the Lord spoke to him about forgiving his family’s killers and how now he is doing reconciliation work with victims and perpetrators. I am amazed at his strength and struggles.

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Can you teach children to think before acting violently


NPR’s Morning Edition has a piece this morning on the problem of impulsive acts of violence by adolescents with guns and an attempt at a prevention plan. You can read and/or listen to the segment here. The researchers discovered that most of the violent gun crimes by teens were not premeditated. Instead, the shooters were in possession of a gun and when the problem became heated, they made the choice to use their gun to solve the problem–they failed to consider the consequences as they “solved the problem” with a weapon.

The intervention used in Chicago schools is a form of Cognitive Behavior Therapy to increase prosocial decision-making strategies. These interventions are not particularly new. The basis of this type of intervention assumes that if a person would pause before acting, step back and make an evaluation of the problem and consider alternatives, then the person would likely make a better decision. In previous research, these interventions are found not to generalize well from session to real life.

But, the research discussed in this piece seemed to point less to impulsive decision-making and more to the base assumptions they assumed others would make of them if they used polite speech to ask for something they wanted.

In one exercise, Ludwig says, the students were grouped into pairs, and one member of each pair was given a ball. The other was told to get the ball out of his partner’s hand. This invariably led to a fight, Ludwig says, as the kids brawled over the ball. After watching the fight, the program leader would ask the student who was trying to get the ball a question: “Why didn’t you ask the other kid to give you the rubber ball?”

None of the adolescents, Ludwig says, ever thought to ask their partners for the ball.

“The kids will say things like, ‘Oh, if I would have asked, he would have thought I was a punk,’ ” Ludwig says. “Then the group leader will turn to the partner and ask, ‘What would you have done had this other kid asked you to give him the rubber ball?’ And usually this other kid will say, ‘I would have just given him the rubber ball. What do I care?’ ”

The goal of such exercises, Ludwig explains, is to help the teens understand that their strong, negative reactions during confrontations are often based on what they falsely imagine is happening in other people’s minds.

Does it work?

You can read in the linked essay that those who received the intervention were FAR less likely to engage in violent crime. But notice that on 1 year follow-up after the intervention, the differences between those who received the intervention and those who didn’t were insignificant. In other words, the intervention works while it is being received, but is not a permanent change. So, one wonders what makes the program work at all. Is it the positive relationship between the students and those doing the teaching leading to more gracious responses to others?

In the past, I’ve read about stop-think-observe-plan interventions and assumed they were worthless since the students didn’t retain the skills to make better decisions after the intervention concludes. But note that the essay concludes with the researching noting that the benefits during the program are worth it in terms of cost-benefit. Maybe it would be good to see a 5 year program and whether the benefits really do continue during a longer program.

 

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Mission to Worship: How Preventing Abuse Fits in the Mission of the Church


I will be part of the speaker panel at a conference entitled: Mission to Worship: With Heart, Hands, Voices, October 16-19, 2013. The catch is (for my N. American readers)…it is in South Africa! The conference is sponsored by North-West University theology faculty and the World Reformed Fellowship. I and Diane Langberg will be doing both plenary and breakout sessions on the topic of trauma counseling and the matter of responding well to abuse allegations in the church. There are other tracks so check the schedule for those topics.

It is exciting to see a theology department, seminary, and Reformed para-church organization take on the matter of sexual abuse and trafficking. Should be an exciting time.

 

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Filed under Abuse, christian counseling, christian psychology, Christianity: Leaders and Leadership

Tuza 2.0: Day Two


[June 24, 2103]: Kigali to Butare to Kigali

Day starts with a breakfast of croissant, hardboiled egg, dragon fruit, and coffee. Our team left Solace Ministries this morning to have devotions with World Vision Rwanda staff. Met with senior staff and Director George Gitau. He gave a history of WV in Rwanda since 1994. They work in 15 of the 30 sectors in the country. They are working to stop most handouts (e.g., school fees programs) and wean off dependency of international donor dollars as much as possible…and replace with economic development plans. They are helping Rwandans form saving and lending formations. Seemed to be saying that focus on genocide and trauma was passing to work on peace building and prevention curriculum with younger children. Using Christian musicians to bridge the cultural divide in the country. While prevention strategies are a great move, just because 19 years have passed doesn’t mean the trauma of the genocide and aftermath are finished. Transformation of traumatized populations are still needed.

From World Vision we left to visit the One Stop Center, a government institution for women experiencing domestic violence, a place to get medical help and seek justice. We were not allowed in for some reason. At this point, our teams split up. The larger group visited the genocide memorial, had lunch and did a bit of shopping. My group, Diane Langberg, Laura Captari (AACC) and Marianne Millen (student from Biblical) took a 2 hour trip to Butare (AKA Huye) to visit with Bishop Nathan Gasatura of the Anglican church. As board member of the Prostestant Institute of Arts and Social Sciences (PIASS), he brought us to the school and led a meeting with the vice rector and key faculty/staff. PIASS started in 1973 as an institute in theology. They added 2 faculties (what we would call schools) in 2010 and expect to had another by 2017 when they reach university status. In 2 years the school has grown from 300 or so to over 1000. Most classes are held on evenings and most students commute. We discussed possible ways we could support counseling training for pastors and school counselors who want to tackle issues of domestic violence, abuse, addictions, and trauma recovery. Seemed the most logical and realistic way to help is to develop some 1-2 night public seminars and a few short courses (100 hours across 2 weeks) for credit. Those with good skills in training pastors, cross cultural competency, and the specific content specialists would be welcome here.

On a tight schedule we “flew” back to Kigali with our driver Jean Pierre. Anyone looking for a careful driver in Kigali should hire him! By a miracle we narrowly missed hitting a young man who was crossing the road without looking. None of us in the car understand how we did not hit him (traveling at 30 miles an hour). Later, we stopped for our driver to make a call and were mobbed by school children on the way home wanting to try out their English with us.

We arrived back at Solace to go immediately into an impromptu meeting with 20 Bible Society volunteers and workers. The other team members had been listening to how the BS was using Healing Wounds of Trauma material in Kigali and other sectors of the country. We listened to some of their trauma cases: cases of forced rape, genocide victims, and forced abortions after rape. Many reported that HWT is the best material they have had access to over the past 19 year. There was one who felt the same but wished to not start with the chapter about why we suffer as there is some in the country who are inclined to quiet people with such material. I did a short presentation about how to ground individuals who are actively distressed and dissociation. We concluded the evening with a late dinner with the BS volunteers. Another home run by Simeon at Solace!

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Filed under AACC, christian counseling, counseling skills, genocide, ptsd, Rwanda

Tuza 2.0: Day One


We arrived last night in Kigali after 24 hours of traveling. Yet, Solace Ministries Guest house provided an excellent rest (and a great meal).

Today, we started with church on Ndera hill. Well, actually we started with breakfast, my favorite meal in Rwanda: fruit, croissants, and coffee…with a view hard to beat. Church consisted of excellent singing, dancing ( the spirit can move my feet when I am here), testimonies, and choirs. Then, I preached from Jeremiah 29 about prospering in exile. Being translated is a different experience.

3.5 hours in total. It passes like an instant despite the hard benches. I imagine we could learn from Rwandans something about doing church.

After church we went to an elder’s home for lunch and then on to Baraka’s house for a visit. Got to get in her banana grove to see the trees up close and personal. After visiting with her, she took us to a residential home for street boys. 124 in residence. The young man showing us around is one of their first graduates. Fine young man. Many of the boys were on the street due to family violence or substance abuse. The organization has just hired a counselor ( herself a former orphan) just out of school. She has been working for 3 months to assess each child’s needs and to determine which ones will get services. She has no resources and said she greatly desires more training. While we were there we watched some outsiders teach the boys break dancing moves.

The day is ending back at Solace with a jam packed day on tap for tomorrow.

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Why do some spiritual leaders abuse power?


The topic of spiritual abuse has been in the news of late. In looking at the problem of cover-ups of sexual abuse within the church, we can see that not only bodies are violated and harmed, but spiritual abuse also happens to victims, their families, and those in the community who know about the abuse but are coerced to remain silent and still. Of course spiritual abuse happens outside of sexual abuse. In fact, I would hazard a guess that most of spiritual abuse happens apart from sexual abuse.

As I defined it in an earlier post, spiritual abuse is: the use of faith, belief, and/or religious practices to coerce, control, or damage another for a purpose beyond the victim’s well-being (i.e., church discipline for the purpose of love of the offender need not be abuse).

Over at www.whitbyforum.com, Carolyn Custis James is blogging each Monday about the problem of spiritual abuse. You can see the first post here along with the topics she’ll look at over the next 6 weeks. Today, she will be raising some questions about the abuser and I may comment on her site as I can [note: this is written earlier and if all happens as planned, I am traveling in Rwanda today]. For those of you who don’t know of Carolyn, she is the author of Half the Church: Recapturing God’s Global Vision for Women.

What Do We Know About Those Who Abuse?

The truth is we do not have empirical survey evidence for those who use spiritual tools to harm or manipulate others. But, we can say something about the kinds of reasons why someone might want to coerce and manipulate. We know things about this activity because we all have participated in coercive acts. We have used others for our own purposes. In the words of an old Larry Crabb book, we have chosen manipulation of over ministry to those we love. So, in this way, we can learn a bit about why some try to control others by looking at why we try to control others:

  • Fear. We fear losing control, having someone disrupt our plans. We worry that we will be left, abandoned, rejected. We worry that what is important to us will not be cherished and valued by others so we seek to control the outcome. Notice that much of what we want as outcomes are good things. In spiritual matters, it is not good for people to do things that dishonor God. So, we may try to force our kids or parishioners to do what they ought to do. But force violates the picture of love God gives us in the Scriptures. He does not force us to come to him. He draws and woos us.
  • Love of Power. We must admit that we sometimes control others because we like seeing the evidence of our own power. Ever had someone trying to do something to you and you wanted to prove that you could beat them at their game? Maybe you thought, “I’ll show you who’s the boss around here!” This is nothing less than a love of one’s own power. God gives us power. Power is not wrong. But the use of it to serve self (even if in the name of God) is an abuse of power. Spiritual leaders have power of words and these words can be easily used to glorify self.
  • Efficiency. Power works. It gets us what we want. If the outcome is good, then the means seem good. End of story. Spiritual abuse works. People fall in line. They remain orderly and do not disturb church leader’s good goals.
  • Ego. Self is part of why we treat others as objects. We think about self, needs, desires, wants, and expectations. The stronger the ego, the more confidence we have that our way of seeing the world, our expectations, our outcomes are the right ones. And the stronger our confidence, the deafer we become to other ways of seeing the world. Narcissism sometimes operates out of fear (see bullet point 1) but also operates out of arrogance and pride. We become blind to others, insensitive to needs of others. Ego in ministry is a worship of self in place of worship of God—a God who illustrates sacrificial leadership! 
  • Habit. I would argue that many of us engage in controlling behaviors without much thought at all. It is habit or learned behaviors from others. It is said, rather crassly, that starving people tend to starve others. It means that we who have been controlled or manipulated tend to learn the habits of controlling behavior (like tug-of-war, it is natural to pull back in the opposite direction). But in doing so we may become controlling ourselves. So, many are unaware that they may be attempting to control others. Spiritual abuse has been passed down in the name of godly leadership and so many are just doing what they learned from others.

 What Can We Do From Inside The System?

There is little that we can do to stop others who want to abuse, especially when they are knowingly predatory. However, much of the above motives do not fall into intentional abuse—even the love of power. In the cases of naïve or unthoughtful abuse, we can bring truth to light in a couple of ways:

  1. Validate: “What?” you might be asking, “Won’t that encourage them?” On the contrary, validation often opens the validated to conversation and dialog where bare confrontation leads to defense and counter-attack. So, if you see someone who is seeking a good end (e.g., obedient children) but using coercive means, try to validate the good goal even as you suggest alternatives or point out that the means seems to be control oriented or objectifying.
  2. Raise questions: What outcomes are you seeking? How do you think the manipulated person might be feeling? How might you convey concern for the person as well as the situation? How might a good goal become perverted in the intensity by which we seek that goal?
  3. Say ouch. Sometimes just saying, “I’m hurt” can signal to some that they have over-stepped boundaries.

Not all should stay inside an abusive system. But, for those who feel they can stay, these are some of the things they can do. I would love to hear what else others have tried.

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Filed under Abuse, Christianity, Christianity: Leaders and Leadership, conflicts, counseling, Psychology, Uncategorized

Trauma Recovery and Counseling Training in Rwanda


Location map of Rwanda Equirectangular project...

Location map of Rwanda Equirectangular projection. Geographic limits of the map: N: 0.9° S S: 3.0° S W: 28.7° E E: 31.1° E (Photo credit: Wikipedia)

I leave today for my second favorite place in the world–Rwanda. (1st favorite is wherever my wife and kids are). We are returning to do another level of training for counselors and caregivers (see this post for our previous Project Tuza reports) from a number of organizations caring for widows, orphans, HIV+ individuals, and trauma victims. [The photo at the top of this blog is from that last training] Our training this time will focus on domestic or family violence interventions, children and sexual abuse, and dealing with dissociation. In addition, we’ll focus on basic helping/listening skills and the features of good storytelling in counseling (not all efforts to tell trauma stories are helpful or healing).

Check back here to see posts about our training. I hope to be able to make some during our trip, but depending on connections, it may have to wait til we return. Here’s our itinerary:

6/21-6/22: Newark to Brussels to Kigali

6/23-25: church (preaching), visiting friends, important sites, meetings in preparation for this and future trainings; in both Kigali and Butare.

6/26-28: 3 full days and 2 nights of training, led and sponsored by World Vision Rwanda and AACC.

6/29: Participate in Umuganda (national required public service in Rwanda), final meetings, and boarding the plane to return home.

It is a short trip but we are able to,

  • give our new team members experiences in listening to the strengths and challenges of a community (essential to provide help that is not harmful or useless)
  • provide objective hands-on skill training (not mere information giving)
  • seek advice of local leaders as to future trainings (we always need to improve our ability to train well)
  • Enhance our relationships (Lord willing, we will continue to return year after year)

Check back for updates.

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Dr. Langberg on Dissociation (part II): DID, Principles and Cautions


Over at my other site, www.globaltraumarecovery.org, we now have part II of Dr. Langberg’s talk (March 2013) on dissociation. This video covers the concepts of Dissociative Identity Disorder (DID) and complex trauma. She ends with 10 principles and cautions for therapists working with clients who dissociate and/or who present with alternate personalities and identities.

Check out the video here. If you missed the first video or want to find other free resources, click around on that website.

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Dissociation: What is it? What can be done?


For those of you who love or are helping PTSD or complex trauma victims, you may find this video link helpful. Dr. Diane Langberg (after an introduction by me) explores the experience and process of dissociation, or “leaving” the present. She discusses why it happens and what is going on when a person dissociates. At the end of the video, she explores a few helpful ideas for helping to ground the individual in the present.

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How one church has taken up the task of addressing sexual abuse


As a christian psychologist, I work with disasters of the church. No one comes to me to tell me how their abuse was handled in a fabulous way. I get to hear all the mistakes. So, it can be tempting for me to believe that no church handles sexual abuse or abuse allegations in a healing manner.

But that would not be true. Many churches do a phenomenal job addressing this problem. Below is a link to a site illustrating how one church handled the topic. This church put a lot of time into crafting an event with aftercare, resources, and prevention plans. Check out this link to see what pastor and counselor Brad Hambrick’s church did: the sermon, video of the after service care, additional resources including other media and policy on dealing with child abuse allegations.

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Filed under Abuse, biblical counseling, christian counseling, christian psychology, counseling