Just posted a short book review over at Global Trauma Recovery Institute. It is a novella about a child survivor of the 1994 genocide 
in Rwanda. If you are interested in getting an inside look at life after a trauma, dealing with memories and spaces in memories, and a common recovery process, I commend the book to you. Quite moving, easy to read (not triggering for most), and gives some good illustrations of actions of the survivor and other caring individuals that help the young woman regain control over her internal world.
Booknote: Broken Memory
Filed under Africa, counseling, Good Books, Rwanda, trauma
Kristof on talent vs. opportunity
Have you caught the recent PBS showing of Half the Sky, a documentary based on the same-titled book about the oppression of women around the globe? Worthy of your time. The previous link will also point you to the book by Nicholas Kristof and his wife, Sheryl WuDunn. Last night, I caught the portion about female genital mutilation in Somaliland, caste-based forced prostitution in India, and struggles in Kenya.
Though there are many movings scenes, the quote that stands out most to me is from Kristof,
In this world, talent is universal, but opportunity is not.
Good reminder. We often believe in a just world, level playing field mentality. You get ahead because of hard work. You don’t get ahead? You didn’t want it bad enough. The problem with this is that the field of life isn’t level. You may be the brightest in the class, but if your parents can’t afford to pay your school bill, you won’t be able to graduate. If you don’t graduate, you can’t get the same kind of jobs, etc.
Rather than wring our hands over the unfairness, we ought to consider what boost we have received at birth and what we will do with our extra talents (to use the word from the biblical parable).
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Filed under Great Quotes
Global Trauma Recovery Institute website launched
We’ve finally gotten Global Trauma Recovery Institute off the ground with our web presence and our upcoming courses! Check o
ut the download forms on the right side of the GTRI page for application, course abstracts, and information on small group consultations with Dr. Langberg and myself.
To refresh your memory, we have a 3 course design for continuing education and training regarding the work of global trauma recovery facilitation. Courses are designed to be at the postgraduate level and each course is divided into two parts, an online portion and an on campus portion. While the online portion can be taken alone, those who wish to be eligible for the immersion portion must complete all three online and on campus portions.
These three courses will prepare participants at a beginning stages of facilitating recovery efforts in the places God has placed on their hearts. We will be exploring the nature and impact of a variety of traumas, how best to listen, learn from, and engage a particular culture, and how to collaborate with local caregivers to improve existing trauma recovery efforts.
In addition, we offer individual or group case consultations. Our first group consultation cohort will begin January 11, 2013 and meet monthly for six months (in Jenkintown, PA). Sign up now since we will only be taking 6-8 for this cohort.
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Filed under Uncategorized
What really caused the Rwandan genocide? Scott Straus’ answer
Have begun reading Scott Straus’ The Order of Genocide: Race, Power, and War in Rwanda (2006, Cornell University Press) [HT to Carol for the copy]. Not sure how many books this makes about Rwanda but I am appreciating his attempt to take a dispassionate approach to answering the question about why the 1994 genocide happened, how it happened, how/why ordinary civilians participated in the killings. Right away, Straus focuses on the methods of data collection and why he avoids the sensationalized approach to describing the gore. Within his introduction, Straus makes this assertion and then spends the rest of the book showing his basis:
I find that the Rwandan genocide happened in the following way. After President Juvenal Habyarimana was assassinated on April 6, 1994, and in the midst of a defensive civil war against Tutsi-led rebels, Hutu hardliners declared all Tutsis to be “the enemy.” In a context of intense crisis and war, the declaration that Tutsis were the enemy functioned as a de facto policy–in effect, an authoritative order and a basis for authority–around which coalitions of actors could mobilize to take control of their communities. Once local actors who subscribed to the hardliners’ position had secured enough power, they made killing Tutsis the new order of the day and demanded compliance from the Hutu civilian population. In the Rwandan context, where state institutions are dense at the local level, where civilian mobilization is a common state practice, where the idea of state power is resonant, and where geography provides little opportunity for exit, large-scale civilian mobilization to kill was rapid, and the violence was extraordinarily intense and devastating. (p. 7)
In reviewing data that he can “triangulate”, Straus helps work through a number of hypotheses that may have explanatory power but lack the data to support them. If you want to gain an experience of the genocide, Jean Hatzfeld’s books are great introductions to the stories of surviving victims and perpetrators. But, this book moves beyond story to fuller explanations of how the violence spread so quickly and slaughtered so many in so few days.
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Mis-speaking, lying, or telling a truth you didn’t mean to tell? Reasons why we say things we regret
If you have been following American presidential politics, you will understand references to candidate faux pas like Romney’s “47%” or Obama’s “guns and religion.” [Check out this link for a comparison of the two].
Ever wonder why these gaffes happen? Is it a matter of mis-speaking as so often is claimed? Or is the candidate saying what he/she believes only to discover in the light of day that they wished they hadn’t been so honest? As I look at the possibilities, I see 4 reasons candidates say things they later must apologize for.
1. They mis-speak. Let’s deal with this one first since it is most often claimed as the reason for the faux pas. Anyone can get their tongue twisted around. My father once quoted Isaiah 40:31 during a sermon and said, “ings as wiggles” instead of “wings as eagles.” This is the usual form of mis-speaking. We can get numbers, facts, and ideas twisted around. Mis-speaking is usually fairly obvious to hearers and quickly fixed once it is brought to one’s attention.
2. They say what they think but later wish they hadn’t. Quite often we say what we think but then wish we hadn’t been so forthright. When it comes out, we recognize (immediately sometimes but not always) that what we said doesn’t sound very good. Sometimes we don’t always recognize what we believe until our own ears hear it. We look down upon a group of people (in the presidential examples, religious conservatives and recipients of public funds) and stereotype them as a group because that is how we have imagined them for some time.
3. They are mis-informed. There are times we say something but have mis-understood the facts. For example, there is a commonly repeated stat that 50% of evangelical marriages end in divorce. This is not true, but someone could repeat the stat as fact but later retract it once they learned the stat was not true. Sometimes we hold a stereotype but later discover better facts and change our opinions.
4. They lie to please others or win a point. Have you ever said something because it earned you some point, even if you didn’t fully believe it. Consider a fight with a family member. Did you ever stretch the truth to win a point, “You always… You never…” Or, maybe you said something that would please your audience. You made a joke about another group of people in order to win a laugh. You suggested you agreed with an opinion even though you did not.
So, sometimes we regret speaking what we believe. Other times we regret saying things for ulterior motives. Can you think of other reasons why we say things we wish we could take back? How would you react if a politician said,
What I said was patently false. I said it because I got caught up in pandering to my audience. It was wrong not only to speak falsehoods but also wrong to give in to people-pleasing. I apologize for these two wrongs and I endeavor to speak only the truth, even if it costs me your support or the presidency.
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Filed under Communication, News and politics
What good is a diagnosis?
At the recent AACC conference Dr. Michael Lyles, a board member of AACC and practicing psychiatrist, stated the following,
A diagnosis is only a word on a page if it doesn’t serve a function.
What kind of function was he thinking about?
- Does it explain a set of symptoms?
- Does it point to a treatment plan?
- Does is help differentiate between overlapping symptoms?
I’m a firm believer that our current DSM diagnostic system is at once both flawed and useful. It is flawed in that DSM diagnoses don’t address causes or do much to point to treatment. It is useful when used carefully to help differentiate between overlapping sets of symptoms–even as it needs considerable overhaul to do a better job. Take differentiating between Major Depression and hypothyroidism instigated depression. The two look identical. But using a multiaxial diagnosis, a person could rule out Major Depression if they were able to make a positive diagnosis of low/inactive thyroid function.
So, until we have a better nosological system (i.e., a replacement for the DSM), I will continue to use it. In years to come we will, however, recognize it for the blunt instrument that it is.
Right Diagnosis…Wrong Focus?
Consider the following case study (not a real person, devised from several stories) as an illustration for the problems we have moving from current diagnostic categories to proper treatment.
Tom is 27, married, father to one young daughter, working part-time as a youth pastor and going to seminary full-time. He comes to counseling on the encouragement of his primary care doctor. One month ago during final exams and an overly busy ministry schedule, Tom began experiencing rapid heartbeat, shortness of breath, feelings that he was losing his mind, and chronic fear of dying. After experiencing 4 panic attacks in rapid succession, he began worrying that something was terribly wrong and that he was about to die. His doctor first ruled out a physical origin for these symptoms, taught him breathing and distraction exercises to interrupt the buildup of panic, prescribed an anti-anxiety medication, and recommended he make an appointment with a therapist. During the first session, Tom details his history of stress, reports he has been able to forestall 2 more panic attacks but admits he still struggles with fears of dying, lacks assurance of salvation, and feels flooded with guilt that he worries so much. Upon further exploration, Tom believes the bible teaches him that he should not fear if he has “perfect love”. He has read all of the verses about anxiety and feels condemned for his struggle.
Tom meets criteria for Panic Disorder, without Agoraphobia. This is a highly treatable problem and within a few short sessions, Tom is likely to gain mastery over his body in that he will no longer evidence panic attacks. This, of course, is not the same as saying he will stop experiencing worry, guilt over his chronic worry, or start having assurance of his salvation. Logic, disputing worries, distractions, exploring and altering core beliefs may help reduce the symptoms that brought Tom to his doctor and counselor. A good Christian counselor may also be able to reconnect Tom to Scripture in ways that help him experience God’s care for him in spite of his fears (e.g., hearing the gentle voice of Luke 12 vs. a harsh rebuke).
But has the diagnosis been properly made? Yes. Tom met the criteria for an anxiety disorder. No. Tom’s counselor also helped him discover a deep layer of shame that may have been the source of his anxiety. Without the latter, the former is not altogether helpful.
So, should the diagnosis be an anxiety disorder or shame? Until we have shame as some form of a diagnosis, I’m okay with maintaining the anxiety disorder as a good description of external symptoms. But, Tom and others like him will need wise counselors who can dig a bit to discover diverse multiple shaping factors (e.g., biopsychosociospirtual) that lead to a common expression of symptoms.
What good is a diagnosis? I concur with Dr. Lyles: not much.
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OCD or pathological grooming?
On the way to work this morning, I listened to a story on NPR’s Morning Edition about “pathological grooming.” Never heard of this disorder? It’s called biting your fingernails…or other similar things (hair pulling, face picking, nose wiping, etc.). Apparently, the forthcoming DSM 5 will lump it into an OCD diagnosis.
Here’s a couple of interesting tidbits from the 8 minute show.
- Those with OCD tend to have more of a conscious awareness of unwanted repetitious impulses while pathological groomers may be more thoughtless in their nail-biting
- Some mice with a specific genetic variant are excessive groomers, to the point of going bald, but not everyone with the gene displays the grooming habits. Thus, genes are surely part of the problem but not all
- Given the spectrum of OCD symptoms and mental health disorders, maybe nail-biting isn’t that important to eliminate.
So, what do you think? Do you think chronic nail-biting fit better within an anxiety disorder, an addictive disorder, a tic disorder or just merely a silly habit unrelated to any mental health category?
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Filed under Anxiety, Psychology
Self-care or stewardship?
Last night, Dr. Tan (Fuller) spoke on the topic of self-care. During the presentation he interacted with Dr. Sally Schwer Canning’s short essay in a previous Journal of Psychology & Christianity issue (2001, v 30, p 70-74). Dr. Canning raised some concerns about self-care and “balance” language. We all know that we can get out of balance and that we do need to do things to care for ourselves. However, there are times, Dr. Tan said, that we are put out of balance by God. He reminded us of Paul’s statement that he was overwhelmed to the point of despairing of life. He was ship-wrecked and more.
In the name of self-care, we sometimes put up inappropriate boundaries.
Both Tan and Canning suggest that “stewardship” may be a better image for us to us? How are we stewarding the gifts and resources we have, even when life is out of balance?
What do you think? Does stewardship get the same point as self-care?
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Filed under AACC, christian counseling
Speakers vs. teachers?
At AACC National conference in Branson this week. Good to see a number of old friends and colleagues. Have heard a few good ideas as well. At conferences like these there are plenary and breakout sessions where I can get continuing education. The plenary sessions include widely known individuals and the breakouts may also feature well-known counselors as well as “regular” people like me.
Here’s what I notice when I come to a place like this: there are speakers and teachers and usually a person is either one or the other. The speaker is someone who often displays a great sense of humor, knows how to tell stories, and can move and motivate the audience with information that may not be that new but is packaged in a captivating way. Teachers, on the other hand, tend to deliver new content, provide step-by-step description of interventions and give the audience some new way to think or act. Now, teachers can motivate and be humorous and speakers can deliver new content. But commonly these two types of speakers are very different in style.
Have you noticed this difference in conferences you attend and do you gravitate to one more than the other?
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Filed under christian counseling, christian psychology
Why we lie
Just finishing up Karl Marlantes’ What it is Like to go to War (New York, Atlantic Monthly Press). It is not an easy book even as it is a quick read. There are many psychological frailties brought to the surface that should unnerve any reader, and not just those who want to know about war changes a person. One such human foible, lying, gets a whole chapter. After describing types of lies we tell, he has this to say about why we lie,
We lie because we find ourselves in positions where it appears the truth will hurt us. But a truth isn’t a thing like a flying rock. So by “hurt us” we must mean it will hurt some goal toward which we strive. And we’ve managed to confuse that goal with a definition of ourselves. “Hurt our ability to achieve our ends” equates to “hurt us.” Worse, we have such a large number of goals to use to define ourselves that we rarely know which to apply at any particular time. I want to be a hero. I want to stay alive. I want to be a good officer. I want my troops to like me. I want to defend my commanding officer. I want his job. I want to tell the whole world how incredibly difficult a time I have just had. I don’t want to look like a crybaby. I want to uphold the honor of my service. I want to get even. (p. 132)
I think Marlantes nails us all here. We might not struggle with the same wants but surely we can find ourselves in the same sort of struggle between hero and self, between getting what we want and doing the right thing. And we get confused as to what will get hurt if we tell the truth. Though we lie to ourseves that our lies are to protect others, mostly we lie to protect our own self.
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Filed under Good Books, Great Quotes
Musings on Faith and Psychology 