PTSDland – By Anna Badkhen | Foreign Policy


Anna Badkhen asks, “How do you heal an entire country suffering from shell shock. She describes conditions in Afghanistan. You can see she asks a great question but labors, as we all do, to come up with an answer that makes sense in a place that is still unstable (and therefore still traumatizing) and that fits the cultural and economic realities of the region.

Check out this short essay,

PTSDland – By Anna Badkhen | Foreign Policy.

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Book note: Unbroken, the story of Louis Zamperini’s traumatic WWII experiences and survival


Just finished Laura Hillenbrand’s Unbroken: A World War II Story of Survival, Resilience, and Redemption (Random House, 2010). She tells the story of Louis Zamperini’s early life (which depicts the miracle of his surviving childhood and his own juvenile delinquency) leading up to his Olympic experiences in Berlin and then his airmen experiences in the Pacific. In May, 1943, while looking for another plane that didn’t return to base, Zamperini’s plane goes down in the middle of the South Pacific. Against the odds, he and 2 others survived.

Actually, the miracle that he survived could be said about his entire life: impoverished immigrant family, juvenile delinquency, being an Airmen, surviving a plane crash in the middle of the Pacific, surviving on a flimsy raft for 47 days without any food or water other than rain or raw fish here and there, surviving torture by the Japanese for a couple of years and then, finally, surviving PTSD and accompanying alcoholism.

Read the book of you are interested in the life of airmen in WWII (it is amazing how many died in noncombat crashes). Read the book if you are interested in hearing how psychological trauma from war and torture often impacts a person. Read the book if you like surprising endings.

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7 questions about your church’s abuse policy


Over at Biblical Seminary’s faculty blog, I have a new guest post up pointing readers to 7 important questions to ask as they review their church’s existing abuse policy. One of the questions ISN’T whether or not your church HAS an abuse policy. I assume that every church has one already.

Read the post here.

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Biblical Seminary and global trauma recovery?


I have a short blog post over at Biblical Seminary’s faculty post explaining why the seminary is interested in global trauma recovery. You can check it out here.

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The Five Minute Antidote for Anxiety


I’m an anxious person by trait. It is a common trait, especially in graduate school (in combination with narcissism. I say this also in self-disclosure; both features support successful completion of doctoral studies). Anxious people tend to spend considerable time ruminating through “What if…” questions along with should, coulda, woulda thinking. We worry about our past failures coming to light and whether we’ll be up to the challenge the future presents.

Sound pretty negative way to live? It is. The only way we differ from depressed people is that we still have some thought that our worry might save us from disaster. As you can imagine, such worry robs us of joy. It keeps us from enjoying the present or seeing God’s gracious hand on our lives. And we compound our problems by then shaming ourselves for failing to follow God’s command, “Do not be afraid.”

The Five Minute Antidote

Part of the problem with anxiety is that we are trying to control/manage every possible outcome in order to avoid future disaster(s). Fearful people know that the answer to their anxiety will not include,

  • Just not caring anymore. We’ve tried that…it doesn’t work.
  • Making sure we get it RIGHT. Tried that too. Didn’t work.

So, what might work? Try this on for size,

What is God’s plan for me for the next five minutes?

Most of us have no clue what God is planning for us next year or even next week. But, I suspect most of us can discern what we need to do right now…for the next five minutes,

  • I need to make dinner
  • I need to read this assignment for school
  • I need to attend to my child’s homework
  • I can call a friend who is grieving

We usually know the one thing we can do for the next five minutes. Do that with as much focus as you can. Here’s what you are likely to discover: your anxiety decreases, or at least does not increase. When we stop the ruminations or internal conversations, our anxieties decrease and our ability to be present increases. So, when you find yourself in an anxious stew, try to ask yourself, What is one thing I can do for the next five minutes or What does God want me to do for the next five minutes? Consider this your method of living out Psalm 131, where you are are stilled and quieted like a weaned child, content with what He has for you for the next five minutes.

Oh, did you think this will solve all your anxiety problems? No, of course not. But where God does give you something to focus your attention, call that a success. Part of the Christian life is repetition–repeated worship, repeated repentance, repeated obedience, repeated trust. So, do pray for God to remove your “thorn” but look for five minute relief. Notice when it works and then ask God for another five minute focus on the thing he has for you RIGHT NOW.

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Individual or collective responsibility in matters of justice?


If you read blogs you likely follow current news and are aware that a you tube movie trailer has spawned protests, violence and death in Muslim dominated countries. Haven’t seen the movie and don’t intend to. From what I hear it paints Islam and the Prophet Mohammad is some rather unflattering (and for Muslims, offensive) light.

For most Americans and Westerners, it can be hard to understand the reaction. No one (I think) believes the American Ambassador to Lybia had anything to do with the production of the movie or was in support of it’s depictions of Islam. Yet, it would appear that some thought it reasonable to take his life in response to the film’s damage. The same would be true for lesser forms of violence in other parts of the world (car burnings, threats to life, destruction of US property in foreign territories)

Is it religion or culture?

Though we could easily chalk reactions by Muslims up to religion, I think culture may play a greater role in this one. We Americans, apart from religion, see the world as individual. We are concerned about individual justice and individual fairness. It is hard for us to accept responsibility for things we didn’t do. For example, you might hear someone grouse about affirmative action, “I didn’t enslave anyone, why should they get a leg up that I didn’t get.” Or, if a member of my church is exposed for a heinous sin, I’m sad, maybe a bit embarrassed, but I certainly don’t feel I ought to bear ANY of the responsibility for his or her crimes.

Much of the rest of the world doesn’t see it this way. If someone in your family does wrong, your whole family suffers disgrace. If someone in your community does wrong, it is as if the whole community gets a black eye. It is less about individual sin and much more about corporate sin and shame.

Is there a biblical answer to this?

While in NO way validating the senseless revenge attacks on innocent victims, I think it important to consider whether there is a biblical response to the strong individualist-communitarian tensions we feel when it comes to corporate sin and righteousness. If you are looking for a single verse, there isn’t one. However, it is interesting to see OT leaders lead in corporate confession of sin–even if they themselves were not guilty. There is an emphasis on “we”. Jeremiah’s lament, Nehemiah’s confession of sin, the minor prophets warning of destruction to the entire northern kingdom are all examples of this “we.” Maybe even more provocative is that of the destruction of Aachan’s family and animals for his sin or the salvation of Rahab and her family for her individual righteousness.

You might argue that this is an Old Testament thing, however, the community language continues in the New Testament, even if less pronounced. There is focus on unity of the body, Christians as all attached to the head, Jesus, refusal to allow sin by other members to continue within the body, and finally, serious warnings given to entire Churches in the book of Revelation.

While you and I should not adopt and “eye for an eye” motto nor seek to punish those who are innocent of crimes, maybe Christianity isn’t quite so individual relationship with Jesus as we’ve painted it to be in the West….

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How Does God See the World?


My church is running a Sunday School class on missionary activity around the world. 2 weeks ago, the class watched a video about church planting in the countries of Liberia and surrounding countries and this week, I and another couple presented some information about activities in both West (computer training) and East Africa (trauma recovery through scripture engagement).

The leader of the class, Kurt Wood, brought in a map that was drawn by population size rather than geography. He made an off-hand comment that maybe this was a bit closer to how God sees the world, a focus on the people rather than geographical or political boundaries.

What do you think? Check out this link for another example of a population driven map of the world. Which countries are surprisingly large? Small? In Africa, you see that tiny Rwanda is population dense and Nigeria is huge.

I think it is a helpful reminder even if my country of birth is nothing more than a tiny bit of color on top of the USA. There are a number of other population driven maps that can be found on google images.

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Thomas Szasz, critic of psychiatry, dies


Did you see the obituary notice for Thomas Szasz, a 92-year-old psychiatrist who made it his life’s work to attack his own profession? If not, read the NYT’s article here. Szasz’ beef with psychiatry centered on two complaints: the diagnostic system treated individuals as having “things” rather than describing what they do (thus making it seem like people have diseases AND the coercive nature of treatments (forced treatment and meds for psychotic individuals.

What makes Szasz important to Christian counseling is that many biblical counselors and nouthetic counselors touted Szasz in their criticism of secular psychology and psychiatry. The Bobgans and Jay Adams used Szasz quotes to bolster their own criticisms.

How he was right AND wrong about diagnoses

Szasz was right in that DSM diagnoses tend to treat problems as discrete disease states when in fact they are descriptions of clusters of symptoms. More Venn diagram than discrete thing. Yet, Szasz and his ilk often used examples of diagnoses that he thought were not disease states. Well, some of these diagnoses have turned out more disease than not disease. Take ADHD for example. Many critics complained that there wasn’t anything that could be seen under a telescope…thus ADHD isn’t a real disease. Well, we can see significant differences in brain activity in the frontal lobes of those carrying the diagnosis. While we can’t yet point to a specific cellular structure or gene (and we likely never will since it is more complex than just biology), we are understanding the biological aspects of a number of mental health diagnoses.

Szasz was right that some portions of psychiatry treated those diagnosed as victims and ignored responsibility. Interestingly, as our understanding of genes and brain functioning have improved, the victim mentality has decreased. We are doing better in identifying responsibility even as we are more articulate about the effects of the Fall on the body.

We should thank critics like Szasz for pointing out serious flaws in the foundation of mental health philosophy and practice. And yet we should avoid the all/nothing approach that Szasz and his opponents took in criticizing or defending psychiatry. One common human reaction is to either (a) always look to be the critic, or (b) always look to explain away criticism. Both responses are normal but disastrous to helping others.

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Filed under History of Psychology, Psychiatric Medications, Psychology, Uncategorized

Dissociation (amnesia) and remembering abuse anew?


How is it that someone could forget a horrific event or experience? What is happening when something new is remembered about a very old event? Is it possible to forget (lose the capacity to recall) for long periods of time but then later remember?

Continuing my series on memory, abuse, and the controversies of recovered memories [you can read my previous posts: here, here, and here], I now want to address the issue of dissociation, amnesia, and remembering abuse. In those previous posts we have looked at how memory can be degraded by intent (conscious denial or unconscious rejection), by other overwhelming stimuli, or by failure to encode. But, since I have not spent much time on the topic of dissociation and repression, I want to say just a few words about these two ideas–in part because they are frequently used but poorly defined.

What is Dissociation? Is Amnesia a better term?

People define dissociation in a variety of ways but most definitions include some disconnection from present reality–sensations of disconnection from self, others, or time–and exists on a continuum. The most mundane forms happen everyday. You are driving from point A to point B but realize you cannot remember what you saw along the way. While we could describe this as a failure to encode data into memory, we could also describe the process, a disconnecting from what is happening in the present. Some dissociation is even beneficial. If you have ever been in pain but then got a distracting phone call, your pain perceptions probably decreased. You were, in effect, dissociating from the present experience of pain.

Now, when we talk about dissociation from a counseling perspective, we are talking about a more significant disconnection from present experiences, one that often seems to happen outside the conscious control of the person (but may be a practiced habit that happens without mindful decision). Dissociative experiences include feeling unreal, disconnected from the body, unable to engage the present, unable to remember salient portions of pesonal identity, or even, rarely, the presentation of alternate personality states that appear to fight for control of the individual.

You can imagine that if you are in the position of a repeated trauma (such as child sexual abuse by a parent figure) and unable to escape it, you might develop ways of dealing with the pain by disconnecting from the present. As a result, you might find that any time you begin to feel unsafe, you naturally disappear in some minor or major way. What happens during that “disappearance” depends on the individual. For some, they are reliving some other experience (I’m no longer present but reliving a painful event in my life). For others, they report being blank–thinking and feeling absolutely nothing. The most telling sign to a therapist is that the client no longer seems to be present in the room (nonreactive or reacting clearly to something other than is going on in the present). Whatever the form of disconnection, most then experience some level of inability to remember portions of the trauma.

Interestingly, there is some evidence that those who dissociate have greater capacity to self-hypnotize. In addition, McNally describes a study (in Remembering Trauma) that followed a person with psychogenic amnesia who had altered brain function when in amnestic states.

Does dissociation lead to forgetting traumatic data?

Can a person dissociate enough to create a persistent amnesia for a traumatic event? There is evidence that those who experience frequent disconnected states have greater difficulty remembering important details of traumatic events. However, many would say that repression is a better conceptual tool to explain such forgetting. But then, repression is not well-defined either (even Freud himself interchanged repression and suppression when talking about decisional vs. unconscious forms of forgetting). Despite the frequent use of repression in common parlance (and without the Freudian baggage) I would suggest that amnesia or motivated forgetting may be better terms, a bit more descriptive and less connected to psychoanalytic theory.

Whatever you call it, some level of forgetting can happen to those experiencing relentless traumas.

  • a young Jewish woman forced into an internment camp has her infant child ripped from her and killed. After the war, a relative asks the woman about the child and the woman responds, “what baby?” Only much later does she remember having a child or how this child died.
  • A young male cannot remember much about his childhood. When asked about his Uncle (only 5 years older than he), he can only remember a vague uncomfortable feeling. His younger brother recounts this uncle would routinely enter their bedroom at night to sodomize both boys. Only after numerous conversations does the older brother begin to remember abuse details, even beyond those supplied to him by his younger brother.

Forgetting then Remembering anew?

In my 23 years of counseling I have never encountered someone who recovered memories of a trauma after completely blocking all memory (I believe it is theoretically possible but extremely rare). I have, however, had a number of clients recall previously long forgotten or vaguely remembered traumas. Often when they recall events with VASTLY new interpretations, so new that it feels like an entirely new memory even as they admit the memory isn’t new to them. Here’s a real example (with details changed to disguise identity),

Alice, a 52-year-old elementary school principal, enters individual therapy at her husband’s insistence to deal with her irritability at home. She admits she has developed a fantasy of leaving her husband for the new (and younger) president of the school board. She discloses that this fantasy began not long after her husband suffered a work-related accident rendering him partially disabled. During the initial intake Alice denied any history of trauma or abuse. As the therapy progressed, it became evident that Alice connected her personal identity to that of being pursued–something that her husband no longer attempted. In addition, her attempts to flirt with the school board president had been ignored. In a moment of frustration, Alice exclaimed, “I’ve always known that men found me very enticing, ever since I developed [breasts] at an early age. I’ve always had to be so careful around men, especially married men. I knew they wanted me and that made me feel dangerous but desirable. Now, who am I if no one wants me?” Alice’s therapist asked her to recount a bit of her early sexual history and without much delay Alice reported her first sexual experience at age 12 with her 35-year-old, married Sunday School teacher. She recalled her teacher hugging and fondling her breasts while telling her about his failing marriage and the need for the two of them to avoid further sexual temptation. At age 16, she reported that she and a 4o-something father of a child she babysat engaged in a 6 month sexual relationship.  Alice’s counselor indicated some surprise at how Alice described both experiences. She asked Alice how she would describe the same interactions between one of her current 6th grade students and a school teacher. Alice immediately flushed with horror. “Why, it would be child abuse!” Once Alice regained her composure, she explored how she had always remembered herself as the protagonist in both experiences. In that session and over the next several weeks, Alice reported a flood of new memories, mostly about things done or said by the two sexually abusing men and now interpreted to be predatory behavior. On several occasions she reported that it felt like she had never had these memories before even though she recounted that she never forgot the sexual encounters. The new interpretations and labels created the experience of recovering long-lost memories–ones that seemed blocked as long as she was responsible for the trysts but freed in light of her victim interpretation.

In this little vignette I want to illustrate that memories of abuse can be forgotten, whether only small portions or large, and remembered anew. Recalled or recovered memories are frequent as individuals gain the freedom to explore events from different vantage points. A therapist does not need to go on an abuse hunt or attempt to conjure up forgotten memories for this to happen. Merely exploring the narrative of a prior difficult experience can be all the priming a client needs to begin to experience “new” remembering.

But here’s where good therapy differs from unethical therapy: how the therapist responds to or pursues memories may be the determining factor when it comes to the development of false memories of past abuse. In the next post we will take up the ethics of memory work and explore therapist habits that may produce false memories of abuse.

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Is All Counseling Theological?


Why do we have to study theology? I don’t need that to be a good counselor?

These are words I have heard from students studying counseling and/or psychology in both university settings and seminaries. What would you say?

Biblical and theological training in professional programs?

Most Christian institutions offering counseling or psychology graduate programs require some level of theological engagement. Otherwise, why exist? Some do so via specific course work while others embed the theological or biblical material into classic counseling courses. At Biblical, we do both. We require traditional counseling courses such as Marriage & Family, Helping Relationships, Psychopathology, Social & Cultural Foundations, etc. In these courses we explore counseling theory and practice from an evangelical Christian psychology perspective. We also require students to complete courses like, “Counseling & the Biblical Text” and “Counseling & Theology: Cultural Issues” where they engage biblical texts and theological study as they consider how it forms counseling theory/practice and shapes the character of the counselor.

Is all counseling theological?

Yes. And David Powlison in the most recent CCEF NOW magazine (2-4) talks about this very fact. Here are some choice tidbits,

…counselors deal with your story. In fact, they become players in that story. By word and deed, even by their line of questioning, they inevitably offer some form of editing or rescripting, some reinterpretation of your story.

Counseling is inescapably a moral and theological matter. To pretend otherwise is to be naive, deceived, or duplicitous.

…all counseling uncovers and edits personal stories…. All counseling must and does deal with questions of true and false, good and evil, right and wrong, value and stigma, glory and shame, justification and guilt.

All counseling explicitly or implicitly deals with questions of redemption, faith, identity, and meaning.

Thus, if value-free counseling is not possible (the very questions we ask lead clients in one direction or another), then it stands to reason that every counselor ought to explore the theologies (doctrines, interpretations, beliefs, etc.) he or she brings into the counseling room. Who is God? How does God operate? What is the purpose of the Bible? Does it have anything to say about my life, my attitudes, my relationships? What is sin? What is my purpose in life? What does God think about my suffering? And on we could go.

But counseling is NOT theologizing

But lest you think that Christian counselors spend a great deal of time plying clients with the right answers, on sin hunts, or catechising clients, let us remember that exhortation rarely makes for good counseling. In fact, most clients are well aware of their sins–even those who do not call themselves “believers.” And those who have correct theology are not less likely to have trouble in their relationships or less likely to struggle with racing thoughts or depression or less likely to get caught in addictive behavior.

Instead, good christian counseling consists mainly of,

  1. loads of stimulating questions designed not to get the “right” answer but to awaken the client to how they think, act, believe, relate, etc.
  2. Short observations to stimulate more critical understanding of the personal narratives being written, and
  3. Collegial exploration and practice of new narratives, perceptions, and behaviors.

Wait, just what is Christian about these three points? Couldn’t unbelieving counselors agree with this list? Sure they could. What makes these three activities Christian is the submission of both counselor and client to core convictions and practices of Christ followers.

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