December 1, 2010 · 10:24 am

Chantix and PTSD


For those of you who know, live with, or work with those diagnosed with PTSD, be aware that the smoking cessation drug, Chantix, has been found to be seriously problematic. Apparently, the drug has been linked to a number of suicides as well as to increased agitation, mania, panic, nightmares, and suicidal ideation. One might expect that those suffering the distress of PTSD might experience even more of these side effects.

This isn’t new information. There are news items you can find going back to 2008. Given that there is a lawsuit underway, probably most providers already know about it. But, it was news to me so I’m passing it on to you just in case you know of a vet who is trying to kick the nicotine habit.

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November 30, 2010 · 5:23 am

Life amidst brokenness?


As one who makes a living listening to brokenness, there are times when troubles seem everywhere. Everyone is swimming in a pool of their own tears–to quote the former PBS motivational speaker John Bradshaw. Sometimes, the pool seems pretty deep…cancer, mental illness, sexual abuse, infidelity, mania, marital discord, identity confusion, etc.

If not careful, we counselors can begin to believe that brokenness is the ONLY reality–a dreadful position if all we have to offer our clients is a knowing sad smile. On Sunday I went to a class on Isaiah, what some call 2nd Genesis because of the prophetic descriptions of re-birth and redemption of Israel through the work of Emmanuel.

In the class, someone said something that has been banging around in my head. It went something like this (gist, not quote)

It is not a challenge to see brokenness around us–that is easy. The challenge is to see God’s re-creative activity. Oddly, we call reality (God’s activity in redeeming us) a myth and prefer myth (superficial Christmas peace) over the reality of God’s working through brokenness to make us whole. I repeat, the challenge is to see God’s recreation and Glory.

Not sure how much of that was said and how much of that is just my own thoughts. But, still, the challenge for us is to see re-birth and not merely dying and death. What looks like an ugly stump (Isaiah 11:1) to us is a fruit bearing shoot.

See if you can catch glimpses of growth and rebirth today!

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November 29, 2010 · 10:14 am

“Niceness is a decision”?


Cover of "Predators: Pedophiles, Rapists,...

Cover via Amazon

For “light” reading over the break, I decided to read Anna Salter’s book, Predators, Pedophiles, Rapists, and other Sex Offenders (Basic Books, 2003). I’ve known of this book for some time and viewed her DVDs which cover a chunk of the book’s topic. **I don’t recommend you read this book at night or at all if you have any history of sexual abuse.**

The book reviews research on those who commit these kinds of crimes. What I found most helpful is her treatment of the problem of deception, common techniques, and how both the average person AND expert clinicians are easily seduced by the presentation and lies of offenders. She closes out the book with chapters on detecting deception and protecting children from abusers.

But one particular paragraph caught my eye. The context of what you read below is her discussion of the necessity of a double life (appearances of sincerity, likeability, honest, etc.) in order to gain access to children. As she says, “a surly and obnoxious person would have little access…” (p. 38)

“Niceness is a decision,” writer Gavin De Becker wrote in the The Gift of Fear. It is “a strategy of social interaction; it is not a character train.” There are days I want to tattoo this on my forehead. De Becker is right, but who believes him? (ibid)

Do you agree? Niceness is a decision not a character trait?

Niceness is an action, a behavior. Frankly, any of the fruits of the Spirit may be short-term behaviors as well. I can choose to be gentle or patient for a time. But true fruits come from Holy Spirit induced character change. But what bubbles up in us when no one is looking tells a bit more about who we really are.

We ought to be just a bit more suspicious about ourselves and be wary of the tendency to pat ourselves on the back for being nice–especially if we find ourselves doing calculations on the benefits we might receive for our good behavior.

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November 23, 2010 · 10:37 am

Pastoral Narcissism | LeadershipJournal.net


A friend recently sent me this Leadership article link  (below) on the topic of pastoral narcissism. He wondered if those two words were oxymoronic. Yes, he’s right…but no, we do often seek out self-promoting leaders. It makes us feel good.

I encourage you to read the essay–but not so you can point your finger at some TV personality pastor. Read the essay and consider how you might be tempted to promote yourself in a conversation this holiday week. Or, check to see if you ever dream about your own “brand.”

Pastoral Narcissism | LeadershipJournal.net.

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November 22, 2010 · 10:10 am

Psychological mystery recommendation: White Lies


Just finished Anna Salter’s novel, White Lies. The book was published 10 years ago, so you may have already come across this great read. If not, Dr. Salter is a forensic psychologist with expertise in the area of sex offending. I highly recommend the book if you want to see how a psychologist goes about gathering data on a perpetrator so as to recommend treatment or predict future re-offending.

What I found most interesting was her use of sentence analysis (written and spoken) to highlight how we tend to deceive self and others. Lying comes in what we say and don’t say. At one point, the offender (a doctor) states that he started his residency at such-and-such a place but never mentions where he finishes it. She evaluates the sentence and tells the reader that the offender has told more of the truth than he planned. No one would say they started it somewhere unless they didn’t finish it there. Instead, you would say, “I did my residence at…”

Her work reminds me of some training I got from Eric Ostrov as an intern at a juvenile jail facility. Dr. Ostrov told us that people generally want to confess their sins–or at least a more acceptable version of them. They make themselves passive in an event, they confess a sin they wished they committed (e.g., crossing sexual lines with a client who seduced them) rather than the sin they did commit (inviting and manipulating a client into a sexual situation).

Long ago I had aspirations of becoming a forensic psychologist. In fact, I did some training and practice in my pre and post doc and had a job offer lined up. I ended up choosing to come to Biblical Seminary. While I don’t regret that choice, the work of exploring self and other deception still interests me.

Anybody out there read her other two novels: Fault Lines or Shiny Water?

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November 19, 2010 · 6:46 pm

International Suffering and Trauma Treatment


Am working with a student on building a future course for students, licensed mental health providers, NGO workers to train them on the matters of trauma treatment in international settings with the course goal to take these trainees to a location where they train local trainers to use lay trauma healing measures.  I am imagining a course that is primarily on-line (using a course website, discussion board, webcasts, etc.) with some face-to-face time just prior to having the international experience. The course would enable licensed therapists to receive continuing education credits with the ultimate goal that those who complete this experience would be then prepared to replicate it in other parts of the world. Topics would include:

  1. Overview of trauma symptoms and the things that cause them (genocide, war, trafficking, domestic abuse, rape, natural disasters, etc.)
  2. Overview of local culture and customs re: health, strength, and medical intervention to ensure culture consistency and avoiding colonialistic approaches.
  3. Introduction to training lay trainers
  4. Secondary trauma and compassion fatigue issues

I have two reasons for a course like this: 1. trauma is everywhere, and 2. interventions need to be sustainable (not relying on western therapists to keep doing the direct service) and maintained by local individuals.

So, here’s my question: If you had an opportunity to shape a course like this, what would you want to see as part of the course? What would you want to avoid?

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November 15, 2010 · 9:53 am

Can you change your nightmares?


Blogging has been much harder this fall with a busy teaching and traveling schedule. I’ve been doing a lot of reading and thinking about best practices to deal with trauma in international settings–specifically in the Great Lakes region of Africa. Diane Langberg and I have been consulting with a Christian organization to help develop those practices with a local, sustainable mindset.

One of the recent items I read had to do with attempts to address repetitive “posttraumatic nightmares.” Bret Moore and Barry Krakow published, “Imagery Rehearsal Therapy: An Emerging Treatment for Posttraumatic Nightmares in Veterans” in the September 2010 issue of Psychological Trauma: Theory, Research, Practice, and Policy (v. 2, 232-238).

Imagery Rehearsal Therapy (IRT) attempts to alter nightmares by changing the storyline of the nightmare. The authors view nightmares as learned behavior such as insomnia. The CBT style treatment entails

  1. education about the relationship between nightmares and insomnia.
  2. education about cognitive restructuring via imagery
  3. client selects a particularly disturbing nightmare (maybe not the most disturbing one first)
  4. Client then instructed to “change the nightmare anyway you wish” (notice they are not asked to make it positive or even less distressing)
  5. Client then rehearses (over sessions) the new dream through imagery techniques

Previous controlled studies indicate a reduction in nightmare frequency and intensity. This particular summary article reports that the evidence is there that veterans find it helpful even at 12 months post treatment with 4 sessions.

A couple of things to note. There may be some effect of desensitization from rehearsal of the initial dream (exposure therapy) though the exposure is brief. Also, the client does not spend time rehearsing the actual traumatic events in this therapy–only the nightmares.

Some thoughts:

  1. This treatment makes sense. Ever have a dream that seems to go on and on, or one that you go back to upon waking up in the middle of the night. Often we may find ourselves trying to make the dream turn out okay. This treatment uses our fully awake brains to rehearse something we want to think about.
  2. If nightmares are the result of a collection of anxieties then it stands to reason that repeating new thoughts and images will begin to make associations in the brain that might compete with the anxieties.
  3. Christian living emphasizes re-telling the truth to ourselves. Consider how OT authors remind readers of the Exodus or Paul reminds the Ephesian readers of their prior state (chapters 1-3). What we rehearse does have an impact on our brains.
  4. Finally, some of our nightmares seem written in indelible ink. Do you still have test anxiety nightmares 20 years after your last class? I do. But I feel differently about them now than I might have back when I was still worried about school. It may be that we begin to feel differently about the nightmares. The less we are bothered by them the more infrequent they will be.

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November 9, 2010 · 4:08 pm

Considering Marriage at Virginia Beach


In a couple of days I’ll be going to Virginia Beach to attend the CCEF conference on marriage. If you are in the area or going to the conference yourself do stop by the Biblical Seminary booth and say hello. We have info to show you on

  • new on-line courses next summer and fall
  • a summer class on forgiveness
  • an exciting (FREE) conference next March 17-19 dealing with sex trafficking and abuse and showcasing Diane Langberg and Bethany Hoang (IJM) that can be taken for credit (not free) or CEU.
  • information and even a discount for moving your completed CCEF DE courses into graduate accredited credits.

At the conference I’m especially interested in seeing what will be said on the topic of damaged relationships. Often we Christians paint the beautiful image of sacrificial, Christ-centered marriage. And we should–because too often we lose sight of the vision of what marriage is intended to be. But we ought also to address the issue of brokenness and how to live in the now when marriage does not seem to be working. We of all people ought to be the best at describing marital life when change isn’t forthcoming.

So, here’s a couple of conference session titles I’m most interested in

Thriving in a failure-t0-thrive marriage (Julie Lowe)

Adultery: Can there be a day after the worst day ever (Tim Lane)

Too broken to fix (Mike Emlet)

When will the new day dawn? Loving a spouse who was victimized in the past (Julie Lowe & David Powlison)

Also looking forward to the view of the ocean. Missed seeing much of it this summer. Anyone up for a quick dip?

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November 4, 2010 · 12:54 pm

Passing on a great post on learning


A friend of mine passed on this blog post about learning in an “info-glut culture.” A worthy read if you like learning but feel overwhelmed by the amount of information out there.

Of course, by passing on a new blog for you to read I participating in the info-glut culture. 🙂 However, let this one sink in and then be more choosy about what you read (just as long as you don’t all tune me out).

 

 

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November 3, 2010 · 3:35 pm

Power leads to…?


In the US, we have just completed an election cycle where Republicans have taken back power in the House of Representatives. Behind this change is a fair amount of voter anger with the current Democratic leadership, especially from Tea Party sympathizers.

Traveling to work I heard a snippet of a speech by a person (not elected) stated that if the newly elected individual didn’t meet their expectations, they’d work to vote them out the next time.

Seems that sometimes power acquisition breeds more desire for power and less willingness to compromise. Of course, loss and failure may also breed a desire to pretend to compromise but do everything possible to avoid real flexibility.

What makes me think this is a comment my wife made about her current reading pleasure: Bonhoeffer (by Erik Metaxas). From the author’s perspective, there were a number of German civilian and military leaders who were uncomfortable with Hitler’s grandiosity and even interest in taking over other countries. However, once they were smashingly successful, most seemed to get on board and enjoy the power.

In short, they became comfortable with demanding even more power from those who couldn’t defend themselves.

Now, hear me loud and clear. I am not making an analogy between Hitler and Republicans. Nor, am I denigrating recent voting trends of voter anger. But success in the polls ought not make us more embolden to listen only to our own interests. Access to power sometimes breeds less love for the ones defeated. Our newly elected leaders have to find a way to govern (not something we’ve been doing well at for some time in this country) all of their constituents–even those who didn’t vote for them.

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