Tag Archives: mental health

October 19, 2025 · 5:50 am

Moral distress? Moral trauma? An important update on definitions and concepts


The folks at Harvard’s Human Flourishing Program, led by Dr. Tyler VanderWeale, have published a paper updating the definitions of moral injury and distress. If you work with people suffering betrayal trauma–especially religious betrayal trauma–you may want to take the time to read their piece and recognize the aspects of moral trauma that may not be well addressed in the classic treatment of PTSD.

What is moral distress and trauma?

Years ago, moral injury was something described primarily in terms of an added impact on veterans of war. The symptoms of moral injury were seen to be in addition to PTSD, defined as an added injury when an individual perceived themselves as having transgressed basic human morals (e.g., a soldier is forced to kill civilians who are being used as shields by enemy fighters). It was commonly understood as the idea that I have done something so terrible that it is unforgiveable (or I have supported leaders who have done something that betrays basic humanity). Key features of moral injury focused on the experience of guilt/shame whereas key features of PTSD centered on horror and terror.

As the concept became better understood, we began to understand it’s existance among civilians as well. Here are some examples:

  • Someone who did something wrong (e.g., distracted driving) and badly wounded or killed another person
  • First responders who have to triage and, in essence, decide who lives and dies (e.g., the impossible decision between two terrible outcomes)
  • Victims of abuse who may have enlisted friends who also became victims of abuse
  • Someone who supported and defended a well-known leader who was later found to be harming others

Understanding moral distress of victims of trauma

This paper expands the idea of moral distress beyond the (perceived) perpetrator to that of the experience of victims of trauma/abuse. Consider the new definition offered by VanderWeale and summarized in a recent newsletter,

In trying to bring these concepts together, we conceived of such moral distress as lying on a “moral trauma spectrum” that included matters of both the severity and the persistence of distress. After months of synthesis of prior work, we defined “moral distress” as “distress that arises because personal experience disrupts or threatens: (a) one’s sense of the goodness of oneself, of others, of institutions, or of what are understood to be higher powers, or (b) one’s beliefs or intuitions about right and wrong, or good and evil.” When that distress became sufficiently persistent it would constitute “moral injury.” For such moral distress or moral injury, it was not only that some moral code was violated, but rather that whatever took place somehow challenged one’s whole understanding of right and wrong, or of good and evil, or of the goodness of oneself, others, institutions, or even the divine. That disruption of one’s moral understanding would then give rise to, sometimes severe, distress. When that distress was persistent and would not go away it would be appropriate to speak of “moral injury.” When the distress was sufficiently severe so as to seriously impair functioning over extended periods of time, it might sometimes even be appropriate to speak of “moral injury” disorder.

(Newsletter from Human Flourishing Program, received via email Sept 17, 2025)

Re-read the bolded text. It is not just that some moral code was violated by myself, but that one’s whole understanding of right/wrong of self, others, institutions or the divine has crumbled. Notice how this distress might be observed in individuals having experienced certain types of traumas:

  • Victim of sexual assault seeks help from justice system but ends up feeling blamed for it
  • Whistleblower in a church who seeks institutional support to stop the abuse by a leader but is then scapegoated for disrupting the ministry
  • Someone who is scammed out of money feels they have irreparably harmed others
  • Child experiencing abuse by a family member and when telling a parent is then told to be quiet no longer believes they have value
  • Person prays for justice and expects to be exonerated but ends up feeling abandoned and forgotten by God

How might this change our treatment of trauma?

The treatment of trauma focuses first on the care of one’s nervous system. Learning to modulate and calm one’s body is essential since the very nature of chronic trauma is an overactivated vigilance system even when the danger has passed. As a person develops capacity to return more quickly to baseline then there may be more of a focus on addressing the narrative and memory of how the traumatic experience changed perceptions of self and the world.

When we make room for the spiritual/moral impacts of both trauma and how communities respond to people who have suffered trauma, we can better address the moral distress experienced. Treatment modalities that only focus on the reduction of nervous system overload may miss addressing the existential and spiritual crises that haunt survivors. This is especially true when (a) faith communities implicitly (or explicitly) discourage expressing doubt about God, or (b) when clinicians ignore spiritual and moral discussions in therapy. Inviting and validating the very deep moral questions of hurting people is essential for their recovery, even when answers are not readily (or ever?) available. Any treatment that ignores moral distress will not be sufficient to the task of recovery. While I am hopeful that some of the recent trauma treatment modalities may speed recovery, I notice that these newer treatments often ignore questions of existence, narrative, and faith and focus almost solely on nervous system function. This may be needed in the first line of care but let us now be more alert to moral distress and injury in those who have survived abuse, assault, and other forms of betrayal trauma.

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January 13, 2025 · 9:51 am

Your handy psychological fact…might be false: Why we believe what we believe and what it says about us


Ever heard of Stockholm Syndrome? The psychological phenomenon where hostages begin to identify with and feel positive feelings towards their captors, maybe even to the point in helping them escape? For many this is accepted, even if rare, fact. It supposedly why kidnapping victims don’t try to run away when they have the chance or why domestic abuse victims stay with their abusers.

But, what if the concept behind Stockholm Syndrome is only based on assumptions, rumors, falsehoods, and repeated unscientific “trainings” offered around the world by experts. THIS is the case. I highly recommend you listen to this December 2024 episode of Radiolab. It just might blow your mind. Even if you have no interest in the history of Stockholm Syndrome, the applications to how we treat victims and how we simplify psychological explanations can do harm to others.

The problem of face validity

As you listen to this episode you will hear how the name for the syndrome was created without

  • Interview or study of the hostages
  • Verifying the “facts” that were frequently repeated as undisputably true (e.g., that the hostage wanted to marry the kidnapper when he got out of prison)
  • Replication studies

Why the wholesale acceptance at the public and even governmental level? Because it seemed to explain the behaviors of hostages. It made sense. This is what we call face validity. Makes sense…and is a false understanding. To quote HL Mencken, “Explanations exist; they have existed for all time; there is always a well-known solution to every human problem—neat, plausible, and wrong.”[1] 

The problem is, we (the public) don’t know that they are wrong and so we promulgate simple yet wrong answers. Listen to the above episode and you will hear recordings of the police trainer who trained thousands of officers and departments on how to handle hostages who likely will develop the syndrome. Listen to how confident he speaks. So, we believe him, because how could we know any better?

But this confidence puts the focus on the wrong place and causes society to pathologize the wrong person.

This reminds me of the era of the late 80s and 90s where so many experts appeared talking about the reality of Satanic Ritual Abuse. Turns out many of these experts where self-proclaimed. But, the problem seemed real enough to be possible, so some accepted SRA as valid because it seemed to fit a probable reality. Sadly, this social angst created victims—not just those convinced to make false allegations but those whose lives were destroyed by those allegations.

While we could write about WHY some people present themselves as being experts when their theories and interventions are not really supported with empirical evidence, I want to consider why WE are prone to believe them. We believe them because we need simple answers to allay our own fears as to whether we are okay.  

Heuristics make life easier…and are close enough, until they are not

Heuristics are a method by which we ignore complex information that might overwhelm us in order to come to a reasonable and timely decision. For example, you look up 3 websites to discover the best diet to try and you decide to try the last one (recency effect) to avoid information overload. Or, you listen to an expert talk about a subject and you generally believe them because they are talking about some recent research.

Let’s talk about a common heuristic that probably you have used that makes sense and seems to explain things about personality—Myers-Brigs Type Indicator (MBTI). Surely you have taken this test and found you fit one of 16 variations of 4 letters. The assessment tool tells you which side of the 4 categories you fall. You can easily summarize your personality by saying you are an ENFP or INTJ or the like. This makes it easier for others to understand what you are like and might even explain why you approach the world the way you do.

Simple, right? But the MBTI lacks adequate reliability (getting the same answer every time) and validity. What It does do is communicate some things well, hence why we use it. But it lacks significant empirical backing and should not be used as a tool describing personality. Why do we accept it? Because it is easy. And we don’t mind so much that it is actually rather weak in describing personality variants.

No one is really being harmed with being labeled as INTP. But what if a heuristic points us in the wrong direction and creates additional harm to a victim?

Why the Stockholm Syndrome heuristic sends us down the wrong path

Back to the Radiolab episode. Listen to Grace Stuart talk about why she stayed with an abusive partner.

Grace: …people don’t realize how much of domestic abuse is about confusion….confusion about what was even happening….What if I overreacted and made something out of nothing…

Sarah (interviewer): Whether to judge her ex by his good days or his bad days.

Grace: Is he the good guy or is he the bad guy? Is he kind or is he cruel? … Am I the perpetrator? Am I the narcissist?… Let me just change this one thing about myself.

Grace was looking to make sense of what was happening. To ask the why question. And she wasn’t asking so much about her abusive partner but about herself. What is wrong with me?

This is where the Stockholm syndrome answer takes us. What is wrong with the hostage or the partner who seems to be tied to the abuser? It has the focus on the wrong person. In the interview between Grace and Sarah, Grace’s voice fades out when she is about to answer what helped her change her point of inquiry. As the sound fades in the interview she mentions a book that helped her, “Why Does He Do That? By Lundy Bancroft. This book has helped many women better frame the questions from the why about themselves to the why and the what about their abuser.

You see, we are focused on the wrong person when we try to answer the question about why someone might stay in a bad situation. What if we changed our question to, “what do abusers do to keep people trapped.”

All explanations will fail. All theories will fail. So now what? Ask more questions

Nearer to the end of the episode, another story about a young man who was in the “Sarah Lawrence” cult. Daniel states that after he was able to get out of the cult, it took him 6 years to be able to process what happened to him. He says that he had to come to terms that he would never have a satisfactory answer to the “why” question. And that he had to come to terms with the factors in why he stayed were complex and the tools he had to make decisions at that time were limited.

What is his solution? Keep asking curious questions about human behavior. “Be suspicious of any concept which doesn’t invite further curiosity.” “If it is a thought terminating answer…anything that ends our curiosity is bad.” So, he invites people to ask, “what helped you leave?” rather than “why didn’t you leave?”

Concluding thought

If you have read this far and listened to the podcast (if not, I remind you to not miss it!), take a moment to consider what easy explanations you might be using about yourself or others. Can you allow yourself to accept the answer, “Its complicated” to the why question. Now, try to move on to some different questions.

  • What can I do to make the moment better?
  • Who might I be able to enlist to help me understand my options?

And when someone offers you a simple (simplistic) solution (e.g., “just breathe” or “just leave” or “just eat better”), smile and look for those who can sit with complicated things and help you decide the next one move to make.  

[1] Prejudices, Second Series, p. 158.

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November 13, 2024 · 9:01 pm

Helping children after disaster: A webinar


Over my many years of trauma care training, I can say that the most frequent question I get is something like, “do you have anything about caring for kids after (or during) traumatic events and disasters. And usually, the answer is there isn’t much. So, in light of that, if you are interested in knowing more about helping kids in a state of crisis and after a disaster, check out this webinar by my colleagues Stacey Sutherland and Misty Bodkins. Free with a suggested donation. When? Nov 21, 7-8:30 EST.

This is the abstract of what they intend to present:

Join us for an engaging online workshop for parents, educators, and those who work with families as we provide training in the basics of crisis intervention for children and teens. Topics to be covered: What is Trauma? How does it uniquely impact children? Trauma-sensitive care principles and practices to effectively support children Collaborative opportunities for parents, educators, and others. Self -care for the caregiver. Who Should Attend: Teachers/Educators Administrators Social workers Parents Anyone who cares for children or works in children support services Faith and community leaders who work with children ministry.

https://crisiscareinternational.networkforgood.com/events/79027-helping-children-after-disaster

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June 17, 2024 · 5:52 am

Why am I STILL afraid? Some thoughts on what recovery from chronic anxiety looks like


I provide psychotherapy for many with chronic and debilitating anxiety. Anxiety is the most common malady in the world and comes in all sizes and shapes: panic, phobias, OCD, GAD, social anxiety, PTSD and more. For some it is very context driven (e.g., fear of flying) and for others it is constant and wide-ranging (e.g., OCD, PTSD).

Frequently, when a person comes to therapy, their first and enduring question is, “Can you make this go away? I just need it to stop.” They have struggled for a long time and have tried many things. Some have tried medications, others tried to limit exposure and avoid situations that would trigger the anxiety, and almost everyone has tried to talk (aka berate) themselves out of their feelings. “If I really trusted God this would not be happening!”

This desire to extinguish anxiety is completely understandable. Anxiety is horrible, consuming, and exhausting! We want it to go away and never come back. But–and this may seem absolutely disappointing to many—having the goal of zero anxiety is actually detrimental to a positive outcome and recovery.

Let’s explore what therapy is/does and why changing your relationship to anxiety is a better goal than trying to extinguish it.

What does therapy for anxiety look like?

Therapy for anxiety (at least what I practice) tends to have these common features1:

  • Compassion, understanding and curiosity about the physiology of anxiety
  • Experimentation on what short-circuits anxiety and identifying what intensifies the sensations
  • Practice relaxation/mindfulness/distraction with increasing exposure to feared stimuli
  • Exploring experiences/beliefs/values that may contribute to ongoing anxiety (e.g., a part is burdened with shame, perfectionism, assumptions of failure, etc.)

Notice the flow and trajectory. Compassion…Understand…Experiment…Practice…Examine (held beliefs). The flow isn’t really linear but it is hard to examine underlying beliefs or childhood experiences when you are in the middle of a panic attack.

Sessions early on look like understanding what is happening in our bodies when we are anxious. As we progress, we explore successes and challenges. We notice things that helped a little, or things that may have intensified anxiety. For example, having a friend try to convince you that your worries are unfounded may feel good at first but then leave you feeling more shame and more helpless. Or, maybe listening to a great podcast on the way to work reduces anxiety by a good 30 percent. This is, in essence, somatic psychotherapy.

The goal: PIVOT

When I am afraid, I put my trust in you. Ps 56:3

Notice the verse above says, “when.” Not if. When. We will be afraid, maybe often. And when that happens, we will do something. But what? How? In practical terms, we pivot.

What is pivoting and why do we do it? Pivoting is moving our mind/body/attention away from the cascade of fears. Instead of trying to dialogue with anxiety, we pivot away. Why do we pivot? We do so because anxiety is a TERRIBLE and completely unfair and unreasonable discussion partner. And since anxiety intrudes without your permission, you are not obligated to talk with it nor accept it as if anxiety is you.

Here is how it might work for me once I have recognized that what is happening is that my mind and body are locking onto an intrusive fear. I name the fear, then I pivot my mind by looking intently at the Ansel Adams photograph of El Capitan next to me. I describe the shadows and features I see. Or, I pivot my body by getting up and feeling the sensation of walking. I may pivot to my senses by smelling my coffee and taking a deep breath in and out. I do this pivot again and again in order to de-couple from the thoughts. And I actively use my body to lower felt tension. At first, this many seem about as successful as jumping off a cliff while flapping your arms. And yet, over time, your pivot will decrease your anxiety.

Notice what I do not do. I do not,

  • debate the fears
  • beat myself up for having fears
  • assume success is the cessation of anxiety

Why does it take so much work to fight anxiety?

We have been habituated into fear. Changing the automatic response takes work. It wasn’t our choice to be afraid but now we have to find a way to pivot out of something we never wanted. It isn’t our fault but now it is something we must respond to, just like someone with a migraine didn’t choose it but now will have to discover what helps curtail one. As we practice our pivots we will find they become slightly easier and more effective, just as when you practice a sport or an art, you will notice you are becoming more skilled.

What if my goal is not extinguishing anxiety?

In short, it is building a new relationship with anxiety where you accept that it exists but does determine how you will live. You acknowledge it but do not engage it. In doing so, you accept the challenge of building a competing neurocircuit alongside the fear pathway and activating that experience on repeat. The best competing circuits have deep meaning and connections with others. Here are some examples:

  1. Instead of trying to avoid making mistakes, look for mystery and experimentation
  2. Instead of trying to avoid panic, lean into doing something with your body that you have not doe (advanced yoga or stretching, increased weight lifting, knitting)

I want to leave you with one thought. If you learned something new about how anxiety is expressed in your body and if you learned how to gain even a little mastery over your body’s anxiety response then you have already begun to change your relationship to fear! You are beginning to be in charge rather than feeling controlled by fear. Your success is not always winning against fear but knowing that when you are afraid, you will put your trust in God and in the body he has given you.

_____

1These are common factors to all anxiety therapies though they may differ when focused on a particular kind of anxiety. In addition, I always recommend a medical evaluation to rule out other potential causes of anxiety as well as consideration of medications that may help support recovery.

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April 9, 2024 · 7:44 am

When accusing thoughts are not what they seem. Scrupulosity: Recovering faith from toxic theology ep 3


Do you have intrusive and unwanted thoughts that you take as evidence you are guilty of terrible sins? You might be suffering from scrupulosity. Listen to my 2 minute podcast describing this problem and giving a short experiment to try the next time you face these unwanted thoughts.

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April 2, 2024 · 6:01 am

Did you forgive? Recovering faith from toxic theology, ep 2


Forgiveness is often misunderstood and misrepresented as a recipe to stop hurting after a betrayal. In this 2 minute podcast, I define forgiveness and bitterness since so often when we want to talk about our pain someone asks us if we are embittered and if we have forgiven the one who wounded us.

Thanks to those who gave me ideas about lengthening the podcast. I’m considering that but will trial out a few more of these shorter episodes first.

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March 23, 2024 · 1:37 pm

Recovering faith from toxic theology, ep 1


I’m trying out a little podcast. I don’t know about you, but I don’t have time to listen to hour long podcasts very often. Sometimes, I just want one thought to mull over for awhile.

So, I’ve created a two minute podcast and my first episodes will be about toxic theology that may interfere with living well with hard and confusing things in our lives. Episode 1 is about anxiety.

I’d love to hear from you as to whether this format works for you. Feel free to give advice or identify episodes you would like to hear.

https://www.podbean.com/eas/pb-ufsrp-15bdd0c

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January 9, 2024 · 8:48 pm

Crisis care training opportunity


For those of you who have been following my work over the years, you know that I have travelled quite a bit recently providing trainings with Crisis Care International in places to support local leaders learning best crisis care practices (AKA psychological first aid). In the last year, we provided in person trainings in Ukraine, Hungary, Turkey, and Morocco as well as here in the United States.

Crisis care is not just for mental health providers but any humanitarian can learn the essentials to provide support and encouragement for those in the middle of a crisis. If you are interested in learning a bit more of the essentials, my colleague Stacey Sutherland will be offering a 2 hour overview online on January 18, 2024. Here’s the link to see more about what the training is all about: https://crisiscareinternational.networkforgood.com/events/66056-essential-crisis-care-basics

This is the abstract for the training:

Join us for a comprehensive online event that equips responders with the essential crisis care basics they need to know. Whether you’re a seasoned professional or just starting out, this event is designed to provide you with the knowledge and skills necessary to effectively respond to people in crisis. From understanding the basics of trauma to the fundamentals of trauma assessment and psychological first aid our experts will cover it. Don’t miss this opportunity to learn in an engaging and participatory format. Thank you for joining us! Please spread the word. Your participation and giving help us make training available to everyone.

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October 29, 2023 · 12:57 pm

Am I doing this Trauma Healing Thing Right? Part 5, Finding a therapy and a therapist


So, now that we have identified some barriers to recovery (myths and red flag moves by helpers) and noted essential items you need for this journey—like compassion and curiosity, let’s conclude this series by exploring how to choose a therapist and a model. 

It can feel impossible to find a quality therapist and downright overwhelming to choose a particular model of trauma care. If you have started to look you probably began first to explore credentials and general styles of therapy (models). 

Do you choose Christian or biblical or secular? How much does licensing and credentials matter? 

Which model? CBT, TF-CBT, DBT, PE, EMDR, Tapping, CPT, Brain spotting, NET, PFA, Debriefing, and somatic psychotherapy? Neurofeedback? IFS?

Medications? Ketamine? Transcranial magnetic stimulation?

Or maybe skip the therapy altogether and focus on yoga, mindfulness, meditation, art, or acupressure?

Feeling overwhelmed yet? 

If you have been looking for very long, you probably heard someone sing the praises of one of these types of therapists or models over others and noted it to be a miraculous cure for them. And just as likely you have heard, “that didn’t work for me.” 

Cutting through the fog

Several of the models listed have some scientific support. And some others have a lot of hype and anecdotes but little in the way of actual substantiated research. Randomized control trials, the gold standard of research, attempt to look past correlational data to determine if a positive result can be attributed to the intervention used. Sometimes we learn that a particular model is effective even while we do not fully understand why or what part of the model is having a positive impact. But, it should be noted that many RCTs tend to be small in sample size and somewhat limited in generalizability. In other words, it worked for the research group but until it is replicated many times with different populations, we won’t yet know if it works for most or for you or me. 

One more frustrating part is that disciples of a model may suggest to you that an intervention they use is more successful than the researchers who developed and studied said model. We have this annoying habit of overestimating the value of the thing we have learned to do. 

Pick your person first

So, don’t start with which model you should choose from. Yes, models and ideologies matter and influence the work done in session. But there is something more important to consider. It is…drum roll…the character and person of the counselor. Trust and connection in therapy has more to do with success than the model being used. We have already identified the characteristics of a good therapist in the last post: 

  • Goes at your pace.
  • Is curious about what you need. 
  • Wants to learn what helps you more than tell you what you should do.
  • Is aware of and adjusts when you are overwhelmed.
  • Invites your pushback and doesn’t get defensive.
  • Listens more than talks.
  • Checks in to make sure you are talking about the things that matter to you the most.
  • Does not criticize your faith journey.

If you have such a person now, ask yourself if you are holding back. Don’t judge yourself if you are, but ask what it might mean. It may mean there is something you are not ready to talk about. Good for you to know what you need. It may mean there is some bit of safety that still needs to be built in the session. It may mean something is off in the therapy. See if you can find a way to discuss this dynamic without talking about the thing you are holding back. How your therapist navigates this bit of information will tell you much about the safety and trust in the relationship. 

But I don’t have this person yet, how do I find them?

I recommend you start by asking people who you trust, who they have heard does good work. Get firsthand reports whenever possible. You want to ask, 

“Who would you go to or send your family member to if you knew they needed a good therapist? What makes them a good therapist?”

Once you locate someone who seems to fit the bill—experience…known to be a good listener…has credentials and training—you will still need to find out if this person is going to be right for YOU. 

Once you get an appointment, interview them in that first session and keep in mind these questions as you progress in your therapy. 

  1. What models/authors do you most likely follow?
  2. What are early signs that therapy is working? Signs that maybe something else is needed?
  3. What do therapy sessions look like? Hopefully, their answers include some form of:
    • Grounding/calming. Before/during/after triggers in session and practiced at home. It should be tailored to your needs and flexible. 
    • Small exposure to trauma via your story—not rushed in the therapy process—with more grounding sandwiched around the exposure. This should be well-planned and short, and not a whole session focused on traumatic stories and triggers. The goal is not reliving trauma but remembering, lamenting, and then shifting weight to the present.
    • Narrative or meaning focus (who am I? who is God? Was it my fault?). Exploring and grounding in new narratives This often comes later in therapy work.  
    • Grief work. Most therapies will have some exploration of grief and lament. Naming what was lost and what has been suffered is necessary for good healing.  
    • Finding and celebrating strengths and resilience. An important part of recovery is seeing where and how you have grown and developed new capacities. 

But, what model should I be looking for?

I won’t be able to tell you what works for you. But use the following questions to determine what works for you now. It might be that you need one supportive therapy now and a different one later. 

  • Are you struggling with being on high alert all the time? Do you want to find something that helps you calm your body? Consider something that helps you practice calming and stabilizing your body. Somatic psychotherapies that follow work by Janina Fisher may be most appropriate for you. 
  • Are you a writer? Consider more narrative focused treatment like NET or CPT. 
  • Do you find yourself stuck in patterns of bad relationships and self-harming behaviors? Consider a DBT oriented group or therapist.
  • Do you find yourself in a frozen state (vs flight/fight/fawn)? Consider something that is less exposure oriented. You may find that certain exposure-oriented interventions (CBT/EMDR/PE) are unhelpful in early phases. Similarly, if you have many traumas versus one, consider something that goes much more slowly and helps you stay connected to parts of yourself. You may find that someone who follows the work of Diane Langberg or Judith Herman is a better fit for you. Also, the work of IFS can help you make some safe room for exiled/shamed parts.   

Concluding thought

The work of trauma recovery is slow, repetitive work. You learn something, then need to learn it again. You feel some growth,  and then feel yourself slipping, especially when you hit anniversaries and reminders. Give yourself permission to keep trying old and new things. 

The journey of recovery (whether in therapy or just waking up to another day) is an ongoing reminder that something has died. Maybe for you it is a relationship or trust or a body that didn’t bear the invisible wounds. You will grieve these things. Try to grieve without confusing grief with shame and guilt. You may have to relearn that grief does not mean shame. 

Remember also that your journey will show you that you are still alive. You survived. Slow your breathing and feel your aliveness. Feel your aliveness—even the pain—telling you that you are here, and you reflect courage and beauty. Take note of the small things growing in and around you. These are the bits of beautiful creation that tell us you reflect God’s glory. You may not feel the beauty but consider that it is still true. 

For further reading about the healing journey, consider reading “Wounded, I am More Awake.” You can read my thoughts on this book beginning here.

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October 27, 2023 · 6:00 am

Am I doing this trauma healing thing right? Part 4, Key characteristics of good trauma care


Now that we have identified some of the myths we might have about the healing journey and further highlighted problem behaviors by helpers, let’s consider characteristics of trauma recovery. This is our preparation for our next and final post of this series where we will consider how to choose a model or therapist that works best for you.

In the part one in this series, I gave some good therapy landmarks, or, to use a different image, necessary ingredients for a recovery recipe: take care of your body, find stability, and begin (again) telling the story of you. But diving deeper, let’s explore those ingredients further.

Deepen compassion and curiosity.

Do you find it hard to experience compassion about what is happening in your body and curiosity about what can help it feel even just a little bit better? Many of us do. When we live on high alert, our bodies do not function the way we would like. We may be prone to self-criticism due to family or religious messaging. Unfortunately, this tends to shut down our capacity to remain curious about what helps us feel better and find stability again.

Imagine that you were recently diagnosed with migraines. You hate them, they disable you for a time and they come on out of the blue. Would you be prone to beat yourself up for having them? Compassion means not beating yourself up during or after an episode. Curiosity means staying focused on what helps shorten headaches; what foods, activities, medications, and supplements help you have fewer and shorter episodes.

It will be an exhausting endeavor for you to care for your body after trauma since many voices out there offer you false promises. But starting with yourself, be a learner and have the mindset of experimentation. Try things. See if they work a little or not at all. Keep trying things because these are signs you are regaining your ability to know what you need.

One last word on the necessity of compassion. It is not sinful or selfish to feel compassion towards you the way you would feel for a friend. If you struggle with this feeling this way towards yourself, consider why. Is there yet another barrier belief getting in the way? A voice telling you that you are undeserving?

Develop community.

Recovery from trauma requires a network (even small) of people who know you, see you, and who are committed to being there for you. Some may be more involved, some on the periphery. These are people who aren’t prone to preach, but rather to bear witness to the suffering and the small victories. You are looking for more of a witness and a cheerleader and less a coach. Together, find small spaces outside of trauma. For example, start a walking club, or an art night where you all draw together.

Evaluate your therapist.

In our next post we will talk about models of therapy and how to choose one that fits you. But, even more important than choosing a model is finding a therapist of good character whose primary skill is listening and bearing witness to you. I acknowledge upfront this can be a process of trial and error. Since many already have a therapist, consider these questions as to how well the person is working for you.

Does your therapy go at your pace? Or, do they demand that you run at their pace. If you ask to slow down in a session or ask to not venture into some topic, take note of how they respond. It will tell you much about that person. We talked about red flags responses by therapists in the last post. But any response that includes pouting, pressure, withdrawal of support, or criticism is a sign you should not miss. Instead, they should exhibit curiosity and interest about what you need.  

How does your therapist respond when you hesitate or even doubt the value of some of their recommendations? Resistance is normal in therapy. Frankly, it is necessary and not a sign of rebellion (something that many in faith communities fear being labeled). No, resistance or pushback is a sign you are using your power again after it was stolen from you by your traumatic experience.

When you finish sessions, ask yourself: Did we talk about the things that were most important to me? Did I feel listened to?

Limit your exposure to other’s trauma.

There is a fine line to finding community support and being overwhelmed by the pains of others. If you are spending a great deal of time invested in the world of other people’s trauma, it may feel good in the moment to realize you are not alone However, it also will keep your body in a state of heightened alert. Certain news and social media platforms are designed to keep telling you how doomed the world is. Be wary of taking in so much pain that you are unable to care for yourself.

Develop a list of opposites of trauma.

Trauma forces us to experience chaos, voicelessness, destruction, isolation, and ugliness. Recovering from trauma means finding and imbibing the opposite experiences. Begin making a list of those opposites. You can do this by creating a T chart. On one side of the chart you list words the represent the experiences you had during or the result of trauma. On the other side, list things that would be the opposite experience. Did you experience chaos? What might help you experience order? Did you experience destruction? What might help you experience creativity? Did you experience loss of voice? Can you write? Did you experience ugliness? What might be beauty around you? Keep the list with you so you can add to it and try to use it when you are feeling overwhelmed.

Now what?

Now that we have identified the ingredients for good trauma care, we are ready to explore how to find a good therapist to walk this journey. We will explore some different models of trauma care and give you some tools to help you make the right decision for you. In the meantime, see if you can expand your practice of the characteristics of trauma care we just reviewed. Ask a close and safe friend to sit with you and review each of the items above. Which ones have you made progress? What might be the next steps or ideas to try to implement? Have an experimental mind. Try things and remember that it is okay to find out something doesn’t work for you.

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