Tag Archives: Posttraumatic stress disorder

Watch this on shame and trauma


A couple of years ago Diane Langberg spoke on shame and trauma for the American Bible Society. I highly recommend this 56 minute presentation. She talks about the experience of shame, the stickiness of self, communal forms of shame, and the myriad ways we respond to shame across various cultures.

We watched it again in staff meeting today. Make sure you catch her discussion of what some cultures believe cleanse shame. And then notice how that is close but a huge distortion from a Christian view of what heals shame.

Watch it here.

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Counseling Adult Survivors of Child Sexual Abuse: Phase 2 mis-steps and correctives


Today Dr. Diane Langberg and I will be offering a 3 hour pre-conference CE training at AACC’s 2015 World Conference here in Nashville, TN. Our focus is on some of the common counselor mistakes made during the phase of processing the abuse history and all that happens as a person tries to see self and history through different eyes. We focus on the relational approach to repair the mistakes we make. I have a small bit on reframing resilience and posttraumatic growth. Our perceptions of recovery and where we (counselors and clients) should be headed sometimes need to be examined.

For those interested in seeing the slides from my portion of the talk, click: AACC WC Pre-conf 2015

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How childhood trauma could be mistaken for ADHD


This article: (http://acestoohigh.com/2014/07/07/how-childhood-trauma-could-be-mistaken-for-adhd/) was sent to me by a GTRI student (Thanks Charity!). Worth the read to consider how we may mistake hyperactivity as evidence of ADHD vs. evidence of hypervigilance and PTSD. Given the high prevelance of ADHD diagnoses in areas where there is also much trauma (urban and impoverished settings), it stands to reason that there could be significant misdiagnoses. I began to understand this problem some 17 years ago during my pre and post doc experience in small town Concord, New Hampshire. We saw all sorts of boys first diagnosed with ADHD, then diagnosed (and heavily drugged) with bipolar disorder. Back then we called them emotionally-dysregulated. Nearly all had been subject to domestic violence and had witnessed their mothers abused by boyfriends. A large number had seen their mothers had guns held to their heads. Such experiences shape a child and so it stands to reason that a brain bathed in the hormones released during terror and horror would have an impact. It is also true that in this same population there was a high incidence of tobacco use, also known to be highly correlated with ADHD diagnosed children.

My suspicion is that one day we will find syndromes that encompass both diagnoses but that will not be until we have better understanding and technology to assess what is happening in the brain during an episode of “hyperactivity.”

Check out the above article and if you are a clinician, consider alternative explanations for ADHD diagnosed children. Do you see signs of emotion dysregulation? And if so, how might that be more central feature of the treatment plan?

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Filed under ADHD, trauma

Brooks on journaling about emotions


Friend Jeff McMullen pointed out a recent David Brooks op ed in the New York Times. (Read it here). While I’m not sure I agree fully with his journaling/not journaling point he says something very important about the timing of writing one’s emotions after a traumatic event. He says,

When people examine themselves from too close, they often end up ruminating or oversimplifying. Rumination is like that middle-of-the-night thinking — when the rest of the world is hidden by darkness and the mind descends into a spiral of endless reaction to itself. People have repetitive thoughts, but don’t take action. Depressed ruminators end up making themselves more depressed.

Then later, this important distinction between immediate processing of emotions and later processing,

We are better self-perceivers if we can create distance and see the general contours of our emergent system selves — rather than trying to unpack constituent parts. This can be done in several ways.

First, you can distance yourself by time. A program called Critical Incident Stress Debriefing had victims of trauma write down their emotions right after the event. (The idea was they shouldn’t bottle up their feelings.) But people who did so suffered more post-traumatic stress and were more depressed in the ensuing weeks. Their intimate reflections impeded healing and froze the pain. But people who write about trauma later on can place a broader perspective on things. Their lives are improved by the exercise.

David points to some research that exists that suggest CISD is unhelpful for some participants. Some are made worse. Yet, narrating one’s trauma in the broader context of a life tend to see a reduction of symptoms. The difference seems to be whether the focus in on life or mostly on the trauma. Trauma in perspective is the goal. Just reviewing trauma may in fact strengthen the traumatic reaction rather than weaken it.

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Filed under Abuse, counseling, counseling science, Post-Traumatic Stress Disorder, Psychology, ptsd

GTRI 2014: Day 4


July 4. Transit day.

Today is a transit day. Breakfast of hardboiled egg, bread, and coffee. Talked with Klero of South Sudan. Discussed ideas of how to bring GTRI courses/materials and other counseling training to local areas here in Uganda and in S. Sudan. While Juba has great Internet per Klero, most people there do not have access to it. The same is true here in Uganda. I am very interested in finding a way to bring this training (videos, readings, exercises) to this region without it being in an online format as it is right now. Seems the areas of greatest interest are basic helping skills, trauma healing from the Bible Society, deeper understanding of impact of trauma and expression of PTSD across cultures, and exposure to psychopathology. My goal would be to give this material away and offer live conferencing sessions to the training mentor as needed. Then, possibly follow-up with a visit to “t0p-up” as Harriet Hill is fond of saying.

Anyone want to fund that or help me figure out how to get others to do so? (Smile)

After breakfast we made our way to a nearby Catholic college to talk with Sister Bokiambo and the dean of the counseling department, Fr Evarist Gabosya Ankwasiize. They were interested in future opportunities with shared learning (my bringing students here to engage and interact with their students and participate in joint training). I left with new ideas for this location (on the shorts of Victoria) and with the encouragement that the Bible Society might be able to begin some seminars here to improve the dialogue between Scripture engaged trauma care and traditional mental health trauma care.

After a lunch of fried fish on the shorts of Victoria, I said my good-byes to Justus and Esther at Entebbe airport. The added security was quite evident (3 bag checks and 3 metal detectors before boarding) but there were no problems. The flight to Kigali was under 1 hour on a very new Rwandair airplane. Just enough time for a Passion fruit drink from the steward. Arrived to significant upgrades to the airport.

Arrived at Solace Ministries Guesthouse, our usual haunts since 2011. Solace isn’t hotel level but I love it for many reasons: Simeon’s great cooking (he makes fantastic vegetable soups and dessert of fresh tropical fruit and ice cream tonight), my money goes to a ministry and not a behemoth corporation, the water is hot, the rooms are clean, and it is centrally located. Seems Internet is a bit upgraded since I was able to SKYPE with Kim and boys.  [For a 2012 video of Solace Guesthouse, see here.]

I arrived here after the major July 4 celebrations today. Today marks the end of the 100 day mourning period and celebrates the liberation of Kigali. This is the 20th anniversary. A number of fireworks were shot off tonight, which I was told later triggered some local people into thinking the city was under attack.

Tomorrow, Lord willing, the rest of the team will arrive from the US and other points and our GTRI immersion trip will begin in earnest.

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Training Trauma Healers For The Church


Over at our faculty blog site you can find my summary of a recent trauma recovery training for pastors and church leaders. Biblical co-sponsored this training with the American Bible Society in an attempt to bring a well-established, scripture-engaged trauma healing model to the Philadelphia area. Read more about the model and its value as well as see a picture of the training (thanks Heather Drew).

Trauma comes to us in all shapes and sizes. Traumatized outsiders (i.e., immigrants), child sexual abuse, domestic violence, community violence, racial injustice and natural disasters are here, not just something that is “over there.” While we may have more professional mental health resources here than other communities have access to, we still do not have enough to serve the need. And even if we did, the best models of recovery connected traumatized people to their faith and their communities. What better place to do that than in the church?

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Filed under Biblical Seminary, counseling, counseling skills, suffering, trauma

Can you have “church PTSD”?


A friend of mine has written about her experience as a pastor’s wife and youth worker. Having gone through several painful experiences–“normal” church drama and then way beyond normal–at the hands of other church leaders, she details her current “church PTSD” that kicks in now when considering going to church

What if I WANT the community and the bumping up against different people with different opinions, but I CAN’T, I mean physically CAN’T go?  I have usually discovered in life that if I have a feeling, I’m not the only one.  So it makes me think there must be others out there like me.

What do I mean by “physically unable”?  I shake, I cry uncontrollably, my skin crawls, I am unable to speak.  It’s pretty difficult to be a part of a community, broken or not, with all of that going on.

Honestly, I have something akin to a PTSD (not to take away from anyone who actually has full-blown PTSD) when it comes to church.  When I hear people talking in Christian catch phrases I want to run away.  This is the language of the culture of people who persecuted and bullied my family and me.  If you speak their language, you must be one of them, too.  So I stay away.

Having worked with a large number of current and former pastors and families, this reaction is sadly not unique. So, it begs the question: What might be the root of this “church PTSD” (by the way, I think some of these features sound just like PTSD so we may not need the quotes)?

My friend hits the nail on the head: we accept meanness in the church because we fear disrupting our own safety and security.

there is a culture of acceptance in the church today that allows for people to be treated terribly under the umbrella of it being what is “best for the church”.  I would imagine that if a teacher was abusing children in the toddler department or if there were drunken parties going on at youth group there would be some type of outrage, as there should be.  But somehow just plain being “mean” doesn’t garner any type of outrage.  “It’s not ideal, but we are fallen people, after all, so you can’t expect anything better.”

Read her full post over at Scot McKnight’s blog here. Consider what one thing you might do to stand up to those who put down others rather than image Christ in sacrificing for the weaker party.  

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Filed under Abuse, Christianity, Christianity: Leaders and Leadership, church and culture, conflicts, suffering, trauma

Free Issue of Journal of Traumatic Stress


As a member of International Society of Traumatic Stress Studies (ISTSS), I am able to offer you a link to a free issue of their journal, Journal of Traumatic Stress.

Click this link for the February issue page with links to download individual articles.  Several essays relate to PTSD treatment for veterans, at least one essay re: child maltreatment in Uganda.

 

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Filed under counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd, trauma

What is Global Trauma Recovery Institute all about? Check out this video


At the beginning of 2013, Biblical Seminary launched Global Trauma Recovery Institute to train recovery specialists here and around the world. We’re small but thus far we have taken 20 students through 120 hours of continuing education, another 15 have just begun, and we are now preparing some of those first students to travel to Rwanda to observe and participate in trauma recovery training with local caregivers. Those students we serve are from or located in three continents plus the United States. In addition, we have represented GTRI in trainings in South Africa and Rwanda this year as well as engaged Christian counselors in Romania during one of their trainings. Our hope for 2014 includes more of this kind of training as well as our first immersion trip with students. Think we are just focused on the international scene? No! The “abuse in the church” video on the right hand bar of this site was sponsored by GTRI as well.

Maybe you wonder what we do and how we handle cross cultural challenges. Check out this short 3 minute video below to see our (myself and Diane Langberg) heart for raising up capable recovery specialists here and around the world as they follow Jesus into the world.

Want to support? After viewing the video, please consider supporting us with prayer and even tax-deductible donations. If you do choose to donate, this link will bring you to a donation page. You can give to the seminary’s general fund (without their support, GTRI would NOT exist!) or you can give a specific gift to GTRI. Just note that in the comments section. Your gifts will enable us to serve more international students and to begin the formation of learning cohorts on other continents!

[Note: Link on image is broken, click here to see the video]

GTRI Video Image1

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Is PTSD an internal problem causing social problems? Or the other way around?


I am finally getting around to read Ethan Watters’ polemic Crazy Like Us: The Globalization of American Psyche (Free Press, 2010). In this book he details the way America has exported not only its pharmaceuticals but have redefined mental health and disease. As the promotional material on the front cover says, the book “[uncovers] America’s role in homogenizing how the world defines wellness and healing.”

As I read the book, I find he is overly negative and pessimistic, even as he right points out some major bumbling when bringing Western mental health ideas to the world. And yet, consider this…

In chapter two he examines the way Western mental health providers flooded (bad pun but appropriate picture) Sri Lanka after the Tsunami to treat all the PTSD that would most definitely come to light. They “educated” the country about the symptoms of PTSD and trained caregivers and counselors to provide counseling interventions. When certain symptoms weren’t presenting widely, some helpers assumed victims must be living in denial.

Watters describes how one researcher began looking to see how Sri Lankans described symptoms of poor responses to trauma–instead of using a pre-determined set of symptoms. This researcher concluded that Sri Lankans experience trauma quite differently.

1. Sri Lankan PTSD symptoms were primarily physical in nature.

2. Sri Lankans did not identify anxiety, numbing, fear symptoms but rather identified isolation and loss of social connection as key to PTSD symptoms.

The root problem in PTSD? 

So, is PTSD internal or external? Intrapsychic or social? Most Westerners think of psychopathology in terms of the individual. A sick individual will likely find their social lives eroding and less supportive. It appears Sri Lankans think of pathology in terms of social connection which when broken results in some of the physical symptoms. So, does trauma cause psychological damage which in turn harms social networks…or does trauma harm social networks which in turn causes distress?

Your answer to this question likely reveals whether you see the world as a community or a group of individuals.  Or, your answer reveals whether you focus on universal human experiences or constructed human experiences.

One semi-helpful answer

My answer? Our minds, bodies, spirits and social networks are not disconnected. While distinct entities, we are far more connected than disconnected. To paraphrase the bible, if the eye is sick, the whole body is sick. Psychopathology does not reside only in one location, even if we can see it’s impact in one specific location (e.g., cells not functioning). We would not assume that seeing the destruction after a tornado would be all that is needed to find the cause of that same tornado. Whatever interventions we devise, we will not find a one-size-fits-all solution. For some, we will intervene first in the interior of their lives (medications, private counseling). For others, we will start with social reconnection.

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Filed under counseling, counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd