Tag Archives: Posttraumatic stress disorder

Healing, recovery, restoration and other words for “getting better”


Recovered. Healed. Better. Restored. Resolved. Whole. What words do you use when describing positive change regarding traumatic events like abuse, the pain of adultery, or other like experiences? And more importantly, what do those words convey to yourself and others?

Why am I thinking about this? Soon, I will begin teaching an on-line summer class called “Healing Trauma in International Settings.” To be honest, I’m a little uncomfortable with the title I chose. Words matter and “Healing” conveys a message. Imagine replacing “healing trauma” with

Trauma treatment

Trauma recovery

Trauma care

Now, maybe I’m being overly sensitive but consider some of these other kinds of problems we face

  • You break your tibia during an aggressive move on the basketball court. Your leg heals and you go back to your basketball playing. Here we use healing to denote that you regained your former capacity to play sports. You are back to normal or near normal.
  • You cut your finger while slicing vegetables. You go to the hospital to get stitches. While you have a scar, your finger heals and you use it again. In time you have only a slight scar to remind you of that day.
  • Your house sustains a fire. You lose belongings. Your insurance company restores your house and replaces your possessions.
  • Your car is stolen. The police recover it and return it to you (with fuzzy dice attached)
  • You have a protracted conflict with a family member. At some point, you have a heart to heart and resolve your differences.

My examples all convey a resolution of a problem where the problem recedes, maybe even disappears. But what about trauma? Is there a form of resolution and healing of rape or sexual abuse or domestic violence where the memories disappear? Should there be? Wouldn’t forgetting these experiences place the person in danger of living in unreality and, in some cases, at risk of re-injury? Here are some important questions:

  • What does healing from an affair look like? How do you know you have “recovered”? What symptoms or experiences would remain?
  • What does healing from a rape look like? What would be expected if you “pretty well recovered”? What is to be expected to not change?

As a counselor I do not want to under or over-sell the recovery process. Victims do find tremendous healing but to assume all vestiges of a traumatic experience go away would be false. Unfortunately, we who have not been traumatized sometimes expect the kind of recovery where victims go back to a way of life and thinking as if the trauma never happened.

If we are honest, we wish to live in a world without lasting consequences from sin and suffering.

We want people to “get over” their pain and go back to a way of life as if it never happened. It would be like asking a person who lost a leg to hope they will run exactly like they did before losing the leg. Indeed, they may run again. But never as fast and never as easy. There will be a stump to care for, a hip to learn new motion, phantom pains to re-interpret, and limits to accept.

This world of limits is one God wants us to live in and one we detest. Our first parents saw the limits of their wisdom and desired to get wisdom on their own. We too love the happily ever after story where humans obtain health and healing apart from limitations. We tell the stories of miraculous healing as if we no longer live in a broken world.

Let us endeavor to tell true stories of healing that glorify God and remind us that we depend upon him for every breath.

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Filed under Abuse, adultery, biblical counseling, christian counseling, christian psychology, Christianity, counseling, Post-Traumatic Stress Disorder, Uncategorized

Physiology of fear


Regions of the brain affected by PTSD and stress.

Image via Wikipedia

Had a conversation regarding fear and anxiety with someone yesterday. In light of that I am resurrecting a post I wrote from 2007 (with a few edits) regarding the physiology of fear. We often view fear as only a spiritual or faith problem. But for those who want to know what is going on in their bodies when they experience fear, consider the following:

(Those interested in other posts on anxiety can search that and related terms in the search box at the upper right hand of this blog)

Am teaching on anxiety, panic, and OCD tonight. Definition of anxiety: Responding to ambiguous stimuli (life situations) by reading them in the worst or most dangerous possible light. The Scriptures teach us that fear and worry are not good things. Time and time again God tells his people not to be afraid. We see that God wants us to see life through a different set of eyes, much as Elisha wanted his servant to see the army of angels instead of their enemies (2 Kings 6). But given the numerous encouragements to not give in to fear, we must admit it is a common struggle for every human being. Some struggle more than others.

What is going on with those whose lives are filled with worry and fear? Are they less spiritual? More sinful? It is easy to say, “buck up” to folks who are anxious–and entirely unhelpful to most. Logical challenges to fear (e.g., really, what is the chance you will die in a plane crash today?) may help some in the moment, but usually don’t get to the root of the matter. Jesus encourages fearful people by pointing them to see life from 40,000 feet. He doesn’t deny risk and suffering but encourages folks to keep their eyes on him. And with Peter, he reaches out to grab him even when he does start looking at the waves.

But what of the physiology of anxiety? What do we know and how does the christian counselor make use of the data?

  1. Fear responses are quickly learned and seemingly etched into the amygdala. One bad experience of food poisoning from a turkey sandwich at Applebees means my stomach tenses a little when I see deli turkey, even without remembering the food poisoning. Imagine what happens if you suffer repeated assaults or worse! The earlier the person is exposed to deep fears, the more likely they suffer from hyperarousal and startle responses.
  2. Neurotransmitters are involved which means you act first and think later. There’s little conscious cognitive processes involved until after anxiety is under way. Fear inducing stimuli lead to immediate neurotransmitter changes that then divert blood from organs to muscles. Tension builds, shallower, less effective breathing begins. Carbon Dioxide levels decrease in the blood stream which in turns creates pain, numbness, and a sense of danger. And so the cycle continues. During and after, we make attributions and so enhance the connections of the feared stimuli and our flight response. The higher the perception of pain, the greater fear/flight response. Despite medical advances, most of our medications either shut down the feed-back loop (beta blockers, anti-anxiety meds like xanax) or attempt to increase the available neurotransmitter serotonin associated with positive outlook.
  3. OCD, in particular, has some probable links to early exposure to viruses such as Strep and Flu. There is a higher incidence of OCD in people born during winter months and who live in colder climates. The link is not clear.
  4. PTSD patients have higher right hemisphere brain activity (than do non-PTSD individuals) when exposed to anxiety provoking stimuli. Further, it appears that trauma patients have greater difficulty coming back to “center” after a trigger. Likely the hypothalamus and other brain structures are overactive in the stress response and do not “cool” down quickly.

That’s just a few things we think we know about the physiology of fear. Now, what do we do with fear from a spiritual standpoint?

  1. Worship. Worship/meditation on other things takes our attention away from the fear stimulus. It forms habits and relationships as we repeat what we want to believe until we actually own it and believe it on its own merits.
  2. Fight. We do challenge our thinking as soon as we can. Yes, the fight/flight chemicals are coursing through our veins but we challenge just the same so we can break some of the connections and the ways we reinforce our fears. One other way we fight may seem a bit odd. We admit there are real things that are scary and overwhelming out there. We do not try to deny the reality of suffering (past or future) but admit it over and over. It is scary to die. I was assaulted in that alley. I am in pain and more may be coming. But, God is with me and it is good to call on him and ask him tough questions about his protection of me.
  3. Stay Present. Being present in the moment is essential to avoiding living in the fear of the past or the future. Some fear is indeed in the present but most are not. When I am able to focus or describe the now, I am less likely to be imagining a future feared event. “Right now I am sitting at my desk and looking at a picture of my children and enjoying the smiles on their faces. Right now I am getting ready for bed and working on a sudoku puzzle and noticing that I am getting tired.”
  4. Work. Building habits where I do not allow myself to run from the feared situations (where appropriate!). Moving myself closer to some of the feared scenarios in a slow and consistent manner. No, this is not flooding (where you are dumped in the pit of snakes because you have a phobia of snakes…). Allow the work to take the time to reorient the deep recesses of the brain. Don’t expect or look for immediate change!

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Filed under Anxiety, biblical counseling, christian counseling, christian psychology, counseling science, counseling skills, Mindfulness

Webinar on Complex Trauma: April 19, 2011


Diane Langberg and I are scheduled to do a three hour webinar for the American Association of Christian Counselors (AACC) on the topic of complex trauma and sexual abuse. It will run live April 19, 2011 from 6p to 9p. You can learn more about the content of the webinar by visiting this link.

Use the above link to register. Cost is $59 to “attend” via your computer or $69 if you want CEUs. AACC is able to give 3 CEUs for those needing APA and NBCC approved continuing ed.

Our presentation will be broken into 4 segments with Q & A. Topics include: overview, differential diagnoses, 3 phase treatment approach, educating the church about trauma, connecting victims to God, counselor self-care, and next steps for church leaders.

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Filed under Abuse, christian counseling, christian psychology, counseling science, counseling skills, Diane Langberg

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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Filed under Psychiatric Medications, ptsd

Coming to Peace with Psychology 2


In chapter 3 and 4 of his Coming to Peace with Psychology (IVP, 2010), Everett Worthington continues to show us how we are not near as good at intuiting facts as they really are. We us heuristics (rules of thumb). Hidden factors influence our views, ideas, experiences, and behaviors. In chapter 3 he gives an example of clinical judgment about trauma vs. research data. He suggests that most clinicians believe that the vast majority of survivors of traumatic experiences will have some form of PTSD. In contrast to this assumption, George Bonanno provides research data suggesting that some 10-30 percent of trauma survivors have chronic problems. Another 5-10 percent have delayed problems. However, the rest recover quickly or are resilient altogether. His point? Clinicians think resiliency in the face of trauma is rare when in fact it is quite common.

I find this example a bit strange. He did not cite sources pointing to the fact that clinicians assume PTSD in most survivors. I would have expected that he, a scientist, would have done that. Most therapists I know don’t go fishing for PTSD when no symptoms exist.

I think his deeper point still stands. We humans believe what we believe in the face of inconsistent data. So, he wants to explore what more objective research about human behavior might give us in our quest for consider the relationship between psychological science (not psychotherapy) and Christianity.

These first 4 chapters appear to be Worthington’s efforts to make sure we recognize that empirical research can teach us much about human nature; that research is going to be useful in building a model relationship between psychology and Christianity. Good for him! Let’s see how he begins to deal with the disciplines of psychology and theology in the next chapters.

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Filed under biblical counseling, christian counseling, christian psychology, Christianity, Psychology