Tag Archives: Psychological trauma

DRC/Rwanda Trip: Day 9


October 19, 2011, Kigali, Rwanda

Finally! Our conference begins. 19 separate group represented here for a total of 42 caregivers. Baraka Unwingeneye (IJM and lay counselor trainer) opened the conference with small and large group discussions on the causes, symptoms, and definition of trauma. The participants were active in discussions. The energy is high! Baraka concluded her section by reminding us all that everyone can be traumatized, even the strong in body and faith. Diane then spoke for 50 minutes or so on the nature of traumatic memory and an overview of the first two phases of intervention. Her voice was a bit weak as she came down with a cold but she delivered it well just the same. Her outline provided a useful reminder of treatment necessity: talking…tears…time. She concluded with some discussion of how having healing relationships, a purpose, and faith all play significant roles in the recovery process.

We ended the morning with a handkerchief project where participants created a depiction of their grief/suffering and then shared it with others. We knew this was going to be powerful and that it would take time. However, we were somewhat surprised at just how powerful it was and how much the participants valued telling others (in dyads and groups) a portion of their trauma story. Several told us that even though they had been counseling others since the genocide in 1994, they had never told anyone their own trauma story.

Our afternoon continued with small and large group activities/discussions and concluded with a question and answer session. The group is hungry for information and we do not have to do much to encourage conversation, discussion, and engagement. Our late afternoon and evening is spent resting, planning for tomorrow’s work and enjoying each other’s company. The food continues to be outstanding at Solace. The only complaint I have is how early the roosters and birds start calling. 4 am is way too early for this. Just outside my window is something sounding like a bird having swallowed a bugle. I later discover it is the gray crowned crane. Here’s a short video I shot from my balcony where I got it to “sing.”  (photos by Joshua Straub)

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DRC/Rwanda Trip: Day Two


October 12, 2011

Woke up to a beautiful morning in Entebbe. Enjoyed a brief walk along Lake Victoria and the garden areas just outside our hotel. Everything is green and warm. Ate a breakfast of roasted vegetables, croissant, a tamarillo (tree tomato), and coffee. Also read the local English paper. It was all about anti-corruption in politics. Seems to be a universal problem.

Wanted to tell my family that I had arrived safely but the Blackberry system had crashed in Europe and Africa so I resorted to finding a nearby business center that charged me 2 dollars for 30 minutes of internet access. I’m reminded how fast our net speed is here in the states.

By 1 pm we were in the air in a 10 passenger Cessna operated by Missionary Aviation Fellowship (MAF). I got to sit right behind the pilot and had a great view of the landscape below. The short videos I took do not do the landscape justice. But what I saw looked like Savannah (grasslands with stands of palm and other trees) bisected by dirt trails/roads and dotted with small villages and neat terraced farmland. Some abodes had metal roofs whole others were clearly thatch. Throughout our trip we saw small fires being used to clear land for farming.

Our flight took us from Entebbe, Uganda northwest to Bunia, DRC, across the southern end of Lake Albert. Bunia was the site of terrible fighting in 2003-4 between warring tribes, renegade militias, and both Ugandan and Rwandan military. From my seat behind the pilot I got a great view of the runway and the significant presence of UN peacekeepers around the airport. One of the reasons this area has so much UN presence is that it is rich in gold, diamonds, and other important natural resources. Prominent at the airport are rusting and cannibalized UN aircraft.

On the ground, we were met by DRC bible society staff who helped us through the customs. Though we had already secured visas, we were still asked to fill out all the same information and demanded that we present additional passport photos (that we did not have). Our handlers spoke both in French and Swahili and at some point the officials relented. DRC is known for the reality of bribes. However, I did not see money exchange hands. To us US folks, bribes only represent individual corruption. But, I’ve come to understand that many officials in the DRC do not get paid and thus the bribe becomes one way to make some money.

Without much delay we were on our way to Shalom University where we met with faculty and administration to discuss the needs around trauma counseling. The University has a great research department and is having students do field survey work to understand the extent of rape and other traumas as well as the problem of literacy. They spoke of a couple of trauma trainings that had been brought to campus and how they were helpful but not yet enough. One of the key problems was the fact that many good students are still struggle with war/conflict related trauma and are not doing as well as they could. They would like training for their faculty to address the needs of students in all departments.

After the meeting, we were shown around the campus where we saw the chapel, the new library building, some student housing and the house of a top administrator. As we passed the student housing–cinder block 2 room abodes that might have had electricity but surely no other amenities as the outhouses were about 15 feet from the front doors and the “stove” was an outdoor fire pit–I was reminded just how blessed we are in the US. Many of us would think that this housing was traumatizing when I suspect these students are quite thankful for the opportunity to study and live in a relatively safe environment.  Each house had a small garden of beans and other veggies for their food.

Once our meetings were done we then followed Bagu (our ABS host/guide) to the church he planted and had built here while a student at the university. We met a couple of the pastors there who showed us the grounds. This is a burgeoning church with English, French, and Swahili congregations. While there we ran into a choir practice–teens practicing their English singing. In the dusk of the night and in the cramped quarters of a side shack outside the church we were treated with one of their songs. What I am struck with is how much activity, growth, and excitement there is around this church where if it were in the US would be seen as squalor. Also, I’m struck with just how much Bagu is a rock star here. People keep coming up and being amazed at seeing him again after not being here for 15 years (I’m vague on this number but I know it has been a long time!).

As dusk turns to full darkness we walk the dirt streets back to the Hotel, still teeming with people walking here and there, passing shanties filled with people buying various items such as cds, SIM cards, alcohol, photocopies, food and whatever else you might want to buy.  At the hotel, I find the room consists of a bed with a mosquito net, a TV! that gets 2 stations when the electricity is on, and running water. The toilet works great and the shower is in the opposite corner with a drain but no enclosure.

Just before turning in we had a dinner of beef skewers and pomme frites–you need to love potatoes if you live in this part of the world. I think I ate them at every single meal.

As I doze off (or try to in spite of getting used to the net over me, the fighting dogs in the alley below, and later a person who must have screamed for at least 1 hour) I am reminded that I am more blessed than I deserve. I recognize that some of my stress these next 11 days will be the result of the strangeness of my surroundings, my lack of personal comfort, and my missing my family. However, I also recognize that I will be able to rectify these stresses by leaving and that those I will interact with do not have the luxury to leave the difficulties behind. We Americans view suffering as something to get through and not something to live with in this life.

Diane and Bagu resting at Hotel Karibunde

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When someone you love suffers from PTSD?


Has anyone read this book? The full title is: When Someone You Love Suffers from Posttraumatic Stress: What to Expect and What you Can Do  (By Claudia Zayfert and Jason DeViva (Guilford Press).

If so, any thoughts on it? I do not yet have it in my possession. One of the areas I found wanting re: PTSD is a good book for spouses of survivors of sexual abuse. There was a book that I would use but is no longer in print. Some do read “Stop Walking on Eggshells”, a book about living with Borderline Personality Disorder. While there are relational behaviors commonly seen in people with either complex PTSD or BPD, the two problems are different and sadly, those with complex trauma reactions get stigmatized with the BPD label.

So, if anyone has seen this and wants to lend their comments, I would welcome them here.

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Safe churches for sufferers of PTSD?


A friend recently asked me about the characteristics of the kind of church someone with PTSD should seek out in looking for a safe place to heal. I’d like to ask that of my readers. What special characteristics might someone look for as a good church family when they suffer from hidden damage? If YOU were looking for a church and wanted to find a safe, compassionate, sensitive church, what would you look for? What characteristics would tell you that the church was what you wanted?

Preaching and teaching? Interpersonal characteristics? Resources? Characteristics of leadership?

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Heal thyself? Do we have the capacity?


Those who follow the Christian faith wholeheartedly believe that God is the “great physician” and eschew the belief that humans heal themselves. As a result of this belief, Christians sometimes react rather strongly to humanistic language of “self-healing.”

But before you do, consider this: if we assume that God is indeed the creator of all things, then we must also assume he puts into place the many corrective features found in the body. The liver and kidneys remove toxins from the body; blood clots when we cut ourselves; we sneeze to get rid of irritants; we sleep to rejuvenate what has become run down. In better words, Richard Mollica says,

This force, called self-healing, is one of the human organism’s natural responses to psychological illness and injury. The elaborate process of self-repair is clearly seen in the way physical wounds heal. At the moment of injury, blood vessels contract to staunch bleeding. Chemical messengers pour into the tissue, signalling a multitude of specialized cells to begin the inflammation process. White blood cells migrate into the wound within twenty-four hours, killing bacteria and triggering a process of cleansing and tissue repair. A matrix of connective tissue collagen is then laid down, knitting together the ragged edges of the wound in a repair that may not be perfect but is highly functional. (p. 94)

He goes on to say,

The healing of the emotional wounds inflicted on mind and spirit by severe violence is also a natural process.

I find his writing on this subject rather helpful. Sometimes we look passively to God to resolve our traumas, as if it were entirely up to Him. Other times we either resist what we can do or attempt what is not healthy for us. Dr. Mollica (an MD) provides many examples in his book of how the body naturally tries to heal/respond to trauma (e.g., DHEA counteracts toxicity of too much cortisol), where the system goes wrong, and what we can do about it from a therapeutic standpoint.

Dr. Mollica is right in that our bodies are designed to respond well to traumatic experiences. However, I’m pretty sure he also agrees that we are not designed to do this unassisted. The community must participate in the process. We are social beings and thus our healing must be socially situated.

Two Toxins: Emotional Memory and Poor Storytelling

Part of the problem, says Dr. Mollica, is the emotional memory system. When we experience a trauma, our cortex forms declarative memories of the event. These are where we store the “facts” (where we were, what we felt, and how these events connect to previous experiences). But there is another memory system, one he calls “emotional memory” (p. 96). Declarative memory involves the cortex and hippocampus while emotional memory involves the amygdala.

The amygdala is the fear-response command center of the brain, and it does not wait around for the conscious mind, located in the cortex, to decide if a threat is real or not. The amygdala can activate an emergency response throughout the body within milliseconds by calling the stress-response system into play.  (p. 96)

Unfortunately, traumatic events can create emotional memories in the amygdala that keep on replaying and are difficult to extinguish over time. (p. 97)

Another toxin is the re-telling of the trauma story in a way that retraumatizes the victim. Dr. Mollica, in chapter 5, describes the problem of poor storytelling. Poor storytelling evokes only the trauma, the shame, the degradation experienced. Storytelling should cause us to form images in the teller and listener’s minds. These images need to symbolize the whole person/story and not only the most damaging details. The problem is we tend to tell stories that fixate on the intense emotions and thus elicit toxic emotions and maintain the experience that the trauma is still ongoing.

Many traumatized persons are plagued by the two poles of humiliation–sadness and despair on one side, and anger and revenge on the other. (p. 122)

Assisted Self-healing?

Mollica says, “A proper clinical approach to emotional memory avoids triggering the emotions stored in the amygdala and enables the cortex to assert conscious control over the recollection of traumatic events. (p. 97)

How do you do this? With the help of a storytelling coach, a person tells their story in a factual, direct, but not grotesque way that would cause the listener to turn away. Why does this matter? Because part of the healing process is to be heard, seen, and empathized with. Fixating on the most grotesque details only enhances the emotional memory system and pushes others away. Good storytelling still tells the truth but does so in a way that reconnects people with the world, enables them to feel sadness but in community with others, and helps them see that their lives are not solely defined by the traumatic events. Further, good storytelling points to larger values that are still held and not lost due to the evil done by others. Surely trauma does shape and change us. Recovery and healing to the point of living as if the event did not happen would be to live in a world of denial and self-deception. But good storytelling reminds us that we are not ONLY defined by and/or limited to being victims. And good storytelling reminds us of God’s sustaining power that is greater than those who can only destroy bodies.

Dr. Mollica summarizes this chapter this way,

Strong emotions comprise the traumatic memories that are imprinted in the survivor’s brain. One of the mind’s key tasks after trauma is to take these strong emotions and gradually reduce them over time through good storytelling. A poor storyteller tells a toxic trauma story, unhealthy to mind and body with its focus on facts and high expressed emotions. In our society situations that demonstrate this type of storytelling are common, including superficial, sensational media reporting of tragedies and debriefing therapy by misguided mental health workers. In contrast a good storyteller is able to express tragic emotions with the artfulness of a musician playing an instrument, engaging the listener’s interest and involvement. (p. 133)

I commend to you the book. He discusses both good and bad dreams, the role of “social instruments” of healing and a call to health. Very helpful book if you are interested in international trauma recovery.

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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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