Tag Archives: trauma

Free online master class with Diane Langberg on redeeming power


Forum of Christian Leaders will be hosting Dr. Langberg for a 3 hour master class on March 20, 2021. The forum is entitled, Redeeming Power: Understanding Authority and Abuse in the Church. For more information on how to register for this session, please check out this flyer.

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Join me at this virtual conference this week: Grace for the Broken: Preventing Ministry Burnout


I’m participating in a free virtual conference for church leaders entitled: Grace for the Broken: Preventing Ministry Burnout. Conference sessions are free when shown live. For those who want an all access pass for viewing later, they offer the entire conference for $47 until March 11. Here are the links:

Conference information and free registration

All access pass for purchase.

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Welcoming faith-sensitive mental health care: An op ed


In June, one national study indicated that 40% of Americans admitted to currently struggling with a mental health condition or addiction. Where will people turn? Many people of faith turn to their church leaders. Others turn to mental health care providers.

In either case, people of faith would like help. They want their clergy to be competent to understand the complex experiences they are having. They want their therapists to respect and even engage their faith questions. While we are doing better training both clergy and therapists, we still have a ways to go.

Here’s an op-ed I wrote and published today discussing our need to improve faith-sensitive mental health care. Take a look. How can we take the next step in improving the care that people of faith are seeking?

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Trauma in America, unveiling a Barna study in a webinar


in 2019, American Bible Society sponsored a study comparing chronic trauma in both churched and unchurched populations. It is out now and you can learn about it on a free webinar on August 6 at 2 pm EDT. I will be one of the guests talking about the implications of the research findings and how pastors and church leaders can be part of the healing path.

Sign up here. If you attend, Barna will give you a discount code if you want to purchase a print or digital copy of the monograph.

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Looking for online trauma related resources related to COVID-19?


If you are looking for learning opportunities or materials to use with your friends or church community, check out some of these links:

Learning opportunities:

Beyond Disaster and COVID related materials for use in small groups

The Trauma Healing Institute has a number of resources you may find helpful. Each one below is found here.

  • Beyond Disaster. A small booklet that can be read alone or shared in F2F or online settings.
  • Using Beyond Disaster in Small Groups. A guide to use the BD booklet.
  • 2 lessons related to the distress of COVID-19, one for adults and one for familys with young school-aged children.

For more materials as well as these materials in other languages, check out http://www.disasterrelief.bible

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When don’t we support victims of abuse?


At the American Bible Society, where I work, those of us involved in trauma healing often say that what gets us up in the morning is our mission to equip the church to be a safe place, a place of hope and healing, for traumatized individuals. I think most Christians want to believe that the church is a safe place for the most vulnerable among us.

But this has not been the case for far to many who report child or adult abuse and harassment.

Now, as a son of a pastor, I am well aware of the challenges pastors and church leaders have in leading their congregations. Frequently, the leaders need the wisdom of Solomon, especially in cases of life and death conflict. The work of pastoring through abuse allegations is never easy. Don’t let your love of the church stop you from reading the rest!

I imagine we all believe that the Church can do so much better. And we ought to be asking ourselves, why have we failed as much as we have? In theory, we are always against abuse and always for protecting the vulnerable. But it does not always play out this way.

Consider what responses might be given to these three “first meeting” vignettes:

  1. A woman comes to church leadership to seek pastoral support in light of her husband’s abusive behavior. This man is well-known to be antagonistic to church and to the Christian faith.
  2. A woman comes seeking pastoral support in light of her husband’s abusive behavior. This man is well-respected in the community and has been a Sunday School teacher for the past decade. She is also known to be a wise and careful woman.
  3. A woman comes seeking pastoral support in light of her husband’s abusive behavior. The man is involved in the church and the woman has been known to be a bit of a church hopper.

Whether or not there is objective evidence supporting her allegations what response should these women receive? Will it be the same? Will the compassion and support offered be the same for each woman? Who will be treated with more compassion, who will be treated with more suspicion (or even just neutrality)? Will the amount of circumstantial evidence influence our response?

Minto, Hornsey, Gillespie, Healy, & Jetten (2016) have attempted to research (a) whether we are more likely to fail to support abuse victims when the abuser is one of our own and (b) whether circumstantial evidence will change our position. [You can download their full-text research essay here.] Their interest was exploring how social identity (what group you are a part of and have pride in) influences how we handle allegations of abuse by fell0w group members.

Study 1. 601 individuals read a vignette of an adult male alleging that a priest sexually abused him as a ten year old. The vignette included details of the alleged abuse and the rebuttal made by the defense attorney for the priest. Catholics, Prostestants, and non-believers all rated the assumed credibility of the victim and the perpetrator. Results indicate both Catholic and Protestant individuals with high church identity were significantly more likely to defend the accused and doubt the accuser. This was especially true if their faith was central to their core identity.

Study 2. 404 individuals also read the same vignette however the level of circumstantial evidence against the priest was manipulated. For some, the survey participants learned that church authorities were not defending the priest and that there had been a previous suspension for similar behavior (i.e., higher certainty of truth). The remaining participants learned that there had been no other cases and that this case was thrown out for insufficient evidence. The results for this study indicate,

ingroup participants were more likely to defend the integrity of the accused (and to cast doubt on the accuser) than were other participants, an effect that was exclusively driven by high identifiers. Interestingly–and somewhat surprisingly–this effect was not moderated by the subjective level of certainty surrounding the guilt of the accused.

In other words, those who highly identify with the Catholic church are more likely to defend the accused even when there is considerable circumstantial evidence against that person.

While this research was carried out examining responses to Catholic priest allegations, it appears that the problem does not lie only within the Church. Consider the obstructing responses of Michigan State to allegations of Dr. Nasser’s abuse of young female athletes over the years. The authors conclude,

Our data confirm that such highly identified ingroup members are the least willing to believe that the accusations are based on fact. This helps to provide psychological explanations for qualitative and anecdotal accounts of senior group members failing to adequately follow up allegations of child sexual abuse within their institution.

But why? The authors ask, wouldn’t the ingroup members be more motivated to purify their ranks by rejecting those who are accused of bad behavior? What is gained (or lost) by standing by accusers when the there is circumstantial evidence of abuse and no evidence of circumstantial evidence of lying on the side of the accuser? This is the challenge for those of use who listen to stories of abuse that happen in our own cherished communities.

Until we solve this problem, we will stand with the young women who accused Dr. Nasser of sexual abuse because he was not one of us but refuse to do the same when the accused is one of our own.


For further reading on reasons why we fail to act well in light of abuse allegations or reports of failures to act:

  1. Why we fail to act: Sins of complicity
  2. Failures to act: Why we don’t always blow the whistle on abuse
  3. After failures: What is more important? Gospel behaviors or reduction of liability?

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Trauma-informed Churches: Clinical, Pastoral, and Theological Support for Victims of Trauma


Today I will be presenting a one hour breakout at the 2017 AACC World Conference in Nashville, TN. If you are interested in seeing the slides, down them here.

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Belief that a rape victim is responsible for the assault misunderstands what rape is all about


This morning I was reading a journal article in the latest issue of Psychological Trauma: Theory, Research, Practice & Policy (vol 9:3, special issue on South Africa). In discussing rape of women in the context of South Africa, the authors report

In a recent study, 17% of the South African women agreed that rape usually results from what a woman says or does. (p. 310)

Does this number seem high or low to you? 

While 17% do not make up the majority of women, it is not a small number either. Without being able to see the original study, I had the following questions:

  • 17% of South African women agree that rape usually is the result of female behavior. How many more believe that it is sometimes true?
  • What are the numbers for what men believe about the problem of rape?

Lest we think that this is just a problem in less evolved countries (note: that perception is offensive and false), we have the same conversation debate here in the US about whether a woman is responsible for what happens to her if she drinks too much at a party or wears the wrong sort of clothing.

What is behind rape?¹

Rape by men requires two factors: aggression and arousal. First, the rapist is aggressive and uncaring about the experience of the other, willing to take what they want by physical, verbal, or psychological force. Often (though not always) the rapist experiences anger, both during and after the rape. And second, the male must be sexually aroused in order to rape. Normally, one would think that aggression and anger would extinguish arousal but this is not the case for those who engage in rape.

What enables this pairing? Several factors are clearly involved:

  1. Obsession. When someone is obsessed with sex or power or anything at all it has a tendency to shape a person and to increase self-focus and shape beliefs about what others think and want. Wants become needs become demands. “I want” becomes “I’m deserve.” This is even true for those rapes that appear un-premeditated.
  2. Fantasy. Coupled with obsession, a person must then begin to fantasize about getting the obsession. They may find ways to normalize what they want (e.g., the other person wants it in their fantasy). No one rapes without having practiced in their mind.
  3. Objectification. Others only exist as opportunities to solve the obsession. They don’t have feelings. They don’t have needs. They don’t matter. The best example of this in Scripture is Amnon’s rape of Tamar (2 Samuel 13).
  4. Blame-shifting. The victim wanted it, asked for it, deserved it. Alcohol was the cause. They didn’t know it was wrong. They couldn’t help it. Any number of excuses may be at work to shift blame. In order to avoid the crushing weight of a stricken conscience, one would have to find a means to shift blame or deny reality.

Is there a culture of rape?

If a significant portion of a population believes either that victims of rape are responsible for the crime or that perpetrators are unable to stop themselves, then where do those beliefs come from? Culture can support these beliefs, either in an active or passive manner. Mostly commonly we see passive means at work. For example,

  • Failing to investigate he said/she said crimes and thereby failing to bring justice supports rape
  • Responding first to victims about their culpability
  • Promoting violence in media towards victims as normal and acceptable

Who is responsible for rape?

While we can say that sexual violence is multi-factorial (learning, culture, history, habits, opportunity, etc.) it is wrong to say that the victim has brought it on. In fact, a naked individual actually asking to be violated cannot succeed unless there is someone willing to respond. Drunken, flirty, scantily dressed women cannot cause rape (once again, a terrible perception that most victims fit these descriptors). Thus, the only one responsible for a rape is the one doing that act.

For Christians, this should be a no-brainer:

Luke 6:45. A good man brings good things out of the good stored up in his heart, and an evil man brings evil things out of the evil stored up in his heart. For the mouth speaks what the heart is full of.

2 Cor 5:10. For we must all appear before the judgment seat of Christ, so that each of us may receive what is due us for the things done while in the body, whether good or bad.

What can we do?

Simple acts are best.

  1. Notice and correct all “explanations” about causes of rape that do not put the blame solely on the perpetrator.²
  2. Notice and speak up about messages from the larger culture that make light of violence, especially sexual violence. In fact one special area is the sexual abuse of teen boys by female teachers. This is all to commonly treated as a win for the boy. It is not.
  3. Engage in community discussion about the shame tactics used to blame victims for their situation.

¹Rape is not only committed by males against females. And there are many reasons why men rape and many contexts in which it happens. This post is not trying to speak to all the types of rapists nor all of the contexts where it happens. It is only focusing on the rape of women by men as that was the context of the initial article.
²There is a time to discuss with both perpetrators and victims about aspect of the situation that may have contributed. A rapist may need to explore how family history or personal abuse history contributed to their acting out. A victim may also need to explore some of their own choices that may have increased their vulnerability to being victimized. The challenge is knowing when. While avoiding these conversations can be unhelpful, having them too early can be deadly to the soul.

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War-related moral injury: what is it? What helps? 


I’m reading David Wood’s What Have We Done: The Moral Injury of Our Longest Wars (2016, Little, Brown and Company). David is a journalist and has experiences embedded in military operations in Iraq and Afghanistan. PTSD is well-known and discussed, especially in the context of war. If you have listened to the news, you know that many veterans struggle with it and struggle with return to civilian life. Suicide rates of current and former military members should grab your attention and tell you that we have a serious problem on our hands. If you have read further, you probably have heard about treatments such as Prolonged Exposure and Cognitive Processing Therapy being used by VA mental health practitioners. 

This book, however, introduces readers to the concept of moral injury, a cousin to PTSD. While the features may look similar to PTSD, moral injury may better account for some of the experiences, especially where terror (the emotion, not behaviors) may not have been the main experience. 

The book opens with a story of a Nik, a Marine whose position came under fire from a small boy with an assault rifle. 

“According to the military’s exacting legal principles and rules, it was a justifiable kill, even laudable, an action taken against an enemy combatant in defense of Nik himself and his fellow marines. But now Nik is back home in civilian life, where killing a child violates the bedrock moral ideals we all hold. His action that day, righteous in combat, nonetheless is a bruise on his soul, a painful violation of the simple understanding of right and wrong that he and all of us carry subconsciously through life. 

… At home strangers thank him for his service, and politicians celebrate him and other combat veterans as heroes. And Nik carries on his conscience a child’s death.” (8)

The author goes on to argue with illustration after illustration that to go to war is to suffer moral injury, to suffer the disconnect between deeply held values and the experiences during war. While it is easy to see moral injury in the forced choice to kill a child vs. save one’s own life, moral injury can also result from being sent on a fool’s errand–political reasons sent to war vs. need to protect or defend freedoms. 

PTSD v. Moral Injury? 

Post-traumatic stress disorder is biology. It is the body’s involuntary physical reaction as we relive the intense fear of a life-threatening event and the scalding emotional responses that follow: terror and a debilitating sense of helplessness. (15)

He goes on for paragraphs to depict the experience of PTSD and its cascade of symptoms–“fear-circuitry dysregulation.” But then listen to how he talks about Nik

…Nik doesn’t have PTSD. What Nik struggles with is not the involuntary recurrence of fear. He’s okay with the crowds at Walmart. He doesn’t startle at loud noises. In contrast with veterans who’ve experienced PTSD, Nik didn’t feel the pain of his moral injury at the moment of the incident…. [But] he is bothered by the memory of that Afghan boy and with questions about what he did that day. Like all of us, Nik had always thought of himself as a good person. But does a good person kill a child? …No, a good person doesn’t kill a child, therefore I must be a bad person. …The symptoms can be similar to those of PTSD: anxiety, depression, sleeplessness, anger. But sorrow, remorse, grief, shame, bitterness, and moral confusion–what is right?–signal moral injury while flashbacks, loss of memory, fear, and startle complex seem to characterize PTSD. (17)

PTSD has little to do with sin. It is a psychological wound caused by something done to you. Someone with PTSD is a victim. A moral injury is a self-accusation, prompted by something you did, something you failed to do, as well as something done to you. (18)

Guilt and shame are key characteristics. Not being able to save a buddy, making a quick decision that also included losses of civilian life, betrayal by leaders but being forced to carry out orders, or not being protected by buddies–all can create a moral injury. Add a mega dose of grief/loss from death and loss of companionship after the unit breaks up and you have a serious problem. (Don’t forget once home and safe, the loss of adrenaline, the loss of status, the replacement of dullness and the rebuilding of old relationships without your friends and without purpose will enhance all painful feelings including nagging guilt and shame.)

Definition offered

The lasting psychological, biological, spiritual, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. (250)

Spiritual community interventions? 

Despite their attractiveness, short-term interventions like CISD aren’t effective (chapter 6 details this). In addition, straight up attempts to challenge distorted thoughts are likely to fail. So, what might work? The book details some listening and validating activities by chaplains, including the burning of cards listing their “sins” as they leave the battlefront symbolizing their remorse and reception of God’s forgiveness. Talking about guilt, confessing failures and shame seem central. Note that confessing and validating do not necessarily mean that others agree that sins have been committed or that perceptions of self are accurate. They merely acknowledge the burden the veteran carries. Even the secular therapy models validate feelings of guilt while finding acceptance and forgiveness. Saying, “don’t blame yourself, you couldn’t help it” to Nik aren’t helpful. Finding a path that doesn’t blame or excuse (237) allows for a different path between all or nothing shame responses. 

It seems that what spiritual mentors and Christian practitioners have to offer in light of these themes are central to recovery from moral injury. 

The reality, says the author, our current therapies are only marginally helpful and sometimes harmful. Near the end of the book he concludes with this conviction,

True healing of veterans with war-related moral injuries will only come from community, however we and they define community–peers, neighborhoods, faith congregations, service organizations, individuals. That means it is up to us. (260)

And thus, YOU have a job to do

Listen. I highly recommend you read his last chapter (“Listen” begins on page 261). He will tell you how to engage a conversation in order to learn. No matter your personal beliefs about war, this is something you can do. Don’t look for the government to do the job, be the one to listen and learn yourself. Be the one to bear witness, as silently as you can. Your presence (more than your words) will convey compassion, understanding, and God’s presence.

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Single session debriefing sessions? Helpful or harmful? 


I write this from Uganda having just completed a Community of Practice conference hosted by the Ugandan Bible Society. This community of practice is for bible-based trauma healing facilitators and local mental and public health experts. I presented on an update to PTSD causes, effects, and treatment. We looked at the value of Scripture engagement around the topics of trauma, loss, and recovery as well as how it fits into the larger picture of trauma counseling. 

Much of what we clinicians know and do for treatment for PTSD symptoms is based on partial research but a significant dose of “clinical judgment.” What is that? Well, it is treatment models that may have some empirical support but mostly formed over long-held assumptions in the field. One of those assumptions is that we may be able to prevent PTSD if we provide group or individual debriefing sessions soon after a traumatic experience. These debriefing sessions have been offered for decades to first responders, humanitarians, and missionaries after exposure to traumatic and tragic events. In recent years we have seen some evidence that some may not be helped but these sessions. In fact, some may even be harmed. 

The evidence of possible harm is not new. Yet, debriefing is still offered indiscriminately. We find it hard to let go what seems to work. Today I was able to read a 2006 study published in the British Journal of Psychiatry (citation below). This bit of research compared emotional debriefing, educational only debriefing, and no treatment. This study of Dutch civilians who had experienced a single episode of trauma within the last two weeks found that all three groups (emotion oriented debriefing, education only, and no treatment) saw a decrease of symptoms at 2 and 6 weeks post intervention. There was no benefit from either form of debriefing found in this study. 

In addition to no benefit, those individuals with high arounsal trauma symptoms who completed emotional debriefing showed higher rates of PTSD symptoms than the those with higher arousal who did nothing or only the educational oriented debriefing intervention. So, some forms of debriefing may actually worsen symptoms. Why? The authors surmise, 

In previous studies it has been established that high degrees of arousal in the immediate aftermath of a traumatic event are associated with an increased risk for the development of PTSD, measured both by self-report (Carlier et al, 1997; Schell et al, 2004) and physiologically by means of heart rate response (Shalev et al, 1998; Bryant et al, 2000; Zatzick et al, 2005). Encouraging highly aroused trauma survivors to express their feeling and emotions concerning the trauma might activate the sympathetic nervous system to such a degree that successful encoding of the traumatic memory is disrupted. Moreover, during an emotional debriefing session negative appraisal of one’s sense of mastery may be promoted (Weisaeth, 2000). This is assumed to keep the hyperreactive individual in a state of high arousal which may cause symptoms of PTSD to escalate rather than resolve (McCleery & Harvey, 2004). 

So, what should we do with this information? Nothing? No. But what we do should not harm, especially when we know some may be harmed. I suggest a few possible outcomes:

  1. Education about PTSD and trauma should continue. This study does not reveal harm for this intervention and given the relatively low trauma symptoms in this study (and the possibility some may have already been aware of what trauma is), education is likely to be helpful. Education is not only about trauma but also about good coping skills and activities. It does not focus on the events of the trauma experienced.
  2. Bible-based trauma healing begins not with a person’s story but looks at culture and common reactions. It normalizes pain and suffering and connects people to God and others. We do not yet have great empirical evidence (it is being collected) that such an intervention is helpful or harmful. But it appears that giving people permission to ask questions of their faith and to see that God encourages lament may still be helpful. 
  3. We need assessment of the growing movement and art oriented responses to trauma. What do these non-talk therapies add to the prevention or intervention strategies? 
  4. Debriefing or talking about a trauma that has just happened should focus less on replaying the details and more on current cognitive and affective impact with focus on resilience and boosting existing capacities. Brief assessment of arousal symptoms may well be warranted by those who promote processing trauma stories. This may be why NET, CPT and DBT oriented PE have lower drop-out rates than classic PE (prolonged exposure) therapy. 

Citation: Emotional or educational debriefing after psychological trauma (Randomised controlled trial) by MARIT SIJBRANDIJ, MIRANDA OLFF, JOHANNES B. REITSMA, INGRID V. E. CARLIER and BERTHOLD P. R. GERSONS. In BRITISH JOURNAL OF PSYCHIATRY (2006), 189, 150-155. doi: 10.1192/bjp.bp.105.021121

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