Tag Archives: trauma

Is it trauma or is it intensity/identity loss?


The current definition of PTSD requires an exposure to an intensely distressing event or events (either witnessed or told about in great detail) resulting in a pattern of intrusive re-experiencing, attempts to avoid such experiences and an ongoing negative cognitive/mood pattern. Such a diagnosis might be made after domestic and sexual violence, accidents, natural disasters, war, betrayal traumas, and even after hearing repeated stories of traumatic experiences to others (called secondary trauma).

Someone experiencing PTSD after life-threatening events might feel disconnected from family/friends, find it difficult to sleep, experience repeated nightmares, have difficulty not thinking about events during and after the traumatic experience, choose unhealthy coping patterns like alcohol abuse, or place themselves in situations where they re-enact parts of their trauma story.

But not everyone who has intrusive thoughts about a challenging situation, feels disconnected from their community (and previous self), drinks too much, or impulsively jumps back into danger have PTSD. Some of these same behaviors and experiences also show up in those who have left dangerous and all-consuming experiences and now do not know how to re-engage in regular life.

Consider these words of Dr. Steven Hatch, who spent time in Ebola clinics in Liberia at the height of the 2014 pandemic crisis in West Africa. He describes his experience after returning to his job at the University of Massachusetts.

To match the outside weather, my mood willingly turned dark. I withdrew from people, wandered about in a daze, and avoided public gatherings. When I did venture out, I carried myself in a completely different manner than I had before in my life.


The simple explanation was that I had post-traumatic stress disorder, and a few people, including some whose job it is to make such diagnoses, thought this to be true. (p. 239, Inferno)

He goes on to dispute his experience fighting Ebola as trauma. While difficult, he did not think it rose to the level of trauma experienced in war or even other more overwhelming Ebola clinics.

I could, however, recall the event [death of a toddler] in my mind without being emotionally overwhelmed, but also just as importantly I was able to still experience emotions about it, feeling appropriately somber. I just didn’t feel traumatized. (p 240)

So, what was his problem?

What I did share with many other volunteers was a sense that I didn’t belong in the States, for the work in West Africa was far from over. I desperately wanted to return, and almost within days of coming home I was trying to figure out how I could get back to an ETU [crisis Ebola center]. What I missed was the profound sense of purpose that such work had provided, and I slowly realized why people talked of “missing the war,” a phrase that always seemed discordant to my ears. You miss being in the midst of senseless butchery? Great. But I belatedly realized it was that purposefulness, the sense that you were doing something that was deeply and truly meaningful, that drove people back to such unstable situations. (p. 240-41)

There you have it. The seeming loss of crystal clarity or purpose in life can be very painful. When you are in an intense helping situation as Dr. Hatch was, every movement leads towards life or death. At the end of a day, you can count who lived and who died. No ambiguity. In addition, you are doing it with a team of people all committed to the same thing. You share the same vision, goal, and daily experience. You do not have to explain anything. And in these intense situations, you can have the kinds of intimacy not often experienced even in your immediate family. Also subtract mundane activities (grocery shopping, cleaning, taking care of children, etc.) that may not need to be done.

This is a recipe for distress upon return.

Return to regular life where you are expected to do these seemingly inconsequential activities AND where you have no one around to save AND no one who was present with your toughest experience…and you have a recipe for trouble. You may find it difficult to find joy in light of intrusive thoughts of recent emotionally intense experiences. You may long for a return to that sense of purpose and value. Because others do not understand and aren’t part of your “tribe” you may withdraw or find other ways to numb the pain.

Loss of identity and intensity may mimic trauma symptoms. They may be significant to need treatment. Military ending tours of duty, missionaries returning from field, humanitarians returning from doing crisis work, church planters leaving high stakes urban church plants, and trauma healing trainers returning from intense experiences may be at risk.

What can be done to prevent this distress?

  1. Probably nothing will take care of the problem. One could not go do intense work. Or one could become a crisis junkie. Neither are good options.
  2. But developing re-acclimation plans can help. Yes, training done before entering the intense experience will set the stage for healthy returns but post-tour of duty re-entry work is more important. The Army has develop protocols for re-entry by beginning the process even before leaving the “theatre.” Creating space for coming off the “high” giving time to process and following-up in the early days back can help. Involving family in the re-entry planning and building activities that can elevate family intimacy upon return will help immensely.
  3. Encouraging time and space to lament and process in group settings. This is where a therapist can help. Group process helps to put words to experiences and acknowledges impact on identity. This can also help re-connect with meaningful activities and experiences at home. One has to re-learn that meaning is not solely connected to intensity.

I have some very small personal experience with this. I’ve had intense experiences in international settings. When I have returned, I have sometimes found it hard to be at home when my head was still overseas. Being able to share with Kim and others helped. Practicing lament helped. Learning to be mindful of the present also helped me remember what has meaning and value in everyday life.

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Complex Trauma: Going Deeper, By Diane Langberg


As part of our staff meeting today we watched this video by Diane Langberg. It reviews the 3 stages of typical trauma recovery process plus focuses on the impact of the work on the counselor. Self-care is a common conversation these days. However, a few lines stuck out to me:

Unless we take care of ourselves, we will not be able to bear witness…. Vicarious trauma is not something done to us but a consequence of having empathy…. Evil and suffering also provide an opportunity to expose the weak places in [the counselor]…. Seek out the antidotes to the poison that you sit with…[these antidotes] are not just good coping mechanisms but part and parcel to living the life obedient to God.

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Reading the bible through the lens of trauma?


What if you read the bible through the lens of trauma? Some are quite obvious–catastrophes are all throughout the bible. But are these stories of trauma in the bible merely keeping a record of it or attempts to deal with the trauma, to put the world back proper perspective after chaos?

Consider this 2015 video by Rev. Dr. Robert Schreiter entitled: Trauma in The Biblical Record. He gives some background about this newer way to read the bible through this lens and then ends with 3 examples. I’ve just ordered this book on the subject, but those wanting to jump ahead may wish to know about it as well.

 

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Diane Langberg: Living with ongoing trauma


A few years ago, Dr. Diane Langberg gave a talk about ongoing trauma experiences, when there is no “post” in the posttraumatic stress disorder. When there is no after trauma yet (e.g., ongoing domestic violence, living in a war zone, etc.), what kinds of help and hope might a survivor hold on to? Is there anything that can be done?

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Diane Langberg on Shame


A few years ago, Dr. Diane Langberg presented on the topic of shame at the 2014 Community of Practice hosted by the American Bible Society. She describes the toxicity of shame as a distinct part of trauma, especially betrayal trauma. You will learn about the cognitive phase of shame, kinds of shame experienced and how the response to shame takes one of 4 common forms (i.e., withdraw, avoid, attack self, attack others).

Make sure you watch to the end as she shares some insights to how God understands and responds to our problem of shame. See how Jesus enters in to our shame.

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Why we need a theology of trauma


[Previously published April 2015 at http://www.biblical.edu. The faculty blog no longer exists there thus re-posting here]

We live in a world shaped by violence and trauma. This week that I write 147 Christian Kenyan university students were killed because of their faith. Such horrific forms of violence shock us. But they shouldn’t given that in our own country violence and trauma are everyday occurrences. While some of our local brothers and sisters face actual death, all of our communities are shaped by soul-crushing abuse and family violence. Take the most conservative numbers we have—1:6 males and 1:4 females have experienced sexual assault before age 18—and realize that a large portion of your friends and acquaintances have traumatic experiences.

In a congregation of 100, 20 of your fellow church members are walking around with invisible wounds of sexual violence on their bodies and souls. And that number says nothing about those walking around with other invisible wounds, such as caused by domestic violence, racial prejudice, sexism, bullying and the like. Were we to include these forms of interpersonal violence the number would likely reach 70!

As my friend Boz Tchividjian asks, what would the sermons and conversations look like if 20 of our mythical congregation of 100 had just lost a house in a fire or a child to premature death? Wouldn’t we be working to build a better understanding of God’s activity in the midst of brokenness rather than passing over pain as a mere hiccup of normal life?

Yet, we continue to imagine trauma as some sort of abnormal state.

Ruard Ganzevoort[1] tells us that, “When one looks at issues like these, we must conclude that our western societies are to no less degree defined by violence and trauma, even if everyday life is in many ways much more comfortable” (p. 13). Thus, Ganzevoort continues, we must “take trauma and violence not as the strange exceptions to an otherwise ‘nice’ world” (ibid, emphasis mine). He concludes that while we have a strong theology for sinners, we have a less articulated theology for victims.

What if we were to read the Bible in such a way to build a theology of trauma for victims? What would it look like? I would suggest that Diane Langberg’s maxim sets the stage quite nicely: the cross is where trauma and God meet. Jesus cries out due to the pain of abandonment by the Father. Since we do have a high priest who understands our trauma (Hebrews 4:15), we can read the entire canon from the frame of trauma—from the trauma of the first sin and death to the trauma of the cross to the trauma just prior to the coming new heavens and earth.

Key Themes in a Theology of Trauma

Reading the Bible through the lens of trauma highlights a few key themes beyond the foundation of a God who Himself knows trauma firsthand in the unjust torture and death of Jesus:

Anguish is the norm and leads most frequently to questions

When more than 40% of the Psalms are laments (and that doesn’t count the primary themes of the prophets!) we must recognize that anguish is most appropriate forms of communication to God and with each other. But we are not alone in the feelings of anguish. God expresses it as well. Notice God expresses his anguish over the idolatry of Israel (Eze 6:9) and Jesus expresses his when lamenting over Israel (Luke 13:34) and cries out in questions when abandoned by the Father (by quoting—fulfilling—Psalm 22).

Despised and rejected, a man of sorrows, acquainted with grief.

Peace happens…in context of chaos

Psalm 23 comes to the lips of many during times of trouble as it expresses peace and rest during times of intense trouble. Shadows of death yet comfort; enemies around yet feasts. Peace happens but rarely outside of chaos and distress. Consider Jeremiah 29:11, frequently quoted to those going through hardship to remind them that God has a plan. He does have one, but recall that the plan was to live in exile among those who see the Israelites as foreigners and second-class citizens!

The kingdom of God in the present does not promise protection of bodies

Try reading Psalm 121 aloud among those who have survived genocide or been raped repeatedly by soldiers. “The Lord will keep you from all harm.” Really? You lost 70 family members? You cannot maintain your bladder continence due to traumatic injury to your bladder? Where was your protection? Our theology of God’s care must take into consideration that He does not eliminate disaster on those he loves. Recall again the trauma wrought on those God chose to be his remnant. They were the ones ripped from families and enslaved by the Babylonians.

God and his people are in the business of trauma prevention, justice, and mercy responses

The kingdom of God is not for those who have pure beliefs. The kingdom of God is for the poor in Spirit, the persecuted, those who provide mercy and those who hunger for justice (Matthew 5). True or pure religion is practiced by those who care for the most vulnerable among us (James 1:27). Jesus himself is the fulfillment of healing as he claims Isaiah 61 as fulfilled in his personhood and mission (Luke 4:18-21). We his people are the hands and feet to carry out that binding up and release from oppression.

Recovery and renewal during and after trauma likely will not eliminate the consequences of violence until the final return of Jesus Christ

Despite our call to heal the broken and free those enslaved, we are given no promise that the consequences of violence are fully removed until the final judgment. Rarely do we expect lost limbs to grow back or traumatic brain injuries to be erased upon recovery from an accident. Yet sometimes we assume that traumatic reactions such as startle responses, flashbacks, or overwhelming panic should evaporate if the person has recovered. A robust theology of trauma recognizes we have no promise of recovery in this life. What we do have is theology of presence. God is with us and will strengthen us guiding us to serve him and participate in his mission to glory.

There is much more to say about a theology of trauma for victims. We can discuss things like theodicy, forgiveness, restorative justice, and reconciliation. But for now, let us be patient with those who are hurting as they represent the norm and not the exception. And may we build a missional theology of trauma, not only for victims, but also for all.

[1] Ganzeboort, R. Ruard (2008). Teaching that Matters: A Course on Trauma and Theology. Journal of Adult Theological Education, 5:1, 8-19.

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Trauma and the Church presentation this Friday night


This weekend, Foundations Christian Counseling is hosting a 2 day conference, Counsel From the Cross at Spruce Lake Retreat. I will be speaking Friday night (8 pm) on “The Cross, the Church, and Trauma: Making the Church a Safe Place for Victims of Trauma.” Use the 2nd link above to register for the day or the weekend.

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PTSD: A New Theory? An Old Treatment


Researchers Liberzon and Abelson at the University of Michigan have published an essay articulating a new way of conceptualizing what is happening in the brains of those with Posttraumatic Stress Disorder. While you can’t read their essay for free, you can read this good summary here.

What is their new theory? the neurobiological problem of PTSD is “disrupted context processing.” In simple terms, I fail to respond to the “stimulus” in its proper context when I am triggered by old experiences in a new setting. Even more simply, when I wake up on full alert in the middle of the night after smelling wood-smoke in my sleep I initially fail to recognize the context (my neighbor burns wood) and immediately think my house is on fire (as it once was). Thankfully, the alertness is less than it used to be and I don’t always get up to check on my house.

The authors suggest that 3 separate and current brain models are inadequate in their scope of understanding the brain’s activities in PTSD. From their perspective the “fear model” (Fight/flight learning), the “overactive threat detection model” and the “executive functioning model” work best when integrated into one unified theory with their new label. And, in true humble researcher fashion, they request help in testing this model to see if indeed it can carry the freight.

An Old But Essential Treatment?

It is good to have a better handle on what is happening in the brain when someone experiences PTSD. Neurobiological research is growing by leaps and bounds. It is hard, frankly, to keep up. And yet, let us not forget an old but essential part of PTSD treatment, the person of the therapist. Humans are designed to be in relationship. PTSD has a way of shattering connections with others and thus the treatment must reverse the disconnect. Being present and bearing witness to trauma will always be the first and primary intervention every therapist must learn. Our temptation is that we want to move beyond the bearing witness phase into change phases. While this is understandable (we want others to get better as fast as possible), we sometimes want this for our own reasons–to avoid the pain we experience in sitting with traumatic experiences of others.

Let us remember that we therapists (and pastors, friends, etc.) are the primary intervention when we are present with those who suffer, when we become a student of their suffering. All other treatment activities stem from this foundation. To use a different analogy, consider Dr. Diane Langberg’s meditation, “Translators for God” (Day 26 of In our Lives First). In this meditation she describes the experience of being translated in a seminar. The translator must fully understand both languages in order to accurately communicate the speaker’s words into the heart language of the hearers. Counselors are translators for God and for healing. And yet, if they do not deeply learn the heart language (pain and trauma experience) of the client, they will not be able to connect the client to healing and to the God who heals.

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Is God eternally traumatized?


The first words of Alwyn Lau’s “Saved By Trauma” essay remind us that the work of Jesus Christ on the cross is the foundation and center point for all of Christianity.§ Without the cross, there is no Christian faith.

The Christian faith is centered around the historical trauma of the suffering, death, and bodily resurrection of Jesus. Christian theological reflection starts from and eventually relates back to the work of Christ. Indeed, for some theologians, the resurrection points back to and affirms the cross. The apostle Paul’s declaration that the Christian pronunciation is essentially “Christ crucified, a stumbling block to the Jews and foolishness to the Gentiles” (1 Cor 1:23) ontologically entrenches trauma, destabilization, and anxiety at the heart of kerygymatic [sic] proclamation. (p.273)

Sit with that last sentence a bit. Christianity is at its core or essence a faith wrapped up in trauma. Yes, there is an all-important resurrection, but a resurrection cannot happen without a traumatic story (false-blame, injustice, torture, abandonment, and death). If Christianity is ANYTHING, then it is a faith that takes seriously the impact of brokenness.

So then, Lau makes an important next point about what a Christian theology should provide:

Theology proffers a distinct vocabulary to talk about personal and interpersonal wounding and trauma; the Christian community approximates a traumatic community. (ibid)

Victims of trauma ought to find great comfort and help from Christian leaders and communities because they observe a community that really gets their experience, both by word and deed.

Are we that community?

Or, are we a bit more like Job’s friends? Consider Lau again,

 Job’s friends, in presenting all kinds of explanations for why Job suffered the tragedies he did, were attempting to obscure the trauma of the truth of evil in the world. Job’s disagreement–and God’s eventual vindication and endorsement of his views over against that of his friends–demonstrated resilience in the face of such tempting illusions of closure. Job refused to look away from the void in his pain. He refused to accept cheap solutions to the problem and “causes” of his suffering. (p. 274)

To become a safe community for victims of trauma, we must continue to highlight that God and trauma are put together (albeit willingly) for eternity in the abandonment and death of Jesus on the cross. In this God takes trauma (injustice, torture, and death) into his own being–no longer does it exist in creation.  Again in the words of Lau, we need a “theology of Holy Saturday” if we are going to show that “hope can be spoken of only within the context of injustice, negativity, and despair; the joy and the Lordship of Christ takes place in and through sickness, death, and sin.” (ibid)

“If God’s being cannot be comprehended without factoring in the suffering and death of Jesus Christ…” (p. 275) then consider this statement:

“If indeed God suffers in the cross of Jesus in reconciling the world to himself, then there must always be a cross in the experience of God as he deals with a world which exists over against him.” (quote of Paul Fiddes in Lau, p. 275)

God is defined by trauma. But he, unlike creation, is not weakened by this trauma. Rather, Lau encourages us to see that “the God self-revealed  and depicted in the Judeo-Christian tradition is a begin who, out of love for the created order, chose the trauma of death as a central facet of God’s self-definition.” (276) In an immeasurable act of love that had been present in God from eternity past, God chooses self-sacrifice to break the power of sin and death. And since this love is not temporal, then neither is God’s character ever without the knowledge and drive to reconcile a people to himself–even through trauma.

So what? What if we really understood God’s experience of trauma?

  1. The church would follow her head in the care of the most vulnerable even at the cost of her own comfort and safety. “A bruised reed he will not break, and a smoldering wick he will not snuff out, till he has brought justice through to victory.” (Matt 12:20, quote of Isaiah 42:3)
  2. The church would regularly make room for lament (individual and corporate) as acts of faithful worship. Like Thomas, we need to see the wounds that remain in the risen Christ.
  3. Hope would be illustrated in her ability to equally cry out about the “not yet” part of God’s present kingdom even while she looks for the “already” present redemption and healing. There is as much hope in Psalm 88 and Lamentation 3 as there is in Revelation 21.

 

§Lau, A. (2016). Saved by trauma: A psychoanalytical reading of the atonement. Dialog, 55, 273-281.

 

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Abusive Marriages: Restoring the voice of God to the Sufferer


In breakout format, Darby Strickland presented on this topic today at #CCEF16. She defined emotional abuse using the word oppression instead. She defined it as a pattern of coercive controlling and punishing behaviors whereby one spouse seeks to control and dominate the other. Oppressors enslave others, but tend to self-justify behaviors.  The oppressor tends to be entitled (people are there to please them; people should sacrifice for their well-being). They tend to dominate others and threaten as a means of control. Oppressors are willing to wound to keep control (which Darby reminds us is the opposite of how Jesus wields power–he was willing to be wounded for others). On the other hand, oppressors tend to be self-deceived, lack remorse and blameshift when accused.

Sometimes abuse is misunderstood as an anger problem. But the reality is that the root is self-worship and control. The only thing that matters are their words, their rules, their emotions, and their physical and sexual needs that must be obeyed. It is “enforced worship.”

Darby then explored emotional abuse in particular. Symptoms include a chronic pattern of rejecting, neglecting, degrading, terrorizing, isolating, exploiting, belittling, deceiving, blaming, ignoring, shaming, and threatening. She also talked about “gas lighting” which is the attempt to make someone think that something that did happen never happened. Within emotional abuse is also spiritual abuse. The use of Scripture, doctrinc, or position of leadership to abuse. It can be subtle but it lording power over others, demanding submission, and use Scripture to shame.

Darby pulls no punches when she describes behaviors by oppressive and abusive men (yes, women can do this as well, but this talk is focused on the experience of oppressed women). It is destructive to souls and does not reflect any part of Jesus Christ. She was equally clear on the destructive impact on victims. Eccl 4: the dead are happier than the oppressed.

What does God say about oppression?

  • Not your fault. Evil comes out of the heart of the one doing it: Mark 7. You might be a stressor by just being a person.
  • You do not deserve this. (Victims and leaders look for reasons, like Job’s friends). Heb 10:17. Your sins and lawless deeds I will not remember anymore. God is your rescuer, not your punisher
  • It is not a marriage problem. Luke 6:45 shows us that evil comes out of the evil person’s heart. It is not merely some interaction problem. Do not ask the oppressed to serve the oppressor more. It emboldens oppressors.
  • Oppression violates God’s design for marriage. It is not to be submitted to but rather brought into the light. He tells the head to reject control for self sacrifice.
  • God sees your suffering. Jesus sees and knows oppression too.
  • God cares about your safety. Do you think that God cares more about you keeping your vows than he does about your safety? 
  • God’s desire is to rescue you. I will rescue my flock and they show no longer be a prey (Ex 34:22)

Draw near to God through laments; he does not ask you to forget your suffering. Learning to lament is a process. It may not be “sanctified speech” when you first start to speak. That is okay, just begin to speak. Listen for the content, less focus on the tone. Then, you can ask God to help shape your expression. To counter the shaming words, remember who God says about you. “Remember who Jesus is because he is everything your oppressor isn’t.” He woos you, he does not demand subjection.

She closed with Proverbs 12:18: The words of the reckless pierce like swords. But the tongue of the wise brings healing.

_____

You might find it interesting that Darby chose to not take questions at the end. Her reason is that knowing that 25% of the christian world has experienced domestic abuse. Thus, she expected a number of victims in the room. She felt that taking questions might subject some, inadvertently, to further pain. (She was willing to take questions afterwards in private).

I very much appreciated her strong words to identify the pattern and indicate the primary concern for care for the victim. I know she has written and spoken on the topic of working with oppressors. This was not that talk.

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