Tag Archives: trauma

June 20, 2011 · 10:36 am

Must Read: Diane Langberg on “Trauma as a Mission Field”


My supervisor, mentor, and colleague, Dr. Diane Langberg has been telling us for some time that “trauma is the mission field of our time.” Recently, however, a few Christian NGO/Missions leaders have heard this line in one of her talks and have become electrified by it. I cited it last week in a board meeting at Biblical as I was trying to make the case that developing postgraduate trauma training at Biblical fits our mission: following Jesus into the world.

But, some of you have not heard her give one of these talks. For you, I point you to the World Reformed Fellowship website so you can read a report she made on June 5 regarding the problem of trauma and the opportunity of the church to have a hand in healing this man-made scourge. Below is an excerpt of that short report. Do go to the WRF link and read it in its entirety. The report is not long but it is powerful and includes a couple of specific comments from two leaders in Africa.

We are the church. That means we are the body of Jesus Christ and He is our Head. In the physical realm, a body that does not follow its head is a sick body. That is also true in the spiritual realm. We are His people and I believe with all my heart He has called us to go out of ourselves and follow Him into the suffering of this world bearing both His character and His Word. And we do go – we send missionaries and the Scriptures; we provide food, clean water, education and jobs for many. And we should. We have rarely, however, seen trauma as a place of service. If we think carefully about the extensive natural disasters in our time such as earthquakes, hurricanes and tsunamis and combine those victims with the many manmade disasters – the violent inner cities, wars, genocides, trafficking, rapes, and child abuse we would have a staggering number. I believe that if we would stop and look out on suffering humanity we would begin to realize that trauma is perhaps the greatest mission field of the 21st century.

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May 31, 2011 · 5:40 am

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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May 27, 2011 · 4:27 pm

Introduction to Healing Trauma course


Starting July1 I will be teaching an on-line course, Healing Trauma in International Settings. Here’s the introductory video for students to watch during week one that tells what I plan to have them do during the course. Don’t worry, most of the course ISN’T watching me talk. You can see the full syllabus here.

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April 13, 2011 · 8:24 pm

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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March 17, 2011 · 4:01 pm

Trauma the greatest mission field of this time?


Sometimes a line you say strikes a nerve. It happened this morning when Diane Langberg made a passing comment to attendees at the She’s My Sister impact summit. Diane was to make some introductory comments about the nature of trauma and the fact that God’s children, the body of Christ, “are to follow the head” into the problem of injustice. Following her I was to make some summary of the trauma healing advisory council’s work from the previous day.

To a room full of ministry leaders (from World Relief, IJM, Saddleback Church, American Bible Society and other international societies), Diane made this statement,

Trauma is the greatest mission field of this time.

Soon after a number of folks began running with this idea. Trauma, they could see, is an opportunity serve others and bring the Gospel to bear in word and deed. Trauma is everywhere. The need is overwhelming. The Gospel has something to say about the experience of suffering and what the Christian life offers to suffering people. One of the first ways people heal from traumatic events is when they are able to speak their experience; when they feel heard and cared for. They realize they matter.

Abolition of slavery was the great mission field of the 19th century. Trauma may be that field for this season.

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January 5, 2011 · 5:06 am

Additional information on the March 2011 sex trafficking and abuse conference at Biblical Seminary


I’ve mentioned the conference before here on this site. But here is additional information for those considering the conference in order to acquire either graduate academic or continuing education credit.

NOTE:

  • Conference dates: March 17-19
  • The conference is free for all attendees, only those who want CEs or grad credit will have to pay a fee
  • A PDF of the information below is available here: Please pass on to anyone who might be interested.

Continuing Education at Biblical Seminary

March 17-19, 2011

The Biblical Call: A Christian Response to Human Trafficking and Sexual Abuse[i]

Mental health professionals and clergy interested in attending this seminar may be able to acquire 10 contact hours of continuing education by attending this conference. Biblical Seminary is an accredited graduate institution and thus is qualified as a pre-approved provider of continuing education in the form of graduate coursework by Pennsylvania’s State Board of Social Workers, Marriage and Family Therapists, and Professional Counselors (§47-49.36) and Pennsylvania’s State Board Of Psychology (§41.59). (Attendees who wish to receive academic credit should follow directions in the footnote below.)

While Biblical Seminary provides verification of attendance and a transcript showing completion of the CE course, attendees are responsible to verify acceptance of these hours by their particular licensing boards prior to registering and paying for CEU credits.

The following information may be used to apply for approval to your licensing body.

Speakers:

Diane Langberg, PhD; Bethany Hoang, MDiv; Pearl Kim, JD; Robert Morrison, MBA; Philip G. Monroe, PsyD

Seminar Overview:

This conference continues the “Conversations on Christianity and Culture” series focusing on sexual violence and injustices in a variety of contexts: domestic and international settings and sexual abuse in Christian communities. Attendees will explore these issues from biblical, psychological, legal, and sociological perspectives. The conference will conclude with a focus on practical intervention and prevention strategies.

COST:

The conference is free for all attendees. Register here. Those who wish to receive CE credits will be charged $20.00 per CE unit (0-9 credits) or $180.00 for all 10 CE units. Attendees will be billed following the conference and certificate of attendance will be held until payment is received.

Educational Objectives:

  1. Become familiar with the psychological and sociological data regarding domestic and international trafficking phenomena and also sexual violence within Christian settings
  2. Describe common community and individual consequences resulting from these sexual traumas
  3. Consider biblical and theological factors relating to sexual violence
  4. Identify effective and practical interventions as well as preventative actions to treat and stop sexual slavery and sexual violence

Tentative Schedule:

Thursday, March 17

Speaker Title Time length
B. Hoang Biblical Call: Response to Violence (obj. 3) 1:15
D. Langberg Biblical Call: Global Violence against Women and Children (obj. 1-3) 1:15

Friday, March 18

Speaker Title Time length
B. Hoang International Human Trafficking (obj. 1) 1:15
D. Langberg Domestic Human Trafficking (obj. 1) 1:15
Breakout Sessions (choose two as each session is repeated; total length: 2:30)
B. Hoang Follow up from morning session (obj. 3) 1:15
D. Langberg Follow up from morning session (obj. 1-3) 1:15
P. Kim Spiritual Warfare and Criminal Prosecution (obj. 3) 1:15
R. Morrison Mobilizing all Christians in Effective Action Against Human Trafficking (obj. 4) 1:15

Saturday March 19

Speaker Title Time length
D. Langberg Sexual Abuse in Christian Organizations (obj. 1-4) 1:00
Panel (all speakers) Panel Discussion (obj. 1-4) 1:30

[i] This course is also available for one (1) academic credit. Credit students will be required to complete additional readings and coursework after the seminar. Those interested should view the course syllabus on our school’s website and complete a brief, online non-degree application. Cost for a one credit course is $447.

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November 19, 2010 · 6:46 pm

International Suffering and Trauma Treatment


Am working with a student on building a future course for students, licensed mental health providers, NGO workers to train them on the matters of trauma treatment in international settings with the course goal to take these trainees to a location where they train local trainers to use lay trauma healing measures.  I am imagining a course that is primarily on-line (using a course website, discussion board, webcasts, etc.) with some face-to-face time just prior to having the international experience. The course would enable licensed therapists to receive continuing education credits with the ultimate goal that those who complete this experience would be then prepared to replicate it in other parts of the world. Topics would include:

  1. Overview of trauma symptoms and the things that cause them (genocide, war, trafficking, domestic abuse, rape, natural disasters, etc.)
  2. Overview of local culture and customs re: health, strength, and medical intervention to ensure culture consistency and avoiding colonialistic approaches.
  3. Introduction to training lay trainers
  4. Secondary trauma and compassion fatigue issues

I have two reasons for a course like this: 1. trauma is everywhere, and 2. interventions need to be sustainable (not relying on western therapists to keep doing the direct service) and maintained by local individuals.

So, here’s my question: If you had an opportunity to shape a course like this, what would you want to see as part of the course? What would you want to avoid?

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May 20, 2010 · 5:39 am

Frontline on PTSD in soldiers


Caught a portion of the PBS Frontline show, The Wounded Platoon, documenting the extensive combat trauma in the 3rd Platoon, Charlie Company, 1st Battalion, 506th Infantry stationed in Fort Carson, CO. Click the above link to watch it on-line if you missed it.

It is heartbreaking and mind-boggling to consider that so many of these young men are now in jail or dead due to suicide. The PTSD is evident to all. The men admit to massive drug and alcohol addiction, trauma, domestic violence, etc. What is even more mind-boggling is the interviews with some of the platoon leaders–some of whom are quite matter of fact. Yes, they say, it is bad. But it is part of what we get. Too much demand for soldiers, too few to meet the demand. This equals spending longer rotations in theatre thus more PTSD.

They discuss the amount of psychiatric meds prescribed for these soldiers while in Iraq. While this means they are getting some treatment, others see this as merely allowing them to suffer more damage while still being able to fight the next day.

I’m thankful for my freedom in the US. But never forget the cost. And do remember that few of these men get any decent treatment once they return.

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April 22, 2010 · 5:23 pm

Staff Mtg on Prolonged Exposure treatment for PTSD


Had a fabulous staff meeting at our practice today given by fellow colleague, Marta MacDougall. Marta also works at the Philadelphia area VA. She presented an overview of Edna Foa’s Prolonged Exposure Therapy for PTSD. You can find the book here.

PE looks at trauma this way: PTSD is maintained by avoidance behaviors. One avoids memories, triggers, emotions, places of traumatic experiences. While avoidance works in the short-term, it exacerbates the symptoms over the long haul since they are not fully processed. In fact, the better able one can avoid these feelings, the more likely their PTSD will be worse later. Hence why you can have some very functional people become unable to function later in life. She used this illustration. For many Vietnam Vets, Vietnam is part of a book they keep trying not to read. They shove it away over and over but it has a habit of falling off the shelf and opening to the same page, even the same couple of very painful sentences. Thus, despite their attempt to avoid, the only thing they keep rereading is the same couple of sentences; thereby reinforcing and even rewriting the whole experience as if it were only those two sentences.

Thus, the goal is break the “phobic reaction” to painful thoughts and feelings. How? By two prongs: (a) imaginal exposure (memory encounters), and (b) in-vivo exposure to avoidant stuff in the present.

The therapy consists of 12-20 sessions (1.5 to 2 hours each). In the sessions, the person develops a current list of avoidance in their life  or other subtle safety behaviors. They begin to daily pick easy to hard avoidant tendencies to expose themself to in order to break the fear pattern. Now, these are things that aren’t actually dangerous. Second, in session 3 they begin to recount the most salient trauma from the point in the story where they were safe to unsafe to safe again. So, it could be a story of waking up to a rape, going out for a particular traumatic battle, etc.). This portion of the story may only take 5-10 minutes to recount. That same memory is recounted, in the first person with eyes shut, repeatedly for up to 45 minutes. During the exposure, the therapist asks for their subjective units of distress level (0-100) every five minutes. This exposure to the same memory is repeated in each session with time to talk about and process at the end. The levels of distress are tracked over time (both from imaginal and in-vivo exposure experiences. On top the therapy intervention, the in office imaginal exposure experience is recorded and the client is to listen daily to that recording.

Sound like torture to you? It does to me. Here’s the reaction rationale. The avoidance of memories and emotions tied to them is causes even greater distress. Thus, getting the client to face that distress and process the emotions as well as uncover subtle lies believed about self and other is only dealing with reality directly.

You can imagine that many refuse this kind of therapy. Those who do it…about 80% see a significant reduction in PTSD.

Not sure I’m going to begin doing this kind of therapy as I’m not set up for it being in the office only 1 day per week. However, I will pay more attention to the ways avoidance behaviors or safety seeking behaviors accentuates PTSD and will be more likely to give daily homework to address this problem.

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March 10, 2010 · 10:28 am

Here’s a cache of info on abuse trauma


If you are interested in reading some of the most recent research literature on complex trauma and treatment, take a look at the Trauma Center at JRI in Brookline, MA. Click their “publications” tab for a host of full-text articles on the topic. Bessel van der Kolk, MD is one of the foremost researchers exploring trauma’s impact on the brain.

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