Tag Archives: trauma

February 6, 2015 · 9:31 am

From Protest to Process: Law Enforcement, Race, Trauma, and the Church


In the wake of Ferguson, NYC and many other struggles regarding race and law enforcement, BTS is hosting a free seminar on February 23, 2015 at Temple University to hear community leaders, law enforcement, and mental health discuss some of the struggles and look for ways the church can be a healing force. The hidden matter of urban forms of trauma and impact on the conflict will be the highlight of the night.

Here’s why you should sign up now!

  1. It is Free!
  2. Great speakers: Former Commissioner of Philadelphia Police, Sylvester Johnson, Mike Majors, community leader, Rev. Desiree Guyton, LPC, Dr. Shannon Mason, and Dr. Dan Williams. There may be even more!
  3. Opportunity to ask questions
  4. Though free, space IS limited.

Sometimes we complain and feel the conversation isn’t going in the right direction to solve these complex problems.  I encourage you to be a part of the solution.

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January 30, 2015 · 4:05 pm

PTSD “A Disease of Time”


David Davies, part of the staff of “Fresh Air” on NPR, has conducted an 35 minute interview with David Morris, a journalist who was embedded in a unit in Iraq and who suffers from PTSD resulting from an explosion he survived. David has written a book, The Evil Hours: A Biography Of Post-Traumatic Stress Disorder. If you want to better understand the experience of PTSD and its impact on a person, you should listen to this show (or read the transcript). For therapists, Morris discusses his experiences with Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). He also describes the use of propranolol when repeating trauma stories.

Here’s a couple of my take-aways:

  • PTSD is a disease of time.

“…in some ways, PTSD is a disease of time. And a lot of people – PTSD is many things, but one of the things it is a failure to live fully in the present. And I think what happens a lot of times with traumatic – survivors of trauma is they have these compulsive returns to awful events, and they are unable to live in the now.”

  • The best treatment never removes all symptoms of PTSD

“The best we can do is work to contain the pain. Draw a line around it. Name it. Domesticate it, and try to transform what lays on the other side of that line into a kind of knowledge, a knowledge of the mechanics of loss that might be put to use for future generations.”

  • Honest reflections of the impact of PE and CPT (and why so many dropout from PE treatment)
  • Honest admission about the most common “treatment” of PTSD–alcohol (and evidence why so many end up abusing it!)
  • War traumatizes far too many but rape is 5x more traumatizing

[in discussing how helplessness/lack of control is a significant factor in the development of PTSD] “Yeah, the helplessness is one of the main predictors of who’s going to end up with PTSD and who doesn’t. And the idea that you have absolutely no control over your environment is very hard for people to deal with because, you know, you are basically completely helpless and unable to control your destiny and your survival….and that’s one thing I discovered in the book is I thought – you know, we sort of assume that PTSD is sort of the realm of soldiers and veterans, when in fact, the most common and most toxic form of trauma is rape.

…a soldier may have some control over his or her environment. They have a weapon with them; they can move; they can take cover. But oftentimes in the cases of rape, the victim is completely overwhelmed and trapped and cornered. And from the moment the attack begins, they are rendered almost completely helpless, which is interesting. And you see that in the diagnosable rates of who gets PTSD and who doesn’t. Rape survivors tend to have it almost 50 percent of the time, whereas your average war veteran – particularly for Iraq and Afghanistan veterans – the rate of PTSD diagnosis is more around 10 to 12 percent. So a rape victim – rape is, in a manner of speaking, five times more traumatic than combat.”

 

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January 21, 2015 · 3:35 pm

Knowledge vs. information: When trauma stories change you


Last night in our Advanced Global Trauma Recovery Institute (GTRI) course web conference, we were discussing the weight of listening to trauma stories. This conversation spawned from our delving rather deeply into the systemic torture, trauma, and loss of identity occurring in post-WWII eastern Europe (specifically in Romania). We considered the question

What should we do when we are overwhelmed with the weight of trauma stories around the world? Especially, what are we to do when we can do little to nothing about the new stories we hear every day? How do we respond to temptations to despair?

Knowing or just information?

During the web conference, Diane Langberg pointed out the common phenomenon that sometimes we hear of atrocities but do not really know about them. We hear information on the news about various tragedies (e.g., ISIS, Boko Haram, shootings, suicides, etc.) and sometimes fail to process it. One of our students reminded us of a bit of dialogue in Hotel Rwanda between the hotel manager and an American journalist,

Paul Rusesabagina: I am glad that you have shot this footage and that the world will see it. It is the only way we have a chance that people might intervene.

Jack: Yeah and if no one intervenes, is it still a good thing to show?

Paul Rusesabagina: How can they not intervene when they witness such atrocities?

Jack: I think if people see this footage they’ll say, “oh my God that’s horrible,” and then go on eating their dinners.

Not far from the truth, right? However, when someone takes the time to really listen to trauma stories, something changes in that person; they are no longer able to go about their life as the did in the past. When we choose to sit with stories of pain, we gain knowledge that changes our view of the world. For example, when we take new individuals to Rwanda, we often hear, “I remember hearing about the genocide….but I didn’t know. I knew but I didn’t know what I know now.” The same thing happens when individuals are willing to learn about racism, domestic violence, gender based sexual violence and the like.

When you see something in detail, you can’t unsee it. You will be changed.

I know…now what?

Once you know, really know, the depth of suffering of a community, you are changed. That knowing often creates deep pain, especially when we can do nearly nothing about it. So, now what? What can we do? Here are a few things that may be overlooked as insignificant

  1. Listen. Wait, didn’t we already do that? What good is hearing more about the story if I can’t do anything about it? No, listening is part of the solution. Individuals and communities who are enabled to tell their trauma story benefit from repeated truth-telling. They benefit from “being seen and heard.” It matters that those from outside cared enough to come and hear of the pain. Do not underestimate how such listening may empower a trauma survivor to move towards healing.
  2. Lament. Laments are conversations with God about the brokenness before you. Whether done in private or in public, these laments help us to communicate to God what we find intolerable, to ask God to do what is impossible, and to look closely for his response. Laments hand the problem back to God. “Do something Lord!” Laments also tell victims that their pain is real and not merely an emotional weakness on their part.
  3. Look for seeds of healing. If you are hearing a story of tragedy, then you are also hearing a story of survival. While being careful not to dismiss losses and pain, we can also point out signs of life, of resistance, of resilience. These seeds do not deny the damage being experienced. Jeremiah’s plaintive sigh, “Yet this I call to mind and therefore have hope: because of the Lord’s great love we are not consumed…” does not undo his previous tears, “I remember my affliction and my wandering, the bitterness and the gall. I well remember them, and my soul is downcast within me.”
  4. Do one thing. If you are in direct contact with the person who is suffering, you can check in with them, find out what would be helpful. If you are not in direct contact, then do any number of “one things.” You can pray daily. Ask not only for restoration and justice but also for God to direct your response. You can tell one person about what you have learned. You can look for ways to identify how the seeds of the same tragedy might be in your own environment and not just “over there.” You can give an alternative points of view when you hear someone speaking naively about the situation. Start a conversation with friends.
  5. Remember. Look to find God’s view of the situation. How does He feel about injustice, whether minute forms in us or the massive ones we see on television? What reason might God have for waiting to bring all things under his control?

 

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January 14, 2015 · 2:33 pm

Turn the other cheek? Does this apply to abuse victims?


The Christian Scriptures teach followers of Jesus to forgive as we are forgiven, to love our enemies, and to turn the other cheek rather than seek revenge when mistreated. Does this mean that victims of domestic violence and abuse need to, sometimes quite literally, take it on the chin without seeking protection or justice?

There are a good many resources out there right now that help teach Christians how we should respond to domestic violence and abuse. If you want some in depth argumentation why victims do NOT need to just take it, you can consider my top 3

  • Leslie Vernick (website and books)
  • No Place for Abuse (Book, and when you follow the link, notice the many suggested books on the same topic; books by Brancroft, Roberts, Crippen, and more!)
  • G.R.A.C.E (website with information about the moral requirement to report child abuse)

Rather than repeat the good advice in these resources–biblical foundations for protecting victims and calling out offenders–I want to point you to an older resource given to me in the past week. Older resource as in from 1840! Henry Burton, in chapter 22 (“The Ethics of the Gospel”) of his Expositor’s Bible: The Gospel of St. Luke discusses the application of Luke 6:27f to those inside the community of Christ as well as to “enemies.”

First he reminds readers to love enemies,

We must bear them neither hatred nor resentment; we must guard our hearts sacredly from all malevolent, vindictive feelings. We must not be our own avenger, taking vengeance upon our adversaries, as we let loose the barking Cerberus to track and run them down. All such feelings are contrary to the Law of Love, and so are contraband, entirely foreign to the heart that calls itself Christian. (p. 344-5)

I suppose his words capture most Christian teaching on what it means to love our enemies and to use the Golden Rule as our measure for how we respond. And yet, listen to his very next sentence:

But with all this we are not to meet all sorts of injuries and wrongs without protest or resistance. (p. 345)

Did you catch his point between the double negatives? We MAY and OUGHT to meet all injuries with resistance and protest. Burton goes on to answer why we should resist wrongs done to ourselves and to those around us,

We cannot condone a wrong without being accomplices in the wrong. (ibid)

There you have it. Complicity with evil, especially evil within the community of Jesus, is tantamount to approval and support of that evil act. Thus, telling a victim of abuse to “turn the other cheek” is essentially the same as abusing the victim yourself.

Burton extends his argument in the following way,

To defend our property and life is just as much our duty as it was the wisdom and the duty of those to whom Jesus spoke to offer an uncomplaining cheek to the Gentile [outsider] smiter. Not to do this is to encourage crime, and to put a premium upon evil. Nor is it inconsistent with a true love to seek to punish, by lawful means, the wrong-doer. Justice here is the highest type of mercy, and pains and penalties have a remedial virtue, taming the passions which had grown too wild, or straightening the conscience that had become warped. (ibid)

He completes his thoughts on this by reminding the reader that none of this justice seeking activity (to the point of excommunication if necessary) negates forgiving when the offender repents. We still love, we still forgive, we still treat others by the Golden Rule. But we do not avoid justice and protection seeking behavior, both for the sake of the one being harmed and for the one doing the harm. Both need rescue. The means of rescue differ for sure and may not be viewed as rescue when it comes in the form of sanctions and restrictions. But to look away from abuse and cover it up with “turn the other cheek” does not do right by the true meaning of love.

 

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January 12, 2015 · 5:59 am

Why are Some Trauma Victims More Vulnerable to Re-Victimization


For those who have not suffered a chronic trauma reaction it can sometimes be hard to understand how a victimized person gets situations where re-victimization can happen. Wouldn’t one trauma at the hands of another cause you to be vigilant against any subsequent danger?

You might think so, but here’s how it happens in simplistic terms:

  1. Interpersonal Trauma leads to confusion, self-doubt (and hatred), loss of voice.
  2. Vigilance against one kind of victimization leads to making decisions to give up other values/interests to avoid the trauma
  3. That decision (or impulse) leads to opportunity for exploitation

Still doesn’t make sense? Consider how a societal trauma preps a community or country for re-victimization. Dave Zirin writes about the use of “Shock Doctrine” in his 2014 book, Brazil’s Dance with the Devil: The World Cup, the Olympics, and the Fight for Democracy. Shock doctrine is opportunist moves by governments interested in taking advantage of a traumatized population

Left to their own devices, people tend to vote for things that make their lives better, like sharing wealth and resources and ensuring quality health care and education for all. Nobody wins elections by promising to turn the country into a sweatshop zone. So in order to put neoliberal policies in place, the world’s elite need a strategy—some clever sleight of hand to get what they want before anyone can object. Enter the shock doctrine

The idea is simple: people who are traumatized are more likely to agree to authoritarian measures, to suspending democracy, to doing whatever it takes. The trauma can be unexpected, like a natural disaster or a terrorist attack, or planned, like a massive budget cuts or a military coup—anything that

‘puts the entire population into a state of collective shock. The falling bombs, the bursts of terror, the pounding winds serve to soften up whole societies much as the blaring music and blows in the torture cells soften up prisoners. Like the terrorized prisoner who gives up the names of comrades and renounces his faith, shocked societies often give up the things they would otherwise fiercely protect…’

While people are reeling, trying to figure out how to survive, corporations and the corporationist state walk through the open door and take what they please.” (p 73-4)

Zirin illustrates this by pointing to countries who take privacy rights or freedom of speech from citizens in the name of protecting the people (state) from outside attack. Or corporations who find ways to take land from poor citizens after a natural disaster—to use for their own benefit.

My point is not to attack political ideologies, corporations, or governments. Rather it is to show that trauma sets us up to give up rights and boundaries more easily in order to avoid a terror. That same willingness is more easily exploited by one who sees the vulnerability. The authority will protect us we think. But if the authority is only interested in its own protection, the victim is prone to re-victimization.

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November 5, 2014 · 5:58 pm

Overspiritualizing invisible wounds?


When someone suffers an obvious injury to a leg it is clear to us that this injury limits prior capacities for walking, running, standing, and other things we do with our legs. If the injury is slow to heal, would we be likely to tell them to act as if the injury never happened? No. We can see the injury, its effects, and we recognize that recovery may be limited. We would be unlikely to judge the person for failing to run like they had prior to the accident. Of course, physical wounds will prompt spiritual concerns, from “where was God…?” to trusting God for the future even while continuing to experience pain symptoms and the inability to complete tasks that used to be easy.

But what about the wounds we can’t so easily see?

Sadly, I think we spiritualize them and do judge others for having them. Take for example a victim of abuse or trauma that results in a diagnosis of Posttraumatic Stress Disorder. We see no obvious wound. The body looks sound and fit. So, the anxiety we see, the hesitancy to trust others, the mental confusion, the inability to sleep well…these symptoms must be primarily evidence of a spiritual problem, right?

Wrong, at least in part. While we rarely see the damage done to victims of trauma, changes to the brain are nonetheless present. Here’s a couple of things we think we know about trauma and the brain:

  • The brain is an adaptable organ and use-dependent. Activity along neural pathways can become more efficient with practice (i.e., the more something happens, the easier it is for the brain to respond). So, certain pathways and structures in the brain become more easily activated
  • Observing activity brain scans in those who suffered severe traumas such as child abuse, we see evidence that the part of the brain that processes emotion seems to be routinely overactive. Likewise, the part of the brain that provides conscious analysis of where we are in time and space, seems underactive when emotional processing increases. This activity problem (too much in some areas, too little in others) appears to cause individuals to relive/re-experience trauma and have less capacity (in the moment of reliving) to talk back to their feelings (analyze what is happening) or explain it to others
  • Along with these structures, hormone feedback systems appear to produce fight/flight hormones in the presence of triggers

Simplistic as my points above are, I hope you can see that a person has little conscious control over these reactions in any given moment. Now, there are things that can be done to help the brain adapt and respond better, but the fact of being triggered is not the result of not trusting God.

So, consider the multiply-traumatized man in your church who reacts negatively to well-intentioned requests to join a small group or to be prayed over with the laying on of hands. Is this because they do not trust God, are sinfully fearful, or evidence of invisible wounds of PTSD? I suspect some would be inclined to assume this man had a spiritual problem. In fact he may, but the reaction he is having is most likely not that problem.

A Better Question

Recently I asked my students to consider this question: What does faithfulness look like for the Christian who is suffering pervasive panic? Does it mean an absence of fear? Forcing themselves into situations that will flood them with panic? How would you answer this question? Are the evidences of fear in your life a sign you do not trust God? Can you acknowledge fear and still trust God? What does that look like for you?

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October 31, 2014 · 6:00 am

Making the Church a Safe Place for Victims of Trauma


This afternoon I will be speaking at Chelten Church on the topic of “Making the Church A Safe Place for Victims of Trauma.” This 3 hour continuing education seminar (co-sponsored by Biblical Seminary who provides the NBCC approved CEs) will focus primarily on trauma resulting from child sexual abuse. However, other forms of sexual violence and traumas (domestic violence, military trauma) will get a bit of attention as well. If you can’t make it or wish to see what I am talking about, you can download and see the slides: Making the Church A Safe Place For Victims.

Tomorrow, Mary DeMuth will speak on a topic similar to her book. Her talk is entitled, “Unmarked Marriage.”  I suspect the conference organizers will take walk-ins!

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October 30, 2014 · 9:03 am

Cameo in “Hope Rising” on ABC on November 30


Hope Rising, a documentary about The American Bible Society’s efforts to bring trauma healing to the Congo is going to be played on some local ABC stations beginning November 16. However, it airs here in Philadelphia on November 30 in the wee hours of the morning. I make a brief cameo in the documentary. Plus many of my friends doing the work are featured quite a bit. It will be aired on another local ABC affiliate channel, #246, the Live Well Network (LWN) on December 3. But, as they say, check your local listings or follow the instructions on this page to ask your local affiliate to air the program. In the meantime, check out this trailer,

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August 15, 2014 · 8:00 am

GTRI 2014: Day 12 Kigeme Refugee Camp


July 12, 2014. Kigeme Refugee Camp to Kigali

For all who travelled with us, our visit to the refugee camp was moving in many ways. We saw deep poverty and yet deep resilien

Heather with her new friends

Heather with her new friends

ce. The following observations are from Heather Drew, a counselor and one of my GTRI students and who begins her tenure as Fieldwork Coordinator in my seminary department today! Please welcome Heather and check out her blog as she is a gifted communicator in her own right.

—

Today was our last full day in Rwanda. We woke up in Butare, got one last cup of the best coffee I’ve ever tasted at a lovely coffee shop called Cafe Connexions, then rode our bus to a UN refugee camp in Kigeme. Around 20,000 Kinyarwandan speaking Congolese

Kigeme camp children

Kigeme camp children

refugees live in this camp, 12,000 of which are children, we were told. The abundance of children was immediately apparent to us as we were greeted by dozens of sweet smiles peering into our bus, waiting for us to climb out. Some of us took photos of/with the children and showed them the photo (they love that). Stan The children followed us around like we were pied pipers. The parents followed us with their eyes, and greeted us kindly. The camp was made up of rows upon rows of small mud houses with metal roofs – living spaces the size of a small American living room – containing 6-8 (or more) family members each. Our group wove through the narrow, red-dusty walkways between houses, climbing up slippery hills with the help of our small chaperones. They taught us some additional phrases in Kinyarwandan, showed us their beautifully-made and efficient water collection/filtration system, and held our hands. The EUG_7154children who could speak a few words in English were eager to do so. The ones who knew no English spoke to us without any words, showing us their homemade toys constructed with old bottles and broken pieces of things. It made me realize that the less a person has, the more resourceful and creative they become. This is a very prevalent characteristic throughout Rwanda.

At the base of the hill on which the camp sits is a meeting space where our team met with several leaders within the camp who lead trauma healing groups with fellow refugees. We were traveling with our friend Harriet Hill, one of the writers/developers of the Healing Wounds of Trauma material put out by American Bible Society, which this group has found so useful. (This book has been translated into several languages and is effectively used to facilitate around the world.) I had greatly anticipated this day, and in the moment the depth of it was not lost on me at all; here we were sitting in a room with about 50 Congolese refugees who use this book to lead healing groups in one of the most trauma-impacted areas of the world with Harriet Hill, the woman who had a dream over a decade ago to develop the material. It was extremely moving.

Leaders/facilitators gave testimonies about the groups and about personal healing, and presented questions they had. One person shared, “We are all traumatized…This material heals us and then we can help others heal.” Another shared, “During the genocide, so many of us – on both sides of the conflict – had hearts like animals. The Bible takes away our animal hearts.” Not all of these testimonies were ones of “arrival,” however. A few shared how they are still in the midst of the long healing process. The truthfulness of this impacted and inspired us.

After their testimony time Phil, Diane, Harriet, and their two leaders were invited to speak. Remarks were encouraging and thankful. Harriet Hill shared how much it meant to her that they have such bravery to share the comfort they themselves have received from Christ. She also shared Psalm 126, words that resonate with their stories. Finally, at the end of the meeting, we shared Fanta and

Zenko with Marianne Millen

Zenko with Marianne Millen

snacks together (a tradition of hospitality in Rwanda), then we said our goodbyes – even to Zenko, our dear new friend, which we were very sad about! – and boarded our bus for a 2 hour ride back to Kigali. I tried to focus on taking in the breathtaking beauty of the country as we made our last drive, because no photo can capture it.

Our final night was spent at East African Villas in Kigali. This was a hotel in Rwanda managed by a lovely Christian man called Ezekiel who was wearing a Georgia Bulldogs shirt when we arrived, which we enjoyed. We rested and enjoyed hot showers (a luxury I will no longer take for granted) during the few hours before dinner. Then we settled together in the dining room, ate our final Rwandan dinner feast, then Phil initiated our final team debriefing & sharing time.

We all shared 3 words that we each felt best expressed what we had learned in Rwanda. Among the things shared: new meaning of “celebrating the recovery of life” and also of “groans that words cannot express,” what it means to embrace Jesus’s invitation to “watch with Him,” the privilege of carrying people’s stories with them, how impactful people’s eyes and testimonies were, how much courage we saw, how much desperation we saw and how that was pointed at God in many cases. It was a much-needed time of sharing. To my knowledge, there wasn’t a dry eye among us.

We ended our night by taking a few group photos on the balcony.

GTRI 2014 Team

GTRI 2014 Team

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August 13, 2014 · 9:47 am

GTRI 2014: Day 10, Muhanga


July 10, 2014. Centre St. Andre

Thursday, Day 2 of the Community of Practice with the Bible Society of Rwanda. Already we are seeing deepening relationships. Last night many Americans and Rwandans sat together in the dining area talking and getting to know each other and revealing deep stories, stories of courage, pain, and hope. Precious times.

On day two of the Community of Practice we began with a short devotional considering Jeremiah’s lament. Barbara Shaffer and Carol King led a training and discussion of the problem of domestic violence. This is a new chapter in the Healing Wounds of Trauma materials. We discussed how much of a problem it is in Rwanda, why women stay, and how we can help both victim and abuser.

DSC_0307In the afternoon, we did another teaching (Carol and myself) regarding the problem of suicide. It appears that most Rwandans believe that one who commits suicide is automatically going to hell. In addition, the family is often shunned. This seemed a very entrenched belief and so my raising doubts and questions resulted in very spirited debate. While we also discussed how to help the suicidal person and how to help the family members, I left them with the encouragement not to speak for God and since no verses speak to the future of suicide persons, they ought to be careful to put words into God’s mouth.

We ended this conference day by giving the Rwandans an opportunity to have a session for their own care. We can see the weariness on their faces. Baraka led a care for the caregiver session while the GTRI team met to process what we were hearing and seeing–the heartache and the resiliency.

Monique (R) with Souvenir

Monique (R) with Souvenir

We had the privilege of listening to Monique’s story of surviving the genocide as a teenager and God’s subsequent call on her life. The story is too precious and hard to share here beyond a few words. She survived when family members around her were executed (shot) and fell on top of her. The killers left the pile of bodies, not knowing that she was not killed. Just prior to this event, she had read Psalm 91 and heard God speaking to her about her own future when she read verse 7,

“A thousand may fall at your side, ten thousand at your right hand, but it will not come near you.” 

She has gone one to become an evangelist for Christ and a helper of the hurting. I can attest that she has a gift that few have. And I will never read that verse again in the same way

As the previous night, many of us stayed up quite late deepening relationships with new and old Rwandan friends. Looking over the dinner area, I saw heads bowed in prayer, attempts to speak in French, cackling laughter, and the sharing of food and drink. Such a beautiful sight.

Tomorrow will end our COP and we will move on south to Butare.

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