Biblical’s Global Trauma Recovery Institute is sponsoring the American Bible Society’s Trauma Healing Equipping seminar set for the Philadelphia area late February 2014. This is a week-long seminar that gives participants hands-on experience with the Healing Wounds of Trauma material. If you are local and would like to have experience with this Scripture engagement material (excellent for use in churches or lay counseling contexts) that explores both content and means to teach others, I highly recommend you check out this 2014-02 Equip PA Flier.
Tag Archives: trauma
Want to be a Global Trauma Recovery facilitator?
Our Global Trauma Recovery Institute is gearing up to start our 2nd continuing education cohort in November for those who want training to become culturally savvy trauma recovery specialists. If you have been wanting to understand and address the issues of trauma that exist here and around the world, have graduate education in a counseling related field (or are involved in similar kind of work) and are able to complete both online and on campus training, then please check out our other site: www.globaltraumarecovery.org. This flyer will give you the nuts and bolts of our 3 course series (times, locations, and costs). This link will bring you to the course abstract downloads so you can see what you will be learning.
The first course begins November 9 and is fully on-line. We are NBCC approved provider of continuing education in mental health and counseling.
Who are the teachers? Diane Langberg, PhD and myself.
Check us out!
Cohort One
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Filed under Biblical Seminary, Diane Langberg
When trauma isn’t “post”?
Over the last year or so I have been doing some thinking about those experiencing ongoing trauma. We talk of PTSD, Post-traumatic Stress Disorder, as a set of symptoms experienced after a traumatic event or time. But some people continue to live in ongoing trauma. I’m reading James Fergusson’s The World’s Most Dangerous Place: Inside the Outlaw State of Somalia. Early in the book, he talks of seeing “Sister Mary, a warm-hearted big-bosomed Ugandan in combat fatigues, dispensing medicines from a table in the ruins of the villa’s kitchen.” (p. 45). Sister Mary explains that there are two medical problems she sees. The one she treats most often is diarrhea. But, she says, the other problem she could not treat,
The people here are stressed, she explained. They are traumatized. They do not know where to turn.
You talk a lot in the West about PTSD-Post-Traumatic Stress Disorder…but for these people there is no “post”. The trauma never ends.
What can people do when trauma isn’t post? Do they have to wait until the traumatic experience is in the past in order to deal with it? What can we do for others who remain in precarious and life-threatening situations? A friend raised this question when working with a group of refugees in a UN temporary camp. Some of the suggestions that were given this friend
1. Helping refugees find some way to hang on to small measures of empowerment: set up classes for children, build huts for those who are just arriving, develop “positions” for adults to fill so the camp runs smoothly and has a modicum of safety.
2. Reinstate religious and cultural traditions where possible
3. Practice corporate lament along with other worship activities
4. Allow people to tell as much story as they wish, whether by voice or artistic rendering
Notice that these are finding ways to cope by (a) making the moment better and (b) bearing witness, even if they can do nothing about the crisis. When a person feels some level of ability to respond to a difficult situation, that person often experiences less trauma than those who are unable to express any agency. Further, when they feel that they matter to others (someone listened to whatever they had to say), they tend to have less long-lasting PTSD symptoms.
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Filed under Abuse, Psychology, Uncategorized
Telling Painful Memories: Recommendations for Counselors
[What is below was shared with Rwandan caregivers and counselors. It is written in simpler English and has no footnotes. Academically oriented readers will recognize the interventions come from narrative exposure therapy models for children].
Counselors invite others to tell their stories of pain, heartache, fears, and traumas so that they can find relief from their troubles. However, not every way of talking about past problems is helpful and some ways of talking can actually harm the person. So, it is important that all caregivers and counselors understand how to help others tell their difficult stories in ways that invite recovery and do not harm.
Good Storytelling Practices
Counselors who do the following can encourage healthy and safe storytelling of difficult events:
- Allow the client to tell their story at their own pace without pressure
- Allow the client not to tell a part of their story
- Use silence and body language to show interest
- Encourages the use of storytelling without words (art, dance, etc.) or with symbols
- Ensures the difficult stories start and end at safe points
- Encourages good coping skills before story telling
- Points out resiliency and strength in the midst of trauma
- Encourages the story to be told from the present rather than reliving the story
Unhelpful Practices
Here are some things that we should avoid doing when helping another tell a difficult story
- Frequent interruptions
- Forcing the person to tell their story
- Asking the person to relive the story
- Avoiding painful emotions
- Exhorting the person to get over the feelings; telling them how to feel
- Only talking about the trauma, ignoring strengths and other history
- Ending a session without talking about the present or a safe place
**Trigger Warning: rape, threatened violence
A Case Study With 2 Storytelling Interventions
Patience, a 13 year old girl, suffered a rape on her way to school last month. The rapist’s family paid a visit to the girl’s family and offered money as a token of penance. The girl’s father accepted the money because, “nothing can make the rape go away so we will take the money for now.” Patience was told by some family members to not tell anyone about the rape and to just act as if it never happened. However, Patience is suffering from nightmares, refuses to go to school, and sometimes falls down when she catches a glimpse of the rapist in town. Her father has threatened to beat her if she doesn’t return to school or help out with the chores at home. Her favorite aunt, a counselor/caregiver, learns about the rape and asks her to come for a visit in a nearby city.
[Warning: these two interventions are not designed to rid a person immediately of all trauma symptoms. In addition, these interventions must be used only after a counselor has formed a trusting relationship with the client.]
- Symbolic story telling. The aunt tells Patience that keeping a story bottled up inside can cause problems, like shaking a bottle of soda until it bursts out. Using a long piece of rope (representing her entire life) and flowers (representing positive experiences) and rocks (representing difficult experiences), the aunt directs Patience to tell her life story. They start with her first memories of her mother, father and two brothers. She tells of her going to school, the time when her mother got really sick but then got better again, the time when her cousins moved away, and the time when a boy told her he liked her. Patience noticed how she had many flowers along the rope and only a few rocks. Then, they put a large stone down on the rope representing the rape. Patience had difficulty saying much at all. She remembered being afraid, the weight of the man, the pain, and worry that her family would reject her. She remembered getting up and going to school and acting as if nothing happened. Her aunt noted that Patience was a strong girl—she had gone to school for a week before telling her mother. So, Patience placed a tiny flower next to the rock to represent that strength. After stopping for a cup of tea and some bread, the aunt asked Patience to notice how much more rope was left. This represented her future. Patience was surprised to see the rope and said that she didn’t think she would have a future now that she was spoiled. Her aunt encourages her to consider what she would like to be in her future. They continued to discuss this over the next day. By the time Patience returned home, she was able to see that she still had a future. Seeing the rapist still bothered her. However, she was able to go to school with two friends along a new path so that she would feel safe. Patience kept a drawing of the rope with the flowers and rocks and extra rope to remind her that she had a good future.
- Accelerated Storytelling. About six months later, Patience visited her aunt again. She was still going to school and able to do more chores (getting firewood and buying food in the market). However, she still suffered from nightmares and sometimes fell down when she heard footsteps behind her. This time, her aunt asked her to help create a “movie” of event. Before Patience was to narrate the rape, they first recounted the safety she felt at home before the rape and the safety she felt when she told her mother about the rape and was comforted. Next, her aunt asked her to identify all of the “actors” in the play: her mother, father, herself, brothers who went to school without her, classmates, teacher, and rapist. Patience then made a figurine out of paper for each actor and drew a small map of her village including the path from home to school. Then, the aunt asked her to tell her story as fast as she could from safe place to safe place and to only look at the figurines (and to move them along the map). Her aunt noted those places where Patience slowed down in the story. When she paused, the aunt asked her to try to keep moving. Once the story was complete (when she told her mother about the rape), she asked Patience to tell the story backwards as quickly as possible. Then, she instructed Patience to tell the story forwards again twice as fast. However, this time, Patience stopped part way through the story. She added one detail she had not disclosed before. She recalled that a young boy of about 5 was peering at them from behind some bushes. Her aunt encouraged her to finish the story and thanked her for her courage. Patience indicated that she was so ashamed of being seen in such a position. Again, her aunt thanked her for working so hard but asked her to tell her story forwards and backwards one more time. Patience noticed that she was less upset by the presence of the 5 year old than she had been the first time through the story.
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Filed under Abuse, counseling, counseling science, counseling skills
Tuza 2.0: Day Five
[June 27, 2013]. Day two of our three day conference. Today Dr. Barbara Shaffer talked about the problem of marital rape and reviewed 6 common characteristics of some abusive spouses. The participants were very involved in this presentation and the discussion about sex in marriage provoked some interesting debates among the group. The large group discussed the matter of dowry. In Rwanda, a husband’s family agrees to pay an amount to his bride’s family. The price is in terms of a number of cows. A friend told me that nowadays, “cows are kept in the bank.” This tradition gives many men the belief that they have purchased their wife. Now the wife is his (cherished) property. As such, he has rights to her body. Based on the conversation, I would argue that the concept of marital rape might indeed be foreign. One participant asked how 1 Corinthians 7 fit into this discussion. We were able to examine that this passage offers women the right to control their husband’s bodies just as much as he gets to have a say about her body. Not being sure where everyone stood in the debate, I concluded with a reminder that Philippians 2 requires that we emulate Christ in not demanding what we are due but giving it up so as to shine like stars.
After lunch Dr. Langberg presented on dissociation and a group of Rwandan counselors illustrated a counseling scene of dissociation and a counselor’s techniques in calming and grounding. Very well done! Just before the end of this day’s training, Rowan Moore gave a talk about child abuse. 
Before dinner, we hired a local young man to take us out onto Lake Kivu in his boat. Ten of us motored out toward Peace Island. We didn’t have enough time to go all the way to Napoleon Island but we rounded several small islands and enjoyed the setting sun. We passed several fishing boats netting the tiny fish that are in the lake. We could feel the stress of the day fade with the lap of the waves. [photo courtesy Laura Captari]
After dinner, we had an evening of celebration. We identified our Barnabas’ (each person secretly wrote notes of encouragement and prayer to another). And of course, there was dancing and laughter. I have come to love the fluid hand motions during dancing and the energetic movements of men and women. Sadly, I cannot dance to save my life. I have not rhythm. Of course, there was a dance where I had to be front and center. I tried hiding behind a camera but even that did not save me. Still, it was sweet medicine after 2 days of talking trauma, abuse, and violence.
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Filed under AACC, Abuse, counseling, counseling skills, Rape, Rwanda, Uncategorized
Tuza 2.0: Day Three
[June 25, 2013: Kigali to Kibuye]
Our day started with devotions with IJM staff at their office in Kigali. After devotions we met with the social work staff on a beautiful balcony overlooking the city to hear about their work with victims, the process of getting information to determine 
if they could take the legal case and the counseling they could offer. IJM offers TF-CBT informed therapy for parents and child victims. You could hear the heartache as the counselors can only offer counseling to those whose cases IJM agrees to investigate and work for prosecution. They do what they can in those cases where abuse has happened but lack necessary evidence for courts. Unfortunately, there are few options for referral.
After IJM we proceeded to go to Ndera Psychiatric Hospital. As the ONLY psychiatric inpatient facility in the country of 11 million people, they about 350 beds. Do the math! About half of their patients are those with serious seizure disorders. Those in the crisis units have severe psychotic and disruptive behaviors. We saw one man who was stark naked. When asked about census, we discovered that while they have 60 or so beds for men in crisis, their current census is 78. Meaning, men share cots for sleeping!
We visited the stabilization units for men and women, the pharmacy, and kids ward [Picture below is of the daily schedule for kids in picture form]. It seemed that the hospital has a few
more medications available to use since our last visit in 2009. Then, they only had access to Haldol. Now, they have some atypicals like Risperadone. Most stay at the hospital for about 3 weeks, though we were told that someone was in the crisis unit since 2001!
After the hospital, we intended to take a trip to one of the church memorials in Nyamata. However, we were running late so we returned to Solace for lunch and discussions with Bishop Alexis, an Anglican Bishop. Bishop has been engaging with us since 2009 for counseling help. He suggested that we come next time with a plan to engage key principles for a country-wide response so that we avoid overlap.
By 3pm, we were on our way to Centre Bethanie on Lake Kivu in Kibuye. Our bus was packed with people and luggage. The road from Kigali to Kibuye has more twists, turns and vistas than you can possibly imagine. Lovely drive, though long. Finally, we arrived 3 hours later (after dark) to the conference center. Dinner was served in the restaurant (open sides to the lake!).
Today was a full day in many ways. One fun item: I received an African shirt from other team members. Wore it with pride today. One serious item: on our trip to Kibuye, I sat next to a man who told me his genocide story. Lost wife and 2 children. Survived hiding in the reeds for over a month. He told me how the Lord spoke to him about forgiving his family’s killers and how now he is doing reconciliation work with victims and perpetrators. I am amazed at his strength and struggles.
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Filed under Africa, counseling, Rwanda, trauma
Tuza 2.0: Day Two
[June 24, 2103]: Kigali to Butare to Kigali
Day starts with a breakfast of croissant, hardboiled egg, dragon fruit, and coffee. Our team left Solace Ministries this morning to have devotions with World Vision Rwanda staff. Met with senior staff and Director George Gitau. He gave a history of WV in Rwanda since 1994. They work in 15 of the 30 sectors in the country. They are working to stop most handouts (e.g., school fees programs) and wean off dependency of international donor dollars as much as possible…and replace with economic development plans. They are helping Rwandans form saving and lending formations. Seemed to be saying that focus on genocide and trauma was passing to work on peace building and prevention curriculum with younger children. Using Christian musicians to bridge the cultural divide in the country. While prevention strategies are a great move, just because 19 years have passed doesn’t mean the trauma of the genocide and aftermath are finished. Transformation of traumatized populations are still needed.
From World Vision we left to visit the One Stop Center, a government institution for women experiencing domestic violence, a place to get medical help and seek justice. We were not allowed in for some reason. At this point, our teams split up. The larger group visited the genocide memorial, had lunch and did a bit of shopping. My group, Diane Langberg, Laura Captari (AACC) and Marianne Millen (student from Biblical) took a 2 hour trip to Butare (AKA Huye) to visit with Bishop Nathan Gasatura of the Anglican church. As board member of the Prostestant Institute of Arts and Social Sciences (PIASS), he brought us to the school and led a meeting with the vice rector and key faculty/staff. PIASS started in 1973 as an institute in theology. They added 2 faculties (what we would call schools) in 2010 and expect to had another by 2017 when they reach university status. In 2 years the school has grown from 300 or so to over 1000. Most classes are held on evenings and most students commute. We discussed possible ways we could support counseling training for pastors and school counselors who want to tackle issues of domestic violence, abuse, addictions, and trauma recovery. Seemed the most logical and realistic way to help is to develop some 1-2 night public seminars and a few short courses (100 hours across 2 weeks) for credit. Those with good skills in training pastors, cross cultural competency, and the specific content specialists would be welcome here.
On a tight schedule we “flew” back to Kigali with our driver Jean Pierre. Anyone looking for a careful driver in Kigali should hire him! By a miracle we narrowly missed hitting a young man who was crossing the road without looking. None of us in the car understand how we did not hit him (traveling at 30 miles an hour). Later, we stopped for our driver to make a call and were mobbed by school children on the way home wanting to try out their English with us.
We arrived back at Solace to go immediately into an impromptu meeting with 20 Bible Society volunteers and workers. The other team members had been listening to how the BS was using Healing Wounds of Trauma material in Kigali and other sectors of the country. We listened to some of their trauma cases: cases of forced rape, genocide victims, and forced abortions after rape. Many reported that HWT is the best material they have had access to over the past 19 year. There was one who felt the same but wished to not start with the chapter about why we suffer as there is some in the country who are inclined to quiet people with such material. I did a short presentation about how to ground individuals who are actively distressed and dissociation. We concluded the evening with a late dinner with the BS volunteers. Another home run by Simeon at Solace!
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Filed under AACC, christian counseling, counseling skills, genocide, ptsd, Rwanda
Tuza 2.0: Day One
We arrived last night in Kigali after 24 hours of traveling. Yet, Solace Ministries Guest house provided an excellent rest (and a great meal).
Today, we started with church on Ndera hill. Well, actually we started with breakfast, my favorite meal in Rwanda: fruit, croissants, and coffee…with a view hard to beat. Church consisted of excellent singing, dancing ( the spirit can move my feet when I am here), testimonies, and choirs. Then, I preached from Jeremiah 29 about prospering in exile. Being translated is a different experience.
3.5 hours in total. It passes like an instant despite the hard benches. I imagine we could learn from Rwandans something about doing church.
After church we went to an elder’s home for lunch and then on to Baraka’s house for a visit. Got to get in her banana grove to see the trees up close and personal. After visiting with her, she took us to a residential home for street boys. 124 in residence. The young man showing us around is one of their first graduates. Fine young man. Many of the boys were on the street due to family violence or substance abuse. The organization has just hired a counselor ( herself a former orphan) just out of school. She has been working for 3 months to assess each child’s needs and to determine which ones will get services. She has no resources and said she greatly desires more training. While we were there we watched some outsiders teach the boys break dancing moves.
The day is ending back at Solace with a jam packed day on tap for tomorrow.
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Filed under Uncategorized
Trauma Recovery and Counseling Training in Rwanda
Location map of Rwanda Equirectangular projection. Geographic limits of the map: N: 0.9° S S: 3.0° S W: 28.7° E E: 31.1° E (Photo credit: Wikipedia)
I leave today for my second favorite place in the world–Rwanda. (1st favorite is wherever my wife and kids are). We are returning to do another level of training for counselors and caregivers (see this post for our previous Project Tuza reports) from a number of organizations caring for widows, orphans, HIV+ individuals, and trauma victims. [The photo at the top of this blog is from that last training] Our training this time will focus on domestic or family violence interventions, children and sexual abuse, and dealing with dissociation. In addition, we’ll focus on basic helping/listening skills and the features of good storytelling in counseling (not all efforts to tell trauma stories are helpful or healing).
Check back here to see posts about our training. I hope to be able to make some during our trip, but depending on connections, it may have to wait til we return. Here’s our itinerary:
6/21-6/22: Newark to Brussels to Kigali
6/23-25: church (preaching), visiting friends, important sites, meetings in preparation for this and future trainings; in both Kigali and Butare.
6/26-28: 3 full days and 2 nights of training, led and sponsored by World Vision Rwanda and AACC.
6/29: Participate in Umuganda (national required public service in Rwanda), final meetings, and boarding the plane to return home.
It is a short trip but we are able to,
- give our new team members experiences in listening to the strengths and challenges of a community (essential to provide help that is not harmful or useless)
- provide objective hands-on skill training (not mere information giving)
- seek advice of local leaders as to future trainings (we always need to improve our ability to train well)
- Enhance our relationships (Lord willing, we will continue to return year after year)
Check back for updates.
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Dr. Langberg on Dissociation (part II): DID, Principles and Cautions
Over at my other site, www.globaltraumarecovery.org, we now have part II of Dr. Langberg’s talk (March 2013) on dissociation. This video covers the concepts of Dissociative Identity Disorder (DID) and complex trauma. She ends with 10 principles and cautions for therapists working with clients who dissociate and/or who present with alternate personalities and identities.
Check out the video here. If you missed the first video or want to find other free resources, click around on that website.
Musings on Faith and Psychology 