After trauma, what does recovery look like? Is it possible to “move on?” How can you when you can never unsee or unremember what happened to you?
Is it possible to experience joy rather than emotional pain when remembering past or ongoing hurts? If so, just what does that look and feel like for the victim? What can be expected if I am “healed”? Can I be free from the typical experience of trauma (e.g., Hopelessness, despair, anxiety, confusion, shame, anger, loss of identity, feeling stuck but the demand to act as if the trauma did not take place, and spiritual angst over the goodness and love of God)?
As Diane Langberg has so aptly reminded us, “Trauma is the mission field of this century.” Around the world there is much openness to talk about the impact of trauma and to use spiritual practices as part of the recovery process. In Christian language, we talk about healing the wounds of the heart and one of the best programs out there is the Trauma Healing Institute’s, Healing the Wounds of Trauma. This program is based on the strong Christian belief that God, through the work of the Holy Spirit and the Scriptures, is in the business of healing wounded hearts. At the heart of this belief sits two important passages:
Isa 61:1-4 The Spirit of the Lord Yahweh is upon me, because Yahweh has anointed me, he has sent me to bring good news to the oppressed, to bind up the brokenhearted, to proclaim release to the captives and liberation to those who are bound, to proclaim the year of Yahweh’s favor, and our God’s day of vengeance, to comfort all those in mourning, to give for those in mourning in Zion, to give them a head wrap instead of ashes, the oil of joy instead of mourning, a garment of praise instead of a faint spirit.
2 Cor 4: 16-18 Therefore we do not lose heart, but even if our outer person is being destroyed, yet our inner person is being renewed day after day. For our momentary light affliction is producing in us an eternal weight of glory beyond all measure and proportion, because we are not looking at what is seen, but what is not seen. For what is seen is temporary, but what is not seen is eternal.
These two beautiful passages present a picture of recovery. Good news, release, favor, comfort, joy and beauty in place of mourning and oppression. Renewal in the face of affliction. But what does this mean in real life? Does a “double portion” instead of shame feel like to a victim of sexual trauma? What does renewal and release feel like after a natural disaster?
Prognosis for Complete Recovery?
If you suffer a serious knee injury requiring surgery, you will need time for rehabilitation. But rehab does not necessarily mean you will recover the full range of motion you once had, or that your knee will be entirely pain free when you are finished with physical therapy. Your prognosis for recovery depends on many factors such as age, extent of injury, physical health prior to the accident, and availability of quality care. Even with the best care provided to top athletes, recovery may not lead to return to top form. For example, an Olympic skier may be able to ski again but not at a quality that allows for competitive skiing.
What about the prognosis for spiritual and emotional recovery? Of course, just as in the knee injury example, the answer must be “it depends.” Still, considering the two passages above, words like liberation, joy, release, and renewal shape our imagination for recovery. Do we imagine complete recovery to top spiritual and emotional form, without pain and limitation? It appears to me that we sometimes imagine emotional and spiritual healing without taking consideration the reality of broken bodies and a fallen world. We are not guaranteed a pain free life or faith without distressing questions. In fact, Paul’s beautiful words in 2 Corinthians bear this out. afflicted in every way, persecuted, perplexed, persecuted, struck down, always carrying around death, burdened, groaning and more. Yes, he also says not crushed, not despairing, not destroyed, but alive. But both must be considered together at the same time if we are indeed to imagine our prognosis. Recovery means comfort and lament, joy in mourning, perplexed while trusting, dying yet alive.
Sprouts of Justice and Recovery?
Isaiah describes sprouts of justice and righteousness beginning in the recovery of the oppressed (Isa 61:11). As a gardener, I see sprouts as the beginning of hope. After planting seeds, the tiny sprouts give me hope for a later harvest but that hope is still tempered with the knowledge of the challenge of getting sprouts to develop into fruited plants. I have to be vigilant about bugs, weeds, and drought. I need to cultivate and fertilize or my sprouts will not turn into much. And even if I do everything right, the seed may be weak or the weather may mean I only have spindly or stunted plants that cannot bear much fruit. Yet, the sight of sprouts brings the hope that empowers us to keep at the gardening work.
So, what are these sprouts of justice and recovery that victims of trauma may first see that encourage hope and further empowerment? Consider some of these:
- Capacity to Name Truth and Justice
Recovery begins when oppressed people find words to name injustices done to self and other. For example, a victim of domestic violence may become well aware of the subtle signs of verbal and emotional coercion, long before any physical violence. They become the canary in the mine, aware of poison that others may not yet sense.
As this capacity grows beyond a mere sprout, the person may be able to speak the truth aloud, even with courage to say it to leaders.
As naming capacity grows, it moves from awareness of personal risk to capacity to notice and care for the injustices others experience
- Accepting weaknesses without hopelessness
Part of recovery requires honest reflection of the damage done. Signs of recovery include the ability to recognize limitations and working within capacity without self-hatred (though there may be lament for losses of previously held abilities). When we truly accept the “new normal” we then can stop evaluating daily life from the perspective of who we used to be
As we accept our limits, we can then begin to see the opportunities we do have even within our limitations
- Identify resilience and new capacities in the midst of struggle
There may be new capacities we never observed before (e.g., the capacity to speak up to power, the ability to withstand rejection, increased empathy for the pain of others). We now notice these resiliences and growth as they stand on their own
Though we will not call the suffering good, we will be able to identify blessings that we have received in spite of and as a result of the trauma experienced
Be Careful Not to Damage the Sprouts
For those who are not attempting the impossible, to “move on” from trauma and abuse, it is good to remember that sprouts are tender and can be easily damaged with too much interference. You may need to leave a few weeds you see near the fledgling plants so as not to disturb their roots or bruise the green shoots. How do we do this to the sprouts of recovery? We may unintentional limit growth by questioning why the person learning to speak the truth isn’t doing it in a even-tempered manner. Sadly, too often those in domestically violent marriages are told to stop being so dramatic and to calm down when they begin to speak about the truth of the violence they have experienced. Or, we can point out the sins of the victim as if somehow their responsive sins eliminate their right to speak up about the trauma they experienced. Or, we can hear someone accepting brokenness and accuse them of not trusting God for complete healing.
Nurture recovery as you would a tender plant. It is a scandalous act of grace! By paying attention to safety needs, by bearing witness to trauma, by being willing to lament and to stay connected, we provide a greenhouse for such plants to grow into levels of recovery never before dreamed of.
There has been a lot of focus on telepsychology over the last decade. What started out being about counseling over the phone has morphed to counseling via the video chat, text chat, instant message, social media, and even in virtual settings with avatars.
At times it seems like the wild west, that anything goes without regulation.
But now, more counseling related associations have developed standards for telehealthcare delivery. And licensing boards are also beginning to restrict who can offer telecounseling. Did you know that Georgia only allows Georgia licensed mental health providers to provide telecounseling to its citizens?
Ken Pope has an excellent website listing many resources you will need as you consider what you might be allowed to do. He lists standards of care, recent professional articles, and links to state boards who are beginning to regulate telepsychology. I encourage anyone who currently practices “Skype” counseling (BTW, SKYPE is not HIPPA compliant), to become informed.
Free resource available here (filmed October 2013). (Overlook that maniacal looking pose from the image below)
[Note: the video-based training described below is available to anyone for free. The information below is for those interested in purchasing continuing education credits after watching the video. If any of the titles interest you, click the link below and start watching right away!
BTS is an NBCC approved continuing education provider. Just in time for those looking for last-minute CEs before renewing their LCSW or LPC this month, please check out our new online offerings. We offer three new trainings:
- Narcissism and the System it Breeds, By Diane Langberg, PhD
- Understanding and Responding to Dissociation, By Diane Langberg, PhD
- Making the Church a Safe Place for Trauma Victims, By Philip Monroe, PsyD
The videos are free for anyone to watch. If you desire CE certificate, the cost is quite nominal in comparison to the usual going rate. Check out the abstract and objectives and follow the links to pay for your CE quiz. Watch the videos, complete the quiz, and we will email you a certificate you can use to claim on your license renewal form.
For my counselor readers, I want to let you know of a free counselor journal. Click here for free access with search capacity. It is published by NBCC and is open access to anyone who wants to try to stay current on counseling literature.
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!
- It is Free!
- 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!
- Opportunity to ask questions
- 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.
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.”
Someone sent me one of Ken Pope’s summaries of a recent essay about the differences in research findings when asking men if they have ever used force and held someone down during sex versus asking them if they had ever raped another person. You can read the original research he was discussing here, which is by some researchers at the University of North Dakota.
No, I’m not a rapist, but I have used force to make someone to have sex.
Let that previous line sink in a bit. We’ll discuss it in a minute. But first, you might not want to read the article so let me tell you what the authors were interested in knowing. They wanted to know if there were differences between men who are hostile towards women and accept the label of rape and those who have used force but deny the label.
This allows us to test whether there are differences in men who do not identify with the “rape” label on sexual aggression surveys, although they have committed acts that would be defined as rape. Men who admit intentions to force women to have sexual intercourse only, but do not believe that this act constitutes rape, might not be primarily motivated by a desire to retaliate and overpower women. Their behavior could be guided by other factors in line with stereotypically masculine gender roles such as having a high desire for sexual activity, viewing sexuality as a competition and a way to gain respect among peers, and lacking consideration for women or viewing them as sexual objects. Therefore, we hypothesize that men do not endorse any intentions for sexual aggression will differ from the other two groups of men primarily on a dimension characterized by hostility toward women as the strongest loading factor. (emphasis mine)
What did they find?
As hypothesized, a sizable number of participants indicated that they might use force to obtain intercourse, but would not rape a woman. Men who indicate intentions to use force but deny intentions to rape exhibit a unique disposition featuring an inverse construct of hostility toward women but high levels of callous sexual attitudes (Check 1985). Given that hostility toward women involves resentment, bitterness, rejection sensitivity, and paranoia about women’s motives, we consider the inverse of hostility toward women in men that intend to use force to be indicative of an affable, trusting, and nonreactive affect toward women. When combined with callous sexual attitudes, we interpret this function as representing personality characteristics that might lend themselves to allowing men to not perceive his actions as rape and may even view the forced intercourse as an achievement. The primary motivation in this case could be sexual gratification, accomplishment, and/or perceived compliance with stereotypical masculine gender norms. The use of force in these cases might be seen as an acceptable mean to reach one’s goal, or the woman’s “no” is perceived as a token resistance consistent with stereotypical gender norms. While the ultimate outcome of either act constitutes rape, this pattern of results suggests that there might be different types of offenders with potential differences in underlying motivation, cognition, and/or personality traits.
So, not every rapist does so for the same motives (and therefore our interventions will need to be different). Some knowingly rape and are not self-deceived about their actions. Others who are willing to acknowledge “forceful intercourse” group reveal deceptions (probably both in view of self and other) that enable rape to be considered something less than it really is.
Labels and what they may reveal
What labels do you use and what do they reveal about yourself and your proclivity to self-deceive? Here are some examples
- I exercise (once in a great while)
- I stand up for myself (I attack anyone who disagrees with me)
- I used to struggle with porn (well, I look about once a month but I don’t think I will do it again)
- I eat healthy (I’m obsessed with food labels)
- I am good at doing my taxes (I underreport income)
- I’m a Christian (I go to church but never really talk to God)
- Let’s just call it sin rather than abuse (because I won’t accept my actions are abusive)
- I need (I want/demand)
New child abuse reporting rules are now in effect in Pennsylvania. These rules not only make changes for licensed therapists and for those seeking licensure, but also clarify mandated reporting for volunteers who work with children. These changes directly impact both paid church staff and all volunteers such as Sunday School teachers, youth group leaders, and the like.
BTS will be offering a DPW approved training on child abuse reporting and prevention at our Hatfield campus on June 15, 2015, from 6pm to 9pm. To register, click the link above.
Sign up now for this incredibly cheap and important training. June may feel like a long way off but we know our space is limited and will fill up quickly. Only $5 for alumni and $10 for the general public.