Making the Church A Safe Place For Victims of Trauma

Philip G. Monroe, PsyDBiblical SeminaryGlobal Trauma Recovery Institute

Objectives

• Identify the common struggles of trauma survivors in faith communities.

• Identify three ways to make churches safer for trauma survivors.

• Learn effective trauma healing support techniques.

pmonroe@biblical.edu www.wisecousel.wordpress.com

• If you need a break, take one!• Consider your neighbors when you speak

– Avoid unnecessary trauma details– Remember who may be in the room

Care for yourself and others

What is trauma?

• Overwhelming experience disrupting life as you know it

• Alters view of self, other, and God• Most toxic? Betrayal forms of trauma• Response continues on after event(s)

Anything that exceeds one’s capacity to cope

What is trauma?

More specifically:

Overwhelming experience; demands placed upon the

physiological system that result in a profound felt sense of

vulnerability and/or loss of control

Posttraumatic Stress Disorder

• Traumatic experience• Intrusive symptoms• Attempts to shut down intrusions• Negative feelings about life and

self

Trauma turns complex when:

• Terror goes beyond typical PTSD• Stressors are interpersonal, premeditated,

planned and caused by humans• Stressors are repeated and chronic in

nature• Victims are exploited by “caregivers”

PTSD on steroids: Complex PTSD

• Mood and impulses• Attention and consciousness• Self-perceptions; perceptions of abuser• Relationships• Physical symptoms• Meaning and values

In addition to the conditioned physiological and emotional responses to reminders characteristic of PTSD complexly traumatized children develop a view of the world that incorporates their betrayal and hurt. They anticipate and expect the trauma to recur and respond with hyperactivity, aggression, defeat or freeze responses to minor stresses.

Their cognition is affected by reminders: they tend to become confused, dissociated and disoriented when faced with stressful stimuli. They easily misinterpret events in the direction of a return of trauma and helplessness which causes them to be constantly on guard, frightened and over- reactive. Finally, expectations of a return of the trauma permeate their relationships. This is expressed as negative self-attributions, loss of trust in caretakers and loss of the belief that some somebody will look after them and making feel safe. They tend to lose the expectation that they will be protected and act accordingly. As a result, they organize their relationships around the expectation or prevention of abandonment or victimization. This is expressed as excessive clinging, compliance, oppositional defiance and distrustful behavior, and they may be preoccupied with retribution and revenge

Not Marked list of symptoms

• Sexual problems• Emotional problems• Relational problems• Daily life problems• Health problems• Identity problems

Intense fear, paralysis/helplessness, inability to effect any change, threat of annihilation, leading to experience of,

Loss of voice, control, connection, and meaning, resulting in,

Disorganized physical, cognitive, and emotional response system thereby increasing,

Relational pain, distrust, self-contempt, overwhelming anxiety, evidenced as,

Running from the past…afraid of the future

DepressionAnxiety

Trauma

• Shame– I am dirty.

• Dissociation– Adaptive disconnecting, becomes chronic.

• Relational/emotional dysregulation

Three other consequences of CSA

Other Diagnoses?

Complex Trauma

Borderline Personality D/o

Complicated Grief

Primary Affect: Panic and pain Has capacity for positive affect

Intrusive sad or guilty thinking

Relationships: Passive, avoidance, re-victimization

Vacillates between desire and devaluation

Loss of pre-existing good coping skills

Dissociation: Present Transient, if present

Not likely

Cognitive Focus:

Fear Idealized identity

Loss

Self: Consistent self loathing

Confused Compare/ contrast with self prior to loss

• When you hear these real impacts– Where does your mind go?

• Self-blaming?• Hopelessness?

Reflect:

• Some numbers– 1:4 women; 1:6 men with sexual assaults– Adverse childhood experiences (ACEs)

• 30% with physical abuse• 12% witnessed domestic violence• 11% with emotional abuse• 20% sexual abuse• PHL receives higher than national average rates

So…how many hidden in your church?

How common is trauma?

CAVEAT: Don’t argue backwards

Don’t assume symptoms predicts abuse!

Correlation Causation

Hint: It has NOTHING to do with the victim.

Secret ingredient to trauma

• Traumatic events do not always lead to traumatic reactions. Only 25-35% end up with traumatic symptoms. Why?

– Social support? Continuing isolation? Community response?

– Active, successful reaction?

Why aren’t MORE traumatized?

Factors involved

• Type and origin of exposure• Age/developmental stage during exposure• Public versus private• Chronicity• Lasting impact• Social support• Other resources and resiliencies• Other vulnerabilities• Individual differences (coping style, cognitive,

temperament)

Factors that impact trauma and stress reactions

Fawcett (2003), as cited by Boecker (2007)

Traumatic Event

Organizational Support

Background

Level of Traumatic Response

Resilience Factors

Occupational Environment

THE BIOLOGY OF TRAUMAIt IS all in your brain!

Your brain is:

• Adaptable• Use-dependent

The brain develops efficient ways to cope with and respond to daily experience!!!

Experience processing• Three types of experience processing

– Cognitive (frontal cortex)– Emotional (limbic systems)– Reactive (brainstem)

• Overactive limbic system (amygdala) seems to shut down prefrontal cortex (used for activation, assessment, etc.)– Disconnects cognition from affect

Prefrontal activity? One study:

• PTSD sufferers showed decreased prefrontal cortex activity when asked to remember or think about former traumatic events.

– Hypothesis: PTSD victims re-experience their trauma rather than recall from their present position.

How the brain responds to memories of trauma:

– Activation of the survival response: • Heightened amygdala and other limbic activity

– Not just a memory--Seeing and feeling• Activation of sensory areas

– Inability to speak:• Decreased activation of Broca’s area

– Emotions are more salient than language:• Marked Rt. hemisphere lateralization

2 overlapping systems

• Amygdala + Hippocampus + Cingulate– Arousal + Evaluate + Decide– Michael Lyles: accelerator, no brakes, no steering

• Hypothalamus + pituitary + adrenal– Cortisol/stress feedback loop

• low cortisol but more frequent “radar” results in overreaction to weak “signals” and no correction back to norm

Impact of chronic stress?

• Excess stress slows– Down-regulation (calming)

• Chronic stress– Immune system breakdown

Remember: biology only 1 factor

Biological Psychological Social Spiritual

Predisposing factors

Prenatal care/insults;Genetics

Attachment; personality features

Socioeconomic Status

Generational patterns

Precipitating factors

CNS diseases and other med. problems

Abuse, trauma, chronic poor functioning; emotional sensitivity

Abuse and neglect; social support?

Current faith context

Perpetuating factors

Chronic disease

Poor adjustment to change

On-going lack of resources

Rigidity

Your brain is STILL adaptable and can change!

Remember:

• Military related trauma• Domestic violence

What about job-loss, mis-carriage, adoption?

One note about other traumas

THE CHURCH AS THREATTo Traumatized Parishioners

What are the dangers of having invisible wounds in the church?

Question:

• Trust given to authority• Culture of intimate sharing• Beloved narratives

– Redemption and restoration– Suffering well– Changed lines

Normal expectations in church?

• Spiritual forms of abuse– Prayer manipulation– Bible used to condone victimization or silence– Over-focus on sex and family ideals– “Get over it” theology

When the church hurts victims

AGENTS OF HEALING IN THE CHURCH

Leaders, Parishioners, & Counselors

Church as Refuge

• Teaching– Normalize brokenness

• Speak about shame but also “beauty for ashes”

– Encourage corporate lament– Paint a true picture of restoration

• Highlight courage over idyllic endings• Highlight hope

Leaders setting the foundation

An oppressing spiritual force– Opposes love, the true picture of God and

church– Paints a false picture

• Abuse of power immobilizing fear• Deception moral and relational confusion• Failure to protect chaotic choices• Objectification distorted view of self/bodies• Forced false worship Enslaved to false gods

The spiritual damage of abuse

• Naming evils, oppressions, injustices, losses• Expressing sorrow and despair• Asking God to act• Waiting/entrusting oneself to God

Lament as worship

• Offender repentance? Accountability?

• Forgiveness?

• Restoration and reconciliation?

True picture of restoration

• Honest admission• Sacrificial efforts to repair• Accepts and requires discipline/accountability

True Repentance?

• Policy development– prevention policies; train– response policies to abuse/violence– Engagement with mental health services

Leaders setting the foundation

• Train– Lay care teams to support and encourage victims

and their families

Leaders setting the foundation

• Listen and learn– Be a student more than a teacher!

• Understand what encourages safety

– Bear witness• Identify losses and resiliencies

Individual efforts for change

• Don’t talk too much, become pushy• Watch out for rubber-necking

– But don’t avoid difficult subjects• Pay attention to your body language• Validate• Use question to keep the conversation going• Listen at 3 levels

Counselor 101 skills

• Validating• Not looking for an

explanation

Listening means

• Safe, predictable boundaries heal• Avoid all control or coercion• Speak the truth• Allow for brokenness• Notice incremental change

Remember!

• Validate (again)• Gentle reframes

– Ex: Noting all/nothing thinking– Ex: Finding the good without discounting the bad

• Validate (again)

When you do speak

– Medications?– Counseling models?

• Safety memory processing reconnection

– Counseling interventions• Mindfulness; narrative work; Exposure

desensitization response change

Understand their therapies

• Awareness of the moment• Focus on being (vs. doing and reacting)• Waking up from life on automatic• Non-judgmental attitude

What is mindfulness?

• Intention, attention, attitude• Not grasping at judgments• Observing, noticing, describing, labeling• Attending to sensations; Acting with

awareness

Mindful activities

• Naming the rumination; accepting• Focusing on the present with senses• Repeating a verse• “What do you want me to be doing in the next

5 minutes?”

What might it look like?

• Increased patience, decreased stress response

• Processing of emotions• Present rather than withdrawing• Increases curiosity, openness, acceptance

and love

Benefits?

Narrative work: Good story telling•Tells story at own pace, no pressure•Chooses when not to tell a part of the story•Listener silence and body language to show interest•Storytelling without words•Difficult stories start and end at safe points•Good coping skills before starting story telling•Notes resiliency and strength in the midst of trauma•Story told from the present rather than reliving the story

• Frequent interruptions• Forcing the story• Reliving 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

– Fishing for memories– Re-birthing– Imagery and some forms of healing prayer– Enmeshed therapists

Recognize dangerous interventions

• Friend, support, prayer partner, ear• Watch out for splitting

Remember your role

• Does the heavy lifting of therapy• Encourages healthy boundaries and safe

spaces• Collaborative efforts/goals• Teaches/trains lay helpers• Gives voice to common pit-falls and

roadblocks

Counselors as agents of change

• Distancing from the church and other social supports; Criticizing lay efforts

• Assuming church is healthy• Forgetting permission to collaborate• Failing to connect trauma and faith

First, some pit-falls of our own

• Advise clients how to use their voice; give space for making choices

• Increase empathy for self and other (orgs) for failings and disconnects

• Avoid all/nothing responses to faith/church

Support the client voice

• Find mutual goals where possible• Identify how counseling fits into big picture• Speak the native language!• Be gentle with errors

With permission…engage leaders

Remember to listen first!

• Be willing to consult and encourage leaders• Be willing to teach on counseling topics• Connect trauma recovery to faith

Give back to the church

SARAA Case Study of a 27 year old married woman

• Abused at 5 by uncle• Abused as teen by brother• Marries at 18• Involved at conservative hierarchical church• Marital sex problems• Self-despising; distrustful

Her history

• Church leader helps?• Lay supporter helps• Counselor helps?• Collaborative efforts?

Making church safe?

• The Long Journey Home (Schmutzer, A. ed.)• Counseling Survivors of Sexual Abuse; • On the Threshold of Hope (Langberg)

– Group workbook now available• Rid of My Disgrace (Holcomb)

Book resources:

• www.dianelangberg.com• www.globaltraumarecovery.org

– Free videos by Diane Langberg on abuse, trauma, and narcissistic systems and leaders

• www.netgrace.org

Web resources: