1. Making the Church A Safe Place For Victims of Trauma Philip G. Monroe, PsyD Biblical Seminary Global Trauma Recovery Institute

2. 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

3. 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

4. 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)

5. Anything that exceeds one’s capacity to cope What is trauma?

6. More specifically: Overwhelming experience; demands placed upon the physiological system that result in a profound felt sense of vulnerability and/or loss of control

7. Posttraumatic Stress Disorder Traumatic experience Intrusive symptoms Attempts to shut down intrusions Negative feelings about life and self

8. 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”

9. PTSD on steroids: Complex PTSD Mood and impulses Attention and consciousness Self-perceptions; perceptions of abuser Relationships Physical symptoms Meaning and values

10. 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

11. Not Marked list of symptoms Sexual problems Emotional problems Relational problems Daily life problems Health problems Identity problems

12. 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

13. Depression Anxiety Trauma

14. Shame –I am dirty. Dissociation –Adaptive disconnecting, becomes chronic. Relational/emotional dysregulation Three other consequences of CSA

15. Other Diagnoses? Complex Trauma Borderline Personality D/o Complicated Grief Primary Affect:Panic and painHas 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:PresentTransient, if present Not likely Cognitive Focus: FearIdealized identity Loss Self:Consistent self loathing ConfusedCompare/ contrast with self prior to loss

16. When you hear these real impacts –Where does your mind go? Self-blaming? Hopelessness? Reflect:

17. 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?

18. CAVEAT: Don’t argue backwards Don’t assume symptoms predicts abuse! Correlation Causation

19. Hint: It has NOTHING to do with the victim. Secret ingredient to trauma

20. 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?

21. 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)

22. 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

23. THE BIOLOGY OF TRAUMA It IS all in your brain!

24. Your brain is: Adaptable Use-dependent The brain develops efficient ways to cope with and respond to daily experience!!!

25. 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

26. 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.

27. 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

28. 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

29. Impact of chronic stress? Excess stress slows –Down-regulation (calming) Chronic stress –Immune system breakdown

30. Remember: biology only 1 factor BiologicalPsychologic al SocialSpiritual Predisposing factors Prenatal care/insults; Genetics Attachment; personality features Socioeconomi c 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

31. Your brain is STILL adaptable and can change! Remember:

32. Military related trauma Domestic violence What about job-loss, mis-carriage, adoption? One note about other traumas

33. THE CHURCH AS THREAT To Traumatized Parishioners

34. What are the dangers of having invisible wounds in the church? Question:

35. Trust given to authority Culture of intimate sharing Beloved narratives –Redemption and restoration –Suffering well –Changed lines Normal expectations in church?

36. 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

37. AGENTS OF HEALING IN THE CHURCH Leaders, Parishioners, & Counselors

38. 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

39. 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

40. Naming evils, oppressions, injustices, losses Expressing sorrow and despair Asking God to act Waiting/entrusting oneself to God Lament as worship

41. Offender repentance? Accountability? Forgiveness? Restoration and reconciliation? True picture of restoration

42. Honest admission Sacrificial efforts to repair Accepts and requires discipline/accountability True Repentance?

43. Policy development –prevention policies; train –response policies to abuse/violence –Engagement with mental health services Leaders setting the foundation

44. Train –Lay care teams to support and encourage victims and their families Leaders setting the foundation

45. Listen and learn –Be a student more than a teacher! Understand what encourages safety –Bear witness Identify losses and resiliencies Individual efforts for change

46. 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

47. Validating Not looking for an explanation Listening means

48. Safe, predictable boundaries heal Avoid all control or coercion Speak the truth Allow for brokenness Notice incremental change Remember!

49. Validate (again) Gentle reframes –Ex: Noting all/nothing thinking –Ex: Finding the good without discounting the bad Validate (again) When you do speak

50. –Medications? –Counseling models? Safety  memory processing  reconnection –Counseling interventions Mindfulness; narrative work; Exposure  desensitization  response change Understand their therapies

51. Awareness of the moment Focus on being (vs. doing and reacting) Waking up from life on automatic Non-judgmental attitude What is mindfulness?

52. Intention, attention, attitude Not grasping at judgments Observing, noticing, describing, labeling Attending to sensations; Acting with awareness Mindful activities

53. 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?

54. Increased patience, decreased stress response Processing of emotions Present rather than withdrawing Increases curiosity, openness, acceptance and love Benefits?

55. 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

56. –Fishing for memories –Re-birthing –Imagery and some forms of healing prayer –Enmeshed therapists Recognize dangerous interventions

57. Friend, support, prayer partner, ear Watch out for splitting Remember your role

58. 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

59. 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

60. 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

61. 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!

62. Be willing to consult and encourage leaders Be willing to teach on counseling topics Connect trauma recovery to faith Give back to the church

63. SARA A Case Study of a 27 year old married woman

64. 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

65. Church leader helps? Lay supporter helps Counselor helps? Collaborative efforts? Making church safe?

66. 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:

67. www.dianelangberg.com www.globaltraumarecovery.org –Free videos by Diane Langberg on abuse, trauma, and narcissistic systems and leaders www.netgrace.org Web resources: