A Pastoral Approach to the Trauma Coping Process
A Pastoral Approach to the Trauma Coping Process
In every community one comes across people who are living with traumas. Trauma means ‘wound’, and they require wound care just as external and internal injuries do. Once these wounds are acknowledged, the sufferers sometimes (not always, unfortunately!) start to seek psychological and social care. Yet it is becoming apparent in the practice of trauma care that this also touches upon the relationship with God and the religious domain.
What can a spiritual counselor or pastor specifically contribute to the trauma healing process? I asked myself this question when I was approached by a church member in my pastoral practice for help. She was severely traumatized. This initiated a search within the field of pastoral counseling, in close cooperation and contact with specialist mental health care and with the counselee herself. After my counselee had been referred and subsequently diagnosed with Post-Traumatic Stress Disorder (DSM IV, TR, 2001) in a psychiatric care unit, several consultations took place between a Creative Arts Therapist and myself as pastor. The close co-operation between our varying disciplines proved to be mutually inspirational and thus beneficial for the counselee.
Purpose and description⤒🔗
With this summary of my paper, which is soon to be published in full at William Carey University (Connecting horizons with Job, Pastoral care [in cooperation with other professionals] in the trauma-coping process, Pasadena)1
I would like to interest people in this subject. My wish is that traumatized persons too may benefit from adequate pastoral care, and I would like to recommend co-operation between pastors – from within their own competence – and mental health caregivers.
Trauma is too general a specification. The literature on trauma distinguishes various types. Within PTSD a distinction is now being made, based on the kind of trauma, between a ‘single incident’ Type I and a chronic Type 2 PTSD. In the case with which I was confronted, it was not about coping with a single traumatic event, which can cause a stress disorder. In this case I was dealing with a complex post-traumatic stress disorder, designated as Type II Trauma. This concerns repeated, prolonged traumatic events that have posed a threat to the physical (and mental) integrity of the person involved. It was a matter of a sudden loss through death and having suffered various kinds of abuse.
In order to survive, people with PTSD bury their memories of the trauma as deeply as possible. They often have isolated their emotions from their cognitions resulting in an emotional numbness. Trauma, it freezes thinking (Wright 2011, 198). All situations that could possibly bring to mind the traumatic event are avoided as much as possible, because memories come with pain.
This is true of all sorts of traumas. Victims of war could come to mind here, but people who have been subjected to spiritual terrorization just as well, or those who have fallen victim to abuse: abuse of power, sexual abuse, emotional damage ... Too much to mention here. All that causes wounds or internal damage in life.
In the following, I would like to mention certain basic principles that can be of great importance when approaching people with a traumatic past.
In order to help traumatized people, a pastor must realize that the quality of his relationship with the counselee is of the utmost importance. First and foremost, it is a matter of providing safety (holding environment). Of course the professional code of confidence offers protection, but that in itself is not enough. Safety must also become apparent within the relationship. For example, the pastor should never take the initiative to approach the traumatic events. While a concerned interest from a serving and listening attitude is beneficial, curiosity (a search for sensation), on the other hand, is harmful and will create an unsafe setting. Traumatized people are especially in need of extra protection before they themselves dare to approach the traumas. Whether they ever reach the stage where they are able to share those experiences is not a given fact.
Sense of security←⤒🔗
Safety should also be reflected by a sense of security. Trauma literarily means: serious injury. The intention must therefore be to treat the wound with the utmost care, bearing in mind the seriousness of the injury. Unfortunately, people suffering from a traumatic experience often find their wounds multiplied by insensitive and unenlightened reactions to their pain and troubles. A sense of security makes it easier to express confused feelings and allows the counselee to address God with the most penetrating why-questions.
Apart from safety and security, it is also necessary to give the counselee enough space so that autonomy can take shape (with which I do not mean autonomy in the sense of being independent of God but in the meaning of particularity/personality, being able to take control of one’s own life once more and make one’s own decisions). Because the traumatized person is usually overwhelmed by feelings of helplessness and powerlessness, great effort is required to stimulate and challenge autonomy. After all, it is characteristic of traumatic events that the person who suffered had little or no control over the situation whatsoever. The safe environment was violated and because of the trauma the person involved was out of control. As a result, trust in others and in oneself can be seriously damaged, while the trust in God is also challenged.
After twenty years of experience as a pastor, it has become clearer to me how essential it is that the spiritual counselor creates space for the transformation to take place, never dominating or intervening, but always in a following and accompanying role. The image of a caterpillar, wrestling its way out of the cocoon, before emerging as a butterfly, often comes to mind. Outside intervention will only frustrate the attempt to fly, as the struggle required for the butterfly to emerge forces fluid from the body of the butterfly into its wings giving it the strength to be able to fly.2Therefore, as pastor, it is important to adopt an attitude of empathic guidance, accompanying the counselee on his or her search and never stepping outside of the boundaries marked out by the other. Counselee must have full control over what it is that he or she wishes to share.
Since anxieties of all sorts play such an important role, the attitude recommended by Edwin Friedman in the leadership field is very useful here. He speaks of a ‘non-anxious presence’ that does not allow itself to be led by fear and keeps well away from a random ‘quick-fix’ in which something must be solved, removed or ‘dealt with’. For this reason I prefer the term ‘coping with trauma’ to ‘dealing with trauma’ (as if it can be dealt with...). The aim is to find a way to connect with the counselee and offer the possibility to connect with his or her suffering, in order to perforate the isolation and lessen the loneliness.
Connecting in the pain←↰⤒🔗
In the trauma coping process it is of the utmost importance to integrate the memories and learn to handle them. This becomes possible if the counselee starts to learn to connect with his memories, with the pain and the anxiety, which brought unspeakable suffering from time to time. The pastor can be of assistance in making this connection, without himself taking over the suffering! (Only the great Pastor, Jesus Christ, is capable of doing that. He makes connections in a way no one else can, and does not walk away from any kind of suffering).
Trauma and Job←↰⤒🔗
During our first pastoral talks, I suspected that the Book of Job contained elements that might help the counselee to find new outlets for her suffering, and to make a connection with her wounded self. This route might help to search for the connection with God, other people, herself and the experience she was still suffering from. The language of Job in the jargon of the experience of death could prove helpful in approaching the trauma (Mathewson 2006).
Why Job? The Book of Job deals with the trauma of suffering. Although it is hard to say whether Job himself was traumatized or suffered from PTSD, the events that took place in his life were evidently traumatic: the loss of his wealth and possessions, the sudden death of his children, the sheer attack on his health. His safe world has been shattered, so that it is no longer a place of refuge – and that is not all: traumas are also caused by reactions from the environment.
Initially his friends reacted adequately by sitting at his side in utter silence, because they saw how great his suffering was (Job 2:13). This gives Job such a sense of security that he vents his feverish grief by cursing his day of birth, but not God (Job 3:1 ‘After this’!). Regrettably, it does not stay that way. When they speak, they aggravate the wounds with their logical reasoning. In fact, the friends are applying the same logic as Mrs. Job, who deserted him. Her reasoning is as follows: the disasters that happened to them cannot be Job’s fault, as she knows him to be a man of great integrity and, therefore, it must be God’s fault. So she takes her leave of God and disappears from the scene of disaster (Job 2:1-10). Job can expect no attempted connection and no security from her. The three friends (Eliphaz, Bildad and Zophar) apply the opposite logic: all that happened to Job cannot be God’s fault, so the cause must lie with Job himself. They constantly act as God’s advocates.
In this way Job is being attacked from all sides in his suffering. He is longing for compassion, that his anguish and misery should be weighed (Job 6:2). In the beginning the Name of God is his refuge like a fortified tower (Job 1:21, cf. Proverbs 18:10), but that becomes more and more difficult to maintain. Job experiences God as an Adversary (Job 6:4; 23:6), complains and cries out his suffering to God. He is, in fact, cornered and makes a passionate appeal to God as Advocate ‘challenging’ God... (Job 16:19-21)! Elihu continues along the same lines, talking about a mediator, one out of a thousand (Job 33:23-24). Eventually, Job is forced to recognize God as his superior and admit that he went beyond his limits (Job 42:3). Yet Job is told that, in his assertive behavior, he spoke justly of God, as opposed to his friends (Job 42:8). By recompensing Job with double what he had, God indirectly admits that Job had been robbed (cf. Ex 22:9)3God takes the highest responsibility and recognizes that all that happened to Job had no direct cause (Job 2:3): Job as the suffering righteous.
Connecting horizons (hermeneutic concept)←⤒🔗
Horizon of understanding is a concept from hermeneutic science, first introduced by Hans Georg Gadamer. Everyone brings along his own background in the process of understanding. Whenever we open ourselves up and experience or learn something new, our horizon expands. The wider this horizon, the greater is our chance of increasing our understanding.
The process of an encounter between two people can be called successful if there is a form of fusion of horizons. Each person, so to speak, retains his/her own identity and horizon of experience. The different horizons touch each other and subsequently start expanding. In order to prevent the misunderstanding of ‘merging’, I would like to coin a new phrase: connection of horizons. I interpret connecting of horizons as an encounter in which the different identities shape one another but also remain intact, in a dynamic approach.
In all awareness of each individual horizon of understanding, I made the suggestion to the counselee of reading the Book of Job together. As opposed to taking the (hermeneutic) lead, I as pastor adopted an attitude of cautious guidance. The goal which we set was to allow ourselves in all openness to be led by the Book of Job as Word of God, and wherever possible to make connections between Job’s reality of suffering and her concrete life story. In addition, she was invited to openly express to God all her faith and life questions in a quest for the living God.
This hermeneutic attitude demands an unbiased and open-minded attitude towards the other person’s views. For this reason, it was agreed with the counselee that she would take the lead in the Job readings, so that the pastor and theologian was compelled to put all initial interpretations concerning Job on the line and abandon every theodicy concept. It is important to realize that the pastor’s own hermeneutic understanding of the Book of Job also plays a role. Furthermore, it is just as much an encounter between the counselee and the pastor’s horizon of understanding from his own Christian frame of thought and experience of suffering.
Pastoral route and result←⤒🔗
The effect of this attitude in the trauma coping process is described at length in the research paper that will appear at the William Carey University. There I describe the process in full, aided by material made by the counselee during creative therapy. One passage from Job in particular plays an important part: Job 16:19-21. The trauma victim feels a connection of horizons with Job when Job puts into words that he has experienced God as his Adversary, and subsequently calls out urgently to God to defend him against God...!
Further along the pastoral route, more space arose to bring the questions about suffering into connection with Jesus Christ by prayer (Heb. 4:14-16). And especially to talk in detail about the evil (abuse) from which He suffered so deeply. Jesus invites one to identify with Himself in all the anxieties He has been gone through, Jesus who is more than the suffering Job (Heb. 5:7-10). The mystery of God (God above me) taking it up against God (God with me) has eventually become reality in the unique suffering of Jesus Christ. He is the Judge-Witness in the ‘God versus God’ trial (in Job’s tentative words), as between a man and his friend (Job 16:19-21). He is, more than Job, the Righteous One, and at the same time, the Mediator, who suffered the most, but triumphed. Oh, the depth of the riches of the profound wisdom and unsearchable knowledge of God!
In the traumatic context, it is the pastoral counselor’s calling to operate alongside other therapists, from his own field of competence. This can benefit the trauma coping process and add value to the assistance offered. Contact with the other specialists is of eminent importance for working in harmony with each other. For a healthy basic attitude, three elements are required: a safe setting, guaranteeing the counselee’s autonomy, and a ‘non-anxious presence’ in which one does not walk away from unspeakable suffering.
Pastoral counseling in the context of post-traumatic stress disorder demands great patience, caution and restraint. The pastor can specifically help by adopting an open attitude towards the most penetrating questions about suffering, without taking an apologetic stance, like the friends of Job. The language of Job himself proves to be very useful in formulating the experience of suffering and asking penetrating life questions. The book of Job helps to understand and helps to express feelings that are evoked in a traumatic context, especially in the relationship with God.
The pastor’s activity should be characterized by willingness to serve, open-mindedness and caution. He should not force anything, but should let the other be himself as much as possible. Carefully, and in the counselee’s tempo, he looks for common ground in the traumas and experiences of suffering. The most important part of pastoral care in the trauma coping process is guiding the counselee in connecting to the memories, the pain and the anxieties. These are brought into relationship with (the) God (of Job), the other person and oneself. Making these connections means taking the road towards healing. It perforates the isolation and lessens the loneliness. In the treatment and care of the wounds, the pastor is called upon to show love, compassion and patience, thus following Christ.
In the end Jesus shows us how seriously He takes traumas, when He, even after His resurrection, with His glorified body, displays the wounds of his suffering (Luke 24:40).
Literature on trauma counseling←⤒🔗
- Blink, A.J. van den (1998). Trauma Reactivation in Pastoral Counseling: Implications for Theory and Practice. American Journal of Pastoral Counseling, 1, 2, 23-38.
- Matsakis, A. (1992). I Can’t Get Over It! A Handbook for Trauma Survivors, Oakland: New Harbinger Publishers.
- Mathewson, D. (2006). Death And Survival in the Book of Job: Desymbolization And Traumatic Experience, Library of Hebrew Bible/ Old Testament Studies T & T Clark library of biblical studies. Vol. 450, New York: T & T Clark.
- Scott, M.J. (2007). Moving On After Trauma, New York: Routledge.
- Wright, N.H. (2011). The Complete Guide to Crisis & Trauma Counseling, Ventura; Regal.
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