Wednesday, December 12, 2007

Trauma

When I first started doing Social Work in Los Angeles after graduating College, I was not terribly surprised to discover that most of my clients showed evidence of having gone through psychological trauma. At the time I thought, "well, this population is disproportionately affected by violence and abuse." But when I started doing pastoral care in seminary and beyond I discovered that I was wrong--it's not just "the population" of people I was seeing in Los Angeles that show such prevalent signs of psychological trauma, it's rampant across all sectors of society. Now I'm not sure if this is an increase from historic levels, but I am positive that our methods of healing psychological trauma have vastly improved. I also think that another difference of our age is that people have an expectation that they will be reasonably healthy and happy.

So it is that many of us who want to help people have learned first hand about how to help those who have experienced trauma of one kind or another. This kind of work is hard and hazardous, but also incredibly rewarding. It's amazing to be able to work with someone to achieve the wholeness God has intended for them.

If any of you reading this blog are interested in learning more about helping people affected by trauma, I highly recommend this book: Trauma and Recovery by Judith Herman, M.D.


It's a ground-breaking work that shifted much of my thinking on the subject to a new level. It's particularly good at explaining the dynamics of Borderline Personality Disorder and why therapists have such trouble treating it. It was assigned reading for a course of Pastoral Care and Violence that I took at YDS with Kristen Leslie. I have a lot of respect for Kristen--she's the real deal. As an aside, she does a great version of "Simple Gifts" on the Hammer Dulcimer. I also learned a lot about this subject from Bede Mudge and Mary Gates. Yet learning about trauma is a whole different thing from learning how to treat trauma in a care-giving scenario. That, I'm afraid, only comes from encountering people in need, listening to their stories, and allowing oneself to be changed by them. I'm fortunate to have been able to refine some of those skills under the supervision of some masterful practitioners. And yet I'm still a newbie at this.

The key seems to be self control in the midst of disturbing revelations. In other words, maintaining a relaxed but firm grip on oneself even as you see and hear things that are quite disturbing. Yet it's not enough just to sit there like a stone--you have to know when to give back some of the things swirling around inside of you, the care-giver. It's about figuring out the right balance between receiving the revelation and responding to it. Respond too much or too quickly and you shut down the disclosure and impose your own interpretation. Give too little and the client feels isolated and unheard. Worse, you miss the chance to transform their story by adding to it.

Another note worth mentioning: trauma is very much about the story. The client's account is the absolute most important artifact of their experience. In some ways maladaptive responses to trauma can be said to be misinterpretations of the person's own story. Therefore, healing can come in the re-articulation of history when that re-speaking leads to better integration and adaptive response. Efforts to achieve psychological healing through litigation often fall short because they bring out a story, but it's not necessarily the client's and it's not done in a way that necessarily encourages new responses within the client. This is why it is a huge mistake to force a new interpretation of events onto a client ("maybe he didn't mean it like that..." "in her culture it's okay to do that..." "I'm sure that will never happen to you again...").

Notice, BTW, that Trauma is central to the Christian Story. The moment of Christian Salvation is affected by God's reinterpretation of the story of Christ's death. And therefore we keep telling that new story that brings healing to the world.

Good stuff.

-t

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