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Crisis Prevention, Trauma and Disaster Information: Training, Supports and Materials

 
     
 

Kaylene Scholl Henderson MA, BCCLC

Author, Trainer, Board Certified Christian Life Coach, consultant

Trauma

Kaylene Scholl Henderson

Liberty University

(C) 2/2015


Abstract

 

              According to the Center for Disease Control and Prevention, (2010) trauma from injury and violence results in 1 out of 10 deaths each year in the world defining this a major public health issue.   Approximately 5.8 million people die in the world each year from volatile related injuries, leaving family, friends and neighbors from all walks of life in a state of crisis.  Crisis states that leave persons with a lack of safety and security have the potential of deeper traumatization affects and consequences.

Trauma is a word used in many venues to describe negative exposures and horrifying experiences. Defining trauma, its causes, effects, responses, related difficulties, and treatment options will be researched and discussed from a Biblical and secular world view.

 

Trauma

 

Trauma, as described by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is described as an exposure or direct threat of death by accident or violence to one’s self, as a witness of the eventful harm to another person or information of a close relationship. (Briere, Scott 2015) Trauma is a bi-product of crisis. Crisis is defined as the perception of a critical incident that produces subjective distress causing the person the inability to cope and function at their normal levels of performance. Crisis can serve as an opportunity to learn and grow, however if the person is not able to work through and regain normal functioning the probability of a crisis cycle may develop causing emotional and mental health dysregulation. (Kanel 2007)  

Loss is at the heart of every trauma and crisis. (Wright 2011)  Loss is a death that causes one to have to readjust to their original way of living creating a new normal.  The death can come in the form of a physical death, debilitating health functioning, loss of a relationship, death of a dream or idea, loss of a community or social status and position.  With each of these, additional unrecognizable losses join the list of suffering that requires a grieving process. (Cisney, Ellers 2007). This grieving process or lack thereof exposes trauma effects, trauma responses or related difficulties requiring an eclectic approach to trauma treatment modalities.

Trauma effects-  

            The brain was created in an amazing and profound way causing the specific body organs to function and behave according to the messages that are relayed to that particular body part. Cognitive brain functions (mental process that induces behavior) takes each life experience through the lens of the five-sense stimuli creating an interpretation of meaning known as the perception. When new experiences are happening our brain retrieves information that was previously organized and filed from a similar situation, influencing how a person acts or reacts to the current circumstance.  This process is usually outside of the conscious awareness of the individual.  Therefore a stimuli from outside sources triggers an internal warning bell (the traumatized brain) causing a response of learned behavior. (Riegler, Riegler 2008) The consequence or result of this learned behavior causes physical bodily symptoms, manifestations of wrong thought processing or interpretation of external stimuli, and spiritual soul wounds.

            The body’s memory has the capacity to observe, measure and repeat behavioral responses.  The frequency of a particular outcome to a perceived reality reinforces the belief system that an exact consequence follows the certain stimuli, therefor calling for the same precise behavioral/bodily response. Psychology researcher Sir Frederick Bartlett defines memory as, “a reconstructive process rather than a reproductive one…Guided by schemata, generalized knowledge structures about events and situations that are constructed based on past experiences.”(Riegler, Riegler. 2008. P.13)

            The term “sweet heart” has won the young girl unwanted affections from a person in the past.  In the new foster home the church family smothers the child with what they believe to be love in affection calling the child sweet heart.  Although the person is different and the location is not the same, the term of sweet heart causes the young child to reconstruct the scene while her body starts to react to the thought of the unwanted attention she anticipates is coming.  Real physical pain penetrates her body as she runs to the lavatory to discard the content that has risen up to her mouth.  The next time the family prepares to return to church psychosomatic symptoms will explode and declare war in the mind.

            The initial trauma is being relived and the child’s cognitive mental processing steps up to bat. The invitation to return to church has set off unguarded dynamite manifesting deliberate offensive behavior toward the host.  Survival is the name of her game, yet at the expense of self-destruction.  The perception of her last visit experience, in which she revealed evidence of real physical pain, has added church as another unsafe place to be.

            The child’s mind has now reinforced the intention of pain with the term of endearment which produces intense mental and emotional turmoil.  The perception screams that those who exhibit what they term love cannot be trusted therefore they must be avoided at every opportunity. This new wound cuts deep to the inner soul while blocks are added to reinforce the wall of safety, solidifying the destructive patterns of isolation. Hebrews (10:22-25b) encourages,

“Let us draw near with a true heart in full assurance of faith, having our hearts sprinkled from an evil conscience, and our bodies washed with pure water. Let us hold fast the profession of our faith without wavering, for He is faithful that promised; And let us consider one another to provoke unto love and to good works: Not forsaking the assembling of ourselves together.”

            The soul or spirit of a person encompasses their mind, emotions and will.  The encoding of life experiences inflames the belief system surrounding a particular situation. Those beliefs stir up emotions which put the will into gear affecting behaviors. If the infected soul is not healed it will die (emotionally and spiritually) from fear and unforgiving hatred. (Herbst 2008) “Whoever hates his brother is a murdered: and you all know that no murderer has eternal life abiding in him.”(I John 3:15)

          The motivating vow of the will locks in the defense mechanism to strengthen the belief system.  The belief, “I am not safe at church.” Pure unadulterated care has been turned into the war zone.  For the young child who now declares that church (and therefor God) is not safe, “love provokes an army of strong holds.” (Scholl-Henderson, 2007) Exposures of true love are now a trigger that reinforces the lie, people are not safe. The more others try to prove their love and care is real, the more the traumatized brain has to dig deeper and manifest volatile destructions on themselves or others to try to prove that their lie is real. This behavior is all about perceived self-preservation and the denial covering losses in life; thus, resulting in a purposed or intentional way that violates moral and spiritual law, usually through offensive behaviors. Galatians example of spiritual and moral law towards others is, “love, joy, peace, patience, kindness, gentleness, goodness and self-control.” (5:22-23)

          The spirit of a man mediates between his body and his soul, yet interchangeably, the spirit, soul and body influence each other. When one of the three is out of balance negative demonstration occurs in all three. “Why are you cast down, O my soul? And why are you disquieted within me? Hope in God, for I shall yet praise Him for the help of my countenance and my God.” (Psalms 42:11)

            Scientific discovery informs us that trauma reconstructs the brain functions in how it processes and communicates information.  For a developing brain of a child experiencing trauma, the brain may discontinue (emotional) growth at the time of trauma resulting in an emotional age freeze in functioning throughout life. The brain disconnect or rewiring precipitates trauma responses and other related difficulties.

Trauma responses and related difficulties

            Responses and other difficulties of trauma are indications of internal or external stimuli that triggers the body or brain memory to a previous experience that was painful to the point of diminished global functioning. These responses influence every area contending within the environment, relational, safety, and health of the traumatized person and others in proximity to the traumatizing responses.  Most of us have heard the saying, “hurt people, hurt people” (unknown) and shrug off the behaviors of those demonstrating a foul disposition, yet the related difficulties that bury deep within the psyche and spirit fight resulting in either life or death. Daniel described it this way, “I was grieved in my spirit within my body, and the visions of my head troubled me. (7:15 KJV) These troubles instill a distorted attachment to other people, diminish sense of safety, and develop mental health disorders.

            Fearfully and wonderfully we were created in the womb of our mothers, (Psalms 139) and He, God, delivered us from the womb and taught us to trust while at our mother’s breasts. (Psalms 22:9) Theories on attachment and attunement describe the incredible attachment and attunement between the mother and child in the formative years of development.  Attending to the cries for hunger, care and comfort teach the infant that the mother can be trusted.  The nurturing of the mother teaches the baby how to self-regulate and downloads information from her brain to the baby’s (imprinting) during feeding time where eye contact is evidenced. Attunement creates a strong bond in the relationship.

            When this deep connection of attunement has not been established, the child’s overall development, ability to express emotions and development of healthy relationships have been aborted. “Symptoms of disorganized attachments could include an aversion to touch, control issues of defiance, disobedience and argumentative to ‘win’ at all costs, anger problems, having difficulty showing genuine  care and affection towards others and an underdeveloped conscience.” (Smith, Saisen, Segal 2014)

          Characteristics of distorted relationships with other people often resemble the inhibited person that is withdrawn from relationships, is emotionally detached and denies comfort.  This individual is often extremely aware of surroundings but shows no reaction or response. When other people try to build relationship they are ignored, pushed away or experience aggression from the traumatized person.  The disinhibited person prefers to get attention and comfort from strangers over those who are part of their family. This person will communicate through behavior that the significant others in their life (parents) are mean, abusive or neglectful, controlling strangers to get what they (traumatized person) want by inducing pity.  This person is dependent to the point of learned helplessness, acts younger than their age and presents with acute anxiety.  Lack of trust causes this person to be in control of every encounter they have.

            Self-sufficiency is the key to this persons thinking.  Traumatic events, even those beyond anyone’s control, have secured the fate; Primary care-givers, persons in community positions, and protective authorities have failed the self-administered test of the traumatized.  Even the all-powerful God did not come through as expected or hoped. Confidence in others to protect, shelter and comfort has been smashed against the cliffs falling into the drowning sea of bitterness.  Safety has been reduced to a figment of proclaimed imagination, imposed reality too harsh to comprehend. Paranoia crouches at each corner of the impending threat. Fear is the culprit that has captured the mind throwing sanity into the gulf of powerlessness.  Love is reduced to shreds of unnatural, repulsive, harsh responses of unreciprocated affections. The absence of T.R.U.S.T.; True relationships united (in) strength together is a gaping hole. When trauma affects the mind, will and emotions and the promise of God’s word is not applied, mental health disorders consume the very life of a person. God’s promises that He will not “give us the spirit of fear, but of power and love and a sound mind.” (II Timothy 1:7)

            The debate continues, illness or sin? What about illness because of (effects of) sin?  Illness is an unhealthy condition, (restricting or modifying) indisposition, (unwillingness) sickness (malady-chronic disorder) and wickedness (distressingly severe, troublesome or dangerous). Sin is referred to offending against a principle, a transgression or willful and deliberate violation.  Trauma makes lasting impressions on the brain functions and on the mind, thought, functioning and comprehension.  The decision making in this dysfunctional state tend to be defensively willful, restricting counsel, distressingly negative, inviting danger, and counterintuitive to the natural order of life giving principles.  The resistance in accepting help is based on belief, motivation, attitude and coping styles associated with the current cognitive and neurological functioning of the traumatized brain.

            The primary mental disorder identified from trauma is, Posttraumatic Stress Disorder. Anger, shame and guilt are contributing factors in cognitive behaviors and “attitudes about life events as outside of their control or as potential threats.”(Briere, Scott. 2015 p27)   These behaviors shadow every aspect of this individuals life patterns.  Intrusive memory, dissociative reactions, physiological reactions, inability to experience positive emotion, an altered state of reality and declining memory destroy interpersonal relationships, along with functioning in society. (Briere, Scott. 2015) Limited cognitive ability dictates the level of comprehension of spiritual matters regarding self- directive, deferring to God, collaborating with God and eventually, surrender to God. (Roehlkepartain, King, Wagener, Benson. 2006)                 

          People are encouraged to renew their mind daily in the promises of God.  The mind is where the battle field rages for our spiritual state. Romans (1:28) shows us, “even as they did not retain God in their knowledge (mind), God gave them over to a debased mind.”  The effects of a traumatized brain weaken the resolve to trust in a God they cannot see, especially when those who are entrusted for their care were not able to prevent or protect from the critical incident that cause traumatizing episodes, lack of trust and painful interventions. With each experience of trauma, or development marker in a person’s life, a nagging thought digs to the depth of conscious reasoning, “Where was God when this happened to me?” (Maltby 2012 p 310) The anguish presented with this question may cause a traumatized individual to seek out counsel or help from another person. “For you were bought with a price; therefor glorify God in your body and in your spirit, which are God’s.” (I Corinthians 6:20)

Treatment options

            The primary goal of treatment is healing; a healing that allows for the opportunity to grow, develop and be strengthened for any future crisis. (Hoff, Hallisey, Hoff 2009) Healing comes in the form of acknowledgement, (to recognize the existence of truth) confession, (to own or admit as true, to reveal) and repentance (deep sorrow for wrong doing, regret). James instructs the sick (ailing, deeply affected, mentally, morally or emotionally deranged) to, “confess your faults (in a dilemma, imperfection) one to another and pray for one another that you may be healed.” (5:16 KJV) This healing comes from treatment modalities that consist of crisis counseling, psychotherapy and spiritual interventions.

          Crisis counseling is the immediate care and love to minister to the physical, mental, emotional and spiritual needs of a person at the time of a critical incident.  This act of compassion is a mandate to every disciple of Christ. Assessment of physical injury and the need for safety are the primary tasks of ministry. A constant presence during the initial stage of assessment and grief are critical to help the person gain a level of normalcy in their own ability to function, especially with self-care skills. According to Young, (2007) “A crisis counselor is a healing bridge from unspeakable pain to hope which helps the victim to look evil in the eyes and recognize sanity in human form. The counselor points to hope for a future and is a sanctuary for the hurting.” Silent suffering bottles up intense feelings that lead to resentment and stress in the body. These need to find a way out. “Mary McCambridge” (Cisney, Ellers 2007) If crisis work does not help the victim regain functioning to the level prior to the incident, Psychotherapy will be a needed intervention.

          Assessing trauma and posttraumatic outcomes through clinical interviews, include life threats, psychological stability and stress tolerance.  The clinician first order is to establish a sense of trust for a working relationship between the clinician and the victim. To assist the victim to move towards healing with a new normal of positive life responses entails an understanding of trauma exposure/ history, medical history, family relationships along with other interpersonal encounters, and cognitive effects of the trauma.  Evaluating process includes activation and avoidance responses, identifies defensive responses of emotional numbing, disengagement, thought suppression, denial, and possible uses of chemical dependence. “Effective therapy almost always consists of a variety of interventions and theoretical models.” (Briere, Scott 2015)

          Therapeutic models consist of talk therapy, group therapy, psychological education, behavioral intervention therapy, neurobiological intervention, desensitization exercises, and pharmacology trials and administration.  Continued biological research reveals new information for the development of more treatment options. (Briere, Scott 2015)  These therapies help to find the root issue of the impending outcomes of trauma or at the least, bring a reduction in the manifestations of damaging behaviors while trying to “weigh the relative contributions of reality and fantasy.” (Everstine, Everstine 2006. p.120) Although secular therapy continues to research for a cure, a cure will not be conclusive without a holistic approach.  This not only includes the spiritual but requires a strong spiritual base.

          Research has proved that the brain comes alive and calms the nervous system when there is an act of worship or prayer. (Brooks 2014) Many believe that trauma is impossible to heal as evidenced by the lack of many that do not reach a strong faith in spiritual growth.  According to Feldman (2014) moral and spiritual development are not possible until cognitive (mental processes of perception, memory, judgment and reasoning) development has reached its potential.

          “The prayer of faith shall save the sick,” according to James 5:15, “and the Lord shall raise him up; and if he have committed sins, they shall be forgiven.” Faith is confidence or trust in another’s ability that is not based on proof. (dictionary.com) Faith, however, exercises the process of perception in the judgment of (past) positive memory which is strengthened with the reasoning that a similar outcome will emerge. The spiritual outcome that promotes healing is the anticipated fulfillment of God’s promises to walk with and comfort us in the trials of this earthly world.  And though God does not endorse the pain and trauma, He is able to take what was meant for evil and bring growth in life’s encounters (Genesis 50) through the power of His strength in our life. God’s thoughts for human kind is peace to give a future and a hope (Jeremiah 29:11)

          Healthy relationships are the glue that build trust and reciprocal interactions with others.  The strength in these relationship helps to keep each other in balance when life challenges taunt and thrash to take our focus off of the abundant life that is freely given to all who believe in Jesus the Christ and His redemptive work at Calvary. (John 10:10) When trauma shakes people to the core, man has the opportunity and choice to run for the counsel of many where there is safety, or be swallowed up in grief which leads to destruction. (Proverbs 11:14)

          When destructive patterns and behaviors have had the opportunity to take root in the life of a person, rage, hatred and bitterness fester into an abscess of infection.  The only way to bring healing is reconciliation in the relationship that was damaged.  The way to reconciliation is to admit any offense, disclose and confront areas of non-truth and surrender to all truth relinquishing rights of vengeance for the healing of forgiveness. (Herbst 2008)

Closing

          Trauma, the Greek word that means wound, “is more than a state of crisis. It is a normal reaction to abnormal events that overwhelm a person’s ability to adapt to life.” (Wright 2011 p189) The treatment timing and modalities impact the level of emotional and mental trauma which could produce growth and opportunity to live or the continuous cycle of a hamster on a wheel getting nowhere, on a slippery slope to personal destruction. Jesus said, “These things I have spoken to you, that in Me you may have peace. In this world you will have trouble, but be of good cheer, I have overcome the world.” (John 16:33 KJV)

References

Briere, J.N., Scott, C. (2015). Principles of trauma therapy: A guide to symptoms, evaluation,

and treatment. DSM-5 update. (2ed ed.). Thousand Oaks, CA: Sage Publications.

Brooks, J. (2014). Moral development vs spiritual development.  American Association of Christian Counseling. Retrieved from

http://learn.liberty.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=/webapps/blackboard/execute/courseMain?course_id=_84344_1   

Cisney, J., Ellers, K. (2007). Lost grievers: Helping people through unrecognized losses.American Association of Christian Counseling.  

 

Everstine, D.S., Everstine, L. (2006). Strategic interventions for people in crisis, trauma, and Disaster. (revised ed.). New York, NY: Routledge

Feldman, R. (2014). Development across the life span. (7th ed.). Upper Saddle River, NJ: Pearson Education Inc.

Herbst, D. (2008). Relational healing journal. Lewisburg, PA: Bethesda Publishing. This information can be retrieved from www.bfsf.org

 

Hoff, L.A., Hallisey, J., Hoff, M. (2009). People in crisis: Clinical and diversity perspectives(6th ed.). NewYork, NY: Routledge

Kanel, K. (2007). A guide to crisis intervention. (3ed ed.). Belmont, CA: Cengage Learning.

Maltby, L.E., Hall, T.W. (2012). Trauma, attachment and spirituality: A case study. Journal of Psychology and Theology, 40(4), 302-312. Retrieved fromhttp://search.proquest.com/docview/1319455318?accountid=12085

 

Riegler, G.R., Reigler, B.R. (2008). Cognitive psychology: Applying the science of the mind.(2ed ed.). Boston, MA: Pearson Education Inc

Roehlkepartain, E.C., King, P.E., Wagener, L., Benson, P.L. (2006). The handbook of spiritual

development in children and adolescents. Thousand Oaks, CA: Sage Publications.

 Smith, M., Saisan, J., Segal, J. (December 2014). Attachment Issues and Reactive Attachment

Disorder: Symptoms, Treatment, and Hope for Children with Insecure Attachment. Retrieved fromhttp://www.helpguide.org/articles/secure-attachment/attachment-issues-and-reactive-attachment-disorders.htm      

World Health Organization (WHO). Injuries and violence: the facts. Geneva, Switzerland:

 

WHO; 2010. Retrieved from http://www.cdc.gov/injury/global/

Wright, H.N. (2011). The complete guide to crisis and trauma counseling. (updated &expanded).Bloomington, MN : Bethany House Publishing

Young, T. (2007). Responding to rape and sexual assault. American Association of Christian Counseling. Retrieved from liberty.edu