PTSD and Spirituality

Running head: PTSD AND SPIRITUALITY 1

Rex Wooddell

Liberty University Online

Crisis Intervention

CRIS 304

Robert Friberg PTSD AND SPIRITUALITY 2 PTSD and Spirituality

Abstract

PTSD has been a very common phrase that we have heard since the Iraq War, and unfortunately it has become a label for certain behaviors that exist, but in the realm of labeling something or someone with PTSD, there seems to still be some major questions about treating

PTSD. To begin to understand PTSD, you have to first look at the fact that a trauma has occurred. Many families are struggling with this because they just don’t understand what is going on when their loved one comes home. It is the intent of this research paper to examine more closely at the information available, it is also intended to address spiritual care as it pertains to PTSD. PTSD AND SPIRITUALITY 3 I want to first look at PTSD in an illustration of an Octopus, I know you may think I’m a little crazy, but here is my point, if you look at PTSD in the shape of an Octopus, the body, or the center of the Octopus is where all the power is, and it has many legs that are attached to that power, and those legs can cause some serious damage. I wanted to first put that picture in your mind because, PTSD is kind of like that as well, the root source is a traumatic experience, and that trauma reaches into all areas of our life. When we talk about PTSD, we also have to talk about other things associated with it, and what it is not, PTSD is not a mental illness, although it has been said that people with PTSD may have earlier conflicting factors that have made the experience with PTSD worse. For technical purposes, we have an actual definition of PTSD from the DSM. Diagnostic criteria for 309.81 Posttraumatic Stress Disorder: “A. The person has been exposed to a traumatic event in which both of the following were present: (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, (2) the person’s response involved intense fear, helplessness, or horror. B. The traumatic event is persistently re-experienced in one (or more) of the following ways: (1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. (2) Recurrent distressing dreams without recognizable content. (3) Acting or feeling as if the traumatic event were recurring. (4) Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. (5) Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. C.

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before trauma), as indicated by three (or more) of the following: 1. efforts to avoid thoughts, feelings, or conversations associated with the trauma, 2. efforts to avoid activities, places, or people that arouse recollections of the trauma, 3. inability to recall an important aspect of the trauma, 4. markedly diminished interest or participation in significant PTSD AND SPIRITUALITY 4 activities, 5. feeling detached or estranged from others, 6. restricted range of effect, (unable to have loving feelings), 7. Sense of a foreshortened future, (does not expect to have a career, marriage, children, or a normal life span) D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: 1. difficulty falling or staying asleep, 2. irritability or outbursts of anger, 3. difficulty concentrating, 4. hypervigilance,

5. exaggerated startle response. E. Duration of the disturbance (symptoms in Criteria B, C, and

D) is more than 1 month. F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. (DSM-IV-TR (2000), pp. 467-

468) There has been some people associate PTSD with Acute Stress Disorder, the difference however, is that an acute experience is only about 1 month after exposure, and less than 3 months. Because trauma is at the center of PTSD, it is important to give a better description,

“Trauma is the response to any event that shatters your safe world so that it’s no longer a place of refuge. Trauma 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-where you feel powerless” (Wright, N. (2011), p.189) as I stated earlier, we need to talk about other things associated with PTSD; some of those other things are depression, survivor guilt and grief. “Depression is a medical illness that causes a persistent feeling of sadness and loss of interest, also called major depression, major depressive disorder and clinical depression, it affects how you feel, think and behave. Depression can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn’t worth living” (www.mayoclinic.com)

It becomes very interesting to note that some of the symptoms of depression have similarities to PTSD, which is why it can be considered as one of the side effects of PTSD. Grief is another topic that needs to be addressed, “Grief is a transformational multidimensional, and unique experience; no two people experience grief in exactly the same way. Although grief is often conceptualized as a response to death or dying, persons may also struggle with grief in the PTSD AND SPIRITUALITY 5 wake of divorce, termination from work, loss expectations, and lost dreams” (Clinton, T. &

Hawkins, R. (2011), p.393) Survivor Guilt is one of the more serious side effects of PTSD, it is because Survivor Guilt has also been linked to suicide, especially among our veterans. “There are two types of survivor guilt: existential survivor guilt and content survivor guilt. Existential survivor guilt refers to feelings you have about staying alive in situations where others died or about being less injured or harmed than others. Content survivor guilt refers to guilt feelings about something you did, thought or felt in your efforts to stay safe and protect yourself from psychological or physical harm” (Matsakis, A. (1999), pp. 39-40) The compounding evidence of suicide among our service members has grown to get the attention of a high ranking general,

“It’s safe to say, then, that the suicide rate among service members and the nation’s youngest veterans-the men and women returning from deployments in Iraq and Afghanistan- is, as of July

2012, dramatically higher than that of other Americans, a fact that prompted Army Vice Chief of

Staff Gen. Lloyd James Austin III, in a statement released in August, to call suicide “the toughest enemy I have faced in my 37 years in the Army”

(www.defensemedianetwork.com/stories/prweventing-military-suicides)

By now, it may seem a little confusing that I have talked about other things that are not directly PTSD, but are related in some way, there is a reason for that, we are wanting to look at the spiritual implications that can be applied to PTSD, and this line of thought and subject matter that has been presented in hopes bringing to light, something that has been called “The Silent

War”, this is a reference to PTSD, but it is more than a reference, anyone who struggles with

PTSD, has also battled this “Silent War”, because for many victims of PTSD, they feel like they can’t talk about what has happened to them, either they will be judged, or people may blame them or not understand what they went through, or they just don’t know how to talk about it, but the war still rages on inside that person, that is why it is called “The Silent War” A person’s own spiritual walk, in many ways is a silent war also. There are many aspects of PTSD that can be PTSD AND SPIRITUALITY 6 discussed in clinical and medical terminology, but what about things that feed into PTSD from the home life and family settings? It is always hard on the kids on wives when the husband and dad has to go away, but the war at home has its own consequences too, one of those consequences is divorce or infidelity. There was a study conducted and titled “Veteran Status,

Marital Infidelity, and Divorce”, from this study that was done, we find these quotes, “The study, based on data from a 1992 national survey, found that more than 32 percent of ever-married veterans reported extramarital sex, which is about twice the rate among ever-married non- veterans (16.8 percent), the results of this study provide evidence that the concerns about infidelity among spouses of persons who have served in the military are to a considerable degree valid, said Andrew S. London. The study also found that among those who had ever married, veterans were almost 10 percent more likely to have gotten divorced (38.5 percent compared to

28.9 percent) (www. asanet.org) The shift of emphasis I want to communicate here, is just one dimension of what is a Spiritual Warfare, it shows itself in PTSD, and the side effects of grief and guilt and suicide, and destroyed families through the lies of infidelity and sexual sin. This has given way to find a deeper meaning of Compassion Care and something that is called “Soul-

Care” PTSD is very treatable, there have been treatments that have proved to be successful,

“Soul-Care” is a term many people may not be familiar with. “The world of Christian soul care covers the gamut of helping approaches. There will be differences in our approaches, goals, training, and expertise, but the work we do will be similar in commitment to bring honor to Jesus

Christ and helping each counselee find peace direction, and stability that are ultimately found in

Him” (Clinton, T. and Ohlschlager, (2002), p.15) Another therapy that coincides with Soul-Care, is the power of prayer, which had some interesting results to show. Fueled by a desire to search out alternative medicine, the term, “CAM” came about. “Complementary and alternative medicine, (CAM), the results; “Sixty-two percent of adults used some form of CAM therapy during the past 12 months when the definition of CAM therapy included prayer specifically for PTSD AND SPIRITUALITY 7 health reasons. A couple of CAM the therapies used during the past 12 months were; use of prayer specifically for one’s own health (43.0%), and prayer by others for one’s own health

(24..4%)”, “Seventy-five percent of adults age 18 and over have ever used CAM when prayer specifically for health reasons was included” (Barnes, P. M., Powell-Griner, E., McFann, K. and

Nahin, R. L. (2004) In a world where prayer has been shut out of multiple areas of the public arena, this has some encouraging evidence of how a spiritual connection has major health benefits. Two treatments for PTSD have become quite popular because of the positive outcomes; they are Cognitive Behavioral Therapy, (CBT) and Eye Movement Desensitization and

Reprocessing, (EMDR). What is CBT? “Cognitive Behavioral Therapy (CBT) is a form of treatment that focuses on examining the relationships between thoughts, feelings and behaviors.

By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping” (Duckworth, K and Freedman, J. L., 2012) “A growing number of studies have indicated that eye movement desensitization and reprocessing (EMDR) can be very effective in the treatment of PTSD. Dr. Bessel van der Kolk, a Boston University and Harvard psychiatrist and leading PTSD authority, has observed that encouraging studies indicate that EMDR seems to be capable of producing powerful therapeutic effects in some patients with PTSD” (Schiraldi, G. R.

(2009), p.211) What we are talking about with EMDR, is that many soldiers can suffer from their memories being frozen in their mind around a particular event, or many different events, and when this happens, the eyes can become frozen and people can look like they have a distant blank stare. The benefits of EMDR, is that disturbing memories are confronted, with the help of a therapist, and new thoughts are introduced while holding onto that memory, and the therapist helps the patient do a series of eye movements, what this does, it allows electrical stimulations to move back and forth between the brain and the eyes, (a kind of reprograming or reprocessing). In an earlier description of the problems of PTSD, I had said that one of the problems was having a PTSD AND SPIRITUALITY 8 problem falling asleep or staying asleep, in a normal functioning person, when they fall asleep and start dreaming, many people enter into a state of “REM” (Rapid Eye Movement) while they dream and sleep, it is my belief that PTSD disrupts this process of REM. I hope it is becoming more clear as we talk about PTSD and Spirituality, that the path of emphasis I have chosen in this research is what would be considered a “Holistic” approach, which is defined as

“Emphasizing the importance of the whole and the interdependence of its parts” (American

Heritage Dictionary) The holistic approach allows to investigate the effects of a relationship with the Lord Jesus Christ as it pertains to someone’s mental, physical, and spiritual health, and we can’t truly do that until we look into His word and see what He says about us, our lives and His commitment to us. Psalms 34:7 “The angel of the Lord encampeth round about them that fear him, and delivereth them” Psalm 34:9 “O fear the Lord, ye his saints: for there is no want to them that fear him” Psalm 34:15 “The eyes of the Lord are upon the righteous, and his ears are open unto their cry” Psalm 34:17-18 “The righteous cry, and the Lord heareth, and delivereth them out of all their troubles. (18) The Lord is nigh unto them that are of a broken heart; and saveth such as be of a contrite spirit” (Holy Bible, KJV) PTSD AND SPIRITUALITY 9

Conclusion:

It would almost be impossible to include every scripture in God’s word that shows His love and mercy for us, and how many times He is there to rescue us from our troubles. PTSD and

Spirituality is not going to be a popular subject in the media, because our present media only focuses on pain and suffering and victim mentality, what a world it would be, if every man woman and child could know they could be set free from all their burdens, they just need to believe and ask. Part of the reason why Spirituality is so important in matters like PTSD, is because the problems of man are all too prophetic, man is constantly be faced with the reality that he is the “Fallen Man”, we have been products of the Fall ever since the Garden of Eden, and the pain and suffering we go through only point to two things, 1. We are disunited from our

God as a race and a nation, 2. We are ever constantly being reminded that we need to be redeemed, and our only source of redemption is in The Lord Jesus Christ, man left to his own devices can only count on pain and suffering and receiving the fruit of his ways. I applaud the advances in medical knowledge and the new developments in the mental health field, but how PTSD AND SPIRITUALITY 10 much healing can be accomplished without man recognizing his God? I cannot answer that, because to me, He is the source of all healing.

References

DSM-IV-TR, (2000)

Clinton, T. & Hawkins, R. (2011), The Popular Encyclopedia of Christian counseling

Clinton, T. and Ohlschlager, G. (2002), Complete Christian Counseling, volume one

Matsakis, A. (1999), Survivor Guilt, a self help guide

Wright, H. N. (2011), The Complete Guide to Crisis & Trauma Counseling

Schiraldi, G. (2009), The Post-Traumatic Stress Disorder Sourcebook, second edition

Barnes, P. M., Powell-Griner, E., McFann, K. and Nahin, R. L., Advance Data from vital

and health statistics, number 343, May 27, 2004, www.cdc.gov/nchs/data

Duckworth, K. and Freedman, J. L. (July 2012), National Alliance on Mental Illness,

(CBT), www.nami.org

www.asanet.org, Study: Extramarital Sex and Divorce More Common Among Veterans

www.mayoclinic.com, Depression

Holy Bible, (1996) Oxford University Press, King James Version

ahdictionary.com, Holistic

www.defensemedianetwork.com/stories/prweventing-military-suicides