Thinking About PTSD (Post Traumatic Stress Disorder)…..What Would Jesus Do?
Another Christian counselor and I were discussing PTSD recently. We were observing how often it tends to be thought of in the context of combat-experienced veterans. But, as he and I talked, it was clear that there are a number of other situations in which PTSD is observed…..particularly among victims of childhood sexual or physical abuse. But any number of other traumas can be responsible for setting up the psychological/ emotional scenario for it to manifest.
Information on the Mayo Clinic website notes:
“Post-traumatic stress disorder symptoms may start within three months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships.
PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.”
As our discussion continued, we focused on how to deal with PTSD’s intrusive memories and the accompanying emotional distress. Part of our conversation focused on forgiveness, as the causative traumas often have an actual or perceived perpetrator. Even acts of God or accidents may have perceived causative agents who are blamed or the victim may blame herself.
He and I shared our respective research and observations about the ability of a victim to find peace and extend forgiveness if the act of forgiving is focused on its benefits to the victim and not on one’s desire to obtain repentance or restitution from the perpetrator, or to see justice done with regard to the harm.
That led us into an interesting discussion about the relationship of forgiveness to reconciliation and repeated offenses by the same person or by the same class of people, i.e. an offending archtype.
Anyone who is biblically literate will likely remember Peter’s query to Christ regarding forgiveness and Christ’s response from Matthew 18:21-22:
Then Peter came to Jesus and asked, “Lord, how many times shall I forgive my brother or sister who sins against me? Up to seven times? Jesus answered, “I tell you, not seven times, but seventy-seven times.” (Some translations say “seventy times seven…..implying indefinitely or as long as necessary.)
In that moment it occurred to me that, especially in regard to helping clients with PTSD, Jesus’ response is exactly right and quite understandable. If one has been traumatized and experiences intrusive memories, either spontaneously or when triggered by sensory activation of specific “memory hooks”, then the painful emotions tied to that memory will rise up afresh with each memory activation. And although one may have intellectually desired to forgive, committed to forgive, and willed herself to forgive, the fact that there is a PTSD memory hook that may be triggered repeatedly until effectively healed will require forgiving over and over and over again…..not because of repeated abuses or additional traumas, but simply because of the power of the memory hook and the emotions associated with it that are triggered again and again. The willingness and exercise of will to forgive will have to be repeated within one’s heart and mind every time the memory rises up. This is most likely the experience to which Jesus is referring. Although one might be placed in harm’s way repeatedly, even as many as seven times in the case of some abuses, it is not likely that one would continue to be exposed to the same harm for 77 or 490 or any other number of times. One would hope that an individual would have enough of a self-protective instinct to remove herself or the arrival of a protector who would rescue him or her from extensive repetitions of a traumatic abuse. But the memory and the emotions hanging on that memory hook, from even a single traumatic event, can be incited over and over and over again…..indefinitely, with little or no repeated traumatic actions. That unwelcome and intrusive memory and its painful emotions would conceivably put one in a position of having to forgive the offender (even including oneself) every time the memory arises.
There are some situations, as in the case of Jewish bigotry against Samaritans, in which there might be persistent repeated offenses that are culturally perpetrated not specifically against an individual but against all persons who are part of an identifiable demographic class, either by direct action, stigmatization, or slight. In such cases as that, the number of times one feels the pain of trauma from bigotry….actual, perceived, or remembered….could be repetitive, frequent, and seemingly endless. Again, Jesus’ words would direct forgiveness with every conscious rising memory of the pain of bigotry in one’s heart and mind.
This response by Jesus is difficult to embrace, perhaps even more so in the case of bigotry that is ongoing, no matter how non-specific or subtle, than in the case of PTSD that tracks back to an historical traumatic event or period in one’s own life. But it certainly seems clear in scripture that “backwoods” Galileans like Jesus and most of his disciples were, in fact, subjected to such cultural bigotry by the more cosmopolitan Hellenistic Jews and the occupying Romans…..perhaps not as blatantly as that experienced by the Samaritans, but it is there in the record nonetheless.
Jesus knew what was in people’s hearts….not only their motivations, but also the woundedness of their spirits. His standard for forgiveness certainly rises to the level of godliness…..and is one that we are directed to follow. We cannot accomplish that without embracing Jesus’ example of humility and surrender to the will of the Father. It still doesn’t mean that we are required to grovel before our abusers, continue to allow ourselves to be abused, or even allow them back into our lives or trust them….ever. But we do need to be able to forgive them and pray for their salvation and sanctification. And, in as much as it is up to us…..be at peace one with another.
When I am doing a spiritual biopsychosocial interview I ask a lot of questions. One question I ask is about prior mental health evaluations and results. “I have no mental health diagnoses,” a woman said. Yet, as we talked about certain times of her life, events, or people tears welled up and there was obvious anguish in her demeanor. The tears seemed to surprise her…..she had not realized how close to the surface the pain of the memory of certain circumstances was. That is indicative of a problem that has not been dealt with……PTSD that is resulting from a memory that has the power to emotionally transport one back to that time and place. Trauma-informed and sensitive care is not always provided for those who are suffering. The professionals evaluating them do not spend the time questioning enough outside the bounds of the current problem. This happened three times in two days as I talked to women whose lives are disordered in one way or another. God’s Holy Spirit uses the Word to discern the heart and go right to the point of pain. When one recognizes and confronts the pain that still exists and has the support and counseling to deal with unresolved grief, anger, and confusion she can find peace, forgiveness, and acceptance that can put a lot of other things like anxiety, impulsiveness, and self-sabotage to rest.