Ministry During a Time of Major or Sudden Loss. H. Norman Wright. Mozart. Misty Blue. Shadow. Aspen. Shaelyn. Norm and Tess. Princess, James and Tristen. Jacob and Alex. Case Study.
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H. Norman Wright
The parents as well as three siblings of a twenty-three-year-old woman came in for grief counseling. All were neat, well dressed and fairly quiet. The parents were first to speak about their daughter. They began with a description which characterized her as a quality young woman, their first born in the family. She was gifted in every area of her life and had a bright future ahead of her.
The parents went into great detail about her abilities and accomplishments, stopping every now and then because of their inability to talk. Often all five were in tears. Two weeks prior she and her seven-month old unborn child and her mother-in-law were driving on a freeway when a truck struck and killed all of them. Since that time every member of this family has been struggling.
1. How would you begin this session? Describe your exact words.
2. What would be your goal in this initial session?
3. What would you say or ask to engage the three siblings?
4.What would you want them to take away from this session in a tangible way?
5. Based on this information identify all the possible grievers.
6. What are the factors which contribute to this loss being a complicated grieving process?
1. After greeting each person I would validate the fact they have experienced a great loss in their life. If I didn’t know already I would ask the name of the daughter as well as the mother-in-law and whenever I made reference to either I would use their name rather than refer to them in a general way. One of the first questions I ask is, “Tell me about (the daughter) and have each of the family respond.
Too often children are left out of the interaction. After each has responded my next question is, “Would you describe for me what the last two weeks has been like” so each has a chance to tell their story. Within this I often ask how they heard the news and to describe their reaction.
2. My goal is to have them tell their story and then normalize for them what they are experiencing and educate them about grief and what to expect in the future (using the handout on the “Crazy Feelings of Grief”). I’d also want to find out about their support system as well as giving some suggestions to eliminate the pressure of other individuals.
I also mention that each of them may grieve in a different way and with a different intensity. That’s all right and it’s not a sign that the other person doesn’t care if their grief is less intense. I ask, “How can the other family members support you at this time?”
3. Some of the questions directed toward the parents could be asked of the siblings. I also let everyone know that I would be willing to meet with each one individually. One reason for this is the deceased was described as a “special gifted” individual but was she in the eyes of the siblings? Sometimes even in the initial session I ask for a favorite memory from siblings.
Some may have a mixture of feelings. At some point I would ask the parents and siblings alike if there was any unfinished business or issues between them and the deceased or if there was something they wished they could have said to her before she died. If so, I would suggest writing a detailed letter and reading it aloud at the place of internment.
4. I would like each one to believe there will be help for all of them during the months and years ahead of them. Any suggestions or recommendations made need to be put in writing such as the list of “Crazy Feelings of Grief,” etc. I would give each one a copy of Experiencing Grief as well, and suggest they read it when they’re ready. I also let them know that it is normal not to remember what they read at this time. I send home a DVD called Tear Soup and ask them to watch this together.
5. There are two other family members who were lost as well. It would be easy to ignore them and gloss over this loss. I would ask about them as well as the effect this loss is having. For the parents, the loss is a grandchild which is major.
The possible grievers would include husband, aunts, uncles, cousins, friends, fellow workers, pastors, church, ob gyn, husband’s family, grandparents, truck driver, first responders and similar group of individuals. It’s important to consider who will minister to them and how. One of our tasks is to identify neglected grievers and reach out to them as well. Sending or giving them Experiencing Grief as well as making available copies of the Tear Soup DVD has been helpful.
6. Not only was this a sudden death but it was multiple tragedy involving someone’s child and unborn grandchild. There could be the possibility of legal complications because it was a vehicular accident. The way in which the notification was made could be a factor as well. (Refer to the section on sudden death for additional information).
Death of an ex-spouse
2. List the essentials and the non-essentials
3. List what I know how to do and what I don’t
4. Help them handle the advice of others
5. Help them handle the holidays
6. Explanation letter – Change monthly or quarterly
7. Identify safe people
8. Set up a team of people – Different each month
10. Handle the feelings
The “crazy” feelings of grief are actually a sane response to grief. The following examples are all symptoms of normal grief:
When you lie down you shall not be afraid; yes, you shall lie down and your sleep shall be sweet. Be not afraid of sudden terror and strong, nor of the stormy blast or the storm and ruin of the wicked when it comes [for you will be guiltless], For the Lord shall be your confidence, firm and strong, and shall keep you foot from being caught [in a trap or hidden danger]. Proverbs 3:24-26, AMP
You will not be afraid when you go to bed and you will sleep soundly through the night. Psalm 3:5, Good News Bible
If I’m sleepless at midnight, I spend the hours in grateful reflection. Psalm 63:6, The Message
When my anxious thoughts multiply within me, Your consolations delight my soul. Psalm 94:19
I will lie down and sleep in peace, for you alone, O Lord, make me dwell in safety. Psalm 4:8
In a dream, a vision of the night
When sound sleep falls on men,
Then He opens the ears of men,
And seals their instruction. (Job 33:15-16).
We give thanks for the darkness of the night where lies the world of dreams. Guide us closer to our dreams so that we may be nourished by them. Give us good dreams and memory of them so that we may carry their poetry and mystery into our daily lives
Grant us deep and restful sleep that we may wake refreshed with strength enough to renew a world grown tired.
We give thanks for the inspiration of stars, the dignity of the moon and the lullabies of crickets and frogs.
Let us restore the night and reclaim it as a sanctuary of peace, where silence shall be music to our hearts and darkness shall throw light upon our souls. Good night. Sweet dreams. Amen
Michael LeuingA Common Prayer
“Deposits of unfinished grief reside in more American hearts than I ever imagined. Until these pockets are opened and their contents aired openly, they block unimagined amounts of human growth and potential. They can give rise to bizarre and unexplainable behavior which causes untold internal stress.” Robert Cavanaugh
Your Block – Who is There?
Working in the Community
What are the losses? Have you asked? What has been taught on loss?
What has been taught on grief?
What has been taught on how to help others?
Is the teaching incident or situation prompted or purposefully done to prepare and equip the congregation to handle their losses and be a caregiver on their block and at work.
Is there a special ministerial care team to provide ongoing two year support to grieving families? Pastors need this help.
What to Say and What Not to Say
“Conversations that Count” from San Joaquin Hospital
What to Say and What Not to Say –
printout for each member of the congregation
download from web
always have books available
1. Develop Spiritual and Emotional Caregivers
2. First Response Team in the Church
3. Grief Coaches
5. Grief Recovery DVD series
6. Grief Share
7. Memorial Day or Remembrance Day
8. Your Calendar
9. Care Partner MINISTRY
10. Help the Christian Schools Develop a Plan
11. Cards to Families on Obituary Page
12. Let Others Tell Their Stories— from the pulpit and in the class
1. Real or Material
First loss as a child
Many are replaceable which could mask the grief reaction
—Love —Hope —Ambition —Control – Loss of Face
We think…the other no longer loves us
Elderly woman complains children have abandoned her – Expectations
4. Relationship Loss
The end of an opportunity to relate—death, divorce, moving, end of friendship
5. Intrapsychic Loss
Losing an image of oneself
Losing what “might have been”
Death of a dream
Loss of Face - Shame
Questions to ask:
“Has the way in which you view yourself changed recently?”
“Could it be that a dream you had or some plans have gone by the wayside?”
6. Functional Loss
Sometimes good health is not a blessing but a curse—What if you’re in good health and active and you’re 80 and your wife is deteriorating mentally with Alzheimer’s and what if most of your friends, your siblings and others that you know that you used to do things with are in deteriorating health or have died? Where does that leave you?
God grant me the senility
To forget the people
I never liked anyway,
The good fortune to run into the ones I do,
And the eyesight to tell the difference.
Questions to ask:
“What physical changes may have occurred in your life in the past five years that may have been a significant loss for you?”
7. Role Loss
Questions to ask:
8. Systemic Loss – Child leaves home; fellow-worker;
family from your church; pastor leaves
Questions to ask:
9. Threatened Loss
10. Ambiguous – Variations - 2 Main Types
Deployment, adoptee’s search for parents, MIA, The World Trade Center, strike, Alzheimer’s – Abortion
Childhood abandonment – Physical & Emotional – The loss of childhood from physical and/or sexual abuse – Family member in jail, Chronic illness
Questions to ask:
“Is there any kind of loss that you’ve experienced that doesn’t make sense or you can’t seem to get any closure over?”
Ambiguous loss is the most devastating – Why?
1. The loss is confusing – doesn’t make sense and you can’t problem-solve.
2. You can’t adjust to the loss so the family freezes in place.
3. Family is denied the rituals that support a real loss.
4. It reminds you that life isn’t fair.
11. Disenfranchised Grief
…the grief that persons experience when you incur a loss that is not or cannot be openly acknowledged, publicly mourned, or socially supported.
Three types of Disenfranchised Grief:
The relationship is not recognized
The loss is not recognized.
The griever is not recognized.
0 3 4 5 7 8 10
Died Died Broken Arm
Couldn’t Play Soccer
To Attend Funeral
0 3 4 5 10
Counselor: I’ll let you begin where you’re comfortable, Eve.
Eve: This is a bit of a recent loss. (pause) In November, November 5th I lost a very, very close friend. It was from the swine flu. It was a very sudden loss, unexpected. And we had recently had a disagreement. So I blame myself. Somehow I felt responsible, so that made it harder, because I wasn’t there to encourage proper medical care and that sort of thing. (speaking slowly and softly)
Counselor: So you’re taking on some real responsibility for this person’s death.
Counselor: And what was this person’s name.
Eve: His name was Warren.
Eve: And they didn’t go to the doctor soon enough and I felt like that was the reason that he died. So it’s been very difficult. I can’t… I know logically I’m not responsible, but internally I was thinking, I keep telling myself, “If only this…” I reenacted making contact in time to say, “Oh, are you sick? You should go to the doctor.”
Counselor: So your mind is telling you one thing, but your heart seems to be overriding that and you’re taking on that responsibility? (tentative)
Eve: I am
Counselor: And when you reenact this in your mind, how does that leave you?
Eve: Oh, I feel terrible. I feel so guilty, I feel lost and sad. I started to get migraine headaches. I realized was punishing myself each time I’d think it.
Counselor: How long did you know Warren?
Eve: Probably 32 years
Counselor: So it was a long relationship?
Eve: A long friendship…very long friendship. Very long (voice trails off)
Counselor: And you’re thinking if we haven’t had this riff then I could have saved him.
Eve: Right, I had tried to get back in touch but by then I didn’t know he was sick. I actually heard about it accidentally. Someone who knew I knew him said, “You know Warren’s in ICU how’s he doing?” I said, “Oh, I don’t know.” I was in shock, I couldn’t believe he’d had been there for 17 days before I heard. And he was all alone during his illness part. So, waited to go to the doctor to the last minute to go to the doctor and it was too late.
Counselor: You’re thinking I could have prevented this from happening.
Eve: Yeah, I think that over and over and over. And I know he probably wouldn’t have ever listened to me. He was a very stubborn person, very stubborn because his son was living with him and he wouldn’t listen to anybody.
Counselor: So there were other people who probably encouraged him to go to the doctor.
Counselor: But he didn’t listen to them.
Eve: Well, actually just his son. He never let anyone at work know how bad he was, how sick he was. They just kept thinking he would be coming back next week. One of his co-workers felt guilty too because she was with him when she dropped him off and she knew how sick he was. But she didn’t have the kind of connection with him that she would call. Well, she got sick herself from the swine flu. And it’s been since November, it’s a little better, but suddenly it will come over me.
Counselor: It’s still heavy on your heart.
Eve: It’s so heavy, it’s so painful
Counselor: But you’re not certain he would have listened to you.
Eve: No, honestly I know he probably wouldn’t have. He’s very stubborn about going to the doctor about anything.
Counselor: Like many men
Eve: Yes, like many men (smiles)
Counselor: But still because of that connection you just wish, “I could have done something to help him.”
Eve: I feel so helpless. This is the worst part though. I never say anything to somebody. He had sort of a sharp way of saying things. It was part of him, everybody knew that. And I never said anything back. And this one time it was over something stupid. He made a comment about my car. I carry all my files. And he made some comment. And I said, “I don’t ever want to talk to you.” But it was a lot of things. I said, “I don’t want to talk to you anymore.” It hurt my feelings.
Counselor: It sounds like it was a build up, it wasn’t just what happened then.
Eve: So I said, “I never want to talk to you again.” I didn’t really mean it because I never say that to anyone. But then I thought he probably really believes it. So, then I was afraid to call him back. We didn’t speak ever again. It was so hard. I feel like he left the earth thinking that I never wanted to talk to him again. He was such a good friend.
Counselor: You had a lot of good times together.
Eve: We worked in a lot of different places together. He was a very great person. Just didn’t like to go to the doctor. I felt so helpless.
Counselor: It sounds like you still have some things you’d like to say to him. Have you written him a letter?
Eve: No, I haven’t. It’s an idea.
Counselor: Do you think it would help?
Eve: Yeah, I think it would.
Counselor: If you were to write it, what would you do with it?
Eve: Oh, I’d probably would read it out loud. That would probably help.
Counselor: Where would you read this?
Eve: I just heard they are getting ready to get his headstone ready. Maybe I could read it at his grave. It’s funny because I’ve been thinking about what to do to go there what would I do? In Judaism you leave stones to show that you have been there. And I was reading about it last night you know like an altar.
I have a stone from Israel. It’s a tradition that comes from many different places. And I have a stone that I have from when I went to Israel. He always said he wanted to go to Israel for the history. He didn’t have any belief system at all, in God. (takes a Kleenex) That would be a healing thing to read the letter.
Counselor: What would you like to say?
Eve: Just to thank him for being such a good friend. To tell him I miss him and that a lot of people miss him. He such a beloved person. To tell him I wish he hadn’t been so stubborn, but we know that was who he was. Just to put those feelings into words, give words to those feelings.
Counselor: Churning. They’re churning around a lot inside of you, aren’t they?
Eve: Just even talking I feel some relief. They come back. It’s seems that they come back all of a sudden.
Counselor: You also alluded to regrets. I wonder what you could do about the regrets.
Eve: Well I think the one thing was the regret. I rarely even speak to somebody if they have a bad temper - I think I won’t talk to them for a while. And I thought to make sure I never leave a friend without making sure that we’re still connected. Never say I won’t ever talk to you again. I don’t know why I said that.
Counselor: This is becoming sort of a learning experience?
Eve: To learn how important every moment is. And not to lose a chance to do some healing. And to make sure we reconnect with each other even when we’ve been upset in a moment. Never walk away from anyone whether I care about them or not, like Warren. Every person is important who comes in my path.
I don’t want to ever regret the thing about words. Not to put words out that are going to hurt. I do regret that. Because you don’t know if you’re ever going to see that person again. You just don’t know!
Counselor: And you really don’t fully know how he felt toward you after that either. I guess we all tend to assume the worst.
Eve: Oh, yes.
Counselor: Can you think of anything else you might be able to do that can help you at this time?
Eve: I think talking about this here and writing the letter. I need to reconnect with the woman who was with him when he got ill because she carried so much guilt, too because she didn’t go back and reconnect with him.. We’ve formed a bond and friendship together and because of that we can both share together. That’s been very helpful.
Counselor: The situation itself where you had the altercation with him, does it play over sometimes in your mind?
Counselor: I imagine when that happens it’s still pretty upsetting.
Eve: It still hurts
Counselor: What do you think about writing that out in detail in longhand?
Eve: Oh, I hadn’t thought of that. I have such rare altercations… Yeah, that would be good because it’s painful to think about.
Counselor: Sometimes those thoughts get stuck on a circular loop and they keep playing. And one of the best ways is just best to write it.
Eve: I like that idea. (pause) Yes, that would be good.
Counselor: Can you think of anything else you might be able to do?
Eve: Well, one of the things I am doing - that’s why I’m taking this class because I want to be able to help others. I’ve counseled for a long time but feel like I went right through the fire with this loss.
I lost my dad 11 years ago, that was hard and I’ve had the miscarriages, that was hard. Maybe part of this is I’m feeling I should have known. I’m mad at myself as a counselor, I should have known to do this differently. Just to give myself permission to be human, not to expect myself to know everything when I’m in a situation like this.
“Kind of feeling…”
“Sort of feeling…”
“As I get it, you felt that…”
“Sort of a feeling that…”
“If I’m hearing you correctly…”
“To me it’s almost like you are saying, I…”
“Sort of hear you saying that maybe you…”
“I’m not sure I’m with you, but…
“I wonder if you’re expressing a concern that…”
“Your message seems to be, I…”
“So your world is a place where you…”
A. Loss can strengthen our faith.
B. Loss can produce maturity.
C. As we suffer we enter more into the suffering of our Lord and become more Christ-like
D. When you experience loss you will discover the extent of the comfort of God.
But whatever things were gain to me, those things I have counted as loss for the sake of Christ. More than that, I count all things to be loss in view of the surpassing value of knowing Christ Jesus my Lord, for whom I have suffered the loss of all things, and count them but rubbish so that I may gain Christ, Philippians 3:7-8, NASB
Peter said, “Beloved, do not think it strange concerning the fiery trials which try you, as though some strange thing happened to you”
(I Peter 4:12, NKJV)
The Message translation puts it in a unique way: “Friends, when life gets really difficult, don’t jump to the conclusion that God isn’t on the job. Instead, be glad that you are in the very thick of what Christ experienced. This is a spiritual refining process, with glory just around the corner.”
A Biblical perspective – Purpose of Loss
“Consider it all joy, my brethren, when you encounter various trials, knowing that the testing of your faith produces endurance, “ James 1:2,3
Grief will take longer than you’ve ever imagined. It tends to intensify at three months, special dates and the one year anniversary.
Grief is a journey, a process and there is resolution. Hear the words of Scripture:
“I weep with grief; my heart is heavy with sorrow; encourage and cheer me with your words,” Psalm 119:28, TLB
“He heals the brokenhearted and binds up their wounds—curing their pains and their sorrows,” Psalm 147:3, AMP
“I cried to the Lord in my suffering and he heard me, he set me free from all my fears,” Psalm 34:6, NLT
“For You have delivered me from death, my eyes and tears, and my feet from stumbling and falling. I will walk before the Lord in the land of the living,” Psalm 116:8-9, AMP
“Then maidens will dance and be glad, young men and old as well, I will turn their mourning into gladness; I will give them comfort and joy instead of sorrow,” Jeremiah 31:13
“ ‘You will grieve but your grief will turn to joy,’” John 16:6
3. The body and the mind grieve. It is a full time job. Often the grief has symptoms erupt that imitate the cause of death of the loved one.
4. Grief is a wound that needs attention in order to heal. The mourning period is really a time of convalescence.
5. Grieving is relearning your world. We have to reshape our lives, reinterpret and redirect our life story and find our way back to purposeful, meaningful and hopeful life again.
Understanding and using the tasks of grief as your primary therapeutic approach
1) Through grief you express your feelings about your loss.
2) Through grief you express your protest at the loss
3) Through grief you express the effects you have experienced from the loss.
1) The person in grief needs to find the words for the loss.
2) Say the words aloud.
3) Know that the words have been heard.
“Grieving is a journey that teaches us how to love in a new way now that our loved one is no longer with us.”
“Consciously remembering those who have died is the key that opens our hearts, that allows us to love them in new ways.”
The words of grief are many and varied –
I need some help. My cousin’s cat had kittens and he was able to give away all but 3 of them. I told him I would help him find homes for the last 3. I can’t take any because I’m allergic, but if 3 of you could take just 1 it would be such a help and the kittens could have a nice home.
Since he lives up by the San Mateo Nuclear Power Plan I’ll go pick them up for you. I’ve attached pictures of the last 3 kittens. Will you help?
Some individuals are intuitive grievers. For them:
1. Feelingsare intensely experienced. They want and need to express them.
2. Expressions such as crying and lamenting reflect their inner experience.
3. These grievers need to express feelings in order to create successful adaptive strategies. For them feelings are vibrant, intense “colors.”
Some individuals are instrumental grievers.
1. They thinkof their grief more than feel it: Feelings are less intense.
2. There’s a general reluctance to talk about feelings
3. Instrumentals are often identified by the absence of crying and seeking help.
Some individual are blended grievers.
1. They have both elements but with a greater emphasis on one or the other.
From — Men Don’t Cry…Women Do, Martin & Doka
Job, having lost all 10 of his children, laments, “My days have passed, my plans are shattered, and so are the desires of my heart” (17:11). He concludes, “Where then is my hope? Who can see any hope for me?” (v.15)
Bildad, who probably had never had training in communications, could not simply receive Job’s words (18:2). He had to “correct” Job. Possibly while Job was lamenting, Bildad was composing a challenge:
When will you end these speeches? Be sensible, and then we can talk.
Bildad the Shuhite to Job, Job 18:2
What you can say
“A man has joy in making an apt answer, and a word spoken at the right moment, how good it is!” Prov. 15:23, AMP
“A word fitly spoken and in due season is like apples of gold in a setting of silver” Prov. 25:11, AMP
“Watch the way you talk… Say only what helps, each word is a gift” Eph. 4:29, The Message
The three most important steps to take in helping a person:
1). Listening with your eyes
2). Listening with your ears
3). Listening with your heart
James 1:19: Prov. 18:13
I am frightened inside; the terror of death has attacked me. I am scared and shaking, and terror grips me. I said, “I wish I had wings like a dove. Then I would fly away and rest. I would wander far away and stay in the desert. I would hurry to my place of escape, far away from the wind and storm.”
Psalm 55:4-8 New Century Version
How long must I wrestle with my thoughts and everyday have sorrow in my heart?
Psalm 13:2, NIV
It can strike anyone
Trauma leaves us feeling unsafe
It involves a loss
Trauma makes us feel overwhelmed
It is often unspeakable
Trauma can change or challenge our view of God
Trauma produces “hyper-arousal,” “hyper-alertness” and “hyper-sensitivity.”
Those traumatized often re-experience the trauma
It leads to feelings of helplessness
Trauma does not make sense
Trauma is the response to any event that shatters your world.
It’s more than a state of crisis. Trauma leaves you feeling unsafe because your place of refuge has been invaded
The word trauma comes from a Greek word that means “wound.” It’s a condition characterized by the phrase “I just can’t seem to get over it.”
1. Trauma’s a separation from safety.
—It’s invasive – invades all areas of our life
—It must be dealt with in a unique way for each one
2. It’s unpredictable – You think you’re dropping your child off at daycare or high school or your spouse goes to work or a parent boards a plane.
3. Every new trauma activates the old one. It taps into all the old stuff
4. Trauma means that nothing will be the same again.
5. Pain will not last forever – it will diminish.
6. Half to two-thirds of victims grow in a positive way.
—Develop a greater appreciation for life
—Deepen spiritual beliefs
—Build closer relationships
7. Those who recover
–They see the event as a challenge, not an overwhelming problem.
-They connect with people.
-They use their spiritual resources.
Persistent Intrusive Recollections
Self Medication – Substance Abuse
Dazed or Numb Appearance
Exposure to trauma that is repeated is more disabling as is those events that are unpredictable.
Violation by another person is always worse that an impersonal trauma. Complex trauma is premeditated and caused by others, usually someone known
Hidden traumas occur when the trauma has been repressed, when you live in an environment that is trauma blind.
In trauma there is two kinds of suffering, one is the trauma caused by the suffering living with the experience and the aftermath. And the second type of suffering is part of the healing process. This is the pain that was too overwhelming to feel before.
Traumatic events are like thieves that takes something from us.
When we encounter something that we feel threatens our life, a cascade of hormonal reactions is triggered.
Something happens deep inside our brains, too. Our right-brain alarm goes off and drowns out the logical analysis of our left brain. It screams, “Less thinking, more action!” It also starts taking pictures like mad—the nonadrenalin heightens the emotional aspects of the situation making it more vivid and notable. Very strong and clear memories are being recorded, probably so that we will remember this event and avoid it in the future.
What you experienced during the incident was so traumatic that your brain took special note of it, and anytime you approach a person, place, thing or experience that is similar to your original trauma, your right brain whips out its “photo album” and puts on an intense presentation (sights, sounds, smells, tastes) attempting to alert you of the danger that could be waiting there.
Remember, our left side is more like a “computer,” our right side is more like a “photo album.” This side remembers faces and craves rapport and relationship. It’s our emotional side. It is intuitive, spontaneous, experience-oriented, artistic, creative. It stores emotions. We dream on this side of our brain. And very importantly, this is the “alarm” side of our brain.
Your logical left brain gets muted, and the calming influence of your hippocampus gets pinched off. You’re off on a “re-experiencing” jaunt which, if your right brain would only listen, your left brain could explain why you didn’t need to take that detour today.
It’s important to invite Jesus Christ into the episodic memories of your trauma, visualizing Him experiencing it with you. Hopefully, you’ll be able to continue engaging in this spiritual exercise, giving Him more and more access to your places of pain and darkness and thereby bringing about some direct healing.
In this Step we want to encourage you – with Jesus’ help – to take action concerning the things that trigger your re-experiencing episodes. By now, you are probably well-aware of what your triggers are. In the space following, write down any people, places, things or experiences that trigger your re-experiencing episodes, and what the typical effect is (use additional paper if needed).
Golden retriever: “The sun is shining, the day is young, we’ve got our whole lives ahead of us, and you’re inside worrying about a stupid burned-out light bulb?”
Border collie: “Just one. And I’ll replace any wiring that’s not up to code.”
Dachshund: “I can’t reach the stupid lamp!”
Toy poodle: “I’ll just blow in the Border collie’s ear, and he’ll do it. By the time he finishes rewiring the house, my nails will be dry.”
Lab: “Oh, me, me!!! Pleeeeeze let me change the lightbulb. Can I? Can I? Huh? Huh? Can I?”
Cocker spaniel: “Why change it? I can still pee on the carpet in the dark.”
Australian shepherd: “First put all the lightbulbs in a little circle…”
Old English sheep dog: “Lightbulb? Lighbulb? That thing I just ate was a lightbulb?”
Chihuahua: “YoQueiero Taco Bulb.”
Begin by developing an atmosphere of safety, trust and exploration. Just talking and listening with your eyes and ears is more important than techniques. “Tell me your story.” Honor their way of thinking and speaking. The more similar you appear to counselees the greater comfort the client will experience.
Comfort is vital (commonalities create comfort, differences produce distance, Schupp, 2003). If counselees are comfortable, they are more likely to discuss the trauma.
Decondition harmful affective responses. This critical step is much easier to state than to accomplish. Help them discover new ways of responding to difficult responses—reframe and reinterpret.
Reframe symptoms as “signs of coping ” and as “protective and healing mechanisms” and “normal” part of the recovery process.
The problem with traumatic memories tend to be their intrusion into the present, not an inability to recall them. When they intrude, discussing them and understanding how they may unconsciously influence our behavior can be helpful. At the same time, some people heal by fighting their fears and never discussing or explicitly recalling their painful memories at all. For people whose memories don’t negatively affect them in the present, pressuring them to focus on them may actually harm.
A. Intrusive thoughts are an attempt to make sense of the experience, the brain’s attempt to assimilate the experience. Not just let the experience go, but rather make sense of it; flashbacks/ nightmares are access routes to memory. Flashbacks is a way the brain is attempting to heal itself. It’s the mind’s attempt to make sense of what happened. What can be done about intrusive thoughts or flashbacks?
B. Denial/numbing are ways that the mind takes a “time out,” as a way of “dosing” or of “pacing” oneself so you only have to deal with so much stress at one time.
C. Dissociation at the time of the event was a potentially useful skill. Speak of the “wisdom of the body,” e.g., “mind is taking time out from overstimulation”’ “denial is one of nature’s small mercies.”
D. Convey that the “survival skills” that the client once used and were adaptive at the time may no longer be appropriate.
E. Commend the counselee for being distressed. The counselor might say something like the following: “Given what you have been through, if you didn’t have stressful reactions, weren’t depressed, had a short fuse at times, dwelled on what happened (use counselee’s symptoms), then I would be really concerned.
F. Indicate that PTSD is definitely responsive to treatment and that healing can be a lifelong process. Convey to the counselee that symptomatology may not go away complete, nor forever.
G. Indicate that it is possible that symptoms “may get worse before they get better” as we discuss and work through what happened and why, as we begin to refocus on the trauma.
H. Finally, “although this may be difficult to believe right now, you may even find that there will be some positive benefits to you and your life as a result of the experiences you have had and your willingness now to face and work through what you must work through.”
Re-exposure to the trauma is critical, as is how and when the person is re-exposed. Research with all trauma survivors indicates a principle that the individual must mentally revisit the traumatic experience again—but with the supportive assistance of someone who can help them through their fear.
When they write longhand it’s a tactile memory. It involves better hand/eye coordination and accesses all parts of the brain to help bring it together.
Battling illness and pain with pen and paper may be unorthodox, but it may also spell relief. “People who write for twenty minutes a day about traumatic events reduce their doctor visits, improve their immune systems and, among arthritis sufferers, use less medication and have greater mobility,” James W. Pennebaker, Ph.D, professor at the University of Texas at Austin.
Why the relief? Suppressing negative emotions can weaken the immune system and arouse your fight-or-flight system, churning up blood pressure and heart rate…Writing about conflict or trauma helps organize the experience. The net affect is that people can move beyond the stressful event. How?
Replace problematic behavioral responses with adaptive behaviors. Teach the person how to make positive changes. “Remember you can write the last chapter of your trauma. It hasn’t been written yet.”
Build a new internal self-view. Understanding the meaning of past trauma to the individual, which is Step 2, will help you understand what the post trauma self-image is. “Don’t define yourself permanently as a traumatized person. Teach them when to remember the trauma instead of the traumatic memories being in charge.”