PTSD and the Bible

This is a bit off-track as far as topics I normally put on this blog, but I have never sought to define appropriate topics too narrowly.

Years ago, I wrote a little article for our counseling center’s journal entitled, “Divine Intervention: The Flight of Elijah in Dialogue with Crisis Care.” You can see the article HERE.

I noted the story of God’s dealing with Elijah in his escape from Samaria to Mount Horeb. I noted the similarity between God’s response and the three step process used in crisis care, especially the NOVA system (Safety & Security, Validation & Ventilation, and Planning & Preparation).  But part of the paper was also suggesting that Elijah’s flight was not an act of faithlessness, or of weakness. Rather it was a stress-overload, such as in burnout. (I don’t feel the need to justify people’s actions in the Bible. Many “heroes of the faith” act in ways quite sinful or foolish. I don’t however, see that being true of Elijah in this case. Elisha, the youths, and the bear— well, think that is a different matter.)

Recently, Fr. Ernesto Obregon wrote an article. Actually it is part of a doctoral course project. He quoted me quite a bit in it (which is always nice… at least when it is done in a positive way). His thesis is related, but a bit different. He is looking at the diagnosis of PTSD (Post-traumatic Stress Disorder). He suggested that the story of Elijah here could be seen as an account of PTSD.

In a sense, it doesn’t matter. However, PTSD has only being a formal diagnosis since 1980, and earlier iterations (Battle Fatigue or Shell Shock) only go back to around 1915). As such, the question can come up as to whether it is a valid condition to speak of at all.

Some Christians question any condition that is not specifically noted in the Bible. This may not make a lot of sense (does one have to find reference to cell phones in the Bible before believing they exist?). Regardless though, being able to identify the condition in antiquity places the condition more firmly as a part of the human condition, rather than simply as a culthural phenomenon.

Anyway, it is an interesting read, I think.  You can read it HERE

(Don’t be thrown off by his referencing the book of Third Kings (III Kings). He comes from the tradition of Orthodox Christianity.)

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Thoughts on Joshua 24:31

I was listening to a Carey Nieuwhof podcast (CNLP 134) interviewing Carl George and Warren Bird. One statement struck me and then I lost the train of the interview as I mulled on that. My internal monologue/dialogue tends to be louder than my laptop speakers.

They were talking about how many church leaders take seriously training up the next generation of leaders. However, relatively few take seriously training leaders to train up the successive generation of leaders.

I have seen a great amount of this problem.  Consider the following diagram:

Leaders

George and Bird noted II Timothy 2:22, and that the goal of training and leading is not simply to develop the next generation, but to develop the next generation TO develop the generation afterwards.

Even the first step is difficult to focus on. In the figure above, the left side feels right. We have seen many examples of this in the Bible. Jethro had to pressure Moses to develop leaders. The book of Judges appears to be a big collection of leaders who led without developing the next generation. Eli would have developed no one if God did not intervene with Samuel. Samuel would have developed no one unless God (or was it the people?) intervened with Saul. Elijah would have developed no one if God did not intervene with Elisha.

But some embrace the right side of the figure above and DO develop leaders. But often they develop a different kind of leader. The type of leader they develop is not trained to develop leaders. When I was listening to the podcast the first thing I thought of was the end of the book of Joshua.

Israel served the Lord throught the lifetime of Joshua and of the elders who outlived him and who had experienced everything the Lord had done through Israel.  Joshua 24:31

Now I am not sure how to interpret the passage. Were these elders of the same generation as Joshua (or, I guess, slightly younger)? Were they his colleagues or trainees? Regardless, soon after Joshua died, the leadership broke down. Moses trained up Joshua and Caleb, but soon after those two died, things began to fall apart and we are into the cycle of Judges where everyone did “what was right in their own eyes.”

The leadership of Moses and MAYBE Joshua followed the pattern of the upper right figure. What was not done was the figure below.

Leaders 2

How does this happen? I can think of two ways.

First, they train but don’t empower those they train to train others. I am part of the CPE (Clinical Pastoral Education) movement in the Philippines. People in this movement are trained and certified to supervise and train others. However, in the Philippines the desire generally has been to train pastoral counselors or clinical chaplain, but not so much to train others to train others. Often those that wanted to be trained from the third generation still had to go back to the first generation. It is not surprising that the CPE movement in the Philippines has been “sputtery.” It has struggled because the training often did not include the empowerment and certification to train others. The power of certification was often held by the originally certified.  Ordination in church can do the same thing. Ordained ministers train up unordained ministers but those unordained ministers are never ordained or empowered to do certain things. Thus, there is no repeatable process to succeeding generations. When the first generation is gone, there is no one to slip into the role… and they have to look for a 23 year old fresh out of seminary to take over the role. This is not a good system.

Second, they may train but for a different role. I have seen this also in the Philippines. Missionaries came to the Philippines to train up Filipino leaders. However, the roles they generally were trained for was not missions or higher level teaching. They were taught to pastor, lead worship, or plant churches. As important as these roles were, by not training Filipinos to be missionaries or seminary professors, the people became dependent on the missionaries. The problem is that while the church may endure, missionaries come and go, and sometimes just go. I have seen many a missionary refuse to leave a role because he believes he is indispensible. It may be true he is, but if he is, it is because he created the system to maintain his indispensibility. (It is quite possible that I have been guilty of this myself.)

Leaders need to do more than train up leaders. They need to empower these leaders to train up other leaders.

We can do better than in Joshua 24:31. We should do better than training up a generation to be faithful as long as they can remember us. We need to train up generations that have never heard of us.

“Footprints” Thoughts

One of the great inspiring messages is “Footprints.” It’s author is unknown, but frankly that added to its popularity since it lacks any copyright issues. There are some claims as to who first wrote it. Some thoughts on the authorship and inspiration of it can be found at https://www.thegospelcoalition.org/blogs/evangelical-history/where-did-the-footprints-poem-come-from/

I always liked the story and can recall having one of

https://s3.amazonaws.com/tgc-web/wp-content/uploads/2017/09/27130053/footprints.jpg

those wallhangers with the story on it. But writing a sermon recently I began thinking about it more, and had reason to disagree with the story… just a bit. That being said, I am not trying to say, “It is wrong.” Rather, I am saying that perhaps the imagery can be a bit misinforming in some ways.

On a positive side, the story utilizes the image of walking and walking with Christ as a metaphor for the Christian life. I feel that is a strong metaphor. I did several posts a few years back on the use of “Walking With” as a metaphor. You can look at these if you want

Walking With. Part 1

Walking With. Part 2

Walking With. Part 3

Walking With. Part 4

Walking With. Part 5

Walking With. Part 6

So why would I have any problems with Footprints then? There are three (somewhat) minor issues.

Issue One. Task-Focus versus Person-Focus. In the imagery, Jesus carries the writer during difficult times. To me the image is one of being task-focused. The person goes through a time that he can’t continue, and Jesus carries him. To stay with the person in a difficult time suggests person-focused. To keep moving by carrying the person suggests a bit of greater interest in keeping to the task than to the person. But I believe that Jesus is more committed to us as people, than to the tasks we do.

Issue Two. Dependency. In some manner we are to be dependent on God. But generally speaking, God seeks us to mature, and that maturity comes through the trials. Peter notes that we go through suffering. James notes that we develop perseverence through the testing of our faith. The image of the story suggests more of a coddling. Kelly O’Donnell (in “Doing Member Care Well”) has noted that Jesus Christ in His handling His disciples maintained a balance that could best be described as in the region of Comforter and Challenger, while avoiding the extremes of Coddler and Condemner. Carrying to me suggests coddling.

coddling

Issue Three. Example. As I noted in my sermon (HERE). Jesus is our model for ministry. God did not create us with great power. He gave us the ability to be present with others in their struggles. We can’t carry people through their times of pain and struggles. We can suffer with the suffering. We hurt with the hurting. We can struggle with the struggling. We can take none of these things away. We can embrace a ministry of presence. We can bear the burdens of another, but only with mutuality, where others also bear our burdens.

Of these three issues, the only one that I consider strong is the third one. The first two are picky. However, if we want to understand what we are to do, following the example of Jesus, we need to understand that Footprints does not give us a good understanding of that role. It does, however, give a good image of the Christian life.

Here is another perspective (thanks to Chaplain Sal for sharing…

Three Servants: Guiding, Healing, Sustaining

Seward Hiltner was a leading, some would say THE leading, Pastoral Theologian of the 20th Century, serving as a professor at Princeton Theological Seminary. He saw the pastoral function as best understood with the metaphor of the shepherd. A few weeks ago, Ptr. II Samuel spoke on this metaphor of the shepherd. Within the pastoral role, Hiltner saw three primary functions of pastoral care: These are Guiding, Healing, Sustaining. Others later added more. But for today, let’s stick with the primary three— Guiding, Healing, and Sustaining. I find these primary pastoral care functions illustrated in three servants in the story of Naaman the Leper. Please open your Bibles to II Kings 5: 1-14. So for those taking BP, you should note that I am using a passage from the Bible for illustrative purposes, rather than expositional or topical.

Now Naaman was commander of the army of the king of Aram. He was a great man in the sight of his master and highly regarded, because through him the Lord had given victory to Aram. He was a valiant soldier, but he had leprosy.

2 Now bands of raiders from Aram had gone out and had taken captive a young girl from Israel, and she served Naaman’s wife. 3 She said to her mistress, “If only my master would see the prophet who is in Samaria! He would cure him of his leprosy.”

4 Naaman went to his master and told him what the girl from Israel had said. 5 “By all means, go,” the king of Aram replied. “I will send a letter to the king of Israel.” So Naaman left, taking with him ten talents[b] of silver, six thousand shekels[c] of gold and ten sets of clothing. 6 The letter that he took to the king of Israel read: “With this letter I am sending my servant Naaman to you so that you may cure him of his leprosy.”

7 As soon as the king of Israel read the letter, he tore his robes and said, “Am I God? Can I kill and bring back to life? Why does this fellow send someone to me to be cured of his leprosy? See how he is trying to pick a quarrel with me!”

8 When Elisha the man of God heard that the king of Israel had torn his robes, he sent him this message: “Why have you torn your robes? Have the man come to me and he will know that there is a prophet in Israel.” 9 So Naaman went with his horses and chariots and stopped at the door of Elisha’s house. 10 Elisha sent a messenger to say to him, “Go, wash yourself seven times in the Jordan, and your flesh will be restored and you will be cleansed.”

11 But Naaman went away angry and said, “I thought that he would surely come out to me and stand and call on the name of the Lord his God, wave his hand over the spot and cure me of my leprosy. 12 Are not Abana and Pharpar, the rivers of Damascus, better than all the waters of Israel? Couldn’t I wash in them and be cleansed?” So he turned and went off in a rage.

13 Naaman’s servants went to him and said, “My father, if the prophet had told you to do some great thing, would you not have done it? How much more, then, when he tells you, ‘Wash and be cleansed’!” 14 So he went down and dipped himself in the Jordan seven times, as the man of God had told him, and his flesh was restored and became clean like that of a young boy.

The first servant here is described as a young girl from Israel… living as a captive… a slave in Aram… Syria. This young girl typifies the first function of Pastoral Care. That is Guiding without much knowledge. This young girl did not seem to have a lot of knowledge. But that is okay. Hiltner points out that good guidance is not highly directive. He states that it should be more eductive than deductive. Deductive guidance is acting like a detective. I have studied your situation, and I am able to deduce that THIS is what is going on and THAT is what you need to do. Eductive guidance is drawing out. Picture a bucket that draws water from a well. It presumes that the other person already knows most of what they need to know… so you as a pastoral care provider help draw that out of him or her. Consider the case of the prophet Nathan speaking to King David. The story or parable of the Ewe lamb is a classic example of Eductived Guidance. Nathan really did not tell David anything he did not already know. David already knew that it was wrong for a rich and powerful person to use his power to steal from the poor and needy. This was not an issue he was confused about… but he needed to be reminded. Maybe he had sort of forgotten. Maybe he had rationalized his behavior. Or maybe he had bracketed his knowledge, compartmentalizing what he knew to be true from what he did. Nathan drew out what David knew, guiding him eductively. In this case, the young servant knew something that General Naaman did not know, but he needed to know, so she gave the guidance. There is a prophet in Samaria who can cure him of his leprosy. Apparently she did not know the prophet’s name or where he lived. If she knew these things, they would have been added to the letter and the King of Israel would not have been so distressed. She did not know much… but she knew enough to guide Naaman.

Guidance without much Knowledge is good… because the temptation in pastoral care is to be Clever. It is tempting to show off what we know. Someone comes to you about a marriage problem. It is tempting to start talking about the 3 Greek words for love… or the 4 Greek words, or 6, or 7 (depending on which book you are reading at the moment). But while you are showing off all of the cool things you learned in seminary, what you are doing is caring for yourself— satisfying your need to be seen as clever, knowledgeable, wise… when really they need just a little guidance, and have a great need to be listened to. Times of Guidance are actually great opportunities to practice the Ministry of Silence. That is not easy. Pastors love to talk… they don’t like to listen all that much. Seminaries have classes in Preaching. They have classes in Teaching. Some even have classes in Arguing or Apologetics. Not too many have classes in Listening. Yet guiding a little in an environment of unclever, silent listeing is commonly what the other person really needs. I struggle with this principle because I want to be seen as clever. Maybe you share that same problem with me. However, the second principle I am much better at.

The second principle is Healing… but without much skill. I am much better at this… since I have no real skills at healing. When Naaman finally gets to Elisha’s home. Elisha does not come out. Instead he sends a servant, described as Elisha’s messenger to pass on the healer’s words to him— go to the Jordan River and wash yourself 7 times to be healed. Naaman was angry. He wanted to be healed by the prophet… the professional healer… not simply get a message from his servant. People want to see an expert. In fact… in pastoral care, that is the temptation for a pastoral person— to be seen as the expert… especially an expert healer. If you as a pastor, or a chaplain, or as a seminarian visit a sick person, you will be asked to pray for them. Why? Typically, they believe that you as a religious professional have prayers that are just a bit more UMPHH then their own. And often, we love that. We love it when people believe that we are closer to God… that our prayers have more power— that our requests are put on the top of God’s to-do list. The temptation to be an expert can show itself in other ways as well. Celia is a nurse, and it is tempting when doing chaplain work at the hospital to draw from her nursing background and second-guess the doctors, nurses, psychiatric staff, and social workers. She fights that temptation. There are some ministers who believe that they have received from God the gift of supernatural healing or deliverance. That’s fine. Maybe they do. But most of the time, God doesn’t look for us to be the expert. Most of the time, God wants us to serve in a ministry of mediation. We connect those in need with the resources of healing— within themselves… with God… and with others.

Reading the passage here… Naaman wasn’t happy that a servant came out rather than Elisha. Naaman said “I thought that he would surely come out to me and stand and call on the name of the Lord his God, wave his hand over the spot and cure me of my leprosy.” In a different context he may have said… “I expected someone who would sprinkle me with holy water… mark me with olive oil… dust me with salt… blow cigar smoke or spit Tanduay on me… all while saying some holy incantation. Why didn’t he put his hand on my forehead and shove, while declaring “I declare you healed!!” But the servant was not a healer and that’s okay because Naaman did not need a healer. He needed a mediator— one who connected him to the one who truly heals. He did not need someone to wave their hands over him. He needed to hear the word of the Lord and obey it. Elisha’s servant did not provide what Naaman wanted, but rather what he needed.

The third servant is listed as the servant who joined Naaman on his journey. Actually it describes Naaman as having several servants, but one presumably served as the spokesperson for the rest. The servants exhibited the pastoral function of sustaining. Sustaining but with not much power. Naaman was a sick man… having leprosy. Skin diseases were a public shame… not just in Israel but throughout the world and throughout history. Such skin diseases were contagious, and the shame, the stigma, associated with such visible illness are also contagious. Shame is always contagious. But the servants traveled with him in his illness and shame through Israel— enemy territory. They even called him “Father,” a term of both honor and affection. They sustained him. But they did not sustain with power… they were simply servants with very little influence or strength.

Those who are hurting, struggling, shamed, need our presence… a ministry of presence. We walk with them, sustaining them and encouraging them to keep progressing. But when things get too difficult and they refuse to go on— we don’t carry them… we can’t. We stop and remain with them until they move forward. (For those who are familiar with the Christian poem, Footprints, I feel it is a bit of questionable imagery. I believe Christ is best understood as one who does not carry us in difficult times, but remains with us where we are.) Certainly that is what we can do. We don’t have the power to carry them. We can barely carry ourselves. That is not exciting. We have a temptation here as well. Our temptation is to “Be the Hero.” To be the Savior… to be the Messiah. But Jesus is the Savior… they don’t need you to be a second one. They need your presence. Chaplains in the olden days had two different roles. One roles was mobile and one was stationary. Some chaplains would travel with military forces or other trading groups to be a constant presence with the group. Others lived along traderoutes or other major roadways. In that setting, they were a stationary presence for those to be cared for as they passed through. Both are forms of presence. Sometimes your role is to be a mentor for someone… a supportive companion and accountability partner. Sometimes, you are the one to show temporary presence to people who need support is that pass through where you are.

In the story, Naaman had servants who traveled with him to care for him wherever he went. They not only sustained, but they also guided. In this case they practiced eductive guidance. Remember eductive guidance is where one guides by helping to draw out what the person already knows. Namaan was ranting about how he had been insulted and told to do some stupid silly thing to be healed. His servants said, My father, if the prophet had told you to do some great thing, would you not have done it? How much more, then, when he tells you, ‘Wash and be cleansed’!” Naaman was willing to give a king’s fortune to be healed. He was prepared to walk through fire or do most any extreme thing to be healed. He already showed this by traveling into enemy territory as a military general without his army risking his own life to be healed. Naaman already knew that he would do most anything… even something seemingly stupid or silly to be healed. He just needed a bit of help to remember this.

In Pastoral Care, the Cure of Souls, there are many temptations. When I came here back in 2004, I was told that people who took CPE, Clinical Pastoral Education, were often prideful about it … acting like they were better ministers or seminarians than those who had not taken it. Was this bit of gossip true? I don’t know. As Paul might say, “May it Not Be So” or in another translation, “Horrors No.” But maybe the perception was correct. There is the temptation to be the Clever One, to be the Expert, to be the Hero.

But… We are NOT called to be Clever, but rather to be a Guide with little knowledge, practicing the Ministry of Silence.

WE are NOT called to be the Expert, but rather Be a Healer without much skill, practicing the Ministry of Mediation

We are NOT called to play the Hero, but rather to Be a Sustainer without much power, practicing the Ministry of Presence.

My hope is that each of you will seek to develop the ministries of silence, mediation, and presence. My desire is that the people you provide care for will not see you as clever, as and expert, or as a hero. My prayer is that you will embrace a life-long ministry of care for others where you will be seen as having little knowledge, little skill, and little power.

Theodicy– The Questions Real People Ask

Here is a quote by Howard Stone from “The Word of God and Pastoral Care”

Over the years, while making pastoral carecaution2bagainst2bbad2badvice visits and especially hospital visits, I have sadly encountered many people whose well-meaning friends and acquaintances have responded to their why questions with theological answers that left them terribly upset and proved actually to be destructive: ‘This is God’s punishment on you and for your sins.’ ‘This is God’s will; you have to accept it.’ ‘This has happened to bring you to the Lord.’ ‘God wanted your dear one with him in heaven.’ ‘If you hadn’t skipped out on your wife, this wouldn’t have happened.’ ‘If you had stayed home with your children where God wants you to be, they wouldn’t have started taking drugs.’

More recently I have also come across another whole class of answers — more psychological than religious — to theodicy issues: ‘You are responsible for your illness.’ ‘You are sick because of your destructive thoughts.’ ‘The cancer inside you is pent up anger; you’ve got to release it to get well.’ ‘You are what you eat; if only you had cut out salt and exercised more.’ Some people are so eager to give their answers that they scarcely wait for the questions to be asked. The results are often quite grim.

When I first began pastoral care work, I would have thought such pronouncements were rare, or occurred only in the more conservative denominations. Not so! Things such as this happen everywhere, regardless of the conservative or liberal orientation. Simplistic and damaging answers flow from well-meaning people at a time when their hearers are in considerable distress, vulnerable, and unable to talk back. I raise the issue here because if ministers care only for people’s emotional pain and do not respond theologically to the issue of theodicy, parishioners will inevitably get their theological education elsewhere, and it may not be the kind we would have wished for them. In other words, if ministers will not respond, sooner or later, to the vital questions of theodicy, neighbors and friends are likely to do so, and not always in a helpful manner.                                       –page 165