Posts tagged " soul care conversation "

Soul Care Conversation (Caregiver)

August 24th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

In previous conversations we have explored the challenges of the veteran returning from war. We determined that the effects of trauma and moral injury on the warrior’s bodies, minds, and spirits, are profound. We understand that the transition from warrior to civilian can be overwhelming. These may appear as insurmountable obstacles.

Beyond the most telling hardships on our returning warriors, the transition home from combat effects the family as well. All of these factors are compounded when the returning veteran has been wounded, whether physically, psychologically, or spiritually.

BACKGROUND

Because of a trauma experience, many of our returning warriors have lingering fear. Some struggle with a moral injury resulting in guilt or shame from ethical and moral challenges that they faced. Some a soul wound so deep that they feel broken and hopeless. Often, it is a family member or friend who becomes the caregiver.

In our conversation this month, we will explore the numerous challenges the caregiver faces. We will discuss in some detail the following:

  • reintegration
  • injury
  • support

Reintegration – is characterized by the veteran’s returning to his or her daily life as experienced prior to deployment. Despite much literature suggesting that the reintegration stage lasts several months, this stage can actually persist for months to years depending on the individual veteran, his or her family, and the fuller context of the service member’s life.

Reintegration can be a turbulent time for the family, as members must re-form into a functioning team. The re-deployment “honeymoon” may last 4-9 months, and then relationship stress and negative family functions usually reach a peak. One of the greatest challenges for the family appears to be renegotiating family roles as the veteran encounters the often-unexpected difficulty of fitting into a home routine that has likely changed a great deal since his or her departure.

Typically, over the course of one or more deployments, the at-home parent and children assume new responsibilities. While the veteran was deployed the spouse took on many of the roles the warrior accomplished prior, such as paying bills, disciplining the children, repairing the car.  Now that the veteran has returned, the veteran may desire to take back the responsibilities. This can cause conflict.

Also, the family may have to find a “new normal.” Neither the returning warrior, spouse, nor children may be the same persons they were prior to the deployment. Because of the experience of war for the veteran and separation for the family members, each person may exhibit subtle changes at first, but drastic personality changes surface such as fear, loneliness, isolation, anger, pain, and depression follow.

Understanding the nature and patterns for reintegration challenges enables the veteran and family to have more control over their lives. This knowledge will enhance a good reintegration and also allow for the veteran and family to engage conflict well.

The challenges of reintegration are drastically compounded when the warrior has been wounded.

Injury – The Post 9/11 wars will have long term affects for decades due to the young age of our troopers. Of the over 50,000 serious wounds, a large percentage are brain or spinal injuries. The total excludes psychological injuries. U.S. veterans with serious mental health problems – 30% of U.S. troops develop serious mental health problems within 3 to 4 months of returning home.

The one aspect that these statistics do not reflect, those who experienced the wounding of the soul. Department of Defense nor the Veterans Administration have collected data on those warriors who have experienced spiritual or soul wounds.

Support – An additional statistic that we must address, the caregiver. There are 5.5 million caregivers who are family members or friends of a wounded veteran, 1.1 million from the Post 9/11 wars alone. These persons provide 24/7, 365 days a year care to their loved one. (Statistic from the Elizabeth Dole Foundation report.)

The duties of a caregiver to the veteran might include:

  • managing medications
  • helping to bath or dress
  • taking care of household chores, making meals, paying bills
  • providing transportation to medical appointments
  • being the emotional support system for the veteran

The strain associated with caring for a wounded veteran may result in stress for the caregiver. To provide for a wounded warrior proves to be both a huge physical and mental strain. In fact, the mental strain can be so demanding that the caregiver her/himself risk at becoming a casualty as well; tension, anxiety, worry, pressure, depression, and fatigue. Another factor often overlooked, in order for the family member to provide 24/7 care, the caregiver must stop working outside the home thus contributing to possibly an already difficult financial situation. This also effects the caregiver’s self-esteem and well-being.

The physical, financial and emotional consequences for the family caregiver can be overwhelming. Where can the caregiver find support?

IMPLICTIONS FOR THE FAITH COMMUNITY

Who provides them care? Who do caregivers turn to for support? The Dole Foundation discovered through a survey that over 90% of the caregivers turn to the faith community for support. (Statistic from the Elizabeth Dole Foundation.)

If a caregiver knocks on your door, how will you respond? In order for individuals to respond effectively, there are several key preliminary components to consider:

  • knowledge of military culture and military family dynamics
  • appreciate the challenges of transition from not only military to civilian life, but from the battlefield to the bedroom, and from the unit to community
  • understand the context of war
  • know what resources are available in your community for the veteran and family

Each of these components become the building blocks for the faith community to begin to build relationships with the veteran and caregiver. Now that you have been approached for your support and you have initiated developing a relationship, you can take the next step, determine the need.

It is important to realize that caregivers can be overwhelmed with their situation. Most often they will ask for:

  • someone to take their wounded veteran to medical appointments, or watch their children while they take them to the appointment
  • a person to do home or car repairs
  • mow the grass or shovel snow

However, there are two other services the caregiver will rarely seek help for:

  • respite
  • support

Respite – Most likely the caregiver will not even consider respite. The caregiver’s attention is on their loved one, not themselves. However, respite will provide long term benefits. Without respite, caregivers may face serious health and social risks as a result of stress. Respite provides the much needed temporary break from the exhausting challenges faced by the caregiver.

The faith community can prove supportive in this need. Train volunteers to provide care to wounded veterans, with the following skills:

  • give medications
  • listen without judgement
  • knowledge of CPR

Support – Caregivers do not take the time to reach out to others because they think they cannot find the time to be away from their loved one. However, social support becomes a critical component in caregiver care. Peer support groups have provided caregivers a great source of comfort knowing that they are not alone, that others share similar situations, and that there are resources available.

The faith community can extend hospitality by opening their facilities for a caregiver support group. However, the faith community must extend their hospitality beyond opening the facility. They could also consider the following:

  • provide a trained volunteer to be with the wounded veteran while the caregiver is at group, or offer a wounded veteran group meeting at the same time and location
  • offer child care during group meetings
  • if a pastoral counselor is on staff, have that person available as a resource

The faith community can truly be a place of grace where the wounded veteran and caregiver feel safe to share their feelings.

The faith community does not need to do this alone. Begin networking with resources on line such as https://milvetcaregivernetwork.org/, http://militaryoneclick.com/15-organizations-godsends-military-caregivers/, and https://www.elizabethdolefoundation.org/.

We have learned the wounds of war are contagious as they affect the warriors, their families, the caregiver, and the communities. Thank you for joining this important conversation as we explored the support and services our veterans and their families need in order not just to survive, but thrive in ways meaningful to them.

 

 

 

Soul Care Conversation (Spiritual Model for Healing from Moral Injury; Sixth Step – Accountability)

July 26th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community.

We continue our conversation on a proposed spiritual therapeutic model toward healing from moral injury. As a reminder, this six step model includes;

  1. Acknowledge (confession) – take an honest assessment of thoughts and behavior, then acknowledge guilt and shame, and anger
  2. Forgiveness – choose forgiveness of self in the trauma experience as well as others who may have had responsibility
  3. Self-acceptance – renounce self lies like; I’m no good, I’m nothing, I’m worthless, I can’t be loved, and accept the reality of being a child of God
  4. Renewal – begin to retrain mind
  5. Amends – restoration involves a direct way to repair what has been damaged or broken
  6. Accountability – be in a community that offers accountability and support

We have discussed the first five steps; confession, forgiveness,  self-acceptance, renewal of the mind, and making amends. This month, we will discuss the sixth and final step, accountability.

BACKGROUND

Accountability is defined as taking or being assigned responsibility for;

  • something that you have done or
  • something you are supposed to do

Veterans have familiarity with accountability. All service members have responsibility for either property or people, and are answerable to those in authority over them.

In today’s culture, most persons understand and experience accountability through a group. The groups meets for various interests and reasons;

  • fitness
  • diet
  • addictions
  • writing, reading, biking, hiking, etc.

Often we feel ill-equipped to ensure our own success. So, we join a group that sets various goals and we hold each other in check on a daily or weekly basis. We accomplish this through Facebook, meeting in person, conference calls, or email.

Ultimately, accountability is optional. We can leave a group at any time. There may be days or weeks we voluntarily pull back from a group because we feel more anxiety over reporting than if we simply do what we say we will do.

Most often accountability groups assist us to be more self-aware, to realize that we need the sense of obligation. Knowing someone will ask me whether I have met my goals will help me do what I otherwise may have blown off resulting in the possibilities of better health or greater happiness. More importantly, the encouragement helps, knowing I have a friend who will offer commiseration or motivation.

THEOLOGICAL IMPLICATIONS

The story of David in the Hebrew scripture illustrates for us what can happen when we fail to create a structure in which we are accountable for how we spend both our professional and private time.

The story found in 2 Samuel suggests to us the dangers of living our lives free of accountability. David was a great warrior and capable leader. From all accounts in scripture, he;

  • enjoyed an intimate relationship with God
  • experienced a stable political position
  • secured a string of military victories

David had it all, but…!

David did not wake up one morning and decide to trash his life by committing adultery with the wife of one of his leaders, then have that man killed in battle. David began his descent into compromise by taking an additional wife, then another, and another. Eventually David had seven wives, but that was not enough. He added a harem. We can easily surmise that David had an issue with self-control.

David compounded his issue of self-control by not having someone around to question his lack of wisdom or to share his ever widening problem with someone else. As we read this story, we wince at the slow leak of self-control as;

  • David looks
  • David wants
  • David takes
  • David tries to cover it up
  • David thinks he has gotten away with it

We read the results of David’s sin in the Psalms. David experiences a deep soul wound. Reflect for a moment on these powerful words shared in several of David’s Psalms;

  • “I am worn out from sobbing. Every night tears drench my bed, my pillow is wet from weeping.” (6:6)
  • “How long will you forget me? Forever? How long will you look the other way? How long must I struggle with anguish in my soul, with sorrow in my heart every day?” (13:1-2)
  • “My God, my God! Why have you forsaken me? Why do you remain so distant? Why do you ignore my cries for help? Every day I call to you, my God, but you do not answer. Every night you hear my voice, but I find no relief.” (22:1-2)

Here lies the crux of the story, when Nathan confronts David about his sin, David had two options, confess or deny. By being a “man after God’s own heart” does not mean David was perfect or flawless. Rather, David had to be honest about his failures. When confronted with his failure, David replies, “I have sinned against the Lord.” (2 Samuel 12:13)

Most likely not long after, David composes Psalm 51, his confession. David pours out his heart to God. “Have mercy on me, O God, according to your unfailing love; because of your great compassion blot out the stain of my sins. Wash me clean from my guilt. Purify me from my sin.” (verses 1-2)

Nathan becomes the catalyst toward spiritual healing. Nathan cared enough for David to counsel, rebuke, and encourage him when necessary.

PRACTICAL IMPLICATIONS

We shared in a previous conversation about the need to be accountable to others, as a part of restorative justice. Both the Hebrew and Christian scriptures are filled with stories of people struggling with their accountability with God, and leaning on others for personal and spiritual development and growth. From Genesis through the letters to the churches, there are stories shared about the deep connections that help people through their darkest days and assist them to see what they cannot see on their own. We know of the stories of Moses and Aaron, David and Jonathan, Paul and Barnabas, and Silas and Timothy. In all of these stories and others, men and women of faith understood the importance to re-connect with God, one another, and with community by taking responsibility for their own behavior and then taking action to repair the harm. Through this process each person found another person to be accountable.

Most likely we do not practice accountability because we do not experience a sudden blow-out. Rather we make small compromises over time. We do not think we need someone to be our “Nathan.” But over time our compromises begin to snowball and before we know it our life spins out of control.

We have to be intentional about inviting someone like Nathan into our lives. Accountability relationships must be invited. The responsibility is on each of us to establish the structures and relationships to be accountable.

Our responsibilities are as follows;

  • seek people of mature character
  • give them permission to ask the tough questions
  • be honest and vulnerable to them

Veterans, as we consider inviting someone for accountability, there are two essential elements;

  • trust
  • ability to relate

Element of Trust – In order to establish accountability, the foundation centers on trust. Developing trust takes time. As we begin to share our stories with one another we begin to establish a rapport with each other. Trust is developed through several techniques;

  • active listening
  • non-judgmental attitude
  • caring for each other

Trust opens each group participant to sharing their most innermost thoughts without the concern of betrayal. Trust is at the heart of accountability because it involves opening oneself to the most sensitive and personal information.

Element of Relating – It is helpful when the group participants share a common bond or have been through similar experiences. Veterans can relate to one another and therefore can share with an empathetic heart. Vets would feel more comfortable sharing their experiences, circumstances, and feelings with another vet without fear of rejection or judgment.

Over these last several months we have shared a spiritual model for healing from moral injury. This month we have discussed the last step, accountability. However, accountability may not necessarily be the last step in the process. Accountability can be the catalyst, the first step that moves the veteran toward acknowledgement. Accountability can also sustain the veteran during the journey in finding forgiveness, self-acceptance, renewal of the mind, and making amends. The objective in this model is for the veteran to find healing and restoration.

So, are you accountable? Do you have a friend or group that will hold you accountable? “Two are better than one, because they have a good return for their work: If one falls down, his friend can help him up…” (Ecclesiastes 4:9-10)

Next month, we will begin a discussion on the care giver. Until then, thank you for the conversation…

 

 

Soul Care Conversation (Spiritual Model for Healing from Moral Injury; Fifth Step – Making Amends)

June 19th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community.

We continue our conversation on a proposed spiritual therapeutic model toward healing from moral injury. As a reminder, this six step model includes;

  1. Acknowledge (confession) – take an honest assessment of thoughts and behavior, then acknowledge guilt and shame, and anger
  2. Forgiveness – choose forgiveness of self in the trauma experience as well as others who may have had responsibility
  3. Self-acceptance – renounce self lies like; I’m no good, I’m nothing, I’m worthless, I can’t be loved, and accept the reality of being a child of God
  4. Renewal – begin to retrain mind
  5. Amends – restoration involves a direct way to repair what has been damaged or broken
  6. Accountability – be in a community that offers accountability and support

We have discussed the first four steps; confession, forgiveness,  self-acceptance, and renewal of the mind.  This month, we will discuss the fifth step, making amends.

BACKGROUND

Making amends is an integral component in any recovery program. Addiction, whether to alcohol, drugs, sex, or gambling creates moral wreckage. Broken relationships and a deep soul wound result.

In these situations an apology will not suffice. Alcoholics Anonymous (AA) calls for making amends.

Additionally, AA understands that making amends is a delicate process, therefore the guidance of a sponsor or counselor is required.

Making amends is a critical component toward recovery from addiction. This process also has importance to a veteran regarding restoration from doing or experiencing harm resulting in moral injury. The same components exist;

  • experiencing the reality of broken relationships and a deep soul wound
  • offering an apology is not enough
  • needing someone to be a confidant, listener, counselor or friend

We will look closely at these three factors in making amends as they relate to healing from moral injury.

 THEOLOGICAL IMPLICATIONS

Experiencing broken relationships and soul wounds – The conduct of war often descends into brutality. Even when the outcome may bring peace, broken and shattered lives along the way become a reminder to those who were engaged in war’s harsh realities. A sense of brokenness and alienation from God, others and self occurs and the consequences are grievous wounds to the soul. A soul wound goes deep because the battlefield strips away the veteran’s belief system. At the very core of the wound is the feeling or brokenness and hopelessness.

From the opening pages in the first book of the Torah, the Hebrew scripture tells us something has gone wrong; loving relationships have been broken, creation has been marred, humanity has been separated from God, all resulting in the need for God’s healing. Good news begins right here; God does not simply step in and by coercive force make things right. Rather, love shapes God’s activity; patient and persevering. Love becomes the “healing balm” that galvanizes God’s response to a broken world.

Offering an apology is not enough – The core ingredient to experience healing is restorative justice. Restorative justice becomes the central focus. One of the clearest and most holistic words for justice is the Hebrew shalom, which means both “justice” and “peace.” Shalom includes wholeness, or everything that makes for a person’s well-being, security, and the restoration of relationships that have been broken. Restorative justice is about repairing broken relationships with other people.

For a veteran who may have experienced a moral injury while in combat, it may be difficult to see how they can experience “wholeness” after what they may have done or seen. Yet, it may be in service to others that the veteran begins to see the positive connection with others, and see this as a way to make amends.

Shalom is not a passive concept, rather it is lived out in community. That is why justice always has to be social. So restorative justice, most simply, means putting things right again — fixing, repairing, and restoring broken relationships. And doing justice restores our relationship with God.

Needing someone to be a confidant, listener, counselor or friend. – The faith community is uniquely positioned to be a blessing to veterans who have experienced a soul wound. After wars of the past, the faith community has played a key role in helping veterans find healing of the soul. Clergy and laity have offered through their actions hope, love, patience, forgiveness, trust, and comfort.  They have offered words of assurance from Holy texts. Both actions and words living out the sacred Love story provide remarkable healing power.

Also, other veterans can be a solace to one another. Through a like minded community, veterans can encourage and support each other.

Restoration will involve a lot of lists. In particular, the veteran should make a list of all the people he/she has hurt physically or emotionally. The memories may be painful, especially when listing family members. When attempting to make direct amends, there might be people unwilling to forgive. This is where the veteran should turn to a counselor or clergy to assist the veteran through the painful process.

BIBLICAL BASIS FOR “MAKING AMENDS” 

We are reminded of the scripture that states, “An eye for an eye.” However, there is much more to Biblical justice than this statement. In fact, the Hebrew and Christian texts call for justice is a much deeper and more involved approach. Rather than retribution, justice involves making amends.

The Biblical concept of making amends involves restoration:

  • restoration of self
  • restoration in community
  • restoration to God

Human failure is nothing new. In fact the Bible contains so many stories of people of faith who failed; Samson, Abraham, David, Solomon, Jonah, all of the Disciples, and the Apostle Paul. The evidence of failure is sobering.

But, equally overwhelming is the evidence that God restores those who have failed. There are passages from both the Hebrew and Christians texts that reveal God’s character as the One Who Restores! God reclaims and restores those who in a moment of weakness failed. This is God’s Love in action! Restoration involves;

  • acknowledging the wrong
  • making amends with those harmed
  • making peace with God

In the Hebrew texts, the Law of Moses specified the various circumstances and processes for restitution to one’s neighbor (the victim) and sacrifice to God (Leviticus 6:2-7). All are as important as the other.

In the Christian texts, there are numerous examples of restoration, one being the story of Zacchaeus (Luke 19). This story reiterates the importance of acknowledging the wrong, making amends to neighbor, and making peace with God. Zacchaeus shared before Jesus and his neighbors that “I will give half of my wealth to the poor, Lord, and if I overcharged people on their taxes, I will give back four times as much.” Jesus responded, “Salvation has come to this house today, for this man has shown himself to be a son of Abraham.”

Restoration is not only possible, it is hoped for and encouraged.

IMPLICATIONS FOR THE VETERAN

Let us briefly explore each of these three areas.

Acknowledging the wrong – “Acknowledge” is defined; to admit to be real or true, recognized the existence, truth, or fact of.  A synonym is confession. Confession is a written or oral statement acknowledging guilt.

Confession. The word stirs up memories. Whatever the memory, most likely it is not pleasant. In fact, for many confession connotes pain from failure and being weighed down with guilt. However, confession offers us healing through a face to face encounter with the grace, love, and forgiveness of God.

The first step toward restoration with God is to acknowledge our sin. Confession becomes a vital part of our fellowship with God as it provides an opportunity to be reconciled within the community.

Making amends with those harmed – An amend has to do with restoring justice as much as possible. The idea is to restore in a direct way that which we have broken or damaged – or to make restoration in a symbolic way if we cannot do it directly.

There are many ways for a veteran to make amends, however, amends may not be possible to the person(s) directly injured or wronged because danger remains where the harm occurred. There are indirect ways. Veterans can offer assistance to organizations assisting war refugees. Additionally, there are non-governmental organizations (many faith-based) serving in war torn countries that are in need of not only financial assistance, but volunteer service.

Sometimes it will be difficult to make amends even indirectly. Veterans have another option, to make “living” amends. This simply means that the veteran lives differently. Amends are about genuine change in our behavior instead of a simple apology. We take on a whole new way of living.

Making peace with God – In Christian traditions, the prayers of confession and great thanksgiving prior to communion can make peace with God. More powerfully, the communion service is not only a means to confess, repent, and hear words of assurance, but we also participate in the powerful act of receiving God’s grace through the bread and wine. Hope and new life not only become words, but experienced realities. Communion becomes an act of making peace with God.

BENEFITS TO MAKING AMENDS

If we have not made any effort to make amends to those we have harmed, we may then have a lot of people, places, and things to avoid. We tend to live in isolation. In fact, large areas of our lives become closed off to us. When we make amends, are lives are open to new possibilities. We will experience a new freedom and Shalom.

Lastly, we are reminded in Micah (6:6-8) that God does not require our words or acts in worship to make peace, but “to do what is right, to love mercy, and to walk humbly with your God.” To do this, we become restored people.

Next month we will discuss the last step, accountability. Until then, thank you for the conversation…

Soul Care Conversation (Spiritual Model for Healing from Moral Injury; Fourth Step – Renewal of the Mind)

May 19th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community.

We continue our conversation on a proposed spiritual therapeutic model toward healing from moral injury. As a reminder, this six step model includes;

  1. Acknowledge (confession) – take an honest assessment of thoughts and behavior, then acknowledge guilt and shame, and anger
  2. Forgiveness – choose forgiveness of self in the trauma experience as well as others who may have had responsibility
  3. Self-acceptance – renounce self lies like; I’m no good, I’m nothing, I’m worthless, I can’t be loved, and accept the reality of being a child of God
  4. Renewal – begin to retrain mind
  5. Amends – restoration involves a direct way to repair what has been damaged or broken
  6. Accountability – be in a community that offers accountability and support

We have discussed the first three steps; confession, forgiveness, and self-acceptance.  This month, we will discuss the fourth step, renewal of the mind.

BACKGROUND

How can a person renew their mind? What can we do to get rid of negative thoughts? This is the challenge for a veteran who has experienced the horrors of war resulting in PTSD or moral injury.

Sergeant Caleb Jones served in Mortuary Affairs in Afghanistan. He returned two years ago. He and his family attend church regularly where they have made new friends. But, he still struggles with anger. “I can’t stop my rage. I really get irritated at the way people treat me,” he confides with his pastor.

Colonel Aimee McBride, a Marine pilot, was verbally abused her father. He told her that she would never amount to anything. She was reminded constantly that she was “good for nothing.” She has been back from Iraq for 12 years, but the experience of losing a subordinate still haunts her. She still feels responsible and has confessed this to her priest. Yet, she cannot find forgiveness for her guilt.

Both of these veterans are connected, not just because they are combat veterans, but because they are still at war. Their minds are caught up in a daily battle. Even though they are a part of a faith community that reminds them of God’s promises, each struggle with bitterness, anger, fear, shame, guilt, and depression. They see themselves as victims, but they also blame themselves.

What steps can they take toward healing? In an earlier conversation we discussed that a study suggests that Cognitive Processing Therapy (CPT) significantly reduces PTSD.  (“Duke study shows therapy effective for military sufferers of PTSD,” News and Observer, written by Gavin Stone, 28 November 2016)

As a review, CPT has two factors; methodology and outcome.

CPT’s method;

  • face the trauma through a detailed written account
  • share the account with a therapist
  • work within a group process

CPT’s goal;

  • break the pattern of avoidance
  • enable emotional processing

Emotional processing allows for the clarification and modification of cognitive distortions. CPT provides the trauma survivor the opportunity to begin to look at the cause of the trauma and its effects in a different way. The bottom line is that the trauma survivor can choose to move beyond being a victim into being a stronger person by living into the possibilities of growth from the trauma experience. This is mind renewal.

LIVING LESSONS

In my opinion and from my experience, CPT assisted me to approach my PTSD and moral injury through a balanced psychological methodology. CPT helped me to move beyond feeling as if I were a victim into looking at how I can use my experience for growth. However, there still was something lacking that I could not move past.

After my return from Iraq in 2004, my soul wound was so deep. The symptoms of my spiritual injury were;

  • shattered self esteem
  • finding it difficult to pray
  • no spirit of thankfulness
  • seeing no value in the Scripture

Although CPT was helpful in working through my fear, anxiety, anger, and isolation, I still needed to work through the battle raging in my mind of;

  • doubt
  • grief
  • guilt
  • hopelessness
  • depression
  • abandonment

Several years later as I was working on a blog, I recalled the passage of scripture from Romans 12:2 that went to the heart of the problem and that offered a working solution. “Don’t copy the behavior and customs of this world, but let God transform you into a new person by changing the way you think.” (New Living Translation)

If only I can let God change the way I think? Scripture affirms that to do so God offers an awesome benefit. The God of peace will be with me. “And now, dear brothers and sisters, let me say one more thing as I close this letter. Fix your thoughts on what is true and honorable and right. Think about the things that are pure and lovely and admirable. Think about the things that are excellent and worthy of praise. Keep putting into practice all you learned from me and heard from me and saw me doing, and the God of peace will be with you.” (Philippians 4:8-9, New Living Translation)

PRACTICAL APPLICATION

So how can I let God change the way I think? The strategy is in that passage from Philippians;

  • constantly look for God’s standard not my own (if a thought fails the test of being true, or noble, or right, or pure, then I turn my thoughts from my old way of thinking toward God and a new way of thinking)
  • put into practice (a renewed mind should lead to changed behavior)

These two steps can bring us closer to encountering God’s peace, Shalom. But they are just that steps. Renewing the mind is a process, not a once in a life time experience. I often miss the mark. At times I continue to think in my doubt, anger, and guilt. Because of this, my behavior reflects discouragement and despair. But, I have learned not to beat myself up. Rather, I must focus my mind on moving beyond my old way of thinking and looking for God’s standard and putting it into practice.

A great example of this is the story in the Hebrew scriptures about Joseph, who was sold as a slave by his brothers. Joseph ended up in Egypt and eventually prison. He easily could have lost hope. However, it is so amazing that nowhere in this story do we read that Joseph was bitter, angry, or hopeless because of the injustice he experienced.

Years later Joseph meets his brothers. They feared that Joseph would take revenge. However, Joseph’s response suggests that he had a renewed mind and he put it into practice. “Don’t be afraid of me. Am I God, to judge and punish you? As far as I am concerned, God turned into good what you meant for evil.” (Genesis 50:19-20a, New Living Translation)

This powerful story of redemption is about making a choice, deciding. This story points to that;

  • I continually make decisions,
  • they are my decisions,
  • God will not decide for me,
  • I must decide for myself.

Therefore, if I do not want to be bitter, angry, feel guilty, or be depressed, I change the way I think.

Both scriptures above (Romans and Philippians) state that I must renew my mind. Neither say that God will renew my mind. I must take responsibility to renew my mind by;

  • learning to think like God thinks
  • changing my critical thinking and negative attitudes

To be effective, I have to remind myself of my responsibility throughout the day.

Tools are provided to assist us in our journey toward renewal of the mind;

  • Reading of scripture, daily
  • Finding quiet places to be in prayer and meditation
  • Attending weekly worship
  • Finding an accountability group to encourage one another especially when we do not desire to use the first three tools

Lastly, when we face those difficult days of loneliness, confusion, and despair and the feeling will not go away, there is a step that will help us renew our mind. Both the Hebrew and Christian scriptures remind us to focus on God or Jesus. (Psalm 16:8, Hebrews 3:1, and 12:2)

When our heart and mind centers on the Living God, we can set aside feelings of bitterness, discouragement and despair by focusing on the promise of God’s faithfulness, compassion, and loving kindness. If we do this, the problems most likely will still exist, however emotionally we can face our challenges with confidence because God is with us.

Since my return from Iraq and Afghanistan, renewing my mind has been a challenge. In fact, it will take a life time of hard work. However, at times when I do experience renewal, I discover incredible blessings.

Soul Care Conversation (Spiritual Model for Healing from Moral Injury; Third Step – Self-Acceptance)

April 17th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

During the last several months we have had a conversation on a proposed spiritual therapeutic model toward healing from moral injury. This six step model includes;

  1. Acknowledge (confession) – take an honest assessment of thoughts and behavior, then acknowledge guilt and shame, and anger
  2. Forgiveness – choose forgiveness of self in the trauma experience as well as others who may have had responsibility
  3. Self-acceptance – renounce self lies like; I’m no good, I’m nothing, I’m worthless, I can’t be loved, and accept the reality of being a child of God
  4. Renewal – begin to retrain mind
  5. Amends – restoration involves a direct way to repair what has been damaged or broken (for the veteran, maybe difficult to go back to place of injury, however, there are other ways; contribute to refugee or orphan fund in the area of the war, volunteer at a shelter or soup kitchen, etc)
  6. Accountability – be in a community that offers accountability and support

We have discussed the first two steps; confession and forgiveness. This month, we will discuss the third step, self-acceptance. The concept of self-esteem, self-love, and self image has become a relevant and hot topic, and the subject of much debate. One of the criticisms for today’s culture is that people have become self-centered. We live in a day and culture in which we have become lovers of self. We have become self-centered and satiated with self-actualization, self-esteem, self-worth and self-fulfillment. All we need to do is look at the titles of best selling books or read contemporary psychology.

However, without getting into the debate, one thing that is clear, a veteran who experiences moral injury finds it extremely difficult to accept self.

DIFFICULTY WITH SELF-ACCEPTANCE

In my counseling sessions as a chaplain, I have experienced many who are insecure. People simply don’t like themselves. I have counseled numerous persons who engage in self-rejection because they think that God is angry with them because they have done something terribly wrong or because they are not perfect. As a result, they live in a constant state of frustration, continually rejecting themselves. Many feel bad every time they make mistake.

Or, people try to please God with their works. They live daily on a performance treadmill, always trying to do something to feel good about themselves. Everything they do is to ensure they are in right standing with God. To live this way, they become exhausted, frustrated, and unhappy.

What often happens is that no matter how much we love God or chose to do what is right, we still cannot accept ourselves. It is difficult to like “me.” Both of these life styles lead to negative feelings that result in depression, discouragement, and possibly self-destruction.

IMPORTANCE OF SELF-ACCEPTANCE

From a previous in-depth conversation about moral injury, we understand that moral injury produces guilt and shame from something done or witnessed that goes against one’s values. We have looked at the spiritual implications of confession and forgiveness. Both can be a means to experiencing positive spiritual, emotional and physical well-being. The critical phrase is “can be.”

Both the Hebrew and Christian scriptures remind us that there is nothing we can do to earn right standing with God or salvation. There is absolutely nothing we can do to make God love us more or less that God already does.

Our self-acceptance affects our understanding of and relationship with God. Our self-acceptance also influences our social life and our relationships with others. So, how can we move beyond “can be”?

STEPS TOWARD SELF-ACCEPTANCE

Scripture reveals to us a spiritually balanced concept of self-image. Let’s review some of the steps to self-acceptance;

  • we consider our worth as individuals (Psalm 139:13-14, “You are made all the delicate, inner parts of my body and knit me together in my mother’s womb. Thank you for making me so wonderfully complex! Your workmanship is marvelous – and how well I know it.” [NLT])
  • we think properly of ourselves (Romans 12:3, the Apostle Paul writes, “As God’s messenger, I give each of you this warning: Be honest in your estimate of yourselves, measuring your value by how much faith God has given you.” [NLT].)
  • we will continue to make mistakes, however God will continue to cover us and not condemn us (Isaiah 61:10 shares, “I am overwhelmed with joy in the Lord my God! For he has dressed me with the clothing of salvation and draped me in a robe of righteousness.” [NLT])
  • we learn to accept ourselves as God sees us (because of grace); who we are and where we are (Romans 3:23 states, “For all have sinned; all fall short of God’s glorious standard. Yet now God in his gracious kindness declares us not guilty. He has done this through Christ Jesus, who has freed us by taking away our sins.” [NLT])
  • we then can discover the concept of self as it develops out of our understanding of God and God’s grace (Paul writes to the church in Corinth, 1 Corinthians 15:10, “But whatever I am now, it is all because God poured out his special favor on me – and not without results.” [NLT])

How we understand these steps will be key in how we live our lives, in how we treat others, in how we think of ourselves, and ultimately in what we do with our lives. That we think properly of ourselves is important.

Also important to understand, each day we will most likely mess up, sin. God will not be mad at us because we are not perfect. God desires for us to run the race!

For the veteran, it takes on importance knowing that God is on the veteran’s side, God wants the veteran to feel good about her/himself, and that each day the veteran makes progress toward accepting self. It is in this journey the veteran can realize and live out his/her life with contentment and even joy.

What stories do you have from your personal journey or the journeys of others in how to experience self-acceptance? Next time, we will discuss the fourth step; renewal. Until then, thank you for the conversation…

 

Soul Care Conversation (Spiritual Model for Healing from Moral Injury; Second Step – Forgiveness)

March 14th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Some researchers and practitioners claim that there is no place in psychoanalytic work for forgiveness. “Clinically, the concept of forgiveness is seductive, implying that there should be a common outcome to a variety of injuries, stemming from different situations and calling for different solutions.” (“Leaps of faith: is forgiveness a useful concept?” International Journal of Psychoanalysis, October 2008, abstract) Possibly the researchers and practitioners are correct, forgiveness has no place in psychoanalysis.

However, I would submit that forgiveness has a role in sustaining personal well-being with profound spiritual implications. We are all wounded. When individuals hurt because of the acts of another person or their own volition, we feel anger, resentment, betrayal, and at times hatred. All of these negative feelings can result in depression, discouragement and defeat.

Forgiveness can be a means to experiencing positive spiritual, emotional and physical well-being. Research has suggested that forgiveness can decrease blood pressure, reduce depression and stress, and bring calmness, growth, and serenity. When we forgive we let go of damaging feelings and are then able to rediscover compassion and grace.

HOW DOES FORGIVENESS HAPPEN?

Max Lindenman states in his article, Moral Injury Shows the Limits of Forgiveness, “God’s mercy doesn’t heal moral injury; instead, moral injury prevents us from experiencing, or accepting, God’s mercy.” (July 8, 2015, posted on Patheos, Hosting the Conversation on Faith) If Lindenman is correct, how can the veteran journey toward forgiveness? How can the veteran who has experienced a spiritual injury, whether PTSD, moral injury, or a soul wound, journey toward transformation and healing of the soul? They begin a long spiritual quest that includes confession and forgiveness. Last month we discussed confession. Now we turn to forgiveness.

Forgiveness is an active choice. It is intentional and voluntary. Intentional – It follows personal assessment and insight. Voluntary – Forgiveness cannot be imposed by others.

It is a process and it takes time. Process – Forgiveness is not about saying the words. It is an active process where the person wronged or the person who has committed the offense undergoes a change in feelings and attitude toward the offender, or the incident, or themselves. We must also remember, forgiving does not mean forgetting. Even after forgiving, most likely we will remember the injury, but we will no longer be controlled by anger, resentment, and hatred.

Time – Forgiveness occurs over a period of time as the person works through several phases; exploring the pain, gaining insight, and exploring resolution. Also, forgiveness does not necessarily connote reconciliation with the offender. We can forgive and later decide we do not want to be in relationship with the other person. Important to note, when we forgive, we are no longer bitter toward those who wronged us or shamed by the act toward the person we wronged.

By forgiving others and ourselves, we gain control of our lives from destructive and hurtful emotions.

THREE KINDS OF FORGIVENESS

Both the Hebrew and Christian scriptures offer much instruction when it comes to forgiveness. There are three kinds of forgiveness;

  • God’s pardon of our sins
  • our obligation to forgive others their sins
  • the ability to forgive ourselves

All three are important to understand for our discussion. In order for any of us to experience personal well-being, we must experience all three. Let’s briefly look at each.

God’s pardon of sin – War has been regarded as a gross consequence of human failure; in theological language, sin. The conduct of war often descends into brutality. Even when the outcome may bring peace, the broken and shattered lives along the way become a reminder to those who were engaged of war’s harsh realities.  A sense of brokenness and alienation from God occurs resulting in warriors experiencing grievous wounds to their souls.

We cannot repair our broken relationship with God on our own. David, warrior and general, experienced a spiritual injury. He boldly confesses his sin to God and asks for forgiveness. (Psalm 51) God can remove the stain of guilt, create a clean heart, and renew the spirit. We are reminded each time we celebrate Holy Communion, that on the night prior to Jesus’ crucifixion, Jesus took a cup of wine and told his disciples, “This is my blood of the covenant, which is poured out for many for the forgiveness of sins.” (Matthew 26:28, NIV)

Our obligation to forgive others – Forgiving others means releasing the other person from blame, leaving it to God, and moving on. Some guiding principles are: We do not seek revenge. (Romans 12:17ff) We are tenderhearted toward the person who sinned against us. (Ephesians 4:32) We actively seek the repentance of the person who wronged us. (Matthew 18:15-17) Lastly, we do so because we have been forgiven by God. In Colossians, Paul reminds us that just as the Lord graciously forgave us, we should extend the same kindness to others. “You must make allowance for each other’s faults and forgive the person who offends you. Remember, the Lord forgave you, so you must forgive others.” (3:13, NLT)

Our ability to forgive ourselves – Often the most difficult thing for us to do is forgive ourselves when we do something wrong. We are our hardest critic. Even long after God and others have forgiven us, we still beat ourselves up. Learning to forgive others involves learning to forgive ourselves. Seeking forgiveness from God and others when we are in the wrong is important. But it is just as important to learn from our mistakes and move on. Scripture reminds us to love one another as we love ourselves. Should we not also forgive ourselves as we forgive others?

IMPLICATIONS FOR THE VETERAN

Forgiveness opens the veteran to experience an abundant life. A path of forgiveness represents growth and can lead the veteran toward personal well-being.  To do so, we rediscover compassion and grace.

All too often, society replaces grace with shame, resulting in feeling unworthy, cutoff from God and one another. Once we throw off shame, grace seeps into our souls. Forgiveness is the vehicle to experience grace.

If forgiveness is the vehicle, what is the path? There are numerous paths to experiencing grace. We will highlight three: ritual, story, and service.

Ritual – The faith community over the centuries has practiced forgiveness through ritual. Ritual can help the veteran to accomplish several things;

  • come to terms with that which hurt
  • move from anger to understanding

There are many rituals available to the veteran. Central to most faith communities are practices and rituals offering forgiveness. Whether through corporate or individual prayer, persons can seek forgiveness from God, their neighbor, and themselves.

Prayers of forgiveness can take many forms;

  • composed prayers or litanies (The Book of Common Prayer, Iona Abbey Worship Book, The Work of Your Hands are some examples, or websites: http://prayersofthepeople.org, http://godprayers.org, http://worldinprayer.org)
  • extemporaneous prayers
  • a letter to God
  • praying in action (art and craft, collage, symbolic actions)

Often the veteran cannot express or seek forgiveness face-to-face from the persons they have harmed. However, the veteran can journey toward forgiveness through ritual by practicing forgiveness by a simple act such as;

  • write a letter expressing hurt and anger, then burn it
  • write another letter expressing forgiveness and the reasons behind the decision, keep letter or mail it to the person harmed

Story – One of the most powerful paths a veteran can take is through community, a community of other veterans. Other veterans understand the story of pain, death, destruction, and desolation. Because veterans share a similar context of loss, guilt and shame, they most often will listen, respond with support not judgment, and not condemn nor excuse what has happened. Just sharing it is helpful, but having others who understand becomes healing.

Service to others – By practicing acts of kindness opens the veteran’s heart and eyes to recognize the goodness in themselves. This also reinforces a sense of belonging in community and of acceptance in the community. Acts of kindness avails the veteran to work through the most difficult part of forgiveness, self.

Forgiveness is truly the grace by which we enable ourselves and others to begin anew with dignity. If you have experienced other ways toward forgiveness, please share with us.

Next month, we will discuss the third step in the spiritual model for healing from moral injury, self-acceptance. Until then, thank you for the conversation…

Soul Care Conversation (Spiritual Model for Healing from Moral Injury; First Step – Acknowledgement)

February 9th, 2017 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last month we discussed a study by Duke University on a successful therapy for military sufferers of Post Traumatic Stress Disorder (PTSD). The study reviewed an article published in the JAMA Psychiatry suggesting that cognitive processing therapy (CPT) significantly reduced PTSD symptoms. (“Duke study shows therapy effective for military sufferers of PTSD,” News and Observer, written by Gavin Stone, 28 November 2016)

As we discussed, CPT is a method of treatment that involves evaluating the thoughts and beliefs associated with a patient’s traumatic experience, which for many in the military involves blaming themselves for events in combat that are out of their control. We then did a deep dive into guilt and shame as it pertains to Post Traumatic Stress Disorder (PTSD). Guilt and shame is also a symptom for warriors experiencing moral injury.

In our conversation we discussed that people experience guilt and shame for various reasons. Many find it difficult to move past guilt or shame, which can lead to chronic psychological issues such as depression and anxiety. However, guilt and shame have more than psychological implications. From the perspective of a chaplain or a pastoral counselor, guilt and shame as it is associated with trauma and trauma care must also consider a spiritual dimension.

For this reason, we discussed a spiritual therapeutic model which includes the following components:

  1. Acknowledge – take an honest assessment of thoughts and behavior, then acknowledge guilt and shame, and anger
  2. Forgiveness – choose forgiveness of self in the trauma experience as well as others who may have had responsibility
  3. Self-acceptance – renounce self lies like; I’m no good, I’m nothing, I’m worthless, I can’t be loved, and accept the reality of being a child of God
  4. Renewal – begin to retrain mind
  5. Amends – restoration involves a direct way to repair what has been damaged or broken (for the veteran, maybe difficult to go back to place of injury, however, there are other ways; contribute to refugee or orphan fund in the area of the war, volunteer at a shelter or soup kitchen, etc)
  6. Accountability – be in a community that offers accountability and support

We will discuss in some detail each of these components. For this week’s conversation, let us discuss the first component, acknowledge.

BACKGROUND  

“Acknowledge” is defined; to admit to be real or true, recognized the existence, truth, or fact of.  A synonym is confession.  Confession is a written or oral statement acknowledging guilt. Confession has deep roots in traditional religious rites in both Judaism and Christianity.

As we examine the religious act of confession, we are reminded that from the opening pages in the first book of the Torah, the Hebrew scripture tells us something has gone wrong; loving relationships have been broken, creation has been marred, humanity has been separated from God because of human sin. All of creation is in need for God’s healing. What are we to do? The first step toward restoration with God is to acknowledge our sin. Confession becomes a vital part of our fellowship with God as it provides an opportunity to be reconciled within the community.

THE PRACTICE OF CONFESSION

When we sin we alienate ourselves from God, community and self. Sin blocks us from becoming all that we are created to be. We acknowledge our sin through confession. Confession enables us to be reconciled to;

  • God
  • community
  • self

Confession. The word stirs up memories. Whatever the memory, most likely it is not pleasant. For many, confession connotes pain from failure and being weighed down with guilt. However, confession offers us healing through a face to face encounter with the grace, love, and forgiveness of God.

As humans, no matter if through faith we are committed to God, we still have difficulty turning away from sin. We recognize our weakness and constant need for turning back to God and be reconciled. We do this through confession of our sin.

Soul Care Conversation (PTSD, and Guilt and Shame)

December 21st, 2016 Posted by Blog 4 comments

 

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last week I concluded the outline for the Soul Care Conversation that we began over one year ago. We discussed networking with community agencies and governmental organizations regarding veteran care. As we look to future conversations please consider topics that we have discussed that you desire to go deeper, or offer suggestions on a particular topic that you desire to discuss. For this week, I received a suggestion from a colleague that desired to be in conversation about guilt and shame as it pertains to Post Traumatic Stress Disorder (PTSD).

BACKGROUND  

Recently, I read an article in the News and Observer that discusses a Duke study suggesting that Cognitive Process Therapy (CPT) significantly reduced Post Traumatic Stress Symptoms.

The study, in the journal JAMA Psychiatry, is the largest randomized clinical trial to date to apply cognitive processing therapy, or CPT, which has been used among civilians for decades, to active-military patients who are suffering from PTSD. It found that while using the treatment in both group and individual sessions significantly reduced PTSD symptoms, individual treatment was nearly twice as effective. (“Duke study shows therapy effective for military sufferers of PTSD,” News and Observer, written by Gavin Stone, 28 November 2016)

CPT is one of numerous forms of psychotherapy being used with our veterans diagnosed with PTSD. Therapies that have exhibited a track record of success include;

  • cognitive behavior therapy (CBT)
  • cognitive process therapy (CPT)
  • eye movement desensitization and reprocessing
  • exposure therapy

The VA and DoD also have used additional therapies as reported by the Washington Post to include;

  • equine therapy
  • alpha stimulation
  • guided imagery
  • yoga
  • hypnosis
  • aqua therapy
  • Botox

To understand CPT, let’s briefly review two factors; methodology and outcome.

CPT’s method;

  • face the trauma through a detailed written account
  • share the account with a therapist
  • work within a group process

CPT’s goal;

  • break the pattern of avoidance
  • enable emotional processing

Emotional processing allows for the clarification and modification of cognitive distortions. In other words, CPT provides the trauma survivor the opportunity to begin to look at the cause of the trauma and its effects in a different way. The bottom line is that the trauma survivor can choose to move beyond being a victim into being a stronger person by living into the possibilities of growth from the trauma experience.

The article continues to flush out the thought process of a trauma survivor, especially a combat warrior. The trauma survivor see themselves as a victim, but they also blame themselves for the event.

CPT is a method of treatment that involves evaluating the thoughts and beliefs associated with a patient’s traumatic experience, which for many in the military involves blaming themselves for events in combat that are out of their control, according to Patricia Resick, a professor of psychiatry and behavioral sciences at the Duke University School of Medicine and lead author of the study. Resick said that this tendency comes from the belief that in a “just world” good things happen to good people, which for some could also mean that if something bad happens it’s because you’re a bad person. “Instead of looking to the perpetrator of the trauma, they look to themselves to assign blame,” Resick said. “What we do is we systematically lead them through a series of steps to teach them to ask themselves questions so they can make more balanced statements about themselves.”  (“Duke study shows therapy effective for military sufferers of PTSD,” News and Observer, written by Gavin Stone, 28 November 2016)

People experience guilt for various reasons. Many find it difficult to move past guilt which can lead to chronic psychological issues, such as depression and anxiety. I have read research, surveys, periodicals, and books that all look at treatment from a psychotherapy model.

However, guilt and shame have implications beyond the psychological component.  From the perspective of a chaplain or a pastoral counselor, trauma and trauma care must also reflect a spiritual dimension.

LIVING LESSONS 

For one year I took part in a trial program, PTSD Pathways, at Fort Belvoir 2013-2014. The program included psycho-education, CPT, CBT, relaxation techniques, coping skills, and the understanding of relationships.

I learned that the primary focus of CPT was to help me re-conceptualize my traumatic event in order to reduce its ongoing negative effects. The Pathways program using CPT proved somewhat beneficial in my initial healing. However, the psycho-therapy did not go far enough. CPT lacked the spiritual component.

Trauma effects not only the body and mind, but also the spirit. From my foxhole, the behavioral health community has been reluctant to recognize the relevancy of the spiritual component in our veteran care.

However, recently the conversation about PTSD now includes another dimension, moral injury. (We discussed in detail in an earlier conversation.) Some behavioral health experts describe moral injury as a psychological scar of war.

Moral injury is unlike PTSD, which is based on fear from feeling one’s life threatened. Moral injury produces guilt and shame from something done, or not done, or witnessed that goes against one’s values. Men and women have returned from war broken and their diagnosis is wrongly labeled PTSD because their wound was not recognized as a moral injury. Often PTSD and moral injury overlap. But, it is imperative that the therapists/counselors differentiate the two.

I believe one of the reasons I continued to struggle after completing the Pathways program was the absence of the spiritual component in my work toward healing. I worked with diligence attempting to overcome my fear from my trauma, however, I had yet to work on the damage left by decisions made in war.

Moral injury has taken on life within the behavioral health community. Should not the faith community become involved in the discussion, offer ideas for healing, and partner with the behavioral health community for our veterans?

IMPLICATIONS FOR THE FAITH COMMUNITY 

For the purpose of this conversation, let’s look at a possible spiritual therapeutic model. What should be some of the critical components? For me, a model may include;

  1. Acknowledge – take an honest assessment of thoughts and behavior, then acknowledge guilt and shame, and anger
  2. Forgiveness – choose forgiveness of self in the trauma experience as well as others who may have had responsibility
  3. Self-acceptance – renounce self lies like; I’m no good, I’m nothing, I’m worthless, I can’t be loved, and accept the reality of being a child of God
  4. Renewal – begin to retrain mind
  5. Amends – restoration involves a direct way to repair what has been damaged or broken (for the veteran, maybe difficult to go back to place of injury, however, there are other ways; contribute to refugee or orphan fund in the area of the war, volunteer at a shelter or soup kitchen, etc)
  6. Accountability – be in a community that offers accountability and support

Do you have a model? What would you include? What components should we include that are missing from the model here? Have you included a spiritual dimension in the care of a veteran diagnosed with PTSD? What does that look like?

I hope this sparks a conversation among us. This is an important aspect of caring for those affected by trauma.

I pray that you have a very blessed Holyday season and a Happy New Year. Until next year….thank you for the conversation.

 

Soul Care Conversation (Network with Community Resources)

December 3rd, 2016 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last week I hope you enjoyed the blessings of celebrating Thanksgiving with family and friends. Due to celebrating Thanksgiving with my family, I did not write our weekly blog. This week, we will discuss the importance of networking with faith partners and other community resources in order to care for veterans and their families.

BACKGROUND 

From a geopolitical perspective, war is about national defense and strategy, often linked to patriotism. However, the personal factor of war is about courage, sacrifice, pain, sorrow, and tragedy. There often is disagreement among our national leaders and among our citizens as to the geopolitical importance or legitimacy for a particular war. However, only a few will argue about the personal cost of war for those who were asked by their nation to fight in them.

Regardless of the purpose of war or the conditions of combat, fighting is intensely personal to the warrior. To the individual Soldier, Sailor, Airmen, Marine, or Guardian, war is about staying alive and providing support and protection to his/her battle buddy. Daily survival takes precedence over national strategy.

This factor is often forgotten when the realities of war are put behind us. This is an important distinction, when our nation is ready to move on after war has ended or even in the midst of our current war, the individual veteran can not put the war behind him/her.

All wars since the American Revolution have been described in terms of the length, cost, and casualties. But each war had its unique aspects that posed challenges to public support and the military/veteran care system. These factors affected the veteran.

The needs in our veteran community are great. Whether a veteran has served 6 years stateside supporting the war effort or a 3 year enlistment of 2 years deployed, veterans have earned our nation’s care and service. They have served selflessly and have made great sacrifices. Veterans seek the following;

  • employment
  • medical care and mental health care
  • education and training
  • housing and home loans
  • disability compensation and pension
  • burial benefits

The Department of Veterans Affairs (VA) coordinates and manages the nation’s largest integrated health care system with more that 1,700 hospitals, clinics, counseling centers, community living centers, and other care facilities.

Additionally, there is a plethora of community and faith based organizations, and local and state government agencies partnering with the VA to complement care and services.

However, I believe there are two factors that can affect comprehensive and quality veteran care;

  • large number of veterans accessing the VA
  • network of care for veterans and their families is vast but disconnected

Lets look briefly at both of these factors.

First, we have 21.5 million veterans from World War II, Korea, Vietnam, Grenada, the Cold War, Panama, the Gulf War, Bosnia, Kosovo, and the Post 9/11 Wars. The Department of Veterans Affairs often becomes overwhelmed with the challenges of managing veteran needs. The problems at the VA are well documented; long waits, poor service, and delayed or at times denied health care and other benefits.

Second, our communities have an extensive network of veteran services; non-profit and charities as well as local and state government agencies. There are over 20,000 organizations designed to provide a specific aspect of care to our veterans and their families. The list is quite vast. However, there is a lack of integration within the network.

This week, google veteran care and you will see pages of services available to veterans and their families. A few examples are;

  • Veteran Service Organizations (VFW, American Legion, Disabled Veterans of America, Wounded Warrior Project, Red Cross, and hundreds more)
  • Operation We are Here and Veterans Families United Foundation (Resources for the military community and care providers for veterans with PTSD)
  • Citizen Soldier Support Program (Connects veterans and their families to primary health care and behavioral health providers)
  • Vet Jobs (Connects transitioning military men, women, and family members to the civilian work force)
  • Hidden Heroes Foundation (Provides awareness of the challenges experienced by military/veteran care-givers and a national registry)

Additionally, over the last decade, more and more organizations provide spiritual care resources. Some include;

  • We Honor Veterans (National Hospice and Palliative Care Organization provides care at the end of a veteran’s life)
  • Veterans Health Administration recognizes the importance of providing for the spiritual care of veterans
  • Coming Home Project (Provides care, support, education, and tools to veterans, families, and care-providers committed to the silent wounds of war)
  • Soul Repair Center (Provides workshops, conferences and resources to faith communities dealing with veteran moral injury)
  • Mighty Oaks Warrior Program (Mission is to provide veterans a new life purpose through hope in Christ)
  • Military Outreach (Connects faith communities with veteran needs)

FAITH COMMUNITY IMPLICATIONS

We recall the two factors that can affect comprehensive and quality veteran care; millions of veterans overwhelming the VA system, and a large disconnected network of agencies providing care. To meet these challenges, the faith community can provide three critical components;

  • partner with the various entities in the community offering veteran care
  • network with the organizations and charities providing mental, spiritual and physical care
  • provide a connection through spirituality

Partner with community organizations and governmental agencies – Because our congregations include persons who live and work within their respective communities, they have connections either through professional or personal relationships with veteran care organizations. Faith community leaders can cultivate these connections, develop relationships, and offer support through the volunteering of time, financial contributions, or establishing long term commitments in leadership. Through relationships, faith community leaders can ensure the spiritual dimensions of our veteran care will be addressed.

Network with organizations and charities –  The faith community can be the conduit for veteran care. There are several steps that can be taken that bring an integration of support; research those entities within the community offering veteran support, reach out to and develop a relationship with these organizations, design a “yellow pages” that delineates support agencies and distribute to community leaders, and collaborate within the network in order to discuss and meet veteran challenges by leveraging community resources. A practical step, call the VA Hospital Chaplain, or the VA Clinic Director in your community. Seek information on how to be supportive of the VA programs.

Provide a connection through spirituality – Each veteran’s journey is unique. Whether renewing their faith or finding a new spiritual path, veterans are exploring and discovering the role of spirituality to overcome their challenges. Through awareness, training, and sensitivity, the faith community can provide a role in healing, restoration, and well-being.

What has been your experience with charities and organizations supporting veterans? What good news stories do you have in networking with community resources?

So, I have exhausted my outline for the Soul Care Conversation. I would appreciate hearing from you as far as future topics to discuss. Let me know. In the mean time, thank you for these conversations…

 

 

Soul Care Conversation (Faith Community Response, Make Meaning)

November 18th, 2016 Posted by Blog No Comment yet

(The purpose of Soul Care Conversation is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last week as we honored our veterans, I shared a personal reflection on the sacrifice our veterans make while serving our nation. This week, we will discuss the fifth and last response of the faith community, make meaning.

BACKGROUND 

Meaning and purpose are central in human life, particularly when individuals confront highly stressful and traumatic life experiences. Some researchers have suggested that traumatic events frequently challenge one’s core beliefs about safety, self-worth, and the meaning of life.

For individuals whose core values are spiritually grounded, traumatic events may give rise to questions about the fundamental nature of the relationship between God and humankind, and between God and self. Survivors may question their belief in a loving, all-powerful God when the innocent are subjected to traumatic victimization. In this way, traumatic experiences may become a starting point for discussion of the many ways in which survivors define what it is to have “faith.“

Trauma can shake one’s faith.  The veteran wants to understand why. Why did the traumatic event occur? Why did they survive? The journey to understand the why can be a long process for the veteran.

Trauma interferes with the practices that embody our systems of belief. The soul of veterans often demonstrate the ineffectiveness of their prayers, their worship, the value of scripture, and their faith. For many of our veterans, their traumatic experiences with which they struggle will affect their understanding of God and faith. The pain and terror of trauma can infuse such doubt in God and God’s faithfulness that the veteran reaches a point of denying God and their faith. The veteran can question God’s ability to intervene in the situation. The veteran can feel that God is punishing them and blame God for the loss.

For others, the presence of a meaning-making system, such as faith, serves as a protective factor when trauma strikes. Faith and spirituality can assist the veteran in developing a sense that love shapes God’s activity; patient, persevering, and long lasting. It is through love that God responds to a broken world.

Holocaust survivor Viktor Frankl writes in his 1946 book, Man’s Search for Meaning, that the primary motivation of a person is to discover meaning in life. Throughout this powerful book Frankl insists that meaning in life can be discovered under all circumstances, even in the most miserable experiences of tragedy and loss. Through his own experience Frankl shared that people can discover meaning through doing a deed, experiencing value, and even by experiencing suffering. Meaning making is a key component in trauma healing.

LIVING LESSONS

During my deployment to Iraq, 2003-2004, I experienced a wounding of the soul. The circumstances of these wounds I have shared in previous conversations. My symptoms of soul loss were the following;

  • shattered self esteem
  • finding it difficult to pray
  • no spirit of thankfulness
  • seeing no value in scripture
  • not interested in attending worship
  • deep self-doubt

These symptoms would ebb and flow for 8 years. At times I would find myself experiencing a sense of peace through the ritual of worship, or a sense of healing through a spiritual retreat, or a sense of community when with other combat veterans.

However, I noticed that many of my symptoms subsided when I began my tour in Afghanistan as the Command Chaplain for all US Forces. Possibly because the mission was so daunting that my focus was on the task at hand. But, I believe it was something much deeper.

It became clearer after my re-deployment. I was re-assigned into a new position where I experienced very little significance, meaning and purpose. I began to exhibit similar symptoms that I had following my Iraq deployment.

I finally recognized that I needed professional help to work through what I was feeling and experiencing. During the course of these last four years it has been the wise council of a therapist and the listening ears of fellow veterans in a support group that have assisted me on a healing journey. But I have discovered that at the center of all of this has been re-discovering meaning and purpose.

After my retirement from active duty, JustPeace hired me as staff to be the Coordinator for the Soul Care Initiative. Soul Care was a new emphasis for the United Methodist Church’s resource agency for Conflict Transformation and Mediation. My responsibilities have brought me great meaning and purpose.

But something else happened. I conducted my first workshop in a small college town in central Pennsylvania. As I look back on that first workshop experience, I believe I provided the participants a very sterile/clinical approach to trauma and trauma care. However, I began to include my personal story in my training presentation. This was not easy to do, but I thought it important to be authentic to those who trusted me to share such important information.

A year later I conducted a workshop in a community in close proximity to where my first workshop occurred. A person who attended my first workshop was in attendance. He commented that he was appreciative how I made myself vulnerable to the participants and wished I had done the same the year prior.

I then recognized that I was on my healing journey. Not that sharing the harsh realities of war is ever easy, but in revealing my journey with others proved to me that this was an important step. My healing journey took a big step when I discovered purpose and meaning for my life as I shared my story.

IMPLICATIONS FOR THE FAITH COMMUNITY 

The faith community can become a part of the veteran’s journey to find the answer to “why?” The faith community can engage veterans in their journey toward finding meaning and purpose by;

  1. Offering numerous interest groups – Research has suggested writing workshops and art therapy have value in spiritual healing. But there are numerous opportunities such as; rock climbing, bicycling, motor cycle riding, hiking, and other high adventure activities.
  2. Providing veterans opportunities for service – This gives them a connection beyond themselves and an opportunity to serve others. Invite veterans to participate in a Habitat for Humanity project, a Volunteer in Mission project, or some other work project that allows the veteran to give back. There are some groups whose focus are veterans; Team Rubicon, Volunteers of America, and Grace Under Fire, are some examples.

What examples can you offer, whether an interest group or volunteer opportunity, where you have seen success? Have you found other methods for veterans to find meaning and purpose?

This concludes our conversation on the faith community response. Next week we will begin to explore the various veteran support agencies that the faith community can collaborate with in veteran care. Until then, thank you for the conversation…