T R E A T I N G T R A U M A I N C H R I S T I A N C O U N S E L I N G EDITED BY HEATHER DAVEDIUK GINGRICH FRED C. GINGRICH InterVarsity Press P.O. Box 1400, Downers Grove, IL 60515-1426 ivpress.com [email protected] ©2017 by Heather J. Gingrich and Frederick C. Gingrich All rights reserved. No part of this book may be reproduced in any form without written permission from InterVarsity Press. InterVarsity Press® is the book-publishing division of InterVarsity Christian Fellowship/USA®, a movement of students and faculty active on campus at hundreds of universities, colleges, and schools of nursing in the United States of America, and a member movement of the International Fellowship of Evangelical Students. For information about local and regional activities, visit intervarsity.org. All Scripture quotations, unless otherwise indicated, are taken from The Holy Bible, New International Version®, NIV®. Copyright © 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission of Zondervan. All rights reserved worldwide. www. zondervan.com The “NIV” and “New International Version” are trademarks registered in the United States Patent and Trademark Office by Biblica, Inc.™ While any stories in this book are true, some names and identifying information may have been changed to protect the privacy of individuals. Selected excerpts in chapter 14 are from Aten, J. D., O’Grady, K. A., Milstein, G., Boan, D., Smigelsky, M., Schruba, A., & Weaver, I. (2014). Providing spiritual and emotional care in response to disaster. In D. F. Walker, C. A. Courtois, & J. D. Aten (Eds.), Spiritually oriented psychotherapy for trauma (189-210). Washington, DC: American Psychological Association. Used with permission. Cover design: Cindy Kiple Interior design: Daniel van Loon Images: cracked paper background: © ekychan/iStockphoto ISBN 978-0-8308-8912-9 (digital) ISBN 978-0-8308-2861-6 (print) To Rico, Lynette, and Janet CONTENTS Introduction 1 Heather Davediuk Gingrich and Fred C. Gingrich Part One: Foundational Perspectives on Trauma 1 The Crucial Role of Christian Counseling Approaches in Trauma Counseling 19 Fred C. Gingrich and Heather Davediuk Gingrich 2 Theological Perspectives on Trauma: Human Flourishing After the Fall 39 Richard Langer, Jason McMartin, and M. Elizabeth Lewis Hall 3 The Neurobiology of Stress and Trauma 55 William M. Struthers, Kerryn Ansell, and Adam Wilson 4 Trauma, Faith, and Care for the Counselor 78 Cynthia B. Eriksson, Ashley M. Wilkins, and Nikki Frederick Part Two: Interpersonal Contexts of Trauma 5 A Developmentally Appropriate Treatment Approach for Traumatized Children and Adolescents 99 Daniel S. Sweeney and Madeline Lowen 6 Treating Sexual Trauma Through Couples Therapy 119 Debra Taylor 7 Assessment and Treatment of Intimate Partner Violence: Integrating Psychological and Spiritual Approaches 141 Terri S. Watson 8 Strengthening Family Resilience to Trauma 163 Fred C. Gingrich 9 Responding to Survivors of Clergy Sexual Abuse 188 David K. Pooler and Amanda Frey Part Three: Complex Trauma and Dissociation 10 Beyond Survival: Application of a Complex Trauma Treatment Model in the Christian Context 211 Jana Pressley and Joseph Spinazzola 11 Sexual Abuse and Dissociative Disorders 232 Heather Davediuk Gingrich 12 The Treatment of Ritual Abuse and Mind Control 257 Alison Miller and Heather Davediuk Gingrich 13 Sex Trafficking: A Counseling Perspective 278 Shannon Wolf Part Four: Global Contexts of Trauma 14 Faith and Disaster Mental Health: Research, Theology, and Practice 305 Jamie D. Aten, Alice Schruba, David N. Entwistle, Edward B. Davis, Jenn Ranter, Jenny Hwang, Joshua N. Hook, David C. Wang, Don E. Davis, and Daryl R. Van Tongeren 15 Improving Trauma Care in Developing Nations: Partnerships over Projects 322 Philip G. Monroe and Diane Langberg 16 Trauma Counseling for Missionaries: How to Support Resilience 340 Karen F. Carr 17 Preventing and Treating Combat Trauma and Spiritual Injury 363 Laura Schwent Shultz, Jesse D. Malott, and Robert J. Gregory Part Five: Conclusion and Appendix 18 Reflections on Christian Counseling’s Engagement with Trauma 385 Heather Davediuk Gingrich and Fred C. Gingrich Appendix: Religion, Spirituality, and Trauma: An Annotated Bibliography 389 Fred C. Gingrich Contributors 469 Subject Index 475 Praise for Treating Trauma in C hristian Counseling 489 About the Editors 491 More Titles from InterVarsity Press 493 INTRODUCTION HEATHER DAVEDIUK GINGRICH AND FRED C. GINGRICH What drew you to this book? Perhaps your interest in trauma emerges from personal experience, and either you or people you care about deeply have suffered as a result of exposure to traumatic events. Or it may stem from genuine compassionate concern for those who suffer, even without such intimate knowledge of the topic. For others, the exploration of this aspect of human existence may be more academic, in the sense that trauma has become a major area of study in the disciplines of psychology, soci- ology, and related fields. Whichever of the above categories best fits you, studying trauma is likely to have some degree of personal impact. The horror of entering into the worlds of those who are trauma survivors, even if only on paper, can often produce a resistance to thinking and learning about trauma, perhaps to the extent of denying its prevalence or severity. Alternately, it can lead to a desire to understand the complexities of why trauma happens, how people survive, and what is involved in recovery. Either way, you may find this book a difficult read as page after page and chapter after chapter describe the ways in which trauma survivors have been affected by the horrendous things they have experienced. So we recommend that you pace yourself as you read so that you can sit with the material and monitor your emotional reactions to it as you go along. Practicing good self-care (see chap. 4 for suggestions) is also a wise idea. How Big an Issue Is Trauma? It is big—unfortunately, too big. In some significant ways trauma provides the context of human experience. Following are a few research-based statistics on the ubiquity of traumatic experiences. Other authors in this volume have added preva- lence rates with respect to their specific areas of focus. The US Department of Justice (n.d.) reports the following: 2 Introduction ● 9.3% of cases of maltreatment of children in 2012 were classified as sexual abuse (62,939 cases of child sexual abuse); however, approximately only 30% of sexual assault cases are reported to authorities. ● Approximately one in seven (13%) youth Internet users received unwanted sexual solicitations. ● About 20 million out of 112 million women (18%) in the United States have been raped during their lifetime. ● Research conducted by the Centers for Disease Control (CDC) estimates that approximately one in six boys and one in four girls are sexually abused before the age of 18. ● Approximately one in five female high school students report being physi- cally and/or sexually abused by a dating partner. Estimated Risk for Developing PTSD • Rape: 49% • Severe beating or physical assault: 31.9% • Other sexual assault: 23.7% • Serious accident or injury (for example, car or train accident): 16.8% • Shooting or stabbing: 15.4% • Sudden, unexpected death of family member or friend: 14.3% • Child’s life-threatening illness: 10.4% • Witness to killing or serious injury: 7.3% • Natural disaster: 3.8% (Sidran Institute, n.d.) The National Center for PTSD (2016) reports that “going through trauma is not rare. About 6 of every 10 men (or 60%) and 5 of every 10 women (or 50%) expe- rience at least one trauma in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, disaster, or to witness death or injury.” Furthermore, about 7%–8% of the population (about 10% of women and 4% of men) will develop posttraumatic stress disorder (PTSD) at some point in their lives. The rate of sexual assault within the military has been a national concern, with 23% of women reporting sexual as- sault while serving in the military. The National Trauma Institute (2014) reports similar trauma statistics in a different way: