Recent years have provided us with a sharpening of awareness of many patterns of trauma in their various unique forms.  Situational trauma, disability trauma, inherited trauma, traumas of violence, among others, all have their particular forms and healing paths, yet even when healed the sufferers carry their permanent scar tissue in their souls.

Approximately 10 years ago in my work as a pastoral counselor, I had a successive series of trauma events surrounding the sudden loss of adolescent children through death (mostly these involved accidents, although some were instances of drug and alcohol deaths). The intensity of these trauma journeys revealed the insufficiency of my standard care-giving and healing paths, and prompted a necessary deeper reflection on my insufficient trauma awareness.

Most of trauma recovery narratives have as their ultimate objective the state of healing that grants the sufferer at a minimum, restored equilibrium, and a sufficient sense of harmony that allows life to find the goodness that makes life worth living. This goal is not inappropriate but comes with the additional profound recognition that certain wounds will not heal. The death of a child is such a wound. What makes such trauma enduring is multilayered, but two factors do reveal why such trauma remains.

The very structure of the universe seems to evoke of this state of permanence. None of us believes we should outlive our children. Losing them before their time is an affront to creation. It comes to us as a violation of an implicit “pact” we make with life. Deep in our bones we know life is meant to be full and complete, and when a child dies before we do, it defies that deep inner logic. That fact alone brands us forever as sorrow carriers.

But there is an even deeper core to the permanent wound of such a sufferer, which is the flow of love itself. Love, by its very nature is abiding and internal. Love for a child is a “forever love” and is indivisible. Even ruptured parent-child relationships carry that love that even in their alienated form. If anything, an alienated parent-child bond burdens in the love-permanence even more deeply in a stuck way, because the love cannot find the flow, the soothing and reconnecting that the love journey might otherwise find.

Many suffering outcomes flow from this abiding wound. A loss of a child, young or old, researchers have found, leads to all the obvious outcomes such as chronic depression, which often in addition lead to poorer physical health, higher rates of failed marriages, as well as factors such as addictions. Often, these outcomes become more visible even decades later.

A recent New York Times report highlights the preponderance of these trauma events in people’s lives. A Federal Health and retirement study from 1992 to 2014 reported that 11.5% of persons over 50 have lost a child. This number is higher among blacks (16.7%) than whites (10.2%).[i] Demographic changes in society are accelerating the prevalence of these suffering stories. With greater longevity the chances increase that you will outlive your child. Rising rates of drug mortality and suicide in early to midlife will certainly increase these numbers, and will likely accelerate the deepening of this trauma trajectory because of stigmatization factors. So-called “messy” or ambiguous loss narratives carry a particular vulnerability around trauma that has yet to be worked through, and spiritually-minded caregivers need additional layers of sensitivity to address these deeply entrenched patterns.

Pastoral care providers and their communities will certainly need a deepening sensitivity to this reality.  There are numerous helpful models of care and strategies of support that pastoral persons have historically found helpful when addressing trauma. But I wish to underscore a particular feature that is found within permanent trauma states.  The reason why I need to single out this particular concern will seem obvious, but it remains a difficult notion to grasp.

The great paradox of trauma linked to love is that it cannot be, nor should it be, removed.  The very nature of love suggests it forever seeks its love object. Theology has already revealed this truth to us in our experience of God’s love. God’s love is forever seeking to draw us into such love. We are shaped and formed forever in that mode, however faintly we may reflect that reality in our messy lives. We love because we have first been loved, and love ultimately wants to find its way home.

Thus, the abiding necessary journey of love is to have the flow of love restored. All ruptured or lost love must undergo the arduous journey of being “emptied out” from its here and now form. Such losses must be grieved in their hard reality, their permanence, namely in the tangible and real absence of the loved one. Often, our tolerance for the duration of these journeys is limited, both for the sufferer and for those of us accompanying them. This is long haul work. Yet this is why we call it “grief work.”

Any sufferer, of course, experiences the inevitable wish to repress the pain, to find a timeout, to escape from the ache. These efforts should be understood and accepted with sensitivity, compassion, and deep empathy. There is a point, however, when repressed and suppressed suffering narratives break back into awareness. At that critical juncture active support needs to be made available to allow the love narrative to resurface again, and to be reworked as love in the here and now. This means taking the love back into ourselves as an eternal, abiding link. We do this by reworking memory, by listening for dreams, by sensitively holding all the traces of love for and with another. By reworking the traces of love they are taken back into the soul to soothe, comfort, strengthened, and ultimately guide. We are forever informed and changed by the love we have once lived.

Intentional work with one’s own trauma loss narratives, done with the right preparation and right intention, takes us toward the heart of God. The heart of God is that power of the universe that takes all fragments of its life and holds them secure in their realness, and especially in their absent or alienated form. The careful holding of these trauma narratives as they are worked through, incubates them and makes this love available again for future use and eventual return to the larger wholeness of life, understood both individually and collectively. It is of course, also the journey of God and when we are accompanied in this way, in the great mystery of God, we become partners in this endeavor.
 

[i] NY Times. Paula Span. “A Child’s Death.” September 29, 2017.

ICTG provides restorative strategies to leaders for personal and group growth after loss. You can find training materials here. You can learn more about the coaching and custom care plans we provide here. 

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An ancient proverb says, “Even in laughter, the heart may sorrow.”  People tend to hide their pain when they are in public.  The “faces” they bring to our congregations every week may not always reflect the true condition of their hearts.  What are some immediate steps we can take, as pastors, religious leaders, and ministers, to provide care for those struggling with depression and suicidal thoughts?


Here are three immediate suggestions:

1. Have three current suicide hotlines memorized or available to distribute at a moment’s notice.  Check these hotlines every three months to make sure they are working.
2. Refer your congregant to a licensed psychologist or counselor.  To do this, it can be helpful to build community relationships and partnerships with professionals in these fields. 
3. Call 911. In many states, a pastor, religious leader, or minister is a mandatory reporter.  This means that you may be required by law to file a report to a professional agency if you become aware that someone is a threat to themselves and/or others, or if you suspect child and/or elder abuse. 
   

When it comes to depression, we may feel ill-equipped, discouraged, and even avoidant.  Often times when people do not know how to help, or when they feel overwhelmed by a problem, they may avoid the issue all together.  What are manageable steps we can take can take to offer care for congregants who may be suffering?

I’ll turn to the narrative of a good friend I lost in high school, and one recommendation he shared.  Alex is his name; he died by suicide the summer after our high school graduation.  He was a close friend and all-around great person.  We worked together, played varsity golf throughout high school together, and went through a lot of hardship together.  High school was not easy for us.  Two friends committed suicide, our coach died of a heart attack on the practice field, our math teacher died of cancer, and another close friend died of cancer.  Many students struggled, and Alex and I were no exception. 
I was intentional to reach out.  I knew he was depressed, but I was 17 at the time and didn’t know what to do.  I would try to talk to him, ask him questions, and see if there were places or activities that would help him to feel better, searching for anything that could help. 

One night, we were working at the golf course, and I was reflecting on the difficulties we were facing.  I said, “I feel like I’ve run out of things to say or do or try.  Nothing works, and there’s nothing that can make any of this better.”  Alex turned to me and said, “You’re genuine. That’s what matters.  You actually care about people. You can’t fix me or solve my problems, but you being you makes a difference.  Keep being that person, and don’t let the world change you.”
Pain, anger, violence, despair, and ministry can change us. It can transform us into a shell of a human being. Yet there is a tough call in the midst of it all, to continue to be who we are and to resist the inclination to conform to the pain, anger, despair, or violence in our world. Instead, I believe we can seek to transform it if we stay focused on being who we are and keep moving forward. 


Here is the most important thing Alex taught me that you can do for yourself to become equipped and empowered to care for the suffering of others:

1. Become the best version of yourself possible

Here are five suggestions to get there...

1. Self-care
   1. We cannot care for others if we are not caring for ourselves. Suffering has a way of creating more suffering.  A well -ntentioned caregiver may begin to share, versus care for, their suffering with care seekers if they are not actively engaged in self-care practices.  Healing practices are done from a healed or healing heart. It is because one is actively being cared for that one is able to care for others.
   2. Take 10-minutes to create a self-care plan.  Target areas can include: sleep, eating, exercise, personal time, social time, family time, and recreation time.
2. Self-development
   1. Leadership development is self-development. Congregational care is done from a place of personal formation. We cannot serve beyond the person we are.  Therefore, self-development invites leaders to expand their capacities, including both their strengths and weaknesses, to become more equipped for practices of are.  There are many modes of self-development.  This could be a spiritual retreat, taking a course at a local university, or purchasing a few books.
3. Pursue healing
   1. I would argue that ministry is traumatic. Pastors, religious leaders, and ministers are exposed to so much pain, hardship, and suffering.  This can lead to vicarious trauma. Therefore, ongoing healing is an aspect of self-care that helps leaders to care for their wounds.  Healing is powerful for three reasons.  First, it restores wholeness to the caregiver. Second, it creates sacred spaces for the caregiver to resolve suffering and experience liberation and spiritual growth. Third, it restores the leader so that are equipped to continue to go out and care for the pain and suffering of others.
4. Develop, memorize, and meditate on your mission statement
   1. Our aims and values form an orienting system.  They influence what we pursue, what we ignore/avoid, and tell us why we are doing what we are doing.  It is easy to forget the mission.  Pain, anger, violence, or despair can be discouraging and distract us from our mission.  If you have not developed a mission statement, spend a week developing one. Being able to remember and meditate on a mission statement can refresh, rejuvenate, and re-center our passion to the mission.
5. Stay focused and pursue progress towards this mission every day
   • Discouragement and distraction may take many forms.  The goal of focus is a right attitude.  Pressing forward is about progress, not perfection.  Let your goal be, in every moment, and in every day, to try to become just a little bit better in all that you pursue.
   • Focus is difficult and it is easy to lose. If you have a crisis and become frustrated, lost, or forget why you’re in ministry, re-goal.  Take a 30-minute break and write down your goals for ministry. Reflect on the basics.  Why did you want to become a faith leader?  What strengths, tools, and resources do you have that can enable you to make a difference?  What obstacles are you facing right now and what do you need to overcome these obstacles?  What do you need to get back on track and to pursue the mission that brought you into ministry?

A closing blessing

May you be richly blessed so that whatever your eyes see, hands touch, and feet pursue might be richly blessed.


The easiest distraction to long-term care is our own discouragement, feeling like we don’t make a difference, or perhaps that our life doesn’t matter. In ministry, the time, effort, and energy you put into service isn’t always acknowledged and doesn’t always make its way back to you in the form of appreciation.  And yes, the saying is true, “People who feel appreciated always do more than expected.” Yet, pastors, religious leaders, and ministers are often unappreciated for the work and effort they put into ministry.  If you’re feeling unappreciated or burned out, take a 30-minute recharge.  Get a sheet of paper and write down your mission statement.  What first brought you into ministry?  What do you love most about loving and caring for people? Rekindle the heart that kindles the passion for ministry.  You matter and you are who makes the difference.
 

Six years ago, I received a phone call that I didn't want to receive. In the early morning hours, when I was not yet fully awake, my brother-in-law informed me that my husband had suffered cardiac arrest and was not expected to live.  He was in ICU and I needed to get to the hospital as soon as possible.
 
Unfortunately for me, I was not at home when I received this call, but all the way across the country from where we lived. Frantic plans ensued to get me on the first flight available back home. The almost six hour flight stretched on interminably and the news that greeted me upon my arrival was not welcome. While the medics were able to finally re-start my husband's heart, it came fifty minutes too late. A battery of neurological tests over the next three days presented conclusive and consistent evidence that my husband was now brain dead. Machines kept his heart beating and his lungs filled with air. Once the decision was made to remove him from those machines, he breathed his last, labored breath an hour and forty-five minutes later.
 
A lifetime was over in one hundred and five minutes. Not only had his life ended, but the life we shared together had ended as well. While the grief I felt immediately was over his unexpected death at such a young age, it was the grief that stalked me over several years as I suffered all the 'little deaths' that were yet to come. There were the obvious deaths; anniversaries, birthdays, and holidays marked the absence of my husband, not the fullness of celebrations. Then there were all the deaths that I couldn't anticipate; the loss of energy and incentive for things I once enjoyed, the loss of clarity and sharp thinking for which I was known was now lost in a fog of confusion and forgetfulness. Tasks like going to the grocery store – once shared with my husband and filled with the anticipation for new adventures in cooking –provoked tears and raised questions that mocked my new status as a widow. Just who was I shopping for? 
 
If all of this wasn't enough, there followed the most painful 'deaths.' Ironically, these 'deaths' happened as I began to feel better. Like having the the wind knocked out of me, the pain from using the last of any number of things my husband had purchased, took my breath away. I felt I was losing touch with him. The thought of taking his clothes to the Goodwill store filled me with terror. Not only was he gone, but slowly and surely all of the things of our shared life would go away as well. In addition to all of this, I would face the death of the family I had known through my husband. I wondered how our relationship would continue without him, since it would never be the same again. And as I moved forward into each new day, I feared I was traveling farther and farther away from him—even my memory of him.
 
Of course, my experience was not new except to me. Anyone who has experienced a traumatic event would recognize many, if not all of the same features of disorientation and grief from loss. The work of ICTG is helping to change that, and I am grateful for this work as it is helping countless communities of faith travel with those traumatized by loss and disaster. I was fortunate to have a community of faith and individuals who walked with me through my own grief, and here are just a few practices that were helpful in this journey.
 
Many who belong to communities of faith recognize the term liturgy.  Literally, liturgy means "the work of the people."  Every traumatic event triggers a community response.  These can be positive or negative responses.  When we think of the work that has to be done after natural disasters, for example, an immediate response is required. But, there are also long-term needs and issues that will keep the trauma present for the individual or the community. What are the liturgies for communities of faith that can be performed in response to grief and loss?
 
First, we need to listen to the bereaved, and speak later. The most memorable times of care and comfort were those individuals who came and sat and listened to me. Like the comforters in the biblical story of Job who were silent with him for seven days, we can do much good for those in pain when we listen, and when we keep silence. I am grateful for my community of faith that kept intentional periods of silence in our worship services that made this a liturgy for me and for many who cared for me. What are the ways your community listens to those who have suffered loss?
 
Second, we live in a world full of pain and joy. But, we often find it so much more difficult to lean into the interdependence between these two life experiences. Joy is only fully experienced when one has known sorrow; and sorrow is felt more keenly when one has known great joy.  But, both are an inevitable part of the human experience. From the grieving, we might learn how to grieve and to enter into the world's grief more fully. Grieving well with others holds the potential to enlarge compassion and empathy.  And when the grieving experience joy, we might also learn new ways to rejoice, to feel gratitude, and to share that joy with others. What are the ways your community leans into joy and sorrow in your liturgy and in your life together? Is there room for lament as much as there is room for celebration?
 
Third, caring for those who are bereaved or suffering traumatic loss requires heavy lifting. Caring for grieving individuals is hard work, but good and necessary work. Sacrifices will have to be made on behalf of the one who needs additional assistance or care.  Many in my community gave up hours of time to help clean my house, cut my grass, and any number of tasks that were now overwhelming to me. Without their work on my behalf, I may not have been able to do the necessary work of grieving that would ultimately nurture my healing. And yet, when communities accept their liturgy, many hands can make light work. What are the ways your community cares for those who are hurting, grieving, or working through traumatic events?  What support systems are in place for the one who is bereaved and hurting?  If there are none, what are the ways in which you can grow as a community of care and liturgy?

Does your congregation have military families?  If you are like most congregational ministers, you may be aware of military families but may not have given them a second thought beyond ongoing prayer for safety. Military families are socialized to display strength, endurance, and resilience.  If they struggle, they do so privately.  Military families often “appear” to be healthy and happy, but the mental health challenges they face can often times be suppressed beneath the surface. Thus, in the busyness of ministry, you may not notice anything unusual in your interactions with them.  For some ministers, deployment may be seen as an honorable long-term work assignment, not a significant contributor to stress, distress, and mental health struggles.  Yet deployment of significant others may create many challenges for military families in your congregation.

First, a few facts:

Service to one’s country provides many challenges.  On average, military families relocate 10 times more than non-military families, and average one move every 2-3 years.  Most military spouses tend to be female and are under the age of 35. Since 2001, over 2 million American children have experienced the deployment of a parent, and over 900,000 children have experienced the deployment of one or both parents more than once.  It should be no surprise that children in military families are more likely than civilian families to experience acute distress like anxiety or depression, with 1 in 4  military children having thought about suicide at least once. This not only affects children of military families but is associated with nearly 37% of military spouses receiving a mental health diagnosis during spousal deployment.

How can congregational ministers and congregations be pro-active and responsive to military families during deployment?

Wang et al. (2015) conducted research that discusses the difficulties families face as well as factors that support mental health and wellness.  From this study, there are four responsive care practices that can help your congregation care for military families:

1. Create a physical place for military families.

• Having a physical location for military families to come to is important.  This can be a specialized military family’s group like a potluck, game night, or other social event.

2. Create a relational space for families to experience belonging, control, and fulfillment.

• Opening opportunities for volunteering, service, or leadership is a great way to address core needs and psychologically vulnerable areas of belonging, control, and fulfillment.

3. Address the experience of isolation by assigning or pairing the military family with a pastor, leader, or other family.

• Be intentional in building a relationship, not just a routine check-in, with the family.  The family needs authentic relationships that emotionally support, guide, and invest in their well-being.

4. Hold a service for lament.

• Military families struggle with the deployment of loved ones. By giving them the opportunity to express this struggle you are supporting the family’s mental health through communal social support and participation.

Wang, M.C., Nyutu, P. N., Tran, K. K., & Spears, A. (2015). Finding resilience: the mediation effect of sense of community on the psychological well-being of military spouses. Journal of Mental Health Counseling, 37(2), 164.


* Learn more about congregational care practices on the ICTG Training page. Here, you will find dozens of resources, including the ICTG Congregational Assessment Guide, seminars on becoming trauma-informed, modules, forums, and more!

Suicide is the 10th leading cause of death in the United States.  According to the CDC, suicide is the second leading cause of death among youth and young adults ages 10-34.  This is second only to unintentional injury.  With such a high rate of suicide among youth, traumatic loss is likely to be a painful experience common to many people within a congregation.  In cases of traumatic loss, what are practical steps that congregational care ministers can offer to those affected by suicide?

My point of entry into this conversation comes from my own experience.  When I was 18, Alex, a close friend, committed suicide.  His death greatly affected me and I faced 5 difficult struggles:

1. A need to understand what had happened
2. Feelings of guilt and responsibility
3. Perceived abandonment through loss
4. Anger
5. Trauma

At the time, my faith community was a strong support network and creatively cared for these five struggles.  I should mention, based on my review of the research literature, there are no prescribed methods, steps, or approaches to this type of traumatic loss.  This traumatic loss can be surmised as “complicated grief”.  Complicated grief is prolonged acute grief - grief that includes denial, fear, shock, anger, regret, guilt, anguish, loneliness, depression, and feeling overwhelmed that interferes with everyday functioning.  Based on my experience, flexibility and creativity can be used in the provision of care for complicated grief.

Practical steps that can help to care for traumatic loss and complicated grief include:

Sharing Their Story
At the time, I had three individuals reach out to me and share their stories of loss.  Two individuals had lost a loved one to suicide, and one had lost a close friend.  What was so significant is that they had reached out to me and shared their stories.  I felt empowered to share my own story, and did not feel alone or afraid as I began the grieving process.  In addition, two of these individuals stayed in contact, and we would meet for coffee regularly.

Invitation
On a consistent basis, my congregation and congregational ministers would reach out and invite me to group activities.  In my suffering, I would often isolate myself thinking, “Nobody wants a sad person to be a part of their group.”  I was uncertain as to how to live with ongoing grief in social spaces.  What I learned, through these invitations, is that people can handle my sadness and grief.  While my fears led me to believe that I would burden others with my struggles, I learned that people are happy and willing to help.  I would have never learned this if I had not first been invited.

Intentional
One trait all congregational care ministers had in common was their intentionality.  On a regular and consistent basis, multiple friends and congregational care ministers would check in on me.  This would happen through a short text saying, “Hey, JP!  Just thinking about you and hope you’re having a great day.  Love you, man.”  Others I would see walking around campus and they would yell my name from across the lawn and walk with me to my destination.  It was a combination of many “small” acts of care that helped me to begin caring for my grief.

It is interesting, looking back on the five core struggles of complicated grief, how the heartfelt sharing, warm invitations, and kind intentionality of my congregational care ministers helped me to cope with my traumatic loss and begin the process of healing.  I used to think that helping people to heal comprised a magic formula with systematic steps. I overlooked the efficacy and power of basic human traits of sharing, inviting, and being intentional.

I write this blog in honor of my good friend, Alex White.  1/1/1987 – 7/7/2005