Being a spiritual companion is rewarding in part because it is difficult. It requires that we give of ourselves and our own resources to be present to others. This is especially challenging when the person sitting across from us is suffering. Part of being a good spiritual director is making sure that we are replenishing those personal resources on a regular basis. Self-care should be a routine that is built into our lives for the sake of our own mental, physical, emotional, and spiritual health. These habits might include seeing our own spiritual director or therapist, eating nourishing meals, meditation and prayer, taking walks, developing a journaling or gratitude practice, or practicing yoga. Establishing these rhythms ideally allows us to enter a direction session grounded and ready to be open and present to whatever our directee brings that day.
There is a second level of care for ourselves that we should also practice developing. We need to have techniques in place to successfully care for ourselves not only when we are alone, but also when we are in the presence of a directee whose particular suffering or story is difficult to sit with. This second level of care is especially important if we are sitting with someone who’s story is similar to ours, whether through past experiences or due to present disaster. Having methods and routines in place to allow us to care for ourselves, both in our personal lives and in the midst of our work, will help to avoid burnout or doing harm to a directee in a moment of feeling overwhelmed. This deeper level of care for self and others comes as a result of our own personal growth and continued professional development. Working through our own traumas or stressors is difficult, good work. Having a relationship with a trusted supervisor or supervisory group can also help us identify places in our own souls that need more tenderness or development. Attending conferences, trainings, and continuing to educate ourselves from the abundance of literature available will give us techniques to try and language to use. Having a multifaceted approach in our own work also helps us to be open to hearing from and partnering with other professionals in caring for ourselves and our directees.
Learning to care for both ourselves and others in robust ways, often at the same time is both possible and necessary for spiritual directors. Caring for ourselves is something that we can and need to do, both when alone and when in the presence of others.
“Compassion Fatigue” is a well known term that describes that potential feeling of being overwhelmed. Much of what helpers do is show compassion, however, empathy is the component of companionship that tends to be exhausting. For this reason, some researchers are beginning instead to describe the feeling of being overwhelmed in the presence of suffering, or burning out after a long season of helping, as “Empathy Fatigue.” It is empathy that connects us deeply to what another person is feeling, so much so that we feel their pain in our own bodies. Learning to allow that connection to another, even while maintaining a healthy sense that it is not actually our own distress, actually requires compassion for both directees and ourselves. This empathy connection, resonating with someone else’s pain, is what sometimes makes it difficult to remain attuned to another in the presence of their suffering. Compassion for self is what becomes needed in those moments. Deeply acknowledging the effect of the suffering of another on our own self, acknowledging how hard it can be to sit with suffering, taking deep breaths, making sure our bodies are as comfortable as possible … All of these are good ways to care for yourself while being actively present to your directee.
Humans have great capacities for offering care and kindness. Learning to care for both ourselves and others in robust ways, often at the same time is both possible and necessary for spiritual directors. Caring for ourselves is something that we can and need to do, both when alone and when in the presence of others. Developing an understanding of the nuance between having empathy for someone and compassion for them (or self) is an important step on the way to building a sustainable ministry of care to those who are hurting.
This post, written by Erin Jantz, originally was published on May 4, 2017, on the ICTG blog.
Part of my work as the ICTG Program Director for Spiritual Direction involves researching the past and emerging landscape of trauma-informed spiritual direction in order to develop new tools and programming to assist faith leaders leading congregations after trauma. For example, I am finding fascinating research being done on how spirituality is experienced developmentally, for instance, in a person’s attachment to God. More over, in my travels these days, I am hearing from many field experts who are beginning to turn their scholarly and practical attention to incorporating spirituality into traditional psychotherapy. The goal of this emerging focus is to help survivors in more holistic and multi-dimensional ways.
Most recently, I attended a convention addressing complex trauma, which involves affects from ongoing abuse. One of the recognized affects of complex trauma, in particular, is a disrupted belief system. In cases of ongoing abuse, the ways in which persons find meaning become altered, and their senses of spirituality become troubled. Listening to my clinical colleagues wrestle with how to incorporate spirituality into their practices, I was touched by the incredible honor and opportunity that being a spiritual director or clergy member allows when addressing the spiritual needs of a survivor of trauma.
After experiencing trauma, in this case, complex trauma, one of the choices a person of faith eventually makes is, “Do I still believe?” One of the challenges clinicians face in addressing this area is incorporating a client’s spiritual practices or in making spiritual recommendations into what clinicians traditionally keep a “values free environment.” Sacred experiences and expressions are so personal and “loaded” for many people that it can feel incredibly tricky to integrate into therapy. As spiritual directors, however, we possess the distinct honor and opportunity of addressing spiritual needs, getting to intimately talk with people about belief and meaning. Broadly, we focus on
Then, from within our own faith traditions, we can
We can do all these things without hesitating to enter in to this sacred space with another.
In the same way that I believe a spiritual director or clergy member needs to have a go-to referral list of trusted therapists and others who can help congregants address psychological development needs or critical mental health concerns, I see too how therapists benefit from a reliable referral list of spiritual directors and clergy to partner with in helping clients discern safe places and people with whom they can process their spiritual life. In expanding these types of referral lists, therapists might consider:
And if you are a spiritual director:
As we at ICTG continues to expand programs and tools to support those caring for souls, I find it incredibly encouraging to hear about the research emerging among my colleagues as together we work to create vibrant professional communities committed to whole person health and spiritual care in the light of trauma.
Humans are beautifully complex creatures. One of the privileges of being a spiritual director is walking alongside as our directees journey towards understanding and integrating all of their wonderful systems and weaving them into their experience of the Divine. Trauma often causes disruptions to these systems and to one’s ability to integrate them. In some situations, a directee may have clearly discernible or even previously diagnosed challenges to their physical and mental health as a result of their trauma story. These issues can certainly be brought to direction, but in some instances may impede the direction process, or be more pressing concerns than the spiritual questions related to them. This is why we at ICTG encourage treatment and healing plans that include a variety of caregivers, like those represented in our Village of Care series. We advocate for referral based care, meaning that one particular professional can not heal all wounds. Collaboration with colleagues in other care fields helps us all to provide better support and make sure those we are working with get the best help for their situation.
However, sometimes, we may discover that we have a directee who is resistant to being referred to other caregivers. When we bump into this resistance, communication with our directee is key. We need to take the time to understand why they are hesitant, or perhaps even refuse, to seek other forms of care. It may be that some explanation or education of what other treatment forms entail is needed. Or perhaps they need help finding someone to go with them to a consultation. Appropriate and accurate information may help them to understand what care from a doctor, therapist, or other caregiver might provide them.
We know that neither we, nor our ministry, can heal all wounds. Caring for those who have experienced the disruption of trauma, and caring for ourselves in the midst, will look different in every situation.
In some situations, referral is a difficult option for more concrete reasons. Perhaps services are limited in the area (in many parts of the country therapists in particular are few and far between). Perhaps finances are a challenge and insurance (if they have it) does not cover the needed care. In some cases, online care services via video conference or over the phone may be an option for these folks. The internet can provide exercise tutorials, cooking instructions, and access to shopping for tools or supplements that local stores may not carry. Helping with some creative problem solving is one of the ways we can continue to support the whole person health journeys of our directees.
Another potential difficulty with referral is when the directee has a particular cultural or religious belief that stops them from participating in specific types of care. Here again, communication is key. It may be that there is some work to be done in examining the beliefs that hinder them from receiving care. On the other hand, if it is the case that their resistance to treatment is non-negotiable for them at this time, you as the director will have to decide how you would like to proceed. If applicable, it is important at minimum to have a conversation about how direction experiences or outcomes may be impacted by their decision. Depending on the severity of their situation, it is important to consider your own support system and to maintain appropriate boundaries in offering care or helping to problem solve with and for the directee.
We know as directors that we are primarily witnesses to God working in the lives of those we companion. We know that neither we, nor our ministry, can heal all wounds. Caring for those who have experienced the disruption of trauma, and caring for ourselves in the midst, will look different in every situation. Caring for ourselves will help us to be consistent and steady in our offerings, and communicating openly, with some creative problem solving thrown in, will help our directees renew their sense of Wholeness.
Losing one’s job is a very personal experience. It taps into all kinds of feelings. For an individual there may be concern about financial security and what next steps might be. Depending on the circumstances of the stoppage of work there may be shame, or illness, or some other stressful circumstance affecting their feelings about it. Dismissal from work ranks in the top ten most stressful life events a person can experience which can potentially have long term health impacts. On the other hand, there may also be hope and anticipation, a sense of freedom or a fresh start. Walking through work transitions with a directee does not seem like something outside the realm of possibility for most directors. In fact, most directors probably feel very equipped to support someone in that season. But what if that work loss has ripple effects throughout the community? How do our questions and help differ in that context?
Sometimes the loss of one person’s job affects many throughout a community. If that person was a primary provider for their household, or the leader of a community and they are now unavailable or moving away, everyone experiences an upending to some degree. Or perhaps loss of jobs impacts an entire community at once, as when a town has grown up around a particular industry or business, or when experiencing pandemic or recession. There are a variety of reasons that we as directors may find ourselves working with people who are all from the same community. In these cases, we may begin to hear the story of these events told through a variety of lenses. When we are attending to individuals who share many aspects of their lives we can begin to look for common themes between them, especially when something happens that affects the entire community. Identifying these patterns can help us connect people with appropriate services or give language that can aid in communication with local religious or community leaders who may be meeting with the same groups. Spiritual directors can be valuable voices when communities are discerning next steps together.
If you do find yourself meeting with multiple individuals who are all being touched by changing jobs or economies, group direction is also an option. It may help bring together people who are able to empathize with and support one another in unique and helpful ways.
For the individual who’s work or vocation is intertwined into their community life, losing a job or transitioning into something different may be more emotionally loaded. How do they feel about the impact of their changing circumstances on the community? How are they reflecting their experience to their community? Are they able to share and be supported? Are they hiding what’s really going on in their heart? These additional concerns make someone’s experience more than walking through a transition because of the potential depth and complexity of relationships between affected parties.
If you do find yourself meeting with multiple individuals who are all being touched by changing jobs or economies, group direction is also an option. Starting a group may help bring together people who are able to empathize with and support one another in unique and helpful ways. Group direction may also help by providing a variety of perspectives and can give everyone a sense of togetherness and community as they discern how to handle the challenges facing them.
Whether we are meeting with one person or a group, acknowledging and caring for the complex needs that are sometimes hiding below the surface of circumstances, is the ongoing challenge and privilege of being a spiritual director.
This post, written by Erin Jantz, originally was published on March 20, 2015, on the ICTG blog.
Read Spiritual Direction in the Face of Trauma: Part One here.
A common theme in helping professions is hospitality. We desire to create and hold space for those we are helping. This is particularly true for a spiritual director who is companioning a survivor of trauma. As we hold space for survivors we must be able to put aside, more than normal, our own egos and allow each person’s experience to be unique to them. We must not take their power, but rather empower them towards health. We become a container, an external boundary, within which people can fall apart knowing they will not be shamed, but rather offered strength and courage. We desire to restore functioning, to encourage non-negative thinking, and to help our “directees” form a coherent narrative that integrates their experience – mind, body, and spirit. A spiritual director’s role in the ongoing process of healing focuses on how a survivor’s synthesis of thoughts and feelings are affecting their experience of holiness.
In discerning what practices may be the most helpful for an individual, a director should consider intricacies of the person’s faith. Directors should ask the following questions:
For further help in assessing a directee’s individual spirituality and its role in their healing process, Donald Meichenbaum has created an excellent comprehensive resource for assessing a psychotherapy client’s spiritual functioning that is applicable to spiritual direction.
As directors dealing with a human being, we would be remiss to ignore the role of the body in experiencing holiness. Incorporating the body into prayer may include practices of mindfulness, traditional postures such as kneeling, or nontraditional postures that help a survivor feel safe such as standing with eyes open. Philip Helsel, friend of ICTG, has written out a beautiful ritual that incorporates blessing the body and intentionally including it in prayer in postures of safety. For some, walking or pacing helps to relax tension in the body enough to allow prayer to happen. For others, praying using the traditional imaginative exercises of St. Ignatius can be helpful in engaging the senses. The Jewish traditions of “sitting Shiva” and Tisha b’Av are rich with tangible rituals and practices that are specifically designed to allow space for grief and healing, both for those who have been hurt and those who are grieving the loss with them.
There is so much room for growth in our understanding of how trauma affects the human spirit. Scattered across the traditions are powerful models of both lament and courage as well as celebrations of both vulnerability and strength. We must gather these resources and stay in dialogue with our colleagues in the fields of mental health, medicine, and theology. As we do, we will continue to see new experiences of the holy integrated, and resultantly, strong, intact people who emerge to tell their stories of survival.
In the current pandemic crisis, we are seeing an overwhelm of the health care system that is unlike anything we have seen in our lifetimes. The restrictions around hospitals limiting visitors (for everyone’s safety) mean that often people will be suffering, even dying, in some degree of isolation. For some there may be a nurse or chaplain that stays with them. But many will not be attended to by their family. And in kind, the family will be home without their loved one. Feelings of helplessness, anger, and overwhelming sadness will accompany this difficult experience.
IMAGE: NOVANT HEALTH
It is likely that most of us will know someone either directly or through someone close, who dies of this disease. That means we will also be coming into contact with directees who have lost loved ones in this cold and detached way. In older congregations we may see dramatic drops in members and be grieving these lonely deaths as a group. This experience of losing so many people in a way that is so outside the norm may heighten the experience of bereavement. The strong emotions that accompany grief, combined with a sense of helplessness can quickly reach the levels that we define as being traumatic. How can we help people to process through their experience in a way that helps them avoid becoming stuck? How can we help people to find comfort in the Presence of God in such trying times? How do we honor traditions that normally would comfort people with “last rites” when we cannot be physically present with the dying? Responding well to the very real and tangible losses of life around us will be part of the long term recovery process. Being intentional in our response will also help build resiliency and protect the mental health of our directees in the aftermath of this global crisis.
Different helping professions will all need to navigate their own response and how they provide care. For spiritual directors, this journey will necessitate facing theodicy, or the “why do bad things happen” question, with our directees. We will need to create space for, and perhaps provide instruction about, lament. We must allow space for tears, anger, and the heavy silence that falls when words fail. Embodied work will need higher priority.
For those of us who fill a dual role as minister/shepherd/pastor, or who consider ourselves part of an institution or congregation, attending to the communal experience will also require tender attentiveness. There is so much loss in this season for everyone. Each of us has and will experience different affects on our emotional, physical, spiritual, fiscal, and relational health. Senses of “normal” and security have been and are being threatened. There is so much grief work to be done. Finding the grief connected to losing a loved one and holding it in context of all the other losses swirling around will call for patient and precise care.
If you have not already begun to meet with directees who have lost loved ones, consider that it is likely that you will in the future. Begin to prepare yourself now, both in heart and in training, to walk alongside a level of unique grief, unknown to most of us. This is a new chapter. We are preparing the way for what spiritual direction will look like for decades to come. Discuss this with colleagues. Bring it to supervision. Perhaps the resurgence of interest in being trained as a spiritual director that we have seen over the last decade or so, was for just such a time as this.
This post, written by Erin Jantz, originally was published on February 23, 2015, on the ICTG blog.
Read Spiritual Direction in the Face of Trauma: Part Two here.
One of the joys of being a spiritual director is observing with people how their human spirits and their senses of holiness interact. These unique movements, or faith journeys, greatly affect the way people work and live, and often give us intimate senses of God’s direction and movements in each person’s life. In recent years, as I have walked along with people through their faith journeys, I have discovered a new question for me that I believe is critical to addressing needs of our day. How does God work, and what are individuals’ experiences of holiness, when things go horribly wrong? More than a question of theodicy (i.e., in a world of God’s sovereignty, why do bad things happen?), this question considers spiritual developments amid tragic circumstances. As I research this question I find that excellent scholars can answer what happens in the brain, thoughts, emotions, and body when tragedy strikes, but there are not good answers for what trauma’s impact is on a person’s spirit. This is partly because each person’s experience is so personal, but we know from other disciplines that there are general truths that can provide a foundation for how to approach healing when our perceptions of the world are shattered. This must also be true of healing the soul.
As I look to companion people of faith through traumatic experiences, I am flooded with questions:
These questions, and so many more, are being asked by suffering people and those who love them everyday. As spiritual directors we need to be asking these questions, too, and even more questions, to adequately meet the demands of our times.
Spiritual directors can be an invaluable help to people seeking God in crisis. Yet to approach those who have suffered traumatic losses of any kind as if they are on similar journeys as people in times of peace would be not only unhelpful, it would be unkind. Spiritual direction in the face of trauma must change. Distinct from other disciplines’ outpourings, including therapy from psychology and knowledge from theology, spiritual direction must have a plan for the short, and mid-term, experiences of survivors, prepared to take on embodied practices and to provide structure and hope.
It is the answers to these questions that we are seeking in the spiritual direction program at ICTG. Next month I will share some of the answers that I have found helpful in my search for both lay spiritual directors and clergy to come alongside those who are hurting and be, paraphrasing St. John of the Cross, a voice calling from the unknown saying, “Come this way, I have made it, the path is safe despite the darkness.”
As COVID-19 continues to sweep the globe we all find ourselves in uncertain times. Our daily lives, the routines and rhythms that we had taken for granted have been upset. Some people are finding joy and adventure in the process of discovering new ways of being. Many are facing financial difficulties. And most of us are facing some level of anxiety that changes from day to day. Spiritual direction will necessarily be changing as well. How does spiritual companioning change in light of current safety recommendations? What are we invited to as we walk with individuals through one of the largest shared human experiences in generations?
As always, structuring our self-care to allow us to serve from a place of abundance is paramount. While we are not immune to anxiety, financial distress, or health concerns, it is important for our sakes’ and our directees’ that we continue to be in touch with the Infinite Resources available to everyone. Maintaining your own practices and disciplines during this time can allow a sense of continuity and consistency. It is also important to attend to your own health, physically and mentally. To “put on your own oxygen mask first,” so to speak. Are your needs being cared for? Are you getting a chance to exercise? Are you able to be outdoors at all? Or even by an open window for some portion of the day? Are you connecting with friends and loved ones? Are you continuing to eat well? What do you still need? How are you experiencing the Divine in these times? Now is an important time to be maintaining a supervision group as well. Continue to practice good self and ministry care for increased flexibility as new norms present themselves.
Structuring our self-care to allow us to serve from a place of abundance is paramount.
In terms of ministry, you may find that for a season many of your directees may need more psychological first aid than spiritual guidance. Right now many people need help with managing anxiety and adjusting to new ways of life. Companionship may take on a new form for a time. If it is safe and your local weather permits, consider meeting outside and maintaining recommended distance with directees if you still desire to be in person for sessions. Additionally for many of us, companionship may also mean exploring new mediums.
Virtual meetings will also likely grow in popularity in the coming months. Consider reaching out to colleagues who have been practicing virtually already to see what advice they may have to offer. Practice your digital skills by having virtual calls and “meetings” with family and friends. Ask them for feed back on your presence, pay attention to your own facial expressions, and practice trying not to look at yourself! Platforms such as Skype, Zoom, FaceTime and others still allow for a sense of being face-to-face. If you often incorporate music into your sessions, Jammer is one platform designed to not experience lag when trying to sing or chant together. If you are meeting with groups, setting up a simple Google Hangouts can allow you to share imagery easily and require less administration than sending logins to every participant. It is also possible to still have embodied sessions while remaining distant. Email directees coloring pages, art, or music links ahead of time so you can share in those mediums together during a session.
You may find that for a season many of your directees may need more psychological first aid than spiritual guidance.
Communicating a sense of presence and containment over the internet will require honing a new set of skills. Often we use a read of our directee’s body language as an indicator of unsaid emotion. Similarly, we use our own body language to communicate calm or attentiveness. When we only have faces, or in the case of a phone call only voices, we will need to lean into developing vocal tone, good facial affect, and grace for mediums that can at times feel artificial or impersonal compared to being physically together.
This is a new time for all of us. A season of what may feel like never-ending change. Some will find new practices to be most helpful, some will require the familiarity of the old. Many of us will be brought face-to-face with new depths as we come to the ends of ourselves, our expectations, and what we thought was normal. There will be deep grief and great joy. For all of us, there is a long road ahead. May we have grace, and may we do it together.
This post, written by Erin Jantz, originally was published on March 17, 2017, on the ICTG blog.
A favorite story around my house is “The Lord of the Rings,” by J.R.R. Tolkien. Throughout the book the main characters are regularly faced with a choice between two paths. Inevitably, though both are difficult, one path is more obviously dangerous, and the second path seems easier and more inviting in the short term. Often the choice of the seemingly easier path results in the protagonists having to circle around and revisit choices where they end up taking the dangerous path anyway. However, it is on these more dangerous paths where the characters experience the most growth and gain a deeper understanding of their purpose. These dark places prove themselves to be necessary crucibles in the journey to wholeness. Similarly, it is no surprise to me that in Psalm 23, King David writes that he is walking through the Valley of the Shadow of Death. Not skipping around the borders of it. It is in the journey through this valley that he learns he is not alone, that he need not fear, and where he eventually finds rest. This intentional entering into darkness feels counterintuitive to us. Especially when trauma has come upon us, the idea of facing the experiences of fear sounds like heaping salt into a wound, but healing is a journey through, not around.
Most spiritual directors are familiar with the experience of meeting with a directee who is in denial or confused about the reality of their relationship with God. These people are often confused about how to connect with the Divine or may unconsciously hold conflicting beliefs that cause anxiety in prayer or daily life (for example: God will punish me if I make a mistake AND God loves me even when I make mistakes). Exploring these paths and walking with people as they work through these challenging conflicts to come to a more coherent and integrated faith is one of the great joys of being a director. However, an issue all directors need to be aware of, especially when working with trauma survivors, is the discerning of whether the directee is working through normal spiritual developmental phases, or is engaging in spiritual bypass.
“Spiritual Bypass” is a term coined by psychologist John Welwood in 1984 to describe the use of spirituality (beliefs or practices) as an avoidance tool. Spiritual bypass is when a person of faith uses their spirituality to avoid dealing with painful feelings, developmental tasks, or lingering wounds. Similar to substance abuse or other self-harming behaviors, survivors of trauma may turn to religious practices as a way to numb themselves to the painful realities or questions inherent in their journey. Spiritual bypass goes beyond turning to the Divine, or to tried and true practices, as a place of support and healing and instead creating habits that fill empty, painful spaces with spiritual noise that drowns out the parts of the soul still suffering.
This may look like the directee making statements like, “Whenever I feel sad or overwhelmed, I turn to my scriptures and feel better in no time! I’m so thankful for the encouragement from God!” Or perhaps this is the first-time directee who has suddenly decided that spiritual direction is just the thing to help them “get over” what happened. Normally, these statements about seeking and finding are music in a director’s ear, and I am certainly not advocating suspicion of every step forward or every refreshing practice a directee may share with us. Most of these steps are in fact helpful and healing for survivors, but attention must be paid to the whole of someone’s journey toward healing. If significant steps or phases of healing seem to have been skipped (thorough grieving, for example) then it is worth exploring with the directee whether any newfound relief is the deep, long-lasting relief associated with healing, or the temporary relief of avoiding.
Discerning whether a directee is being helped or hurt by their practices and beliefs is difficult and a director should tread carefully when challenging and testing areas that are being associated with hope. This is why ongoing training and supervision are so important for each director. This is also why it is helpful for trauma survivors to have a team of helpers surrounding them--psychologists, doctors, coaches, and directors--each of whom can bring their own expertise to bear on the journey of healing. Directors are of invaluable help to trauma survivors who are people of faith. Directors can create a more holistic healing experience for trauma survivors by serving as a companion, guiding them through difficult experiences and questions of how grief, anger, justice, and faith intertwine. A safe space to sort through unconscious, and or, unhelpful beliefs allows survivors to walk out into an expansive and freeing connection with God. Like our heroes in “The Lord of the Rings,” going around a problem often means that we end up facing it twice. Directors owe it to themselves and their directees to be educated in the nuances of traumatized spirituality so that they can be adequately prepared to walk with survivors through the valley to help them find comfort and healing.
This post, written by Erin Jantz, originally was published on January 31, 2017, on the ICTG blog.
Often when I speak on trauma and spirituality, I discuss the reality that an organization or congregation is greater than the sum of its parts. Part of keeping our congregations healthy involves caring for the most vulnerable members. Sometimes these vulnerable people are easy to identify as individuals or groups (such as children, women, or the elderly), but sometimes people who otherwise appear to be at the peak of their strength are those who are experiencing deep, life changing traumas. They are hidden among us because their pain is private, but no less in need of healing.
One such group near and dear to my heart are the parents of babies who are currently, or have spent time in the past, in the NICU (Neonatal Intensive Care Unit). This month my family will be celebrating my darling niece’s first birthday. Marking the birth of a human into the world is always worthy of celebration, but a year ago celebration was not the primary feeling surrounding her birth. My niece arrived ten weeks early after a difficult pregnancy and emergency surgery only to be immediately whisked away from her parents. The next months were filled with learning, healing, devastating setbacks, and fierce victories. My niece’s growth and development continue to amaze all of us and while we rejoice in her health now, reminiscing over the last year is a mixed experience.
The March of Dimes reports that 1 in 10 babies born in this country spend time in the NICU because of prematurity, infections, injuries, or other unexpected events at birth or in their early days. Despite excellent care and a positive outcome for many of these babies, 60% of parents who have a child who spends any amount of time in the NICU are at risk for PTSD. One study by the Duke School of Nursing interviewed thirty mothers whose infants had spent time in the NICU and every single one of them had at least one symptom of PTSD as much as six months later. I have talked to parents who are still brought to tears decades later as they remember those early days.
The care needs of a child in the hospital may be more apparent and they are in the hands of professionals. So how do we care for the rest of the family? Those members of the family who are breathing on their own and able to digest food who are sitting next to us as we worship? The new parents of a NICU baby may look as if they are doing “better” than the new parents rocking their infant in the back because they aren’t covered in spit-up and appear to have gotten more than 45 consecutive minutes of sleep the night before. But make no mistake, these families have experienced the painful loss of a dream, and many are haunted by the possibility of death for weeks or months on end with no relief. No matter the reason for, or length of stay in the NICU, a parent’s reaction can range from mild to severe. Many experience grief, numbness, anger, guilt, shame, disbelief, and intense sadness.
These families need a support system that will continue to show up, day after day, for the indefinite future. They need people around them to be flexible as each day brings with it new information and experiences that may be vastly disparate. They need the setbacks and disappointments honored and grieved as much as they need the steps forward and milestones celebrated. These families often suffer in silence because we have few to no social protocols to tell us how to help people in limbo, they need space to give voice to their experience. Like any trauma, they must be allowed to ask their questions of, and make their petitions to, God without judgment from those around them.
NICU families are just one example of the many who may be suffering silently around us. Others may include those with chronic or terminal illness, substance abuse, those who have experienced severe car accidents, or who are the primary caretakers for anyone with the aforementioned conditions. As valued members of our communities, these hidden, silent sufferers and survivors need compassion and care for their, and our, well-being to flourish. May we all have eyes to see and ears to hear.
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