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Discerning Trauma Informed Therapy

Truth In Love 412

Is trauma-informed care biblical?

May 1, 2023

Dale Johnson: This week on the podcast, I have with me Dr. Ernie Baker. He’s married to Rose, and the Lord has blessed them with six children, five that are married, and they have 11 grandchildren. He has the privilege of serving the Lord at First Baptist Church in Jacksonville, Florida as a pastor of counseling and discipleship. In addition, he has the privilege of chairing the online undergraduate degree in Biblical Counseling at The Master’s University, serving as an adjunct in the graduate program in counseling, and as director of training for Overseas Instruction in Counseling. He’s the author of Marry Wisely, Marry Well, HELP! I’m in a Conflict, Help! Disability Pressures Our Marriage. He’s also contributed chapters to five other books and written many journals and magazine articles. He is certified with ACBC, and he also serves as a fellow and a conciliator with the Institute for Christian Conciliation. Ernie, thanks again for being with us, and looking forward to this topic today.

Ernie Baker: It’s always a blessing to be with you, Dale.

Dale Johnson: It’s always good to sit and chat, Ernie, and I always look forward to your measured responses in these things. And particularly we’re going to need that today, as we discuss this issue of trauma-informed therapy and this is something, this is a topic that’s sweeping really across, you know, the secular world. This is something that’s been growing particularly since the 80’s more heavily in the counseling sphere before that in discussions relative to post-traumatic stress disorder in the secular world as well. But even more recently, in the biblical counseling movement, this has been a hot topic of interest for many people. So, I want us to lay out a little bit about trauma-informed therapy, and then I want us to talk about discerning because I think that’s an important role for us, Ernie, to learn how to discern. So if you will, let’s start in the place we’ve just described for a little bit, trauma-informed therapy. And then, I want us to work into how we discern that.

Ernie Baker: A real quick note on how widespread this is, I just recently taught in Africa, and Ethiopia and Uganda. They were all about trying to think about how do we help people with crisis and trauma, and I brought up Bessel van der Kolk’s book, “The Body Keeps the Score,” to my class in Uganda, and one of the students said, “Oh someone just told me last week that I need to read this book.” So it’s not just an American thing. This is kind of a buzzword around the world. People are talking about what do we do with trauma. That’s obvious because our world has a lot of needs, our world is in crisis in many ways. And I’m thankful we have answers.

Dale Johnson: Now, that’s exactly right. So, you’re right. It is spread everywhere. And I want to make clear too, you know, as people think about how folks have been impacted by trauma, they’re seeing a real need. As you mentioned, they’re seeing how broken we are as people. They’re seeing how people are impacted by the brokenness of the world, the curse of the world that we live in, the evil, genuine evil that we see happening in the world. And those things are very real that we are impacted by those things. So talk for a second when we’re describing trauma-informed therapy, what exactly are we describing here? What are some of the primary concepts? 

Ernie Baker: I’m very thankful for the training I received at Westminster Seminary, even though I was involved with biblical counseling before doing my doctorate there, a man that’s had an influence on a lot of us, had a massive influence on me, named David Powlison, and he taught us a way to think about any time we’re hearing theories and concepts from the world, we need to be asking questions through a biblical lens of, what are they seeing? What are they observing? What are they hearing now? How do I think about that biblically? And you were starting to do that when you were talking about evil in the world and just the immense amount of evil in the world. He taught us a system that I’d like to talk about a little bit that can be used with any counseling theory, not just trauma-informed therapy, or it actually would be when you’re talking about therapy, and we’ll talk about this a little bit later, but trauma-informed therapies because there’s many different methodologies that get used. But it really is a whole system of how to think about people and problems, and the way David taught us to think about it, he gave us six S’s, and then I’ve added a seventh through the years. I’ll just run through them quickly, and then we can go back and talk about what each one is in trauma-informed counseling. But every counseling system has a source of authority, and to be a little bit technical, that would be the epistemology.

Every counseling system has a view of what’s wrong or etiology. And I’ll just use our theological word sin because I am Baptist. So I have to have all alliteration here. So source of authority, sin, or etiology, where’s the problem coming from? And then what’s the solution, or our theological term would be salvation. And let me just pause on that one just a moment. It’s very intriguing to me how the psychologies even are self-aware sometimes because Carl Jung, his psychology, his psychotherapy was described as a quote “way of salvation,” so they’re even self-aware at times of what they’re proposing to people. Well, once you decide what the problem is and what the solution is, then you come up with methodologies. I’ll use our S which would be sanctification of how do you help people change, or the secular word would be therapy or therapies, and then every counseling system has a support system, who teaches it, who promotes it and that’s very true in trauma-informed counseling.

The next “S” would be “servants of the system.” And this is the one that we’ve added over the years to the S’s of what’s the role of the counselor, and in each system, the counselor has a different role. It’s very intriguing and trauma-informed counseling because they use all kinds of various therapies. So, the role of the counselor’s different, depending on the type of therapy used, and we definitely have a view of our role, what we see, as our role as a counselor. The next “S” is support systems, who supports it. For us it would be the local church and the local church promoting and teaching and giving support to people who have been through trauma. Then the last S is, here’s my desperate attempt for another “S” sparring, apologetics. Every counseling system defends itself. And we’re definitely seeing in the counseling world there are articles written for and against trauma-informed counseling, a lot of people supporting it. So, I use those S’s, those 7 S is what I use as a criteria; they’re my lens to try to think biblically about whatever theory I’m hearing in the world. 

Dale Johnson: Now, that’s helpful, and I want to get to the discernment part because I think this is where we’re often lacking in how we discern relative to certain therapies. I want to start in two places, if I can Ernie. The first place just in describing more broadly the concepts that we’re talking about here relative to trauma-informed. It begins in a place, you mentioned, Van der Kolk where there’s a description that when trauma happens that the body itself is storing up in some way, whether that be in terms of repression, that it’s repressed in some way or it’s storing up in some way in your neurological system the trauma itself, and that described in terms of neuropathy that neurologically something is happening. Whereas the trauma is experienced your body sort of takes over in autonomic responses and that trauma then stores up to the point where then the body sort of responds automatically in different, you know, situations or scenarios that either like in that trauma or repeated trauma and that sort of thing. And so, these therapies are intended to in some way help to manage this bodily effect that happens. And so, that’s sort of the starting place, in a nut shell. Again Van der Kolk is certainly not the only person who’s written about this. Many, many, many people are riding in this direction. And there’s difference of opinion on neurologically how people are impacted by advents of trauma.

And so, let’s get to the point where we’re discerning. You use this framework as the 7 S’s. I think that’s really helpful because what most people don’t realize is any counseling system as you mentioned they’re promoting a worldview, a setting, a way to understand people, a way to understand their problems, and how to fix those problems. And with that, when we take the Scriptures as biblical Christians, there are certain things as you mention I love the way that you’re describing some of the S’s in terms of doctrinal truths, they’re non-negotiable, and I think sometimes, Ernie we get in trouble when we’re willing to take a methodology because in our heart and mind, we think, man, this can help people. And we never want to deny someone something that we think might quote-unquote help people, but while at the same time we are compromising non-negotiable doctrinal commitments that are true and will always be true according to Scripture. Nobody’s doing that necessarily, intentionally, or as an evil actor to try and maliciously tear something down. But this is a part of how the deception works that we have to be paying attention to. That’s why it’s important that we put it on the same playing field as what you’re trying to do here. So, I’m eager for us to do this as we look into these seven S’s, so start helping us discern Ernie, as you work through these 7s, to understand trauma-informed therapy and how we can discern best this counseling system. 

Ernie Baker: I’ll do the best I can because there are a lot of opinions about these things, my general framework is going to be Van der Kolk again because his book has been, I mean, it’s really kind of a phenomenon. It sold two million copies the last time I checked, which is pretty amazing. And if our listeners haven’t read the book, they really ought to read it If you want to be culturally informed, you really ought to read “The Body Keeps The Score” and think through, “ok, what is he saying?” And you’ll start seeing the epistemology, the source of authority, come out. I was just reviewing this with my wife the other day and I was reading her a couple of pages, page 1 page 2. You start seeing evolutionary theory come out, and he talks about trauma being stored in the primal part of the brain. And as I’ve listened, I’ve listened to many, many, many hours of presentations on trauma-informed counseling, and it’s really influenced by evolutionary theory a lot. So as a discerning Christian, I need to be discerning.

Okay, what’s truth? What’s true? What’s not true? It gets complicated because I’m not a neuroscientist so I don’t know the neuroscience, but I do have core doctrinal commitments about what my source of authority is. I know I don’t believe in evolution. So as soon as I start reading Evolution, I have to say, ok, I can hear him in one sentence say, and he states both as fact, trauma changes the brain. Well, I’m not a neuroscientist again. So I’d have to read someone else of, okay, what goes on in the brain? Well, that could be fact, but in the next sentence, he says, that the trauma is stored in a primal part of the brain. Well, I’m hearing theory there. I’ve run that statement by physicians, a primal part of the brain and they go primal part of the brain? What’s the primal part of the brain? So being discerning is, what am I hearing? What am I seeing? What are they seeing? Because I don’t want to come across critical, I want to be discerning, but I don’t want to sound like a critical spirit. I have to say as I read the literature, as I’ve listened to hours and hours of presentations, I am struck by the compassion for humans. I mean, these are people that are willing to do hard, hard work with people who are really struggling because of the way crisis has hit their life.

Anytime somebody’s willing to struggle with another human and be deeply compassionate, I’m thankful for them. The answers though that we give struggling people are really, really important. So, his epistemology is really clear. It’s brain science. It’s evolution. My source of authority is the inspired, inerrant Word of God, and it’s easy to forget this if we think, okay, the culture has found something. It would be easy for us to get overly impressed with it and forget the nature of what we have. We have the living Word of God that we believe has sanctifying power within it, you know, for our listeners, please think that through, that we believe that the word of God, it’s the word of the living God, and it has sanctifying power to change people who are going through the deepest struggles in life. So, that’s his source of authority. Now, based upon the source of authority, he explains what the problem is. So, the sin is your brain is storing trauma. Therefore, he says, in his book, we remove all the moral responsibility, I think it’s in one of the opening pages of the book, “we remove moral responsibility”, and so, it becomes natural then of why humans respond. And as we know, if you deal with people and trauma, they’re going towards drugs and alcohol to try to deal with the trauma, to try to drown it out, and to help themselves feel better. So, Van der Kolk and others are very concerned about why do people turn to drugs and alcohol, and they directly connect it back to the brain. And so, we now remove moral responsibility from people. They’re just responding naturally to all the horrible things that have happened to them. 

Dale Johnson: Now, I want you to keep going. Let me interject because it is drugs and alcohol. I would also add a part of the narrative that happens here is that hurt people hurt. And so, they’re continuing violence in some way, whether that be through abusive relationships or a child who experiences trauma, you know, at a young age is one who then later perpetuates this in some way, and a part of what you just described is we strip moral responsibility in this case, describing this as being naturalistic built up in the body, a person is not responsible, the category that some people are pushing this in is it then any response that I have to trauma that’s happened to me is a part of the suffering, and it becomes excuse that way. I think Ernie, that’s very dangerous. Because again, we are removing moral culpability from us as being responsible for whatever is entrusted to us, in how we respond first to the Lord and then to our sociological environment, and so, I would think it would be dangerous in some way for us to remove that moral culpability, and that’s what distinction that you’re making. So, keep helping us work through this in discernment. 

Ernie Baker: That brings up the whole issue of causality and what is causing me, and, you know, sometimes I think in terms of primary causality and maybe secondary pressures that can feel like causality, and according to Scripture, trauma would be part of the circumstances of my life that are drawing out what’s already going on in my part. I serve things, I want things, I desire things, and I have been through intense circumstances in my life. So, therefore, I love and hope and want certain things and I’m reacting and responding to that pressure that I’ve been through. Well, that’s a different view of etiology than what the culture has. For Van der Kolk, it’s going to be, no, it’s physiology. You’re just a single part being. There is, you know, the idea of a soul, etc., would not be part of the model of anthropology. You’re just acting out of your physiology. Well, my physiology, we’ve said for a long time, as biblical counselors, my biology can’t make me sin. My body can’t make me sin. I’m responsible for how I am responding to the circumstances of life, no matter how intense they are. Now, can I be compassionate toward a person who’s been through horrible, horrible circumstances and be patient with them because of the way life has gone for them? Absolutely. But the bottom line, they’re still responsible for their behavior. 

Dale Johnson: Yeah, I would even add, not only can we, I think biblically we should be right, compassionate, patient. It’s a part of First Thessalonians 5:14 in teaching us to encourage the faint-hearted, help the weak, and then be patient with them all. That is certainly what we’ve been called to do here. So I think that should be at the forefront of our minds as well. 

Ernie Baker: Van der Kolk then talk about the solution, and the solution is multifaceted. I’m going to run for the sake of time, solution, and sanctification together because they propose a solution while there has to be an understanding of the brain. And then, it’s very intriguing to me to listen to talk about why the multiplicity of therapies. Because if you read The Body Keeps The Score, he’s got suggested therapies from all over the place, and it’s the idea there’s an eclectic approach because of I think he would say, I hope I’m representing him well here, that will people have different personalities and there’s different cultures. So, what may work in one culture may not work in another, what may work in a far Eastern culture may not work in an American culture. So there’s a multiplicity of approaches, including yoga and meditation, cognitive behavioral therapy, and EMDR, and all kinds of things are approached as the way to help people.

For us, that raises a really very important question is, biblical counseling, as we believed from the beginning in what we doctrinally love, is the sufficiency of Scripture, and is there enough in Scripture to help people who have been through the most horrific circumstances in life? My conviction is that the answer is yes. Now, maybe we haven’t thought through all the applications yet of how to get people, help people apply biblical truth to their lives, but that doesn’t mean that the Bible doesn’t have enough or that there’s insufficiency in the Bible, so where the culture is going to say we have to try all these methods. We’re going to say no, our source of authority is Scripture, and I want to work out the applications of Scripture, and I want to build my methodology right out of what I see as my source of authority. And that’s some of my concern is what I hear people saying, okay, I have the same source of authority as you, but I want to use secular methodologies. Well, please understand those secular methodologies are coming right out of a belief system. And I want to be consistent within my belief system so that my methodologies are coming right out of what I believe the problem is and what the Bible would say the solution is.

Dale Johnson: Yeah, because methodologies have a particular aim, and that aim within that system is we’re going to alleviate whatever is hindering this person from operating, you know, what we would consider to be normal or in a healthy fashion, and that methodology, while we want that person to feel better. Okay, and we think the end justifies the means; we forget that methodology from a secular therapeutic approach, has an aim that it’s trying to achieve, and that aim is really becomes a replacement of the work of the Holy Spirit. It becomes a replacement of the work of the Word in the heart of a person in order to overcome deep stressful difficulties to stressors in life. And that it’s making a statement that methodology is aiming at something in particular. And in this case, it’s we’re going to help the body itself to come to a place where now it can obey. Well, that’s taking the place of what God says is the work of the Word and the Spirit in the life of a person. So that methodology in itself is not neutral. It’s aiming at something. And although I’m well-meaning and I want to see something good come out of this. I’m aiming at something in particular, and that’s where you see the discrepancy here from the Scripture. 

Ernie Baker: And I’ll just remind everybody that our Lord said in Isaiah 61, He came to heal the brokenhearted and to set the captives free, and I believe that that can happen with people who have been through deep trauma because embedded in the gospel is the power to change lives. And I have in my mind right now a man who used to walk up and down our street in the town I grew up in, and he was a World War One veteran. And I asked my dad when I was a little boy, who is that man? And he said, that’s Percy, and he was shell-shocked, and he’s just a dirty old man who always wore his trench coat even on hot July days, he was wearing his military trench coat. Something had happened significant to Percy, and he was stuck. How do we help Percy? Well, Jesus came to set the captives free and to heal the brokenhearted, but I want to use biblical principles to help set Percy’s heart free so that he not can just be healed of whatever happened with the trauma but that Percy can be forgiven of his sins and have a relationship with the Creator of the universe. That’s really the answer for the Percy’s of the world is true wholeness, true fulfillment in life is being in relationship with the Creator. 

Dale Johnson: Okay, Ernie. So, we’re moving through these S’s, and we’ve, I think, laid some foundation that’s very helpful. One of the things I will mention before we move on to the next S is, you know, we don’t want to give the impression that, you know, biblical counselors are dismissing the body as if the body is not important. No, we are holistic beings. We are embodied souls. We understand very clearly, we’re trying to explain or see people from the way man is described in Scripture flowing from the inside out, doesn’t mean he doesn’t have responses, reactions that we’re not bodily beings that have real physical matter that operate in the world in which we live. But we are trying to see the flow of that man from the inside out in the way that we’re impacted from the outside in and how the Lord tells us to adjudicate that according to Scripture in a way that still is honoring to Him. And so, that’s what we’re trying to establish here, I think, in a way that’s helpful. So, we have some more S’s coming up. I want us to move forward in helping to discern trauma-informed therapy with the next S. Your alliteration, Ernie, which I love.

Ernie Baker: My Baptist alliteration. So, I’ll just piggyback on what you were just saying because if this brings up the issue of what is the role of the counselor. So, servants of the system, and is it my role? and this is a controversial issue, but how much is it my role as a biblical counselor to care for the body, talk about the body, and counsel people about their body? And I think there is a lot of information for me as a biblical counselor, a lot of things I know that I don’t share in a counseling session, so I go into a counseling session and I might be sharing Isaiah with somebody, I know a lot of information about Isaiah that I don’t share with my typical counselee. But that’s all gone into the hopper and shapes the way I’m talking to the person.

So I think of some of this information as what’s my primary role as a counselor, and what’s my secondary role, or secondary information that’s nice. What’s tertiary information? Like do I really need to have this information to do biblical counseling? Even though it shapes the way I’m speaking to people in the counseling, is that how I should use my hour or my hour and a half with the counselee? So the role of the counselor is really important. I see my role, my calling my specialty is I care about helping people hear the living Word of God, and how it applies to their struggles.

My specialty is not the body. There are other people whose specialty is the body, plenty of people that they can talk to about their body, my role is to be an expert in biblical truth, and I’m to be an expert in how do I apply that to the Percy’s of the world? The next S is support systems, and for us, that’s the local church. We’re being told as the local church to do no harm, that we really shouldn’t be involved with people like this. I would say that it’s part of our calling to love the most hurting people. For us at First Baptist, we have been through some horrific years recently of domestic abuse situations. I can tell you that, even with severe domestic abuse situations, have we done everything perfectly? I’m sure we have not, but we have people that would say we’ve loved them well, and they have learned how to apply biblical truth to their lives. And I love the local church. I love how the Lord uses the local church to minister to people. In the secular world, there are whole other support systems.

The last S is sparring, and that one we can cover quickly because it’s just about apologetics, and in a sense, that’s what we’re doing right now. We’re doing apologetics. Van der Kolk’s doing apologetics for his belief system. Every belief system does apologetics. I believe we have a complete belief system, and one of the ways I define sufficiency of Scripture is not just that Scripture says it’s sufficient. That’s one way to define sufficiency, like Second Peter one or Second Timothy 3, but Scripture is sufficient because it shows it has a complete belief system, and I am so thankful for that. So, we have a whole way with biblical eyeglasses to think about trauma-informed therapies and this whole system of how to think about people.

Dale Johnson: Now, obviously, Ernie, we can’t tackle this subject as widespread as it is, and it’s growing though; this narrative is, we can’t tackle the whole thing even though we went a little long today. We want to make sure that we’re giving a little bit more attention to these things. What we tried to do today is give you just a beginning framework, a way to think about not just trauma-informed therapy but lots of secular therapies, and these are the areas where I think we could be sharpened and refined to think well. And Ernie, I think you’ve helped us here, particularly as it relates to trauma-informed care, something that’s very, very popular in the day in which we live. You’re going to be speaking about things related to this, even at our annual conference, and I’m looking forward to that coming up. And so, Ernie, thanks for spending time with us today and helping us to discern this trauma-informed therapy.

Ernie Baker: Thankful to be with you.

Helpful Resources:

Click here to find the previous resources produced for Mental Health Month.