Dr. Heath Lambert: Post-traumatic stress disorder, on this edition of Truth in Love. I’m Heath Lambert and you’re listening to Truth in Love, a podcast of the Association of Certified Biblical Counselors, where we seek to provide biblical solutions for the problems that people face.
One of the things we love to do on the Truth in Love podcast is, as much as we can, to answer your questions every week and you have been asking for us to respond on Truth in Love to the problem of post-traumatic stress disorder. It is certainly one of the problems that growing numbers of people face and to help me sort out your questions and your concerns the operations director of ACBC, Sean Perron, is here to help me field your questions. Sean, we are glad to welcome you back to the podcast again.
Sean Perron: Thanks, Heath. One of the things that can be scary about labels in the Diagnostic and Statistical Manual is people don’t know what they are or what they mean. So, can you tell us what is post-traumatic stress disorder and how does it come about?
Dr. Heath Lambert: Sean, that question is the question because one of the things about many of the labels in the Diagnostic and Statistical Manual is that they use sort of heavy-handed language that we aren’t accustomed to using in our normal everyday language; that can sometimes be a barrier for clarity. I think it’s good for us to talk about this label that is used with growing frequency. What does it point to? If you break it down, this is a little easier than some of the other labels in the Diagnostic and Statistical Manual. And so, post-traumatic stress disorder. “Post” refers to after. “Traumatic” refers to some sort of traumatic event that you’ve experienced, it doesn’t have to be a dangerous event, though it might have been a dangerous event, but it could also just refer to an event that was very scary for you and maybe an outsider would look at it and say, “Well, there was no real danger.”, but the person in that moment is experiencing it as dangerous or traumatic in some way. “Stress”, the experience of that trauma causes you difficulty. The word “disorder” refers to the way the Diagnostic and Statistical Manual speaks about things that are not normal. It is disordered to have this kind of experience. When you put those four words together, post-traumatic stress disorder, we’re talking about a problem, not a normal part of life but a problem in your life, that is a response to a troubling event or a traumatic event after the traumatic event has happened that causes you great difficulty as you seek to live your life.
Now, not everybody has post-traumatic stress disorder, but many people do, and a person gets diagnosed with that label by a person who is licensed by the state, usually a psychologist or a psychiatrist. Let me tell you how a person who is licensed by the state would diagnose someone with post-traumatic stress disorder. First of all, they have to have had at least one re-experience of the event that happened in the past and that re-experience could be a horrible nightmare, it could be a flashback, something like that. They also, in addition to that, have to have at least one avoidant response. So, they would make a conscious decision to stay away from people and places that sort of trigger the stressful response to the trauma that they experienced. A third is at least one experience of an arousal or a reactivity symptom. Something like being easily startled or being outraged about something that happens would be an arousal response where you respond in this really affective, scared, stressed way. A fourth indicator would be a problem with your cognition or your mood, so maybe as an example, somebody has a loss of interest in an activity that they had previously enjoyed. In order to be diagnosed by a professional licensed by the state, you have to have at least one episode of all four of those instances for at least one month. When all of those things come together, a licensed person from the state would say, “That person has post-traumatic stress disorder.”
Sean Perron: If we’re thinking in biblical terms and in biblical categories, clearly, if you look in the index of a Bible or a concordance, you’re not going to find “PTSD” or “post-traumatic stress disorder”. What are the terms that the Bible uses to describe this and does the Bible speak to this issue?
Dr. Heath Lambert: Yeah, it is of great importance to talk about terminology because the terms that we use and how we understand those terms plays a large role in whether we think the Bible has something to say about this or whether we think the Bible is relatively silent on it. A brief thumbnail sketch of history here, post-traumatic stress disorder is a relatively new term in the grand scheme of human language and talking about human difficulties. The journey began in World War I, where you’re exposed to these brutal and bloody battlefields and it took a toll on the soldiers who were fighting in World War I, and they saw these mass problems with it and the problem came to be called “shell shock”. By the time you get to World War II, a similar problem: mass numbers, many millions of people, experiencing the stress and duress of getting shot, watching your friend die, the blood flows, you’re in pain, you’re hungry, you’re scared, and that experience came to be called, not “shell-shock” as in World War I, but “combat fatigue”. By the time you get to the Vietnam conflict and the aftermath of that, that is where we start to see the birth of the new term “post-traumatic stress disorder”. When we talk about post-traumatic stress disorder, we’re talking about the same reality that soldiers in World War II called “combat fatigue” and soldiers in World War I called “shell shock”. We’re talking about the reality that when you are burdened by the horror of war it is going to have an effect on you. In more recent decades, the experience of post-traumatic stress disorder has moved out of the military and into the civilian population so that now many people, you don’t have to have been on a battlefield to be diagnosed with PTSD, you can experience any stressful or traumatic experience and then the reliving of that or the trouble or the stress that comes after that can get anybody diagnosed with post-traumatic stress disorder.
When we’re talking about this, we’re talking about something that the Bible understands. The Bible understands the experience of being afraid in a foxhole. The Bible understands the experience of being afraid when you are watching a loved one die. The Bible understands the experience of being afraid when something horrible happens to you as you’re walking home tonight by an attacker. The Bible understands the experience of being afraid when a parent or a spouse does something horrible to you and reliving that as you think about it in the aftermath is very, very difficult and very, very stressful. The Bible does not use the language of post-traumatic stress disorder, but the Bible does use the language of fear. The Bible understands that situations can be very, very difficult and very, very painful and we’re not held responsible for being victims of a terrible experience and the Bible then understands that looking back on a situation or certainly living through a situation can produce a response of fear. Even though the Bible doesn’t use the language that modern, secular folks use as they talk about this, the Bible, every time it talks about fear, every time it talks about worry, is understanding the same reality.
Sean Perron: Since the Bible does address this using different language, what should our response be as Christians when we ourselves face a traumatic issue like this or we have friends that are facing PTSD? How can we help them and how can we respond to it?
Dr. Heath Lambert: Well, this is where the Bible is so helpful because the Bible is a book, I think you could win a case, that is all about fear. I mean, there are commands not to be afraid literally hundreds of times in the Bible. God understands our fear better than anybody else and He explains as much of His understanding as He wants us to know in the pages of Scripture. One of the things I always say on the podcast is this is intended to be an introduction. There’s many, many more things we could say about post-traumatic stress disorder or about fear than what we’re going to say in here, but we just want to introduce you to the topic and get you thinking about some general biblical categories. Jesus gives us some very, very helpful categories in Matthew 6 as He talks about worry. In Matthew 6:25-34, Jesus three times will command don’t worry, don’t worry, don’t worry. When He tells us not to worry, He tells us what we’re not supposed to worry about. He says, “For this reason, I say to you do not be worried about your life.” The reason people experience post-traumatic stress disorder is because there was a situation that happened to them in the past and as they relive it, they are afraid and the thing that makes them afraid will be the threat to life—their own life or the life of somebody that they know and love. They’re going to think, ‘Something serious is going to happen that’s going to take away my life, that’s going to take away my joy, and it’s going to be really, really bad’. Jesus says, “Don’t worry about that. Don’t worry about what you’re going to eat. Don’t worry about what you’re going to wear. Don’t worry about what you’re going to do. Don’t worry about your life.” As He goes through His teaching on not to worry, in verse 30 He says, “You of little faith!” Jesus contrasts a life of worry and fear with a life of faith in God. He says that if you’re overwhelmed with worry, then your problem is that you need to trust God. What Jesus does in the context of Matthew 6 is to fuel our faith. He tells us about the love of God, and He tells us about the sovereign control of God. “Look at the birds of the air, that they do not sow, nor reap, nor gather into barns, and yet your heavenly Father feeds them. Are you not worth much more than they?” Jesus is calling attention to the sovereign care of God. He’s saying, “Look how much God loves the birds. He loves the bird so much that He uses His powers to take care of them.” He says, “Don’t you think you are worth so much more than a bird?” God fuels our faith, Jesus fuels our faith, by reminding us that God loves us and He directs all of His love for us towards providing for what we need. That’s why Jesus says, “Don’t worry then, saying ‘What will we eat?’ or ‘What will we drink?’ or ‘What will we wear for clothing?’ For the Gentiles eagerly seek all these things; your heavenly Father knows that you need all these things. But seek first His kingdom and His righteousness, and all these things will be added to you as well.” Jesus is saying, “You need to reorient your thinking towards God and His love and His care for you.”
One of the things that’s really helpful to do this is for people who struggle with these kinds of problems to make a distinction between the event that happened, that was horrible and for which they are not responsible, and their response to that event. The reality is, you know, the Apostle Paul will say in Philippians 4 that we need to think on what’s true. What is true is that that triggering event that is making me scared now I’m not back in the old situation. I’m in a different situation now and I need to think on what’s true and be thankful that as scary and as horrible as that situation might have been, whatever it was, God was faithful in His love and in His sovereign control. He shepherded me through that and now I need to focus on Him and what He has done seeking first His kingdom and His righteousness and have faith in Him—the kind of faith that eradicates the kind of fear on display in post-traumatic stress disorder. There’s a lot more to say about caring for someone who struggles with this very serious difficulty, but you won’t go wrong in pointing them to the words of Jesus that defeat fear and fuel faith by having us pay attention to the character of God.
You’re listening to Truth in Love, a podcast of ACBC. One of the things I said on the podcast today is that we intend the podcast to be an introduction to weighty and serious topics not a comprehensive treatment of them. We’re always eager to point you to other resources. Let me point you to two resources. First is a book called “Helping Your Family Through PTSD” by Dr. Greg Gifford. Dr. Gifford is a professor at The Master’s University in Southern California, and he is an ACBC certified counselor. His book is very, very helpful at understanding the problem with PTSD and it’s also helpful in thinking through ministry solutions. Let me tell you about another resource. I have invited this year a group of biblical counseling leaders from all across the country to a leadership colloquium that ACBC is going to host here in the next few months. The theme of that colloquium is the theme of post-traumatic stress disorder, and how to develop a fully biblical understanding of it, and how to develop a fully biblical system of care for people who struggle. One of the things that we’re going to do in the follow-up to that colloquium is to produce a series of essays from the leaders who are going to be presenting on that and you’ll be able to read about those at our ACBC essays. ACBC essays is one of the things that we do where we try to get leaders in biblical counseling to address urgent and critical topics related to the theme of biblical counseling. We have many of those essays available online right now, but you’ll have to wait for the ones on PTSD. But, if you’d like more information about ACBC essays or about the ministry of ACBC in general, then you can find out about it at biblicalcounseling.com.