Jamal squeezed both the girl’s bleeding wrists as a student called 911.
This was his first lock-in. He was the only adult present and he was just an intern.
He still has nightmares about the suicide attempt that night.
Clay still has flashbacks from when he was called to an emergency board meeting. He had no idea that he was present to defend his position at the church. There were false accusations and gross misunderstandings. With violent anger the elders shouted at him. He felt exactly like when he had been swarmed by a gang as a teen. He was wrongfully dismissed.
He has recurring nightmares of that meeting, even though he has long left youth ministry. Each time his phone rings he’s still nervous and can see their angry red faces.
Jill had a full on panic attack when she received a call from Margarita’s parents about a suicide note. Their daughter was also missing and everyone feared for the worst. Jill had thought she was making huge progress with Maggie. Now she was hyper ventilating as she searched the city for the her.
Even more traumatic things happen in youth ministry. One of my graduates, who was first on the scene of a rolled youth van, described the weeks following as: “Being in an electrified cage and receiving random high voltage shocks. I never knew when they were going to hit. I couldn’t prepare for them or control my reactions.”
Are you or a colleague suffering from PTSD-like symptoms? Here’s how to know and what to do about it. (I also have a link to a self-assessment that you can try.)
It’s becoming clear now that although service men and first-responders deal with the most traumatic situations, that people in the helping professions are also being diagnosed with PTSD or Secondary PTSD.
What is it?
The Diagnostic Statistic Manual indicates that PTSD results whenever a victim experiences the following:
- Actual or threatened death or serious injury, or witnessing death or physical injury
- The individual’s response includes intense fear, helplessness, or horror
- And the individual experiences the following symptoms for at least one month:
- Persistent re-experiencing of the traumatic event
- Persistent avoidance of stimuli associated with the traumatic event
- And persistent symptoms of arousal such as sleeplessness, anxiety, hyper-vigilance, or increased levels of energy
- And the symptoms cause distress in work and social functioning.
- For condition 3.a. above, the event can be re-experienced through intrusive memories, recurrent nightmares, or flashbacks. Flashbacks occur when the individual relives and behaves as though the event is happening all over again.
For condition bullet 6 above, the individual feels intense distress when exposed to cues that symbolize the event. For instance, a firecracker is mistaken for a gunshot. So the individual usually tries to avoid thoughts, feelings, or conversations about the event. The individual especially tries to avoid places or people associated with the event.
PTSD is associated with increased rates for depression, panic disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Agoraphobia (fear of going outside), Social Phobia and Bipolar Disorder. The victim often feels intense guilt over surviving the traumatic event.
You can read more about this at Pastor Self Care
PTSD changes the diagnosed person’s life and greatly impacts the lives of those with whom they are close and regularly interact.
Sadly experts note that “the explosive rage, depression, isolation, anxiety, cognitive difficulties, and lack of vitality combine to cause loved ones to leave.” This is unfortunate because it is at that time that “a strong support network is essential for healing.” Friends and families are an integral part of that network. Trusting relationships are essential to combat the dehumanizing effect of trauma.
Your Work Affects You
Terri Spahn Nelson, MSSW, LISW explains that For persons who work with trauma survivors, the most important part of coping with the intensity of the work is to understand it will affect you. She says that “If you’ve been trained in crisis intervention and empathic, active listening skills, this work will affect you. If you really listen to what the student is telling you, this work will affect you.” She suggests that, “recognizing that it is “normal” to be affected by this type of work is the most important coping skill that you can give to yourself. You’re not alone. It’s okay to feel outraged, horrified, shocked, saddened, or vulnerable.”
Vicarious or Secondary PTSD is Real
According to the Nation Child Traumatic Stress Network, “Secondary traumatic stress is the emotional duress that results when an individual hears about the firsthand trauma experiences of another. Its symptoms mimic those of post-traumatic stress disorder (PTSD).
What’s frightening is that “individuals affected by secondary stress may find themselves re-experiencing personal trauma or notice an increase in arousal and avoidance reactions related to the indirect trauma exposure.” In addition helpers “may also experience changes in memory and perception; alterations in their sense of self-efficacy; a depletion of personal resources; and disruption in their perceptions of safety, trust, and independence.”
Here is a self-assessment tool you can try to see if you are experiencing secondary stress: Cohen STS TEST
According to the experts, “the diagnosis Complex PTSD comes from being exposed to multiple traumas, sometimes small but causing cumulative emotional damage over a long period of time.” That almost sounds like the definition of youth work to me! As I have journeyed with students, I have been in emergency rooms, psych wards, police stations, witnessed domestic violence, stopped suicide attempts….the list goes on.
PTSD is treatable. “Getting help is important,” says Christopher Sarampote, a program officer with the National Institute of Mental Health’s Child Trauma Program. “Not treating PTSD, or traumatic responses in general, can impair people’s recovery and even lead them to be victimized again,” he says. A mental health professional can provide a diagnosis, prescribe medications if appropriate, and offer therapy”
Evidence-based approaches that may help include Trauma Focused Cognitive Behavioral Therapy and Psychological First-Aid for Youth Experiencing Homelessness (PDF, 1.5MB).
It is so important for any person in the helping profession and many parents, that they seek help whenever they have gone through a crisis or when they are helping someone else in crisis. It’s not that PTSD is contagious, but as research is showing, there’s no way to be untouched by work that we do. As we enter into a student’s or a family’s pain, we too can suffer.
I believe that after years of dealing with students’ suffering, my perspective on the world has changed. I know that having heard so many terrible firsthand stories of what students have experienced has left me over-cautious as a parent. Sadly, it has also left me cautious about other teens and parents; including those who attend church regularly.
You don’t have to be in youth work very long to experience compassion fatigue, burn out, or PTSD. I would suggest trying the self-assessment above. If you are experiencing symptoms, talk to a trained counselor with experience with PTSD and those in the helping professions.
Of course you should invite God to heal you and provide a different outlook on life and ministry. Whatever you do, please find someone that you can talk to about your thoughts and feelings.