Today I witnessed my first serious trauma admission in the Emergency Department. When a trauma call is made, it is ‘all hands on deck’. As soon as a call comes through from the paramedics, the team starts preparing—the room, the equipment, the medications. Everyone knows their roles and there is a set protocol of what needs to happen to stabilise the patient. Specialist teams are on standby, so specific skill sets are available if necessary – an anaesthetist for managing the airway and ventilation, neurology and neurosurgery teams for looking after the brain, and surgeons in preparation for managing the sustained injuries. Trauma is unexpected, it can be messy, and outwardly, it is often very clear what is going on—if a leg is cut open and bone is sticking out, you know that there is a fracture and probably a lot of blood loss.
‘Spiritual trauma’ is much the same. A big event happens, often seemingly out of the blue, a fight or falling out, a break of trust, being sinned against by a fellow brother or sister, someone in leadership abusing their position. It is messy. It often involves others, and gossip can lead to more and more people involved, like a multi-vehicle pile-up. However, just as a brain injury may not be immediately apparent, the big problems can sometimes be hidden. The underlying pride, the unstable marriage, the hidden greed are sometimes the root of other more obvious problems such as lying, anger or being unkind.
In the hospital, it is clear that when a trauma comes in, something needs to be done quickly if the patient’s life is to be saved. Spiritual trauma too, can have potentially disastrous consequences if not dealt with early and effectively. This could be church divisions and disunity, ongoing hurt and damage of relationships, and at its worse, people turning away from God entirely. Now I am no expert on dealing with church conflict, and I am certainly not an experienced or qualified Emergency doctor, but I have noticed some similarities in the management of trauma in both circumstances. So to help us understand how we can effectively manage spiritual trauma, we’ll look at 3 aspects of the management of trauma in the Emergency Department.
If you have ever learnt any first aid, you have probably learnt the acronym DRSABCD. In the hospital we use it too, just some of the letters stand for slightly different things. However, in both circumstances, the first letter ‘D’ stands for ‘danger’. This is a reminder to check if the patient is in danger, or if you are in danger yourself.
I think this is a good place to start in considering how to deal with ‘spiritual trauma’ too. This is a reminder to look after yourself, to not get ‘burnt out’ in carrying others burdens, as well as to be wary of the more subtle danger we pose to ourselves by entering such a situation—falling into sin. “Brothers and sisters, if someone is caught in a sin, you who live by the Spirit should restore that person gently. But watch yourselves, or you also may be tempted” (Gal 6:1). It is rare for spiritual trauma to occur without sin having occurred at some point in the process. So in attempting to help deal with the situation, we need to be aware of our own tendencies, weaknesses and temptations. If gossip is something you struggle with, you must be careful of each word you speak and who you speak them to as you seek to help in the healing process. You must be aware of sin’s great ability to disguise and justify gossip as ‘being concerned’ or considering it as ‘ok because they were in the wrong’. If you struggle with pride, you must be conscious of how you think about your brothers and sisters, and be careful not to let discernment lead to unhealthy judgement or comparison with yourself. You must be sure to remember your own failings and the grace of God expressed in the transforming work of His Spirit in you. Or maybe it is a love of always being ‘in the know,’ pursuing the satisfaction and praise of others for being the person who ‘makes things right.’ Or maybe it’s a sense of feeling not good enough, so comparing yourself to others in this situation helps your self-worth. I encourage you to first prayerfully self-examine and seek out the potential danger for yourself before committing to attending the trauma call.
2. Send for Help
Calling for help (once again part of our DRSABCD acronym) is one of the things they drill into us in medical school in our training to be junior doctors. It is an expression of one of the characteristics of a great doctor – knowing your limitations. Now this approach is not so easily transferrable from physical to spiritual trauma, because in most situations, it is probably best to try to deal with spiritual trauma with as few additional people as possible—unlike in a hospital trauma, where some 30 people may be in attendance! (In Matthew, we read about conflict resolution and what to do when a brother or sister has sinned against you. The first step is to approach them by yourself. If they do not repent, another person is bought in as a mediator, and if they still will not listen and there is no resolution, the church is bought in. You can read it in Matthew 18:15-20).
Knowing our limitations however, is so very applicable to spiritual trauma. We cannot change hearts. We cannot restore what is broken. We cannot forgive people for their sin. Only God can do these things. So it is vital that we recognise this and our own limitations in light of these truths. This means that as much as we might try to help or even feel like we are useful in the spiritual trauma process, we will achieve nothing without God. In light of this, prayer should be one of our biggest priorities, as it demonstrates a humble submission to and trust that God will achieve his will. There is also wisdom in seeking the help of a pastor, elder or someone you trust in the church if you think it is needed, and remaining accountable to them throughout the process.
3. Advanced Life Support
In the acute setting, as soon as the patient comes through the door of the ED, the initial aim is not to be returning them to their full normal function, but keeping them alive. We keep their airway open, we breathe for them, we compress their chest to pump their heart, we give them medications to make sure their brain and heart are being perfused with blood. In the case of a spiritual trauma, we need to know that in the ‘acute setting,’ our aim is not to be solving the fundamental or underlying problems, to be seeking reconciliation and returning to normal function. Our aim is to be keeping that person alive – in a spiritual sense. The worst case scenario is for them is to lose connection with God, to throw in the towel. So our job is to support them in providing the ‘advanced life support.’ This may mean that we need to support their airway and breathe for them when they can’t; that is, we are to prayerfully intercede on their behalf regarding the situation and their relationship with God, trusting that he will be at work. We can pray for peace in God, for trust in God’s goodness and revelation of the hope found in the truth of the gospel. We need to encourage them, listen to them, affirm them and remind them of who God is amidst the difficulty.
These are so vital, not just because they are an outpouring of love, but also because they really set the scene for ongoing management for that person. If you don’t secure your airway and breathing, later on the patient may deteriorate again when you are trying to manage something else. In the same way, how you go about spiritual truama management is really important. If you set a foundation of blame, judgement and gossip, or of discontentment and self-pity, you can potentially be worsening the situation – even if it seems the most effective way of dealing with it in the moment- or be inhibiting healing down the track. Having the end goal in mind – reconciliation with God and reconciliation with others (ie: ongoing life and return to function)- should shape what we say and do.
And finally, just as sometimes we need to give medications to ensure blood and oxygen is getting to the heart and brain, we may need to deliver life-giving substance to those in the midst of trauma to ensure that their hearts and brains are also being fed. God’s Word is described as ‘the Word of life’ (Phil 2:16), ‘God-breathed’ (2 Tim 3:16) and as being ‘active and alive’ (Heb 4:12). As the ultimate truth, it has transforming power and is a source of comfort and encouragement. In times of pain, uncertainty, and brokenness, we can be sure in God’s powerful working through the Spirit of His Word; “For everything that was written in the past was written to teach us, so that through the endurance taught in the Scriptures and the encouragement they provide we might have hope” (Romans 15:4). Let us build each other up in the Word, encouraging and reminding each other of the great hope we have in Christ.
Spiritual trauma can be difficult and messy, and can take us by surprise. But just like a trauma in the emergency department, we fall back on our foundational knowledge and resort to our already-formed habits in the midst of a high pressure situation. For this reason, it is so worthwhile for us to think about how we approach such a situation before we are thrown in the deep end, and to practice these components of being aware of danger to ourselves, making God our ‘go-to’ for help, and practicing a prayerful dependence on God in our day to day lives. What a blessing to be able to imitate the work of a God who saves, and reflect his love, goodness and faithfulness in the process.
“May the God who gives endurance and encouragement give you the same attitude of mind toward each other that Christ Jesus had, so that with one mind and one voice you may glorify the God and Father of our Lord Jesus Christ” (Romans 15:5-6).