We live in a day when the Christian counseling world is sharply divided. There are good reasons for the concerns voiced on all sides, but if we are to reduce the level of hostilities in the field and promote greater understanding and dialogue, reading and reviewing Christian counseling books will need to be marked by a hermeneutic of grace and good will that supersedes our criticism, to love our brothers and sisters, to highlight the glory and goodness of God in their work (1 Pet 1:22), to promote the unity of the body of Christ (Eph 4:3), and to overcome divisiveness (Gal 5:20). This is easy to do with a recently published Christian counseling book on complex trauma.
The author is a professor of counseling at Denver Seminary who has done extensive counseling with Christians and non-Christians who have experienced complex trauma. Whereas posttraumatic stress disorder is due to a single traumatic event or episode—like being in war and witnessing or experiencing terrible violence—complex traumatic stress disorder (CTSD) is due to ongoing physical, sexual, and/or emotional abuse for many years in childhood. Well-read in the available secular literature in this area of study, the author has developed a distinctive Christian counseling model for dealing with this kind of psychospiritual problem, and, in my estimation, this book is the best recently published Christian text available on the treatment of CTSD.
What characterizes this disorder? Those who have endured severe, chronic trauma during childhood tend to have problems with emotion regulation (having overwhelming emotion or no emotion), distortions in self-perception (extreme shame and self-hatred), problems in the perception of others (sympathy toward the perpetrator, distrust of or co-dependence on others), physical problems (pain, numbness, and medical issues), and relational difficulties (fear of intimacy). In addition, they often have some degree of dissociation, that is, the splitting of consciousness into more or less isolated components, which resist exposure and full integration into consciousness. In the most severe cases of abuse, these dissociated aspects can become discrete personalities or identities. Regardless of the degree of dissociation, Gingrich refers to these aspects as “parts of self,” and the book’s most important contribution is the detailed model of therapy she has worked out for addressing these parts and promoting their reintegration into a unified self (though she suggests a full integration may not be possible or necessary, p. 166). Some Christians are skeptical about any kind of dissociation, particularly those who have never encountered it, but the book is thoughtful and well-documented, and for those who have worked with such people, reading it will be extremely helpful.
According to Gingrich, counseling with people with CTSD is marked by three distinct stages: an initial phase of trust-building that fosters a sense of safety; the second, major phase of working on dissociated memories and intense emotions, which facilitates the strengthening of the core self; and a final phase that focuses on developing new ways to live in light of the healing that has occurred, dealing with the perpetrator, and concluding the therapy relationship.
Gingrich’s evangelical faith, gentleness, and humility permeate the book, likely reflective of her counseling practice. She repeatedly speaks of dependence on the Holy Spirit and our need for Jesus, the counselee’s sin is never condoned, she advocates prayer (though in session, with some caution, p. 113) and the use of the Bible with Christian counselees (pp. 135, 178), and she provides many examples of how God figures into her understanding of counseling and the Christian life. Because survivors of childhood abuse often take responsibility for their abuse, Gingrich emphasizes its injustice and always refers to the perpetrators critically, which helps survivors recognize, perhaps for the first time, the wrong that has been done to them. Before concluding, however, she also provides a nuanced and balanced discussion on forgiving perpetrators. At the same time, she might have gone a little further to state that, as hard as it may be to accept, perpetrators too are created in God’s image, and they also need God’s grace and warrant Christian love.
Abuse survivors also often struggle with where God was during the abuse, and Gingrich wrestles wisely and sensitively with these issues (pp. 174–78). She also addresses inner healing prayer—which invites the healing presence of Jesus into memories of past trauma—and suggests it may be a helpful Christian approach for some counselees (pp. 178–80), but offers some sound cautions regarding its use. She also recognizes that demonic forces are sometimes involved with those with CTSD, but warns against abusive “deliverance” ministries that can re-traumatize already vulnerable persons.
Are there any limitations? As with most books that exemplify an “integrationist” orientation, the book’s familiarity with the secular literature on the topic and its significant psychological sophistication is not matched by a familiarity with relevant theological literature and a comparable biblical and theological sophistication. Its repeated use of the Bible is more proverbial than theoretical and principled. There is little if any criticism of secular therapeutic concepts or models of therapy (even “person-centered,” p. 125). Considerable use is made of creational/common grace resources in the model—the therapeutic relationship, emotion-focused strategies, cognitive techniques—but relatively little of redemptive resources. The model would have been significantly enriched with reference to the perspectives of Creation-Fall-Redemption-Consummation; a consideration of how the atonement addresses shame, guilt, and suffering; the relevance of union with Christ, justification, and adoption for the reconstruction of the self-understandings of survivors and the integration of dissociated parts; and how the daily cultivation of one’s personal relationship with Christ in meditative prayer can contribute directly to the healing process.
Because of such limitations, some more biblically oriented Christians will be tempted to reject this book. But that would be unfortunate, because of its considerable strengths. Someday, perhaps, the Christian community will compose counseling books that are characterized by sophisticated biblical/theological and Christian psychological understanding. In the meantime, we need to avail ourselves of the best literature in both areas, as wisely as we can, to provide the best care for God’s people possible.