They say that words have meanings, and that those meanings matter. It seems, however, that in a culture formed by social media and hot takes, the use (or overuse) of certain key words that should communicate big ideas has frequently resulted in confusion surrounding those same words. Evidence of this phenomenon is the misshaping or warping of formerly useful words and concepts as they are appropriated by popular culture.

Take, for example, a phrase that I come across on occasion: “All is grace!” In my experience, those who use this phrase simply desire to highlight their awareness of the unspeakable kindness God has shown them. Their intention by declaring that kindness to the world is to display their gratitude to him. How curmudgeonly must one be to quibble with that?

The trouble for me is that I am not willing to assume the premise—that everything God does and works is properly assigned to the theological category of grace as opposed to kindness. To be sure, it seems the two words are inseparably related; yet nonetheless, they are distinct. In this brief example, we can appreciate how words, when over-used or misused, can lose their effectiveness toward good communication.

With that as the backdrop, I turn to the hot button topic of trauma, specifically with an eye toward the word’s use in the broader field of mental health counseling, and how that usage may be more or less useful in the church. Questions I want to consider include defining trauma clinically (in distinction to its popular level use), identifying its usefulness as a category of thought to the church’s ministry of caring for traumatized, emotionally hurting, or spiritually despairing people, as well as considering what the church risks when she uncritically assumes the culture’s malleable definition.

First, let me say that, as a seminary-trained, clinically-informed biblical counselor, I am thankful that across the board we have a much better understanding today than in the past of the topic of mental and emotional distress, its potential causes and effects, as well as clinical treatment options and/or discipleship approaches to soul care. It is an exciting time to be in this particular arena.

I am glad, therefore, that a topic once thought of as belonging mainly (if not exclusively) to combat veterans is now able to be properly applied to survivors of childhood sexual abuse, domestic violence, natural disasters, and even serious car accidents. In many ways, this new understanding represents the opening of the door to help, which for many in times past was otherwise closed.

Even so, every action has an equal and opposite reaction; and so it goes with trauma. What was once narrowly applied to combat soldiers, is now being applied—at least in culture at a popular level—to a broad swath of scenarios that are questionable and warrant careful inspection.

All is not grace, but is every bad, troubling, distressing, or disruptive event in life properly identified as “trauma”? Or (to borrow a thought I heard elsewhere), if everything is trauma, then nothing is trauma. This is part of what we are risking, however unintentionally, when we are not careful with how we understand this insightful word, instead applying it to every disappointment in life, big or small.

So, what is “trauma”? We see that it now depends on how one intends to use it. Clinically, the Diagnostic and Statistical Manual of Disorders (DSM-5) defines trauma as:

Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways: (1) Directly experiencing the traumatic event(s); (2) witnessing in person, the event(s) as it occurred to others; (3) learning that the traumatic event(s) occurred to a close family member or friend, the event(s) must have been violent or accidental; (4) experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).¹

Beyond this description, there are a variety of other criteria that must be met before an assessment can be given that an event was clinically traumatic. These would include such things as reliving the event in triggering scenarios, avoidance of uncomfortable settings, and functional impairment as the result of psychological distress. When we apply the clinical criteria to facts and circumstances often labeled as traumatic in popular discourse, we see that not all is trauma, or at least not trauma as defined and intended by the clinical realm.

For pastors, deacons, and small-group leaders everywhere, it is now common to hear those under their care describe themselves as “traumatized,” or as “having trauma.” The cultural expectation today is that ministry leaders will respond quickly, with compassion and competency. But there is a good chance that some pastors are not exactly sure what the word means, or even how it is being used from one scenario to the next. This matters, because how the word is being used may have a definite influence on the best type of response.

For example, when one person says, “I have trauma from ‘church hurt,’” do they mean they have been clinically diagnosed with something like PTSD according to DSM-5? Or on the other hand, are they using the word in a more colloquial way? What is more, does the person who is using the word “trauma” colloquially actually need to be assessed clinically based upon their self-reported cluster of symptoms?

The only way any of us can navigate these issues with love for neighbor is to educate ourselves to at least some basic level of competency that helps us identify particular markers that trigger specific courses of action—for instance, scheduling follow-up sessions for pastoral counseling, and/or giving a referral to someone with a greater skill set or expertise than our own.

I would encourage every church and pastor to establish a relationship with one or more trained counselors in their community, who can come alongside them to help care for those with concerns about psychological trauma. Gone are the days where it was shameful for a pastor to discern that a certain counseling case was beyond their comfort level.

And here is a little secret I want all pastors to know: Even if you discern that the person sitting in front of you needs a higher level of counseling care than you feel equipped to provide, you can and should still seek to encourage them regularly by and through the wisdom of God’s Word. Even if they have clinically diagnosable PTSD, they still need to understand their circumstances in the context of a biblical worldview, and they need to be encouraged to respond daily to their suffering in ways that are in keeping with Scripture.

In this sense, there is never a counseling case for which you are utterly incapable of providing meaningful help. In case you wonder whether that is true or not, consider that even the secular American Psychological Association (APA) now advocates for clinicians to more openly incorporate “religion” and “spirituality” in mental health counseling. We may not agree with how they employ these words, but we can welcome their observations as a doorway into the lives of those who need the gospel applied to their suffering.

A recent article published in the APA’s Monitor states that, “Religious and spiritual beliefs and practices can be a powerful resource for patients who are working through challenges, including traumatic experiences.”² Understood in this way, we can rightly say that a referral to a counselor should never be thought of as total disengagement. Indeed, quite the contrary. Collaboration between a person’s counselor and their church holds out the hope of tremendous progress, and specifically, progress centered upon gospel hope marked by kindness and grace.

Notes

1. American Psychiatric Association and American Psychiatric Association, eds., Diagnostic and Statistical Manual of Mental Disorders: DSM-5, 5th ed. (Washington, D.C: American Psychiatric Association, 2013), 271.
2. Zara Abrams, “Can Religion and Spirituality Have a Place in Therapy? Experts say Yes,” Monitor on Psychology 54, no 8. (November 2023).

© Joshua Waulk. All Rights Reserved.

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