Healing by the Book

One day in the Democratic Republic of the Congo, Elizabeth Lukalu was gathering vegetables from her garden and looked up. In her sightline was a gang of men she recognized. They had recently been incarcerated for raping a little girl and leaving her to die on the side of the road. Elizabeth had rescued this girl, nursed her to health, and helped take her attackers to court. But scant justice had been rendered—the attackers spent just two months in prison—and now they stalked toward Elizabeth, bent on revenge.

“Mother Elizabeth!” they spat. “Today it’s your turn to save yourself.”

With the help of a neighbor, Elizabeth survived the assault. But her hands are mangled and gnarled. She’s missing five fingers. And a deep scar cuts down the back of her head. Lonely and terrified after the episode, Elizabeth fled to a refugee camp in Uganda. For a long time, she kept her pain to herself. But all that changed when someone in her refugee camp invited her to a trauma-healing group.

Led by other refugees in the camp, this group used readings and principles from the Bible to speed emotional and spiritual healing. Elizabeth was encouraged to open up about her pain, cry out to God, and let Jesus take her grief. This brought her great relief.

This therapy—Bible-based trauma healing—grew out of a partnership between African pastors and workers from Scripture translation agencies. During the 1990s they had witnessed the effects of war in many of the countries where they were stationed. Local pastors reached out for help, asking, “What can we do? Our people are acting strangely since the attacks.”

In 2001, a group of ministry leaders met to address this problem. They wrote a curriculum that would be easy to teach, translate, and train church leaders to share. The group included mental-health professionals, Bible translators, religious consultants, and African church leaders.

In small groups of about six to eight, guided by a trained leader, trauma survivors “listen, lament, and let go.” They read stories of pain, including contemporary accounts and Bible narratives. They discuss Scripture passages that help them reflect on God’s love and presence in the midst of suffering.

Participants discover that it is okay to bring their raw feelings of anger or abandonment to God. They write their own laments and express their feelings through therapeutic exercises.

Participants write down things they are afraid of and angry about, and place these at the foot of a large cross where they are destroyed. In the following weeks and months, they are encouraged to find strength and support in worship and local community. Like Elizabeth, who helps fellow refugees, some share their healing with others.

The new curriculum was tested in war zones, then printed in 2004 by Paulines Publications in Nairobi. The effort was picked up by American Bible Society in 2011. The society revised the program into a workbook called Healing the Wounds of Trauma and translated the book into 102 languages. It established a Trauma Healing Advisory Council so mental-health professionals can implement best practices, and a Trauma Healing Institute to support the program’s use around the world. There are now more than 8,000 trained leaders, and hundreds of charities, who use the therapy to help people of all backgrounds in 101 countries.

Churches fill a void

Many traumatized people in poor nations lack access to mental-health assistance. There are few trained professionals, clinics, or resources for persons suffering from psychic wounds. So this Bible-based approach uses as leaders and instructors local residents who have overcome trauma themselves. All go through a healing process and Biblical study during training. “I did not know that someone who passes through trauma could be released and live a normal life,” one Ugandan survivor told trauma expert Dr. Bryan Gouge for a 2014 study of the program.

The Western approach to psychological wellness is often highly individualized. But in developing countries, many people view mental health as a community issue, in which families, neighbors, and churches all have a role to play. Hurting individuals may go to churches rather than medical establishments for guidance and support. So American Bible Society’s model equips local religious leaders with tools to meet these appeals.

With support from donors, ABS covers most costs of introducing Bible-based trauma healing in a community, then helps build local funding. Depending on the country and setting, training a classroom of leaders can require from $2,000 to $25,000. Classroom resources then require about $15 to $20 per group and about $1 to $5 per participant.

Of the many charitable causes that Memphis, Tennessee, donor Katherine Barnhart supports through her family company’s giving program, the Grove Group, Bible-based trauma healing ranks high in her esteem. “I find myself in the field quite a bit assessing projects that we have funded,” she says. After visiting some healing groups in the DRC her conclusion was that “This is the first time, the only time, that what I saw in the field exceeded the impact that we were hoping for.” (To read more about her family’s philanthropy, see “Giving It All,” Spring 2014.)

Barnhart chose to invest in Bible-based trauma healing because it “serves the indigenous church through indigenous leaders. And it’s a self-sustaining model. A stimulus can come in from the outside, and then the church can own it and reproduce it themselves. That church becomes healthier, and then it can help others.”

While on her DRC visit, Barnhart met a group of widows who underwent Bible-based trauma healing together and then set up their own residential community. They tilled a piece of land given to them by the local chief, and harvested food to share with orphans and other struggling neighbors. They also trained to lead healing groups. These women went from being completely vulnerable to being self-sufficient helpers of others. Seeing how well this worked “overwhelmed me,” comments Barnhart.

In the wake of more violence in the region, the widows’ pastor sent out a radio message to victims: “Come to us. You don’t have to keep hiding. Come to us.” Frightened residents poured in, and the widows’ group provided them with compassionate guidance. All without outside direction or money. “That’s sustainability,” says Barnhart.

A different approach

The Trauma Healing Institute now trains local leaders on several continents. Its materials are designed so that ordinary people—not just counselors and academics—can infuse mental-health best practices and Biblical wisdom into their ministries. Leaders use two short books to operate their groups; stacked together they are less than one inch thick. This makes them inexpensive to reproduce and easy to carry to remote places. The minimalist layout and clear content is simple to read and digest.

“It’s not easy to be simple,” Barnhart explains. “Simple is profound. I’ve seen these materials used by people with advanced degrees, and people who can’t read. With the same kind of influence.”

Simple also allows leaders to make necessary adaptations to lessons to reflect distinct ways that different cultures experience trauma. When linguistic translations are needed, the work is done by a team that includes a language specialist, at least one trauma-healing expert, and church representatives from that language group. The Trauma Healing Institute reviews all curriculum changes for quality assurance.

The program has also experimented with an audio trauma-healing ministry that is broadcast over the radio in countries like Kenya and the DRC. Thirty-minute segments use storytelling, Scripture lessons, expert advice, group discussions, songs, and follow-up lessons to help listeners cope with difficult experiences. Among other advantages, this approach can reach persons who are not literate.

A 2016 pilot study of the effects of this trauma-healing curriculum revealed a significant decrease in personal symptoms six months after participation in a healing group. In another test of effectiveness, 47 local group leaders were surveyed, and 92 percent reported positive changes in the lives of participants such as renewed interest in daily activities, reduced anxiety, and less isolation. Pastor Bwambale Mamboleon, from an Assemblies of God church in the DRC, says the program helped people open up on previously taboo subjects like rape and lingering grief. It also revitalized his church by helping people to forgive each other.

The theme of forgiveness has been especially relevant in the DRC and Rwanda, two countries wracked by genocide. “Because of this program,” explained Leah Ndikumana, an Anglican refugee in Uganda’s Nakivale settlement, “I forgave those who caused the war.” Patrick Peter, another participant from Gulu, said, “The most important topic that benefited me was forgiveness. I learned to forgive—that when you forgive, you forgive wholly.”

This area marks one clear difference between Bible-based therapies and psychotherapy models—some of which do not view forgiveness of the perpetrator as a vital part of the therapeutic process. There is a mounting body of medical, mental-health, and social-science research suggesting that forgiveness positively promotes trauma healing. Bible-based trauma healing includes discussion of both healthy and unhealthy forms of forgiveness, ruling out measures that might justify ongoing abuse. Leaders are taught to avoid unhealthy pressure to forgive too quickly, while providing tools to help victims move toward forgiveness in an appropriate way. Participants work to attain not only personal wellness, but in some cases also the strength to address injustices that caused their suffering. “They knew forgiveness was necessary, yet acknowledged they had no idea how to effect it,” says the Catholic Archbishop of Gulu, John Baptist Odama, of his parishioners in Northern Uganda.

Branching out

Faith-based healing techniques are also useful in disaster response, when emotional as well as physical care is needed. ABS and its partners are creating an easy-to-understand short guide that leaders can use with victims after a disaster strikes. This seeks to reduce post-traumatic stress symptoms through religious means of coping, especially where there is a shortage of mental-health professionals and infrastructure. Equipped in this way, local church leaders can join first responders more effectively, and later minister to victims through follow-up groups.

With the help of Barnhart and other philanthropists, trauma-healing groups have spread beyond Africa to the Middle East, India, and South America, as well as to ministries in the United States. Barnhart is personally using trauma-healing materials in her own volunteer work with refugees in Memphis. “To be able to enter into somebody else’s pain and know that that doesn’t have to be the end of the story” is encouraging, she says.

A staggering 97 percent of women and 75 percent of men who are incarcerated in the U.S. are estimated to have experienced trauma, so in 2016, American Bible Society forged a partnership with Good News Jail & Prison Ministry to bring Bible-based trauma healing to American inmates. Prison chaplains from across the country were invited to gather and discuss the programming. There was so much demand that ABS is tripling its training events for prison chaplains in 2018. Now the Trauma Healing Institute is producing a curriculum aimed specifically for use with refugees in the U.S. and inmates in U.S. prisons and jails.

One inmate named Lori had experienced so many years of physical and mental abuse that she almost came to believe it was the life she deserved. She numbed her anguish with drugs and alcohol. Then a prison chaplain invited her to join a Bible-based trauma-healing group. There she listened to stories that echoed her own, and her buried feelings bubbled to the surface. “I cried, I grieved, got mad. I called on God and trusted in his power.” She now says simply, “I see a new vision.”

Bible-based trauma healing is much more than an abstraction to American Bible Society president Roy Peterson. He was incarcerated in a Mexican prison at the age of 19, where he expected to die. Instead, he found hope when two inmates offered to read the Bible with him. This started him on a path to recovery from bad decisions and their consequences. Later, when he and his wife Rita lost a son to an accident, despair threatened to overwhelm them both. It was help from fellow Christians that “made it possible for us to take the next breath, the next step.”

After two years, Rita found that she was offering help to others with their own troubles. She returned to school to be trained as a professional counselor and family therapist. Through the trauma-healing ministry, Roy and Rita have found a way to transform their own heartache into assistance of others. “Because we know what it is to suffer pain beyond bearing,” Roy explains, “we are determined that wherever there is suffering, there is also the healing word of God.” 

The Commerce Cure

For survivors of trauma like war, natural disaster, or human trafficking, psychological healing is only one stage of the recovery process. If they lack a secure economic foothold, they may remain highly vulnerable. But few services exist to help survivors achieve long-term economic security. This is a gap that Dorothy Taft noticed over and over in her long career in overseas assistance. So she founded an organization to help people who have been victimized become stable and self-supporting.

Taft was inspired by Healing Invisible Wounds by Harvard professor Richard Mollica: “During the time of healing after violence, work is the compass that shows the survivor the direction he or she must take to get out of a psychological dead end. Work not only gives survivors an opportunity to earn money and be productive, but also a concrete time and place where they must show up, a familiar cast of friends…and an overall sense of purpose and value.”

Enter the Market Project, launched in 2015 to foster healing through work. But not just any work. Unlike many efforts to provide employment to trauma survivors, its products are not advertised in connection with its mission. Taft did not want the business model to rely on buyers’ sympathies. She wanted to connect participants to actual demand and future growth based on satisfied needs.

Based solidly on market principles, the project strives for a “quadruple bottom line”: To generate a profit. To be sustained by market demands. To foster healing. To be harmless to the earth. It is structured as a 501c3 in the U.S. that launches carefully planned business ventures in various locations throughout the world. To capitalize the first venture, individual anonymous donors contributed funds—over $100,000 so far, with an additional low-interest loan of $30,000. Once a Market Project venture is up and running, it will be funded by earned revenue.

The first business is in northern Uganda, producing and selling yogurt to local consumers at an affordable price. The World Health Organization estimates that the population of this area has access to only about a tenth of the dairy products it needs for a healthy diet. Taft’s team stepped into this market opportunity with gusto, launching the Nguvu Dairy, which now has a workforce of 35 women and men. The dairy’s starting wage is more than 1.5 times the national average, so those employees support 175 children and other family members, and their products also help 47 farmers who supply them with milk to thrive. The dairy hopes to triple its employees in the next year.

While on the front end Nguvu Dairy looks no different from any other business, on the back end it is a “trauma-informed workplace.” Managers are trained to work with employees on issues that may arise from Uganda’s bloody tribal conflicts and problems with warlords, as well as domestic-violence situations. Stress comes back up at the moments you would least expect, Taft notes, sometimes leading to inappropriate reactions. In other settings, those could lead to lost jobs, but these supervisors have learned to spot symptoms of lingering trauma, and work with employees to find healthier ways of coping. They are also committed to providing a safe work environment, with plans in place for protection and pacification if old ghosts turn up.