Bonura, Dean. Beyond Trauma: Hope and Healing for Warriors, A Guide for Pastoral Caregivers on Post-traumatic Stress. Springfield, MO: The Warriors Journey, 2019.
Beyond Trauma was written during the American military’s surge in Iraq in 2006. At that time, numerous veterans with combat-related trauma were returning and rapidly rejoining the civilian population. But 15 years later, with wars winding down and actual combat rare, caregivers may be less familiar with the needs of veterans and the continued persistence of PTSD as a serious problem. Chaplain (Colonel) Bonura’s presentation of spiritually-based Christian solutions to trauma helps uncomplicate the process of walking through PTSD for pastoral caregivers and persons seeking healing. But for the ones for whom healing feels hard: hard to accept Christ’s forgiveness, hard to discern one’s real guilt from invisible wounds of war, hard to read the Bible, and hardest still to reintegrate with a faith community…an actual sit-down with the author would be better than reading his book. Such veterans would want the physical presence of this chaplain who, like them, has walked through some of the hell of war. His faith-filled belief that though tragedy be a part of their story, that triumph is coming, would likely be a welcome lift.
A great strength of Chaplain Colonel Bonura’s “Beyond Trauma” is his contagious hope that healing is possible, and that PTSD can lead to greater wholeness and post-traumatic growth in veterans. His argument that pastoral caregivers are uniquely qualified to impact spiritual dimensions of trauma will give chaplains and pastors increased confidence to utilize their ministry skills to serve, see and help veterans within their sphere.
Bonura clarifies in his preface that his book is not a “comprehensive treatise… nor a clinical exposition.” Its relative simplicity and straightforwardness are both its strength and its weakness. It is accessible and relevant, footnoted with helpful research and literature, but it also seems light regarding engagement with wider conversations of trauma theory, other effective therapies, and discussion of the successes and failures, post 9/11, of pastoral caregivers in ministering to those with PTSD.
Readers may want to know more of Bonura’s process of developing his pastoral care approach. Does the guidance he gives arise from the unique authority of 29 years of military chaplaincy coupled with focused PTSD research? Or, for example, did Bonura receive PTSD therapy himself for his combat experiences? Perhaps he also speaks with an insider voice. As a military chaplain, has he served on integrated care teams of psychiatrists, psychologists, nurses and clinical social workers, working to support needs for veterans with trauma? If so, it would be enriching to learn insights from that experience which helped accentuate to him the limitations and successes of pastoral caregivers and clinicians who serve those with PTSD.
I wondered what theological resources he would recommend to ministers. While mentioning the importance of referral, he does not offer guidance for a referral process. Many pastoral caregivers would like help navigating this challenge, and to learn of available therapeutic practices, and of helping organizations, parachurch and civic, which are effectively serving veterans in addition to the VA.
Bonura recommended the use of small groups and spoke of the merits of “communalization of trauma” for veterans with PTSD, but as we get farther removed from active combat deployments, it will become more challenging for pastors and military chaplains to find enough peers to form a small group who would understand what a post 9/11 veteran is going through. Does he have an answer for this problem?
From my vantage as a Navy Chaplain, many active-duty service members understand the term “PTSD” to connote “broken.” “Broken” doesn’t mean “bad” to them, but it does mean troubled. To these servicemembers, their peers who identify with a PTSD diagnosis often (broad strokes here): fight dark thoughts like self-harm, struggle with negative coping strategies like alcoholism, are isolated, potentially burned-out from the military’s operational tempo of two decades of deployments, and may have family disintegration issues. Instances of TBI, may also be in play. With this layman warrior’s list of symptomatic issues in mind, many currently serving veterans rarely consider PTSD as their main problem. They would likely acknowledge, “the issues I’m having are related to combat and deployment.” But they are more likely to see PTSD as a contributing factor, rather than their main problem. The problems associated with PTSD listed above are what capture their attention and concern. Pastoral caregivers who read Bonura’s book as a guide on serving those with PTSD, are cautioned that ironically some veterans suffering from PTSD may not closely identify themselves with a PTSD diagnosis.
Beyond Trauma is a helpful resource, aimed especially at evangelical pastoral caregivers. It is published by The Warriors Journey.org. This organization is very interdenominational in relationships, but under the leadership of an Assemblies of God online ministry, “Network 211.”
I believe the book would most benefit civilian pastors concerned for veterans, military chaplains, spiritually-inclined military leaders and spiritually-open veterans with PTSD. The opening chapters on trauma and its spiritual effects offer solid orientation to the issues. Later chapters which include illustrations from Scripture, film, personal ministry experience and numerous personal interviews are relatable and help texture the experiences and needs of those suffering from PTSD.
The opinions of this review in no way reflect the opinions of the Department of Defense, they are the author’s alone.
CHAPTER BY CHAPTER SUMMARY:
Introduction and Chapter 1 Trauma and Post-trauma Stress Effects (1-34)
Colonel Dean Bonura, a combat-experienced Army Chaplain of 33 years, writes to provide Pastoral Caregivers a guide to enhance ministry to veterans with PTSD. In his opening chapter Bonura constructs a foundation for understanding trauma as he argues for the relevance of spiritual intervention. (10) PTSD affects nearly one in five veterans from trauma which he describes as a “wounding of the heart and soul” (13) He explores the Biopsychosocial aspects of trauma (14-22) explaining the autonomic nervous system and limbic system and how, “the body cannot remain in a constant state of vigilance without an effect.” He next covers common reactions of intrusive reexperiencing, triggers and retraumatization. While PTSD may result from combat, dysfunctional units, betrayal, and poor leadership can also cause it. Soberingly, PTSD is closely linked with suicidality—(20% of veterans with PTSD had thoughts). (18) Bonura discusses moral injury, “a violation of conscience… or the transgression…of beliefs” (20) and its similarity to spiritual injury. He shows that PTSD’s severity correlates to degree (intensity) proximity (range) and extent of exposure (duration) to trauma (22). He closes with guiding principles to pastoral caregivers (27). His approach is founded on CBT theory coupled with pastoral presence and Biblical admonition.
Chapter 2 Spirituality and Trauma (35-58)
In Chapter 2, Bonura discusses the spiritual dimensions of trauma on one’s meaning-making, concept of self, view of God, and understanding of suffering and evil’s causes (37). He believes that clinicians’ focus on the visible symptoms of PTSD: “anger, sleeplessness, hyper-alertness… numbing, dissociation, and depression” opens the door for pastors to reach other “below the waterline symptoms.” (38) Pictured as an iceberg, below the waterline issues include “hopelessness, loss of trust, lack of…spontaneity… conflicted belief systems and existential questioning.” (38) Where spiritual trauma exists, Bonura argues, spiritual interventions are needed. (40) Bonura highlights insights from Judith Herman and Kenneth Pargement. In his own chaplaincy work he found that veterans with strong faith, and without faith, prior to combat suffer spiritual wounds. Reconnecting with God or becoming spiritually active again were difficult. (41) Research shows benefits of spirituality (e.g. prayer, rituals, scripture study and faith community involvement) but studies also showed negative impacts. (42-46) Bonura offers practices Pastoral Caregivers can introduce to build spiritual coping skills. He explains that community can help absorb trauma’s impacts by listening to and upholding veterans. (48-54)
Chapter 3 The Problem of Grief (59-80)
This chapter engages the challenges of grief upon veterans. Bonura provides illustrations from film, personal interviews and biographies. (60) Common effects include insomnia, depression, preoccupation with the dead, and social withdrawal (61). He names three types of grief: complicated grief (survivor’s guilt and loss of meaning), chronic grief (unresolved and debilitating), and disenfranchised grief, (grief that is understood by wider society or family). (61-62) Combat deployment rarely offered adequate time for veterans to manage grief (63, 64) “The loss of noncombatants creates a moral dissonance that tears at the warrior’s soul.” He references Dave Grossman’s text “On Killing.” Bonura next focuses on Biblical concepts of grief (64-67) from the Old and New Testaments, among these are God’s role as “the great Comforter” and the understanding of death not as an end but as an eternal gain. (65) He closes the chapter (67-79) highlighting theoretical understandings of grief with close attention to Alan Wolfelt’s model: Evasion, Encounter, Reconciliation. (68) Veterans will travel back and forth on the grief continuum. (69) Key aspects of the reconciliation stage involve willingness to live with loss, cope with pain, and move on. (77) Bonura also addresses war crimes and anger (74-75).
Chapter 4 Forms of Loss Associated with Grief (81-104)
In this chapter Bonura describes common losses from grief: innocence, peace, faith, meaning and community (83-101). He notes serious problems arising from grief: dissociation, identity dysfunction, personality change, and in extreme situations “soul death” (83-85). Loss of Innocence (85) can develop into cynicism or lead to a mission to serve others (86) Losses of Peace and Faith (87-92) cause intense inner and relational conflict. “Many are in a downward spiral, unable to extract themselves…feel(ing) abandoned by God” (87-89) Trauma often challenges core beliefs and prompts questions about God’s love, like the experience of Army Chaplain Roger Benimoff who lost (and later regained) his faith after deployments to Iraq. Perhaps the most paralyzing loss is of Community. (95) Some traumatized veterans exhibit an inability to reconnect. Encouragingly, studies point to clergy as those “best equipped to address existential issues.” Bonura challenges caregivers to care like “the Shepherd who left the ninety-nine to look for the one.” Churches can help reverse the course of alienation and isolation (97)
Chapter 5 Guilt and Shame (105-122)
Bonura explains that “many veterans are hammered by shame and guilt or held captive by war’s dehumanizing spell” (118) He counsels caregivers to help them distinguish among guilt feelings: false guilt, justified personal guilt, self-blame, survivor’s guilt and perceived punishment from God. Clarifying scriptural truth can lead them toward a new perspective. (109-114) Bonura surveys Biblical passages about guilt including Israel’s Day of Atonement and Jesus and Paul’s teaching on justification, propitiation and redemption (110-111). Shame contributes to isolation and disconnectedness. (119) Bonura wants caregivers to help minister God’s forgiveness and offer of inner cleansing to veterans. (120)
Chapter 6 Confession and Forgiveness (123-138)
Bonura opens the chapter sharing two cases of victims’ families who forgave: the brother of the victim murdered by Karla Faye Tucker, and families who lost teenage daughters to a drunk driver. (123-124) He then discusses the healing practice of confession through the lens of Psalm 51 and explains the freeing spiritual impact of forgiveness: sins taken away, covered, & debt cancelled. (125-128) Through two stories of American survivors of WW2 Japanese prison camps, Bonura explains that “People who’ve decided to forgive their enemies learn to finally put an end to the constant, intrusive cycle of trauma that holds them captive to…anger, grief and revenge” (133-134). Bonura summarizes that forgiveness acknowledges the wrong, differentiates the event from the perpetrator, and never minimizes the crime. Forgiveness can be empowering, breaking isolation and victimization. He closes with the Stanford Forgiveness Project’s findings on the benefits of forgiveness. (136)
Chapter 7 Developing a Theology of Suffering (139-160)
Bonura attempts to build the scaffolding of a theology of suffering. Many veterans struggle with feeling that “things don’t make sense” and ask, “why all this suffering?” Bonura believes that the problem of evil (143-149)) is a prevalent concern because of the mismatch from what veterans had learned about God, and the dissonance of that with their experience of war. He highlights Job, Joseph and Paul to help frame the issue of theodicy, that God allows for evil in his plan but is never responsible for it. (146) Bonura believes that the suffering of Christ is the best lens to understand evil. (153) He argues that positive outcomes can emerge from questioning including greater clarity of purpose, deeper bonds with humanity and confidence that God will transform suffering. (154-156) He cautions pastors not to suggest reasons for veterans’ suffering. (157)
Chapter 8 The Trauma Narrative (161-178)
This chapter centers on trauma’s disruption of meaning making. (161) Narrative reframing and reconstruction can help one change one’s perspective. (163-168) Bonura uses Psalm 73 to show this method. The steps of the narrative approach are: Traumatic Eventà Traumatic EffectsàAssumptionsàNew Informationàand Reappraisal. When combat veterans say: “Why did this happen? This isn’t fair! It doesn’t make sense!”, (170-172) narrative reframing and reconstruction can help them integrate their experience. Therapeutic treatments of prolonged exposure (PE) and Trauma Incident Reduction (TIR) also use reframing. (173) Bonura explains that our national memorials (e.g. 9/11 memorial in NYC) exemplify narrative reconstruction by “secur(ing) tragic…events to the past (&) enabling people to focus on the future.” (175) He uses Robert Hicks’ “Circle of Assumptions” to break trauma’s impacts into four categories: the assumption of invulnerability, rationality, morality and identity and the attendant wounds: losses of safety, justice, secure identity and of a meaningful life script (175-177)
Chapter 9 The Trauma of the Cross: A Narrative for Healing (179-190)
Bonura turns to apply the Trauma Narrative Model to Christ’s passion. He draws insights from Noel and Johnson’s Pastoral Theology article about African American Slave’s appropriation of the Spiritual “Were you There?” As they found hope in the midst of misery, (181) veterans too might find wisdom in such courageous communalization of trauma and clinging to the cross. (183-184) He finishes the chapter claiming that the cross is the greatest theodicy. Christ, the God-Man, is one whom sufferers can relate to. He knows injustice, shame and abandonment, and dealt with sin and evil. (187) Pastoral caregivers have the privilege of being agents of “loosing”, introducing the spiritual possibility of new identity and life in Christ (184).
Chapter 10 Biblical Models for Healing (191-208)
Bonura next applies the Trauma Narrative approach to Job, David and Paul. (191-192) Job can hone one’s Biblical view of the purpose of suffering (192-195), his “traumatic experiences turned his theoretical and theological knowledge of God into personal reality” (194) David’s “vital relationship with God overflowed…despite his…traumatic experiences and personal failures” (195-199). Studying Paul (199-205) shows that suffering can show the power of Christ in our lives and strengthen others who observe us.
Chapter 11 Resilience and Spiritual Coping (209-236)
The focus shifts to research-proven trauma prevention methods for building resilience (213-222) and utilizing spiritual coping methods (222-236). Some aspects of resilience can precede military service, like strong bonds with God and one’s community. Other resilience factors can be trained, helping Soldiers face war. These include warrior ethos, discipline, camaraderie, professionalism, realistic combat training, debriefing, mentorship and Just-War Theory. (213-222) The presence of a metanarrative is protective and provides a framework to process trauma (223). Bonura mentions again the spiritual coping practices of religious fellowship, prayer and ritual. Multiple studies of Soldiers demonstrate that spiritual values can enhance resilience after combat. (226) Herman’s work shows how group treatment (231) builds resilience. This chapter informs leaders and pastors how to cultivate resilience.
Chapter 12 Post-traumatic Growth (237-246)
In this final Chapter Bonura describes post-traumatic growth. He opens with the story of the 33 Chilean miners rescued after 69 days. (237-238) Their experience highlights that “trauma does not have to lead to a bad end…(it) can be a catalyst for positive change” (239) Bonura cites Tedeschi and Calhoun’s definition of Post-Traumatic Growth as “permanent advance beyond baseline functioning…in emotional, mental and spiritual aspects…a reconfiguration of schema.” (239) Bonura acknowledges that post-traumatic growth is harder for those affected by direct or heavy combat exposure. (246) But he still believes that “trauma (can) either define or develop a person…life is a school of learning.” He contends that trauma can provide the key to answering “profound questions” of the soul and can enlarge a victim’s capacity to live fully and authentically. (244) Bonura’s mission is to inspire pastoral caregivers to humbly and confidently partner with combat veterans suffering with trauma and PTSD to lay hold of the developmental potential God has waiting for them in the unlikely place of their trauma.
Annotated bibliography created while studying at Duke Divinity School, opinions expressed do not reflect those of the Divinity School
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