Are those of us who do lay post-abortion counseling adequately trained to handle someone experiencing more severe forms of post-traumatic stress disorder?
I don't think very many people working in the area of post-abortion healing have targeted training about recognizing and working with specific trauma symptoms, whether lay or professional.
Many, many licensed mental health professionals regardless of the underlying problem (abortion, sexual abuse, rape, war events, etc.) are not all that good with trauma symptoms.
Part of the reason for this is that it's just very, very difficult to soothe, heal, cope with, grow through, and recover from the more extreme manifestations of trauma, regardless of what caused those symptoms.
The main models I work with are groups, whether on weekends or in 10- to 15-week sessions, meeting once a week. There are a number of different weekend retreat models for healing after abortion (of course, Rachel's Vineyard is the most well-known) and many, many different weekly support group models.
In order to get better, people have to experience extremely uncomfortable underlying feelings. Strong grief is often one of those extremely uncomfortable feelings.
As the brilliant therapist Marsha Linehan says in
Cognitive-Behavioral Treatment of Borderline Personality Disorder, the emotional storms, frequent life crises, and other things to tend to happen to people with unresolved trauma make it very hard to get to the underlying root of the problem, which she says is normally unresolved deep grief. She says that with more deeply wounded people, the therapist has to spend a huge proportion of their time working with the immediate emotional storms and life crises, and thus usually only has a precious few sessions or moments where the client can feel, and genuinely start healing, from what is causing all those storms.
My experience of weekend retreats is that, especially with a great program like Rachel's Vineyard, people who come are able to "go there", because there's enough safety, space and time built into the process. Also, participants are able to experience that the Holy Spirit is there to help them, not to judge them. This is what enables people to make such great strides forward.
I think it's a little harder to go into the deep grief place in the weekly support models, because you're usually home alone when those feelings come up. This, I think, accounts for the fact that a couple of people will often drop out of a group at week two or three. This is true in any weekly support group (rape recovery, etc.), because the person's feelings are started to get stirred up by what is being discussed in group, and their sense becomes that the feelings that are getting stirred up are too intense for them to handle, with their present level of coping skills.
That said, due to the situation with my beloved friend, I have recently learned a whole array of ways to help a person cope with overwhelming, immediate trauma recall, so I'm feeling like I just got a lot of on-the-job training. Going back to Julie's original question about level of training, I do wish I had learned these rather advanced techniques earlier. I can see that they will be helpful to me in ministry going forward.