The Soul in Trauma

In August of 2013, I began working with survivors and their families impacted by the Boston Marathon Bombing. Four months earlier, On 15 April 2013, I was living in a small apartment finishing up my thesis on the theology of the body to complete a degree in Theological Studies. Having run the Boston Marathon in the year 2000, I had the television coverage on in the background. Like most people, I was horrified by what unfolded on the fifteenth of April. Two pressure cooker bombs were detonated near the finish line by religious extremists, killing three people including an eight-year-old boy. Fifteen spectators in close proximity to the bombs had one or more limbs amputated, and a total of two hundred and sixty-seven people were treated at nearby hospitals.

In a four-day manhunt for the perpetrators, a police officer was killed, an MIT student was taken hostage, and another police officer was nearly killed in a shootout that ended in Watertown Massachusetts, where over three hundred bullets were exchanged. One of the two perpetrators, hiding in a resident’s boat, surrendered while the other was killed in the gunfight.

A few months after the bombing I was hired under an Antiterrorism Emergency Assistance preparedness grant to provide navigation services and support to approximately five hundred survivors and first responders, including crisis support to families at the federal trial of one of the perpetrators. Eventually, I moved on to become program director providing assistance to survivors coping with the long-term effects of acoustic trauma, traumatic brain injury, and post-traumatic stress disorder. I now manage a national peer support program for survivors of all natural and human caused disaster in the United States. For almost a decade, working with survivors of mass violence has provided a unique vantage point as a theologically trained trauma professional to speak to the effects of violence on the embodied person.

Victims of mass violence such as the Boston Marathon bombing commonly experience a range of physical and emotional effects in the immediate aftermath and long term. Some of these effects include hypervigilance, depression, anxiousness, brain fog, and exhaustion, as well as physiological symptoms like headaches, back pain, digestive problems, etc. When these symptoms persist long-term, they can have a detrimental impact on a person’s quality of life.

Yet, beyond the physical realm, is the moral injury to the soul. The very nature of trauma is to rupture what was once whole. The soul, as the core of who one is, is no longer in unity with the whole person and needs healing. The term “moral injury” was originally used to describe soldiers who have committed acts (or failed to act) against their own values. The term resurfaced early on in the COVID-19 pandemic when equipment shortages forced physicians to make decisions about who had the best chance of survival. In “Beyond PTSD: Soldiers Have Injured Souls,” Diane Silver describes moral injury as a “deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”

This reminds me of a mother I worked with after the Marathon Bombings. She was a spectator with her young children near the finish line and contacted me needing help for intrusive thoughts that disturbed her everyday activities. Just before the explosions, the perpetrators approached her and her children, trying to convince them to move closer to the finish line (where the bombs were planted). She took their advice and tried to make her way through the crowded sidewalk. It became too much of a challenge so she gave up and went home. She blamed herself for months after, for what almost happened. But this is a lie: she was not guilty of anything. These are the lies that ground themselves in the body and corrupt the soul.

Having worked with hundreds of victims of the Marathon Bombing confirmed for me the need for a new model of treatment for traumatic stress that goes beyond the mind-body paradigm: a model that is inclusive of wounds to the soul. Naturally, I was intrigued to read Julia Yost’s recent review of Bessel van der Kolk’s bestselling book, The Body Keeps the Score: Brain, Mind, and Body in Healing of Trauma. Van der Kolk is famous for theorizing that traumas are inscribed in our flesh.

Yost recognizes the book’s appeal as a validation to sufferers who may feel like they are coming apart, unable to battle the mental fog, intense range of emotions, and physical symptoms long after the traumatic event has taken place, but she is skeptical of a theory that suggests trauma is everywhere. There is the potential for mislabeling personal difficulties as trauma, thereby creating a culture of traumatized posers. Yost has a point, but she misses an opportunity to expand the far-reaching effects of individual and collective trauma. Admittedly, Yost said recently in a podcast she herself has not experienced trauma, and perhaps is somewhat removed from the urgency of van der Kolk’s message.

Nevertheless, Yost captures what I would suggest is the hidden gem in her review of van der Kolk’s book, quoting a psychiatric expert who notes that the book is an “affirmation of the embodied soul”[1] Trauma may be inscribed in the flesh, but our body is formed by the soul. The soul therefore absorbs the impact. In this article, I will explore the soul as the core identity of the person, establish the need to consider the soul in modern treatment approaches to trauma, and demonstrate that the whole person can only be healed from trauma through the body/soul connection.

What Is the Soul?

The concept of the soul is somewhat elusive and defies a concrete definition, in part because it cannot be seen. Whether the soul is material or immortal has been a perennial question throughout history. Even the actual location of the soul within an organ has been explored by physicians. In one article, several prominent physicians reviewed the origins and development of the soul from the early Egyptians to modern science. In their review the physicians draw from the souls etiological meaning to build a consensus of the soul’s meaning asserting that the soul is “the intrinsic principle of motion in every human being . . . the internal embodiment of the prime mover whose origins are divine.”[2] Linking the soul to the divine means the soul is connected not only to a metaphysical dimension but also to a moral one. In other words, the soul is connected to the moral life.

The Ancient Egyptians believed the soul was located in the human heart, and at the same time was immortal. Plato suggested the rational soul was located in the brain, a prescient consideration if one thinks about postmodern trauma related treatments that engage the mind. Aristotle, on the other hand, expanded upon ancient Egypt’s theory, believing the soul was located in the heart, a place where blood is pumped to sustain life. In the material realm it is also notable that that the father of human anatomy, Herophilus of Chalcedon determined the soul existed in the brain, specifically, the fourth ventricle. Among his observations, he concluded the sensory nerves responsible for the transmission of information from the senses to the motor nerves stimulated movement, and this movement was the soul. Even in 300 BC, the specificity of dissecting mental functioning to identify the soul correlates with contemporary mind/body treatment approaches to trauma that focus on neurological processes for healing.

For Christians, it was not until the nineteenth century that this soul business was resolved. Saint Augustine in the fourth century confirmed the soul’s immortality, and that its presence was in the entire body. He also suggested the time of the soul’s entrance into a fetus happened around three months inside the womb, known as a delayed ensoulment. Thomas Aquinas continued Augustine’s theory of the souls delayed presence in the womb, which of course had significant consequences in terms of abortion. The Church at this time allowed for abortion as long as the body had not received the soul. Eventually, in 1886, Pope Leo XIII declared the soul’s existence at the moment of conception which has become the bedrock of the Church’s prolife stance. The authors attempt to collate their historical scan of the soul’s existence by establishing a common thread in the definition of the soul, stating it is that which is at the core of the self, making a person who he or she is.[3] In other words, the soul is the core of a person, who is in the image of God and therefore has dignity and worth.

Nevertheless, the existence and realty of the soul has been an evolution of discovery across many fields of discipline without accord. It is no wonder there has been a reticence to consider the soul in mental-health treatment models for trauma. Still today, the reality of the soul and its connection to the human person and God could be more deeply explored. In the context of modernity and its vast trauma pervading our lives, theologians have a duty to work with trauma experts to develop a working theory that incorporates the soul, instead of eclipsing it.

When dealing with trauma, the core of one's identity is ruptured, which is why the body is only one part of what needs healing. The body reflects the trauma from without meaning it reflects pain and suffering in a visible way. But what is happening from within? It is an invisible wound tearing apart one’s identity, as a person with dignity and worth. Trauma is not only an assault to the body but an assault to one’s dignity in which the person may suffer from a sense of inadequacy, guilt, low self-esteem, and lack of trust, ultimately weakening one’s core identity. Therefore, it stands to reason when considering a more holistic vision of the human person in the treatment of the invisible wounds of trauma, that the soul, an invisible but indispensable link to human dignity, should be considered. Let us explore deeply the reality of trauma in order to understand better how the soul fits into trauma theory.

What Is Trauma?

Trauma is like a subnetwork of human suffering that many human beings will experience at some point. The Diagnostic Statistical Manual, fifth edition (DSM-5), defines it as the experiencing or witnessing of events in which there is actual or threatened death, serious injury, or violence.[4] The DSM conveys a more sterile, objective description of trauma. To emphasize the impact of trauma, van der Kolk describes it as an imprint: trauma is not the story of something that happened back then. It is the current imprint of that pain, horror, and fear living inside people.

The imprint of a trauma creates a neural pathway that keeps replaying the same images and feelings whenever a person is activated. The imprint will block the emotions associated with the original traumatic experience and continue on its merciless way, getting the entire body to cooperate. For example, during the 2013 Boston Marathon, runners were finishing up their twenty-six-mile feat that ends on Boylston Street and continued toward the finish line despite the explosions.

In this case, a runner may try to compete in other races going forward but images of the injured victims who were left helpless might cause heart palpitations that make it impossible for the runner to compete again. Body and mind become fragmented and they are forced to find a false narrative, one that is self-reliant, and disconnected from God. In The Body Keeps the Score, the idea of a false narrative is underscored by van der Kolk’s mentor, who believed that the greatest sources of our sufferings are the lies we tell ourselves.

Van der Kolk illustrates the loss of self and erosion of one’s dignity in the first chapter of his book. He describes the brutality of trauma through a client’s experience as a Vietnam veteran whose platoon was ambushed. The veteran witnessed the brutal killing of a close friend and many of his comrades. Following the ambush, the client revealed he took revenge and killed nearby villagers, small children, and raped a woman. Van der Kolk explains, “deep down many traumatized people are even more haunted by the shame they feel about what they themselves did or did not do under the circumstances.” The veteran’s circumstances are extreme but do acknowledge something about trauma that is beyond gut-wrenching. It is soul wrenching.

Trauma Today

We face a new urgency to shift the paradigm of trauma treatment due to the effects of the COVID-19 pandemic. Traumatic stress has taken on new meaning. When the entire nation originally shut down, mental-health specialists observed almost immediately an uncommonly referenced and complicated emotion. It was later identified as anticipatory grief, in which people brace themselves for a loss they know is coming, and not only of a loved one but no longer being able to socialize or connect with one another in a physical way, among other losses.

The therapists turned to leaders in the field like van der Kolk who responded by offering a free webinar called, Global Coronavirus Crisis: Steering Ourselves and our clients through New & Developing Traumas. Within three minutes after it began, the webinar also shutdown. The system was so overloaded it could not handle the level of global participation. It is as if the entire mental health profession went into a panic, knowing that their go-to treatment models might not work. But what are those go-to treatments? I will now explore some of them.

Psychological Treatment of Trauma

There are numerous models of treatment for post-traumatic stress that have some documented success with people with post-traumatic stress disorder such as Cognitive Behavioral Therapy (CBT), and Eye Movement Desensitization and Reprocessing (EMDR). These treatment methods have provided significant relief to some who suffer from PTSD. The question we need to ask today is if they go far enough. The answer depends on who you ask, which is a precarious solution to a crippling problem with no hope of waning in the near future.

One of the more recent trauma models that has gained traction is brainspotting, a psychotherapeutic method developed in 2003 by David Grand. Grand and his colleagues describe it as a focused treatment method that works by “identifying, processing and releasing core neuropsychological sources of emotional body pain.” The process is described as a “relational attunement” between practitioner and client. The client is asked to follow a wand with their eyes until the practitioner notices a bodily response such as a slight movement. The client will stay focused on that spot, until the original target memory is reached. They will notice the thoughts and feelings that arise which leads to the healing of the traumatic memory.

One of the conclusions of this approach is that there is an innate human neurological capacity for self-regulation.[5] In other words, human beings have a natural capacity to calm the body down in order to release painful emotions related to a traumatic event. This is a vital step in the process of recovery and brainspotting as a therapeutic tool has shown initial promise. However, brainspotting does not address the invisible wound at the core of one’s being. Only treatment of the soul can do that. As Yost rightly points out in her review, “Souls admit of healing.”

The Soul in Medicine

For roughly a century, consideration of the soul has been removed from the medical model of treatment. In an article entitled, “The Soul in Medicine,” Arthur Kleiman, Professor of Medical Anthropology and of Psychiatry at Harvard, points to the famous psychologist William James, who helped develop psychology as a discipline but removed references to the soul early in his career. James later resurrected the term in Varieties of Religious Experience yet it has all but vanished from psychiatric/therapeutic models.

Kleinman, having worked with numerous patients with post-traumatic stress, argues for the necessity of considering the soul in medical models. He does so by recounting his attempts to help a patient with PTSD and failing. The patient, a World War II veteran who had killed a man, refused to call Kleinman’s treatment a total success because it ultimately did not address what Kleinman says was a “perduring moral and emotional core to his being, a vital human essence, a spiritual touchstone that cannot be conveyed by technical and psychiatric terms.” It is imperative now that trauma theory move beyond the mind/body connection and include consideration of the soul. Traumatic stress specialists must stop avoiding the topic out of fear of potentially excluding a particular faith or belief. Likewise, theologians must stop the esoteric banter amongst themselves and seriously engage trauma theory and social work in theological anthropology.

The mind/body connection allows for cutting-edge treatment methods like brainspotting a far more nuanced understanding of the brain’s participation in the effect of trauma. The idea that following a stick with one’s eyes reveals subcortical cerebral activity that can elicit healing from trauma is extraordinary and harkens back to Herophilus, who suggested the seat of the soul was in the brain. Alternatively, Christian theology provides a much richer context for healing from trauma through salvation history that current treatment methods like brain spotting are not designed to address.

Our ancestors have a long list of traumatic experiences (albeit self-imposed) that separated them from the divine. God in his infinite love and wisdom then sent Jesus Christ, to pick up the pieces of our fragmented humanity and, through his salvation, to unify us body and soul to him. Jesus did not do brainspotting or talk of polyvagal theory in the Sermon on the Mount. He saved souls so that we could realign ourselves with the purpose for living: to love and serve God.

Physicist Mark Harris, lecturer at the University of Edinburgh’s Divinity School (oddly a non-believer of the soul), expands upon this idea of the soul’s role in salvation. Through the Fathers of the Church, such as Gregory of Nyssa, he describes the ascent of the soul, an embodied journey toward God. His counterpart, Gregory of Nazianus, added that the soul is where sin is found in the human condition. In simple terms, if you remove the soul, there is nothing for Christ to save us through.

For trauma survivors, sin and trauma are of course not the same thing, but it is not the initial assault that ruptures the soul. It is the lies that trauma produces that act like sin and separate us from God. The body may keep the score, but it is the soul that settles the score. The central theme of theological anthropology is that the body is considered an organic structure with a sacred purpose. The body (including the brain) has such a profound organizational unity that it could not possibly be random. Together with the soul it moves naturally in the direction of what is good and what is likely to make it more complete, whole-er (or perhaps holi-er).  

Saint John Paul II labored over the meaning and ethos of our bodies in Man and Woman He Created Them: A Theology of the Body. He believed the body is imprinted with a “spousal” meaning and a vocation to love, the antithesis of a traumatic imprint. We are not made to be alone; our bodies are part of a composite that expresses the meaning of the whole person to be in communion with others. In the marital sense, the spouses are a gift to one another; but as human beings we are drawn to be in communion with others. 

Coming together in unity with others is the way we are made. Trauma threatens this unity and shatters our sense of self. The soul is the animating force in the physical and moral dimension of the body, operating together with the body as a unified whole that demands a more holistic criteria for the healing of traumatic stress, one that is inclusive of the body/soul connection. I would suggest the psychologists and theologians “come together” and prioritize these new criteria for trauma and recovery, or else we will have a much larger population of victims walking around with trauma fog and chronic pain without a proper remedy.