Trauma on the Mission Field
Recently I was struck by an article in Psychology Today by Elyssa Barbash, that explained the difference in various traumas, labeling them small ‘t’ versus large ‘T’.
The large ‘T’ traumas are fairly easy to identify since they tend to bring on PTSD (Post Traumatic-Stress Disorder) through a personal or physical threat.
According to Elyssa Barbash, “A large ‘T’ trauma is distinguished as an extraordinary and significant event that leaves the individual feeling powerless and possessing little control in their environment. Such events could take form as a natural disaster, terrorist attack, sexual assault, combat/war zone, car or plane accident, etc.”
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By Larry Dinkins
During my many decades working in Thailand I have observed missionaries that have been affected by all of the above, plus a few more which are not listed.
While in Thailand our family had to deal directly or indirectly with terrorist bombings, military coups, robberies, car accidents, flooding, life-threatening tropical diseases and cancer.
Read just about any classic missionary biography and somewhere on the pages you will read about a large ‘T’ trauma. The reader should not be surprised, knowing that such incidents are often part and parcel of the calculated risk that missionaries take when they respond to God’s calling to a foreign field.
The Development of Member Care for Missionaries
In more recent years, there has been a great deal of stress placed on member care for missionaries who find themselves encountering these large ‘T’ traumas.
There are evacuation plans in place for most all fields and teams of counselors ready to walk shell-shocked workers as well as their children through their trauma.
I see this as a very positive development. 40 years ago, when I joined OMF, mission organizations did not have the understanding needed to provide member care or the availability of trained professionals to deal with the unique stresses associated with cross-cultural ministry.
Today it is much easier to both recognize and treat these large ‘T’ stressors and for those of us on the field we are very grateful.
The Long-Term Impact of Daily Stressors
However, as significant as large ‘T’ traumas might be, the small ‘t’ stressors seem to be more insidious and destructive in the long run and contribute more to the attrition rate of missionaries than the large ones.
The Psychology Today article stated, “Small ‘t’ traumas are not life-threatening and may include conflict issues, financial stress, marital misunderstanding, parenting challenges, moving locations, etc.”
One stress test that helps quantify these small ‘t’ traumas is the Holmes stress chart. I was so impressed with this instrument that I wrote a whole section about it in a book I wrote:
New missionaries can calculate how much pressure they are facing through the social readjustment rating scale devised by Dr Thomas Holmes – the Holmes stress chart.
Each point on the Holmes’ scale is called a “life-change unit” or LCU. An accumulation of more than 200 CUs in any one year could be potentially dangerous both physically and emotionally. The death of a spouse is highest at 100. Even happy events like Christmas or vacations are worth 10 LCUs.
During our first six months in central Thailand we were robbed repeatedly, Paula, my wife, delivered our second child, we moved house, studied a new language, changed jobs and the whole family was sent to the hospital for various illnesses.
Myron Loss, who wrote a book on culture shock, estimated that the normal first termer is running at or above 400 LCUs. Ours being an abnormal first term must have pushed the LCUs past the 500 mark at times. When you are functioning at this stress level, the chances of going into “shock” are high.
The Holmes chart is helpful in measuring major changes like illness, birth or death but it overlooks seemingly insignificant inconveniences which are equally debilitating.
To correct this oversight, I have devised the Dinkins social readjustment scale:
7 LCU – Bargaining for everything from taxi rides to vegetables
8 LCU – Having to tear all correspondence into small pieces (the locals make bags out of scrap paper)
10 LCU – Not being able to point your feet, hold hands, wear shoes inside and other cultural “No-nos”
12 LCU – Finding a fly floating in a new bottle of fish sauce
15 LCU – Having to fish live mosquito larvae out of your cereal bowl
16 LCU – Opening a gift of chocolate from home, only to find it melted and ant-infested
18 LCU – A four-hour bus ride that stretches into eight
18 LCU – Your chicken soup includes the head and feet as well
20 LCU – Plugging a 110-volt appliance into a 220-volt outlet
The LCUs above may seem low, but it is the day-to-day incremental accumulation of these strains that most contribute to missionary “burn out”.
Pray for Missionaries Facing Small T’s and Large T’s
Elyssa Barbash explains it this way, “One of the most overlooked aspects of small ‘t’ traumas is their accumulated effect. While one small ‘t’ trauma is unlikely to lead to significant distress, multiple compounded small ‘t’ traumas, particularly in a short span of time, are more likely to lead to an increase in distress and trouble with emotional functioning.”
As you pray for missionaries, you always want to pray for their protection from the large ‘T’ traumas, both physically and spiritually. Early missionaries like Paul encountered a lion’s share of such stressors (2 Cor. 11:23-27).
Mission fields today have many of the traumas mentioned in Paul’s list but in this modern age of technology we have added many more. I believe that we can expect an increasing number of large ‘T’ traumas as we enter into what many feel are the biblical “last days”.
Yet even as we anticipate these trends, we cannot overlook the day to day grind of living in challenging circumstances in foreign contexts with the inevitable small ‘t’ culture shocks and stresses.
Missionaries need to prepare for the inevitable large ‘T’s that may come their way as they serve the Lord on foreign soil. Being able to cope with the small ‘t’s in an effective way to prepare for this. Most importantly, the prayers of God’s saints will be one of the best ways for missionaries to face daily life.
Lord, you indicated that in this world we would encounter various trials and tribulations, both small and large. We ask you to give us the grace and power from your Spirit to overcome the large ones when they come, but moreover, the perseverance and strength to gain needed small victories in the daily grind of life.
Dr. Larry and Paula Dinkins served 22 years in Thailand with OMF in church planting and theological education. Later they served 9 years as mobilizers in Pasadena California at the US Center for World Missions. Paula was called home to glory in March of 2011 and Larry returned to Chiang Mai Thailand for full-time ministry in 2012. Larry rejoined the staff of the Chiang Mai Theological Seminary and acted as Director in 2019. Larry teaches seminars on Walk Thru the Bible, Perspectives, prayer counseling and oral Bible storytelling. He has four children and eight grandchildren.