The Body’s Response to Stress

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CHAPTER 2 Trauma and its effects

Thloki, one of my friends’ spouses had complaint of a serious headache for a long time. This problem has deterred her to do any formal work over a long period and productively. This resulted from the fact that at every time she concentrates for a long period of time, she suffers from the problem so much so that she is booked off-sick by medical doctors. Sadly, this same problem was the reason for her (Thloki’s) dropping-out of tertiary education in the year 1998. After a number of follow-up consultations with empty test results one doctor suspected something unknown to himself (doctor), he referred her to a psychologist. Coming from a consultation with the said psychologist, Thloki reported that there was a query, by the psychologist, of some kind that her problem emanates from the trauma that resulted from Thloki’s loss of her brother who was ruthlessly murdered on New Year’s Eve some sixteen years before the time this problem became evident. We can all remember how sad the whole incidence was to the family and community, but also thought that it must have gone and completely been healed. Nevertheless, Thloki’s feed-back to us concerning the diagnosis of her long standing problem, was one word which we had heard about but never knew its effects to have the potential of being so long-lasting—Post Traumatic Stress Disorder. The bad effects of stress inflicted by such sudden death came alive.
One of the mostly sounded terms regarding handling problems surrounding people struck by sudden death, is trauma. To be more specific, the psychiatric and the psychological worlds qualify what they talk about as post-traumatic stress. The victims of the said outcome and/or result of stress are said to be suffering from post-traumatic stress disorder. Given the practicality of the life that we live in, it is safe to say traumatic events are a compliment of real life, and hence it sounds like there is no problem without trauma. The effects of traumatic events have remained a challenge to people from time immemorial. Thus, it is named posttraumatic stress disorder (PTSD), thereby inferring from the name itself that the problem is known to be post or after the incident or incidence.
Psychologically, the people who are struck by sudden death are emotionally wounded, and this wound is painful to their whole being. This wound is called trauma, and hence it is said that they are traumatized. They become stressed, and because the cause of this stress in the death of the loved one. It (death) becomes then the stressor. With the complications of their responses when viewed against social normality and abnormality, they are judged as having either order or disorder resulting from their trauma.
For purposes of progress in the subject, the author shall follow the terminological relationships of the terms by Briere and Scott as they locate problems as stated in the responses of PSTD. They list types of Posttraumatic responses as:

• Depression
• Anxiety
• Stress disorders
• Dissociation
• Somatoform responses
• Brief Psychotic Disorder with Marked Stressor
• Drug and Alcohol Abuse. (Briere and Scott 2006: 17- 30).

Following the line of posttraumatic responses as listed above one finds out that Stress and depression result in people’s lives as they are consciously or unconsciously responding to their life conditions. The big difficulty about the said subjects is the fact that no one chooses to respond in a particular way. They are rather spontaneous responses that a person finds him/herself in after being traumatized by a life reality which in this case is sudden death. Given our current stages of pastoral care and conditions in which many of us work, and the complexity of psychiatrical/psychological terms and developments, there is a high need of seeking more understanding on the said subjects.

UNDERSTANDING STRESS

It is a struggle to try to explain the concept of stress without considering what the body feels like or the human being appears like when under attack. From what is shared above and various known conditions that have passed our eyes over time, we can attempt to grasp the problem and share.
Stress is a body condition that occurs in response to actual or anticipated difficulties in life. It may occur in response to daily problems, such as driving in heavy traffic or being hurried by someone etc. It may also occur as a result of people perceiving threat to them (themselves).
“Selye makes the point that stress is a normal part of everyday life and affects all living creatures. He differentiates between two types of stress namely: Eustress and Distress. Eustress refers to the level of stress which motivates us to perform well, solve problems, be creative, and grow in confidence. Distress is where our performance deteriorates, our adaptive bodily functioning becomes disrupted, and our response, whether physiological, cognitive, emotional, or behavioural, becomes maladaptive”. (Powell & Enright 1991:19).
In the light of what Selye points out in the above statements one can say that there is both positive and negative stress in our lives; and we react and respond to these differently but holistically. One can also draw from Selye’s argument that ‘stress becomes dangerous when it is unusually prolonged, which comes too often or concentrates on one particular organ of the body’. The same might also re-iterate the English expression that says ‘too much of a good thing is dangerous’. It is from the same saying that affirmation comes to say that even the so-called positive stress can turn to be negative and dangerous in instances that are sited by Selye above.
There are many common signs of stress and these include, but are not limited to, increased heart rate, raised blood pressure, muscle tension, mental depression, inability to concentrate etc. Stress may be caused by anything to any body. The factors and circumstances causing stress are called stressors. Stressors differ from person to person and one factor that is a stressor to one person may not necessarily be a stressor to another.
Barnhart distinguishes five major types of stressors as:

• biological variables
• environmental circumstances
• life situations
• behaviours and
• Cognitive activities. He continues to warn that:

“Biological variables affect a person’s physical state. These include illness and physical exertion. Environmental circumstances are forces in the person’s surroundings such as noise, overcrowding, poverty, and natural disasters. Life situations include stressful incidents such as death of a close friend or being in a group of strangers. Behaviours that may act as stressors include smoking cigarettes and poor eating habits. Cognitive, or thinking activities include taking a test or concentrating on getting a high score in a video game” (Barnhart Vol. 18, 354).
It is true that not all stressors affect everyone the same way. But the particular stress that is under investigation here is the one that results in the event of sudden death, an example of the stress resulting from the life situation. Sometimes and varying from person to person, this stress leaves unpleasant emotional experiences that have a lasting impression on the persons concerned. When this happens, the mind is injured and sometimes wounded to warrant therapeutic attention and healing. Any incident that a person experiences that is sudden and unexpected can result in emotional as well as physical trauma and shock. Parkinson has the following to say about this emotional shock:
“emotional shock can cause stress reactions, which are called post-trauma stress or critical incident stress. This kind of stress therefore results from experiencing a traumatic incident and can be the result of anything from slight accident to involvement in major disaster” (Parkinson 2000: 18).
The reading of the practical circumstance in any event of sudden death against what Barnhart and Parkinson say about stress and trauma guides pastoral care practitioners and givers on the exclusiveness of the stress they handle when they are in the midst of mourners through sudden death. The author is reminded here, as it is happening time and again in his life, about his own sister’s situation cited in chapter one above, and affirms that during sudden death instances of numerous kinds, including murder, accidents, suicides etc. there may be different stresses in concurrent play with the after effects of trauma. The skilful pastoral caregivers therefore know, or at least must know, the paramount importance of their interventions, and that they should be particularly focusing on post-traumatic stress for it to be equal to the therapeutic challenge it faces.
In his illustration of what he means about such incidents that results in stress that is challenging people, he cites a simple story that;
“Billy, age 4, has fallen off his bicycle and runs to his mother, crying. He has bruised both knees as well as his pride. His mother puts her arms around him, comforts him and asks what happened. He sobs out his story. He was riding down the path on his new bike when suddenly the front wheel slipped and he crashed onto the ground. He has hurt his knee and the bike is still lying where it fell. He is sobbing gently in his mother’s arms, breathing in short gasps.
He tells her that it’s a rotten bike anyway, and it was the bike’s fault, and he’s never going to ride it again, ever! His mother holds him and tells that he’ll be all right. She will go with him to get his bike and bring it home, and then he can ride it again when he feels better. She puts ointment on his knee and some tender loving care on his pride and gradually he stops crying. She takes his hand and they both go outside and get the bike. He is frightened at first, but with her beside him holding the seat, he climbs it again and slowly pedals down the pathway, wobbling from side to side.”
It is a simple story that can be viewed childish by anyone reading it, but a story that marked one step in Billy’s life that may almost define him in the way he perceives matters. He runs to his mother for help and comfort, tells his story and the mother first listens and then helps him regain his confidence to try riding the bicycle and his dented pride. He is suffering from physical pain and from mental and emotional shock and stress caused by the unexpected fall. If his mother had told him not to be stupid and had not offered him comfort, maybe having told him ‘get out there and be a man’, either he would have been afraid of bikes for the rest of his life or gritted his teeth and climbed back on again.
There are, however, more than just one way of approaching this incident by any mother. For example:
“just don’t worry about that nasty little bike. Leave it there in the road, and when Daddy comes home, he’ll get rid of it. Daddy will then get you a nice football, which will never hurt you”.
This might have been another response possible by this mother, or any other mother. But clearly, Billy would have responded differently to both. He might have buried his fears, had dreams or nightmares about the fall, kept away from bicycles forever and cried or screamed with fear whenever one came near. Equally likely, he would cope by forcing himself to conquer his fear, but this fear could have emerged in some other way, either at the time or later.
The reader will agree that this is an exaggerated example. But it is very important to note that even a relatively simple incident can cause reactions of stress and trauma, and at varying degrees in different people. In the story, Billy has experienced some of the typical symptoms of post-trauma stress— shock, pain, fear, crying, blaming, avoidance and the need for help and comfort. Death causes some of the above symptoms every time it strikes; it is even capable of containing all of the symptoms and sometimes even more of the responses which happens not to be captured here at a time, especially when it is sudden. It is far more serious an incident than falling off a bicycle.
Pastoral care during the times of bereavement where stress and depression are challenges has many parallels with riding a bicycle. For instance, much as there are natural laws that have to be balanced to maintain the bicycle on the move and in safe directions, there are natural responses in the entire being of a person who is bereaved and such responses happens in the midst of saying that this is natural, and practically that life hat must go on. The author is reminded of the situations of his own learning to ride a bicycle, which comes very clear to mind every time. He was not so privileged to have the bicycle of his own size as many are. Resultantly, the challenges of inability to ride were complemented by those of size over and above own short stature by birth.
“The fact that no single accepted definition of stress has emerged is not surprising, as stress is one of the most complicated phenomenon that can be imagined. It involves all the systems of the body— cardiovascular, endocrinal, and unconscious; and occurs in all social systems— interpersonal, intrapersonal, small group, large group, and societal. It is evoked by such varied stimuli as minor daily hassles, and the threat of star wars nuclear conflict. It involves our loves, hates, closest attachments, competitions, achievement—stress is a matter in which all humans are involved evenly and all the times.
In a sense, stress is the most narcissistic area of study that psychology has undertaken. It is a reflection of ourselves and the things that concern us. It involves our worries, fears, goals, hope, and faith. It might be worthy to ask the question, what more is human than all these things?
I am going to share two stories in the Bible as a way of illustrating the effects of stress and its impact on human beings. The story of Job in the Old Testament is the story of every man and woman. Despite faith, caring, family, holiness, and righteousness, Job was tested by the Lord. In this story we see our fear that despite all our good deeds and intentions, calamity may randomly or fatefully strike. For Job, everything was lost: his children, his land, his wealth, and his health.
Though what is perhaps the greatest of all stress resistance resources— faith—Job survived his ordeal. In this, we express our own hope that despite life’s many challenges and stressors, we will, or at least can endure.

TOPIC PAGE
1. Chapter 1 
1.1 Background to the Study
1.2 Is all kinds of Death the Will of God?
1.3 Problem Statement
1.4 The Aim, Objectives and Relevance of the Study
1.5 Research gap
1.6 The Research Design and Methodology
1.6.1 A Closer study at the Shepherd Perspective
1.6.1.1 The Concept of Perspective
1.6.1.2 The Threefold structure of Pastoral Perspective
1.6.1.3 The Concept of Shepherding and its aspects
1.7 Summary
2. Chapter 2 
2.1 Trauma and its effects
2.2 Understanding Stress
2.2.1 Complications and Complexity of Stress
2.2.2 The Body’s Response to Stress
2.3 Depression, What is it? How does it feel?
2.4 Can there be a Chord of Relationship?
2.4.1 Grief
2.4.2 Mourning
2.5 Response to Loss
2.5.1 Denial and Avoidance
2.5.2 Endurance and Rumination
2.5.3. Anger and Aggression
2.5.4 Meaninglessness and Hopelessness
2.5.5 Transformation and Growth
2.6 Common Referral Sciences
2.7 Summary
3. Chapter 3 
3.1 Death and Dying
3.1.1 Analysis of Kubler-Ross’ View
3.1.2 Dying Stages
3.2 Towards defining Death Anew
3.3 Death Viewed by Psychologists
3.3.1 Ernest Becker
3.3.1.1 Death and Denial
3.3.2 James Hillman
3.3.2.1 Hillman Mythology in a nutshell
3.3.3 Robert J. Lifton
3.3.3.1 Lifton’s Psychology
3.4 Death viewed Theologically
3.5 Sudden Death, an Enemy to the Bereaved?
3.6. What, then, is Sudden Death?
3.7 Summary
4. Chapter 4 
4.1 Pastoral Care
4.1.1 A Brief Reflection
4.2 Funeral Service
4.3 Pastoral Care and Pastoral Counseling
4.4 Comfort and Comforting
4.5 Rituals
4.6 A Closer look at African views
4.6.1 Death among the Ndebele
4.6.2 Death among the Abaluyia
4.6.3 Death among the Barolong of Ganyesa
4.7 Can Death be Cultural?
4.8 Valuable Utilization of Religious Resources
4.8.1 The Scripture and Religious Literature
4.8.1.1 Prescriptive
4.8.1.2 Contextual
4.8.1.3 Sparingly
4.8.1.4 Verbally
4.8.2 Preaching as form of Pastoral Care
4.8.2.1 The Minister/Pastor’s Role
4.8.3 Preaching/The Sermon
4.9 Possible Bereavement Model
4.10 A Good Shepherd is a Skilful Counselor
4.10.1 Emphatic Understanding
4.11 Unconditional Positive Regard
4.12 Congruence
4.13 Summary
5. Chapter 5 
5.1 Introspecting the Church
5.1.1 From our Position
5.1.2 UCCSA Origins in a Nutshell
5.1.2.1 Individualized
5.1.2.2 The Church is Privatized
5.1.2.3 Bureaucratic Organization
5.1.2.4 Invalid Practice
5.1.2.4.1 The Church is one
5.1.2.4.2 The church is holy
5.1.2.4.3 The Church is Catholic
5.1.2.4.4 The Church is Apostolic
5.2 The Bible as the Necessary Point of Church Departure
5.2.1 The People of God
5.2.2 The Servant People
5.2.3 The Body of Christ
5.2.4 The Community of the Spirit
5.3 The Current Church Model and its Failure
5.3.1 The Church as an Institution
5.3.2 The Church as the Intimate Community of the Spirit
5.3.3 The Church as Sacrament of Salvation
5.3.4 The Church as the Herald of Good News
5.3.5 The Church as the Servant of the Servant Lord
5.4 The Possible Turning Point
5.4.1 The Education of Ministers
5.4.2 Ministers/Pastors—The Rightful Bereavement Counselors
5.5 Life When Death is the Context
5.6 A Glance through the Theology of the Funeral
5.7 Sharing with the Victims of Sudden Death
5.7.1 Mancwe’s Story
5.7.2 Mrs Mahlatsi’s Story
5.7.3 Mrs Veronica Malepa’s Story
5.8 Liturgy and its Context
5.9 Summary
6. Chapter 6 
6.1 Lesson that I have learned
6.2 Bereavement relates with Faith
6.3 Grounding on Christian Grounds
6.4 The use of tools
6.5 Personal and Community Use
6.6 Validity of the Study
6.7 Possible Further Research areas
7. Appendices 
7.1 Informed Questionnaire
7.2 Research Questionnaire
8. Bibliography
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