A High-Risk Profession: Pastors and PTSD

Awareness of posttraumatic stress disorder (PTSD) has risen dramatically since 1980 when it was formally given a diagnostic status by the American Psychiatric Association. However, this condition has been around much longer. During World War I it was called “shellshock,” Shakespeare’s Henry IV displays many of the characteristics of PTSD. The condition is perhaps as old as trauma itself.

What Is PTSD?

According to the National Center for PTSD, “Posttraumatic stress disorder is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.” Among the general population PTSD occurs in approximately 10 percent of women and 5 percent of men. Being a victim or simply witnessing the following types of traumatic events can lead to PTSD:

• Physical assault
• Sexual assault
• Military Combat
• Violent Accidents (car crash, sports collision, or mass transit accident)
• Racism
• Terrorism
• Murder or suicide
• Crimes in which a person feels violated (like home invasion, burglary, or kidnapping)
• Life-threatening illness or injury
• Hearing the story of one of the above events (especially in a helping role like a counselor or therapist)

High-Risk Occupations

When people think of PTSD, they often think of certain professions that necessarily face traumatic events on a daily basis – soldiers, police, paramedics, etc. This doesn’t mean that these professions cause PTSD, but they are associated with a higher risk. Consider this list of 7 High-Risk Professions That Can Lead to PTSD:

• Veterans of Military Combat:
  • Iraqi Freedom up to 20%
  • Gulf War around 12%
  • Vietnam as high as 30%
• Police Officers about 10%
• Firefighters & Paramedics 20%
• Healthcare and Mental Health Workers up to 17% depending on the type of work
• Journalists 30%
• Disaster First Responders & Volunteers 15-30%

When individuals have an opportunity to express their feelings or talk to a counselor shortly after the traumatic event, the rate of PTSD dramatically drops. This is why the rate for police officers is so low and the rate for journalists is so high.

Pastors and PTSD

One category that never makes the list of at-risk professions is Religious Leaders. According to a current cross-denominational study being done at the Danielsen Institute at Boston University, 55 percent of clergy had scores that indicated PTSD may be a concern, and almost 35 percent met the criteria for a probable PTSD diagnosis. If these numbers were added to the list above, Pastors would have the highest risk of developing posttraumatic stress among all the listed professions.

Why do pastors have such a high risk for developing PTSD?

There are three primary factors for why pastors are at a high risk of PTSD:

First, pastors are exposed to a lot of trauma. Take another look at the above list of traumatic events that can cause PTSD. Pastors are exposed to many of their either by direct experience or through ministering to people who have suffered such trauma.

Second, pastors have high-stress jobs. They live in a world of high expectations, high criticism, and low support. This is a dangerous combination. According to Dr. Nicola Davies, in her article Anxiety, Depression, PTSD Impacted By Occupational Stress, “Evidence suggests that the key link between occupation and mental illness is high stress, which can increase the risk of PTSD, anxiety, depression, and mood and sleep disturbances.”

Third, pastors often lack training and support structures to deal with the personal impact of traumatic events. As mentioned above, most of the at-risk professions have support systems to help them deal with trauma. They often attend workshops or professional education to train them how to deal with the effects of exposure to trauma. Most of these occupations also have regular access to counselors through their workplace. Pastors are on their own. They rarely have any training on this issue, and if they want to see a counselor, many have to pay for it out of their own pocket (something most small church pastors can’t afford).

Signs of PTSD

Here are some signs that your pastor may be experiencing PTSD, they may:

• Withdraw from family, friends, and church members.
• Have trouble sleeping.
• Seem lethargic or have trouble doing normal activities.
• Become distracted, distant, or forgetful.
• Are depressed, angry, or on edge.
• Seem uncharacteristically negative, pessimistic, or self-absorbed.
• Emotions seem muted or they complain of feeling emotionally numb.
• Engage in addictive or self-destructive behavior.
• Complain of chronic pain or they have been diagnosed with chronic fatigue syndrome or fibromyalgia.

What Can a Church Do to Protect Their Pastor from PTSD?

Please note that not all exposure to trauma will result in PTSD. In some cases, it may actually help the person become stronger. “Almost everyone develops post-traumatic stress reactions shortly after being exposed to severe stressors. However, most stress reactions will diminish within days, weeks or a few months without any intervention. In a significant proportion of those exposed to severe stressors, the outcome is increased resilience, acceptance and post-traumatic growth.” However, given the risk factors that most pastors face, churches would be wise to implement the following:

1. Ask your pastor “Have you seen or heard about traumatic events recently?” This should be asked at least every month. If the answer is “yes,” they should be encouraged to talk to a professional counselor.
2. Provide your pastor with a monthly appointment with a licenced professional counselor who knows the stress of pastoral ministry. Make this part of your pastor’s benefit package (even if they are bivocational). Some denominations provide this free or at a reduced cost.
3. Pay for your pastor to attend training events on primary and secondary trauma. You may have to find one for chaplains, counselors, doctors, or police because there aren’t many available specifically for clergy. If you have the resources, contact a local professional counselor who is an expert on trauma and set up a training day at your church. Invite all the area pastors to attend. Or ask a local seminary to hold a small conference on this issue.
4. Make sure your pastor’s spouse is trained in spotting symptoms of PTSD. Many times they will be the only one who notices the change. Without training they may take it personally or feel ashamed. Trauma affects the whole family and the effects can last for multiple generations.
5. When you know your pastor has faced a traumatic event in the life of your church, give them extra time off within a week or two to process their grief. Taking some stress off their shoulders is one of the best ways to help them thrive in traumatic situations.

Experiencing posttraumatic stress disorder does not disqualify your pastor from ministry. In fact, it can be a power tool that God uses to help others process their trauma. As Rick Warren has said, “Your greatest ministry will likely come from your deepest pain.” If your church gives your pastor the support they need, you are following the biblical command to honor your pastor and it may become a blessing for the whole church.

Your greatest ministry will likely come from your deepest pain. pic.twitter.com/gh9AIwt30q

— Rick Warren (@RickWarren) June 12, 2014