While I don’t claim to be an expert in medical wound care, I have seen enough nasty, smelly, screamingly painful open sores when I worked in healthcare to know that we can learn much from their process of healing. I submit to you that the stages of healing that occur when one’s body works to heal after an injury or surgery run parallel to other types of wounding that happens in life. Further, the risks for complications such as infection or swelling (aka edema) can be symbolic of the “secondary damage” that not only impedes the healing process in both but introduces entirely new problems that must be addressed as well. I have seen in my life that injury, damage, or wounding from various types of abusive behaviors have the same characteristics, the same impacts, the same risks for complications and the same potential for healing in due time as wound care management. These wounds can heal and the scar or scars fade if handled correctly. And while it all can take a little more time than we might like, the process can reveal wondrous truths and blessings as ordained by our Heavenly Father, our Lord and Savior Jesus Christ.
Heal the wound
Check this out from Wound Source:
The stages of wound healing are a complex and fragile process. Failure to progress in the stages of wound healing can lead to chronic wounds. Factors that lead up to chronic wounds are venous disease, infection, diabetes and metabolic deficiencies of the elderly. Careful wound care can speed up the stages of wound healing by keeping wounds moist, clean and protected from reinjury and infection.
Generally, remodeling begins about 21 days after an injury and can continue for a year or more. Even with cross-linking, healed wound areas continue to be weaker than uninjured skin, generally only having 80% of the tensile strength of unwounded skin.
This recovery assumes that the appropriate treatments and dressings are applied right away, any open wound is kept moist, naturally occurring inflammation is controlled, and
a new network of blood vessels must be constructed so that the granulation tissue can be healthy and receive sufficient oxygen and nutrients.
Appropriate compression is applied with proper bandaging, elevation, and reduction of factors that can contribute to swelling. The presence of edema itself is a risk factor for new injuries and complicates the healing process tremendously when dealing with an open wound. According to the EO2 wound care technology company, whatever the reason for the edema, it WILL impair healing through several mechanisms. All of these factors need to be managed well for processes such as granulation and epithelialization to occur. These steps continue at various levels even when the surface wound has closed and things are looking better. The entire amazing physiological process is a testimony to us of the magnificence created by God in our human frame. We can overcome our injuries, our vulnerability to re-injury and complications, whilst moving towards recovery and leaving minimal scarring behind. And even the worst scars do fade in due time.
Heal the heart
Recently I was reflecting on the impact of abusive behavior at various times in my life. The impact was devastating and took on virtually ALL of the characteristics of the injury and damage of a medical wound. Both types of wounds require a careful healing process. In the distant past I defined the abusive behavior that I experienced as that which violated my rights as a human being and professionals labeled as sexual, physical, ritualistic, or verbal abuse. I don’t wish to get caught up in the semantics or seriousness of each type here; all are profoundly impactful.
An individual KNOWS when another person has crossed a line that should never have been crossed and profound damage has occurred even if it takes days, weeks, months, or years to fully realize it. The recipient feels traumatized and goes through a tender, complex grieving and recovery process to heal. For example, the difference between an expression of emotion and abusive behavior can be like a person who uses 1) mean verbiage versus 2) repeated verbal hammering in a tone that purposefully tears down the victim who is yelling “STOP! STOP!” A simple apology may not be enough for the beaten puppy of a person to get past the incident, particularly when the behavior has been repeated. The relationship between the two parties has changed. The recipient is injured, damaged, and wounded kind of like a 3rd degree burn to the soul. Special care and bandaging are needed for as long as it takes for the wound to heal.
Some of my own experiences of abusive behavior happened before I became a Christian: a born-again believer in Jesus Christ. Some of them happened afterwards. Gratefully as unto the Lord, most have healed completely while a few have left their scars. There is nothing unusual about that. My purpose here not to belabor my own experiences but to share with my brothers and sisters in Christ what is and what is not abusive behavior then a model for how a person overcomes it. The Biblical Counseling Coalition provides some definitions as follows.
Abuse entails physical violence (Acts 16:19), threats of physical violence (Eph. 6:9), persecution (Matt. 5:44), sexual mistreatment (Judg. 19:25), reviling (Luke 6:28; 1 Pet. 2:23), speaking evil (James 4:11), or being under the misused power of another person or group of people (Gen. 16:6; 1 Sam. 2:16; Ezra 5:12).
Check the link that I provided above for a more detailed discussion on this topic. Focus on the Family describes emotional and verbal abuse specifically and at more length on their website HERE. They add that
Wounds that typically accompany emotional, physical and sexual abuse must not be ignored. Both men and women inflict verbal abuse, but women tend to be more often on the receiving end of this destructive behaviour. What may seem innocent and infrequent at first can escalate.
All forms of abuse follow a pattern that, left unchecked, will only increase over time. Injuries from verbal and emotional abuse can run deep and leave lasting scars. Many emotionally and verbally abused people reason that, because there are no bruises or broken bones, their abuse must not be serious. But it is. Fortunately, support and resources are readily available to guide individuals into safe, loving relationships. In their well-received book Boundaries, Drs. Henry Cloud and John Townsend state that, “Our pain motivates us to act.” If pain motivates you to act against emotional and verbal abuse, then listen and act.
We can easily see the many parallels between the topics of wound care and recovery from abusive behavior. The pain of each motivates us to act, to fix the situation. What appears on the surface may not reveal all of the layers of injury, damage, wounding that must heal to withstand the testing of the tissues or trials that inevitably follow in life. Choosing to do the work of repairing any remaining wounds of my own experiences required 1) heeding the Lord’s unveiling of my eyes that what actually occurred was damaging and 2) following the leading of the Holy Spirit to move towards restoration. Part of heeding this ongoing process includes writing this blog today. In the past my care also included significant Christian counseling, support groups, Christian books, and the like. Forgiveness, seasoning in my walk with the Lord, restoration of relationships, compassion for others, and spiritual discernment are among the gifts, the fruit for doing the work of recovery.
So what are some specific parallels between healing a physical wound and recovering from abusive behavior?
- Stop the source of injury. In wound care they call this hemostasis where the body begins to clot your blood to stop the bleeding. In personal relationships this may include setting some ground rules, some boundaries, or simply separating from the other person for a time. The thrombus or clot must hold lest it become dislodged and result in a more bleeding, a more serious injury. Similarly, the two parties in conflict must, in my humble opinion, work to stop attacking one another. Yes, the recipient has responsibility here too.
- Inflammation in wound healing controls bleeding through swelling and helps prevent infection by bringing fluids/nutrients to the site. Inflammatory words are exceedingly difficult to control when emotions are running high in an abusive situation. There can be fallout and setbacks while the two parties seek to figure out the best way forward, if each are committed to actually go forward together. Bringing in a mutually agreed upon 3rd party is much-needed medicine at this time to help tone things down. The effect of inflammation may hurt for an unknown period of time and look as ugly as an open sore desperately trying to turn a corner towards healing. Proper “bandaging” and self care for emotional wounds must begin in a responsible manner.
- Wounds are kept moist and hydrated as new cells called collagen and its matrix begin to form. In contrast, the two parties that are able to work together to address the woundedness can do simple things to care for the other parts of the relationship, their shared responsibilities. The darkness still needs to be addressed and treated correctly and what this looks like may change as the two go forward. The antagonist in the story must stop the abusive behavior and create safety in which the protagonist can flourish. New “medicines,” new habits, and new means of communication are needed. Figuring this out takes time. It may actually may be the party that was hurt the most who lovingly leads the two of them through the process of forgiveness and restoration to a better relationship.
- An even longer phase of wound healing is that of maturation. Find your own parallels in this summary from Wound Source:
During the maturation phase, collagen is aligned along tension lines and water is reabsorbed so the collagen fibers can lie closer together and cross-link. Cross-linking of collagen reduces scar thickness and also makes the skin area of the wound stronger.
Recognize that, in the words of Bay Care Health, the healing process will vary among individuals and will depend largely on the cause and severity of the wound. I submit to you that all types of wounds are the same in this regard. And as we noted above, the new collagen fibers are vulnerable to re-injury but their re-formation makes the area of the wound even stronger. This process in wound care may take up to a year. We know that while the body never really forgets an injury and neither does the mind, its power over us can change significantly. The things that happen in our past become our story, our testimony of the Lord’s amazing grace in our lives.
When I was working as an Occupational Therapist, we told our patients in rehabilitation all the time when they got discouraged that recovery is usually a jagged line with lots of ups and downs. They had to work through their fears of getting re-injured, having delays due to complications or a re-occurrence of a disease process, and grieve the losses associated with an extended hospitalization and rehabilitation process. Like my older friend Wanda used to remind me in a 12-step support group, “you gotta feel it to heal it.” Range of motion exercises after a shoulder surgery are excruciatingly painful and so are flashbacks of abusive behavior. It’s like the surgery or incident is happening all over again. But it’s not. Eventually the body and the heart starts to heal with ongoing and proper care. Lord willing, most folks do get better. We come to realize that setbacks, hurts or new injuries are just one part of living in a fallen world with fellow sinners just like us. We learn so much in the process. Thank goodness the Lord Jesus Christ helps us to overcome it all!
Interpersonal relationships seem to me to go through the same wound-healing process as restoration comes, as trust is earned: it “takes what it takes” to get there. The prevention of pressure wounds in particular includes daily skin checks. This entails looking for areas of redness over bony areas of the body and making immediate changes to reduce the pressure, nourish the tissues. Could we say that better care of our personal relationships with a better daily maintenance plan can help raise the threshold over which unwanted behavior spills over? I do believe so. Are we following our home exercise programs, our Spirit-led care plans? I could go on but you probably get my point by now.
Gentle Reader, there’s so much to say on these topics and I am not an expert on either one. I am a fellow sojourner to those who have experienced both and I have seen the power of the Lord in healing all kinds of devastation. Let our salty tears be the saline, the healing salve that washes us clean indeed. May the cross-linking of our entanglements in this life give way to the redeeming grace of our risen Lord Who restores us through and through. For His glory! Amen. JJ