Many Missionaries and Aid Workers Suffer from PTSD After Returning Home

Ray Rising in his radio room at his home in North Carolina (Sam Cranston/Genesis)

In March 1994 Ray Rising disappeared into the Colombian jungle. FARC (Armed Revolutionary Forces of Colombia) had abducted the Wycliffe missionary and radio technician. For the next 810 days, hard men with machine guns in their hands and murder in their hearts held him captive, constantly moving from camp to camp, always watching.

When the guerrillas released Rising in June 1996, he thought his ordeal was finally over. But Rising’s battle had only just begun.

In the 22 years since his release, Rising has suffered from post-traumatic stress disorder (PTSD). Day to day, he is plagued by paranoid thoughts, intrusive memories triggered by little reminders—a Bible verse he read in the jungle, say—scraps of the past that whisper fear and anger.

“If somebody’s [standing] close to me and talking and talking and talking, I start feeling nervous,” Rising told me. “I want to run.”

He’s hypervigilant and has trouble concentrating, constantly scanning his surroundings for signs of danger. Sometimes he’ll feel angry or guilty for no reason at all. Then there are the nightmares—vivid dreams that take him back into the jungle’s shadow.

“You wake up, not sure where you are, but glad you’re not where you thought you were in the dream,” Rising said.

More than two decades have passed since his captivity, but Rising says the symptoms are just as bad now as they were when the trauma was fresh: “It’s a serious debilitating disorder, so you just have to learn to live with it.”

Though Rising’s ordeal was particularly harrowing and the fallout severe, he is far from alone. Missionaries and aid workers across the globe both experience traumatic events and suffer from resulting PTSD and secondary trauma at far higher rates than the average American. Yet the issue is little known or discussed.

EXPERIENCING CRITICAL INCIDENTS, trauma, and high levels of stress is common in many of the contexts where cross-cultural workers serve. Missionaries bringing the gospel to unreached people groups go to remote areas, because that’s where the unreached are. Those who serve the poor or provide humanitarian aid find themselves in slums or conflict zones—places beleaguered by violence, instability, and extreme poverty.

One 2007 study found that 71 percent of men and 64 percent of women serving as missionaries in West Africa had experienced three or more severe traumatic events, compared with only 9.5 percent and 5 percent respectively of the general American population. A 2001 study of returned aid workers found that 30 percent reported significant symptoms of PTSD, compared with a 3.5 percent prevalence of PTSD among the American population measured in a 2003 study.

“Just because people have critical incidents, that doesn’t mean they’ll develop PTSD,” said Mark Ventrella, clinical director for the Well International, a Thailand-based counseling center. “Most people are actually quite resilient. [But] if people feel overwhelmed and their normal coping strategies are undermined, if there’s intense fear, helplessness, or horror … that makes it much more likely that someone will develop a PTSD response.”

According to Ventrella, only 8 to 10 percent of those who experience a traumatic event actually develop PTSD, and there’s evidence that missionaries and aid workers, psychologically bolstered by their strong sense of purpose and an expectation of suffering, are more resilient than most.

“There’s about 425,000 cross-cultural workers in the field,” Ventrella added. “So that’s still over 20,000 people a year developing PTSD symptoms. That’s a significant number.”

But PTSD is only the more obvious of the psychological specters threatening missionaries and aid workers. Secondary trauma, in which a person develops PTSD-like symptoms from accumulated exposure to the stories of others’ pain and trauma, is more insidious. According to Dr. Tim Sieges, clinical director for Wycliffe USA’s counseling ministries, it is not only more common, it’s more difficult to spot.

“It’s a more complex traumatization,” he said. “They could be struggling and nobody’s noticing. That’s what gets through the cracks the most.”

PIP REA had always had a heart for the poor and was no stranger to tough overseas assignments. But when the New Zealander nurse arrived in Kolkata, India, in 2010, she wasn’t prepared for what was to come.

Tasked with setting up a health program for Freeset, a social enterprise that employs sex-trafficking survivors, Rea began by interviewing each woman to assess her health needs.

“Pretty quickly it became apparent that … their social and emotional health was very tied up in their physical health,” Rea told me.

For four hours a day, Rea would do back-to-back interviews with sex-trafficking survivors—one horrific, in-depth story of trauma and abuse after another. Within her first six months, she had interviewed 155 women, and the cumulative weight of their suffering began to overwhelm.

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SOURCE: WORLD Magazine, Andrew Shaughnessy