This paper serves two
related purposes: 1) to provide research data about stress levels in
cross-cultural workers, and to illustrate the data with real life
examples, and 2) to assess the relevance of our data in the light of
other research about stress and mental health, particularly the
findings of Dr. Dean Ornish, as related in his new book Love and
Survival.
We hope that
in reporting our findings, along with the insights of Dr. Ornish, we
can motivate mental health workers and other personnel who work with
international and cross-cultural workers and their families:
1. To have a greater consciousness of the
cumulative effects of stress which result in a chronic high stress
lifestyle for cross-cultural persons and families.
2. To recognize the many threats to health,
well-being and effectiveness created by chronic high stress, especially
isolation and lack of social support.
3. To motivate all of us involved with
cross-cultural workers to reduce the levels of stress through
pro-active planning and training.
4. To teach stress management as one of the
essential aspects of overseas training, both before going abroad and in
the overseas locations.
5. To provide higher levels of support and
more continuous nurture and care for people who work abroad or across
cultures in their own countries.
Methodology
We have been
collecting data for about twenty years from cross-cultural workers
around the globe. The sample reported on
here have been collected mostly in the last five years.
(A larger set from previous years is still not fully
analyzed.) The contexts in which we have
collected data have been primarily missionary field conferences and
workshops, graduate level courses overseas serving cross-cultural
workers, and some U.S. based courses or programs for furloughing
missionaries. This report includes reports
from 582 cross-cultural workers originating from more than twenty
countries and serving in about forty countries. These
cross-cultural workers work in more countries than the number in which
we collected the data, as some traveled to the sites where we collected
the data. Those listed as serving in the
USA or home country have usually served abroad at earlier times; their
scores are for their current year at home.
Stress levels
scores were collected using a modified version of the Holmes-Rahe Life
Event Stress List. The original list was
changed by adding events typical of cross-cultural and foreign-soil
life and work. The points attributed to
the various events were arrived at by comparisons with other events on
the list. The committee which created this
modified list was part of the Quest program staff of Wycliffe Bible
Translators, consisting of several persons who are acquainted with
cross-cultural, overseas life, as well as mental health issues. We acknowledge that to assign points was a
subjective process, and that the list is not comprehensive. (For example, women sometimes have asked, “Why
don’t you include menopause on the list?” We
did not, because the original study done with sailors did not include
menopause, and we did not regard it to be an event typical of
cross-cultural life.) (The stress events
list is appended. Starred items were added
to the original list.)
The
participants were volunteers from many nations of origin who speak
English; they made self-reports. We made
no attempts to change or alter scores, even when obvious over-sights
were made by the participants. We assume
that if a person did not check an item he or she did not perceive it to
be stressful even though he or she may have actually experienced it. It is likely that reported scores are actually
an under-estimate of actual stress experienced, in that the list is not
comprehensive and many people overlook some stressors.
Nevertheless, the levels reported are significant.
The largest
set of data are the Holmes-Rahe scores. A
smaller set includes stress event scores plus personality type (based
on Myers-Briggs Type Inventory) and symptoms and stressors which the
person experiences. Participants could
choose between about 100 symptoms and stressors, and were asked to rank
order the ten they most frequently experience. This
sub-set is reported on here in the section on implications for
personality type.
Results and
Trends
For an N of
582 the mean score was 439.5, including participants from many
countries who were career cross-cultural workers. Table
I shows the countries with an N more than 5 with the mean, median,
mode, minimum and maximum scores. Table II
shows the means by years of service abroad.
Predictably,
the highest scores were reported by people in the first five years,
usually coinciding with the period of candidacy, training of various
kinds, language learning, and first field term. Table
II reports scores for 487 participants who indicated length of service
in their questionnaire. The first five
years includes 208 persons, with a mean score of 541.
Between six and ten years, mean scores drop to 398,
and between eleven and fifteen drop further to 373.
Scores peak again between sixteen and twenty years,
to a mean of 451. This peak likely
coincides with the “empty nest” years, mid-life crisis and the needs of
aging parents.
We assume the
years of service represented in the sample are typical of the range of
persons serving abroad. We made no
attempts to select out those in the earlier years.
It appears that there is a drop off or attrition
rate of 80 percent between the first five years and the sixteen to
twenty year period. This becomes even
steeper after the twenty year mark, with few persons remaining beyond
twenty years.
Implications
We have
reported in earlier papers that the amount of stress experienced among
cross-cultural workers averages around 600 points on the Holmes-Rahe
modified scale, with levels peaking up to 900 and beyond for people in
their first field term. These earlier
estimates were primarily based on U.S. expatriate cross-cultural
workers in Latin America. Our current
sample is more diversified by nation of origin, nation of service, and
organization. Even with the lower mean
score, however, the results are still highly significant for missions,
both in the impact upon individuals and families, and for the agencies
themselves.
In Holmes and
Rahe’s original study, they found that when people scored 200 points
during a given year, the cumulative stress had an impact well beyond
that year. They found that 50% of those
scoring 200 points were hospitalized within the subsequent two years
for heart attacks, diabetes, cancer, or other severe illness. When the scores reached 300 points, 90% were
hospitalized for these illnesses within the subsequent two years. Holmes and Rahe demonstrated that high stress
is cumulative, and that it has a “tail;” that is, the effects of it
continue long after the event itself has passed.
We have been
analyzing the cumulative effects of stress in the missionary life style
for about thirty years. Typically the
effects of stress have been overlooked by mission agencies in their
“processing” of candidate, trainees and appointees.
There has been very little, if any, awareness that
each phase of the process adds additional stress to the individual and
family. The usual progression for missions
includes some years of preparation (such as Bible school or seminary),
a period of seeking, the stress of uncertainty about choosing a
mission, the uncertainty of being found acceptable, and a host of other
uncertainties. These psychological
uncertainties are usually accompanied by several changes of location
for various training periods and programs, often interspersed by
temporary housing and being on the speaking (support raising) circuit. The candidate may be conditionally accepted,
based on performance in future training modules. Support
raising, packing, planning, etc., all consume huge amounts of energy,
and are stressful. Leaving home, family,
friends, church, and all that is familiar precedes adapting to a new
language, home, culture, set of people, and all the adjustments
inherent in a new field setting. (See
“Stressed from core to cosmos: the needs and issues arising from
cross-cultural ministry,” by Dodds, Dodds, and Schaeffer.)
In typical
missionary life, the stresses keep mounting up at a pace far faster
than one can assimilate. Seldom is there
time to fully adjust to one change and regain equilibrium before the
next demand for adaptation hits. This
means the life style itself becomes chronically full of high stress. The “tails” from stress-upon-stress stretch
out for years. Physiologically, this means
living for years with increased adrenalin, which leads to physical
changes in the brain and other body systems.
The positive
side, for those who survive, of the chronic high stress is that most
cross-cultural workers do adapt over time, becoming more resilient and
enlarging their repertoire of coping skills and attitudes.
Even with such high stress scores, we don’t find 90%
of cross-cultural workers in the hospital. People
stretch and grow. However, it is also just
as likely that many drop out (see table two) because they don’t receive
sufficient support in developing more coping skills and strategies. They may become either ill or discouraged with
the chronic high stress life style and give up in the face of
insufficient support or guided recovery.
We can apply
this crucial knowledge about chronic high stress in several ways. It is essential to support mission workers
more consistently, particularly at the predictable high points of
stress, such as the first five years, and again at the mid-life peak. It is also crucial to take into account
the spiritual, emotional and physical impact of a chronic high stress
life style. As the world of missions
increasingly focuses on more hostile environments (such as those in
Muslim settings) and more isolated allocations, we must consider the
stressful effects of isolation, loneliness, and inadequate social and
spiritual support. We must make every
effort to provide sufficient peer support, as well as loving and caring
oversight. Otherwise, we are sending
people into spiritual war zones unequipped and unsupplied with what
they need to become productive and remain healthy.
A Look At
Doctor Ornish’s Work
Dr. Dean
Ornish has pioneered research on heart health, specifically about diet,
and how emotional health, attitudes and communication either help to
restore the heart after an attack, or how they hasten the death of the
patient. In this current book he expands
on what he has previously reported. He
relates the incredible discoveries, literally rolling in from multiple
sources, that show the power of love and intimacy in survival and
longevity. Immediate death and immediate
recovery are directly influenced by the emotional states of ill
patients.
Dr. Ornish’s
thesis is that loneliness and isolation kill people, quite literally. Without love, intimacy, and a strong sense of
connection and community, the body ceases to function in an optimal way. The immune system is depleted and many other
physiological changes take place to prevent or diminish healing. Without love and the positive feelings it
generates, the body simply cannot work to produce healing.
Concerning one study of 10,000 heart attack
patients, he says, “...the greater the anxiety and stress, the more
important was the love of a spouse in buffering against these harmful
effects” (p. 25). He found that patients
who did not feel loved and connected, and who had no religious faith,
were seven times more likely to die within six months than those who
felt loved and connected and who exercised faith (p. 51)!
In another study, researchers reported a four times
higher risk of death when people felt unloved and unconnected and when
they were isolated and had a high stress life (p. 44).
Dr. Ornish
says, “...anything that promotes feelings of love and intimacy is
healing; anything that promotes isolation, separation, alienation,
loneliness, loss, hostility, anger, cynicism, depression, alienation,
and related feelings leads to suffering, disease, and premature death
from all causes” (p. 29). Hostility,
suspicion, cynicism and conflict create havoc in the immune system and
other bodily functions which lead to disease and death (p. 59, 60, 61,
63).
Many of the
research studies have discovered truths which have direct bearing on
our policies and behaviors in mission selection and member care. For instance, in a longitudinal study,
researchers found that the positive or negative feelings and
perceptions of college students about their parental bonds had direct
results in their health status thirty five years later (p. 33, 34) (See
Table III). In other studies researchers
found that weekly support groups, for almost any illness, dramatically
increased the length of survival from the cancer or other illness (p.
50).
Love and
Survival is full of
vital information, both about the positive attitudes and practices
which promote well-being and the negative ones which erode life. Dr. Ornish’s insights are born out by other
researchers. Especially notable are the
works of Horowitz (1964), Lazarus (1999), and Miller (1997). The recommended reading list cites some
additional key works. Other authors relate
the same implications of stress. “There is
elegant work showing that stress, whether environmental or social,
actually changes the shape, size and number of neurons in the
hippocampus,” (Marano, 1999, quoting Dumas, p 36.)
Glaser, et al., report on many of the effects of
stress on the immune system and point to the need for life style
changes to improve health (1999, p. 3 in article reprint).
Implications regarding Personality Type and Stress in
Cross-cultural Life
We know from
the literature about personality type (using Myers-Briggs Type
Inventory), especially the writings of Katharine Briggs and her
daughter Isabel Briggs Myers (1980) that certain defenses and stress
responses are common to individuals of given types.
Some of these are summarized in Appendix II.
Based on both
our thirty years of observation of people in cross-cultural settings
and our research, we have identified some generalities.
Though each person adapts in individual ways,
certain patterns of stress and frustration are common to people of the
same type.
Extroverts
typically are more stressed by isolation, loneliness and separation
from peers or same-language speakers. They
need interaction with many others in their world to be validated. They need a great deal of communication
(talking things out) to help them process the experiences of
cross-cultural life adjustment, because talking is a means of thinking. Under high stress they usually act out their
frustrations more through behaviors.
Introverts
tend to be more stressed by the demands of language learning and the
pressure to relate to people. They are
more likely to escape or otherwise withdraw when the stresses mount up. It seems they symptomatize stress in more
internal ways than do extroverts.
These
communication and relational behaviors and internalized symptoms may
become extreme for both extroverts and introverts under exceptionally
high stress or once they have passed their “threshold” of coping. In that each individual has a different
“threshold” for tolerating stress, based on many factors in addition to
personality type, so the amount or degree of stress required to produce
symptoms is also highly variable (idiosyncratic).
Intuitives
usually find incongruities, redundancies, injustice and unfairness
harder to bear. They see “the big picture”
and are able to more quickly spot the irregularities and differences in
what should be versus what is. Intuitive
feelers are particularly prone to feeling the suffering of others; this
may contribute significantly to their stress loads.
They are
usually more sensitive to conflict than other types, and their idealism
sets them up for perpetual disappointment.
Sensing types
are more easily stressed by lack of predictability, especially when
sensing is combined with judging. When
combined with perceiving rather than judging the sensing types may
become easily bored (yes, that is stressful) in environments which
provide little risk or challenge. Sensing-judging
types are stressed by lack of routine and continuity, and by not having
expectations clearly defined. To not have
a place or a routine is more stressful to them than to other types.
Feeling types
are more often stressed by the human needs, tragedies and predicaments
than are
thinking types. They find criticism, harshness, emotional coldness hard
to bear. They are more easily overwhelmed
by the demands of other, especially if they do not have clear
boundaries and agreed-upon expectations.
Thinking
types find lack of logic and sequential reasoning to be sources of
frustration. They find it harder to
understand and tolerate circular or global thinking patterns in people
and cultures. They are sensitive to lack
of principles, or adherence to existing principles and policies.
Judging types
are easily frustrated by the frequent changes and unpredictability that
is typical in many other nations, especially in materially
underdeveloped countries. Lack of planning
and foresight, such as exists in fatalistic (non-future oriented)
societies particularly cause stress to those whose basic motivations
include everything having a time and a place.
Perceiving
types are stressed by being boxed in with too many expectations or by
schedules and settings which do not allow for flexibility and
spontaneity.
We report
here on a sub-sample of our
research on cross-cultural workers and stress levels.
This includes 211 persons who took the MBTI plus
completing a questionnaire about symptoms and causes of stress. (See Appendix.) Each
person identified ten symptoms he or she most frequently experience,
from a list of ninety-three. The next step
was to rank order the ten symptoms from most frequent to less frequent.
Participants also identified
ten causes of stress (stressors) from a list of one hundred stressors
common in cross-cultural situations. They
also rank ordered these from one to ten, one being most frequently
experienced and ten being less frequent. (When
asked to first check off all the symptoms they experienced, before
selecting the ten most typical of them, many people marked thirty or
forty.)
Emotional
symptoms stand out as most frequently chosen, across all types and
across the ten rank orderings. For symptom
#1, almost half (105) chose an emotional symptom as most frequently
experienced; 80 chose a physical symptom for first place.
Physical symptoms in ranks 2-10 dropped off
considerably, to about 40 choices in each rank. Emotional
symptoms, across the ten ranks, ranged from 105 to 85--well ahead of
any other category of symptoms.
Behavioral
symptoms were chosen between 4 to 10 percent of the time, across ten
ranks. Cognitive and relational symptoms
alternated across the ten ranks, ranging from about 10 to 35 choices,
or about 3 to 15 percent.
The most
frequently experienced stressors were not being proficient in the
language, being criticized, being lonely, experiencing conflict, lack
of recreation, being separated from family and friends, not knowing or
living up to expectations of others, not being able to get work done,
and poverty of those around.
The most
frequently identified emotional symptoms included being overwhelmed,
withdrawing from others, irritability, depression, a sense of
unworthiness or not being loved, feeling impatient, angry or
frustrated, wanting to run away, escaping through T.V. or books,
fearing disapproval or criticism, and loss of joy.
Among the physical symptoms those most frequently
identified were fatigue and a sense of bodily heaviness, headaches,
bodily tension, and difficulty falling asleep.
How can we apply this research in helping
cross-cultural workers and their families:
1. We must do very careful selection, training
and placement.
We know from
Ornish’s report, and others, that early life and family of origin,
particularly the quality of parental bonds, relate to life-long health
and longevity. We know that isolation,
separation, loneliness and such common experiences of first term
cross-cultural workers also diminishes health, producing illness and
delaying healing. Almost all the stressors
we have identified which are common to first-term cross-cultural
workers are debilitating, and because they are continuous, unrelenting,
and cumulative, we put first term people at high risk.
This is especially true of young and idealistic
people. They are already “set up” for
burnout. Allocating them to isolated,
difficult situations without sufficient support almost dooms them to
depression, illness, and failures of some kind due to maladaptive
coping.
In general,
people inadequately loved as children are more likely to feel empty
and to lack resilience and good coping. They
have fewer emotional resources and lower reserves of energy. They are less likely to develop a strong ego,
or basic personality structure. The home
of origin does matter because both the degree of love received
and the patterns of relating which the person has learned shapes
development. We know that some children
become resilient in spite of early deficits, and go on to develop good
resources and highly effective lives. (See
“Children of the garden island,” Werner,
1989.) Thus, persons should be assessed in
the light of how far they have come, given their origins, rather than
just on the basis of their families of origins. Some
of our most productive cross-cultural workers started out in unhealthy
homes, yet grow well beyond the usual outcomes. They
are atypical, however. (See Dodds, “The
role of the holy spirit in personality growth and development.”)
Let me give
some examples of cross-cultural workers with troubled backgrounds and
how they fare in difficulty. These are all
real people, in real places, sent out by real agencies.
I only change the names and places to protect the
privacy of these precious persons.
A. Bob and Susie both
came from very dysfunctional families, both with
addictions to alcohol or other habits. Neither
had much nurture. They had poor parental
models, both for parenting and for marriage. After
becoming Christians in college they felt called of God to serve in
missions. Knowing little of their personal
histories, their mission assigned them to work in a remote Muslim
country, in a setting where no one else spoke their language, and
without any other expatriates. The setting
was dangerous. Most people carried weapons. There were frequent political and tribal
fights. They received many taunts, great
distrust, and suspicion. Their housing was
very substandard, with no indoor toilet or bath. They
had to bathe outdoors, which brought crowds staring at their white
bodies. This was extremely stressful for
the little girls. Every word they spoke
could be heard through the thin walls by their neighbors.
There was little to do for diversion.
To escape their situation for a break meant hours or
days of difficult travel and high expense. Bob
and Susie found they did not know how to create a positive marriage,
and they did not know much about how to parent, lacking both parental
and current models for both. They became
increasing dysfunctional in their own relationship.
The husband became very hostile, the wife very
depressed. Finally they withdrew from
their setting in order to get help. Their
situation precipitated severe spiritual crisis as well as depression,
hostility and illness.
B. Jim and Anne came
from more positive home backgrounds, but still
had some unhealthy messages about their own adequacy.
They too were placed in an isolated Muslim setting,
in which it took them two years to discover any other expatriates who
spoke their language. The wife spent most
of her time in the mud house with the little children, who were always
ill. The open sewer outside their door
hardly made going outside much better. The
husband at least escaped to work, but even there experienced
considerable rejection and sometimes hostility. They
felt so unsupported by their mission that they eventually concluded
they had been sent to country X just so their mission could add another
country to its letterhead. We can not say
whether this was true, but it is tragic that they perceived it to be so.
C. Bill and Carol also
both came from unhealthy homes, having
suffered abuse and neglect. They found
great love in each other, and both came to Christ during college years. They too lacked healthy models for marriage or
parenting. When they felt called to
missions, their church sent them out, with no training, along with
three other couples, to be a team in a closed country.
Within two months, three couples left the field. Bob and Carol stayed, living in a city with no
other foreigners, under constant surveillance and living in harsh
physical surroundings. They were
constantly vigilant, knowing that anyone they were seen talking with
would become suspects to their government. They
attempted to love the people while learning the language.
By the end of two years they met their goal of
“walking out” of the country (rather than being carried out on
stretchers), but both had Post Traumatic Stress Disorder and multiple
physical problems. They were nearly
incapacitated and barely functional when we saw them.
D. Roger and Kathy both
grew up in home that left them damaged and immature in many
respects. Neither knew how to love or to
resolve conflicts in positive ways. Though
they became Christians and missionaries, none of their family of origin
issues had ever been talked about, let alone addressed in ways that
would bring them healing. They actually
knew little about Christian standards for right living.
They were placed as a young couple, alone, in a
hardship setting, with the closest colleagues hundreds of miles away. Not knowing how to create a close
relationship, faced with unending work and distorted priorities, they
grew farther and farther apart until each had an affair.
They left the field, devastated and shamed, when
someone reported on their situation.
We could cite
many other cases like these, where young, inexperienced and idealistic
young people were sent out with little if any support, and lacking
positive models of how to live healthy lives, especially in marriage
and parenting. Our conclusions based on
many such situations are these:
2. Agencies would best not send first term people
into isolated and difficult allocations, such as
Muslim countries or others closed to the gospel of Christ and to
westerners and who are grudging towards foreigners in general. The strains from adaptation to a foreign
language and culture are intensified in young, idealistic, and
inexperienced people, and compounded in the religious or political
setting typified by hostility, suspicion, paranoia, and severe danger
or political control. How much effective
ministry is accomplished through a young couple who crashes before they
ever become fluent in the language and able to relate fully to the
people?
Lest we
conclude that only couples from dysfunctional homes suffer, we have
also seen the “cream of the crop” young families, with very solid
backgrounds and personal formation severely affected by stresses of
life in hostile environments. Some
“jewels”--those your candidate personnel would vote “most likely to
succeed”--have encountered such difficulty they have been debilitated
to the point of severe illness, marital crisis, and crises of faith. We know first hand because we are committed
full time to the restoration and healing of persons who work across
cultures.
3. Agencies would best not send young couples in
child rearing years into such situations because they
so often result in isolation and depression for the mothers. Husbands who are themselves not yet mature and
are unsupported are not good supporters of wives and children! They more often become the source of
additional stresses to the wife and children. (Note:
recent research in the U.S. shows that fifty percent of mothers with
pre-school children suffer from depression. This
is here, in their own language, culture, and familiar setting, with
friends, family and telephones available! How
much more so when isolated from any other mother-tongue speakers, in a
strange culture, a foreign land, and with an immense accumulation of
stress, including frequently ill children!)
4. Agencies would be better served by assigning
experienced, middle-aged couples (or singles) to difficult, isolated
allocations.
By age forty-five or fifty couples are more likely
mature in their relationship, have reared their children, and are more
experienced in cross-cultural life. Wives
can more easily endure the isolation imposed by culture by virtue of
greater maturity and self-direction.
5. Selection and training for overseas or
cross-cultural work should include the following:
A. Know the person! Careful
assessment of the individual’s background: family of
origin issues, degree of nurture as children, patterns of relationships
in the family and since conversion, number of models for godly, mature
living, etc. Time in community is needed
for spiritual formation and learning healthy patterns of life. Our Catholic brothers and sisters can teach us
much about this. Persons with wounded
backgrounds ESPECIALLY need to be placed in allocations with an ample
supply of on-going support and love, because they are likely to lack
the inner reserves and resources to sustain themselves emotionally and
spiritually in isolation. Feelings of
emptiness are typical of people who were unnurtured in childhood. If they themselves feel empty they are not
much able to sustain a spouse or others. Two
empty spouses cannot nurture children or a fledgling community
assistance program or business.
B. Careful assessment
of the person’s actual ability to love and to
interact in loving, non-defensive ways. These
should be observed first hand over a period of time by mission
trainers, and be reflected in the references collected about the person. Individuals who are still defensive,
emotionally cold, tight or angry, and who are immature in self-giving
really will not communicate much of the love of God (which is done
relationally, not through teaching theology). We
often work with individuals who have head level knowledge of the Gospel
but who do not experience it, and are thus ineffective in actually
communicating it. Lacking personal
warmth, loving communication, and heart-felt acceptance by God leads
them to ineffectively living out the Gospel. Loving
requires maturity and skills for building community and intimacy, such
as self-knowledge, self-disclosure, conflict resolution, heart-level
sharing, acceptance and respect.
Ornish says, “If you grew up in a family in which
love, nurture and intimacy were in short supply, then you are more
likely to view your current relationships with mistrust and suspicion. If your family experiences were filled with
love and caring, then you are more likely to be open and trusting in
your on-going relationships” (p. 39). “The
perception of love itself...may turn out to be a core
biopsychosocial-spiritual buffer, reducing the negative impact of
stressors and pathogens and promoting immune function and healing” (p.
34).
C. Training should
include personal growth matters, such as how
to develop self-knowledge and self-awareness, skills for loving
communication, intimacy, conflict management, stress training,
parenting and marriage skills. Each person
needs to learn how one got to be who one has become, to identify
pitfalls from the past which create vulnerabilities, personal habits
and patterns which may be obstacles to relating, and so on. How to create and sustain small groups for
support of one’s self and ministry is another vital tool to increase
the likelihood of love and intimacy and reduce the likelihood of
isolation and loneliness. Some of the
discoveries of the research include the benefits available in
community, such as the importance of telling life stories, having
support groups, the power of the group process, the power of being
touched, the power of family “heart messages,” being open-hearted,
being vulnerable, feeling close, the power of prayer and
meditation, the power of unconditional love received
from a parental figure, and the value of writing, journal writing,
telling about trauma to friends, disclosing feelings, especially about
difficulty. Having friends is not
sufficient in itself--people must be given skills for heart-level
sharing.
One statistic
cited by Ornish is unforgettable. In a
study of childbirth, mothers who labored alone had an average of 19.3
hours of labor. Mothers who labored with a
caring attendant, even if that person had been a stranger to them
before labor, averaged 8.7 hours of labor (p. 65).
If something so physical, so physiologic, is altered
so greatly just by the presence of a loving person, how much might all
of our experiences of difficulty and pain be altered by the presence of
a loving, caring person?
D. Training by
Christian agencies (such as relief organizations, missions,
“tent-making” businesses, humanitarian groups) should include teaching
on spiritual warfare, a theology of suffering, and the role of the Holy
Spirit as our vital
power source. He is our energy for living
godly lives instead of living out of our old patterns of life and
thought. Understanding the big picture of
God’s battle with His enemy, Satan, helps us gain perspectives on the
doubts, attacks, and other ravages of Satan. Seeing
our role as participants in the battle gives meaning to our sufferings,
and helps to explain why ministry can be so difficult.
Understanding the role of suffering, both as a
result of the spiritual war and as one of God’s means for shaping us
and creating His image in us, is crucial to our endurance.
Learning how to live daily, hourly, minutely, by the
power of the Holy Spirit within us is essential for righteous living. Without His prompting, teaching, exhorting,
encouraging, comforting and empowering we will remain stuck in the lies
we believe and ineffective or destructive patterns of life we gained in
early life.
Recent
studies on the sequelae of torture underscores the point of having a
meaningful structure (religious or ideological) in which to interpret
such horrors as torture. Miller (1997, p.
58) reports on several studies including one by Basaglu and Menika. They found that torture victims with prior
knowledge were psychologically more prepared and thus suffered less
intense consequences (such as less severe PTSD). Those
without a means to “make sense of” the torture, or without prior
knowledge that they might experience it, had more severe and lasting
sequelae.
6. First overseas assignments should be made to
teams or groups with warm and supportive leadership, so that new
cross-cultural workers can learn first hand, through instruction and by
models, how to relate to nationals, how to form a good marriage, how to
parent well. Though most agencies give lip
service to “teams” the reality is widely disparate.
Some consider anyone in the same country a team, yet
the individuals may be hundreds of miles apart, and are functionally
separate. Even in a city, teams may be so
far separated by traffic or transport that there is no daily or weekly
functioning together or mutual support. Can
you imagine any professional sports team who never even PRACTICED
together before playing a public game? Placement
of cross-cultural workers “on teams” is often so haphazard and ill
defined that it is in reality an empty phrase. Would
it not be better to consolidate people into larger, genuine teams where
nurture can be provided rather than scatter them out?
We know one couple who said that no one in their
mission knows them or their work well enough to be able to do an annual
performance review for them. Is that
appropriate? A pastor told us that his
organization only puts one couple in any given country, as a matter of
policy. He said that is because two
couples of more can never get along! What
role does such a policy play in preventing cross-cultural
workers from modeling the life of Christ, the body of Christ?
