The book Wounded Spirits by Douglas J. Carragher is subtitled A Biblical Approach to Dealing with the Effects of Post Traumatic Stress Disorder1 [PTSD]. Although there are many Bible verses and some good information later in the book, the overall result of what Carragher teaches is biblically naive and seemingly militaristic, possibly due to his military training and experience. In spite of the many Bible verses used in the book WoundedSpirits is a failed attempt to deal biblically with the symptoms of PTSD and with the ones listed in the Appendix.
In his introduction, Carragher presents what his book is all about. He says:
If you or someone you love is experiencing any of the following symptoms after a traumatic or stressful event, PTSD may be the problem: suicidal thoughts, anxiety, phobias, depression, insomnia, feelings of guilt, anger, irritability, bad dreams, flashbacks, and apathy (page 1).
Later in the book he says:
PTSD is identified by clear physical and psychological symptoms.
fear, depression, sleeplessness, and anxiety
guilt and survivor’s guilt
anger and irritability
nightmares and flashbacks
avoidance of conflict
apathy (page 11).
Although one or more of the above symptoms could be involved in PTSD, one could have all of the above symptoms and still not be diagnosed with PTSD.
Carragher ends each of the Chapters 2-8 with an identical formula of steps to salvation. Chapters 9-10 include no similar formulas, but all have an implied promise that, as soon as one follows these steps and directions, the person can be cured of the symptoms (page 15). Carragher fails to talk about sanctification throughout the book. This is a serious error because spiritual conversion does not result in sinless perfection or freedom from the presence of sin. The apostle John clearly warned: “If we say that we have no sin, we deceive ourselves, and the truth is not in us” (1 John 1:8).
Salvation is just the beginning of new life wherein one must grow by grace. At salvation one is justified and sanctified in the sense of being set apart by God. However, there is also a sanctification process of working out what God has worked and is working within the believer. This sanctification process of spiritual growth does not occur automatically or quickly after salvation. Just as sanctification, spiritual growth, and becoming more like Jesus take time, likewise, dealing with each of the possible symptoms of PTSD discussed in Chapters 2-8 and the Appendix takes time as one grows in walking according to the new life in Christ.
Carragher repeatedly and erroneously offers salvation as the only need to cure the many symptoms he discusses in Chapters 2-8 and the over 70 symptoms listed in the Appendix. Salvation is the necessary beginning of a new life in Christ, but sanctification follows. Salvation without the process of sanctification leaves the new believer in babyhood. Believers are born again to grow into the likeness of Christ by grace through faith. Spiritual growth comes with time for learning more about God and His Word and particularly times of trying circumstances.
Carragher’s major error is his focus on salvation as the sole remedy for the symptoms and cure described in Chapters 2-8. The symptoms are: Suicide (Chapter 2), Fear and Anxiety (Chapter 3), Guilt and Survivor’s Guilt (Chapter 4), Anger and Irritability (Chapter 5), Nightmares and Flashbacks (Chapter 6). Conflicts (Chapter 7), and Apathy (Chapter 8) (page v). Carragher declares in bold: “PTSD is a disorder that is treatable and, with the Lord’s help, curable” (page 15).
This major biblical error is repeated in his Appendix where he lists Bible verses for “Put Off Sinful Behavior; Put On Godly Behavior.” After quoting Ephesians 4:22-32, Carragher gives an alphabetical list of things to be put off and put on, each with supporting verses. However, because he does not deal with the process of sanctification (spiritual growth), this Appendix of over seventy different symptoms to put off appears to be a simple, limited process as soon as one has been saved, rather than a process that normally requires time for change.
There are isolated instances in which, as soon as a person is saved, he is delivered from a particular behavior or symptom. But, in most cases there is a need for repeating the put off and the put on over a period of time along with spiritual growth in knowing Jesus and learning to walk in trust and obedience to Him. In focusing on getting rid of symptoms, one may miss the reality of relationship with Christ and the indwelling Holy Spirit. There is more to salvation than getting over certain symptoms. In the context of his book, because sanctification is not mentioned or discussed, each put off and put on could be reduced to a technique used in hopes of a quick cure. In contrast, in the context of the Bible, these verses of put off and put on are not intended to be a believer’s stand-alone methods absent sanctification for change. They are meant to be lived over a time of spiritual growth to be ongoing aspects of the believer’s life.
The 2014 edition of Wounded Spirits had only the first eight chapters of the current 2017 Revised Edition. Chapters 9 and 10 follow a different pattern from Chapters 2-8 in two ways. First, Carragher does not repeat his boiler plate steps to salvation used in the prior chapters. Second, Chapters 9 and 10 (“Moral Injury” and “Pornography”) include more specific useful information about each of the problems than are included in the previous chapters. In Chapter 9 Carragher gives useful information about Moral Injury and raises the question: “Are Moral Injury and PTSD the Same?” He says, “More research is needed to answer this question” (page 91). This raises the question of why he added this chapter to the book. Chapter 10 on Pornography is a puzzle. The chapter is well written with some good documentation, but there is not one word about its relationship to PTSD. Since Wounded Spirits, according to the “Introduction,” is about PTSD, the revision’s added Chapters 9 and 10 are enigmas as to why they are even in the book.
APA and PTSD
A secondary, but important error is on page 9 where Carragher says:
The American Psychiatric Association [APA] defines post traumatic [sic]2 stress disorder (PTSD) as “an anxiety (emotional) disorder, which stems from a particular incident evoking significant stress.”
The subject of Wounded Spirits is PTSD, but Carragher gives only a brief and out-of-date definition of PTSD from a prior edition of the Diagnostic and Statistical Manual of Mental Disorders, even though the later edition (DSM-5) was published prior to the publication of Wounded Spirits. If one is dealing with PTSD as a DSM disorder, it is important and necessary to have an up-to-date, comprehensive definition that includes both criteria and cautions regarding diagnosis. The first part of Carragher’s error is the brevity of the DSM quote and the second part of the error is the absence of the cautions needed in applying the definition. Because Carragher’s central subject is PTSD with its related symptoms and because of his unbiblical dependence on the DSM category as a basis for his book, the following DSM-5 criteria from the APA should have been included in his book:
The diagnostic criteria…identify the trigger to PTSD as exposure to actual or threatened death, serious injury or sexual violation. The exposure must result from one or more of the following scenarios, in which the individual:
- directly experiences the traumatic event;
- witnesses the traumatic event in person;
- learns that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental); or
- experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related).
The disturbance, regardless of its trigger, causes clinically significant distress or impairment in the individual’s social interactions, capacity to work or other important areas of functioning. It is not the physiological result of another medical condition, medication, drugs or alcohol.3
Many details follow in the DSM-5, but the above criteria should have been in Carragher’s book.
In addition and more serious is the fact that Carragher fails to delineate between PTSD and stress in his attempt to assist the reader. The following quote from an article titled “The Difference Between PTSD and Stress” reveals the differences Carragher should have included the following information:
Not everyone who has experienced a traumatic event will develop PTSD. After a traumatic event, it is normal to have strong feelings of anxiety, sadness, or stress. Some people may even experience nightmares, memories about the event, or problems sleeping at night, which are common characteristics of PTSD.
Information he neglected continues:
However, these symptoms do not necessarily mean that you have PTSD. Think of it this way: Headaches can be a symptom of a bigger problem, such as meningitis.
However, having a headache does not necessarily mean that you have meningitis. The same is true for PTSD. Many of the symptoms are part of the body’s normal response to stress, but having them does not mean that you have PTSD.
There are specific requirements that must be met for a diagnosis of PTSD. These requirements are outlined in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).4
The DSM-5 has 265 diagnoses. The symptoms listed on pages 1 and 11 of WoundedSpirits are found among the various diagnoses and are not solely related to the PTSD diagnosis alone. A danger here is that, without guidelines as to whether or not the symptoms experienced deserve the DSM’s PTSD designation, a door is left wide open for individuals to naively self-diagnose or be misdiagnosed by someone else and then to go spelunking into their pasts in search of what might have been the cause of one’s supposed PTSD. Any believer with any rudimentary experience ministering to others, should know that when symptoms are severe and/or very long-lasting, men and women become desperate for labels and explanations and will glibly swallow what a convincing person or book may say.
We have written much on memory and repression. Memory researchers agree that memory is malleable. The longer ago the memory, the more it is subject to malleability, which would cause it to be inaccurate and therefore untrustworthy. Once people go in that direction in search for a reason for the PTSD symptom, they will be tempted to believe memories that may have been enhanced and changed. Much damage and grief often follow this dependence upon memory.
Because of relating many symptoms to PTSD and using the psychological label, readers will be tempted to think of themselves as having PTSD (a psychological problem) and then needing to find out what caused it. They will see themselves as victims of circumstances, which will, in part, serve to excuse their behavior. Then using the combination of a psychological disease and a limited biblical cure based upon salvation alone, they will be focusing on themselves and ever learning without coming to the knowledge of the truth. Because Carragher uses the APA’s DSM to describe PTSD and is attempting to present a salvation-alone cure for the resulting symptoms, he is locked into being problem-centered in his approach rather than Christ-centered.
Wounded Spirits is based on a mixed foundation of psychiatric/psychological categories (DSM) and the Bible. Although Carragher names certain symptoms listed in the DSM designation for PTSD that may be found in Scripture, one is better off simply dealing with the symptoms as expressions of the old nature and take a more wholistic (the whole counsel of God) approach as outlined in Romans 6-8. Otherwise one may get stuck trying to get over certain symptoms rather than focus on Christ and what He provides for both salvation and spiritual growth (sanctification). This mixed foundation of the DSM and the Bible carries several problems: 1) Using a limited theology of salvation without the accompanying process of spiritual growth; 2) Using Bible verses piecemeal as a sole fix for problems; 3) Linking the Bible with the DSM-PTSD label, category, and diagnosis; 4) Opening the door to self-diagnosing and misdiagnosing for PTSD.
Carragher’s book Wounded Spirits, with its lack of a whole-Bible credible approach for dealing with the symptoms mentioned and its DSM-PTSD connection without detailed criteria for understanding the symptoms of PTSD, will lead many individuals down the primrose path of self-psychological-searching and self-analysis to their spiritual undoing. Wounded Spirits was published by “WaldenWay Publications, A Division of Sword of the Lord Publications,” which claims to be “Publishing the world’s finest Christian Literature.”5 Carragher’s book WoundedSpirits is a contradiction to their claim.
Critical Review of Wounded Spirits
1 Douglas J. Carragher. Wounded Spirits: A Biblical Approach to Dealing with the Effects of Post Traumatic Stress Disorder. Murfreesboro, TN: WaldenWay Publications, 2014, 2017. Hereafter, page references to this book will be in parentheses within the text.
2 Carragher does not hyphenate post-traumatic in his subtitle or in his book. The other professionally accepted designation is posttramatic.
3 “Posttraumatic Stress Disorder” American Psychiatric Association, https://www.psychiatry.org › Practice › DSM › APA_DSM-5-PTSD.
4 “The Difference Between PTSD and Stress,” https://www.verywellmind.com/requirements-for-ptsd-diagnosis-2797637.
5 Sword of the Lord Publishers, https://www.swordofthelord.com/.