Pandemic, Syndemic and Resilience

As a pediatrician with forty years of experience in caring for seriously ill, dying and abused children and youth, I have often been in awe of the wisdom, courage and resilience of some and heartbroken at the life-long devastating wounds to others.

In my personal journey with the clergy sexual abuse of minors, I have moved from direct care of abused children to diagnosing the underlying systemic and cultural factors which have fostered this profound harmful during a critical time in human development.

In 1986, with the public recognition of the longstanding crisis of the sexual abuse of minors in the West, the initial focus was on identifying risk factors in individual victims and in offenders. It became apparent that this approach failed to assess adequately the complexity of causation. The American sociologist David Finklehor provided a helpful framework for assessment of underlying systemic and cultural factors in his “dynamics or preconditions” for abuse.

Vulnerability is inherent in our embodied and embedded reality. It is unique to our personal situation. It can be pathogenic when caused by unjust beliefs, policies and practices. The pandemic has caused unprecedented global vulnerability and a global cultural trauma for all children and adults. It has unmasked inadequacies in accessible, affordable health care for all, adequate mental health care and public health with its attention to poverty and marginalization of communities and populations.

Specific harms to children and youth, the most vulnerable, include short and long-term effects on physical and mental health, an increase in youth suicide, an explosion of child sexual exploitation and abuse, the loss of routine and rituals of identity and security, parental stress and a changing epidemiology of risk.

Epigenetics has shown that our genes are influenced by trauma which affects learning, adaptive behaviors, physical and mental health and adult productivity. In trauma, the suffering caused by violence is remembered and relived. It is not in the past because the body remembers, and wounds and scars remain.

The multiple traumas of the pandemic have raised critical questions regarding a God who allows suffering on such a massive scale. All this requires a deeper understanding of the effects of trauma and the promotion of resilience in the post-pandemic Church and world.

In the critical systems thinking of Merrill Singer and others, the COVID-19 pandemic is increasingly understood as a syndemic, when a number of factors, including the physical, emotional, social, economic, political, religious and spiritual, combine to cause greater impact than the infection itself. A syndemic lens broadens and deepens our understanding of trauma and assists us in viewing the pandemic through the lens of faith and faith through the lens of the pandemic.

Responding to trauma must be rooted theologically and become a reality in our life, worship and mission. Trauma presents challenges to pastoral care and Christian theology.  

Pastoral care is concerned with the well-being of individuals and communities. Pastoral workers themselves have experience tragedy fatigue, especially in ministering to those who have lost their faith and questioning a loving God. This can lead to compassion fatigue, burnout and traumatic stress. Self-care, self-compassion and self-acceptance are essential. No effective safeguarding can occur without the education and support of families who are real first responders as they balance protection from infection with promotion of rituals of identity and security, long-term human development and resilience to the adverse events of childhood.

How can we bring new life out of the death and darkness around us? In crisis we are called to restore right relationships with God, others and all of creation.

The mystery of suffering and belief in a loving God are central to Christian belief. Traditional theologians offer meaning and comfort from the experience of Jesus, the “Suffering Servant.” Christian theology and practice from trauma-informed theologians focus on accompaniment, truth-telling and wound-healing

The promotion of resilience is crucial in resistance to abuse and healing from it. The word’s origin means to recoil or spring back. In psychology it has come to mean the ability to respond effectively to and cope with trauma, adversity and failure. It is an ongoing protective capability.

Research has identified resilience-promoting factors including strong social networks; acknowledging and confronting fears; and an optimistic outlook.

The convergence of the sexual abuse crisis, pandemic and trauma studies raise critical questions. How do we obstruct resilience, and even retraumatize, by bad theology and insensitive, inadequate pastoral care? How can we respond to trauma in ways that promote the resilience of the Resurrection as we move forward? 

Simple ‘quick fix’ answers to our wounded Church and world will not produce healing and renewal in the post pandemic Church and world. As Jesus in his Paschal Mystery and all mothers witness bringing forth new life is painful and messy work. It is our challenge today.

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Sister Nuala Kenny, emerita professor at Dalhousie University, Halifax, N.S., is a pediatrician and physician ethicist.