A Qualitative Understanding of Trauma From A Helping Professional

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Social Workers often work with trauma survivors and enter into the deepest parts of a victim’s psyches in an effort to help them transcend the often dark and debilitating symptoms which stem from trauma. Social Workers also experience direct and indirect trauma as part of their jobs and yet are often left out of the conversation with other first responders.

Last year, the Province of Ontario in Canada, passed The Supporting First Responders Act, which acknowledges and provides a host of benefits for the high rates of PTSD amongst Police, Fire, and Ambulance personnel. Police officers in Ontario also have the benefit of a five-year earlier retirement benefit due to the toll of their work.

I personally support all benefits for first responders, however, I remain mystified as to how social workers have been left out of this group. It almost seems absurd to have to argue the ways social workers are in fact first responders. One need only to look at the fields of crisis response, critical incident response, child protection, mental health intervention, and the like to realize that most direct practice social workers are in fact employed as first responders.

Many researchers have documented and quantified the nature and degree of trauma in the helping professions, however not as much qualitative research has been done. This is not surprising when one considers the stigma and shame associated with mental illness and especially mental illness among helping professionals.

In my twenty years of experience as a front line social worker in Child Protection, Domestic Violence Services, and School Social Work, I have observed too many times how colleagues have suffered in silence and have often been ostracized due to their struggles.

As a social worker and trauma survivor, I have worked much of my life to understand the impact of trauma on people’s functioning and I have searched far and wide for ways to ameliorate the symptoms which often erode one’s core positive beliefs about the world and about oneself. Stories and narratives about trauma are important and legitimate tools we can use to learn about the intricacies of trauma in people’s lives. As professionals, disclosing one’s story, however, is not encouraged, and helping professionals often suffer in silence.

As professionals, disclosing one’s story is often not encouraged or supported, and helping professionals tend to suffer in silence. Disclosure is scary business, and many social workers fear repercussions such as being viewed as weak, unstable, or unfit to perform our duties.

We feel the stigma that surrounds all mental illness and that serves to perpetuate silence and an ongoing lack of recognition and understanding of the cost of caring. There is a profound lack of ongoing dialogue surrounding the impact of the work we do on our own lives.

Most social workers would not trade or change their careers and lives despite the cost of caring. In fact, there is a core of altruism, dedication, ideology, and core values to improve the lives of others in this world that keeps helping professionals on the job during times of personal pain and suffering. We generally are a group that does not exercise good self-care and the organizations that employ many of us do a dismal job of protecting us and supporting our self-care.

While self-care initiatives exist, they tend to lose focus very quickly and they are not progressive in the sense of using cutting edge strategies to seriously help mitigate that stress that is inherent in our work. One need only look at the tech sector and the organizational and occupation health literature to realize that our work culture continues to be largely punitive based and continues to see employees as needing to be controlled.

Trauma refers to not only full-blown PTSD, but it is also the continuum of symptoms associated with experiencing horrific events – events that overwhelm one’s physiological stress response. A debt of gratitude is owed to the trauma sufferers who have allowed researchers to study and understand trauma which is one of the best understood mental health disorders of our time.

In particular, sexual assault survivors, natural disaster survivors, and veterans have shared their experiences over the last several decades and we must honor them continually. And, last but not least, the U.S. Department of Veterans Affairs National Center for PTSD and the PILOTS database must be acknowledged for the research, support, education, and dissemination of information about trauma.

Trauma survivors have the gift of strength and perseverance. I hope it goes without saying that living through and with trauma requires constant effort, energy, and strength. This strength leads to endless opportunities for survivors that can learn to harness their experience and strength toward future goals and achievements. While not always possible for all, finding the gifts and strengths associated with trauma is an area that does not seem to be talked about enough.

My hope is that this article can offer even glimpses of hope to those of you who have experienced trauma and for those of you who offer treatment and compassionate services to victims.

I will not give up strategizing and fighting for change in our organizational and political structures that need to recognize and provide reprieve and benefits to those in our profession who experience trauma like other first responders.

Justin Trudeau: How One Person Can Positively Change The World

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Political ideology is not something everyone thinks about, but for Social Workers it is infused in our profession whether we like it or not. As an eclectic profession whose founders borrowed from psychology, psychiatry, sociology, economics, and political science, we have a long history of working to ameliorate the impact of the political ideology of any given time.

Yet, before the creation of Social Work as a profession, we were born out of altruism and charity work.  Most of us learned about the creation of the modern-day social welfare state which formed as a result of the industrialization of society and the need for help for those who were in one way or another marginalized and/or alienated by the machines of “progress”.  

Progress and industrialization undeniably changed the individuals, families, communities, and nations of our ancestors.  As a social work undergraduate student in the early 1990’s, I wasn’t initially clear on the purpose and connectedness of learning about the history of western social welfare.  

But 25 years later, it is clear social work’s cultural roots continue to inform practice and theoretical understanding of the core difficulties helping professionals face in trying to ameliorate injustices on a daily basis.  Despite the continued modernization of society, helping professionals continue to try and mitigate the numerous costs and effects of working and living in a capitalist, technologically advanced, and alienated communities and nations.

A little over a year ago, Canada elected Justin Trudeau as Prime Minister, and the media is now filled with the typical polarized assessments of Trudeau and his governmental leadership. However, if I had to summarize the rhetoric surrounding the assessment of Trudeau, I would say the press and even the neoconservatives who previously governed Canada are shocked at how someone can unite a diverse Country and in many ways impacting the World. In short, the feeling from the left is that Justin Trudeau is too good to be true.  On the other hand, many of us Canadians believe Trudeau is a dream come true.

For the majority of the last couple of decades, Canada and many of its Provinces have been governed by Neoconservatives.  The traditional Progressive Conservative Party of Canada imploded many years ago and was replaced by a hybrid conservative party which was ideologically very neoconservative. Provinces and Canada as a whole under the neocons lost a lot of ground in terms of our social welfare policy and social innovation.  Neocons convinced people through propaganda that the poor and disadvantaged in Canada were that way because of some type of character flaw –  essentially lazy or weak or both.

While I don’t personally know Justin Trudeau, I feel like I do.  I suspect that the same is true for many Canadians. Justin reaches out to us via social media – imagine a Prime Minister on Facebook!  Leaders of government have never gone out of their way to seek the opinions of the common classes, but Prime Minister Justin Trudeau does.

Although he has inherited many societal problems such as Canada’s poor treatment of our First Nations, Trudeau is trying to correct the damage done to the fabric of Canadian society by past governments. What I see and feel as a Canadian and as a social worker is that Justin Trudeau intends to help our country become benevolent again. Trudeau knows adversity, and he knows the value and strength of diversity and inclusivity.

Under the current political climate, I have often mourned the loss of truly professional politicians. What I mean is political science and ideology were once legitimately held in high esteem by those who sought to figure out how to best govern a population. Political debate was about reason, ideology, rights, and freedoms. But politics has become about personal attacks and quite simply behaving inappropriately and using power and control to get a desired outcome. Our political system in the West at least is not the one envisioned and practiced by our ancestors.

I have high hopes for Justin Trudeau, and he has already accomplished a lot in a short period of time.  I am once again proud to be Canadian.

The Dilemma of the Professional Helper: Cognitive Dissonance, Wellness, and Unhealthy Systems

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Did you ever see the movie, Jerry McGuire?  Jerry wrote a manifesto based on the ills he experienced in his sports management company in an attempt to effect positive cultural change. Do you remember how that turned out? In case you missed it, Jerry was fired.

Another similar real life story was told to me by one of my social work professors who is no longer with us in this world.  He blew the whistle on the corruption in the insurance industry in a Canadian Province which literally led to him being driven out of the province and landing in Ontario.

What Jerry and my professor shared in common was that they were driven to try and make their worlds better places.  In the end, they ended up where they were meant to be and were healthier individuals as a result of it. They rid themselves of the cognitive dissonance and incongruence of working in a system that made them mentally unhealthy and morally/ethically bankrupt.

I’ve attempted to write versions of the following article many times in my life, but fear always prevented me from sharing my perspective and from ultimately blowing the whistle on a system that is making me – and I suspect many others – ill.  I hope to generate honest discussion and thought about the current state of society and the people charged with treating society’s ills.

I am a Social Worker in my 18th year of front line practice.  As I write, I am not well.  Although in the current positive climate of mental health and wellness strategies in our society, I should not feel shame or guilt to admit this, yet I do.  In fact, it makes my skin crawl to utter the words that I am mentally ill.

Although my legitimacy as a professional helper comes from social work education and practice, there are many other people in our field who have other education backgrounds and are equally skilled in there capacity to help, so I will herein use the term “professional helper” to refer to the field generally.

My illness is of the brain and emotional regulation kind.  Diagnosed as panic disorder it is much more complicated than that for me.  While I know that I am human, I have relied on my brain and more fully my “self” to be the treatment for my clients over the years and I feel like I am somehow broken in that I am currently unable to employ my “self” to help others. Although professional helpers rely on knowledge of human behaviour and systems, the multitude of theories and interventions designed to help people in crisis during periods of suffering, those interventions flow from the professional helper.

In addition to the tangible and measurable symptoms I am currently experiencing, I believe my illness is due to much more than my personal mental health functioning.  I have felt like I have been dancing with and around a slow wave of melancholy and dysphoria trying to taint me with its toxicity for several years.

I am under no dissolution that my situation is unique, worse than, or perhaps different than that of others who treat people for a living, but in this day of digital information I find it’s further isolating that other people in similar situations aren’t out there sharing their experiences. I suspect that the lack of information about and for professional helpers isn’t there because like me, others have and continue to suffer in silence.

I finally took a medical leave – but of course like any good helper I argued with my doctor against it – after a chain of events left me in a poor state of functioning.  At the final moment before I called the time of death, my memory was defunct and my focus was non-existent.  I could no longer exude hope for those in my charge who needed hope more than anything.  The hopeless helper is not okay because we adhere to professional ethics and values which above all else necessitate that we are hopeful and active in bringing change to our clients’ lives and society as a whole.

So, in addition to my own intrapsychic mental health, what is the toxicity that I speak of?  I think there have been several factors which have combined to help me along the path to compassion fatigue or burnout or perhaps more aptly, general malaise of the existential variety.   For the purpose of brevity and significance, I will talk about three of these factors and try and explain how these have combined to break one’s spirit.

Cubicle divided offices.

Most professional helpers do not work in offices.  The cubicle or in some cases wall-less office is not an office.  In my opinion it is in fact a legitimate workplace hazard that can make people sick.  How you ask is this possible?  Allow me to explain.  It is well known that stress and traumatic stress is a measurable and real phenomena.  When one of your colleagues is particularly stressed or experiencing trauma or secondary trauma, the stress from that person or the situation that they are dealing with impacts on everyone around them.

If you have ever worked in child protection you will understand immediately what I am referring to.  Once an apprehension has been started the details of the matter and the preparations are inherently traumatizing and everyone in close proximity is impacted by that stress.  Have you ever heard a colleague learn about a devastating event on the phone?  Of course.  What is not so tangible and measurable about the modern day cubicle divided office, is who and how much a person will be affected.  Moreover, if you are an introvert, the mere effort it takes to function in a cubicle divided office is life altering.

One size fits all therapy.

Brief solution focused Cognitive Behaviour Therapy (CBT) and mindfulness based approaches are the most used modalities for therapeutic practice. Many new professional helpers may be hard pressed to be able to identify many more therapeutic modalities than those listed above and for good reason. However, these evidence based treatments which have been the focus of the profession for more than a decade have now created client outliers whose suffering continues and who feel personally responsible for their problems and suffering.

What I mean here is that some people require more time to change and heal while some people may need more evidence based tested therapeutic long term interventions. The longer term the intervention it increase opportunity to develop a stronger therapeutic relationship consisting of accurate empathy, warmth, and positive regard.  Unfortunately, the good old social work texts such as Turner and Tuner social work treatment have no place in the political and economic climate of today.

So, we have people who are once again abused by the helping system in that the conclusion left upon service users who don’t benefit from CBT may be a feeling of failure. It may seem as if they aren’t trying hard enough to change their thoughts, perhaps worse they are resistant to therapy and want to remain in suffering. Ultimately, they are discarded from therapy and left to pick up the pieces alone.

I think would be remise of me not to note that even more appalling than an adult being left after therapy feeling that it is somehow their fault that they aren’t better is the current situation for at risk children who are treated in schools.  Same situation applies.  Although the literature and research surrounding the therapeutic and developmental necessity of at risk children having a caring adult is profound, our helping systems do not support a professional helper being that person. Do we ignore the systematic oppression and poverty while using therapy to help clients cope with society and social justice issues, and how could this be successful?

So, we have children referred for counselling for a variety of reasons (depression, anxiety, domestic family violence, substance abuse, to name just a few), they aren’t cured after six sessions but they have formed a therapeutically important and significant relationship with the helper.  What do we do to these children?

We terminate therapy, and I would suggest do them harm by adding a loss and bereavement to their list of risk factors.  I personally cannot ethically do this to children and I believe many of us in the field have found ways to undermine the system so that we can remain involved with these children beyond six sessions and even for as long as it takes.  But, this comes at a cost to us because there is a great deal of stress associated with breaking the rules even when it is best for children.

The shrunken size of the world.

It is a small world after all.  We now live in a world where global trauma, anxiety, and the perpetuation of fear are common place.  It is hard not to see that our communities and more globally, the world as a whole has both benefitted from the age of technology as well as created a Pandora’s Box.  Readers familiar with the great writing of George Orwell, Adolf Huxley, and more recently, Neil Postman, will understand the dire warnings they tried to convey to humanity as a whole.  While the benefits of technology are widely known and praised, the hazards and negative outcomes for people and communities are less discussed.

For people already suffering with anxiety, for example, symptoms are increased on a daily basis by being consumers of information.  It is next to impossible not to see the world as a scary and unsafe place.  The internet tells us every day about human atrocities and the positive psychological movement which has many potential benefits cannot counter the global anxiety index.

I believe that the global anxiety index is a measurable phenomenon which raises anxiety symptoms in individuals and human systems.  One need not look very far to see the impact of the heightened and highly sustained impact of global anxiety.  We read daily about the increase in sleep disorders, anxiety in all of its forms and symptomology, depression, and all other mental health disorders are at levels not previously seen in humanity.

I believe that this new baseline of high anxiety is not sustainable and is the root cause of many of modern day illness and dysfunction.  Ironically, this is not something imposed on us by some external entity rather than the result of technology in which we have created and embraced. Postman wrote tirelessly about the negative impact of technology on human literacy and intellect.

In my experience, the cures for global anxiety – namely meditation in its many brands – work for some people but herein lies the problem.  I strongly suspect that those of us who have resisted the destruction of our thought processes are more immune to the helpful benefits of meditation and CBT strategies. Why?

In effect, modern day therapeutic strategies are based on one’s capacity to trick one’s mind into thinking positively.  Some of us just aren’t susceptible to trickery.  We have tried and tried again to adopt mindfulness and thought distortion changes in our lives but in the end, we conclude that it is not our thoughts that are distorted.  In fact, nothing is distorted and we live daily with the impact of global trauma and anxiety.

I believe further that the only potentially possible way to get through this life as a professional helper and more generally as a mentally well citizen is to revisit and readapt existentialism. Yalom and others have embraced existentialism and used it to treat people with many mental health ailments.

But, existentialism needs a revamp in the technological age because what many people struggle with is not just the notion that we are ultimately alone, but we must now examine the unretractable information technology systems we are reliant which also may serve to perpetuate our symptomology.  I will be brutally honest, I’m not sure how else we will get through this.

For sure, existentialism is a depressing ideology, but the help in it lies in the paradoxically and poorly understood and discussed end result.  If we can find a way to embrace existential tenets, eventually the suffering goes away.  But, this is a lengthy treatment and one that requires periodic revisiting. Therefore, it cannot be supported by our current mental health systems. If you can’t trick yourself into getting better, you will be discarded to the land of “it’s your fault”.

I am not sure where we proceed from here but I am finally ready and able to be the face of change if that is what is needed.

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