Tuesday, September 8, 2015

The Egg and I - Boundaries

As many of you know, I love to use analogies when I am talking about the various effects of exposure to trauma.  These analogies will pop up at odd times throughout my day when I am not thinking about my work and when I am occupied with something that doesn’t require a lot of thought.  This is just another example of how allowing your mind to rest can help it be more creative.
The other day I was peeling hard boiled eggs for salad and I started thinking about boundaries.  Sometimes I take the egg and lightly tap it against the counter and a small break will occur where I can start peeling away the shell.  Other times I may be in a bit of a mood and I strike it harder against the side of the sink, resulting in a larger break in the shell and the pieces falling off faster.  If the egg is fresh it may be more difficult to peel but there may be more damage to the egg white as pieces of it come off with the shell.
When the egg shell is removed from the egg, the egg becomes vulnerable and we are able to do anything we want with it.  
When a child’s boundaries are broken much care needs to be taken to ensure that the crack does not result in larger pieces of the boundary being removed.  Protective factors such as family support, education, and encouragement of developmentally appropriate physically and emotionally healthy activities can help keep further exposure from happening, increasing the resilience of the child and limiting future vulnerability. 
Many adults with whom we work have had a lot of damage to their boundaries.  I have worked with women who have had so many personal attacks against them starting at an early age that they have forgotten or have never known that that they can have boundaries.  They have been exposed for so long without protection that they no longer believe that boundaries exist for them. For some of them, the idea of personal boundaries may be an alien concept or they may be fearful of setting boundaries because when they do so someone comes along and tries to break their shell again.
We don’t know what has happened to someone when we first meet them.  We don’t know if their shell was removed all at once, in large chunks, or they just have a few cracks.  However, we find out soon enough that they struggle with maintaining boundaries and they may need our support.  We can help them find the resources and strength they need to further protect themselves.  This includes modeling appropriate boundaries and respecting their boundaries.
Unlike the eggs I use for salad, with the appropriate support and building up of community and protective factors, someone who has had their boundaries damaged can rebuild their life. 

Monday, August 31, 2015

Boundaries and the Art of Compassionate Detachment

As I work with advocates I often find that many of them struggle with maintaining healthy boundaries with the survivors with whom they work on a daily basis.  It is so hard to listen to the stories of abuse and see the effects of trauma without ending up giving a little bit more of ourselves until we are eventually drained and feeling our own loss of hope.  There is also a tendency, at times, to enter into special relationships with people with whom we feel a connection.  This may feel like friendship to someone who hasn't many friends or like parenting to someone who feels the need to connect with a motherly figure. It feels good in the short term, but can eventually lead to hurt feelings and a break in the relationship.

We talk about establishing healthy boundaries in our world.  Sometimes this can feel like we are cutting ourselves off from people in order to preserve the advocate/survivor relationship.  However, we can also lend ourselves to the idea of "compassionate detachment."  This allows us to still be caring but we separate ourselves from the outcome of the relationship.  We remember that the person's growth is a process to which we are caring witnesses.  We witness their emerging  power rather than impose our own will and desires.  We also are compassionate with our selves by letting go of the outcome.

Here are a few good articles I found on compassionate detachment that I hope you will find helpful.




Thursday, July 16, 2015

Defining Success: Why We May Feel We Are Working Harder Than the Survivor

I have to admit it.  There have been times in my life as a direct service provider that I have said “if I am working harder than my client, there is something wrong.”  What I am realizing now, though, is that the fault was not with my client.  It had to do with my expectations and the fact that I was focusing on my goals for her, rather than letting her define what success meant.  Even if we had come to an agreement on the goals, there is a good chance that the client was submitting to what I was promoting.  Survivors are very skillful at deferring to others in order to feel safe in a relationship in which they perceive the counselor/shelter manager/advocate may have “power over” or access to things that the survivor needs. 
In a study by the Full Frame Initiative in California, available here http://fullframeinitiative.org/how-do-survivors-define-success-report-recommendations/ it is noted that too often we define success based on our own expectations or the those of our funders and we forget to ask survivors how they define success for themselves.  We can get so caught up in promoting an end to the abusive relationship, permanent housing, employment, parenting skills, etc., that we end up creating a menu of goals for survivors to choose from rather than sitting down and really delving into what is meaningful for the person.  The above mentioned study found that a change in the abusive relationship was considered success by only 7% of the persons who participated in the study.  In fact, “across all survivor responses, they most often credited themselves, family members, and God/faith as the top enablers of moments of success, as well as the top supports for coping in between.” “This is not a wholesale dismissal by survivors of the importance of services, but a reflection of the place that services and professional relationships hold in achieving personal success.. . . clearly services and formal supports help survivors take steps towards that ‘authentic self’ but they are not the only or even most important factor.”
We work very hard to be empowering in our work with survivors and feel that the support and services we provide are a way to do so.  However, we forget that empowerment can be brought forth in a person through strong connections in the community.  Isolation, a tool of the abuser, may have limited connections and through new connections the survivor may be able to find herself and be engaged in ways that are more meaningful than those we can provide in our structure and limitations.  We also know that in our best efforts to provide support through empowerment we still are trying to help survivors navigate systems that are less than empowering and are often abusive.  This can lead to stalling and disengagement if survivors feel this is all we have to offer. 
The Full Frame Initiative study recommends that “programs do ‘success planning’ in addition to “safety planning” based on survivors’ idea of success. Practitioners should learn to ask about what successful relationships and opportunities survivors do have.”  We can also provide more opportunities for success in non-traditional support groups or by increasing engagement within the community.  These will provide those “moments of being connected” and “belonging to something bigger than me”, and “accomplishment and opportunity” that survivors seek. 

The full report will give you recommendations for moving forward.

Thursday, June 25, 2015

The Origins of Addiction - from Dr. Vincent Felitti and the Adverse Childhood Study

In this film,  Dr Vincent Felitti, from Kaiser Permanente presents information from the ongoing 17,000 person Adverse Childhood Experiences (ACE) Study to challenge the conventional view that certain chemicals are intrinsically addicting.  He presents the evidence gathered in the ACE study to show that “addiction is not a disease, but is an unconsciously attempted response to minimize the effects of abnormal life experiences. Addiction can be seen as the unconscious, compulsive use of psychoactive materials in response to the stress of life experiences, typically dating back to childhood.”
Dr. Felitti discusses patients, including the woman who was the first person to draw his attention to the issue of using substances (in her case food), who are engaging in behaviors normally considered harmful in order to alleviate and protect from the pain of childhood experiences.  He primarily addresses food, alcohol, nicotine, methamphetamines and heroin addiction.  They are a few of the things that may be seen as public health problems but may often be “personal solutions to long-concealed adverse childhood experiences.  Describing bad habits as self-destructive behaviors hides their functionality in the life of a trauma survivor.”
As I think about how we try to address substance abuse, the heroin crisis, and human trafficking, I am drawn to the conclusion that we will fail in our attempts to resolve the crises until we begin to talk about the long held private conditions that lead to the public problems.  “These life experiences are very likely to be lost in time, and protected by shame, by secrecy, and by social taboos against exploring certain aspects of human experience.”  So many of us were raised in families and cultures where we did not discuss shameful family secrets.  As we grew up we were seen as the problem when the legacy of adverse childhood experiences presented as addictions and mental illness.
At this point in time treatment options are few and far between and minimally address the origins of the addiction.  By failing to address the adversity experience in childhood by so many people, we fail in our attempts to treat.  When treatment fails, we blame the person instead of recognizing that by “treating someone’s attempted solution, we may be threatening and causing flight from treatment” or forcing them to find another, possibly life-threatening, solution.
When these childhood experiences are named and validated as the source of long term difficulties in adolescence and adulthood we are removing the stigma and helping persons understand that it is not about having something wrong with them, but that something was done to them.  The next steps are to assist in finding healthier solutions and recognizing the strength and resiliency that helped them find solutions in the first place and survive in the midst of extremely adverse experiences. 

Monday, June 22, 2015

Mental Health and Substance Use Coercion Surveys Report from the National Center on DV, Trauma and Mental Health

The National Center on Domestic Violence Trauma and Mental Health has done a study on batterers' efforts to undermine victims' sanity and sobriety, to control their medication and treatment, or to sabotage their recovery and access to resources and support. This is considered to be another element of coercive control and can often lead to long term consequences for the victim.  Please read and disseminate the attached information to your local mental health and substance abuse agencies.


Tuesday, March 10, 2015

An Invitation to Re-consider “Failure to Protect”

I provide training to child welfare workers a few times a year about the impact of domestic violence on children and families.  During most of those sessions I heard a worker talk about a parent’s (always a mother’s) failure to protect her children from the domestic violence.  I usually try to re-direct the responsibility for the abuse back to the perpetrator, but workers seem to be at a loss as to how to address the issue and may look for other language that may still end up stigmatizing the non-offending parent and perpetuating the idea that child protection workers are adversaries.
I reviewed a few articles about failure to protect and have provided the links below.  However, I would like to take space here to paraphrase some of the important points and hope that you will take the time to read the articles in full.  I will not be addressing the issue of mothers as perpetrators and/or persons who are complicit in the child abuse.  Those areas definitely need to be addressed by the child welfare system.  I am just addressing the issue of blaming a non-offending parent for the actions of the offender.
When charging a mother with failure to protect, assumptions and stereotypes create a heightened duty on the part of the mother.  The assumption that women have a greater capacity for nurturing and therefore a heightened duty to protect produces a gender disparity between women and men.  Also, in some cases, when the woman is abused, the court and others may feel that this was sufficient to alert her to the batterer’s tendency to violence and leading her to leave him in order to protect her children.  This viewpoint on the part of the court or services may be in direct opposition to a cultural or religious belief in the keeping the family together at all costs.
In the past, Battered Woman Syndrome may have been used to explain failure to protect; however, BWS is now seen as reinforcing negative stereotypes about women’s passivity and weakness.  On the whole, though, the failure to protect seems to reflect a gender bias, and sometimes racial bias, that needs to be addressed.   
The three stereotypes that appear when someone is charged with failure to protect are:
1.       The All-Sacrificing Mother – in which the assumption is made that the mother can leave the abuser and that the threat of the charge will encourage her to act when she would not do so otherwise.  Workers or the court may not consider what steps she may have taken to leave or protect her family that did not work or if she has been blamed for any steps she did take by being told the actions were “inconsistent or ineffectual.”  The lack of shelter space and permanent housing, lack of financial or other support, little protection from the court system, and fear of the batterer may not be taken into consideration.
2.       The All-Knowing (and Blamed) Mother – mothers are assumed to be all knowing and face harsher scrutiny.  Women are expected to have a greater ability to discern the causes of bumps and bruises and be able to see through their partners’ lies than would a male non-offending parent. 
3.       The Nurturing Mother/Breadwinning Father – Often, in two parent household in which the mother works there appears to be a higher expectation that she be aware of any abuse to her children and more able to prevent it than for the working father. 
Given what we know about the control an abuser has over his victims and the fear a women may have of being involved in the system, we can see that when abuse is occurring in the home she is caught between a rock and a hard place.  Trauma victims will often resort to doing what is important for the moment and do their best to protect themselves and their children; however, these efforts may not be explained and/or considered enough by workers or by the judge if the case rises to that level.  We also know that women often feel conflicted when they know that their children love the offending parent and they may choose to stay because of that bond.  Also, a history of witnessing domestic violence in her own home as a child along with victimization as a child may result in difficulty in making productive decisions for her and her family.  There also may be other issues such as poverty, homelessness, substance abuse, and mental illness that contribute to a sense of powerlessness.
When asked what could be used instead of “failure to protect” in documenting these incidents, I responded by asking the worker to identify what community and societal barriers are in place that make it difficult for the mother to make the changes necessary and to be sure that the final “blame” for the abuse is placed firmly where it needs to be.  Is there adequate, affordable housing near her family supports, daycare, and place of employment?  Is there shelter space for her and her children?  Is there a protective order in place and, if so, is it being enforced?   Is the offender being held responsible for his actions?  If the offender is the father, have protections been put in place for visitation?  If the offender violates the protective order and is back in the home, is this due to coercion on his part or need for financial assistance on her part? Is there a definite pattern of power and coercive control?  When a report needs to be filed, can another reason be used rather than “failure to protect”, such as drug exposure or medical neglect? 
According to an advocate, “if a mom is filed on for ‘failure to protect’ from domestic violence it will be very difficult for her to change that behavior or break out of the cycle of violence given the powerless over the actions of the perpetrator. If a mom is filed on for exposure to substance or anything else, those become goals she will more likely agree upon and will be more likely to constructively work towards.” 
When a situation rises to the attention of child welfare, I am strongly aware of the mandate to ensure children are protected from further harm.  Social workers are dedicated individuals who are burdened by this heavy responsibility.  By recognizing that the “failure to protect” allegation against victims may further harm, stigmatize and create resistance, workers can find other ways to partner with non-offending mothers in creating safe lives for their children. 

 Chickens at a local NH shelter. They provide fresh eggs and the children love them!

Thursday, February 5, 2015

The Four Agreements for Advocates

Back in 1997 a book written by Don Miguel Ruiz was published that one would normally pass by as another piece of pop psychology written by a supposed Toltec to litter the “self-help” section of bookstores for a short period of time.  It would then disappear into the dusty back room of used book stores.  However, the wisdom between its pages was so simple and yet so profound that it continues to endure and influence lives eighteen years later.  Whatever the origins of the wisdom, it is hard to dispute the value of applying the Four Agreements in one’s personal and professional life.  I am going to attempt to take these agreements and apply them to the work that we do as advocates for domestic and sexual assault victims.
The Four Agreements are:
Be impeccable with your word;
Don’t take anything personally;
Don’t make assumptions; and
Always do your best.

The 1st Agreement:  Be impeccable with your word
Ruiz defines the word impeccability as meaning “’without sin.  And sin is anything that you do which goes against yourself.  You go against yourself when you judge or blame yourself for anything.  When you are impeccable, you take responsibility for your actions, but you do not judge or blame yourself.”  In addition we don’t use our words against others in the same way.  Criticizing, blaming, or gossiping about the people with whom we work (other advocates and/or survivors) is not honoring the agreement to be impeccable. 
Honoring our commitments is also considered to be a part of being impeccable in our word.  When we make a commitment to a survivor or a co-worker we must make sure that we are able to follow through on that commitment.  We should not make promises we can’t keep.  It is more honorable to say “no” that to make a promise that we eventually will have to break.  It is important that we be aware of our limitations and the scope of our services so that we do not make empty promises. 
The 2nd Agreement: Don’t take anything personally
This seems to be one of the most difficult agreements for advocates, especially when they feel they are doing everything they can for someone and then the person becomes angry and seemingly ungrateful for what has been done for them.  Don Miguel Ruiz puts it very succinctly, “Nothing other people do is because of you.  It is because of them.”  So when someone is angry at you or if someone is talking bad about your agency recognize that it has more to do with them and how they are feeling than it does to do with you.  Especially if you have been keeping the 1st agreement!  The agreements build on each other. 
The other side of this is that even when someone is saying wonderful things about you and telling you that you are the best advocate in the whole world and they could never have done it without you – well, don’t take it personally.  It is still about them and how they feel about themselves.  They feel great and the whole world feels wonderful.  Just reflect back to them what an awesome job they did and let it go.  We don’t need to fill our heads with a scrapbook of all the good things that people said about us.  It is about them. 
The 3rd Agreement: Don’t make assumptions (or if you do, assume everyone is following the 4th Agreement!)
Ruiz says “the way to keep yourself from making assumptions is to ask questions.  Make sure communication is clear.  If you don’t understand, ask.  Have the courage to ask questions until you are as clear as you can be.”  Often I find advocates making assumptions about how institutions should respond to domestic violence and how survivors should be responding to their circumstances.  This creates more drama and angst.  By asking questions of other service providers we can find out what their limitations are and maybe open communication enough to be able to find out what can be done within their system or create a relationship in which change can be created.  Assumptions build walls of misunderstanding.  By communicating we can tear down those walls.
When we work with survivors we often make assumptions about how they are feeling or what they are doing based on how we would feel or what we would do.  By asking questions we learn more, we find out with what barriers they are fighting, and we learn more about their inner strengths and capabilities.  We become more victim-center when we do not make assumptions.
The 4th Agreement: Always do your best
Doing our best is what maintains our commitment to the first three agreements and keeps us focused.  Don Miguel Ruiz states:  Under any circumstance, always do your best, no more and no less.  But keep in mind that your best is never going to be the same from one moment to the next (italics mine).  Everything is alive and change all the time, so your best will sometimes be high quality, and other times it will not be as good.”  As I said above, it if we are going to assume anything about someone else, it is that they are also doing their best.
The level of our best is going to rely on self-care.  If we don’t take care of ourselves our best will not be very good and our ability to follow any of these agreements will be less than optimal.  When we find ourselves unable to follow through on our commitments, gossiping or blaming, taking things personally, or making assumptions, there is a good chance that our personal well of compassion has run dry because we haven’t maintained good positive self-care.  And, on the other hand, following the Four Agreements is a means of self-care that doesn’t require taking a day off or backing off on commitments.  Once we stop and take a breath, focus back on where we may not be keeping the agreements, we can then move forward with integrity and focus on victim-centered services.