Let’s face it. Everyone once is a while we work with a survivor who manages to pushes our buttons, argues every point, doesn’t show up on time or at all and accuses you of not helping her, has burned bridges at a few agencies in town, and has not always told you the truth. Sometimes before, after or during the time you are with her you get this little feeling in your gut that you are being used, manipulated or just plain jerked around and you confide to a co-worker that you really dread going to court with this person. You may even use the label “borderline” when describing the person. All of this ends up making you feel like a horrible advocate and you start to wonder whether or not it is time to get that job in the florist shop (You know the job I am talking about – the person in the back who gets to make all the arrangements but doesn’t have to relate with the public at all. Yes, that job. The job that is all peaceful and pretty without all the drama and hair pulling.) .
The first thing I want to let you know is that no matter how bad it gets, it helps to remember that it is harder to be her than it is to work with her and all of the emotion and drama that you see on the outside is just a small percentage of what is happening inside her head. Most of that chaos can be explained by understanding how she has developed skills and behaviors in response to trauma and that the trauma may be more complex than she has been willing or able to divulge to you or anyone else.
Before I break this down into the top complaints that advocates, mental health and substance abuse clinicians, and case managers have had over the years and provide an explanation as to why the action may be occurring let me give you a brief review of what trauma does to the brain.
When the brain experiences a traumatic event the “doing” center of the brain, the amygdale, is activated into fight, flight or freeze mode. The pre-frontal cortex or frontal lobe, the “thinking center” assesses the danger and will tell the “doing” center to back down and resume normal activity. However, after many traumatic incidents (complex trauma) the “thinking” area of the brain will stop assessing, assumes the person is always under attack, and will not stop the “doing” center from going into fight, flight or freeze. Therefore, the person is in a heightened state of anxiety and hyper vigilance most of the time and develops strategies to manage that state that would seem foreign and/or maladaptive to the rest of us.
Keeping that information in mind, let’s take a look at some of the things that we often see as barriers to working with a person.
1. Not showing up, showing up late, or canceling at the last minute.
There are a couple of reasons related to trauma that this may happen on an ongoing basis. First of all, if a person has been subject to complex trauma over the course of his/her life, it is highly likely that the focus has been on personal safety and survival rather than learning skills that we often take for granted, such as keeping calendars or managing multiple appointments. We often assume that the person we are working with has the skills necessary to follow through when they may not. Their skills have to do with how to survive a potential threat, not making an appointment.
Secondly, meeting with a provider of services can be a trigger. If the reason the person is meeting with you is somehow related to a traumatic experience, then the thought of the appointment can be a reminder of the event and increase her anxiety. Other triggers could be present. She may have to drive or walk near a place an incident occurred. She may be in danger of seeing his perpetrator in the neighborhood near your office. She may not even be aware of the trigger, she just knows that meeting with you is very anxiety provoking and the appointment becomes something to be avoided. In addition, not being able to articulate why this is happening is probably why you do not receive the call. Avoidance of triggers is a survival skill.
2. Lying, telling half-truths, withholding information
The more I learn about the trauma done by perpetrators, the effects of trauma on the lives of survivors and how they are often re-victimized by bureaucratic systems and overworked, burned out staff, the more I realize that lying and withholding information is a learned skill that comes of out of self protection. If my safety depended on my ability to tell a good lie, I would become a great liar. If my basics needs and my children’s lives were dependent upon my withholding some information about my substance abuse or the whereabouts of my abuser, then I would withhold that information. If my perpetrator told me that if I told anyone about what happened then I or someone I love would be harmed, I would not tell.
Where we, as advocates, become frustrated is when we know that we are here to help and that we do not necessarily present a threat to the person and she continues to lie. Remember, in order to remain safe she has had to stop “thinking” about whether or not telling the truth is an option. She remains in “doing” mode and her survival skill is lying.
3. Accuses you of not helping.
After years of complex trauma, the survivor continues to live in survival mode. She is not able to process whether today is much better than yesterday. She wants things better now and she also doesn’t believe it will ever happen. She has been promised change by her abuser, her caretakers (often the same people), and other agencies and providers. After all of this, things are not getting better. She is still in pain. She is still frightened, hyper vigilant, and struggling to live in a world in which she does not feel safe. She feels that she has no reason to trust you or anyone else and she doesn’t trust life when it does seem to be improving.
Getting help, feeling better, making positive changes and living a new life can be terrifying to a trauma survivor who has lost a lot. The further she moves toward goals the more anxious and frightened she may become, because now she has more to lose. Safety in home, body and relationships is not something to be trusted in the mind of some trauma survivors. This takes time and an ongoing atmosphere of safety and trust in relationships.
Keeping you at a distance and not trusting you to help are survival skills.
So what do we do when working with survivors who are very committed to using their survival skills? We remember that trauma occurred in relationships and that recovery will need to take place in relationships. We can’t expect the survivor to manage recovery all on her own and we cannot take her use of survival skills personally – even when she accuses us of being the problem. Not taking it personally does not mean that we do not use appropriate boundaries to keep from being abused by the survivor. This is our opportunity to model setting boundaries, maintaining equanimity, use our basic advocacy skills, and letting the person know that we understand why they are in survival mode. We may not see immediate change in the person’s behavior, but we may find ourselves responding in ways that cause us less distress and the survivor may find herself following our lead. And, hopefully, we can put off that flower shop job a little longer.
