Monday, September 12, 2011

Poverty and Trauma - A Paper by Jennifer Frechette, Skidmore College

Dr. Ruby Payne states that the definition of poverty is “the extent to which an individual does without resources.” Payne (2005) states that the resources needed include financial, emotional, spiritual, physical, social support systems, and relationship resources, as well as the knowledge of unspoken social norms (p. 7). Without these, Payne states, people are at higher risk of becoming impoverished and homeless. If these resources and supports are in place the individual is more likely to find stability in others and therefore have support in times of need.


According to the National Child Traumatic Stress Network (NCTSN), homelessness results from severe poverty, the inability to find housing that is affordable, single parenthood, and lack of social supports (2005, p. 1). Those who experience homelessness have an increased susceptibility to trauma, loss of community, family, and security. Families who live in shelters are confronted by many problems such as “the need to reestablish a home, interpersonal difficulties, mental and physical problems” (NCTSN, 2005, p. 1). Homelessness makes families more likely to experience various traumas including physical and sexual assault as well as increased anxiety due to feelings of being overwhelmed and hyper vigilance pertaining to maintaining personal safety (NCTSN, 2005, p. 1). Payne (1996) outlines important things to know about poverty. Firstly, poverty is relative; meaning that it depends on your surroundings and community. Second, poverty occurs everywhere in the world. Third, economic class is ever changing. Fourth, there are different types of poverty, those being generational and situational. Generational, as defined by Payne, is “being in poverty for two generations or longer” whereas situational poverty is caused by circumstances and generally lasts a shorter amount of time. Fifth, society as a whole operates under middle class norms and finally, Payne states that in order to move from “poverty to middle class or middle class to wealth, an individual must give up relationships for achievement.”

The NCTSN ( 2005) states that children bear the most trauma from homelessness stating that homeless children get sick “ twice the rate of other children” and that they “suffer twice as many ear infections, have four times the rate of asthma, and have five times more diarrhea and stomach problems” ( p. 2) . Among these statistics homeless children go hungry twice as often as non-homeless children and are twice as more likely to have difficulty completing each grade of school, as well as are more likely to have difficulties emotionally and behaviorally in school (NCTSN, 2005, p. 2). The NCTSN (2005) states that, “half of school-age homeless children experience anxiety, depression, or withdrawal” (p. 2).

It is important for children in poverty to receive assistance from those around them, including shelter staff. But what is essential is that those that choose to support homeless families provide a safe environment which includes positive role models, positive social interaction, and equality. The NCTSN (2005) states that

By making families co-participants in establishing rules and regulations, and by housing caregivers and children together, programs can help prevent re-traumatization. Programs can also empower families by maximizing their choice and control, thereby ensuring that they constructively use services to attain personal stability and heal emotional hurt (p. 2).

Shelters are the primary safe zone for homeless families in the United States. Many shelters work closely with community health agencies as trauma specific care givers to homeless families (NCTSN, 2005, p. 2). It is important to restore stability, assess trauma within the family, and create a safe net to understand and address the trauma between family members in order to best address and assist each individual family members needs. NCTSN (2005) states that it is important to train shelter staff to understand the link of homelessness and traumatic experience by “promoting wider awareness of the role of trauma in precipitating and extending family homelessness” (p. 2). Collins et al (2010) cite Figley (1988) state that,

"Trauma can impact the family system through several distinct pathways: simultaneous exposure when all members of the family are exposed to the same event; vicarious traumatization or contagion of trauma from an exposed family member to others in the family; intrafamilial trauma when one family member is the perpetrator of the trauma; and secondary stress when traumatic distress symptoms disrupt family functioning (30).Balancing these various pathways for and of trauma can many times distance supports from the
purpose of working with family members who have been exposed to traumatic experiences. Validating each individual in the family’s experience with trauma while balancing the family’s impact or possible perpetration of that event can be difficult. However, what is important to keep in mind is that each family member has a right to be heard and each one is likely to have experienced victimization at some time or another. Balancing the various traumatizations and homelessness of families can be cumbersome; however, there are multiple other factors that play a key role in family functioning. "

Families living in poverty are at risk of facing a number of stressors including conflict within family, violence, various abuses, and neglect from society and are vulnerable to homelessness, financial disparity, and substance abuse (Collins, K., Connors, K., Davis, S., Donohue, A., Gardner, S., Goldblatt, E., Hayward, A., Kiser, L., Strieder, F.& Thompson, E. , 2010, p. 30). Putnam and Tricett (1993), as cited in Collins (2010) state that there is a concern, among impoverished, about physical safety which is found among multiple generations (p. 30).

Psychological trauma is likely among the homeless for three reasons, (1) The sudden or gradual loss of one's home, (2) the conditions in a shelter and (3) the occurrence of past sexual or physical abuse history previous to homelessness (Goodman, Saxe, and Harvey,1991, p. 1219). Goodman et al( 1991) state that learned helplessness is a potential effect of homelessness that can be prevented by creating an empowering environment around post trauma living and a rebuilding of expectations and norms within the individuals social constructs (p. 1219).

The event of losing one’s home is traumatic enough. What accompanies loss of home is loss of neighbors, community, and places the family that is in this transition in a state of perpetual stress. Goodman et al (1991) cite Shinn, Knickman, & Weitzman (1989, 1991) and Sosin, Pihavin, & Westerfelt (1991), as stating that the transition from being housed to being homeless lasts days, weeks, months, or even longer. Most people living on the street or in shelters have already spent time living with friends or relatives and may have experienced previous episodes of homelessness (p. 1219).

Collins et al ( 2010) cite Wethington et al (2008) as stating that “Although exposure to the social ecology of urban poverty carries significant risk, most children continue to function well and do not develop PTSD” (p. 13). Through supportive relationships with family and friends, these children learn and use coping and problem-solving skills that encourage positive adaptation. Problem solving, coping skills, trauma history, intelligence, supports, poor attachments, and gender of the child are some of the risks and protective factors that children living in poverty can either benefit from or limit children’s ability to adapt and grow (Collins et al, 2010, p. 13) .

Children are the most susceptible to traumatic experience and this susceptibility only increases when they are faced with displacement of home. Goodman et al (1991) state that those that are homeless experience trauma from the process of being homeless but also are traumatized by lack of safety and loss of control in the shelter system (p. 1219) . For many children, stability means going to school each day where their friends are and going home at the end of the day to their family to their bedroom and their space.

One of the most traumatizing experiences that the homeless have is that of leaving the societal norm of what is considered normal for housing and entering into something that is viewed as less than desirable by society. (Goodman et al, 1991, p. 1220). Bowlby ( 1969, 1973) as cited in Goodman et al (1991) states that humans need intimate and long lasting attachments and for homeless children the loss of safety and autonomy makes creating secure emotional attachments difficult (p. 1220). Van der Kolk( 1987) as cited in Goodman et al ( 1991) proposes that “psychological trauma is the perceived severance of secure affiliative bonds, which damages the psychological sense of trust, safety, and security” (p. 1220). Trauma victims that are placed in an unknown and perceivably unsafe living situation often exacerbate their trauma and this often causes distrust and isolation from the social supports of the traumatized, homeless victim ( Goodman et al, 1991, p. 1220). Goodman et al (1991) state that homeless individuals who are able to enter into shelters in their own communities are better off because they can maintain already established connections; otherwise, those made to move out of their neighborhoods many times experience difficulty maintaining ties to that community. Goodman et al (1991) states that, “Physical distance may engender a sense of psychological distance that increases the sense of isolation. Shelter providers should encourage and help homeless residents maintain social networks, thereby building on strengths rather than focusing on deficits” (p. 1222).

By becoming homeless, the individual can often no longer continue their normal routine or functioning extending to work, friends, and otherwise. They lose control over their personal space and their needs which they are forced to rely on others for. Goodman, Saxe, and Harvey (1991) state that the homeless, “may depend on help from others to fulfill their most basic needs, such as eating, sleeping, keeping clean, guarding personal belongings, and caring for children” (1221) . Many shelters separate families, women and children go into one shelter and men in another making what is a stressful situation even worse by further fragmenting families and taking away natural supports put in place within the family as well as removing a potential “safe person” for each individual in the family.

The victimization experienced by homeless women in New York City ranged from 43% being raped by a member of their family, 74% reporting physical abuse, and 25% were robbed (D'Ercole & Struening, 1990 as cited in Goodman et al, 1991, p. 1222). Bassuk and Rosenberg (1988) compared homeless and housed mothers in Boston and found 41% of homeless compared to 5% of housed experienced physical abuse during childhood, and 41% of homeless and 20% of housed had experienced intimate partner violence in their adult lives (Goodman et al, 1991, p. 1222). Collins et al (2010) found in a national study that “50% to 90% of adults in the United States have experienced one or more traumatic events; and 10% to 20% of those exposed will develop all of the symptoms necessary to establish a diagnosis of PTSD” ( p. 21) . Wilson( 2005) cited Newmann and Sallman’s ( 2004) finding that women who experience child abuse are at much higher risk to develop disorders such as anxiety, and substance abuse than women who did not experience child abuse. It was also found that women who experienced sexual abuse as a child ran a higher risk of developing mental health problems such as depression, anxiety, posttraumatic stress disorder among others.

Many of us, when thinking about the poor, automatically turn to third world countries; however, the statistics regarding American children are astounding. According to Collins et al (2010), “49% of American children in urban areas live in low-income families” and that “Families constitute two-fifths of the U.S. homeless population.” (p. 4). 83% of inner city teens have experienced at least one traumatic even and that in that same population, 59%- 92% who are involved in the mental health system report traumatic experiences and urban females are four times more likely to develop severe traumatic stress (Collins et al, 2010, p. 4).

In order to assist those traumatized by and in the homeless and poor communities it is important to keep in mind the family system and structure as a whole. What is important, is treating the family as a whole while recognizing past, present, and future traumas as a whole as well as the various trauma modes experienced by each individual and how that impacted each individual in the collective. Evans & English (2002) and Esposito ( 1999) as cited in Collins et al (2010) state that “There are few well-developed, standardized and empirically supported family therapies for treating family systems impacted by trauma” ( p. 2), meaning those treating family systems in impoverished communities face even a more difficult time finding a successful treatment regime. It is important to understand the effects of trauma and poverty on different family members and among familial relationships, as well as understanding the full range of family members’ responses to trauma and poverty, is critical to improving outcomes.

Collins et al (2010) states that the traumatic context of urban poverty has pervasive effects that slowly erode parent and family function and affect outcomes. Contextual risks of urban poverty (meager resources, crowded conditions, trauma, etc.) affect everyone exposed, but effects on children are exaggerated by reduced parental well-being and family functioning (p. 6).

Understanding the risks of poverty and supporting families, children and parents alike, is essential for actions by parents on children’s problem behaviors (Collins et al, 2010, p. 6).

Goodman et al (1991) states that by viewing homelessness as a psychologically traumatic experience has a number of implications for psychologists and other mental health practitioners. Given that the presence and severity of psychological trauma depends in large part on community response to victims and the overall environment in which they function (see, e.g., Green et al., 1985), improving the psychosocial conditions of shelter life could mitigate or even prevent the development or exacerbation of psychological trauma (p. 1222).

Homelessness in of itself is traumatic. The relief that supports in shelters and social services can provide victims of homelessness is insurmountable.

Homeless children and families experience trauma by virtue of losing their home, community, and stability. Homeless and impoverished people are more likely to experience other forms of trauma as well, such as physical and sexual abuse. What the homeless and impoverished need is support in finding stable employment and housing as well as assistance in addressing their past traumatic experiences. What can assist with decreasing trauma caused by homelessness is support from the surrounding communities and a willingness from society to accept poverty as a reality while breaking down barriers caused by economic status. These actions need to be taken to fully address the trauma the homeless and impoverished experience daily in the United States.


Works Cited:
Collins, K., Connors, K., Davis, S., Donohue, A., Gardner, S., Goldblatt, E., Hayward,

A., Kiser, L., Strieder, F. Thompson, E. (2010). Understanding the impact of trauma and urban poverty on family systems: Risks, resilience, and interventions. Baltimore, MD: Family Informed Trauma Treatment Center.

http://nctsn.org/nccts/nav.do?pid=ctr_rsch_prod_ar or

http://fittcenter.umaryland.edu/WhitePaper.aspx

Goodman, L., Saxe, L., & Harvey, M. ( 1991). Homelessness as psychological trauma: Broadening perspectives. American Psychologist, 46( 11), 1219- 1225.

National Child Traumatic Stress Network: Homelessness and Extreme Poverty Working Group

( 2005) . Facts on trauma and homeless children . www. NCTSNET. org.

Payne, R.K. (1996). Understanding and working with students and adults from poverty. Instructional Leader 4(2).

Payne, R.K. (2005). A framework for understanding poverty.Highlands, Tx : AHA! Process inc.

Wilson, D. ( 2005). Poverty and child welfare: Understanding the connection. Northwest Institute for Children and Familes.