I am often asked about how to help a survivor manage their
mental health issues. The advocate is
usually feeling that the “symptoms” are possibly unrelated to domestic violence
or sexual assault and the advocate does not feel qualified to address what is
happening.
Yes, there may be instances, such as when a survivor is
suicidal or psychotic when an immediate mental health intervention is
necessary. However, the skills that
advocates have can be used to help reduce the reactions a person may be having because
she does not feel safe in her environment or her body.
Being trauma-informed includes having the understanding that
the behaviors that an advocate sees may be directly or indirectly related to
the trauma the person has experienced over their lifetime. These behaviors can range from anxiety to
depression, anger to paranoia. What is
important to remember is that what the person probably wants more than anything
is to feel safe even when they are yelling at you, refusing to get out of bed,
or having difficulty making a decision.
We don’t even have to know what caused the behavior. We can just start the conversation with “what
would help you to feel safe at this moment?” and work from there.
Here are a couple of examples:
A woman is having difficulty going to social services to
fill out paperwork. She gets angry when
she is reminded that she needs to do this and she starts avoiding staff rather
than following through with the plan.
When sitting with an advocate she may become agitated when she feels the
conversation moving toward talking about taking the trip to social services.
The advocate can either remind her that it is necessary that
she do this and if she does not follow through she will be reprimanded or the
advocate can ask the following questions:
1.
Is there something
about the social services office that is stressful for you?
2.
Do you feel safe going to and from the office?
3.
Is there any additional assistance that you need
in order to fill out the paperwork? (She
may not feel safe talking about literacy issues and asking for help.)
4.
Do you feel like you aren’t ready to take this
step? (She may be considering returning
to her abuser and is afraid to talk to you about it.)
5.
Would you like to do a safety plan around making
the trip or do you need a volunteer or staff to accompany you?
There are a number of reasons why she may not be taking the
trip to social services but more than likely she does not feel physically or
emotionally safe doing so. She may also
be fearful that failure to follow through may mean not being able to receive
further services from your program.
A survivor is placed in a hotel room for a few nights due to
lack of shelter beds. She is taken to a
local grocery for some food that can be kept in the hotel room
refrigerator. However, she keeps calling
the crisis line and staff asking for someone to take her out for a hot meal or
more groceries. Some staff may feel
inconvenienced or that the person is trying to get as much free food as
possible. However, the person may be
using the frequent calls to staff as a way to touch base with another
person. Hotel rooms can be lonely and
the person may be afraid to ask to have her needs met. She may also need to talk about how she feels
about leaving her partner, may not feel safe with her emotions or be fearful of
being seen. It all comes down to wanting
to feel safe but not knowing how to ask for it. In many survivors’ lives,
asking to get needs met put them at risk of harm.
Even events of extreme paranoia or delusion can be calmed by
helping the person find a way to feel safe.
If someone is feeling they are
being watched or that a tracking device has been put on their clothing, it helps
to ask a few more questions including “what can I do to help you feel safe?” It may mean making a couple of changes to the
environment in order to help the person feel heard and safer. More than likely the paranoia and delusion
can be traced to some recent or long ago trauma but it is usually evident that
the person is not feeling safe in their body or environment.
Start with what you know and domestic violence and sexual
assault advocates know about talking about safety.
