Insidious Traumatization – How Recent Events are a Call to Self Care

Over the past months we have been exposed to a large amount of hate speech.  We have also seen a number of reports of poor to dismal responses to sexual assault and domestic violence.  I won’t go into those in detail.  They fill our inboxes, Facebook feeds, newspapers, and news channels.  The images fill our brains or we create our own images based on the details we are given.  We become angry at the way people do not seem to take the allegations seriously and how systems and persons continue to find ways to re-victimize.  We lose hope in our ability to make and sustain change.  We are reminded of our own victimization(s) and we start to feel helpless and hopeless.

Our response to the ongoing exposure to the victimization of others is the result of insidious trauma, often called “micro-aggressions.”  According to Laura S. Brown in her book, Cultural Competence in Trauma Therapy, “in the lives of many individuals who are members of target groups, daily existence is replete with reminders of the potential for traumatization and the absence of safety.”  These micro-aggressions can often seem fairly benign such as when a group is ridiculed in a public way or when one’s group is betrayed in a stereotypical way.  However, when a person is targeted in a violent way through hate speech, threats, invalidation of or disbelief in their experience and this is made public the impact on other members of the group can be significant. 

Laura Brown goes on to quote Root (1992) as arguing that “when a person is subjected to insidious traumatization, that individual experiences a gradual and often imperceptible erosion of the psyche.  A useful metaphor is that of very small drops of acid falling on a stone.  Each drop by itself does little damage and may in fact etch the stone in such a way as to make it more beautiful.  Thus, in some ways the experience of daily micro-aggression may evoke resilient coping responses (as when we find positive strategies to address the ongoing violence against the groups of which we are members).  Yet each drop of emotional acid creates just enough damage to render the next drop more damaging.  Over time a fissure develops in the form of an emotional vulnerability that is invisible so long as certain aspects of the biopsychosocial and spiritual environment remain steady or supportive.” (italics mine)

This insidious trauma can create conditions in us similar to those to whom the significant aggressions are directly applied.  When it is combined with the effects of previous trauma that we have experienced and are now re-living it damages the psyche and makes us weary. 

Our only hope is to surround ourselves with others who understand what this type of trauma can do to a person and find ways to care and nurture each other as we continue to face the onslaught of further violence against groups to which we belong or have a strong affinity.  We may, at times, need to take a break in order to be able to come back in support of victims, but it is by filling our cup that we are able to have enough to help others. 

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 1^st 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 2^nd 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 1^st 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 3^rd Agreement: Don’t make assumptions (or if you do, assume everyone is following the 4^th 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 4^th 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.

Take a Breath

I was reading a book about trekking through the Himalayas last week.  As part of my self-care I like to make sure that I read things that don’t pertain to anything I do as part of my work life.  However, there were a few paragraphs that jumped out as me as being very important for advocates and survivors. 

The writer was describing how difficult it is to hike at high altitudes.  The oxygen is thin at those altitudes and the effort of climbing over rocks with a heavy backpack can make one feel that she just won’t be able to make it to the next hospitality stop.  The views can also take one’s breath away.  The writer went on to describe a trick that high altitude trekkers use when the going gets tough.  They breathe.  They take ten steps and stop to take ten very deep breaths and then take ten more steps and repeat.  It may feel like slow going but at the end of the day the goal is reached.

I tried it out.  I was biking in unfamiliar territory one day.  I had mapped the route ahead of time but had not paid attention to the fact that there was a half mile stretch that was uphill on a gravel road.  I decided I would need to walk it.  Normally I would force myself to just trudge up the hill and stop when I was out of breath and probably in pain.  I would be red-faced, sweating, and gasping for air.  However, on that day I decided to try the breathing technique they use in the Himalayas.  It was just a New Hampshire hill and not K2 so I modified the technique a little.  I counted fifty steps and then stopped to take ten deep cleansing breaths whether I felt I needed the or not.  I found that not only did I make it to the top of the hill without gasping for air but that I felt pretty good when it was all done.  At the time I was stopping to breath I thought it was just slowing me down, but then I realized that by taking the time to stop and breath I was less likely to need a longer rest period once I reached the top. 

I talked to two different groups of advocates last week and I asked them why they felt they couldn’t do self-care.  The number one reason was “I don’t have time.”  Many felt that they were too exhausted at the end of the day to do anything and some felt that it would be selfish to take time away from family members in order to take care of themselves. 

Advocates often feel like they are trying to climb mountains.  There are obstacles and demands on energy that can make one feel like she will never reach the goal.  When we are under stress we actually do not breathe as well.  Our breaths can become shallow and we take in less oxygen, causing us to tire more quickly and lose the ability to focus.   If mindful  breathing can be a part of your  day it may help to dispel some of the exhaustion that can go along with doing this work.  Take a breath before you pick up the phone.  Take a few breaths before you open a door, as you shift between tasks, or before you get out of your car.  Find some way to remind yourself to do so.  There are plenty of apps on the market or there is even a bracelet you can buy that vibrates to remind you to take a moment to breath.  This blogger has a number of techniques she uses to remind herself to take a break:  http://healingwhole.blogspot.com/2011/05/take-break-create-mindfulness-reminders.html

Remember, though, self care is as important to being able to do your job as it is to have nice clothes to wear to court or have gas in your car to get there.  Find ways to incorporate it into your day or you may find yourself clinging to the side of the mountain.  

The pictures in this post were taken in Tibet in 2007.  Mount Everest is over my left shoulder in the above picture.  

Why Is Self-Care So Hard?

I was talking to another advocate the other day about the importance of self-care and came to a few realizations.    Those of us working in domestic violence and sexual assault field are impacted every day by the stories that we hear and we need to have downtime in order to recover from the effects of vicarious trauma.  But many of us seldom take the time.  When asked “why not?” many will just shrug their shoulders and say “I don’t have the time.”  I think that for many people it really goes deeper than that.  I think that if a person asks herself why she can’t find the time, the answer reflects more about the person’s regard for herself than it does time constraints. 

1.        “I am not important enough.”  This reflects an attitude that the advocate feels that the problems of others are more important than her own and that she just needs to buck up and not impose on others in order to take care of herself.  She doesn’t see herself as having any value.  The important thing to remember is that if you don’t take care of yourself, you can’t take care of anyone else. 

2.       Imposter syndrome – This has been written about in different places.  It basically is the innate belief a person has that she is hiding her basic unworthiness from the world and that it is only time before every one finds out what a fraud she is.  Staying busy and refraining from self-care is a way of proving one’s value to the world and/or keeping people from finding out the secret.

3.       The depression that comes from vicarious trauma makes it difficult to do any more than what is asked for and taking the extra steps for self-care seem overwhelming.  Depression also makes a person lose touch with the things she used to love to do.  It always amazes me when an advocate can list the contents of a whole tool box of self-care items for a survivor but fails to open that box for herself. 

4.       Trying to stay ahead of the effects of trauma – Many advocates have their own trauma history and are regularly triggered by the stories they hear.  Staying busy is a way to keep from facing one’s own past, but it can often lead to complete burn out and collapse.  It also contributes to being ineffective as an advocate. 

It may take a few tries to find  activities to alleviate the effects of vicarious trauma.  It may be helpful to think about what you used to do that lifted your spirits and find new ways to enjoy them.  Did you enjoy singing – how about joining an acapella group?  Have you always wanted to play music?  Then take lessons or join a drumming group.  Sports?  I know advocates who have joined roller derby teams and love it.  Outdoors?  Check out www.meetup.com to find out what activities are going on in your area or just grab a friend for a hike in the woods.

If you find you are hesitating or it is difficult to engage in activities that you enjoy or you refrain from spending time with family and friends, then the effects of the vicarious trauma may be deeper.  Seriously consider looking for a good therapist in your area to talk to about what you are experiencing.  It could be the best thing you could do for yourself and for the people with whom you come in contact.