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day 48: passing it on

March 21, 2011

Ten years ago, when we moved to North Carolina, I’d just left a job counseling survivors of sexual assault and domestic violence.  I’d spent my entire career, up to that point, steeped in crisis:  responding to three a.m. hospital pages, waiting with rape victims in blinding white rooms, drinking coffee with cops while shattered women struggled to give their statements, breathing in stories of people who didn’t deserve to be parents and children who didn’t deserve to be hurt.

In my early twenties, I always joked that I was the person others avoided at cocktail parties, that my response to the inevitable, “what do you do?” question sent people scurrying for the artichoke dip.

I loved crisis work, and I was good at it.

I found that, although mundane dilemmas left me ruminating and agonizing and worrying, in the raw moment of an emergency I was rock-steady.  Back then, I listened to stories I now wish I could erase from my memory — that make me cry just thinking about them — with an even gaze.

When a client’s pain felt too big for me to bear (like that of the fifteen year old who, after being assaulted by boys who videotaped their crime, shaved her head and lost 25 pounds in a month… so desperate was she to disappear) I employed an odd strategy.  I would imagine myself encased in a bubble of protection, picturing my clients’ words approaching the bubble but not entering it.  I’d then imagine a beam of white light streaming from my heart to theirs, extending my compassion.  The focus on this imagery, no doubt gleaned from listening to far too many New Age meditation tapes, kept me from dissolving into tears.  It also kept me grounded in my purpose, which I believed was to guide people through devastation and into hope.

This strategy worked for a while.

What also worked was the wise supervision I received from Harriet, a senior clinician whose office I visited every other week as I earned my clinical licensure.  Because my little agency didn’t have a staff person credentialed to provide me with supervision, I sought Harriet.  She was the first person to talk with me about vicarious trauma, about the importance of shielding myself from all that I saw and heard every day.  I listened to her intently, but did little else to actually protect myself from all of the horror.

Because of Harriet, I recognized what was happening when, four months finished with my counseling job and working in a new state, I began having nightmares so vivid they left me drenched in sweat and tachycardic.  My new work role was far less intense, providing my brain with just enough space to finally assimilate all that I’d heard and seen over the previous dramatic years.  Faced with years of others’ demons, I was forced to either find healthy coping mechanisms or just stop sleeping.

I chose the former, and in the years since have made the study of secondary trauma (or, as reframed positively by my colleagues John Alderson and Sara Jarvis, “resilience”) part of my professional mission.  My work now involves training other social workers, writing curricula, doing research, and maintaining a small clinical supervision practice on the side.  God knows I am no Harriet, but I have done my best to spread the gospel of self-preservation among therapists.  I’ve recommended this book more times than I can count,

and I’ve tried to remind helping professionals at every level of practice that they require self-care.  So often I train social workers who identify secondary trauma’s only symptoms as tearfulness, or collusion with the client, or poor boundaries.  They say, “That’ll never be me.  I’m too tough/too careful/too invulnerable/too experienced to suffer from this job.  I’ve seen it all and I am fine.”

A far more damaging outcome of secondary trauma, in my opinion, is disconnection from empathy and misdirection of anger.  This looks like burnout.

I can hear you shifting around in your chairs.  “This is depressing,” you say, “could she just get on with Day 48’s gift already?”

And I will.  So, on Day 48 I thought a lot about the young clinical social workers I have supervised in recent years, and I decided to check in on them.  I wrote a note to the three whose contact information I still have, asking how their clinical practice is going and (more importantly) how they are shielding themselves from trauma.  While I was at it, I wrote a letter to Harriet (according to the trusty internet, it appears she is still working in the same comfortable office).  I thanked her for her thoughtful guidance.  I told her that she’d served as a model for me both as a therapist and as a clinical supervisor.

I don’t know if I will ever go back to crisis work (after all, just because I am good at something doesn’t mean it is good for me), but one day I’ll write a paper on secondary trauma.  I’ve written half of a workshop already, and Day 48 convinced me to finish it.  Until then, I’ll keep playing my game of Social Work Telephone, whispering in the ears of the field’s bright-eyed newbies, “Take care of yourselves.  Talk about it.  This work needs you, but it needs you whole.”

Today, I hope you take care of yourselves and talk about it.  Thank you so much for showing up.

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2 Comments leave one →
  1. Meg permalink
    March 25, 2011 9:28 am

    I loved this post, Anne. I remember my first year working at a rough inner city preschool in Nashville. There was a moment when I realized that if I couldn’t figure out how to create some emotional boundaries for myself, I wasn’t going to last. And then what good what I be? I’d love to hear your workshop some day. xo.

    • March 25, 2011 9:35 pm

      thanks, meg. you’ll be the first to receive a copy of my workshop — I promise. 🙂

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