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Chapters 5 & 6

"Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives"

(Van Der Kolk, 2015, p. 81). 

     I really enjoyed these chapters, especially chapter 5 as it relates to the importance of social support and relationships when it comes to trauma victims. Whenever I read this text, I can't help but think about the children on my caseload who carry significant trauma. Now might be a fitting time to share that my sweet 5-year-old client who I have made connections with before on this blog turned 6 since my last blog post! Not only did she turn 6, but a few days before her birthday she was removed from her mother's care. I have seen her multiple times since the removal in both a one-on-one setting and in the context of a supervised visit and reading these chapters about emotions and bodily responses to trauma have really challenged me to think about the work we do together and the way she responds to me. Pavlov and his work with the dogs was eye-opening as it was revealed that some of the dogs were stunned, shaking in kennels while other dogs appeared to try and attack their caretakers. I thought of my client and how recently her actions have been more of the latter. She has taken her aggression out on me by punching, hitting, pinching, cussing, and throwing toys in my direction. 

    These actions are often performed in the supervised visit when mom is present, however, when we are one on one, she seems to be more in control of emotions that further lead to her actions.  These actions are honestly frustrating as we have not only developed rapport but have also established that I am a safe person. Perhaps these situations are confusing to her because both safe (me) and unsafe (mom) people are present during these visits and Van Der Kolk states that is quite difficult for traumatized children or adults to discern whether or not they are actually safe. Or perhaps it is because I am that safe person, and she knows that these actions she directs at me will not change the way I perceive and love her. I have often thought in the middle of these behaviors that I am glad she is taking this out on me, rather than on someone else who might retaliate or engage in the same actions back towards her. While she has these outbursts, she also has moments of silence and stillness in which she sits under my desk, quiet as can be, and just closes her eyes. In either one of these states, I often encourage her to engage in deep breathing, which I now know activates our SNS and PNS Since she is a child, we also focus on watching our tummies inflate and deflate like a balloon. I also pay special attention to the way I react to her - I would be lying if I said I never felt like raising my voice or sternly telling her to stop, but I often catch myself taking a deep breath myself, getting on my knees so that I'm on her level and having a conversation with her. I also think it's important, as the text points out, that extra-curricular activities are not taken away despite the appearance of defiant behaviors. 

    Chapter 6 further explored the ideas of relationships and how "not being seen, not being known, and having nowhere to turn to feel safe is devastating at any age, but it is particularly destructive for young children who are still trying to find their place in the world" (Van Der Kolk, 2015, p. 90). This is heartbreaking and this is my reason why. My reason why I want to be a social worker and further mental health therapist. Right now, it's my reason why I show up the work every day and the reason why I give my 6-year-old client the biggest smile and hug every time I see her. The reason why I ask her about her day and the reason why I color unicorns and cows with her. I hope that in our work together, this little girl will someday have a sense of agency as the book describes, that she might have a sense of control and that she might have a say. While there is so much more that I highlighted in this text and so much more that could be said, the bottom line is that trauma work is important work. Stress and fear are ever-present in trauma responses and it's important that the right people with the right skills are in place to help walk alongside side trauma survivors. 


Comments

  1. I'm sorry to hear about your client. How does your client interact with the mother? Does the mother have good parenting skills? What does their attachment look like? I haven't witnessed a child be that extreme in their behaviors. How sad. The people the child was placed, have they reported those types of behaviors as well? What does the child say after the visits?

    Would she be the type of clients you would want to work with in therapy? Do you believe her to be resilient?

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    Replies
    1. Her interactions with her mother are very, very poor. Part of this is due to mom's lack of parenting skills as she does not offer redirection to the children. These supervised visits usually result in this sweet girl hitting, punching, cussing, throwing toys, etc. When the visit is over, the child is in tears and appears very distressed. She does not act this way way at home at daycare, or even with me - it appears she only acts this way in the presence of mom. We are working hand in hand with CPS in trying to decide if these visits are in the child's best interest.

      I believe my client is starting therapy soon and I am so excited for her! I think this child is very resilient and I hope to be able to continue to help her develop coping skills and emotional regulation so that she can continue to be resilient.

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  2. Wow was a unique opportunity to see things your reading about in your practice. It's been such a joy to do my internship alongside of my class for that reason. Hoping that the knowledge you've read about in these chapters informs your care with this little girl. You have such an incredibly opportunity to walk alongside of her, and I'm excited to potentially hear more about how this book will help you in that process!

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  3. It sounds like you are integrating your knowledge the best you can--it sounds like she is shutting down and/or her mom is triggering. In later modalities we'll learn about "felt safety" which is different than actual safety. I'm guessing her sympathetic nervous system (fight or flight) is triggered by mom thus not allowing her to use her good thinking. From your descriptions, it doesn't sound like mom is able to help her regulate so these visits could be a pretty negative experience for her right now.

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