Trauma Stewardship

by Laura van Dernoot Lipsky

  If we are to contribute to the changes so desperately needed in our agencies, communities, and societies, we must first and foremost develop the capacity to be present with all that arises, stay centered throughout, and be skilled at maintaining an integrated self. For many, this requires a daily practice of “handling your business,” as the singer and social activist Stevie Wonder says. Our goal is to reach the places where we can conduct our own lives with ethics and integrity—day after day, and in situation after situation. The more that we can accomplish this, the clearer our path at every level of trauma stewardship will be.

  CHAPTER TWO

  The Three Levels of Trauma Stewardship

  The rule of no realm is mine, neither Gondor nor any other, great or small. But all worthy things that are in peril as the world now stands, those are my care. And for my part, I shall not wholly fail in my task, though Gondor should perish, if anything that passes through this night can still grow fairer or bear fruit and flower again in days to come. For I too am a steward. Did you not know?

  Gandalf, in J. R. R. Tolkien’s Lord of the Rings: The Return of the King

  In the following pages, we will consider some of the specific ways in which suffering may be perpetuated at the individual, organizational, and societal levels. Reactions to the hardships of humans, animals, and our planet—that is, trauma exposure response—may manifest very differently at each of these three levels, but the risk of behaviors that inadvertently magnify the pain and suffering of direct trauma is always present. The more deeply we realize this, the more we understand the potential—and the necessity—for a trauma stewardship approach. I encourage you to keep all three levels in mind as you read this book. If we can transform ourselves, we have the potential to change the world.

  Personal Dynamics

  One of the most profound influences on trauma stewardship is who we are as individuals. What is our own history of hardship, pain, suffering, and trauma? What resources were available to help us? What led us to the work we do? The more personal our connection to our work, the greater the gifts we bring to it—perhaps. At the same time, the more we identify with the type of trauma we’re exposed to, the greater its impact on us may be.

  “Why do you think you cross the road?”

  Prison work will have a different impact on someone who has never been incarcerated or had a friend or relative in prison than on someone who lives in a community where 40 percent of the men are currently incarcerated. If you have no personal history linking you to your work, you may be able to care deeply about it while still maintaining some useful distance from it. This distance may limit your insights about your work, but you may retain greater reserves of psychic strength if you are not also reexperiencing the pain of familiar wounds.

  On the other hand, if you are working with a population with whom you have a history, you may feel a rawness as you approach your work. This rawness may allow you to connect with the work in an intimate, knowing way. Although we can never presume to fully understand what it’s like to walk in another’s shoes, you may indeed have a very good sense of what that walk feels like, looks like, sounds like, and tastes like. While this awareness may help guide you, it also can dramatically heighten your own vulnerabilities as someone who can truly feel the other’s pain.

  For many workers, it is difficult to perceive a clear line between the personal and the professional. Obviously, this is not the case for everyone whose work and personal history overlap, but there is often a correlation. To be an effective trauma steward, it is important to know where our own self ends and another’s self begins. This can be a hard distinction to maintain even when we are working with other adults, who, whatever their difficulties, are clearly separate people with agency in their own lives. Ironically, it may be even more challenging when we are working with populations that seem particularly defenseless—young children, for example, or abused animals or endangered species. When we speak up for people or creatures or environments that are unable to speak for themselves, we may gradually lose the ability to distinguish their voices from our own. If we don’t pay careful attention, our feelings of identification and responsibility may increase to the point that we experience their anguish in a debilitating way. In the long run, this can diminish our ability to be effective advocates. We can sustain our work with trauma only if we combine our capacity for empathy with a dedication to personal insight and mindfulness. This is difficult terrain to navigate.

  Organizational Tendencies

  I honestly think every person I work with in my division is on antidepressants at this point... everyone here.

  Child protective services caseworker

  Organizations play a multifaceted role in trauma stewardship. The people who make up any organization help to shape its culture, so in some ways each organization is a reflection of the collective capacity for trauma stewardship of all the individuals involved. At the same time, organizations themselves have the potential to either mitigate or exacerbate the effects of trauma exposure for all of their workers. The way those workers manage trauma will in turn have an impact on the experiences of already traumatized clients. Golie Jansen, an associate professor at Eastern Washington University, recently concluded a study in which she found that “when people perceive their organizations to be supportive, they experience lower levels of vicarious trauma.”

  Because of multiple and conflicting objectives, insufficient resources, and other difficulties, organizations often ask employees and/or volunteers to perform demanding jobs without adequate support. As a result, people are unable to do their jobs as well as they would like. For example, many teachers in the United States find themselves unable to attend to their students’ emotional needs—an essential element of creating a good learning environment—and at the same time prepare them for the rigorous state exams required by the No Child Left Behind legislation. Doctors are unable to attend to the psychosocial needs of their patients because they work for medical organizations that limit the time for each patient visit.

  “I don’t know how it started, either. All know is that is’s part it’s part of our corporate culture.”

  This leads to a phenomenon that Michael Lipsky, a political scientist and the author of Street-Level Bureaucracy, calls service rationing. Service rationing refers to the process that workers go through to bridge the everyday divide between the ideal of how they would work if they were free to function to the best of their ability and the reality of how they can work, given the numerous obstacles in their way. An effect of service rationing is the continual defining and redefining of one’s job. If it’s not quite the work you had originally hoped to do, you mentally redefine it in some way that allows you to reconcile the growing contradiction.

  How much these cognitive shifts are necessary varies from organization to organization, policy to policy, and supervisor to supervisor. Still, many workers walk a common path, trying to find a satisfactory compromise between what they can do and what they are asked to do. Service rationing surfaces when a legal aid attorney is more sympathetic to a compliant client who seems willing to take direction than to one who is belligerent, for example, or when a homeless shelter worker prioritizes the resident talking loudly about suicidal fantasies over the resident who is morose but just as severely depressed.

  Initially, many workers may find that these choices go deeply against the grain. They truly want to attend to everyone equally. But over time, rationalizing such behavior may be the only way to contain remorse and preserve a sense of satisfaction in your work. A social worker in the Office of Indian Child Welfare who is in the 28th year of her career told me, “I had three supervisors in one year and a coworker who committed suicide. I was so overloaded that I had to figure out, given my caseload, what the bare minimum was that I could do while continuing to serve my clients well and trying to not get in trouble myself.”

  Service rationing is paradoxical. It may diminish people’s spirits and possibly the quality of their work
, but at the same time it is often an essential coping mechanism. Without it, many people simply couldn’t stay in their jobs at all. As we can see from Lipsky’s research, there is a desperate need for environments that help people to do good work and achieve personal satisfaction even when compromises are inevitable. Without effective policy in place, both direct service delivery and efforts at larger social change are undermined. Ethical work cannot be sustained in an eroding environment that fails to support its workers.

  Lipsky also coined the phrase street-level bureaucrat. This is a neutral term that describes many police officers, lower court judges, social workers, and countless other public service workers. It refers not to their personalities but to the characteristics of their work. Street-level bureaucrats are workers who interact with people in ways that significantly affect the clients’ lives, who have broad decision-making power with respect to these interactions, and who lack sufficient resources to do their job the best they can. Furthermore, they are in positions where it is hard to hold them accountable because of the wide discretion they have in their jobs.

  Some street-level bureaucrats do their jobs ethically and well, hold their heads high, and find satisfaction in their efforts. Others may become defeated by their work, make poor choices, and shirk their responsibilities. Street-level bureaucrats are prime candidates to adopt service rationing as a coping mechanism. Facing overwhelming challenges, they salvage job satisfaction by shooting for lowered goals that they have some hope of meeting. A high school math teacher with too many students may seek professional gratification by focusing on the most advanced pupils, who are more likely to be boys; as a result, the girls, who often begin to lag in math and science after receiving less encouragement in their middle school years, may not get the attention they need to catch up. In the long run, such coping mechanisms add up to policies detrimental to society.

  Good policy, both political and personal, takes into account the reality of the need for service rationing. Effective policymakers look without flinching at the possibility that scarcity of resources will require workers to take shortcuts. We should strive for policy that eliminates the need for shortcuts—and, if they are unavoidable, tries to preserve results that are as close as possible to what we want as a society.

  Our responses to trauma exposure can foster a defended, exclusive, and hopeless culture in the organizations we work for. Think about how your workplace feels. What’s the energy level? What’s the vibe? These qualities have nothing to do with the intensity of the work. Instead, they have to do with the degree to which the organization’s structures, policies, and attitudes support or impede the workers’ efforts to fulfill the mission.

  In the early days of HIV/AIDS in Seattle, there was an organization (still around as of this writing) called People of Color Against AIDS Network. This was one of the most exquisite places I had ever encountered, and every time I left the building, I couldn’t wait to go back. The work was intense, difficult, and often very sad, but the feeling we had working together was amazing. There were people who were radiant, who sang while they worked, who took time to catch up daily on each other’s families, who lovingly greeted everyone with whom they came in contact, who remained inspired in spite of the despair around them.

  And then there were other organizations whose buildings I left desperate to take a shower and rid myself of the feeling I had experienced just being there. It wasn’t about the condition of the carpet or how many multicultural posters were on the walls. It was whether light and hope and feelings of possibility were emanating from the institution or whether the organizational culture felt negative, exclusive, and hopeless. There are many factors affecting organizational culture. The negative ones range from irrational norms to ineffective leadership to nonsensical personnel policies.

  A longtime leader in the domestic violence movement, Beth Richie, recounts a story illustrating how organizational culture can become confused over time. During a visit to a confidential domestic violence shelter for women and children, she happened to overhear one of the advocates preventing a child from taking a banana off the kitchen counter. The advocate said, “Oh no, I’m sorry, the bananas are not for the children.” It was an eerie moment, Richie said. An organization’s culture can become so steeped in notions of scarcity that it enforces policies radically incongruent with the original mission.

  We frequently see trauma exposure response manifest in our work in two other ways: lack of accountability and unethical behavior. A New York Times Magazine article in 2000 told the story of Kerry Sanders, a man with a history of mental illness who was arrested for sleeping on a park bench, mistaken in court for a fugitive with the same last name, and sent to prison, where he served two years for a crime he had never committed. The article traced the progression of this horrendous story from the police to the mental health workers to the prison guards to the probation workers to the attorneys and so on. Ultimately, over 20 professionals were deposed to try to make some sense of how this had occurred and why Sanders had spent years in prison unjustly.

  No decent answers were found. From prosecutor to prison guard to recreational therapist to psychiatrist to nurse, everyone claimed they were blameless. They replied to Sanders’ pleas for help with a range of responses from “I let him know there was nothing I could do” to “I am not a legal aid society” to “It’s not my job—I don’t do that.” The article described how “a prison psychiatrist who treated Mr. Sanders said that given his mental problems and homelessness, he was better off in prison.‘He should say,“Thank you, for two years you guys treated me very nicely.”’”

  The article concluded,“The issues of responsibility and culpability, of quality of care and of monumental and systematic failings, continue to surround the lawsuit. Yet in 2,000 pages of depositions, there have been few displays of compassion and fewer of outrage. At Green Haven [the prison where Sanders was held], no one on the staff was even told what happened, and no one asked. One day, Kerry Sanders just disappeared.”

  In almost every paragraph of the article is an example of how a trauma exposure response, on both the individual and organizational levels, was a contributing factor in the lack of accountability and the unethical behavior that led to the incarceration of an innocent man. This is partially a testament to the power of denial and rationalization as they relate to unethical behavior; I imagine the people involved in this story truly believed on some level that they were not to blame. A follow-up article the next year quoted a New York correctional services spokesman, James B. Flateau, as saying, “The commissioner’s feeling was that as unfortunate as the outcome was, there was no venality on the part of any employees. It was just an incredible confluence of events that we had never before seen happen.” Robert Gangi, executive director of the Correctional Association of New York, a prison monitoring group, said, “It’s definitely a worst-case kind of scenario, and at the same time it reflects the lack of attention and lack of resources that the state devotes to prison mental health services.”

  Often, people begin recognizing the effect of trauma exposure when they realize they are behaving in ways they never would have when they first started working in their field. Perhaps when workers start out, they have the energy required to navigate the gray areas of their work, to question their assumptions, to stay open-minded about what is possible, and to truly believe that it matters if they do right in the work and in the world. Over time, the complexity of the issues may surface, the scarcity of resources may feel overwhelming, and one may feel more and more isolated. At that point, a sense of entitlement creeps in: We may feel so desperate for satisfaction that we will try to meet the clients’ needs by any means necessary—and so what if it compromises the integrity of the work? After all, who is going to notice? Who is going to care?

  The vast majority of people I’ve worked with are not stealing office supplies or embezzling money. Instead, just as in the examples above, they may be unknowingly abusing their power in their client intera
ctions, or developing policies that are not mindful and consistent with the values of the organization, or competing with other organizations instead of collaborating. In my experience, when this type of behavior takes root, born out of some of the reasons we discussed above, it can become a tremendous source of guilt. Later on, when we survey the specific aspects of a trauma exposure response and how they surface in our lives, we’ll see that guilt, fatigue, a sense of entitlement, and other deeply ingrained habits are all facets of the same cumulative effect.

  Societal Forces

  To fully comprehend trauma stewardship, we must pull our perspective back even more. We want to understand how society at large interfaces with our trauma exposure response. If we are ever to realize our hopes of creating and re-creating a society in which we are all free from suffering, we must take a macro view. Without a sense of the big picture, it is impossible to have any meaningful conversation about what we want to do collectively to improve the circumstances of our lives and work.

  We can use the analogy of cleaning up a river. Retrieving and recycling the plastic bottles or other debris we find floating toward us is a needed step in a cleanup. But to be stewards, more is required. We can’t just pick up trash and dig out polluted sediments at the stretch of river directly in front of us. We need to identify and address all the sources of that pollution. We start with the local community, asking people to stop littering or dumping household chemicals down the drain. Beyond that, we need to go upstream. We need to look for factories piping chemicals to the river, septic systems leaking contaminants to its banks, and polluted rainwater as it runs off a hundred roadways to contaminate a dozen tributaries. We need to look to the sky, where the toxic emissions produced by distant coal plants fall from the air as acid rain. To do the cleanup right and to make sure that it lasts, we need to foster a stronger sense of conservation in the citizens and businesses of an entire region. Trauma stewardship works much the same way. Numerous forces contribute to the flow of trauma, and to accomplish lasting repair, we need shifts in attitudes and practices by ourselves, our organizations, and our infrastructures, thus protecting the watershed for years to come.