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Relationship Templates and Trauma Informed Care

Posted on November 21, 2013

In our last few posts we have been discussing the power of environments and relationships to structure the brain physically.  This week I want us to examine why many traumatized people seem addicted to trauma.  Understanding the brain helped me understand the choices clients.  I could see that gangs gave them safety, selling drugs were their only way to escape generational poverty and getting high allowed them a temporary relief from pain and stress. 
From our previous posts we learned that the environment will determine which genes are activated in our DNA, which creates proteins that develop cells and ultimate leads to physical traits including the physical structure of our brain. If we live in traumatic or highly stressed environments, genes are activated that strength the fear based limbic system in our brains.  It also means that other brain structures for managing stress and challenges may not be developed fully limiting our ability to engage with the world intellectually.  This brain structuring can be the very reason we survive the trauma and can allow us to thrive in highly stressful environments.  Unfortunately the same brain structure is not equipped with the cognitive or emotional capacity to succeed in our normal society. 
In this post I want to examine why most of these clients continued these behaviors even after they left, or were removed from these stressful environments. I have always struggled with the reality that after working so hard with a client to set them up with housing, education, food and other needed resources they would disappear or engage in a behavior that gets them kicked out of the very programs and services they need to change their lives. Why does trauma continue to organize many of our clients’ lives even when they have a chance to make different healthier choices and live the lives they say they want? 
Relationships and environment start to wire the young brain creating structures that are needed to survive and thrive in the world in which they exist.  Unfortunately for many of our clients these environments are highly stressful and traumatizing through their experience of abuse, neglect, extreme poverty, racism, etc.  When we are young the relationships we have with our parents or caregivers become our entire world.  We take the mind of our mother, father, grandparents or foster parents as our own.  Their stress becomes our stress, their experience of racism or discrimination because our experience, the abuse and pain in their lives because our reality as well. 
We are incredibly resilient even at a young age.  We internalize the fear, hurt and pain in our environment in order to survive a home environment which the brain believes is representative of the entire world.  Our brain develop the structures needed to survive and thrive in these highly stressed situations. 
Relationships with high levels of stress and trauma structure the brain.  This structure gives the individual the capacity to survive this stressful reality.  Very quickly the individual (and their brain) develops insecure and/or disorganized attachment to our parents or caregivers.  Attachment is its own post (if not book), for our purposes lets simplify attachment as a template we use to view all relationships.  For example, if our parents cause us pain and abuse us, we will assume our teacher, lovers and friends will treat us the same way.  Attachment is a powerful force throughout our lives.
This relationship template serves as a self-fulfilling prophecy and why many of our clients seem so stuck.  Once the template is established, all other relationships can fall into the template.  As we get older we transfer our attachment with our parents to teachers, friends, lovers, bosses, helpers and police.  If our template for relationships tells us that other people will cause us pain and hurt, we will find people that fulfill that template.  If they do not fit we will often treat them in a way to make them fulfill our expectation.  As a helper I have fallen into this template with many of my past clients.  Kicking them out of programs, giving them illogical consequences or just getting pissed off, fits into their expectations of how people will treat them.  We are in a position to fall this complex dance of past trauma and self-fulfilling prophecies which too often puts us in a role of an abuser and in our clients minds we often play this role all too well.
This creates what some have called an addiction to trauma.  The client has a template that relationships are painful and people will abuse them.  They either find people that fulfill this template or force others into behavior that fit their template.  Every time people reinforce the template this brain structures that created the template are reinforced further, hope because lost and the world and everyone in it can seem dangerous.  I do not believe that people are addicted to trauma.  I believe that traumatic relationships are all that they know.
Let’s leave this post on a positive note.  If you have been to one of my trauma trainings you might remember my statement “A healthy relationship is the greatest gift we can give our clients.”  I think Judith Herman said it best, “Recovery can take place only within the context of relationships; it cannot occur in isolation. In her renewed connections with other people, the survivor re-creates the psychological faculties that were damaged or deformed by the traumatic experience.”  As healers we challenge the template.
It is our work to replace the pain, hurt and trauma the client associates with relationships, with trust and safety.  We know that the quality of relationship is the greatest predictor of clinical outcomes that we have influence over.  This will not be a quick or easy change for most of our clients.  Many will drop out of care, resort to flight or fight behaviors and challenge us at every turn.  They are not bad people but traumatized individuals trying to fit someone who is giving them respect and caring into their brain’s template of a world of pain and fear. 
Many clients do not have the brain structure to comprehend someone who cares and does not judge them.  You bring something they may have never felt…hope.  This process will take a great deal of resiliency on our part.  We will be put in the familiar role of abuser and challenged in many ways.  Earning trust with a traumatized client is a process that rarely happens in eight sessions or over a 72 hour hold.  Restructuring the brain takes time, a safe environment and a very dedicated and caring healer.
Eventually we help “the survivor re-creates the psychological faculties that were damaged or deformed by the traumatic experience.”  If we can meet the challenges of the traumatized brain structure, that structure can and will evolve.  Events that would have gone to the fear based brain systems are directed to the thinking brain.  Relationships can become a source of strength instead of pain, and a hope for a better future starts to become of reality.  This is truly what I mean when I say Post-Traumatic Growth.

This is not easy work.  For many of our clients it takes years to replace trauma and pain with hope, trust and safety.   In my mind there is no more meaningful work than the work to which you have dedicated your lives. It can be frustrating, painful and might seem impossible at t
imes but this gift you give your clients is something we cannot replicate no matter how advanced our technology.  You are the healers in world dominated by pain and trauma and for that dedication I thank you and wish you a great Thanksgiving!  

4 responses to “Relationship Templates and Trauma Informed Care”

  1. Thank you Matt. Such great information.

  2. Thank you Matt. Such great information.

  3. Matt Bennett says:

    Love having you as a reader Alicia! Hope our paths cross soon.

  4. Matt Bennett says:

    Love having you as a reader Alicia! Hope our paths cross soon.

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