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At the HIV and Social Work Conference in Denver last week, I did a 50 minute talk on the Trauma Informed Paradigm, and I introduced those attending to the concept of homeostasis as it relates to our clients with traumatic pasts.  As we talked, it became clear that it wasn’t just the clients impacted by this phenomenon, but that our organizations and we as helpers are also impacted.  In this post, I want to explore this concept a bit further, in hopes it can give us a more complete understanding of ourselves and our work.

In my previous post, we used Google’s definition of homeostasis as, “the tendency towards a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes.”  In other words, the internal state of the individual or system will seek to create a balance with their environment by either changing their own functioning (mental state and eventually physical brain structure) and/or working to change the environment to match their internal state, expectations, and desires.  Could the same push towards equilibrium give us insight into the states of our organizations, and our own well-being as helpers within these organizations?

I often encourage those I train to think of their organizations as sanctuaries or refuges for clients who live highly stressful and often traumatizing lives (please see the past posts on the Pu’uhonua for more information).  While creating refuges for those in pain to find peace, hope, and healing might seem obvious, why are so many of our organizations and systems of care seemingly so dysfunctional and struggling to maintain a stable, much less healthy, culture?  We all understand the importance of the health of our organizations and the helpers who work there, but homeostasis theory helps shows why this can be so elusive.

In order to not just to survive, but thrive, an organization often must adapt (find homeostasis) with the bureaucracies and funding structures under which they operate.  Many of our systems of care have developed to manage an identified problem and the cost associated with that problem.  Few systems have the funding levels necessary to address the true causes of problems such as homelessness, child abuse, failing schools, severe mental health issues, and criminal behaviors.  Instead, we create systems that try to manage the problems at the lowest possible costs.  For example, it isn’t tolerable to allow homeless people to freeze to death on the streets, but we also do not want the costs associated with providing all homeless people with safe and permanent housing.  So instead of ending homelessness (which is well within the economic means of our country), we manage the problem by putting people in shelters, a cheaper management solution. (Note: I use “cheaper” only in the context of the short-term.  If we could look at cost from a long-term perspective, the investment in ending homelessness now would have tremendous long-term cost benefits).

So instead of providing the services our clients need, we provide services that match the funding streams that we can secure.  The money we do receive is often not enough to create programs that allow staff to provide the services our clients really need to heal.  We understand that healing on all levels (physical, psychological, and spiritual) happens primarily in the context of relationships.  Study after study has demonstrated that for clients to achieve the outcomes that they want and also that our programs are designed to deliver, they must have a trusting positive relationship with a helper.  Yet our funding rarely seems to give us more time to develop and nurture these relationships.  We are asked to measure this or collect that or have clients fill out another form, but when was the last time a funder said, “We want your helpers to really have the time they need to be present with their clients”?

Just as powerful as our illogical funding systems, our organizations also work with communities that are often struggling, producing clients who are in constant pain and suffering.  We start out by trying to provide hope and a positive light in these communities.  All too often, though, the pain and hurt caused by poverty, racism, discrimination, and other traumas start to overwhelm our ability to maintain a positive mindset.  I see this to be like going into a burning building and attempting to stay calm and cool – it is possible but takes almost superhuman resiliency and strength.

It is one thing to stay healthy in a larger community that is struggling it is even more difficult when that pain comes through our doors every day in the form of individuals and families we value and care so much about.  We bear witness to the pain and hurt our clients are experiencing.  No one likes poverty, homelessness, addiction, or child abuse, but it is a whole different experience when the person impacted by this traumas sits across from you with tears in their eyes.  This pain is transferred from clients to helpers every day.  We ask those who work with clients to do something nearly impossible – to solve the huge problems facing their clients without the resources, funding, and societal support necessary to do what is being asked.  Understanding the contagious nature of emotions, it is amazing that we are not all burnt out, traumatized, and totally ineffective in our work.  I think it says a lot about our own resiliency.

My friends, we are taking on the impossible when we attempt to actualize our missions!  There is no other industry that faces the challenges we face, especially considering that we rarely receive enough support and resources to do our work.  How do we stay sane, much less produce the miracles that can help our clients and communities transform themselves?  In order to do this, we must create organizations with such high levels of health and resiliency that, instead of being transformed by illogical funding and trauma, it brings the community and society into homeostasis with its values and missions. 

Is this type of transformation possible?  I believe that it is more possible that we realize.  What gives me this hope?  As I travel around the country, I meet social workers, nurses, librarians, physicians, teachers, therapists, and many others with a passion to change their communities and help those they work with to heal and thrive.  We are a larger army who understands the problems and has many of the solutions needed to fix the wrongs of our society. 

In the next several weeks I will post some ideas on how we can create sanctuaries that can transform our communities and provide the healing our clients really need.  I would love to hear any of your ideas about the role of your organization and what you do, or can do, to be a part of this transformation.