Homeostasis and Healing: Safety
Posted on June 6, 2014
In this post, I want to focus on the role of homeostasis and equilibrium in healing from past trauma and building a better future. Just as a reminder, we have been using Google Dictionary’s definition that homeostasis is, “the tendency towards a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes.” In essence, we adapt our internal mental, emotional, and physical states (brain structure) to the environment, and/or change the environment to match our internal states. Both actions have the goal of creating a balance, or equilibrium, between the two.
In past posts, we discussed how a traumatic environment most often will result in a traumatized individual. The question today is, what does that individual need to experience post-traumatic recovery and post-traumatic growth? The science of homeostasis presents a clear picture of what our clients need in order to truly heal from the pain and hurt of their past experiences.
Here is where safety, one of the cornerstones of the trauma informed paradigm, comes into play. Safety in this context means both an absence of harm and a sense that there will not be additional harm done in the immediate future. This absence of harm requires access to food, shelter, and people who care about the client. As we better understand the brain, we are having to rethink Maslow’s Hierarchy of Needs. Separating out physiological, safety, and social needs is not necessarily mirrored in our brains. The same areas that process the need for food and water also process the need for social connections and emotional, physical, and social safety.
Collapsing the first three levels of Needs into one all-encompassing foundation helps us to see that just housing a chronically homeless individual is not enough (though it is a hell of a lot better than not housing them!). We also need to ensure that they are connected to caring individuals who help fill the new environment with emotional stability and safety. If we want people to overcome painful traumatic pasts, we need to help ensure that we create a safe path for them to travel.
I know the need for safety is nothing new for us in the helping professions, in good part because of its place on Maslow’s Hierarchy. Yet historically, most of the systems we create for traumatized individuals (many of whom have developed mental illness and substance abuse issues because of what happened to them) have little or no safety. The problem is that safety can be expensive in the short term, and we have sacrificed the long term health and sustainability of our society (and clients) for “cost effective” interventions that just make the problem worse and cost much more in the long run.
Think of the asylums and institutions that we now demonize so easily. We judge the workers and a system that treated those with developmental, emotional, and behavior disorders so poorly. Yet today we throw many of these same people in our jails or leave them on the streets, where we ignore and judge them. Here is a slide from my friend Dan Rabbit’s great presentation at last week’s National Health Care for the Homeless Conference.
The only conclusion we can make from this data is that the United States is the most criminal society in the world. The question that needs attention is: Are the criminals the ones overcrowding our jails, or is the overcrowding due to the policies and the laws that increasingly deny treatment in favor of incarceration? Does locking up the mentally ill, homeless, and those addicted to substances (populations which all have high rates of not just trauma, but repeated and complex trauma) make our society safer?
To save a dollar today we group people together. We put traumatized kids with mental and behavioral disorders in residential treatment, we find another inch in our shelters so we don’t have to turn away someone at risk of freezing to death, and we economically and racially segregate certain parts of the population to “that side of town.” What kind of equilibrium are we creating?
We do our best with limited resources, budget cuts, and lack of community motivation (or knowledge) to face the problems our society has caused. Homeostasis shows us that our clients need exactly the opposite of what most systems provide. They need safety and we give them jail. They need housing, but we have limited shelter beds They need intensive mental health and substance abuse treatment, and we give them limited or no access to the level of care they truly need They need a welcoming, stable environment, and we have to focus on fundraising to keep the doors open. We witness miracles every day, when, despite all this, a client bonds with a helper and together they find a path forward, a resource no one knew exists, and hope in a society that would rather ignore the problem and make it worse than support those in need.
Until we create safety in our communities and focus on healing, the private prison industry will continue to boom, our military funding will continue to be six times higher than the next closest country, and heroes like yourselves will keep trying to pick up the pieces of lives destroyed by trauma.
The first thing that came to my mind when I read your post this morning… we need to keep our helping professionals healthy, and able to be at least a little piece of that safety our clients need. The issues you discussed seem so very big and system based, which to me is overwhelming. When I think about the things we can influence, like staff training, self care, and meaningful supervision, I feel like we can actually make strides toward providing a safe environment for our clients. Thanks for the post!
Great post and a wonderful comment from Biz. My sentiments exactly.
It’s a long road, but I think we may be getting there, in England anyway. I have noticed that change is happening in the NHS within mental health. Probably due to the extent of the problem, something had to be done. With growing suicide rates, more resources are being invested. But waiting lists are long for Psychological intervention.