The ways in which helping professionals address and respond to a client’s history of trauma play a critical role in the adult survivor’s recovery.
— Carolyn Knight, Professor of Social Work, School of Social Work, UMBC
"I grew up in a home where there was a lot of abuse from both my mother and her boyfriend, and I grew up with low self-esteem." Thus begins Tammi Shuron Jones' tale of decline into addiction, homelessness, and incarceration. Tammi's life was derailed by trauma, as were the lives of the other women featured in this section of the book.
Be it from sexual abuse, such as with Doreen Cooke and Carol Smith; or another devastating event, such as Cynthia Hall suffering catastrophic burns as a 3-year-old child; or an un-named emotionally dislodging recollection, such as with Evania Chapman who needed to "get in touch with some of the pain and some of the things from my childhood," trauma is often linked to addiction. Substance use becomes, for these women and others, a form of self-medication. As Carol Smith notes in her story, "I pretty much used anything that would take me out of myself."
Experiencing trauma leads not only to addiction, but also to a host of other psychological problems: Post-Traumatic Stress Disorder (PTSD), complex PTSD, dissociation, depression, and more.1 We see these and similar conditions in the women's stories: "I would have terrible flashbacks" (Carol Smith); "I didn't remember the pain" (Cynthia Hall). When trauma is present, clinicians' understanding of the impact it has on clients is a critical aspect of recovery.
The success of the approach taken at Marian House to address the complexities of trauma is clear from the women's testimonies. For example, perhaps the most fundamentally destructive impact from trauma is a loss of sense of identity-a feeling of alienation both from self and community. The lives of the women in this section were rife with such disaffection prior to entering Marian House, and time and time again they credit Marian House for returning themselves to themselves: "Marian House was the foundation" (Tammi Shuron Jones); "Marian House helped me grow up" (Evania Chapman); "Marian House gave me back to me" (Doreen Cooke).
What is Marian House doing right?
First, the Marian House staff brings sensitivity to the effects of trauma. For example, one common coping mechanism used by survivors of sexual abuse or other childhood trauma is dissociation, whereby feelings and sometimes even memories of what happened are cut off from conscious awareness.2 Survivors might make light of, simply mention in passing, or have no memory at all of the traumatic events they experienced. We see this downplaying in Doreen Cooke's story, where she mentions only incidentally the fact of her rape, and in Evania Chapman, who vaguely refers to "some of the pain and some of the things from my childhood.” Competent clinicians know to be on the lookout for indicators of trauma even when survivors do not directly disclose such a history.
Second, appropriate protocols are essential Supportive relationships at both the individual and communal level are key; establishing rapport and trust through genuine caring and listening creates a baseline for successful treatment. The women's comments are rife with appreciation for these qualities within Marian House: "They really cared about where I came from" (Evania Chapman); "I felt warmed and welcomed" (Doreen Cooke). Once safety is established, processing the trauma can begin.
The stories in this section come alive with the promise of overcoming trauma and its associated conditions of addiction, low self-esteem, depression, and more. The ability of the staff at Marian House to help women reframe trauma as Carol Smith does ("I now think of myself as a survivor and not a victim") makes all the difference. With successful recovery, the women are empowered to give back, perhaps in ways others cannot, as exemplified by Doreen Cooke's extraordinary experience with a young victim of sexual abuse, reaching her in precisely the right therapeutic way because of her own story.
The women whose narratives are shared in this section are not the only ones in this book with histories of childhood trauma, but they epitomize the essential need for comprehensive approaches to treatment.
- Carolyn Knight, Introduction to Working with Adult Survivors of Childhood Trauma: Techniques and Strategies (Thomson Brooks/Cole, 2009), p.9
- Carolyn Knight, Introduction to Working with Adult Survivors of Childhood Trauma: Techniques and Strategies [Thomson Brooks/Cole, 2009), p.13