Trauma Stewardship Read online

  To my profoundly talented editors Stacy Carlson and Karen Cook, whose endless generosity, kindness, commitment, and phenomenal editorial abilities breathed the necessary life and form into each and every sentence. This book could never have been anything close to what follows if not for their brilliance and exquisite vision.

  To Yuko Uchikawa, whose loving friendship and steadfast confidence in this work has been a great blessing and a critical factor in this book’s evolution. Her intuition, wisdom, and marvelous artistic ability are what allow you to hold what you have in your hand.

  And to all those valiant souls with whom I have had the privilege of working since I was 18 years old. I hope this book is worthy of all you have contributed to it, and I ask your forgiveness for any ways in which I was not capable of being as present as you deserved during our times together. I carry all of you in my heart and hope that the lessons I have learned and applied may allow others to be well served through the work of trauma stewardship. I feel humble in the presence of your spirits, and I am deeply honored to have your company on this path.

  ABOUT THE COAUTHOR

  Connie Burk is one of the primary reasons this book exists. Were it not for her vision, generosity, and faith in me, the text would still be floating around in my head. I am forever grateful to have had such an exquisite coauthor throughout the entire process. Connie urged me to turn my ideas about trauma stewardship into a book, and she refused to agree with me when I repeatedly said, “I am so not a writer!” She provided crucial perspective on the book as a whole and invited me to explore and reexplore my beliefs in a way that brought unprecedented depth to my work. Connie has a level of historical knowledge that was essential, and she role-modeled being patient as we tried to put our stream of thoughts into written words. She held the entirety of the process in a joyful embrace.

  I met Connie years ago, when she first moved to Seattle. She had been recruited to be the executive director of the Northwest Network of Bisexual, Trans, Lesbian and Gay Survivors of Abuse. Shortly after she arrived, I was asked to work with the organization as an advocate. Connie and I had our first meeting some days into my employment there. Sitting across from me, she asked what I would need to do my work well and how she could be of help. I told her that wherever I did direct service, I made sure to receive outside consultation twice a month to discuss the impact of the work on me, and that I’d need the Network to cover that. There was a memorably long pause. Eventually Connie said, “I had in mind something more in the shape of a muffin.”

  While obviously we did not start out on the same page about trauma stewardship, Connie is in large part responsible for anything you may glean from this book.

  You can only go halfway into the darkest forest; then you’re coming out the other side.

  Chinese proverb

  INTRODUCTION

  On the Cliff of Awakening

  “Are you sure all this trauma work hasn’t gotten to you?” he asked.

  We were visiting our relatives in the Caribbean. We had hiked to the top of some cliffs on a small island, and for a moment the entire family stood quietly together, marveling, looking out at the sea. It was an exquisite sight. There was turquoise water as far as you could see, a vast, cloudless sky, and air that felt incredible to breathe. As we reached the edge of the cliffs, my first thought was, “This is unbelievably beautiful.” My second thought was,“I wonder how many people have killed themselves by jumping off these cliffs.”

  Assuming that everyone around me would be having exactly the same thought, I posed my question out loud. My stepfather-in-law turned to me slowly and asked his question with such sincerity that I finally understood: My work had gotten to me. I didn’t even tell him the rest of what I was thinking: “Where will the helicopter land? Where is the closest Level 1 trauma center? Can they transport from this island to a hospital? How long will that take? Does all of the Caribbean share a trauma center?” It was quite a list. I had always considered myself a self-aware person, but this was the first time I truly comprehended the degree to which my work had transformed the way that I engaged with the world.

  That was in 1997. I had already spent more than a decade working, by choice, for social change. My jobs had brought me into intimate contact with people who were living close to or actually experiencing different types of acute trauma: homelessness, child abuse, domestic violence, substance abuse, community tragedies, natural disasters. As I continued on this path, my roles had grown and shifted. I had been an emergency room social worker, a community organizer, an immigrant and refugee advocate, an educator. I had been a front-line worker and a manager. I had worked days, evenings, and graveyard shifts. I had worked in my local community, elsewhere in the United States, and internationally.

  Over time, there had been a number of people—friends, family, even clients—urging me to “take some time off,” “think about some other work,” or “stop taking it all so seriously.” But I could not hear them. I was impassioned, perhaps to the point of selective blindness. I was blazing my own trail, and I believed that others just didn’t get it. I was certain that this work was my calling, my life’s mission. I was arrogant and self-righteous. I was convinced that I was just fine.

  “The ringing in your ears—I think I can help.”

  And so in that moment, on those cliffs, my sudden clarity about the work’s toll on my life had a profound impact. Over the next days and weeks, I slowly began to make the connections. Not everyone stands on top of cliffs wondering how many people have jumped. Not everyone feels like crying when they see a room full of people with plastic lids on their to-go coffee containers. Not everyone is doing background checks on people they date, and pity is not everyone’s first response when they receive a wedding invitation.

  After so many years of hearing stories of abuse, death, tragic accidents, and unhappiness; of seeing photos of crime scenes, missing children, and deported loved ones; and of visiting the homes of those I was trying to help—in other words, of bearing witness to others’ suffering—I finally came to understand that my exposure to other people’s trauma had changed me on a fundamental level. There had been an osmosis: I had absorbed and accumulated trauma to the point that it had become part of me, and my view of the world had changed. I realized eventually that I had come into my work armed with a burning passion and a tremendous commitment, but few other internal resources. As you know, there is a time for fire, but what sustains the heat—for the long haul—is the coals. And coals I had none of. I did the work for a long time with very little ability to integrate my experiences emotionally, cognitively, spiritually, or physically.

  Rather than staying in touch with the heart that was breaking, again and again, as a result of what I was witnessing, I had started building up walls. In my case, this meant becoming increasingly cocky. I had no access to the humility that we all need if we are to honestly engage our own internal process. Rather than acknowledge my own pain and helplessness in the face of things I could not control, I raged at the possible external causes. I sharpened my critique of systems and society. I became more dogmatic, opinionated, and intolerant of others’ views than ever before. It never occurred to me that my anger might in part be functioning as a shield against what I was experiencing. I had no clue that I was warding off anguish, or that I was secretly terrified that I wouldn’t be able to hold my life together if I lost my long-held conviction that all could be made well with the world if only we could do the right thing. Without my noticing it, this trail I was blazing had led me into a tangled wilderness. I was exhausted and thirsty, and no longer had the emotional or physical supplies I needed to continue.

  I could have ignored the realization that began on those cliffs. In the fields where I work, there is historically a widely held belief that if you’re tough enough and cool enough and committed to your cause enough, you’ll keep on keeping on, you’ll suck it up: Self-care is for the weaker set. I had internalized this belief to a large degree, but once I realized that
this way of dealing with trauma exposure was creating deep inroads in my life, I could not return to my former relationship with my work.

  Instead, I began the long haul of making change. I knew that if I wanted to bring skill, insight, and energy to my work, my family, my community, and my own life, I had to alter my course. I had to learn new navigational skills. First, I needed to take responsibility for acknowledging the effects of trauma exposure within myself. Second, I had to learn how to make room for my own internal process—to create the space within to heal and to discover what I would need to continue with clarity on my chosen path. I had to find some way to bear witness to trauma without surrendering my ability to live fully. I needed a new framework of meaning—the concept that I would eventually come to call trauma stewardship.

  Seung Sahn, the founder of the Kwan Um School of Zen, once said, “The Great Way is easy; all you have to do is let go of all your ideas, opinions, and preferences.” Following his advice, I began to reconnect with myself. I learned how to be honest about how I was doing, moment by moment. I put myself at the feet of a great many teachers, medicine people, healers, brilliant minds, and loved ones. I asked for help. I began to reengage the wilderness around my home and to learn all the lessons I could from the endless intermingling of beauty and brutality that makes us so keenly feel the preciousness of life in the natural world. I began a daily practice that has allowed me to be present for my life and my work in a way that keeps me well and allows me to work with integrity and to the best of my ability.

  Ultimately, I recognized that it was ego that had motivated me to keep on keeping on in my work long after I stopped being truly available to my clients or myself. Over the years, I gradually let go of that façade, and I reached a deep understanding of how our exposure to the suffering of others takes a toll on us personally and professionally. The depth, scope, and causes are different for everyone, but the fact that we are affected by the suffering of others and of our planet—that we have a trauma exposure response—is universal.

  Trauma exposure response is only slowly coming to the fore as a larger social concern rather than simply an issue for isolated individuals. It was first recognized a decade ago in family members of Holocaust survivors and spouses of war veterans, but it has only recently attracted wide attention from researchers, who are working to assess its broader societal implications. To cite one example:

  According to a March 2007 Newsweek article, a U.S. Army internal advisory report on health care for troops in Iraq in 2006 indicated that 33 percent of behavioral-health personnel, 45 percent of primary-care specialists, and 27 percent of chaplains described feeling high or very high levels of “provider fatigue.”The article concluded with this blunt appraisal: “Now homecoming vets have to deal with one more kind of collateral damage: traumatized caregivers.”

  In 2007, CNN.com published an article by Andree LeRoy, M.D., titled “Exhaustion, anger of caregiving get a name.” It begins,“Do you take care of someone in your family with a chronic medical illness or dementia? Have you felt depression, anger or guilt? Has your health deteriorated since taking on the responsibility of caregiving? If your answer is yes to any one of these, you may be suffering from caregiver stress.” The article reports a finding by the American Academy of Geriatric Psychiatrists that one out of every four families in the United States is caring for someone over the age of 50, with projections that this number will increase dramatically as the population in America ages. Another source for the article is Peter Vitaliano, a professor of geriatric psychiatry at the University of Washington and an expert on caregiving. He reports that many caregivers suffer from high blood pressure, diabetes, a compromised immune system, and other symptoms that can be linked to prolonged exposure to elevated levels of stress hormones. Unfortunately, many “don’t seek help because they don’t realize that they have a recognizable condition,” the article says. In addition, Vitaliano explains, “caregivers are usually so immersed in their role that they neglect their own care.” The article cites online conversations among caregivers who acknowledge that in such an emotional state, it’s difficult to provide high-quality care to their loved ones.

  While most research to date has concentrated on the effects of trauma exposure on those who watch humans suffer, we know that responding to trauma exposure is critical for those who bear witness to tragedies afflicting other species as well. Among these are veterinarians, animal rescue workers, biologists, and ecologists. We cannot ignore emerging information about the profound levels of trauma exposure among people in the front lines of the environmental movement—those fighting to stop the juggernaut of global warming and those who strive desperately, in the face of mounting losses, to ward off the extinction of countless species of plants and animals.

  Pioneering researchers have given our experience of being affected by others’ pain a number of names. In this book, we refer to “trauma exposure response.” Charles Figley uses the terms “compassion fatigue” and “secondary traumatic stress disorder.” Laurie Anne Pearlman, Karen W. Saakvitne, and I. L. McCann refer to the process as “vicarious traumatization.” Jon Conte uses the words “empathic strain.” Still others call it “secondary trauma.”

  Here, we include trauma exposure response under a larger rubric:trauma stewardship. As I see it, trauma stewardship refers to the entire conversation about how we come to do this work, how we are affected by it, and how we make sense of and learn from our experiences. In the dictionary, stewardship is defined as “the careful and responsible management of something entrusted to one’s care.”These days, the term is widely used in connection with conservation and natural-resource management. In the January 2000 issue of the Journal of Agricultural and Environmental Ethics, Richard Worrell and Michael Appleby defined stewardship as taking care “in a way that takes full and balanced account of the interests of society, future generations, and other species, as well as of private needs, and accepts significant answerability to society.”

  When we talk about trauma in terms of stewardship, we remember that we are being entrusted with people’s stories and their very lives, animals’ well-being, and our planet’s health. We understand that this is an incredible honor as well as a tremendous responsibility. We know that as stewards, we create a space for and honor others’ hardship and suffering, and yet we do not assume their pain as our own. We care for others to the best of our ability without taking on their paths as our paths. We act with integrity toward our environment rather than being immobilized by the enormity of the current global climate crisis. We develop and maintain a long-term strategy that enables us to remain whole and helpful to others and our surroundings even amid great challenges. To participate in trauma stewardship is to always remember the privilege and sacredness of being called to help. It means maintaining our highest ethics, integrity, and responsibility every step of the way. In this book, I will attempt to provide readers with a meaningful guide to becoming a trauma steward.