By Sue Richardson
Understanding the impact of childhood trauma on attachment and the regulation of emotional arousal informs the process of healing (e.g. Solomon and Siegel, 2003). It is useful to apply this expanding area of knowledge to the impact of working with attachment trauma on the helper's own attachment system and capacity for emotional regulation. 'Helper' is used here as an umbrella term for a variety of roles, both professional and voluntary. To provide a secure enough base for the survivor's healing journey, the helper needs to be able to regulate their own emotional state and to have a secure enough base of their own. Studies (e.g. Dozier et al., 1994) have highlighted how different care giving responses elicited in helpers according to their attachment style effect the therapeutic process. For example, regardless of client need, helpers with a preoccupied style may intervene more while those who are dismissive may tend not to.
As helpers, we would probably all like to think of ourselves as secure enough to respond appropriately to the client's attachment needs whatever our own attachment style. However, I suspect that anyone who stays the course as a companion on the survivor's journey will find it hard, at least at some point, to avoid becoming over-aroused in attachment terms.
It is both normal and inevitable that the helper's attachment system will be activated by intense insecure ambivalent, avoidant or disorganised care seeking by survivors whose attachment needs have been exploited and betrayed by their abusers. For example, hearing the experiences of a survivor of satanic ritual abuse can lead to anxious, over-involved care giving or to avoidance and disengagement.
Persistent exposure to emotional deregulation in the absence of adequate care, leads to burnout and secondary traumatisation. This causes not only personal and professional distress, but also restricts the capacity for reflection and exploration so essential to helping work. There are several routes by which we can maintain and restore our emotional equilibrium and with it, our reflective and exploratory capacities.
Van der Volk (Counselling and Psychotherapy Journal, May 2004, 10-13) speaks of the particular need of trauma workers for self-soothing, restorative activities such as meditation and yoga. Such physical, reflective and spiritual activities reduce stress, the volume of stress hormones in our brains and help us to hold on to a sense of meaning.
As well as self-care, we also need good enough care giving. This might come from someone perceived as older or wiser but can be from a variety of sources as long as it is sufficiently reliable and companionable. For example, on exploring my experience as a professional caregiver in a threatening and deregulating environment, I identified the absence of supportive and companionable peers as a major source of distress and the support of a few key people as a key component of recovery (Richardson and Bacon, 2001).
Those survivors, who are severely symptomatic, and especially isolated struggling to be self-reliant or stigmatised by other sources of help are a particular challenge to our capacity for self-regulation. How do we respond without either abandoning the survivor or becoming the sole, overburdened caregiver? Thinking creatively and forming 'virtual' teams (e.g. with referrers, other practitioners involved with the survivor) or offering packages of assessment and consultation might be more constructive than saying ‘no’ or more realistic than asking the survivor to find a support system as a precondition for counselling.
Identifying the challenge of emotional regulation may be a helpful way to view colleagues who struggle with their boundaries or who fail to engage in difficult terrain. We can also make decisions on training, conferences and other professional activities in the light of how far they are likely to be stimulating and supportive without being too deregulating. If we can stay in touch with the complex drama going on in our own brains then we will be better equipped to attune to the narrative of trauma being played out in the lives and minds of those who seek our help.
Dozier, M, Cue, K. L and Barnett, l. (1994) Clinicians as Caregivers: Role of Attachment Organisation in Treatment. Journal of Counselling and Clinical Psychology, 62, 4, 793-800.
Richardson, S. & Bacon, H. Piecing the Fragments Together. In: Richardson, S. & Bacon, H. (Eds.) Creative Responses to Child Sexual Abuse: Challenges and Dilemmas. London: Jessica Kingsley.
Solomon, M. F. and Siegel, D.J. (2003) Healing Trauma: Attachment, mind, body and brain. London: Norton
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