Accounting for Culture & Trauma in Your Services & Responses Olga Trujillo, JD Director, Education & Social Change Caminar Latino Latinos United for Peace and Equity Initiative
The National Resource Center for Victims of Crime in Underserved Communities Collaborative Initiative funded by the Office for Victims of Crime Vera Institute for Justice Latinos United for Peace & Equity Initiative at Caminar Latino
Exploring the Impact of Trauma and How its Important to Your Services Examine my experience of violence and trauma Show pictures Describe experience No graphic descriptions of violence Explore the bias, privilege & cultural implications Explore how trauma can impact your work with survivors Examine what you can do to create culturally responsive & trauma informed 3
Representing Domestic Violence Survivors Who Are Experiencing Trauma and Other Mental Health Challenges: A Handbook for Attorneys Written by Mary Malefyt Seighman, JD Erika Sussman, JD Olga Trujillo, JD On behalf of the National Center on Domestic Violence, Trauma & Mental Health Edited by Carole Warshaw, MD December 2011 5
PREPARING FOR COURT PROCEEDINGS WITH Page 1 of 4 March 2013 P: (312) 726-7020 Copyright 2013 National Center on Domestic Violence, Trauma & Mental Health SURVIVORS OF DOMESTIC VIOLENCE Tips for Civil Lawyers and Legal Advocates Legal proceedings are often stressful for participants, whether or not they are survivors of trauma. Many survivors of domestic violence find the proceedings challenging in ways specific to the trauma they have experienced ways that others may not be able to anticipate. Your ability to recognize and adjust to the challenges survivors experience will affect their ability to participate in and contribute to successful outcomes in their cases. Interpersonal violence is usually traumatic to the survivor, especially when the perpetrator is someone who was loved and trusted. Although the experience of violence is subjective and varies from individual to individual, we know that the greater and more prolonged the trauma, the more likely a survivor is to experience some after-effects. Cases of domestic violence involve an ongoing pattern of coercion, intimidation, and emotional abuse, reinforced by the use and threat of physical or sexual violence. Thus, survivors will most likely have experienced more than one traumatic event. Many lawyers and legal advocates find legal proceedings challenged or interrupted when a survivor is reminded of a traumatic experience. Reminders of previous trauma can be evoked by seeing people, by places or activities, or by experiencing the feelings and sensations associated with past traumatic events. These reminders can cause feelings of fear or distress or put people on alert. They can also restart posttraumatic stress reactions or behavior even years after a traumatic event has occurred. * These reminders can cause a literal re-experiencing of the event itself as well as the feelings and sensory associations with the trauma. The feelings associated with trauma may include panic, anger, disorientation, physical pain, grief, or numbing and shutting down. The sensory associations may be smells, sounds, or physical feelings. Moreover, in order to manage the painful feelings triggered by the reminder, survivors of trauma often cope in ways that are instinctive to them but confusing to other people: by dissociating, minimizing, or trying to control unrelated aspects of their environment. Specific to the court environment, traumatic reminders come in many forms. This may be the first time the survivor has seen the person who abused them in a long time, and they may be triggered by being in the same room as their abuser, by a * National Child Traumatic Stress Network. (November, 2011). Emotional Responses to Trauma. Retrieved from http://www.nctsn.org/content/resources-parents-andcaregivers. TTY: (312) 726-4110 www.nationalcenterdvtraumamh.org 6
Impact of Trauma on Your Work It is important to be able to identify when trauma may be an issue so that we can partner with survivors to craft strategies to help them: Stay safe Keep moving forward with what they want and need Avoid triggers Develop plans for when triggers arise 13
Impact of Privilege & Bias Be aware of privilege and bias Understand the realities of survivors lives Will be an issue for the survivor and her family whether you see it or not Partner with survivors to address strategies to help: How will the system see the survivor What is the survivor s experience with the police, immigration, child welfare Develop plans for how to address these with the survivor 14
Question What do you think my experience and the impact of trauma, means for me as a witness? Will I show any emotion? Will I show too much emotion? Will people believe me? Will I remember what we talked about? 15
Question What do you think my experience as a Latina Lesbian with trauma and dissociation means for me in your community? 16
Question What do you think my experience as a Latina Lesbian, non-conforming with DID means for me in your community? 17
Trauma and Dissociation Learn about the impact of trauma and dissociation Incorporate survivors in your learning don t just rely on clinicians
What We See & Experience Flat demeanor or spacey look Not paying attention Overreacting to seemingly benign situations Minimizing the abuse Talking all over the place Scattered (non-linear) thinking Unable to remember key facts Uncooperative Not following-through 19
Diagnoses Arising from Trauma Post Traumatic Stress Disorder (PTSD) Nightmares Nightsweats Startle Response Hypervigilance Flashbacks Dissociative Disorders Losing time Numb Spacey Anxiety and Panic Disorders Phobias such as Agoraphobia & Claustrophobia 20
Dissociative Identity Disorder Have you heard of it? Have you ever worked with someone that has it?
What is DID? A person with DID feels as if she has within her two or more entities, each with its own way of thinking and remembering about herself and her life. These entities previously were often called personalities, even though the term did not accurately reflect the common definition of the word.
DID (continued) Other terms often used by therapists and survivors to describe these entities are: alternate personalities, alters, parts, states of consciousness, ego states, and identities. It is important to keep in mind that although these alternate states may feel or appear to be very different, they are all manifestations of a single, whole person.
What this means for your work
Working with the Survivor Be Aware of the Signs of Trauma Talking in non-linear manner or tangents Flat affect, emotionally detached when discussing violence Blank stare (dissociating) Unable to remember key facts Remove Barriers to Participation If you notice signs of trauma, take steps to avoid triggering feelings that can be disruptive to the survivor as you work together. 25
Working with the Survivor Building Trust and Informed Consent of Survivors Experiencing Trauma Survivors may be unable to access all of the details Provide time/space for fully-informed decision-making Validate Be responsive, even if multiple requests for same information Help identify alternative coping strategies Connect survivors with experienced MH professionals Offer support to survivors who are using alcohol/drugs Adapted from Jill Davies, Helping Sexual Assault Survivors with Multiple Victimizations and Needs, A Guide for Agencies Serving Sexual Assault Survivors (July 2007). 27
Survivor-Defined, Trauma-Informed Services & Responses Work with Survivor to Identify Risks Types of Risks: Perpetrator-Generated Mental Health Risks Life-Generated Mental Health Risks Oppression and bias Perpetrators use mental health risks to further their abuse and get away with it. E.g.: Threatening to use survivor s mental health history against her during legal proceedings or processes. Tactics of intimidation Knowledge and preparation is the antidote Analyze mental health risks now and in the future. 29
Working with the Survivor (continued) Partner With Survivor To Devise Options that Fit Within Broad Safety Plan Strategize about risks and benefits of options 30
Share Information and Listen Key Question: Does the survivor feel that she can participate in your program? Consider the challenge; develop strategies. Examples: Repeat things Use different modes of learning Conduct a Self Assessment 31
Survivor Referrals to Mental Health Collaborating with Trauma- and Violence-Informed Mental Health Professionals Encouraging Survivor-Driven Decision-Making Don t present options until you have context Don t move forward based upon a simple yes Together, analyze risks and benefits Create options that mitigate risks Give client time to consult with friends, family, an advocate 32
Tips to follow Tipsheet
Systems and Services Can be Inherently triggering Prepare early for legal proceedings Predictability
What you can do Repeat things as often as needed Keep it simple Talk about trauma signs and symptoms Be willing to do this over and over Neuroplasticity
Help Access Services Predictability Key to success Plan ahead Prepare Limit stimulation Limit noise and chaos Modes of communication Talk about trauma related issues and how you ll handle them
What else can you do? Plan for triggers Encourage supportive connections Consider support animals or service animals Grounding techniques
Strategize with Survivors to Ensure Emotional Safety Build Trust Help Survivors Understand What to Expect Learn about triggers She may not know all (or any) of them Make a list that she can keep Anticipate triggers What helps? What can you do? What does she do when this happens? Plan for them.
Resources REPRESENTING DOMESTICVIOLENCESURVIVORSWHOAREEXPERIENCING TRAUMA AND OTHER MENTAL HEALTH CHALLENGES: A HANDBOOK FOR ATTORNEYS, Co-authored by Mary Malefyt Seighman, Erika Sussman, and Olga Trujillo (National Center on Domestic Violence, Trauma & Mental Health, January 2012). Preparing Survivors for Court (National Center on Domestic Violence, Trauma & Mental Health (May 2013) 48
Olga Trujillo, J.D. Director of Education & Social Change Carminar Latino Latinos United for Peace & Equity Initiative otrujillo@caminarlatino.org