Listen to thisAfter a particularly difficult day at the facility where I work, I began to ponder whether someone in the Youth Care field ever gets used to dealing with the pain of others. I am left wondering, is it possible for Youth Care Practitioners to rationally detach from the transference of the emotional pain experienced by the youth?
Placing youth in a secure facility for their safety and well-being is an intervention sometimes required in the facility I supervise for young women aged twelve to eighteen.
One day, a fifteen-year-old youth had just returned from an extended absence from the facility without permission, a pattern that had been occurring for quite some time. As the youth readied herself for a job interview, the Youth Care workers and I had to stall the youth from leaving so that the police and social worker could arrive to transport her to the secure facility. Minutes later, two police officers, the social worker and a transport person arrived at the facility. When the youth was told she would be going to the secure facility she attempted to bolt out the front door.
After being given direction from the officers to not resist, the youth became extremely combative, kicking and hitting them. She was placed in shackles, handcuffed and then held face down on the floor of the hallway. I attempted to calm her down, telling her to not resist as she was only making the situation worse on herself. She managed at one point in the restraint to spit towards one of the officers. The officer then requested a ‘spit sock’ that he put over the youth’s head. This was something that I had never seen before, and I found it very distressing. My mind and my heart were both experiencing pain. Watching this youth being treated as an object and not a person, let alone a hurting fifteen-year-old child, was difficult.
While she was lying on the floor she turned her head towards me and asked, ‘Are you proud? This is what you do to little girls?’ Although I know that this was not about me, I have to admit that it felt like a knife through the heart. I reacted in an emotional way, having to turn my head away so as to avoid crying in front of my co-workers and other professionals.
Child and Youth Care practitioners are continually exposed to what James Anglin calls the ‘pain-based behavior’ of the youth we work with. He goes on to describe the term ‘pain-based behavior’ as ‘an abbreviated way of saying behavior, either of an acting out or withdrawn nature, that is triggered by the re-experiencing of psycho emotional pain’ (2002, p.111). The question to be asked then, is how do we respond to the pain? How do we deal with the emotions of the youth and still maintain our professionalism?
Inexperienced Youth Care workers are often exposed to situations that they have never had to deal with before. When I began my career in the Child and Youth Care field, I was twenty-one years old and straight out of university, with little to no experience. I had little idea of the complexities surrounding the field of Child and Youth Care.
After a single ‘shadow shift’, I was scheduled to work my next shift alone. At the time, there was a pattern of self-mutilation with the youth; several residents were engaging in cutting behaviors. I was left alone from 11:00 pm. to 7:00 am.
During a routine night check, I walked into a youth’s bedroom, shone the flashlight on her in her bed, and saw red blood seeping through the white bedspread. I felt panicky and fearful as to whether or not I could deal with this. I had never been exposed to these behaviors or to the underlying causes of such behavior. After tending to this youth and providing medical attention, another youth approached me to say that someone else had also done some cutting. This awoke yet another, who was running around hysterical from the events she was seeing. I managed to get through the night but required a lot of supervision and debriefing the next morning.
I remember getting home and climbing into my bed, unable to sleep. I thought to myself that although I did manage to handle the situation, did I really want a career filled with such crisis, and having to deal with the pain of others? I returned for the next shift and the next, and over twenty years later I find myself grateful for the choice I made that night.
As my practice as an intervener developed , I was exposed to many difficult situations with the youth. Some of the experiences that the youth and I had together involved understanding the nature of their abuse and neglect and dealing with their grief and loss or abandonment. Due to the depth of their trauma, some unfortunately required physical restraint to keep them safe from themselves and others, as they acted out their pain-based behavior.
One thing has remained consistent in my approach. Although I learned to intervene effectively and remain calm and professional in my interventions, the empathy and depth of feelings and emotions I felt when dealing with their pain has never changed. I still get that nauseous feeling in the pit of my stomach when I hear about a child’s painful past, when someone describes just wanting to be loved, or when I see a youth hand-cuffed and shackled by the police.
Non-Violent Crisis Intervention training provides participants with techniques to safely manage disruptive and assaultive behavior. Part of the course speaks about the importance for Youth Care workers to remain ‘rationally detached’ from the youth. Rational detachment is defined as the ability to stay calm and in control of one’s emotions, to maintain one’s professionalism even in a crisis moment. It means not taking things personally, even button-pushing comments that attack your appearance, race, gender, or competence (Crisis Prevention Institute Inc. 2005, p.9).
Through facilitating this training over the last ten years, I have found that inexperienced workers have the most difficulty with this. They tend to take everything personally, and assume that the youth’s seeming contempt means that they are bad Youth Care Workers.
Experienced workers learn to use a variety of coping strategies. They learn to become aware of what might be a trigger for them emotionally and to reflect on what youth could say or do that the workers might react to. They learn to control their behavior by being preventative: getting proper rest, eating well, accessing a support system outside of work, and learning how to calm themselves in the moment. It helps for workers to be reflective, to take mental note of their reactions and ensure they debrief a situation with someone afterwards. Workers might reflect on why the youth are in the program in the first place, recognizing that the behavior is a symptom of the pain, and it is not about them.
In order to remain focused on helping to solve the problem rather than reacting, Rudolph Dreikus, an American psychiatrist and educator says, ‘Amid a crisis, repeat in your head language is behavior. It is my job to figure out what the youth is trying to tell me’ (as cited in Parish, 2008, p. 36).
Being part of a Youth Care team means that there may be times that we have to help our co-workers to rationally detach from a situation. Sometimes in the midst of an intervention something might trigger something for us and we may get caught up in a power struggle or become consumed with our own feelings about the situation. I remember a few years back working with a colleague who had recently lost a child. We had been dealing with a youth who was pregnant yet continued to engage in behaviors that could affect her unborn child. She persisted in doing drugs and said that she had no intent to quit despite the team educating her on the possible side-effects. I noticed that the worker needed to disengage from the conversation as her own biases were surfacing. As an experienced worker she also quickly realized she needed to disengage.
Chris Walker, an internationally known change agent, supports the
concept of rational detachment and ambivalence. He says, ‘If you remain
ambivalent to their emotions, you’re absolutely remaining available for
communication, whereas if you react, well now you know that their
emotions were actually yours... Not reacting to someone’s emotion can
seem harsh because you aren’t buying into it.
However, when one
person is drowning, you don’t usually jump in and create two people in
trouble; you get ropes and life preservers and things to help. So,
reacting means they pulled you in. If there is no reaction, their stress
is not your stress’. (Walker, 2008).
Should we, as practitioners be able to do our jobs with no sense of
feeling one way or another about the youth? As a Youth Care Supervisor I
need Youth Care workers that are skilled in rational detachment and can
handle situations effectively and professionally. However, Anglin (2002,
p.111) assures us that a practitioner’s reactions to client’s
‘pain-based behavior’ are unavoidable. Our work is
relational in
addition to our role of achieving precise contextual interventions
through a clinical process. To achieve balance, the sacrifice may have
to be an awareness that a complete and effective intervention will
likely cause us, on occasion, to become over involved in the emotional
experience of youth. The result may be that we react to the youth from
an emotionally charged position, which can cause them to relive or
experience further trauma. The result for the practitioner is that it
may send us home stressing over the experience. Yet, distant and rigid
responses alone will not provide the healing environment youth need.
The dilemma remains: how do we as practitioners balance a distant, calculated and rigid precision in practice while maintaining a relational, therapeutic context that creates connection, belonging and trust? I believe that achieving this balance is possible through engaging in an interactive supervision process and active self-awareness.
Actively participating in the supervision process with a competent colleague should provide a needed self-awareness of our pain-based reactions to pain-based behavior of youth. If violence was a part of our growing up, we need to realize that an evocative trigger from our past may influence our professional interventions.
Our internal, possibly subconscious, meaning-making connections and subsequent reactions of triggers, like name-calling, sarcasm, gender-oppression, bullying, etc., need to be self-explored through some process of reflection and connectedness and knowledge of how it might influence our professional practice.
Without an exploration of the depth and scope of our own emotional triggers, we, as professional practitioners, run the risk of creating reminiscent trauma for the group of people who we are supposed to be helping. Subconsciously reacting to our own childhood trauma encountered through an experiential trigger in the present daily life events of youth in our care, we may self-project a desire to protect ourselves emotionally under the guise of a clinical intervention.
Providing care with youth while staying detached from our own past trauma is a complex effort to do perfectly in every situation. However, those outside the minutiae of the treatment context will expect us to separate the two every time.
References
Anglin, J.P., (2002). Pain, normality, and the struggle for congruence. Binghamton, NY: The Haworth Press, Inc.
Crisis Prevention Institute Inc. (2005). Non-violent crisis intervention training program. Brookfield, WI: Author.
Parish, R. (2008). Embracing autism: Connecting and communication with children in the autism spectrum. Portland: John Wiley & Sons, Inc.
Walker, C. (2010). How to deal with other people’s emotions. Retrieved from http://www.ezinearticles.com/?How-To-Deal-With-Other-Peoples-Emotions&id=1040 106
