Sunday, November 08, 2009

Victor and Vicarious Traumatization

Victor is eight years old and in residential treatment. He was born to a teen aged mother with a severe trauma history. He has moved around a lot, several foster homes, treatment programs, back and forth to his mother. One difficulty has been that his mother always distrusts his caretakers and forms combative relationships with them. So it is hard for Victor to trust, because he loves his mother deeply. He has a low IQ and sensory issues. He cannot read.

Victor has developed one solid coping mechanism. When ever he is confused, ashamed, sad, upset or fearful, he becomes aggressive. He curses, attacks, spits, etc. He has got this down to a science- because he feels confused, afraid and ashamed often.

Luckily Victor also has a lovable side. Staff care about him a lot. They speak of him with affection and amusement. They go far out of their way to help him feel safe and comfortable.

Victor’s mother has moved to Mississippi, where she has relatives. The long inter-state compact process has been completed, and a plan arranged in which Victor will go to a foster home in Mississippi. In fact, one was located for him. The plan was that he would go there with his state worker for a long weekend, return and say his good byes, and go there to live. Victor was scared, and very excited about being closer to his mother.

Victor was going to be picked up at 5:00 a.m. At 10:00 p.m. the night before, the foster mother called the unit and cancelled the visit, mentioning a "family emergency". Later it turned out that she had not been told any information about the severity of Victor’s problems, and now that she knew more, she was not prepared to take him.

Since then, Victor has fallen apart, and the frequency and intensity of his aggression has increased.

This is why we get vicarious traumatization. Its not just that we read or hear the children’s histories, or that we sit with them and feel their pain from the past- although that would certainly be enough. It is also that we go through with them the terrible things that continue to happen in the present- the many ways the adults (including, at times, ourselves) are not able to provide safe, long lasting homes.

And we have to acknowledge that much as they love Victor, staff were in some ways looking forward to his discharge. It would be a relief not to be spit on, hit or bitten as often. Treaters totally understand why he is falling apart. And, it can be exhausting to deal with the depths of his despair. Especially when we do not ourselves see where there is hope for his future. Not to mention that it can be tiring just to hold a strong wiry little boy over and over again.

But here he still is. And there is as yet no alternative plan. And to give this boy safety, to stick with him, to be there as he survives all this, is certainly the most important thing we could be doing in the world.

So how can we bear it? The most important thing is to talk about it. We have to share all our complex feelings with each other. We have to be free to say that at times we get tired of him, just as we are free to say that our hearts hurt with his pain. Staff have to be commended over and over again for the difficult, repetitive, unending acts of caring they provide. Of course, we continue to advocate that the system give Victor what every child should have.

And we turn to each other with tears in our eyes, make a joke, take a break, have a meal, and return to Victor, and continue the heartbreaking work that will save his life.

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