Wednesday, February 02, 2011


Recently our girls have been expressing their intense and unremitting pain. Latasha finds so many creative ways to hurt herself- she eats staples, bangs her head, and hits herself in the face hard enough to make herself bleed. Jessica is so sure that her family is blaming her for revealing her sexual abuse by her uncle that she tried to hang herself. Shahara ran away and tried to pick up some older men. Marguerita takes off her clothes and tries to scratch herself all over, and then she swallowed an open safety pin. We send them to the ER, they come back in a few hours. We surround them with caring, and they feel only despair.

These girls see no hope. They have no one in the world who they are sure loves them. They hate themselves and blame themselves for everything that has happened in their lives. They see no road to any positive future.

The staff and therapists feel a great deal of caring and compassion for these girls. And yet, their behavior is exhausting. It’s hard to believe that Latasha couldn’t just stop it. And we explained to Sharara the dangers in running away, can’t she see them? We are used to getting through crisis’s, but this unremitting repetitive anguish is so draining.

And the problem is that we don’t see any hope either. When Marguerita expresses her certainty that her life will never be better, we wonder if it ever will. And we can’t think of any concrete reassurance to offer her, anyone who loves her, any good thing that is coming soon.

We forget that we are the hope. What the girls need from us is not a specific reassurance that something good is happening. No, what they need is much harder to provide. They need us to be with them in their pain, feel it with them and not turn away. They need us to see their worst and not give up. They need us to care when they are hurting, and keep caring, validate their pain, and not be disgusted. This is the real, substantial gift we can give them. Hope is created when they experience the possibility of true human connection. There are people in the world who accept you as you are, care what has happened to you, and listen. There are people you can trust who do not hurt you. There are people with whom you are safe.

This isn’t the only thing we have to do in treatment. We also have to teach skills, calm biological activation and develop self worth. But it may be the most important.

So, we have to sustain ourselves and each other, because this is hard, much harder than giving advice or administering restrictions. We are doing the most important work in the world, and real engagement will transform both the girls and us. And what could be more hopeful than that?

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