Tuesday, August 30, 2011

Everyday Life through a Trauma Lens

Jenna’s mentor just called and her therapist, Eileen, is talking to the mentor before transferring the call to Jenna. But she can hardly hear what the mentor is saying because Jenna is banging on her door. “That’s my call!!” Jenna yells. “Stop talking with her!” This feels like the last straw to Eileen. Can’t Jenna just give her a minute? Jenna is always so demanding. Whatever she wants, she wants it now. She asks for the same thing over and over. If there is a delay, she becomes angry and starts calling Eileen belittling names. This makes Eileen less interested in doing whatever Jenna is asking for. Whenever Eileen is involved with one of the other girls, Jenna interferes. She doesn’t have any friends because she is just as demanding and bossy with her peers. Really, Eileen has taken Risking Connection© training and has been inspired to understand her client’s behavior as trauma related. This has helped her respond to Marcelis’s cutting, and Tenisha’s running away. But this constant obnoxious behavior from Jenna is something else.

Eileen has explained to Jenna that her insistence gets in the way of getting her needs met. She has reminded Jenna that she always keeps her promises whenever she can. But Jenna keeps being loud, demanding and rude. She is so self centered, thinks the world revolves around her and she should have everything her way. Maybe they should institute some kind of reward… Jenna could get a prize for polite behavior?

Stop! Just like when we consider the big symptoms (like self harm) let’s try the trauma lens on the everyday behavior that drives us crazy. So, as usual, we start by trying to understand WHY Jenna acts this way.

Every adult in Jenna’s life has let her down. Her mother has been in and out of her life, and in and out of drug involvement and treatment. When she stops using she and Jenna have some wonderful times. But when Jenna least expects it her mother disappears again into the drug world. This has left Jenna caring for her two twin younger brothers, although they are both in foster homes now. Earlier in her life Jenna fed, changed and played with them when her mother was not there. Jenna did her best not to share with anyone at school how bad things were at home, but despite her best efforts DCF became involved after a report from the twins’ doctor. Jenna didn’t fare much better in the four foster homes she has lived in. She experienced one episode of abuse and repeated interpersonal conflict leading to disruption. Jenna’s aunt Mary has been an important person in her life throughout all this. However, Mary too has vacillated about whether Jenna can live with her. Recently after a difficult visit she told Jenna that she cannot live there, and she has started proceedings to get custody of the twins.

Does Jenna act demanding because she thinks she deserves and should get everything she wants? No, she acts demanding because in her life she has never gotten anything she wanted, needed or deserved. Adults have not cared for her the way they should have. She has had to rely entirely on herself. The only way she has survived is through relentless demanding and grasping whenever she could. She does not trust adults, and there is no reason she should. Furthermore, underneath her bluster Jenna is sure that everything that has happened to her is her own fault. It is her fault that her mother went back to drugs, it is her fault that the twins were placed, it is her fault that her aunt doesn’t want her. So she is sure that if adults are talking about her, they are saying something bad. She knows that no one would want to spend time with her, or be nice to her, or take care of her. She will only get what she wrestles from the world.

So now that we understand Jenna’s behavior does that mean we just accept it? No. Jenna will not have a life worth living if she keeps alienating people by being demanding and insulting. So how do we proceed?

One idea would be for Eileen to begin exploring with Jenna how her ability to speak up for what she needs has been and is a strength. But I do not mean saying this perfunctorily and moving on to how she needs to learn to communicate better. I mean discovering times when Jenna saved herself and her twin brothers from death. Were there times when Jenna successfully helped her mother and brothers? Were there times when she got herself what she needed? Stay with exploring the strength Jenna has developed for a LONG time with no hint of wanting her to change. Communicate a genuine appreciation for a little girl who had to find a way to protect herself and her brothers because absolutely no one else was doing it.

Meanwhile, Eileen and all the staff can constantly validate the need beneath Jenna’s demands. Validate without adding “but you shouldn’t talk to me that way ” or “you can’t have everything, you have to think of others.” Instead say, “Jenna it’s hard when you know adults are talking about you, you are sure they are saying something bad. Jenna, you wish Marci could spend all her time with you. Jenna you want Shayna’s book so much you couldn’t wait and you took it.” A constant stream of validating the feelings beneath the words.

And we all should be as completely reliable and trustworthy as we can possibly be. If we have to change something, we should acknowledge it directly. And we should point out when we fulfill our promises, NOT with any implication that Jenna should have known to trust us. Just say: “Jenna, I said I would call your worker today. I did, and here is what she said.”

Is there any possibility that Jenna could use her ability to advocate for the good of others? When she is ready could she call (after rehearsing) a bowling alley and negotiate a discount for the program? Could she collect all the girls’ preferences for activities and present them to staff?

It would be great if Jenna could participate in a social skills training group, such as a DBT skills group. There she will learn interactive skills along with others, without reference to her particular issues.

And most of all, as Jenna feels safer, more appreciated, happier, more included, more trusting and more able to meet her needs she will be able to let her guard down and become more gentle. Then we may reach that miraculous day when Jenna says: “ I tried to talk to my DCF worker about a clothes voucher but it didn’t go too well. Could you help me figure out how to do it better?”

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