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Resolving Trauma – A Personal Journey

Resolving Trauma – A Personal Journey

I was a child protection worker in 2008 in Sydney, Australia. The job title itself was self-explanatory. My job was to protect vulnerable and defenseless children from abuse and neglect. When I found out that in one of my cases a child had died, not only that I felt I had failed to perform my job adequately, I felt that I had let the child down. A human life was lost, and I could very well be responsible for it. To me, this was a real trauma; a trauma that I had not experienced before and did not see coming. I was definitely not prepared for it.

When I first heard from my colleague that the baby with whom I had casework involvement was in a critical condition in the hospital, I was overwhelmed by a sense of disbelief even to the extent of denial. The first stage of grief as proposed by Kubler-Ross (1973) actualized in me, that is, denial. The denial stage was compounded by the fact that just two weeks ago, I was gazing at this adorable healthy baby. Yet I now had to confront the profound loss of someone whom I had had an emotional connection with. Further, the tragic situation was exacerbated by the fact that it happened so sudden and expected. I was completely unprepared for this and have never experienced such incidents before during the line of work duty. Being a more sensitive and empathetic person temperament wise, this trauma had affected me more than I thought it would. Emotional reactions which included feelings of guilt and self-blame ensued and they continued to build up inside me. Many questions kept flooding through my mind:

“What have I missed out in my initial assessment of the family?”

“Why did I not see that coming?”

“Why could I not have done more to prevent such a tragedy?”

I soon began to doubt and question my ability and capability as a child a child protection caseworker. This in turn caused much anxiety, that I would be investigated in relation to the casework I did this this child and the unknown consequences that would follow as more irrational thoughts and beliefs were engendered in my mind. My body also reacted to this trauma with a loss of appetite, feeling of sickness in my stomach and a lack of energy, all of which were common traumatic reactions. As Shalev (2002) puts it, the emotional and cognitive responses during the initial traumatic event impact are often “powerful, unexpected, and take control of a person’s behaviour”.

Promptly after the incident whereby I was informed of the passing away of the child, counselling by a trained counsellor, Judy, (not her real name) was arranged and provided for me. This turned out to be the direct intervention for the trauma which I was experiencing. Indeed, comforting words from another person from an objective standpoint and the opportunity to verbalize my experience and thoughts in relation to the trauma had already made a positive impact on me at the very beginning stage of the counselling. As in all trauma interventions, Judy provided the foundations of an effective helping hand: warmth, emotional support, compassion and empathy in a professional, noninvasive and non-judgmental manner. In fact, empathy shown by Judy which included empathic listening, empathic interpretations and empathic responses had provided much positive therapeutic effect in three ways. First, Judy understood our communication from my viewpoint and validated my feelings of anxiety, guilt and self-blame. Second, the trauma I was experiencing was seen through in the context of my life. Third, the disparity between my viewpoint and the reality was communicated and clarified (Egan, 2002).

Judy was initially able to ascertain that I was not in a high anxiety state, as I appeared rather calm and settled. She also ascertained that I had sufficient emotional regulation capacity and psychological insight to continue with the counselling session. I was not overwhelmed by negative emotions, and I was able to accurately identify my emotions such as perceived feelings of guilt and self-blame for “failing” to prevent the tragedy from happening. As recommended by Briere and Scott (2006), Judy allowed me to talk as much or as little at my own pace so I could feel as comfortable as possible. This created a harmony of providing vital emotional support and obtaining essential information about my traumatic experience. I was asked to narrate my experience from how I came to know about it all the way to the present moment within a safe and private space with my counsellor. I was also encouraged to explore areas as to why I might feel guilty and responsible for what had happened. For example, I was asked questions such as:

“Is it possible to monitor the child for 24 hours a day as a caseworker?”

“Who do you think has greater responsibility in ensuring the child’s safety?”

“What could you have done at that moment given the information that you have?”

“What is a different but more positive story you can tell about yourself rather than blaming yourself for it the whole time?”

“What can you learn from this incident and how would you share this with others so others can learn from your experience?

These questions empowered me to dwell into my earlier thoughts and beliefs and challenge the cognitive distortions of attributing blame to myself in the light of a more accurate and logical perspective. Indeed, I realized that I covered everything in the initial assessment of the family and there was possibly nothing more that I could do at that moment to prevent the tragedy. My feelings of guilt and self-blame abated.

Applying the five components of trauma processing cited in Briere and Scott (2006), the brief breakdown of my own trauma processing is as follows:

  1. Exposure – I was asked to recall and narrate my traumatic experience.
  2. Activation – My emotional responses were elicited such as feelings of sadness, anxiety and guilt.
  3. Disparity – A logical distinction was made in relation to my perceived subjective reality as opposed to a more objective reality.
  4. Counter conditioning – Positive feelings and reinforcement and encouragement from my counsellor had been particular therapeutic.
  5. Resolution – My negative emotions were processed and I no longer felt distressed.

Judy took steps to ensure that I was well taken care of emotionally. She gave me her name card and contact number and she continued to make follow-up counselling sessions with me. She also enquired if I had any family or friends whom I could speak to. All these were essential steps toward a successful client intervention program.

The nature of the role of a child protection worker is always fraught with appalling and highly distressing experiences. These can include witnessing the plight of severely abused children, parents abusing drug and alcohol and other criminal activities, all of which are part and parcel of the job. As such, individuals who choose this profession and stay in this profession long enough not only have the passion to protect vulnerable children, but also develop strength and resilience during the course of their work which is so often fraught with distressing and traumatic experiences.

Thus, the prevention of traumas resulting from child protection work involves the building up of resilience, and the three factors that contribute to resilience as proposed by Holaday and McPhearson (1997) include social support (cultural influences and community, school, personal, and familial support,), cognitive skills (intelligence, coping style, personal control, and assignment of meaning), and psychological resources. As concluded by Holaday and McPhearson, resilience can be strengthened through effective counselling strategies which are reflected in my own counselling experience. Firstly, in terms of social support, the counselling sessions provided by Judy was a form of formal social support which I received after the traumatic experience, in addition to other informal social support I received from fellow colleagues, family and friends. Secondly, through the effective use of the counselling sessions provided by Judy, I was able to reflect rationally and to avoid further self-blame thereby utilising my cognitive skills to reduce the impact of the traumatic experience. Thirdly, some of my psychological resources including having an internal locus of control, empathy and a growth mindset were being tapped on by Judy during the course of counselling.

On the journey of recovery from my short-lived trauma, I have experienced post-traumatic personal growth. As the old adage goes: “no pain no gain”. I have gained confidence, insights, resilience and wisdom. In fact, it is the experience with such difficult events in life or at work, that help us to discover new strengths within ourselves and better appreciate life’s meaning and purpose. A colleague of mine at that time who was in the job for over 20 years, disclosed that counselling service or support was not available in those days, and workers were simply told to “move on”. She was definitely one of the best child protection workers around. So how did these child protection workers cope in the past? They had to rely largely on support from their colleagues, cognitive skills and psychological resources. Unfortunately, these resources might not be enough for a few which eventually led to them leaving the job feeling traumatised. These traumatic experiences if unresolved, may lead to psychological difficulties, especially when memories are being triggered. Thus, there is a need to emphasize the importance of resolving trauma through professional help, in addition to having a good self-care routine, all of which are necessary steps toward increasing personal resilience.

“All children have to be deceived if they are to grow up without trauma.”
–  Kazuo Ishiguro

References

Briere, J., & Scott, C. (2006). Principles of trauma therapy: a guide to symptoms evaluation and treatment. Thousand Oaks, CA: Sage.

Egan, G. (2002). The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Healing (7th Ed.). SUA: Brooks/Cole.

Holaday, M., & McPhearson, R. W. (1997). Resilience and severe burns. Journal of Counselling and Development, 75, 346-356.

Kübler-Ross, E. (1973). On Death and Dying. UK: Routledge.

Shalev, A. Y. (2002). Acute stress reactions in adults. Biological Psychiatry, 51, 532-544.