On Feb. 5, Safe Harbor staff and invited community partners attended a daylong training at Libbie Mill Library. The program was funded by a grant from the DCJS Sexual Assault Grant Program, which allowed participants to attend for free.
“Our goal in hosting this program was to allow counselors, social workers, advocates and first responders to hear directly from Bonnie Martin on best practices in working with clients who have experienced complex trauma,” Community Outreach and Education Manager Jen Miller said. In attendance were representatives from local sexual and domestic violence agencies, universities, social services and corrections facilities, as well as Henrico County Police Department and Victim Witness Assistance.
“You can never compare trauma, and you can never predict,” Martin said.
When you’re working to help people who have been profoundly impacted by trauma, expert counselor Bonnie Martin says there’s a critical difference between working “strong” and working “smart.”
“Nobody is strong enough to do this work,” Martin warned a training room filled with helping professionals and direct-service providers. “Working strong is going to get you burned out. Working smart will allow you to do this work for the rest of your life.”
Martin specializes in complex trauma, which impacts many survivors of sexual and domestic violence. Through her extensive experience working with victims of violence, exploitation and human trafficking, Martin has developed specific approaches to healing that implement the latest research in neuroscience and trauma’s effect on the brain. She’s a licensed professional counselor in both Virginia and Maryland, and she’s conducted fieldwork in numerous countries including India, Serbia, Colombia and Haiti.
“Once you start doing this work, you can’t un-know what you know,” Martin said, a sentiment that resonated with the professionals in the room. Most people who seek help from an agency like Safe Harbor have been impacted by a traumatic event, but many have experienced multiple traumas throughout their life.
Martin explains that each healthy relationship builds pathways in an abused person’s brain: “It’s less about what you do than who you are.”
Martin referred to the Adverse Childhood Experiences Study, which followed thousands of individuals for decades to examine how disruptive and traumatic events in their childhood could affect their health and social wellbeing into adulthood. The study focused on negative experiences that have the power to disrupt a child’s psychological wellbeing, or even impact their personality development, such as growing up with domestic violence, substance abuse or mental illness in the home; experiencing sexual, physical or emotional abuse; or losing a parent due to death, separation or incarceration. These experiences in childhood often underlie significant problems later in life, including chronic depression, suicide, substance abuse or sexual victimization. Going through even one of these experiences is traumatic, but a person impacted by three or more experiences in their lifetime could develop complex trauma.
The primary diagnosis for these individuals is often Posttraumatic Stress Disorder, or any other disorders that are ultimately symptoms of trauma. Martin stressed that making the distinction between PTSD and complex trauma, like all other aspects of this work, is about having the right language.
“PTSD is based on a person developing in a stable environment,” Martin said. When that person experiences trauma, they still have a sense of their identity from before the experience. But if a person grew up in an unstable environment and experienced abuse, violence or neglect in their childhood, trauma may be all they’ve ever known. “They have nothing to go back to,” Martin explained, “because their brain and body have only known chaos.”
Many survivors of complex trauma experience the core symptoms of PTSD, such as flashbacks and anxiety, but they may also struggle to maintain healthy relationships. Because of their experiences, they might hold skewed worldviews or deeply entrenched beliefs that can make conventional therapy challenging. Martin emphasized that complex trauma physically changes the brain, and when life has trained someone’s brain to constantly operate in survival mode, it alters the neurobiological system. She presented MRI scans of a healthy brain and an abused brain to show that the condition can be medical, like a traumatic brain injury, and not just psychological.
Participants practiced diaphragm breathing exercises that help to calm the body’s stress response.
“When people are told what trauma is and what it looks like, it’s normalized,” Martin said. She added that half of her clients have seen an improvement in their trauma symptoms from this kind of psycho-education alone. “Nothing is wrong with you, something was wrong with what happened to you.”
For direct service providers such as counselors, understanding how trauma impacts the brain can help them find more effective ways to approach their work.
“This is an entire population demotivated by fear and stress,” Martin said, explaining that complex trauma impacts a person’s ability to use logic and reasoning to cope with perceived threats. Their brains trigger themselves to operate in terms of fight, flight or freeze. “The brain just can’t reset itself – the hyper-vigilant brain doesn’t shut off in a different environment.”
For example, a survivor of domestic violence who leaves an abusive living situation to stay in Safe Harbor’s shelter may be surrounded by stability for the first time, but their brain still functions the same way it did to survive in a dangerous home. Martin warned that effective techniques for working with complex trauma survivors can feel counterintuitive to service providers. This comes as a shock to many well-intentioned service providers who mistakenly assume that changing a person’s environment can “solve” the other problems they face.
To help the providers understand ways to “work with the brain,” Martin taught techniques that help to regulate stress and shared stories from her counseling experiences all over the world. She encouraged counselors and other helping professionals to adopt a brain-based approach to better understand their clients needs and help them build resiliency to adapt to their environment. Martin’s techniques are the best practices of the future of trauma work, and Safe Harbor was excited for an opportunity to share her knowledge with other counselors, social workers and first responders.
“[Martin] shared her insights in a way that was engaging, entertaining, and compelling,” Miller said. “Most importantly, her presentation was enveloped with a message of hope and encouragement – that we can continue to do this work in a sustainable way.”