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Mental Health Matters

By: a Street's Hope/Voluntad Clinician

One of the integral parts of Streets Hope/Voluntad (SH/V) is offering our clients the choice of clinical services. The main word in this is choice. As we have mentioned before, a major part of what is stolen from survivors is choice, voice, and empowerment. According to Maslow’s Hierarchy, the basic needs that first must be met is housing, food, water, and safety. Without those foundational elements, it is extremely difficult to engage in counseling as survival mode (based in the amygdala) is still engaged which blocks the neural network connections to the decision making part of the brain (the prefrontal cortex). As the SH/V team works to help build those foundational elements, like housing and stability, then a client who desires to connect into counseling can start working on the brain and body integration.

Complex-PTSD is a term that helps to describe what is happening in a client’s life but the depth of hurt and pain which our clients have gone through can’t be fully understood with a term or diagnosis. Sitting with a client is humbling and sobering. Trauma causes dysregulation, body reactions, different mindsets, a desire to escape and seek protection. The brain is made to protect oneself, which means entering into a place of dissociation to disengage with the intensity of abuse and pain. While this can sometimes no longer help a client regulate in the present, the first step is recognizing how amazing the brain is to protect oneself in order to survive. Struggling with addictions, disorganized relationships, and reactions when viewed through the lens of continual childhood and adult trauma make sense.

The steps in clinical work are to see the ways the brain and body respond to pain then connect to why this is happening and therefore be able to move away from a language of shame and move toward a space of understanding and healing. This is not a quick process nor easy for the clients. As I continue to meet with SH/V clients, I am honored to be let into their stories and realities. I am learning how the impact of a secure relationship is integral in our brain’s ability to regulate, cope, and adapt and how often this has been stolen from their lives. Before any work can happen the main predictor of positive outcomes in counseling is the safety and connection that is created between client and therapist. Understandably, they have learned people are dangerous, so protective walls come up fast. Patiently waiting, holding the hard space, and inviting their goal, not any other agenda, is how safety and then new neural networks can start to form.

A part of my job is teaching SH/V staff about the impact of trauma on genes, in one’s attachments, and one’s brain and body. Recent studies are showing that trauma impacts one’s genes and can be passed down plus cortisol (stress hormone) in utero influences the brain’s formation, therefore, impacting how our clients react and engage or disengage with us in the present. Almost every client has asked, ‘am I crazy?’ trying to understand what their brain and body are doing and not feeling in control of it. The answer is no. The answer is learning what is happening in their own body due to the external forces they experienced, and gaining greater empowerment that there is a reason behind what is happening, and there is hope of healing.

This work is long and tiring, but it is also truly an honor.

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