holding space

Holding Space for Horror, Hurt, and Healing

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Have you ever felt the sensation of déjà vu? The gut feeling that you’ve been here before and thus can’t escape this surreal feeling, like you’re floating, your stomach is full of rocks, and there’s a ringing in your ears? For many of us, February 14, 2018 was a day of déjà vu in its worst form, reliving the trauma and horror of another mass shooting.

For me personally, the sudden anger, sadness, grief, and avoidance that came to the surface were the very same that I experienced after the Aurora Theater Shooting on July 20, 2012.  For others, it felt like Columbine on April 20, 1999.  Many people around the world are affected by the loss and violence surrounding a mass shooting and so many of us want answers. As therapists, we hold space for the questions and the grief, providing a safe environment for processing of loss, fear, and desire to understand. As trauma therapists in particular, we encourage clients to explore fears and needs in order to feel heard, and possibly, to begin the healing process again. And yet there are days we struggle with balance, the effort of holding space for others as well as holding space for ourselves.  If we are completely honest, it may even feel easier to hold space for others rather than think and feel our own emotions.

Professionally, it didn’t occur to me that Aurora would stay with me in my practice, year after year. July 2012 was supposed to be a month of celebration as our cohort had graduated and were seeking our first jobs as therapists. We had bonded in role plays, through projects, on adventures, and with humor. Survived internships, passed exams, and grew as individuals. Aurora would prove to impact the cohort quite rapidly when we found out four of our own peers were present and involved in the violence that took place. It took all day to get answers about their safety, and when we finally did receive word, we came together to grieve the loss of one of our own and trauma to three others. You may know him as the hero who took a bullet for the woman he loved, shielding her from the chaos in the theater. His actions show his character and the person he was in this world. There is so much I could say, but know that he was loved by many and brought humor and lively spirit to otherwise heavy work. We grieved together over the weeks that followed, knowing the impact would go beyond our cohort and be felt around the world.  Before we could blink, the cohort was scattering rapidly, almost like a driving force was pushing us away from one another, and away from the reminders of what we’d lost. It became easier to avoid and attend to others, to embrace their pain and needs for healing by throwing ourselves into the therapeutic work, perhaps hoping to heal ourselves in the process.

And yet with each new tragedy, full of images, horror, and tears, we are transported back to our own dark times. Perhaps triggered to the point of needing breaks, tracking our own emotions, and holding boundaries with our clients to stay present in their grief. Grappling with whether to share our pain with clients out of connection and compassion or decide to lock it away for another, more private time.

Whatever direction you decide in your own grief, know that your efforts to help others through connection and compassion go a long way in recovering from these tragedies. Let us be gentle with ourselves as we are with our clients. Let us acknowledge the hurt and remain open to the healing. Let us recognize the avoidance of pain and the safety needed to face it. And let us hold space when words cannot capture what is felt rather than said.  Only when being true to ourselves and embracing vulnerability can we truly support healing.

In loving memory of Alexander C. Teves

Humanity: Transforming Therapy into an Art of Holding Space

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“Do you know what it’s like? Has that ever happened to you? Have you experienced it too?” Your client sits across from you, disclosing some of their most personal experiences in a desire to connect and be seen. In a genuine effort to maintain rapport, you nod your head, agreeing with them. You think to yourself, “Yes, I can connect with just about everyone! This is such meaningful work!”  But then it happens, they’ve sensed something and they begin to pull back, both physically and emotionally as they sit in your office.  They are shutting down and you can feel the energy shift in the room as they begin to disengage, to retreat. What will you do?

What would it cost us as mental health professionals to be transparent and thus more vulnerable in session? Is your client seeking an expert, a confidant, a compassionate ear? Or perhaps they want someone to hold space, to witness their pain. Research tells us that the most important and meaningful indicator for progress and healing is the therapeutic relationship, that the best fit relationship catalyzes positive change. We as mental health professionals desire to help others, to support them in their journey to self-awareness and growth, yet there are times we will witness their story and wonder if what we provide is enough. Our ability to be human and connect can help.

 

Transparency

Back to our scenario. You sense your client is pulling away, disengaging in an attempt to protect themselves. Can you name that in the room, support them in acknowledging what is happening for them in an effort at self-awareness and retained connection? Can you ask them to help you understand what just happened for them in their experience? The client responds by saying, “I just feel like I can’t trust you, that you are judging me.” So, you respond by acknowledging how important trust is and how you want to understand where they are coming from. They share more information, disclosing how they need you to hold space for their processing and truly connect with them. You agree to the importance of connection and ask for feedback on how you can support them in building trust for the work you will do together. You offer a genuine apology for any misunderstanding and resulting hurt. Your client visibly relaxes, feeling seen and heard by you in this moment of vulnerability. You continue the positive momentum, supporting them in exploring other times they’ve felt this way in their community and bear witness to their experience.

 

Vulnerability

Asking a therapist to be vulnerable with a client in session can be intimidating and anxiety provoking. Depending on our own background, experiences, and training, we may feel uncomfortable connecting in this way. There are therapy modalities that deter us from showing emotion or advise against self-disclosure. Yet when you ask therapists in the field about how they use emotion or self-disclosure to connect and support their clients, there are those of us who can recall vulnerability leading to some of the most powerful and meaningful work of our career. As Brene Brown states in her book Daring Greatly: How the Courage to Become Vulnerable Changes How We Live, Love, Parent, and Lead, “Vulnerability sounds like truth and feels like courage. Truth and courage aren’t always comfortable, but they’re never weakness.” Our vulneratbility and truth can show up in the room with our clients in the following ways:

  • Admitting we can’t fully understand their experience as they know it but want to know more what it was like for them.
  • Admitting we don’t understand slang or other word choice and can they educate us so we can best support them.
  • Acknowledging their pain and the tears that show up in our eyes as we witness it.
  • Apologizing when we misunderstand or unintentionally offend.
  • Accepting responsibility for our actions and showing their concerns are heard and can be addressed in our work together.
  • Self-disclosing with the purpose of connecting to their pain, providing validation or humanity, and not for our own gain.
  • Rescheduling due to illness and letting them know we want to give them our best.
  • Recognizing our own triggers and how they show up in the room.

“Courage starts with showing up and letting ourselves be seen.” Brene Brown in Daring Greatly: How the Courage to Become Vulnerable Changes How We Live, Love, Parent, and Lead.

 

Holding Space

Transparency and vulnerability interact in developing a human connection. The art of showing up and staying connected can be further defined as the concept of holding space, written in detail by Heather Plett. Heather writes, “holding space means we are willing to walk alongside another person in whatever journey they’re on without judging them, making them feel inadequate, trying to fix them, or trying to impact the outcome. When we hold space for other people, we open our hearts, offer unconditional support, and let go of judgement and control.” As therapists, let us support transparency, vulnerability, and holding space to best serve our clients in being their own agents of change, thus engaging in a process of healing we are fortunate to witness.

For more information on vulnerability, visit brenebrown.com. For more information on holding space, please visit heatherplett.com.

Sufficiency through the Storm: Needs During and After Crisis

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“What will I do now? Where will I go? How do I survive?” At any time, a client may walk into your office sharing a crisis situation that creates even more stress and anxiety in response to the unknown. Whether it be stressors of eviction, homelessness, loss of employment, disability, or financial strain, it can make it that much more difficult for a client to continue their therapeutic work around self-esteem, coping, or relationship development due to fear.  Fear of where they will sleep, fear of when they will eat, fear of what they will do to support their family, fear of not being able to find a job. As therapists, it becomes even more important to meet our clients where they are in a situation like this, not asking too much of them as they navigate their basic needs.  Needs for shelter, food and water, needs for safety and security. According to Abraham Maslow when introducing his hierarchy of needs, only then, when these basic needs are achieved and maintained, can a person advance to the next level of work on relationships, self-esteem, and creativity or purpose.

 

Hierarchy as a Roadmap to Change

Maslow first introduced the concept of a hierarchy of needs in studying extraordinary individuals in a quest to understand their happiness and ways of life. His concepts have since been applied in medical and mental health spheres to better support patients and clients as they navigate through difficulty and a variety of stressors. It is helpful to look at the healing journey through the lens of a hierarchy of needs to best support a client with treatment planning as well as identifying valuable resources to support growth and stability.

 

Access to Resources

Depending on their needs, knowing where to find valuable resources can be an immense help in supporting our clients through crisis. In Colorado, we can access resources through a variety of databases that allow searches for food banks, clothing, shelter, free legal services, and more. Colorado 2-1-1 and Metro Crisis Services both offer a “service finder,” accessing up-to-date resources throughout the state. The Community Assessment and Coordination of Safety (CACS) is a web tool for professional helpers that allows one to search for mental health and substance referrals including providers, self-help, and community support groups by level of need, city, region, and age. One final resource in Colorado that could be beneficial is offered by Mean Street Ministry, a 16-page resource guide with locations, hours, and type of service offered throughout Colorado that can be meaningful for client exploration and self-advocacy.

 

Awareness and Advocacy

In addition to being aware of appropriate resources, it is important to be aware of client limits in taking in new information during a crisis. For many providers, it is expected that we slow down our goal progression, maybe even put a topic or intervention on hold in order to support the client with the here and now, the need for stabilization. By remaining present with the client in the current moment, we can still serve them by identifying next steps and possibly advocating for their needs in connecting them to a variety of support services. Whether its providing them with a list of resources or connecting them to the most appropriate referral, our response to their needs in crisis can support them in personal advocacy and growth with an opportunity to gain control and practice coping skills to manage the existing stressors.

 

How We Can Help

For many clients, our ability to hold space for their fear, anxiety, and grief is healing in and of itself. Recognizing the immense stress crisis and unanticipated change can have on our clients, acknowledging their fears, and conveying they are not alone can be powerful catalysts for change. Helping to stabilize the crisis is necessary before other therapeutic goals and work can progress. In light of Hurricanes Harvey and Irma, many therapists are signing up to support those most in need and devastated by crisis, by volunteering their time to offer caring, compassion, and space to grieve and heal. There are several ways to help those in need. For more information on how to support our communities impacted by natural disaster, please visit www.redcross.org.

More information on resources in Colorado can be found at https://211colorado.communityos.org/cms/home or by calling 2-1-1, http://www.metrocrisisservices.org, or www.cacs-co.com