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The Trauma of Homelessness



Published July 29, 2009 @ 07:58AM PT

When we hear the word "trauma" we might associate it with shell-shocked veterans, loss of a loved one, or perhaps a bad car accident. But trauma is extremely applicable to homelessness, since it can be both a cause and effect of living without a home.

The first presentation I'll be live-blogging today is about trauma-informed care. This session was presented by Kathleeen Guarino from the National Center on Family Homelessness (but representing the Homelessness Resources Center). Today's topic: traumatic stress in people experiencing homelessness and how to treat it.

9:15am - Round-the-room introductions. Roughly 100 people present from around the country (and Canada!) who do a lot of impressive things. There are people from Texas, Alaska, and even a representative from Miriam's Kitchen in DC (remember this debocle?).

9:17 - We all deal with stress, but it becomes traumatic when it is an overwhelming experience, something that involves a threat, or an event that leaves a person feeling helpless and fearful.

9:23 - Question: How many people in the room serve homeless people with more than one traumatic stressors? All hands in room go up.

9:24 - If you serve the homeless, you aren't just meeting basic needs, you are dealing with people struggling with traumatic stress issues.

9:26 - Talking about the physiology of the brain - how humans are wired to respond to stress. Fight, flight, or freeze. Discussion about how we see these reactions in the homeless population.

9:33 - Talking about examples of "fight" response: verbal aggression... Is this only in Boston?

9:36 - Traumatic stress in a nutshell: When the body's physiological responses (fight, flight, or freeze) do not have the intended effect. A ha. I get it.

9:43 - A few things that influence the way people react to trauma: history, current functioning, culture, and nature of social supports. Many homeless kids are already behind the normal functioning level for their age, so when a traumatic event occurs (like homelessness), they're already more likely to react poorly.

9:54 - Trauma-informed care is about how we understand and act towards people. Removing judgement, for example, through small changes in language can have a big effect.

9:58 - I'm really enjoying the commentary from the crowd in this session. We just had a small discussion about people who cope with trauma through substance abuse. One formerly homeless woman in the crowd acknowledges that it was the patience of her service providers over seven years that saved her life. Powerful.

10:00 - "Homelessness is not an acute trauma, with a definitive beginning and end. It is life. Which makes it more difficult to treat."

10:02 - A note about people serving the homeless: "If [service providers] are not impacted by the traumatic experiences of their clients, I wonder if you're not fully connecting. It becomes overwhelming, so self-care is absolutely necessary."

10:09 - Talking about culture - how messages from our youth stay with us forever. A few good anecdotes from people in the room: "Nobody will ever be better than you, nobody will ever be less than you," and, "I cried because I had no shoes, until I met a man who had no feet."

10:12 - Your culture can also be a negative. A few common cultural quips on mental health: "You're fine, don't tell anyone you're sick." or "Mental illness is a spiritual problem - pray."

11:19 - Back from break. I'm late and missed some good stuff... whoops!

11:22 - Funny, something as simple as a sign-in policy for a shelter can make someone with trauma feel a "loss of power," regardless of how good the rationale is for such a policy. Explaining the need for such a procedure ("We need to know who is in the building in case there's a fire.") can have a big impact.

11:24 - Anyone can be "trauma-informed." It simply means knowing that someone has experienced trauma and understanding that there may be lingering effects.

11:35 - Two important things about trauma: recovery from is possible and healing happens in relationships.

11:42 - To wrap this session up, here's a relieving and enlightening observation: At the end of the day, you have to be enough. Read that again.
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