Trauma and the Peer Support Relationship
The peer support relationship is based on mutuality, empathy and empowerment. Relating to people who have experienced trauma can be exhilarating and worthwhile, but it can also be devastating and disturbing. As peer supporters we are encouraged to try to feel what it feels like to be the other person. The ability to skillfully sense our way into someone’s life experience and emotions is useful, because empathy helps. However it can be a challenging experience.
In module 11 we focus on self-care in the peer relationship and encourage you to consider how you can develop strategies and approaches to ensure that you stay well when working in situations such as those where trauma is being discussed. People who have had their boundaries violated will tend to test the boundaries of those they interact with.
Those who have experienced trauma can also experience ‘victimstance’ thinking where they perceive themselves as being attacked where no such intent existed. This can result in a sense of feeling persecuted, which invites the other into the role of rescuer. In module 4 we learned about power in the peer relationship. We will also go onto to look at boundaries and working with risk in module 10.
Mental health service users as a group have a high prevalence of trauma. In addition to this past experience of trauma, some people face trauma within mental health services. This can be caused by forced treatment, loss of liberty, physical restraints and debilitating medications. When labelled with a psychiatric diagnosis, the person’s experience can be further embedded in the ‘self as problem,’ and their pain viewed as a symptom to be treated.
In the role of ‘patients’ we can learn to view ourselves and our experiences through others’ eyes rather than through our own. Our most personal experiences are interpreted and named by others. Through this we learn to believe that we are ‘mentally ill.’ If we challenge the treatment we could be considered non-compliant, if we disagree with the label we are in denial, and if we ask too often for the help we’ve been told that we need, we are considered ‘revolving door patients’.
Yet all of these things seem to validate and justify others’ opinions that we are the ‘problem’ and in need of ‘treatment’. As peers we have the opportunity to break the cycle by developing relationships that share power, generate new ways of seeing and thinking, and by listening to each other in ways that don’t judge or assess. These relationships can then become the basis for challenging the ongoing proliferation of trauma as well as building more empowered communities.
Trauma informed peer support
When we are thinking about trauma we need to understand its characteristics. It is not just about the event itself, but also about the personal, unique and cultural meaning that the event has for the person and also the impact it has on the person’s life. The destructive force that trauma has on a person’s life has to do with all of these characteristics and also the recognition that it depletes the coping resources that people have.
When those resources are depleted our relationships with others become a crucial way of being able to cope. However one of the issues around trauma is that it significantly impacts on our sense of identity and the way we form relationships. Since peer support is all about building relationships, peer supporters need to pay attention to how trauma can make that even harder. One way to do this is to ask a person ‘what happened to you?’ rather than ‘what is wrong with you?