Feeling Helpless as a First Responder

The First Responder
As a school counselor, I often feel like the first responder in a psychological crisis.  I am like the EMT that escorts the child to the psychological hospital (aka. the therapist's office) where most of the intense recovery work takes place. 

Unfortunately, for some of my students, the parents either do not have the resources or do not see the need for their student to receive counseling, and the child is left in my care.  I am the only "psychological" doctor they will see.

At a recent conference, I was grappling with the anxiety of being a first responder in trauma recovery.  After a presentation on trauma, I once again felt the helplessness of only being a school counselor. 

Hoping to find some inspiration, I pursued a conversation with the presenter. "Many students at my school are dealing with trauma."  I recounted a story to him of a child who had witnessed a terrifying domestic violence incident. The child sobbed in my office as she told me the story.  I felt helpless.  I knew this child needed support to process such a cruel act.  She herself felt helpless.  How could I, feeling helpless myself, help her? 

A Healing Relationship
In this moment, I was to be what Judith Herman (1997) calls "a healing relationship."  Peter Levine and Maggie Kline (2007) compare it to being "a band-aid or a splint. The band-aid or splint doesn't heal the wound, but protects and supports the body as it restores itself" (p.84).  Peace refers to this relationship as "the Constant" - a relationship we can recall in our memory that is comforting, consistent, and inspiring.  Peace says this relationship may be "your mom, a close friend...your cat, a deceased relative." 

In all three definitions, this healing relationship is consistent and provides a safe place for healing to occur. The school counselor is the band-aid.  The school counselor is the healing relationship.  The school counselor is the Constant to many children who have experienced trauma. 

Below are several research-based guidelines for establishing a safe, healing relationship with children who have experienced trauma.

1. Set boundaries.
After a child has experienced trauma, they may actively seek someone to relieve them of their pain.  The child may idealize the counselor, or another adult they trust.  They may set such high, impossible standards for the counselor that the counselor will inevitably fail.  Talk with the child about boundaries, and what you can and cannot do as their counselor (Herman, 1997).

2. Empower the student.
Do not assume the role of "rescuer", thereby allowing the child to stay in the role of "victim."  Herman (1997) warns that "the more the therapist accepts the idea that the patient is helpless, the more she perpetuates the traumatic transference and disempowers the patient" (p.142).  Give the child as much opportunity as possible to make choices, voice their feelings, and be their own advocate.  In the beginning, help the child establish safety by focusing on taking care of themselves (e.g. eating and sleeping routines), managing their post-traumatic symptoms, and developing trust. 

3. Care for yourself.
Listening to traumatizing stories day after day is exhausting.  You emotionally identify with the child, sometimes experiencing similar feelings of helplessness and fear.  As you hear and "re-live" these stories, you must grapple with existential questions like "How can a loving God allow this to happen?"  You may call into question some of your own relationships and find yourself being less trusting of others.  In order to care for the child through this emotional tumultuous process, you must also care for yourself.

Herman (1997) compares trauma recovery to running a marathon.  It is not a single event.  It is not one single moment in time where the child bares their soul.  Instead, it is a slow process that requires honesty, grit, and a healing relationship.

I do not suggest that trauma recovery work should take place in the school setting.  However, trauma and its symptoms are brought to school everyday.  The school counselor must be prepared to be a first responder to children in trauma. While we may not be the private practice counselor that processes the traumatic event with the child, we do want to be a safe, healing relationship for the child.


References
Levine, P. A. & Kline, M (2007). Trauma through a child's eyes. Berkeley, California: North Atlantic Books and Lyons, Colorado: ERGOS Institute Press.
Herman, J (1997). Trauma and recovery. New York, NY: Basic Books.
Peace (unknown). Psychopath free.

Why I Matter So Much (and Why YOU Do Too!)

The past few months have been quite stressful.  Working as a school counselor at a high needs school means lots of crisis intervention, lots of teacher consultation, and lots of individual counseling on serious issues. 

The title of this post may sound pompous.  If so, it is misunderstood.  It is not just why I matter so much, but also why YOU matter so much. 

This week, I had to remind myself that I am the most valuable therapeutic tool I have available.  CBT is great, and social skills training can be effective, but none of these techniques or tools compare to the value of myself.

If the students see me as approachable, they will seek me out.  If the students see me as safe, they will drop their defenses. If the students see me as trustworthy, they will share their hidden truths. If the students see me as caring, they will know that their feelings matter in this great big world.

Any counselor can SAY all of these things - "You can trust me.  Your feelings matter.  You are safe here."  But showing them WHO I AM is what welcomes their trust, respect, and confidence AND makes the difference.

 

Do you feel like you are less than approachable, less than safe, less than....how do you become who you want to be?  I have 2 quick rules that guide me as a school counselor.

1)  No child (or teacher) is an interruption.  Interruptions are part of my job (although they didn't make the official job description).  Deal with interruptions with grace - as if you were expecting the person.  Although boundaries are needed, never make a student feel like their feelings, needs, or presence are unwanted or unimportant.

2)  Be genuine.  The truth is I love my kids.  Carl Rogers speaks of congruence in person-centered therapy.  If you don't love your kids, if you have lost your passion, step back and reflect. Genuineness will fuel the extra emotional energy, the extra time, and the extra creative power you need to be an effective counselor.

Using Guided Imagery and Meditation with Children

What is Trauma?

When we think of the word trauma, we typically think of war, accidents, or 9/11.  However, trauma can be caused by a variety of things - domestic violence, medical procedures, falls, divorce, death of a family member, bullying, and natural disasters.

As Levin and Kline (2007) note, "Trauma is in the nervous system - not in the event."  This basically means that how the child processes the event determines whether it becomes traumatic to the child.

Levin and Kline (2007) identify 3 parts of the brain. 

1. The first is the neocortex, which is the thinking part of the brain.  The complexity of this part of the brain makes human unique.
2. The second is the limbic part of the brain, which deals with emotions and memory. 
3. The last part of the brain is the brain stem and cerebellum, which deals with survival instincts. 

Using Guided Imagery and Meditation

When trauma occurs and is not processed, physiological sensations may remain in the brain stem and cerebellum - such as fear, hyperarousal, or constriction.  Our typical counseling techniques do not work when dealing with unresolved trauma. This part of the brain is not accessed by asking a child how they feel (e.g. happy, sad, angry) or by asking them to think about the situation. 

This brings us to guided meditation.  Guided meditation engages the child's entire being in using their five senses (touch, taste, smell, hearing, seeing).  It helps the child become in touch with 1) a relaxed state of being, the opposite of hyperarousal.  It also 2) gives the child the opportunity to access physiological sensations that may still exist from the trauma.  Often these sensations are semi-conscious or unconscious to the child, but may still impact the child.

Trauma Through a Child's Eyes, Levine & Kline (2007).

Examples

Below is an example of one guided meditation that can be used with children.

The video below is a good introduction to guided meditation for children.  However, I would recommend that children close their eyes throughout the entire meditation.  I find the video to be distracting.

Applications for the School Counselor from "Man's Search for Meaning" - Part 2

Frankl addresses what he calls "the last of the human freedoms - to choose one's attitude in any given set of circumstances, to choose one's own way" (Frankl, p. 66).

Attitude is Everything
Psychology discusses the locus of control within an individual. Students with an external locus of control believe that external events determine their happiness. When things go wrong, they are likely to blame others, blame their teacher, and blame their circumstances. Pointing the finger or phrases such as "But he did this to me" are common from these students.  They feel that their world is controlled by the events around them.

On the other hand, students with an internal locus of control believe that they maintain a sense of control despite external events.  For example, a student with an internal locus of control will say, "I am responsible for my actions" despite their classmates goofing off or being disruptive.

One of my fourth grade students demonstrates an internal locus of control.  Despite living in poverty herself, she chooses to focus on what she can do.  She babysits younger children in her neighborhood and helps to teach them letters and numbers. 

As school counselors, we must help students change the lens through which they view the world. 

Questions that promote an internal locus of control include:

• Can you control him/her?
• Who are you responsible for?
• What was your part in the problem?
• What can you do to help change the situation? 

Helping Students Find Meaning

Frankl said "the prisoner who had lost faith in the future - his future - was doomed" (Frankl, p. 74). Based on Maslow's hierarchy of needs, we know that students living in poverty worry about their physiological and safety needs.  Sometimes my students are sleeping on couches, worrying about what they will eat for dinner, afraid of being evicted from their home, or fearful of neighborhood violence.  These students are living at the bottom of the pyramid.
 


(Image taken from costaricantimes.com)

The top portion of Maslow's pyramid focuses on concepts such as "respect of others", "morality," "achievement", and "inner potential."  When working with students in poverty, it is important to support their ascent to the top of the pyramid.  Frankl quotes a saying - "He who has a why to live can bear with almost any how (Frankl, p. 76)."  This shows us even more so how important it is to help students in poverty find purpose, meaning, and potential.

Practical Ways to Promote Meaning and Purpose
Frankl identifies three main ways: "(1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering" (p. 111)


Work

• Students living in poverty have less exposure to college and professional career options.  College and career exploration is a great way to help students "ascend" the pyramid. 
• Career Cafes 
• Career professionals are invited to speak to students during their lunchtime.  Students learn about the profession and are given the opportunity to ask questions.
• Build connections with the Career and Technical Education programs at your local high school
• For example, the students in the Nursing program at our local high school will be coming to lead hands-on activities with fifth grade students interested in nursing.
• A Good Deed
• Work is not the only way to find meaning.  Frankl also discusses doing "a good deed."  Service projects and fundraisers are a great way to help promote an internal locus of control in students.  Instead of students asking, "What can I get?", they are challenged to ask, "What can I give?"

• Relationships

• Promoting positive relationships is a large part of our role as school counselor. 
• Staff Mentor Program
• Pair volunteer staff with students exhibiting behavior problems - focus on building a positive relationship between the student and staff member!
• "Steps to Respect" Program
• The program is scripted and a "ready to go" program that helps students learn and practice relationship-building skills with their peers.
• Meaning
• Part of my job is helping students find healing, whether it be going through their parents divorce or witnessing domestic violence.
• Frankl encourages us to go a step beyond this - not only can students find healing, but also meaning in their suffering.

 

Existential Vacuum

Frankl conducted a survey which found that 25% of American students showed signs of what he calls that "existential vacuum." Comparable to the Sunday afternoon "blah," the existential vacuum occurs when a person has a lack of meaning for their life.

*Depressed and suicidal students are likely to shows signs of the existential vacuum. 



School counselors can help provide meaning for students through:

• Classroom jobs
• Pairing them with mentors
• Peer helper programs
• Service projects
• Classroom buddies for new students 
• Connecting them with volunteer opportunities

One Last Point...Anticipatory Anxiety
One last point I would like to address is anticipatory anxiety.

The first school I worked at as a school counselor was an affluent, suburban school.  Many of our students, especially high achieving students, experienced anticipatory anxiety. They would become excessively worried before a test, in anticipation of a family change, or before applying for a club or leadership position.

Frankl discusses paradoxical intention. From a layman's perspective, this is basically giving the student permission to do whatever he or she fears will happen. For example, "I want you to miss as many problems as possible on your test." This will likely make the student laugh, but paradoxically giving the student permission to do this will actually ease their anticipatory anxiety.