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We Need the WHOLE to Create Trauma-Informed Systems

 

Sometimes I think I have PTSD from failed change efforts.

I am not kidding.   I have developed symptoms from living through nearly twenty years of failed education reform efforts.  When I reflect on the many change efforts I participated in, I shudder.  I try to block it out.  I avoid discussing it.

There is an "activating" body memory (SE™ talk) for me that is associated with prescriptive change efforts.  When I encounter a stimulus or trigger, like someone talking about a new protocol intended to bring about change, I cringe.  I literally experience a contraction or tightening in my chest, a quickening of my breath.  It happens when I hear people begin a sentence with, "these people..."  implying that the problem lies outside not within.  I am not making light of PTSD. I am referring to the powerful body stress response that ensues when someone encounters a trigger of a cumulative adverse life experience.

Last night, I note that my children's school district had published something online about it being one of the "best school districts" in NH.  When I review our proficiency scores at the high school, 53% of students are deemed proficient in reading and 37% in math.    As I read these statistics, I can feel my blood pressure pumping in my ears.

I just about guarantee that these figures are more or less the same as they were before the enactment of "No Child Left Behind" legislation in 2001.  The "status quo" of performance has been the trend across much of the country for over a decade.  In my opinion, it's because we have gone about change all wrong and it's a significant fear I carry for the trauma-informed movement.

So it begs the question, why have my encounters with education reform efforts become a cumulative adverse life experience?  Frankly, because the change efforts intended to help others do "better" have been about everything BUT THE PEOPLE.

Case in point, I remember working in school district that had a large discrepancy in the academic performance of special education students and non-identified students.  What I refer to is better known as, "the achievement gap."  I wanted to be a part of the solution;  I wanted to give voice and effort to equalizing the achievement potential of all students. So I volunteered to participate in a "focused-monitoring" initiative.

The focused monitoring initiative had stated objectives of narrowing the achievement gap with a "systems approach" and to significantly change the delivery of services, instruction, and assessment to students experiencing disabilities.  These objectives excited me.  I imagined really getting into the "meat" of inequity in education.   Yeah...NO!

We met monthly for two years.  Two consultants, "two experts," led the group.  They arrived with papers, agendas, articles for us to read.  We had "assignments" to complete.  We selected "interventions."  We reviewed data, identified KPI's (key performance indicator), crafted a matrix of goals and dates to accomplish them.  The whole experience conjured a deep "dread" within.  Within myself, and within the group.

We were trying to function as machines - follow a linear sequence of steps, in a predictable, and most importantly, measurable fashion.  The problem is...we aren't machines.

The change effort was devoid of human process.  There was no consideration of the whole, no cultivating collective wisdom, no deepening relationships between key stakeholders, no giving "time and space" for what may emerge, no discussion for underlying or systemic causes of an achievement gap.  There was nothing about it that was about the human experience.  The assumption was that students under perform because there was a failed method of instruction, a gap in curriculum, or an absence of proper assessment.  The flaw was in the "mechanics" of education, not in the human systems.

The trauma-informed movement is facing much the same challenge.

We cannot become "trauma-informed" systems by simply modifying our modalities of treating PTSD, complex or developmental trauma.  We cannot follow a simple road map or a 1,2,3 step guide to making change.  The reason this fails, in the words of Ron Heifetz, professor of public leadership at Harvard's Kennedy School, is that the system, "is the way it is because the people in the system (at least those individuals and factions with the most leverage) want it that way.  There is no such thing as a dysfunctional organization, because every organization is perfectly aligned to achieve the results it currently gets.  The people are the problem and the people are the solution."

Becoming a trauma-informed system is about creating conditions that mobilize people into thriving not just surviving. In order to move toward this kind of adaptive capacity, you have to generate huge gobs of psychological safety.

Curtis Ogden of the Interaction Institute for Social Change, is someone I have long admired.  He writes it best, "working [change] through [systems] calls on a specific set of skills and sensibilities that may or may not be present in organizations and communities.  This includes leading with building relationships and trust across boundaries (geographic, cultural, disciplines), understanding existing patterns of connection and what these facilitate in terms of outcomes and possibilities, creating space for open conversation and emergent thinking, valuing actual contributions over formal credentials, and embracing diversity and divergence."

Someone must skillfully facilitate the aforementioned kind of human process so that a collective can assess the systems functioning from a 50,000 foot vantage point.  Someone must guide conversations about uncomfortable topics such as, "what laden assumptions do we possess about those we employee and those we serve?"  There has to be a willingness to speak and listen authentically and mindfully about power, privilege, and preference in the system.

Without good human process in the change efforts occurring in the trauma-informed movement, I fear that we will be end up exactly where we started - with the status quo. But I am not discouraged!

I have met the some of the smartest, most caring, most dynamic people in this movement.  It's beginning to heal my "change effort" PTSD.    But if the human process thing is new to you, give me a shout.  I love "geeking out" about how to do this trauma-informed movement with the "whole of us" in mind.

 

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I can surely relate to this phenomenon.  As a proponent of mindfulness, I've often said I hope it survives its popularity.  Similarly, the trauma informed care work must fundamentally help us acknowledge our humanness and inherent within this, is our brokenness, which we've been loath to make visible.  We need not another mechanistic, flow chart heavy pedagogy that promises educational reform.  Aristotle was right- "Education the mind without educating the heart is no education at all.".

 It an important way, I agree.  I run a wellness center at the school where I work. I see staff members who are pro-trauma informed... and I see other staff members who  don’t seem to have bought into being a trauma informed school.   Maybe some are fatigued because of many years of change, after change, after change. It is hard to buy into each new thing that comes along , when you have experienced disappointment and painful results from somebof the  bandwagons you have gotten involved with in the past.  I worry about this because teamwork is very important in any group initiative.  After all, we are are either helping our canoe paddle forward, we are not helping at all and are just passengers, we might be dragging in the water behind -or- we might even be chopping a hole in the bottom of our canoe, because our attitude that puts us in the role of saboteur. Everyone has a role to play in a team of any kind. One thing is for sure, it is increasing complicated to serve a student population who are more and more wounded  from damage and dysfunction. We need to find ways to arrive at agreeable attitudes so that we can be cohesive and not decisive in our team efforts.

A lot of us are frustrated with the tendency of large systems to adopt the most current terminology, while ignoring the basic underlying principles. I live in Sonoma County, CA. (One of the sites of the big fires last year.) I was recently at a local training on ACEs, and people asked, "How can we know if our agency is trauma-informed?"

Feeling a bit cocky, I said, "There's a simple test. What did your agency do during the fire? Did you make special efforts to reach out to your clients to see if they were okay? Did you change procedures and resources to make it easier for folks to get your services? What about your staff? Some agencies asked staff to work 12 hour shifts, or cover two jobs. what did you do for them? If you didn't change anything in the face of a real disaster, and are waiting for some after-action analysis months from now before you even think about changes, you're not trauma-informed."

Having worked for a\one county agency, I already knew the answer for some places.  It's not enough to know the right lingo, you need to do things differently. Thanks for your posting.

Allen

Thank you!! I have been struggling with this exact thing. I feel like I am fighting in a very old outdated education system that doesn't want to update and educated themselves for the best of the children. I don't understand. 

Thanks for the wonderful article and "big picture." You may find our non-profit's new book useful: Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment--best, Dom    www.AnnaAgeEight.org  

Steve Brown, Psy.D. posted:

Hi Emily, I think you address such an important problem. You talk about your PTSD from failed implementation of innovations. I think about the collective impact on systems of these repeated failures of innovation and how they become collective triggers for cynicism, decreased morale, passive aggressive actions to undermine the innovation, etc.  I'm curious how the "human process" ideas you discuss meld with growing body of work on implementation science. As you probably know, implementation science was created to address the very same issue you discuss -- why so many seemingly good innovations fail miserably.

Few thoughts from my experience consulting to organizations on TIC system change:

I'm dubious about the ability of an unhealthy organization to implement any systemic innovation successfully. That's why, in an ideal world, the first part of readiness for innovation should be building organizational health. This, of course, is very expensive.

TIC system change is so much more challenging and so much more of a paradigm shift/worldview change than organizations know or expect. Therefore, they often:

  • Attempt to implement TIC alongside many other big innovations.
  • See it as another one of their many patchwork innovations rather than recognize it as an overarching philosophy that impacts everything in their organization.
  • Fail to dedicate the resources truly necessary to make the change successfully.
  • Limit their effort to staff training or trauma screening or training clinicians in a trauma-specific treatment, etc etc

As the field begins (and this is really only just beginning) to build some empirical research that TIC actually does what we think it does, I'm struck by the amount of intervention (dosage) it takes to bring about sustained robust empirical outcomes at the client level, especially in complicated systems like schools -- but in other settings also. For example, changing staff knowledge, attitudes, even behavior may not always result in concrete outcomes that we can measure (such as symptom reduction, better discharge outcomes, reduced school dropout, increased academic performance). This does not mean that positive changes are not happening in these settings, but ultimately we will be judged on whether we can build a body of scientific knowledge over time that TIC works and determine if there are evidence-informed/based methods and models that can produce successful outcomes in whole systems. The trauma field has made important progress doing this with respect to trauma-specific interventions (TF-CBT, CBITS, and the like) but not yet with TIC system change which of course is much harder because systems are harder to change than individuals.

I'll stop my morning rambling now. Thanks Emily for your post. You clearly struck a nerve in me.

Steve Brown, Traumatic Stress Institute of Klingberg Family Centers, www.traumaticstressinstitute.org   steveb@klingberg.com.

 

Steve:

I am riveted by your comment. Would you consider making it a post and sharing it in the Becoming Trauma Informed & Beyond Community? And please share any resources, which you may have done in other posts or comments that I've missed. It sounds like you are a tremendous resource. Thanks for sharing! Also, I notice that you are in CT and am sending you an email to inquire about any statewide ACEs initiatives in CT and/or major local ones. Also, I'm the Community Facilitator and Manage the Parenting with ACEs Community here at ACEs. I'm always looking to learn more, make new and local connections. Cissy

Hi Emily, I think you address such an important problem. You talk about your PTSD from failed implementation of innovations. I think about the collective impact on systems of these repeated failures of innovation and how they become collective triggers for cynicism, decreased morale, passive aggressive actions to undermine the innovation, etc.  I'm curious how the "human process" ideas you discuss meld with growing body of work on implementation science. As you probably know, implementation science was created to address the very same issue you discuss -- why so many seemingly good innovations fail miserably.

Few thoughts from my experience consulting to organizations on TIC system change:

I'm dubious about the ability of an unhealthy organization to implement any systemic innovation successfully. That's why, in an ideal world, the first part of readiness for innovation should be building organizational health. This, of course, is very expensive.

TIC system change is so much more challenging and so much more of a paradigm shift/worldview change than organizations know or expect. Therefore, they often:

  • Attempt to implement TIC alongside many other big innovations.
  • See it as another one of their many patchwork innovations rather than recognize it as an overarching philosophy that impacts everything in their organization.
  • Fail to dedicate the resources truly necessary to make the change successfully.
  • Limit their effort to staff training or trauma screening or training clinicians in a trauma-specific treatment, etc etc

As the field begins (and this is really only just beginning) to build some empirical research that TIC actually does what we think it does, I'm struck by the amount of intervention (dosage) it takes to bring about sustained robust empirical outcomes at the client level, especially in complicated systems like schools -- but in other settings also. For example, changing staff knowledge, attitudes, even behavior may not always result in concrete outcomes that we can measure (such as symptom reduction, better discharge outcomes, reduced school dropout, increased academic performance). This does not mean that positive changes are not happening in these settings, but ultimately we will be judged on whether we can build a body of scientific knowledge over time that TIC works and determine if there are evidence-informed/based methods and models that can produce successful outcomes in whole systems. The trauma field has made important progress doing this with respect to trauma-specific interventions (TF-CBT, CBITS, and the like) but not yet with TIC system change which of course is much harder because systems are harder to change than individuals.

I'll stop my morning rambling now. Thanks Emily for your post. You clearly struck a nerve in me.

Steve Brown, Traumatic Stress Institute of Klingberg Family Centers, www.traumaticstressinstitute.org   steveb@klingberg.com.

 

Emily Read Daniels posted:
Christine Cissy White posted:

Hi Emily:

This writing is wonderful. I LOVE this and it also pains me. I've had some of my own disappointments / heartbreak / disillusionment from trying to change the system only to feel it's changing me instead. That has been true when trying to change my own nervous system or family system as well as other systems. I've ended up feeling the system I'm hoping to change is no different at all and my own change system/self/body is actually all the worse off for the effort which seems pretty lose/lose.

Or, I've worried that efforts have made things not only better but actually worse which can make one queasy. This quote is yikes:

"There is no such thing as a dysfunctional organization, because every organization is perfectly aligned to achieve the results it currently gets.  The people are the problem and the people are the solution."

Becoming a trauma-informed system is about creating conditions that mobilize people into thriving not just surviving. In order to move toward this kind of adaptive capacity, you have to generate huge gobs of psychological safety."

This quote is both the good news and the bad news in all you wrote, to me at least, because it's on all of us to change how things are and even how things are changed. BUT HOW???

How to achieve that gobs of safety when so many of us start out feeling unsafe upon waking? How to make these shifts, individually and collectively, without a road map and as humans who aren't machines? As anyone parenting with high ACEs knows is a lot harder than wishing for more/better when there's a lot of history, programming, etc. to do things as done. It's so much work!

But it's good and important work! It's so freakin exciting as well as hard. I'm glad to be on this journey with you. Thanks for all you bring and for helping move this movement out of the head and into the heart/body. I'm glad to be in a place where it's o.k. and safe to ask questions, even hard ones without easy answers. 

I'm sharing this in Parenting with ACEs. 

Cis



 

Emily: 

Is co-activated a thing? You didn't activate me just got me thinking/process... It's my life's work as well, and all mixed in with parenting, creativity and social justice. Inn the ring and arm in arm. We can keep learning from each other (plural big all of each other) and from lessons past and present. See you next week because wahoo East coast!!! And thanks for sharing all your lessons and learning/s.

Cis

Christine Cissy White posted:

Hi Emily:

This writing is wonderful. I LOVE this and it also pains me. I've had some of my own disappointments / heartbreak / disillusionment from trying to change the system only to feel it's changing me instead. That has been true when trying to change my own nervous system or family system as well as other systems. I've ended up feeling the system I'm hoping to change is no different at all and my own change system/self/body is actually all the worse off for the effort which seems pretty lose/lose.

Or, I've worried that efforts have made things not only better but actually worse which can make one queasy. This quote is yikes:

"There is no such thing as a dysfunctional organization, because every organization is perfectly aligned to achieve the results it currently gets.  The people are the problem and the people are the solution."

Becoming a trauma-informed system is about creating conditions that mobilize people into thriving not just surviving. In order to move toward this kind of adaptive capacity, you have to generate huge gobs of psychological safety."

This quote is both the good news and the bad news in all you wrote, to me at least, because it's on all of us to change how things are and even how things are changed. BUT HOW???

How to achieve that gobs of safety when so many of us start out feeling unsafe upon waking? How to make these shifts, individually and collectively, without a road map and as humans who aren't machines? As anyone parenting with high ACEs knows is a lot harder than wishing for more/better when there's a lot of history, programming, etc. to do things as done. It's so much work!

But it's good and important work! It's so freakin exciting as well as hard. I'm glad to be on this journey with you. Thanks for all you bring and for helping move this movement out of the head and into the heart/body. I'm glad to be in a place where it's o.k. and safe to ask questions, even hard ones without easy answers. 

I'm sharing this in Parenting with ACEs. 

Cis



 

Cis...

I love you...I do!  I got you all activated with my post.  That was not my intention...you are asking "big questions" - the "right questions." 

I am here...by your side...the whole step of the way (as we work collectively to move this forward).  I am in it for the long haul;  this is my life's work.  We are going to fumble through this together.  And I promise, that although we are going to fumble, it's going to be SO MUCH BETTER than the efforts that viewed us as machines.  That I can PROMISE!!!  And the fact that we are going to do this together means that we won't be alone - that's the biggest thing.  We ARE NOT ALONE trying to manifest a new world.

There are many examples of hope - Cowlitz County for starters.  Most every Scandinavian country constitutes another.  Monadnock Thrives at the outset is looking good...

All that we need is intention, commitment, love, and a deference for honoring the human in one another.  

Now move, breathe, and hold someone or your sweet pup ...XO, Emily

Hi Emily:

This writing is wonderful. I LOVE this and it also pains me.

I've had some of my own disappointments / heartbreak / disillusionment from trying to change the system only to feel it's changing me instead. I started out studying social work only to feel it did more harm than good, that it didn't even care what the people being helped thought of the help or the helpers.

I've ended up feeling the system I'm hoping to change is no different at all and my own change system/self/body is actually all the worse off for the effort which seems pretty lose/lose. One middle-aged social worker told me, when I was in my early twenties, that she was pretty sure she got sick from her job. Yikes.

Often, I've worried that efforts have made things not only better but actually worse which can make one queasy.  Like parenting, it's terrifying. 

This quote is yikes:

"There is no such thing as a dysfunctional organization, because every organization is perfectly aligned to achieve the results it currently gets.  The people are the problem and the people are the solution."

Becoming a trauma-informed system is about creating conditions that mobilize people into thriving not just surviving. In order to move toward this kind of adaptive capacity, you have to generate huge gobs of psychological safety."

That can be said about a lot of families and communities as well. The quote is both the good news and the bad news in all you wrote, to me at least, because it's on all of us to change how things are and even how things are changed. BUT HOW???

How to achieve that gobs of safety when so many of us start out feeling unsafe upon waking? How to make these shifts, individually and collectively, without a road map and as humans who aren't machines? As anyone parenting with high ACEs knows is a lot harder than wishing for more/better when there's a lot of history, programming, etc. to do things as done. It's so much work!

But, like parents who work hard all the time know, it's worthy work. It's good and important work! It's so freakin exciting - as well as hard. I'm glad to be on this journey with you. Thanks for all you bring and for helping move this movement out of the head and into the heart/body. I'm glad to be in a place where it's o.k. and safe to ask questions, even hard ones without easy answers. 

I'm sharing this in Parenting with ACEs too because I know you say the first system we have to change is our own  - our own nervous sytem (LOVE THAT!). I also think we families are the organizations a lot of us are helping to lead and so thinking about things and what's working as well as not working is helpful for families, too. 

Cis



 

Last edited by Christine Cissy White
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