It's not your fault, (but)...

This is a follow up post to some thoughts I've been having about The Problem with Trauma Informed Practice (and, really, a lot of our 'practices' in addiction and mental health treatment).

I sat down with a former colleague of mine for coffee the other day. He's now working with folks in the homeless/reintegrating from prison predicament. He said something that really resonated with me on a few levels;

I tell my clients that your trauma is not your fault.

But how you move forward from it is your responsibility.

That distinction of fault vs. responsibility really captures the essence of what makes the disease model of addiction and mental health so challenging to work with sometimes. "It's not my fault, I have a disease" is similar to the "I'm powerless over my addiction" mentality that permeates much of traditional addictions treatment.

Quick side story: about eight years ago I found myself rapidly losing weight. Thirsty all the time. Irritable. A quick lab test at urgent care confirmed what Google was already suggesting to me. "LADA" (Latent Autoimmune Diabetes in Adults), a condition where the pancreas stops producing insulin for largely unknown reasons, probably to do with the immune system getting confused and attacking it.

Having diabetes is not my fault. But it is my responsibility. And of course that makes sense, no one else is responsible for managing what I eat, how much I exercise or when I take my insulin. My doctor doesn't come home with me and inject my insulin. She prescribes it, shows me how to use it and adjusts the dose based on quarterly lab results.

Circling back to some of the conversation about Trauma-Informed Practice, and advances in neuroscience generally, we've found ourselves (as a system) walking a fine line between "it's not your fault that you had an upbringing full of adverse childhood experiences" and "you still need to take responsibility for what you do in your life".

Ultimately, our clients are responsible for making the changes that they seek. Just as I'm ultimately responsible for managing my diabetes. As another good friend and colleague likes to point out to fresh-faced youth workers who might be a little too invested in a client's change;

If you own the change, you own the pain.

Not owning the change is hard (particularly for helping professionals who's sense of worth and identity (that's another post) are often tied very tightly to their work), so we need to get very clear on what we DO own. From a Responsive Practice perspective, we're responsible for cultivating the conditions in which change is possible, both at an interpersonal level with our clients and within our programs and services. That's it.

Listen to Episode #2 of the Responsive Podcast: The Three Great States to learn more about what those conditions are.

And here's what we, as Responsive Practitioners, can do to cultivate those conditions;

1. Be Relationship-Based. Understanding that all healing happens in relationship. Loosening our anxious grip on specific modalities and frameworks so that we can see and feel the quality of the relationship we're building with our clients.
2. Be Power-Aware. The inherent power-dynamics in a helping relationship can be understood and leveraged for growth and healing.
3. Making Meaning. Actively helping our clients make meaning, not only from past experiences, but connecting with what's most meaningful here and now, and into their future.
4. Operating from Values. Client-Centred. Solutions-Focused. Strengths-Based. These are all just words on the wall, or the brochure, until our actions give them meaning. Until our programs intentionally build practices and protocols to reflect them.
5. Strengths-Based. The average client in addiction/mental-health treatment is very keenly aware of their weaknesses, deficits and problems. Focusing on them does little to move their lives forward (in fact, probably just makes it worse).
6. Feedback-Informed. If we're to truly be Relationship-Based and Power-Aware, we actually have to also be Feedback-Informed. There's no way around it. As soon as we realize that it's our impact that matters, not our intentions, we have to have mechanisms (both formal and informal) to assess our impact and adjust as needed.

Our role as practitioners and programs is not to rigidly adhere to models, frameworks or practices.

It's to foster the conditions for connection to our services, by intentionally focusing on those six practice priorities.

Learn more about Responsive Practice here, and we'd love to hear your thoughts!