By: Janice E. Castro B.A. & Danielle Quintero, M.A.
More than one in three women in the United States experience intimate partner violence (IPV) at some point in their lives (Centers for Disease Control [CDC], 2011). There is a correlation between the consequences of IPV and depressive symptoms, posttraumatic stress disorder (PTSD), and suicidal ideation (Pico-Alfonso et al., 2006; Yuan, Koss, & Stone, 2006). Throughout our personal and professional lives, working with survivors of sexual violence (SV)/IPV has been one of the most rewarding experiences. However, considering the impact on clinicians working with survivors of IPV, as advocates, we are aware of our vulnerability to various stressors that could lead to burnout. By sharing our personal knowledge, we seek to provide validation for other students who may have similar experiences. This paper demonstrates the importance of integrating self-care practice among those who have the privilege of working with the strong mujeres (women) recovering and healing from trauma.
As mental health providers, we are highly vulnerable to various stressors that could lead to burnout, which is described as an experience that consists of three dimensions: (a) emotional exhaustion, (b) depersonalization, and (c) reduced personal accomplishment when working with clients (Maslach, Schaufeli, & Leiter, 2001). Some of the consequences of burnout are diminished work productivity and effectiveness, absenteeism, and substance use (Maslach, et al., 2001). It is evident that symptoms of burnout may arise when working with SV/IPV survivors, but sometimes we wait until things are strenuous to consider and engage in self-care.
A recommended self-care strategy begins with clinicians normalizing and validating their own experience by giving voice to their thoughts and feelings (Knight, 2013). In our own experiences working with female SV/IPV survivors, we witnessed the strength and resilience that many of these women bring into the therapeutic relationship and how they have flourished since the time of the event. In the same breath, we acknowledge these women’s traumatic experiences were often difficult to cope with and frequently impacted their healing process, because telling their stories could lead them to revisit emotional pain. A need for self-care is particularly important for doctoral students working with trauma survivors as early-experienced clinicians are at a higher risk for burnout (Craig & Sprang, 2010).
For us, working with these women was particularly impactful because we could empathize with them on a personal and professional level. As Latinas ourselves, we were both able connect on a humanistic level and as mujeres. The intersectionality of our shared cultures facilitated a natural connection, as the similarities in our identities and experiences helped us to better understand each other. When working with Latinas, we felt extremely connected to our hermanas (sisters), due to our shared cultural background, as their stories were similar to those from our own communities. As Latinas/os in the U.S., we have a shared history of painful experiences related to collective and structural trauma, such as being oppressed and colonized, racism, and discrimination (Arredondo, Gallardo-Cooper, Delgado-Romero, & Zapata, 2014). From one Latina to another, we related to the cultural context in which their stories took place and understood many of the political, social, environmental, and cultural struggles they disclosed, but also recognize the cultural diversity within our Latina/o community.
We were privileged to offer support and care to trauma survivors, but also not immune to the possible experiences of burnout. At times we felt overwhelmed, upset and defeated that issues of violence continued to affect many mujeres in our community. Being in session with another mujer has contributed to the therapeutic relationship because of our shared cultural experiences, which allowed us to identify with our hermanas from personal experience in terms of language, customs, immigration, acculturation, and oppression. This shared culture also identified various personal triggers, such as the different levels of acculturation among family members and the English language as a barrier for resources and opportunities. It was during these times that we began to realize in order to continue treating our hermanas, we needed to practice self-care so we could continue walking with them through their therapeutic journey.
These stories are consistent and common experiences we have encountered while working with Latina trauma survivors. We realized that it was not only our duty to care for the mujeres with whom we worked, but also care for ourselves. Our self-care strategies consist of praying, exercising, and grounding ourselves in activities that simultaneously replenish our mind, body and spirit and allow us to stay connected to our cultural roots. Another self-care strategy we use is to connect ourselves with the Latina/o community outside of an academic institution through volunteering. During clinical work and personal time we use mindfulness, a nonjudgmental experience of moment-to-moment awareness of one’s own bodily sensations, emotions, and activities (Dunn, Callahan, & Swift, 2013). Research demonstrates that practicing mindfulness and increasing one’s self-awareness can serve as self-care to combat burnout among mental health counselors (Thompson, Amatea, & Thompson, 2014). We strongly believe that these activities allow us to preserve our overall wellbeing while also nurturing our souls. Self-compassion and self-care also benefit us and allow us to continue our own journey of the systemic oppression that Latinas often face.
As mental health professionals who work in the trenches of trauma, we attempt to practice self-care not only for ourselves, but also for the women with whom we work. In graduate school, self-care is emphasized, but through trial and error we consistently reconsider when to pull back from certain activities to balance responsibilities. However, we strive to include self-care in our lives because we emphasize this need in our work with clients. We’ve learned to value our own experience while honoring the experiences of other Latina trauma survivors. A quote illustrated by Audre Lorde sums this up best: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
First Narrative (Janice)
I reached a moment where I experienced depersonalization (cynicism), understood as feeling emotionally distant from one’s client (Maslach et al., 2001). While sitting in session listening to a hermana’s traumatic narrative, I thought, “what if this story was a lie?” I surprised myself and questioned: “why would she lie?” then reoriented myself to the present moment. It was difficult listening to one client after another tell me their personal traumatic experiences throughout the day, but I did not want to cancel appointments with my hermanas that day knowing I had the time.
Their stories can be hard to hear because of the social injustices happening within my community and across the country. Yet, it is incredible to find how resilient these mujeres are when experiencing individual SV/IPV, as well as collective, and structural trauma. For example, I had a hermana experience multiple types of abuse including sexual assault and victim blaming by her employer, as well as mistreatment due to documentation status and limited proficiency in the English language. These intersecting issues of systemic oppression hindered her healing processing and impacted me as a Latina advocate, who has experienced similar forms of systemic oppression. Hence, I developed a strong connectedness with my hermana because we share similar cultural values and similar abuse was prevalent in my family. To help my hermana, I was eager to provide community resources and grounding techniques for self-care that I use myself during overwhelming moments.
Second Narrative (Danielle)
One particular moment that resonates deep within my heart occurred during my previous work experience as a community rape crisis center counselor. While I was confident that the training I received had sufficiently prepared me to take on any task that may arise, it was not until my first medical accompaniment with a Latina survivor in which I became fully aware of the emotional and psychological effects that rape has on an individual, her/his surrounding environment, community, and loved ones. Upon my arrival, the young mujer who was assaulted was alone and in a state of crisis. As I sat beside her, I proceeded to provide her with crisis counseling, done without the protocol guide sheet in front of me, but rather spoke organically in English and Spanish to better foster communication through our shared language. I identified that she and I had a natural connection which stemmed from our similar cultural backgrounds and upbringings as Latinas who continuously combated against community violence.
We began the medical exam that would ultimately gather physical evidence of the assault for legal trial purposes. While on the medical table, she asked me for a different type of support. My hermana asked me, “Can you hold my hand, please?” I held her hand throughout the entire process, and felt every muscle reaction through her palm as she twitched with pain. I didn’t let go, and felt more of an urge to hold on longer as she periodically squeezed my hand tighter when she felt small bursts of pain from the medical tools being used. I helped guide her through the entire process, and after the exam, proceeded with additional counseling and shared with her the services that were available to her. However, upon departing, I was plagued by the thought of what would happen next and became concerned for her healing, coping mechanisms, and well-being thereafter. I was afraid and feared for the wellbeing of my hermana. This experience proved emotionally taxing as I continued my advocacy work at this agency.
From our experiences, working with these mujeres requires more than just an understanding of their trauma, but also an understanding of the unique impact cultural factors have on healing and coping. Overall, women of all backgrounds demonstrate significant strength when experiencing trauma related to SV/IPV; however, when working with mujeres we also acknowledge significant cultural considerations because of the diversity within the Latina/o community.
A specific suggestion for ways that mental health providers could approach Latina SV/IPV survivors is taking a trauma-informed approach. With this method, at the organizational level, all components of an organization and their practitioners incorporate a thorough understanding of the prevalence and impact of trauma, the role that trauma plays, and the complex and varied paths in which people recover and heal from trauma (SAMHSA, 2014). Importantly, this definition includes a broad understanding of trauma including issues that may impact culturally-specific communities. For example, Bienestar (wellbeing) is a gender-specific and culturally based trauma therapy for Latinas that takes a holistic approach promoting physical, mental, and spiritual wellbeing (Comas-Diaz, 2015). Despite the difficulties and uncertainties of crisis intervention for SV/IPV survivors, having the privilege to hear our client’s stories, being able to provide empathy, unconditional positive regard, and watch them connect with their internal strengths is what invigorates our passion to continue working with and for Latina trauma survivors as well as other women of color who may have similar experiences.
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Janice Elena Castro, B.A., is a doctoral student in the Counseling Psychology program at the University of Nebraska-Lincoln. Her research and clinical interests are in intimate partner violence and higher education among the Latina/o community.
Danielle Quintero is a PhD candidate in Counseling Psychology at the University of Missouri. Her clinical interests include working with clients who have experienced trauma and Posttraumatic Stress Disorder (PTSD) as well as conducting psychological evaluations. Her current research focuses on sexual violence, coping, and resiliency among ethnic minority women, specifically Latinas.