Tomas Casado-Frankel spoke to Represent about how to safely guide a youth who’s been through trauma toward self-knowledge and self-acceptance. He is a licensed marriage family therapist and a graduate of the child and adolescent psychotherapy training program at the William Alanson White Institute.
Represent: What is disassociation?
Tomas Casado-Frankel: Dissociation is a mental escape from an overwhelming situation.
A person who has suffered trauma or abuse, for example, may have the sensation of leaving their body or may not remember something that happened.
Dissociation is a way of defending yourself from overwhelming thoughts and feelings, and it seems to have a biological basis, too.
And later, a sensory experience, like a smell or sound, or a memory of something that happened, can evoke the emotions of the traumatic event.
You may have intense feelings of anxiety, vulnerability, or stress and not know exactly why. These are typically referred to as “triggers.”
Represent: How is dissociation connected to youth not telling the truth to a worker or other adult?
Tomas: Lying can be a way to both escape and avoid experiences that have been too painful, sometimes conscious, sometimes not.
There’s a part of your memory that’s being lost and forgotten for good reason—because it’s painful. Bringing that pain to the surface is tricky because it’s been so hard to bear.
Lies can be a way for teens to rewrite their narrative and create a feeling of control over their lives.
Lying can help them feel like they’re defending themselves against reality and avoiding pain and other people’s pity. It might help them not fall apart.
They also might lie to create a self that can be loved, because they’re afraid they can’t be loved for who they are, but only for how pleasing or good others perceive them to be.
Foster youth who’ve suffered abuse and neglect may also be lying as a way to express longing. They’re saying, “This is what I want my life to be, what I have not had.” They’re envisioning a better life.
But it also keeps them from working through trauma because the trauma stays inaccessible. They have pushed the abuse out of their mind because it’s still too painful.
Represent: How do you help a young person move toward more truthfulness without making them feel ashamed of having lied?
Tomas: The key is building trust over time. Remember that foster youth may have been disappointed by others many times during their whole life.
Foster youth may have particular anxiety about what you know about them from their file. So a therapist or other adult might say, “I know from your file that you’ve been through a lot of things. Do you want me to let you know what I know? Or would you rather we don’t talk about it for a while?”
You could say, “Sometimes it can be hard to talk about things that happened, so I hope we can find a way for you to do that.” You have to get to know them. You might use humor, if appropriate.
You could encourage them to write about it, like Trina did “Easier to Write It.”
Writing helps them make meaning of it, and they can let themselves feel as they write it. They don’t have to see the other person’s reaction. They don’t have to deal with anyone’s pity, or the worker crying.
Not talking about it has been a lot of kids’ first line of defense, so telling someone else will evoke intense feelings they may not be ready to feel.
Giving them space in these ways can help offset all the times adults forced them to do things or say things. By helping them tell you what they want to do, you let them set the pace and that helps build trust.
Represent: What are useful ways to talk to a youth who’s been through trauma?
Tomas: Expressing pity is not helpful. Pity can keep people stuck in the role of being a victim and make them feel worse. “I’m so sorry for you,” is pity and keeps them victims.
Statements like, “That should never have happened to you,” and “It wasn’t your fault,” can help them become survivors. Those words carry very different meanings.
You also might acknowledge that parents don’t always do the right thing.
Guilt is so powerful, and everyone says you need to respect your elders, celebrate Mother’s Day and Father’s Day. Our society celebrates parents, and that puts these kids in a difficult place where love and hate can’t coexist. So sometimes they push aside the hate, which can come out as negative behaviors.
Some foster kids idealize their own parents because that’s all they have. They need to hold on to something good: That’s an example of dissociation helping them avoid pain.
Represent: What can a worker do to create a safe environment for a young person to open up?
Tomas: Working with kids who’ve been through trauma evokes strong feelings, and those are important to listen to. As a worker, ask yourself, “Why am I feeling so angry?” and then think about what the kid’s been through.
Think about it as a replaying of a scene. That kid may have grown up being yelled at and have an unconscious fear that they’re not good enough and that they’ll be sent away.
They’ll test you. So when a worker blows up and says, “I can’t deal with this!” the kid thinks, “Ah-ha, I was right, everyone does get rid of me.” Kids are always testing.
Represent: But it is important for the youth to eventually talk about the trauma, right? How do you guide them safely to that?
Tomas: It is retraumatizing to make someone talk about what they’ve been through before they’re ready. When they switch the subject or talk about something that seems off, that means they’re not ready to talk.
So maybe say, “Hey, I notice we changed the subject just there,” rather than confronting them. Confrontation inflicts an injury.
It has to be at a time when they are ready to talk. There’s no set time, it depends on the individual’s experience and their particular trauma.
What’s the urgency? Why do we need to rush them to confession?
Represent: Well, because all too often, they don’t have a worker or therapist for very long.
Tomas: It’s true, and that’s a replaying of the trauma, the fact that they have to go to nine different therapists. That’s a way our society is failing them. There needs to be a structural change that lets kids make a lasting connection with a therapist.
But until that happens, therapists and other workers should ask, “How does it feel to be on your ninth therapist or case manager or social worker?”
That might be difficult, but it’s important to acknowledge that it is not fair that the kid has to keep telling their story to new people over and over.
It can make a child not want to talk if they think: “You’re going to leave just like all the others. Right when I let myself be vulnerable and open up, I’m going to lose you. I don’t want to talk to anyone.”
Why would they? That’s a conversation that workers avoid, understandably. They’re burnt out and underpaid and have too many cases.
But it’s still worth it to acknowledge that the system can also hurt foster youth.
It’s an issue that should be brought up and worked on in an ongoing way. So if that worker does leave, it’s not sprung on the kid.
Represent: How can workers do the job better, with less burnout?
Tomas: It’s really challenging nowadays with all the push for quick treatments, quick fixes, and quick trainings.
But you need to make a human connection. It’s really hard because hearing kids’ trauma can be traumatic.
Workers need to talk about how they feel about what kids are going through. A process group can really help, where staff can process together what they’re going through.
Just as the kids need to talk about their trauma, so do the workers. The pain of the kids does affect you and may bring up things from your own past. It’s difficult to talk about these things, but it’s worth it. We need to practice what we preach.