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Restoring Sanctuary: A New Operating System for Trauma-Informed Systems of Care


Sanctuary is a place of safety.  It’s a place where the weak and wounded can grow and heal.  It’s the way that we should describe every system designed to help people, but all too frequently, those places we turn to for help are the very ones that harm us.  Instead of healing our wounds and helping us to become more whole, they traumatize us in new ways.  Restoring Sanctuary: A New Operating System for Trauma-Informed Systems of Care is a manual for how to transform organizations into the places of safety we wish they were.

What’s Wrong with You?

It’s the wrong question.  It is accusatory and blame filled.  It devalues the person.  Yet it’s the question that we all too often ask.  It’s the question that implies judgement and creates separation.  The right question is, “What happened to you?”  This question invites understanding.  It invites awareness that all of us have been traumatized in different ways.  It’s aware that our traumas cause us to respond in ways that appear to make no sense.

By shifting the question, we shift the attitude and reduce the judgement.  We create opportunities to connect.  The #metoo movement was a simple way that others could share their experiences of sexual exploitation or objectification.  It was a way to connect rather than divide.  As humans, we’ve conquered the planet because of our connection, so constantly moving towards connection is no small matter.  (See Mindreading and The Righteous Mind for more.)

Viral Violence

Violence in all its forms is like a virus.  It replicates and reproduces.  Dawkins in The Selfish Gene famously created the concept of a meme – a self-replicating idea.  Violence is that, and it’s quick.  The language we use is that “a fight erupted” or started quickly in the same way that a virus often seems to move from relatively low levels to overtaking its host in a short amount of time.

The heart of this observation is the need to curtail violence in all its forms.  This starts as a commitment to avoid restraints and other use of physical force but extends to forms of psychological violence as well.  Psychological – or emotional – violence are coercive forms of control, manipulation, and mental harm that humans all too frequently use on one another.

Traumatic Reenactment

It’s hard to reduce violence when that’s all that those you’re working with have ever known.  They’ll naturally try to replicate what they’ve experienced not out of malice but out of a failure to understand that other options even exist.  Often times, when people have been traumatized, they’ll repeat that trauma, in part because it’s what they know and in part to try to understand it better.  Albert Bandura is famous for his experiments showing that people who witnessed violence were more likely to inflict violence.  In my review of Moral Disengagement where he discusses this, I push back, because he sometimes overplays what his research found.  That being said, those who have experienced the trauma firsthand are definitely more likely to replicate that behavior.

Trauma Processing

There are numerous ways that people cope with their trauma.  There’s a great deal of therapeutic benefit to art, music, dance, and other forms of expression.  These coping strategies can help to down-regulate people’s sympathetic nervous systems, leading to more peace – and the opportunity to directly address the trauma that they’ve faced.  However, what James Pennebaker found, and what he explained in Opening Up, is that only by being able to verbalize the trauma were people positively impacted in the long term.  In his experiments, he discovered that writing about a trauma – whether or not it was ultimately shared – had a powerful, positive impact on trauma in the long term.

If we want to help people process their trauma, we must first deal with the sense that the trauma is overwhelming.  At some point, we’ll need to help people put their experiences into words.  If we can’t articulate an event, we can’t consider it to be a “past” event.

Fear Conditioning

Once we’ve been sufficiently frightened by something, we’ll develop fear every time we approach it – and if we don’t successfully complete the attempt, we’ll reinforce the fear and trepidation that we feel in similar situations. It’s one of the mechanisms that feeds PTSD.  We get triggered by something and shut down.  Because there’s no successful resolution, we reinforce the very feelings that we hope would go away.

The reverse of fear conditioning is called desensitization, and it’s the technique that Albert Bandura pioneered for reducing people’s phobias.  (See more of his work in Moral Disengagement.)  The technique involves progressively exposing people to closer approximations of their phobia while maintaining relative safety and reinforcing progress.

Democracy Power

Democracy is a commitment to the common good, community, and to equal voice free of self-interest.  By these standards, the American form of democracy fails rather mightily.  Instead, we find ourselves caught in the traps of power and coercive influence.  However, that doesn’t stop individuals and organizations from striving towards the ideal.  Gandhi said, “Be the change you want to see in the world,” and to no other concept is the statement more apt.

What’s not obvious about democracy is how it promotes perceptions of safety.  Viewed from the lens of The Fearless Organization, what would it be like to believe that every one of your coworkers and managers only had the best intentions for you?  It would be the answer to Does Altruism Exist?  Of course, it does, and democracy is the exemplar.

It’s easy to call for democracy but much harder to implement.

Thomas-Kilmann Conflict Mode Instrument

Even in sanctuary, democracy isn’t the only answer.  In places where there is little need for innovation and autonomy, democracy isn’t the right answer.  If everyone had their say in every decision, nothing would ever get done.  The powers of the organization to resist disruption would be absolute.  (See The Disruption Mindset for more.)  The Thomas-Kilmann Conflict Mode Instrument is a way of looking at how conflicts are resolved along two dimensions: assertive and cooperative.  One would think that the authors of the instrument would prefer the most assertive and cooperative, but they didn’t; they recognized that sometimes the best answer is a compromise.  Sometimes, the best answer isn’t the best answer.

This is in stark contrast to Jim Collins’ work in Good to Great, where he views good as the enemy of great.  The key to understanding where this is the right advice and where it may make more sense to find balance is found in The Leadership Machine, which explains that there are too many skills for any one person to master.  Said differently, “You have to pick your battles.”  You cannot afford democracy in every aspect of the organization.  We have to be selective about the democracy we create and allow it at the maximum extent for the maximum effect while recognizing the realities of life.

Anxiety Provoking Freedom

The Innovator’s DNA explains that some of the best creativity comes with constraints.  The Paradox of Choice explains that the more options we have, the more paralyzed we become.  Work Redesign tells the story of Ralph, who, long ago, decided to not rock the boat; as a result, when he’s approached with the idea of more freedom and responsibility, he recoils.  He reacts with anxiety, because the additional freedom and responsibility means that he was wrong to have given up so long ago.

We often are so busy looking for higher levels of organizational redesign that we forget that not everyone is at the same place in their journey as we are.  (See Reinventing Organizations for more.)  We fail to realize that there are people who really do just want a job where they’re told what to do and there’s no question about whether they’re doing the right thing or not.

The Commitments

The prescribed sanctuary commitments are:

Despite acknowledging that democracy isn’t possible in every situation and may be anxiety inducing for some, Restoring Sanctuary describes the lack of these commitments as non-democracy.  I struggle with this characterization.  Rather than framing these commitments in terms of democracy and non-democracy, I’d simply describe characteristics and anti-characteristics of democracy.

Not Invented Here and Buy-In

It’s well established that the concept of “Not Invented Here” leads people to avoid buying into an idea.  (See In Search of Excellence for one of the earliest references to this concept.)  However, the real issue is that no work has been done to help them buy into an idea that was created externally.  (See Buy-In for ideas.)  Too often, an external mandate is delivered without a story – and therefore no way to understand why the answers are right.  (See Wired for Story for more about the need for story.)  It’s not necessary for everyone to have a say in everything that happens, but they do have to make sense of it, and when you don’t provide a story, they’ll make up their own.

Moral Distress

I soundly criticized Maslach and Leiter in The Burnout Challenge for confusing compassion fatigue and moral injury.  They’re as distinct and different as night and day.  Moral injury and its precursor, moral distress, are critical to protecting everyone’s sense of self and their sense that they can live to their values.  Laying it out plainly, moral distress happens when people feel pressured to operate against their values and beliefs.  Moral injury occurs when they give into that pressure and violate their beliefs.  In Beyond Boundaries, John Townsend explains that permanent boundaries define who we are, and if we violate them, we’re changed afterwards.  (See also Boundaries, which Townsend wrote with Henry Cloud.)

When we pressure people to behave in ways inconsistent with their beliefs, even if they don’t cave to the pressure, we’re doing damage to our relationship with them, and we’re consuming their psychic energy.  (See Willpower for more.)

Bullying, Microaggressions, and Accountability

Bullying in any environment is toxic to the healthy relationships that we’re trying to create.  Addressing bullying is more than just ignoring it, not reacting, or quietly dismissing it.  It’s more than the leader’s responsibility to prevent it.  In Trauma and Recovery, I shared the story of Kitty Genovese, who was raped and murdered while 38 of her neighbors failed to help her or call the police.  We cannot afford to believe that addressing bullying is someone else’s problem to resolve.  We have to all stand up to it.

As a privileged white man, I’m occasionally labeled with microaggressions – which I apologize for regardless of the circumstances.  (See Effective Apology and Why Won’t You Apologize? for tips on how to do this.)  At the same time, I challenge the concept as it’s generally accepted.  I didn’t call out this aspect in my review of The Coddling of the American Mind, but it was covered.  The distinction that was made is that aggression is intentional – and microaggressions are generally not.  To be clear, I’m not saying it’s okay for someone to be hurt – I’m just trying to find the balance that people should accept that they may be overreacting to innocent comments.  A quick correction and apology should be enough.

In a world where we are overly sensitive to even reasonable comments, we stop being able to see what rises to the level of bullying and simultaneously lose our resolve to hold everyone on the organization accountable for their behaviors.  If they slough off, we don’t want to confront them for fear that we’ll be labeled aggressive or bullying.  Kim Scott in Radical Candor addresses this by saying that “it’s not cruel, it’s clear.”  (See Management and the Worker for more on social loafing.)

Being Heard

It was years ago.  My ex-wife and I were in a counseling session with a wise counselor when I inserted a profanity into a message dripping with anger.  Profanity isn’t my thing, and he knew it.  When my ex-wife turned to him to ask him what he thought, he responded that it sounded like I didn’t feel like I was being listened to.  He was right.  For me, I started turning up the emotional volume. People who have mental illness and severe trauma don’t have the capacity for such fine-grained adjustment.  In too many cases, their responses turn verbally or physically violent.

The starting point, for me, for preventing violence starts with hearing the person you’re with no matter how difficult that is.

Emotional Labor

Some people lift heavy things for a living.  While few shovel coal these days, many lift boxes and move them from one place to another.  Other heavy lifts aren’t so easy to see.  They’re the emotional burden that first responders take on.  It’s the way that the nurse of a dying patient must retain composure as she helps the family process the event.  It’s even the waiter or waitress that must keep a smile on their face when they’re afraid of being evicted.  If, as Robert Cialdini explains in Influence, a mint can make a big difference in tips, how much more powerful can a smile be?

We should not underestimate the toll that this work takes.  I explain in How to Be Yourself that holding a gallon of milk next to your core is easy – holding it out to your side at shoulder level is decidedly not.  This holding of who we are and what we’re feeling separate from the way that we’re reacting is hard – and exhausting – work.

Don’t Do Something, Just Sit There

When trauma and tragedy strike, our natural reaction is to do something.  Anything.  The wrong thing.  It doesn’t matter.  It’s something.  The problem is that we weigh differently errors of omission (doing nothing) and commission (doing something).  (See The Lucifer Effect for more.)  The truth is that often it’s listening that both restores people and provides the information to do the right thing – to do the thing that will make a difference.

One of my most persistent frustrations in the suicide space is that people keep doing things that don’t work.  We have research that demonstrates it doesn’t work, but rather than do nothing – and conserve resources – we must do something.  I was in a conversation the other day with a coalition of people who are working to address suicide.  We were discussing a program that has been out for 15 years and has failed to deliver even modest results.  I suggested that we didn’t need to bring it to our state.  I felt as if I were asking to slay a sacred cow.  Sometimes, doing nothing – and learning – is the better answer.

Stories Will Be Made

As leaders, part of our job is to tell the stories about why we’re doing what we’re doing.  Not everyone will see the market forces operating on the organization or understand the need for change and transformation.  Instead, they’ll see what they’ll lose as the changes happen.  If we don’t write the narrative, they’ll create their own – less generous – narratives, and the grapevine will show us how effective it can be at strangling a good idea and formal communication.

If you want to create a sanctuary, you can’t be quiet.  If you’re trying to work with people who have had trauma (i.e., all of us) or serve those with trauma, we know the challenges and the ways that we’re not supporting each other or those we serve well.  It may be time to start Restoring Sanctuary.