*Trigger warning: description of violence follows*

I have a scar from a client, a man twice my weight, who locked his jaw on me and wouldn’t let go. I was once restrained by a young but strong girl and didn’t know how I was going to get out of it. As a house parent at 19 years old, I was placed alone with two men in their mid-30’s who had sexually assaulted a young woman and I wasn’t told about it, nor did I have access to their chart, until months in. A co-worker I traded shifts with was once pummeled by a client on what would have been my watch. As an in-home counselor I was often unable to position myself in the optimal get-to-the-door-fast position and sometimes tried to decipher which drug my client’s father was on in order to assess my own safety (pot=ok; meth=possibly very bad). I’ve also been yelled at, pushed, sexually harassed, threatened, insulted.  

These things happened while working for agencies and group practices. These things do not always happen while working in these environments, of course, but they often do. The response from the bureaucracy (usually to fill out some meaningless form and return to work the next day) is not in alignment with the ethos of our profession. The flippant response was what my learned helplessness came to expect and assisted my minimizing tendencies. It’s no big deal. These things happen in our profession. It’s just a part of it.

And to some extent, that’s true. I don’t blame the clients, many of whom suffered greatly in their lives and had few skills to manage the emotion dysregulation, for not having appropriate ways to manage the big feelings. It was often my job to teach them that and it can take a while to integrate new skills. But like the research on how trauma impacts those that are supported upon disclosure and those that are not, I believe there are very many of us who CAN hold accountable the workplaces that glossed over our experiences. I really think it’s okay to be pissed that in an effort to shield themselves from lawsuits or culpability, we might have gotten a one hour training on how to restrain someone, which without practice or a great deal of strength is unlikely to help when you really need it. And then when an attack occurred we were reprimanded for not calling upon that training.  

I hear similar stories from Abundance Practice-Building Group members, friends, and colleagues about experiences they’ve had in agencies and group practices. Some of them make the hair on my neck stand at attention, some make me tear up, some make me mad.  

Part of healing from these experiences is working through the frustration with the response. In fact, among the people I’ve talked to, it’s usually their boss’ indifference that bothered them most. Again the idea that it’s no big deal. These things happen in our profession. It’s just a part of it. It can leave the clinician feeling so unimportant and unprotected.

I’d love to promise you that you won’t be assaulted or berated in private practice, but obviously I can’t. I’d bet good money that it happens a lot less in the average private practice. Those incidents I described all happened in a 5 year span of time. I’ve had nothing even vaguely threatening in the last 11 years of private practice.

What I can promise you is that if it happens in private practice, you will be responsible for how you care for yourself afterwards instead of having dictates and control passed down from a boss. That doesn’t necessarily mean you’ll react the way a compassionate boss should, especially if you’re a champion minimizer like me. But if you create a game plan now for IF it happens, you can fall back on your own policy, which I hope would include some variation of: taking some time off, consulting with colleagues, seeing a therapist, getting a massage or other body based self-care, getting some outside time, getting together with your safe people for some fun, sleeping in. Can you IMAGINE what it would be like for a boss to encourage this?

Being unsafe is not an inherent part of our profession. In fact, to be great at what we do we need a sense of safety. It took me a few years to figure that out and I genuinely hope that you were quicker on the uptake.   

I’m curious, how have you helped yourself heal from a client attack or threat? What wisdom do you have for the clinicians not yet out of the kind of agencies that don’t support their safety or recovery?

Allison Puryear is an LCSW with a nearly diagnosable obsession with business development. She has started practices in three different states and wants you to know that building a private practice is shockingly doable when you have a plan and support. After retiring her individual consultation services, she opened the Abundance Party, where you can get practice-building help for the cost of a copay. You can download a free private practice checklist to make sure you have your ducks in a row, get weekly private practice tips, listen to the podcast, hop into the free Facebook Group. Allison is all about helping you gain the confidence and tools you need to succeed.

Private Practice-Building Coach Online Asheville NC

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