The Family Culture of Pain

A client's daughter, a fifteen year old girl, just moved in with a 41 year old crack addict. Another client refuses to file charges against her abusive husband. A third client can't hold a job and has mentioned that she went to six different elementary schools.

To those who grew up in a family culture of pain, all of the above seems normal. Many of your clients come from this culture and it affects their brain chemistry, gives them a skewed “world view” and leads them to repeat the family pattern of surviving, but not thriving.

They have been given a world view which says they are not worth anything, the world is not safe and no one can be trusted. They do not learn practical skills which allow them to be industrious, and their brains have been wired for survival which leads to a difficulty in acquiring new skills. The pain in which they were raised has been internalized so they often suffer from depression (often without knowing it) and seek relief from depression in unhealthy ways, leading to addiction and violent behavior.

Working with clients who come from a family culture of pain, whether adults or children, requires a real understanding of that pain and it's affects on the individual. Unless there is insight into the client's world view, the source of the client's belief system, we often miss the mark. We try to rehabilitate a client who has never been “habilitated” and we fail miserably. It is as if the worker and the client are trying to communicate in different languages …or from different worlds.

The World View

The human brain is not developed at birth. Dr. Bruce Perry, in his article, “The Impact of Abuse and Trauma on the Developing Brain” explains that the brain “learns” by making an internal representation of the environment in which it operates. Through specific brain chemicals which develop in response to specific experiences in the environment, the human brain comes to represent it's environment. Once that internal representation is made, it is the “world view” which the individual holds as truth. Whatever is in that world view is considered “normal.”

One's world view does not seem like it's only a view of life, it seems like objective reality. It colors everything we encounter in our lives, yet we are totally unaware of it. (Much like the student fish who says to the teacher fish “What's this 'water' you keep talking about?)

If I come from an environment in which every person with whom I live is to some degree depressed, abusive and addicted, then depression, abuse and addiction are normal. It is beyond my ability to know that I am depressed. It is impossible for me to discern what is and is not abusive behavior. And it would never occur to me that getting drunk or high every day is out of the ordinary. Placing this individual into the “real” world of school, jobs and functioning in a larger society is analogous to placing him on the moon.

A world view is not problematic when it has been developed in a home where one's parents had reasonable expectations, where home was safe and where one was responded to in a healthy way. But when the world view is developed with only survival in mind, which is the case in a home where violence, addiction and stress are a constant, one continues to try to survive well past the point where it serves his needs. Imagine how far a belligerent, defensive attitude would get you in your present life. It is doubtful that those to whom you are close would want to continue to be part of your life for very long if they had to constantly fight with you, reassure you (to no avail) and defend themselves against your wildly accusatory imagination.

Recovery and Change

In spite of the devastating effects of being raised in a family culture of pain, there is hope for survivors. There is even hope for change. A recovery program which is based on a solid understanding of the painful family culture, which considers the enormous capacity for change in the human spirit and which respects the ability of human beings to heal and thrive can help clients come to grips with their family history.

Recovery programs such as 12-Step programs offer help for clients who were raised in a culture of pain. There are now over 300 different kinds of 12-Step programs. Virtually one for any given problem, such as overeating, gambling, emotional problems, etc. These kinds of programs offer the following advantages:

• the therapy is free of charge, because it is, in effect, co-counseling
• there is easy access to groups, because they are numerous, and the this easy access serves to break the client's isolation
• like-minded fellow group members understand the client and help him to feel at home and to develop personal relationships
• the program offers good, orderly direction for living each day
• The program offers a form of spirituality which is important when dealing with clients who have a low trust level in their fellow humans

But even 12-Step programs have their limitations. Sustained sobriety for alcoholics, for example, range from a mere 20% who get sober to over 75%, depending on which report you read. The fact is that many clients from painful family cultures need more than 12-Step programs can offer.

What Professionals Need to Know:

In addition to being educated to the client's world view, professionals who work with clients affected by violence must learn to:

• accurately assess client problems. This must include assessment for violence because this trauma greatly impacts one's life (whether the violence is happening now or occurred during childhood.)
• understand the treatment issues. These issues include safety needs for both client and family members; the need for clients to heal from the trauma of violence; identifying and clarifying what is abusive and violent behavior.
• educate clients to the issues. Such issues include codependency in intimate relationships; how to stop abusive behavior; identifying stress triggers; stop controlling others; “daily goal mapping”; seeking help and breaking isolation
.
• teach clients how to think (employ new behaviors) instead of react (automatically act out of survival instincts) to situations with an habituated response. Clients who come from a family culture of pain tend to react to life rather than thinking about what their actions should be. They will need help learning how to investigate their current actions with regard to changing future actions.
• serve as a role model. Particularly men raised in the culture of pain require strong male role models to demonstrate the strength required to show feelings, to be respectful of others (particularly women) and to be gentle.
• connect clients to support resources, particularly support systems which include emotionally healthy people who show clients how to maintain healthy relationships.

Our workbook, entitled “Helping Clients out of the Triangle of Pain: Violence, Addiction, Depression” was written to help professionals understand the issues, acquire information they need to know and provide forms to accurately assess and treat the client's problems.

What Clients Need to Know:

Clients need to learn new ways to function if they hope to change their lives. Among the skills they need to learn are to:

• control stress
• develop self-control
• stop external control of others or by others
• seek help for problems
• develop new behaviors
• stop isolation
• set goals
• have fun without an altered state or guilt

While all of this may seem like a tall order, it really isn't when you consider that recovery from a painful family culture is a life-long venture. Personal functioning gradually improves, one's choice of associates gradually change, one's world view eventually changes to knowledge that the world can be trusted. Clients who come from a painful family culture do not have to live in pain for their whole lives provided that the professionals with whom they come into contact understand all that is needed, and have the tools, to help them change.

Geri Redden, M.Ed., Executive Director of the National Violence Prevention Project in St. Louis has worked for thirty years in the field of violence prevention. She was a speaker at the First World Conference on Family Violence in Singapore in 1998. She has written more than forty articles and commentaries and has appeared on numerous radio and TV shows. Ms. Redden is a popular speaker and workshop presenter.

The National Violence Prevention Project provides workshops, workbooks, and client education programs for professionals and others who work with clients from painful family cultures. For more information, go to our web site at nvpp.home.mindspring.com