After a week of talking about medical trauma in honour of International Day of Persons with Disabilities, I hope that you’ve had a chance to begin to see that this experience is both a problem that we can and should do everything in our power to try to prevent and protect against, but also that sometimes the very nature of chronic illness and disability is going to involve trauma. Today I want to finish off our week-long series by looking at what we can do when this happens to help ourselves or our loved ones heal.
Attachment work focuses on three main branches: safe, known and precious. The basic idea of attachment is that it is formed between a newborn and their nurturing caregiver(s) in the first few weeks and months of life. This attached state helps infants and children regulate their emotions, so that they are free to learn, grow and develop to reach their best potential.
However, when something interrupts that sense of attachment (or if that sense of attachment isn’t properly formed in the first few months because of something that happens) then we have to go back and re-attach our kids (or ourselves) so that we don’t get emotionally or developmentally ‘stuck’ or indeed start to go ‘backwards’ with these skills. These basic building blocks of emotional well-being are needed by everyone, and any trauma will interfere with them. But the experiences of disability – and in particular the medical trauma that happens around disability – can give us lots of opportunities to practice these re-attachment strategies.
We reattach safety in very, very practical ways. Establishing (or re-establishing) consistent, predictable structures and routines is incredibly important. While hospitals can seem like very rigid places of routine, the structures of a hospital are not based around the individual’s best times of day, and the nature of hospital stays is that they are often quite chaotic and unpredictable. Re-establishing consistency and predictability around the individual’s medication needs, therapeutic schedule and energy levels can be very helpful in returning to a sense of safety. For some, it is best to write out the schedule and put it somewhere easy to see. Others benefit from having a set of visuals with pictures on them so that they can keep track of where they are at in their day. Still others benefit from telling the story – sometimes over and over again throughout the day – to help them stay clear on where they are in the midst of their day.
Another area that we learn that we are ‘safe’ through is having our basic needs for food, water and toileting met. Keeping mealtimes very consistent, offering water bottles at regular intervals and checking in with a child who needs assistance with toileting regularly can help to re-establish a feeling of safety.
Finally, lots of verbal and physical reassurance can be necessary to re-establish a sense of ‘safety’ for anyone who has gone through a (medical) trauma. With young children or infants, this may include baby wearing. With older children it might involve using the child’s dolls or action figures to tell the story of what happened – always ending with something along the lines of ‘and then we came home from the hospital and we were all together again’ or whatever it is that the child has been afraid of, or scared by. Older children may also benefit from sitting together and rocking in a big chair, cuddling up under a duvet to snuggle while you watch a movie or having a caregiver’s help with tasks that they can ‘technically’ do by themselves.
Known is all about feeling seen and understood. For most of us, we can experience ‘known’ through both non-verbal and verbal interventions.
Non-verbal interventions might include making the person’s favourite meal, bringing them their favourite drink just before they ask for it, or just sitting with them and being present for a little longer than you normally would have because you can see that they’re having a hard time.
Verbal interventions might include helping the person talk through the experiences they had – helping them to fill in any memories they may be upset that they are missing, helping them to understand what happened or helping them to find words for the emotions they are having. It might involve creating space and listening to the person talk about what they are sad that they have missed, what they are angry that they had to go through or what they are scared of having to deal with in the future.
Another very simple verbal intervention that can make a big difference in making folks feel known is words of encouragement. Particularly when you can catch a person doing something that might be simple and obvious or easy for the ‘average’ person, but is really difficult or represents a lot of effort or intentionality for the person in question. This acknowledgment and appreciation of effort can help the person feel seen and known – like their efforts aren’t being missed – and can go a long way towards reattachment.
Although I think most of us know that in the grand scheme of things our chances of becoming famous are very small, we all carry within us the desire to matter deeply to another human being – to be precious. And the interesting thing about communicating ‘preciousness’ is that it is incredibly unique from one person to the next, but it is always built on top of the way we know another person.
So if I know how much my favourite person loves chocolate cake, and I make them a chocolate cake, that might show them that I think that they are precious. Another person might feel precious because I took time to paint their nails. Or maybe read out loud to them from a funny story or novel. Or possibly rub their feet. Or rub their back as they fall asleep. Or change something about the sensory space that they are in so that they feel more comfortable. Or put on their favourite music. Or take them to their favourite coffee shop. Or maybe even buy them a small gift. You will notice that precious doesn’t have to cost a lot of money, but that it probably requires an investment of time.
I have a friend who is incredible at telling me I’m precious. Just last week she showed up at my house and ‘helped me’ bake some of my favourite Christmas cookies (by which I mean she made them and I sat with her and chatted and watched, because it’s not something I can really do myself anymore). I came away from those four hours feeling the weight of a series of hard and difficult medical situations just floating into the distance, because her actions confirmed to me that I would still matter regardless of what my long-term prognosis looks like (a fact that I ‘knew’ before, but that her actions showed me louder than any logic I had been able to muster!)
A Framework of Attachment
I think of ‘safe’ as building a framework for attachment, ‘known’ as filling that framework in and making it solid, and ‘precious’ as strengthening and reinforcing attachment to help build resilience for the future. You really need all three, working together to make long-term progress.