Ad Voiceover:
This episode of Social Work Talks is sponsored by Ironwall By Incogni
Elisabeth LaMotte:
From the National Association of Social Workers. This is Social Work Talks, and I'm your host Elizabeth LaMotte, and I'm so pleased to be sitting down with Social Worker. We are going to be talking about the intersection of grief and trauma. Melissa is, as I said, a social worker. She's the director of training and education at the Went Center for Loss and Healing in Washington dc And we know as social workers and as humans that grief and loss are universal. They're a part of life and they're bound to come up in our social work practice regardless of our area of work. What we tend to know less well is that when trauma A for sex with grief, the healing process is more complex. And Melissa is a real pioneer in field when it comes to training and supporting communities and individuals with respect to the intersection of grief and trauma. So Melissa, welcome to Social Work Talks. Thank you so much for joining us.
Melissa Sellevaag:
It's a pleasure to be with you, Elizabeth. Thanks for having me.
Elisabeth LaMotte:
Could we start with you telling us a bit about the Win Center for Loss and Healing here in Washington dc?
Melissa Sellevaag:
Alright, so the WIN Center has been around for 50 years. Our focus is solely on grief, loss and trauma. We provide individual and group mental health care to kids all the way through senior citizens who are navigating life's worst moments. We offer in-person services in our office as well as telehealth services to those in the DC, Maryland of Virginia area. We're also in DC public and public charter schools providing grief and trauma groups to kids in middle school, elementary, middle, and high school. And then we do a lot of training and education for the community members on understanding grief and trauma and how it impacts us and how it impacts how we show up and interact with other people, really with the intention that the more we understand grief and trauma, the more we can support our community members and each other. I think it's really important that we understand that.
Elisabeth LaMotte:
So Melissa, I want to especially thank you for making time for us so soon after the tragic plane crash here in Washington dc. Is it okay if we talk about your experience this past week?
Melissa Sellevaag:
Yeah, absolutely. First and foremost, our hearts and thoughts go out to those who are impacted by the plane crash and the victims that were lost that day. The Went Center is uniquely positioned to provide support in the wake of mass casualty events. We are part of the larger mass casualty response system in Washington dc In this case, the onsite support was provided through other mechanisms. So we have been called in by specific agencies and groups to provide support to those who are impacted and support in the wake of acute traumatic grief looks like offering information, this is what you might be experiencing. It looks like offering regulation strategies and skills to navigate the immediate days and weeks. We were onsite at various locations. The event happened on a Wednesday night and by Friday we were onsite places providing support, holding space to hear what people were experiencing, provide some psychoeducation around traumatic responses, some very basic coping skills such as drink water, get horizontal, turn off the news, stop looking at social media, and then strategies to support kids because we know that this impacted adults and children across the board. So really,
Elisabeth LaMotte:
Really did
Melissa Sellevaag:
Providing that information to caregivers to be able to provide support to their kids because what we know is that kids who are impacted by traumatic loss need some predictability and stability and need adults who are able to take care of themselves so they have capacity to show up and take care of their kids. So really in the immediacy after a loss such as that, it's a lot of psychoeducation, a lot of validation, a lot of body regulation, and just a lot of sitting with it.
Elisabeth LaMotte:
Can you break down what you mean by body regulation? Just describe that a bit further.
Melissa Sellevaag:
Yeah, absolutely. So when we experience something traumatic, are nervous system kicks into gear in a protective mode, right? Everybody knows fight, flight, freeze. Our nervous system kicks into gear in order to help us stay safe. And so that can mean that our nervous system is operating in this kind of activated state. Some people call it triggered, I use the word activated. I think it's more a better description of what actually happens on the body. So when our bodies are activated, they can feel restless, they can feel like it's hard to sit still, it's hard to concentrate. Our legs are going a mile a minute. As we're sitting there, we're having stomach discomfort, nausea, our heart might be racing. Our chest feels heavy. So literally our body is giving us clues that we are uncomfortable and not okay. And if we pay attention to those body responses, there's things we can do to tend to that and help get our body a little bit back to a little bit more comfortable. Clinically, we call it the window of tolerance, but when I'm working with individuals in the community, we talk about comfortable. And so that can look like discharging that energy through movement, through breath work, through drinking cold water, through humming and activating our vagus nerve through humming, hugging, and touch bilateral tapping,
Elisabeth LaMotte:
Which is a part of EMDR and is so stabilizing for people.
Melissa Sellevaag:
Yes, and we need to go back to basics when we're feeling really activated and remind people, take a breath with me because we're engaging in shallow breathing or we're holding our breath. Let's take a breath together and we're regulating our breath that way. Let's walk and talk. Really, the more we can provide that information and validation, the less people feel like I'm losing my mind, I'm going crazy. I'm not okay, and you're not okay. And we can provide some skills and some strategy so that you can get back to comfortable while you're navigating the traumatic loss.
Elisabeth LaMotte:
What would you say you observe between parents and children in an unfolding of something of this nature?
Melissa Sellevaag:
Most of us are in shock and disbelief. It's hard to wrap your heads around it. There's a great book about the grieving brain by Mary Francis O'Connor that I recommend, and she talks about the science of the grieving brain and how it takes a period of time for our brains to actually understand this experience and create new pathways. And so we're in shock, we're in disbelief. There's a lot of, depending on culture, there can be a lot of outward and vocal expression of emotion. Maybe there's not depending on culture. So there's that shock and disbelief and that need to do something to get back to feeling okay, your sense of safety and stability is shattered. And so what can we do to provide some of that safety and stability in this moment when our entire sense of safety and stability has been rocked?
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Elisabeth LaMotte:
And what is it like for you when you get the news about something like this and you're entering a situation and how has that changed as you matured as a clinician?
Melissa Sellevaag:
Yeah, it's a great question. First and foremost, there's a running joke that we talk about what's the fastest way to get a therapist regulated? Well, it's to put them in front of a client, right?
Elisabeth LaMotte:
I love that.
Melissa Sellevaag:
We talk a lot about, just like we tell caregivers, you need to take care of yourselves. I have to be actively aware of what my body is doing. So I'm highly attuned to, my chest is tight, my stomach is tight, my appetite is disrupted, and that makes sense, and here's what I'm going to do to take care of myself. I also have the privilege of being surrounded by amazing clinicians.
Elisabeth LaMotte:
You do, I know this.
Melissa Sellevaag:
It's like pick up the phone, call somebody within minutes on a Thursday morning, we were on calls talking about how we were going to proceed if we were called upon to provide support. So in a situation that is as large as this one is, people kind of come out of the woodwork that we know and trust. And so we've got a beautiful network of people that we can call on to step in and provide support. But for myself, it's how am I taking care of my basic needs? How am I regulating my body? How am I moving after I've been sitting with people who can I call and get consultation with and share about my experience and get that support and who in my immediate family knows what I'm going through so that they can lighten my emotional load in other areas so that I've got capacity to respond?
Elisabeth LaMotte:
It's so important, and it's reminding me of another of the many powerful passages in the book that you suggested where she writes, combat veterans will not form a trusting relationship until they are convinced that the therapists can stand to hear the details of the war story. Rape survivors hostages, political prisoners, battered women and Holocaust survivors feel a similar mistrust of the therapist's ability to listen, to really listen in the words of one incest survivor, these therapists sound like they have all the answers, but they back away from the real shitty stuff. So respond to that because I think it gets to the rub of what many of us have a lot to learn about from you and from this conversation.
Melissa Sellevaag:
So when you are sitting with people who are navigating traumatic grief, the part of our human being that gets activated is our helplessness. We get into this profession to help to make things better, to help people feel better when a grief event occurs and a traumatic grief event occurs, we have to notice that part of us that's getting activated, that helplessness part that I can't fix this, but I have the courage to go into that space and sit in the pain and to hold that space and to hear what they are offering me. And so when I can stay regulated, stay present, stay attuned as they are sharing some of these really challenging details, then they know I can handle their story. And that actually gives them, it starts that that awareness that with therapy and with that connection and with that attunement, they too can navigate this, that it's not so hopeless that nobody can handle this.
I can't handle this, that we can be highly attuned and stay present and stay regulated and hold what they're holding. Now that being said, there is something about pacing. When you are in a clinical setting, somebody wants to come in and let it all out. My first job is to ensure safety. So I might want to pause people and say, this is so important what you want to share, but let's pause. Let's take a break. Let's notice what our bodies are telling us because an urgency to get it out. And I want to make sure that they stay safe and that they're present and that they're regulated so that they're not leaving dissociated and kind of in an unsafe situation. So pacing is critical, but also making sure that they're feeling that attunement and that presence because that sends the message that I'm here and I can handle what you're going to talk to me about.
Elisabeth LaMotte:
Could you give another example of showing up and holding space that clinicians can learn from in terms of perhaps a place where we commonly may move too fast or may not show up as our best clinical selves?
Melissa Sellevaag:
Yeah, I'm not sure who said it. I know a couple of my colleagues here at the One Center have named it, and it might be attributed to somebody else. So forgiveness for not quoting the right person. But it starts with this idea that our capacity as clinicians to sit with somebody else's pain will never exceed our capacity to sit with our own pain. So it really starts with what are my beliefs, my narratives, my family of origin, story about grief and trauma. How am I able to sit with my own discomfort? What are the tools and strategies I have for being able to regulate myself to stay present and attuned and resist the urge to jump in and say something, some modalities in their training, and one of my colleagues talks about that acronym weight. Why am I talking? And so really it's that idea of slowing ourselves down and giving our clients that space to be able to share at their pace what they would like to share and what they're ready to share. But part of it is really becoming aware of that part of us that comes up with helplessness. So noticing that and that our urgency to fix it and to make it better, of course it's hard to watch somebody in pain. It's really important that we're in touch with that and that we have mechanisms for tending to that as well.
Elisabeth LaMotte:
How does what you're describing relate to the trainings that you have for social workers, which I imagine some or many of our listeners and viewers may be quite interested in?
Melissa Sellevaag:
Yeah, great question. So over the years we've been able to offer trainings on grief and trauma and the intersection of grief and trauma and specific working with specific causes of death and types of grief. And so first thing is that in graduate school, I don't know about you, but grief was an elective. It was one semester if you wanted to take it. So we're not even talking about it and equipping our clinicians to sit in this space. So I think that's important to name that the social work profession, this very natural thing that we're all going to go through. We could probably do a better job of putting into our training and equipping people to be able to sit in that. Right,
Elisabeth LaMotte:
Almost as if the programs struggle to go there and that can carry over into our professional development.
Melissa Sellevaag:
Absolutely. Absolutely. So I think starting there that clinicians, it's not a sign of weakness to seek out additional training. I work at the Win Center and I've done extensive training with other folks on grief and learn through my conversations and collaboration with clinicians here who've been doing the work for a long time. The other thing is through our trainings, we often start with presence and use of self. And I've noticed that sometimes that frustrates some of our participants who are like, give me the interventions, give me the doing. And yes, there are interventions and there is doing, but initially it's the being and it's how am I using my presence tolerating this discomfort and showing up and being connected with somebody. It goes back to that basics of building relationship, establishing trust. And so when we want to jump to the interventions, that part of us comes from a good place, but it's the fixer part. And so we'll get there in our trainings and we'll give you some tools and some strategies and some interventions to use that have worked, but those won't work if we don't start with the presence and the attunement first.
Elisabeth LaMotte:
Right? Isn't that something? So you mentioned training and social work education, and there is something that blew my mind in this book, trauma and Recovery. I learned in graduate school that the field of therapy began when Sigmund Freud, a doctor, had patients with unexplained ailments and they sat down and talked about how they felt and their symptoms alleviated. That's what I learned. This book describes something much deeper than that. What she says is that in 1896, Freud worked with 18 so-called hysterical women. And what he discovered with all 18 of them by truly listening is that they all had a history of child sexual abuse. And he wrote a paper that still stands up today about the post-traumatic history of hysteria and how it had to be connected to trauma in childhood child sexual abuse, and he was essentially canceled for this paper and backed away from it. Is that your understanding as well?
Melissa Sellevaag:
It's interesting. I haven't done as deep a dive on that as you have, but I do think through Judith Herman's work, through the neurobiology work that's been done with the advances in neuroscience and technology and Bessel VanDerKolk's work and the Body Keeps Score, Steven Porges, I mean the list is endless, right? Dan Siegel, there's some really amazing, amazing authors and clinicians out there. What we've been able, how I interpret that, and I don't think I'm alone in this, this is not a Melissa is this is through conversations with people is that the human brain and body is incredibly resilient and adaptive. And so we look at the women who are labeled hysteric like hysterical, and actually we could look at that as well. They came up with some coping strategies to manage what they went through. So we can look at these as adaptations that they had to create to survive. It goes back to that it's not what's wrong with you, what's happened to you and how did you survive?
Elisabeth LaMotte:
Exactly. And what happened when he put this theory out there is that his colleague couldn't sit with that horror just like what we're talking about. And so he had to walk it back because the reality of that possibility was just too disturbing.
Melissa Sellevaag:
There had to be something wrong with these women, and it really inflicts that shame narrative that we talked about. And so even sometimes just providing that information and psychoeducation about how the brain works and how it adapted to what you experienced as a child with pervasive abuse and exposure to intimate partner violence and community violence and the list is kind of endless. How your brain adapted to that and the coping strategies you came up with are remarkable. And perhaps now they're not serving you. So let's use some of our tools to process this and come up with some different coping strategies to manage life stressors. So it's like a both, and we can have new coping strategies and we have these amazing tools through EMDR and Sensory Motor and Play Therapy and Sant Tray and all of these modalities that really help us sit with a client to process their trauma, but not necessarily in that traditional kind of let's just sit down and talk it out kind of
Elisabeth LaMotte:
Way. Is there anything further you would say about how you determine what modality is the best fit for a particular person going through something traumatic?
Melissa Sellevaag:
So at the WIN Center, our clinicians are trained across multiple modalities. We have clinicians that are trained in sensory somatic experiencing and psychomotor and San Tray and EMDR and attachment theory and lots of art-based work. And I think it's first and foremost is it's going back to that core responsibility that we have as social workers is to practice within our competency. And so that's sometimes recognizing, wow, I need to get training in this, or I need to get consultation, or I need to seek some supervision. So I think that's key that it's okay to say, I think I'm in over my head, I need to refer out or get some consultation on this particular case. The other is recognizing that with trauma and traumatic grief, in particular, traditional talk therapy, like your insight oriented questions and your active listening isn't going to be enough because it doesn't exist in the verbal parts of our brain.
And the neuroscience has shown us that it actually exists in the nonverbal parts of our brain. So this is where engaging in modalities and in therapy activities that help us integrate left and right brain can really help us bring the trauma over to the parts of our brain where we can actually access language. When I talk about this with people, it's like when you've experienced the death of somebody and somebody says, how you doing with that? Tell me about it. And you're like, I have no words. Well, of course you have no words, right? It is not in that verbal part of our brain and it's not even encoded in that way. So really having other modalities that allow us to support the client in integrating that and giving language and giving skill, I think is really important. And this is where continuing ongoing professional development is critical.
Elisabeth LaMotte:
You're talking about the vast skillset of the clinicians at the Wen Center, and I think it's important for me to note that there is no organization like We Center that I am aware of with such a substantial focus on grief and traumatic loss. What drew you to work there? Tell us about that story.
Melissa Sellevaag:
So this is a special place, and Elizabeth, I'm biased, but this is a really special place and I am honored and privileged to work here with what I think are some of the most talented and gifted clinicians in the country. So in 2003, I was a baby social worker just out of graduate school a year or two. And my then boss, Michelle Palmer, who used to be the executive director at the Wind Center, was not the executive director there, but she was like, you got to come do this thing with me this summer. You got to volunteer at camp, forget me not. And I was like, what is that? And so in the summer of 2003, I became a volunteer at camp for Forget Me Not, which is now called Camp Forget Me, not Camp Air in dc. And this is one of our flagship programs.
It's been around for, this is our 26th year of camp. Each summer we bring together kids six to 17, 18 years old who are navigating death related losses. And we intermix grief and trauma work with camp and fun and adults. And it's this remarkable opportunity for kids to meet other kids who are grieving and for adults to step into that space and share some of their experiences. So I was a volunteer pre covid. We used to go to Sleep Away camp and I was a volunteer at camp and came back year after year and started as a buddy, paired up with a kid, got to be a group assistant, and then got to be on the clinical team facilitating grief groups. And my first camp that summer, again, I was a baby social worker. It really changed my life. You are witnessing 50 or 60 young people who have the courage to show up to a place where they might know nobody and share the story of their loss and talk about their mom who had died or their brother who has died and be witnessed by adults who are not. We have trained clinicians there, and the Win Center is heavily stopped there, but we also have accountants and lawyers and cops and teachers and you name it, kind of coming in and witnessing and holding their grief. And so they're able to see people who have navigated life with grief. And it changed my world. And seven years ago, the opportunity to work here came around and I jumped at it because there is no other place like the Wine Center.
Elisabeth LaMotte:
And if listeners have a client who they would like to try to sign up for camp, is that an option or do you have to be in the DMV? (District of Washington, DC., Maryland and Virginia).
Melissa Sellevaag:
So camp is open to kids in the DMV area. There are camp errands and grief camps all over the country. So we are not the only one. We are one of a few. And our camp director, Stephanie Handel, who has been here for two decades at this point and has run camp for the full 26 years, consults all over the country on how to run a grief camp. She's really remarkable at it. In this area, we do accept applications. They usually open up at the beginning of March. You can find that information on our website went center.org and it's free, a hundred percent free. We rely solely on donations and volunteer time, and so caregivers can submit the application for their camper, and then we assess every family and camper to make sure it's the right fit. We want to make sure that kids can come in and share memories, can tolerate the memories and stories of other campers that they want to be there.
We've all been with families where a caregiver says, this would be really good for my kid, and the kid is like, no way. So we make sure that kids know what they're walking into, that they're well prepared. So we screen every kid at this point post it's three day camps. So we have our little kids that come together on a full Saturday, our tweens that come together, and then our teens and the caregivers. The beauty of a day camp is our caregivers come back in the evening, our caregivers come back in the evening to be able to join in for a family ritual and for a joint family dinner. So we're able to do this grief work and then we integrate the families. And now in the fall, this happens in the summer and then in the fall, we offer our Family Grief camps, which are a mix of both virtual and in-person camps where they're usually on a Saturday or Sunday morning, and we invite the campers and the adults and they can engage in some grief activity and grief work together.
Elisabeth LaMotte:
And for clinicians who are interested in training with you, do they just visit the website and try to keep up to date on that?
Melissa Sellevaag:
Yes. Right now, my trainings are not posted there yet, but they will be. So you can go to our website and get to the training page and you can follow us on Eventbrite. The exciting thing we're working on, we're in the process of getting our ability to provide CEEs for play therapists. So we know for Kids play is the language of kids and providing high quality trainings in grief and trauma for play therapists is really important to be able to expand the capacity of the community to support kids. So we have just submitted to become a site to provide play therapy ces, so stay tuned for that. We hope to be able to offer play therapy training specific to grief later this spring and into the summer. And then later this spring, we'll be offering our basic grief training for clinicians as well as we'll be able to offer our homicide specific training and supporting individuals impacted by homicide as well.
Elisabeth LaMotte:
And we are going to put the website in the show notes section along with the books that you suggest. One is Trauma and Recovery by Judith Herman. What are the other must read books for social workers?
Melissa Sellevaag:
Yeah, so I love Trauma and Recovery. She was really the first person that talked about stage based therapy for folks impacted with trauma and that you have to establish safety first. You can't just jump into the narrative. We have to have a sense of safety, and I think that was really transformative. So that's the work of Judith Herman. I really like the Grieving Brain by Mary Francis O'Connor. She's a new book out, which I have not read yet called The Grieving Body, so I'm eager to read that because I think it really, her grieving brain book really transformed how we think about the brain and how it integrates grief.
I'm going through my brain. I love the book. The one that I recommend for the average folks to read is Megan Dev Divine's book. It's okay, you're Not Okay. It's a great book around normalizing the grief responses and talking about the common responses. And it also gives really helpful hints on how to support those who are grieving, meaning kind of sitting in the pain and witnessing the book of William Warden. He follows these kind four stages of engaging in grief therapy, which we really lean into heavily here. And so he's got a great grief therapy book, William Warden, and then Alan Wolfel has some really good books. He's out of Colorado and some really good information on his website. And then the last author I really like is Nemeyer, Dr. Nemeyer, who also talks about this idea of integrating grief and looking at it across phases as opposed to stages, but really kind of working with folks to integrate the grief.
Elisabeth LaMotte:
So we will put all of that in the show notes section. Melissa sva, you are such a credit to the social work field, and I know you're so busy. Thank you very much for taking the time to join us today. I hope that we can continue this conversation at some time in the future.
Melissa Sellevaag:
It would be a pleasure. I was thrilled to be with you, Elizabeth. Thank you for having me.
Producer:
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