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Everything is (Not) Fine

Experiential Trauma Indicators for Frontline Advocacy and Outreach Workers

One of our SWOP Behind Bars front line advocate experienced compounding crises' this past year and even though we were all well aware they were “going through something”, they adamantly refused gently framed offers of support. They had thought they were strong enough and the trauma had become such a part of them that it became a familiar comfort. And they felt that acknowledging the fact that they were truly in crisis was evidence of weakness and not an opportunity for a deeper understanding of their life and their work. As a survivor of multiple traumas over decades, we were all well aware that everything was not okay at ALL, but in the spirit of supporting them in the manner that they emphatically stated they wanted support, our team remained available at the distance they requested.

In April, one of our Executive Staff members noted that they seemed to be engaging in some trauma response behaviors, and, in a private meeting, expressed their concern. With care, but also utilizing the tools they knew would be effective in intervening, the staff member took our survivor to task and demanded some improvement in behaviors and production. The staff member pushed back at first but later spoke to another staff member who recognized that their recent trauma had activated their past trauma responses and had indeed affected their ability to engage with other survivors. Changes and improvements ensued and agreements to further engage and seek assistance instead of insisting that everything was okay. They agreed to some interventions from community members and started showing signs of improvement.

But last week, another long time senior front line staff member and very close friend, who also identifies as a survivor and knows the passion and intensity with which their co-worker has for their mutual efforts, took it upon themselves to directly confront the person in crisis with specific concerns and examples of self harming behaviors and concerning social media posts, and boy did that get their attention!

“Wow! You are absolutely right! I’ve not been myself at ALL”

This led to multiple loving and supportive - but firm - engagements from other staff members and they each reached out respectfully - where the survivor staff member was at - to acknowledge and renew commitments of support. It was literally days until the staff member in crisis started to correct and engage with their clients on a completely different level and the effectiveness of their advocacy, communication with other staff members and ability to cope with barriers to advocacy issues with other survivors visibly improved.

It’s hard not to notice the visible trend of survivor and sex worker led movements and it’s exciting to see our community members move into meaningful roles within intersecting movements and this evident trend of survivor and sex worker led movements where community members phase into meaningful roles within intersecting movements is exciting to see.. But, as with everything, this level of engagement comes at a cost and it’s not surprising that sex workers and survivors have to bear the majority of that burden.

Organizations encompassing a spectrum ranging from the anti trafficking spectrum to sex worker rights, to fighting homelessness, encouraging harm reduction,LGBTQIA+ movements and other social justice arenas have seen a marked increase in members of our intersecting movements being hired and paid for their lived experience and all the knowledge and wisdom that comes from listening to people who have lived through tough times and come out stronger. These strategies benefit the communities they serve, the services they provide and the organization - which is only as strong as its weakest member - can thrive when led by people who have lived experience of trauma, lead efforts and generate solutions to complex problems.

What we don’t love is the lack of support that many people who are put on the front lines of outreach and advocacy are failing to get because leadership with these diverse efforts are often ill-equipped tot really know how to spot a looming crisis or support it once it lands on their doorstep with a booming thud. And when the very minimal services and support breaks for marginalized vulnerable people, things can spin out of control very quickly. Given the high volume of support requests received on a daily basis and inherent unpredictability within the lives of the populations we serve, by quickly we don’t mean in the span of a couple weeks…we mean in the span of a couple hours.

Organizations and funders need to know how to build wellness strategies into their projects that are hiring and paying formerly incarcerated folks, survivors of trafficking, criminalized sex workers, formerly homeless outreach workers and people who use drugs. This doesn't imply group outings to have dinner, but building relationships with individuals and connecting with internal networks to establish a culture of supporting the employees that are representing marginalized workers.

This work can be triggering. Even for people with decades of stability in their lives. And more so for people who may only have a year (maybe more and maybe less) of experiencing stability, supportive work environments and healthy social networks, these triggers and discomfort with stability be the very thing that keeps your people and projects stuck.

It’s become very “chic” in philanthropy circles to fund projects and programs that hire people with lived experience to provide services and support for their outreach and programs, and the sex worker rights movement has always been a leader in these efforts. Our lived experiences, paired with harm reduction methodologies often impact our “worldview” about how, what and why we have such a passion for serving our communities.

We have seen many projects and programs that help people help people but who helps the people who help the people? And what are we doing to truly minimize harm and maximize personal growth for our prospective communities?

Our lived experience colors our world and our interactions with the people we seek to serve. Almost all of us have lived experience of violence, food insecurity, homelessness and lack of proper healthcare and structural access to support for our circumstances. We are most definitely the best equipped to provide these services but who is going to assist us in recognizing signs of trauma that might be impacting our work?

Meeting people where they are means exactly that!

Nightmares, flashbacks, mood swings, and panic attacks are often associated with posttraumatic stress disorder (PTSD) in adults. Traumatized people who are still healing from their own trauma can often experience these symptoms and can be triggered when participating in outreach efforts. It is important for organizations who are hiring people with lived experience to recognize these signs and make sure they can support the outreach worker without causing them additional harm.

Here are some of the “signs” that someone has been triggered and you should recognize them as opportunities for growth and development of both the outreach worker and the organization.

Deflection happens when we redirect the focus, blame, or criticism away from ourselves in an attempt to preserve our own self-image and avoid dealing with negative consequences. It can be used as a reactive coping mechanism to avoid feelings of guilt and shame, or as a narcissistic abuse tactic to avoid accountability. This is a PERFECTLY NORMAL response to being triggered but it is incredibly hurtful to helping others.

A good, but very broad example, is the cliche “Hurt People Hurt People” and deflection of responsibility and accountability is harmful to the outreach worker, the community they seek to serve and the organization as a whole.

Oftentimes the “deflection” mechanism is a precursor, or is followed by, over-apologizing. For some survivors of multiple traumas, apologizing served as a means to avoid conflict, blame, and feelings of shame. If you have an frontline outreach worker who is starting to constantly apologize for things that are out of their control, take note!

Worrying that others are mad and working really hard to smooth things over with friends and family or coworkers is a coping mechanism and if they start conversations with “I’m sorry” at the first sign of trouble, even if you don’t know what they are sorry for, you have an opportunity to understand that some survivors of childhood trauma apologize as a means to avoid conflict, blame, and feelings of shame. Saying “I’m sorry” might work to placate an abusive mother, resolve a domestic dispute between caregivers, or ward off a parent’s criticism, but it is not a good way to spark meaningful dialogue in a work environment that doesn’t have built in support methodologies.

People who have experienced any form of complex trauma often experience memory fragmentation as a result. When the brain and body are under threat, the parts of the brain responsible for creating memories are impacted. What’s more, some survivors dissociate or experience a change in consciousness during traumatic events. This can impact how memories are stored and whether they are available for easy recall later.

The Body Remembers experiential trauma - but sometimes we “shuffle the files” in our brains to escape having to relive bad experiences.

Sometimes there is an overlap between chronic pain sufferers and trauma survivors. Physical, sexual, and psychological abuse are reported to be risk factors for the development of pain conditions such as irritable bowel syndrome, chronic pelvic pain, and joint disorders. While researchers are still exploring the causality of this link, many surmise that when the body is under stress for extended periods of time it can have damaging effects to our neurons.

“When we are threatened, our bodies have what is called a stress response, which prepares our bodies to fight, flee or freeze. However, when this response remains highly activated in a survivor for an extended period of time without the calming influence of a supportive friend, family member or co-worker, toxic stress occurs and can damage crucial neural connections in the developing brain.” Harvard Health Blog.

Unresolved trauma can put a lot of stress on your body. The resulting energy from the heightened state of alertness and anxiety can be a lot to manage. Plus, if your lived experience outreach worker also struggles with the effects of generational trauma, it’s likely they had few self-regulation tools to model. So when they have anxious energy and too much adrenaline coursing through their body, and they can’t rely on internal coping mechanisms, they might look to external methods.

And not all external coping methods are always helpful. But external methods of coping are completely normal and should be expected, embraced and addressed in a loving and appropriate way, led with love and compassion and empathy.

Many Frontline Outreach Workers who are also Survivors seek to override the stress response by indulging in changes in substance use, eating, alcohol, spending, sex, and working. They can even change one out for the other. These behaviors do tend to keep the energy at bay, but they only dull the experience. They do little to actually resolve the underlying source of the problem. As human beings we are drawn to comforts that we “know”. Familiarity with chaos can be comfortable. Over working to avoid trauma responses is an American Idiosyncrasy and JUST as harmful as any other coping mechanism…but Americans are unique in their commitment to praising people for working 60 or 80 hour weeks and have been resistant to providing many of the social assistance like mandatory paid time off, more lenient mental health leave and vibrant and effective opportunities for support groups, therapy of therapeutic self care.

People who endured abuse, violence and/or exploitation may struggle to suppress intense feelings of shame as they move through the world. If they get messages that they themselves were the one responsible for the abuse, they may have developed a pervasive frame of self-blame.

This may be reinforced if the work environment implies the trauma is the outreach worker's fault or if the outreach worker is not “believed”. And it is especially hurtful if the work environment doesn’t provide an active process for supporting outreach and advocacy workers.


Here are some of the more common experiential trauma indicators that are totally normal but can have an adverse effect on front line workers;

  • Mood Swings of Visible and Invisible intensity

  • Fear of Abandonment or Losing their Job

  • Conflict in Interpersonal and Work Relationships

  • Self-Esteem Fluctuation

  • Flashbacks

  • Fear triggered by Places, Smells, Sights, Sounds, etc.

  • Depression and Feelings of Worthlessness

  • Anxiety

  • Increases or Changes in Substance Use

  • Impulsivity

  • Mistrust of Authority

  • Attachment or Detachment Issues

If the outreach worker is dealing with any of the above and the symptoms are impacting their work, be assured it is also affecting their overall well-being, it’s a good idea to address it and resolve the issue as quickly as possible, while still respecting the outreach or advocacy workers desire for “presenting” as totally fine.

Survivors don’t come in and apply for jobs at organizations providing survivor led leadership and plunk down a list of their traumas as an appendix to their resume because we admitting to being a trauma survivor foes against everything we know as survivors. A not insignificant part of survival is not showing signs of trauma. This makes it complicated for the survivor, their leadership team and the organization to really identify what's going on.

Regardless of where the survivor is in their healing journey, there are things they couldn’t possibly imagine will trigger them and that makes it virtually impossible for their supervisors and adjacent staff members to recognize the situations that are happening. Dealing with trauma is a lifelong process with lifelong challenges, barriers and breakthroughs. Having the opportunity to be a part of identifying the challenges, navigating the barriers and being a part of the breakthrough is transformational for everyone and creates stronger, more resilient individuals that will then be better equipped to positively impact vulnerable communities and eventually lead to resolutions our society has yet to fully experience.

Don’t fear the trauma! Embrace it.. Love it...and recognize it for what it is; an opportunity for personal, professional and organizational effectiveness and growth!

Although symptoms of trauma can be overwhelming, there are lots of ways to manage them. And when you couple self-care strategies with a supportive work environment and prioritize your outreach workers' well being, you will not only create a great work environment, you will empower your survivors with lived experience to be more effective at their job and your organization will experience more success with client progress.

For symptoms of trauma that impact outreach workers more than you can manage as an individual or a team, it’s a great idea to seek support. Many of our sex worker led organizations can teach effective techniques that will help you process their trauma in safe and productive ways that will improve their ability to do the work and build trust with you and your organization.

Trauma manifests in the body – stored and stuck – sometimes for decades.

Your Frontline Outreach or Advocacy Worker with lived experience may wonder what’s wrong with them. They may feel as though they are broken and their past trauma will define them forever. Neither is true and both are true! Their past is what they "did"'s not "who they are!" Who they are is a miracle and you should take great pride in you part of that miracle!

But it doesn’t have to be that way! Take the time to learn the signs of trauma that served your Frontline Workers in their ability to survive and learn to recognize when they feel they are safe. Learn your Frontline Outreach Workers “triggers” and make sure they have the support they need at the time they need it! Don’t wait for a crisis…have regular check-ins with outreach workers and don’t hesitate to be willing to engage on a much deeper level in order to produce excellence in service provision and build relationships that are built on dignity and respect!

At the end of all of our very long work days, it’s the responsibility - morally and legally - of managerial and executive staff to provide a safe workplace for all. Unaddressed trauma responses can lead to poor client outcomes, burnout, staff conflicts and even hostile work environments when not properly attended to. This is a delicate dance because it is also not appropriate for employers to be overly intrusive or nosy about their staff’s personal lives and private health information. This is why it’s so important to prioritize adequate Human Resources professionals and information - something that is often difficult to budget for small non-profit organizations.

The best people to provide services and support to communities has - and always will be - people with lived experience. But if you or your organization doesn’t support them with more than a paycheck, you are doing a disservice to them, to yourself and your entire organization.

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