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Section 6: Trauma and groups

Trauma and groups

Alisa Ray

Community art counsellor

Group debriefing

  • Group debriefing is a structured group discussion or group process for groups who have shared a traumatic experience.
  • It is not intended or recommended to replace therapy.
  • Classroom debriefing allows the class as a group to sort out the events leading to the incident, and to express reactions to the incident.
  • The purpose is to develop understanding and to increase feelings of personal control.
  • Debriefings are also an attempt to salvage group cohesiveness from the disintegrating effects of crisis.
 Case Study of St Vincent’s intervention after multiple traumas - Trauma debriefing

We received a call at Lefika at about 9:10 am, requesting a crisis team of three counsellors to come to a school for the deaf, for an urgent trauma debriefing. The message relayed to those who were available was that there had been multiple deaths at the school, and a kidnapping. In an attempt to get there as soon as possible and responding to the urgency, we left the building in a rush, talking about what we would need to do when we get there. We decided that we should wait and see what the needs of the resident psychologist were and respond to that. It felt frantic and we weren’t quite sure how we should respond, very aware of our anxiety. On our way to the car we bumped into a colleague. Motivated very much by our pending anxiety and felt inexperience in this kind of intervention, we stopped to ask if she had any advice or thoughts. She spoke about a few different trauma techniques, some including the use of tearing up newspaper and then creating something from these torn up bits. Very importantly, she then asked us where our materials are? We looked at each other, and wondered the same thing, then saying  how we had both thought it, but not actually followed through with this thought - perhaps a direct inability to think in the face trauma. We hurriedly ran back upstairs to fetch a trunk filled with materials (paint, paper, glue, scissors, drawing materials fabric, ink, glitter pens, glitter etc.), adding to it a large pile of envelopes. After packing this in the car, we were eventually on our way, feeling slightly more prepared, although not entirely. On our journey there, we spoke about how we both couldn’t believe that we were planning on facilitating an intervention with no materials? What were we thinking? We weren’t!

On arrival at the school, we waited for our colleague to arrive while we were introduced to the resident psychologist. We were then given the option of working with educators or children affected by the traumas and collectively we decided we would like to work with the children, as we all felt more comfortable with this group. We were taken to the psychologist’s office where we were given a more in-depth briefing on the scenario:

In one week at the school:

a educator had died

a transsexual child had been found in his community physically hurt – there was thought this was an attempted muthi murder

a young girl whose mom was in the dementia stages of HIV/AIDS hadn’t been to school for a number of days and no one knew where she was

a young boy had died the day before we were there in a train accident

and a child had attempted suicide by hanging themselves that morning and educators and some pupils found her on their way to class.

Immediately I felt an enormous sense of overwhelm and urgency to act.

We were briefed that there were 3 classes of children that we would need to work with. At this stage we were also told to not make any mention of the kidnapping and attempted muthi murder, as well as the attempted suicide, and that if either of these two things came up in the group then it was fine to talk about, but not to bring it up ourselves. It suddenly felt like a lot to have to hold.

After our meeting with the psychologist, we were introduced to an interpreter, who would sign for us during the sessions. We were informed that she was bound by the same code of ethics as us, and that anything brought up in the sessions would remain confidential and free of judgement from her. I had reservations working with someone in this kind of intermediary position, wondering how things might get lost or miscommunicated….?

On our journey to the classroom, we were joined by another interpreter who seemed more in the know about what incidents had occurred and who we would be working with. She gave us a break down of the groups we would be working with…There were 3 classes: the first was the class of the boy who died in the train accident (14-18yr olds). We were informed that this would most likely be the most traumatised group to work with. The second class was a group of younger pupils, who knew the boy who died in the train accident quite well, but were not as close or connected to him as his own class. The third class was an older group of learners who had lost their educator the previous week due to an illness, and the majority of who were connected to the boy through their interest in soccer and playing the sport together (18-22 year olds). They had experienced a double loss.

After some discussion amongst ourselves as community art counsellors, we decided that we would work with the first group as a team of three community art counsellors (because it was the largest and supposedly most traumatised group – 18 children) and then split up for the last two groups – I would run a group with the older children and my colleagues would run a group with the younger children. We had a time limit to work with in that there were breaks for lunch and the end of school was at 14:30. We would work with the first group from 11:00 – 12:40 and the second group would run from 13:00 – 14:30.

As community art counsellors, we spoke about a loose plan: checking-in, saying a bit about who we are (community art counsellors from Lefika) and why we are here (there have been some terrible things happen at the school over the last week, and we would like this to be a space for everyone to find a way to express how they are feeling about it) and then opening up conversation to them, and try to weave in some psycho-education about the bodies response to trauma and what is normal to expect in the face of such stressors in what they offered. One of the community art counsellors suggested a breathing exercise before we then introduced the art materials to them to explore their feelings through making an image. We would then come back together as a group and share thoughts and processes and close. Mostly, we spoke about how we would try and just create a contained space for them to share how they were feeling and try to just be present and respond to their needs. We also acknowledged the potential for the space to become whatever the group needed, and that our structure and plan might have to change/ adapt accordingly. While having this conversation amongst ourselves, I asked one of the interpreters if the children had had any debriefing yet, and she said that they had only spoken to their class educator, and not had an official debriefing.

The children were still on a break while we then set up the room in a large circle of chairs. There was a challenge in that there weren’t enough chairs, and we had to continue going to other classrooms to find more. Break ended and the children began to trickle in to the classroom, the three community art counsellors and interpreter seated. We motioned to invite everyone to take a seat. It felt like it took a very long time to get everyone into the classroom and sat down – and I was very aware of running out of time, or not being able to give such a large group enough time. The group began according to our discussed structure of an introduction and acknowledgment of why we were there and a rough break down of what we would be doing with the time. In speaking about how the space would be a safe one, and that anything they chose to share would be confidential and kept safe, we offered it to them to share anything they might need to feel safe to share. At this point, more pupils arrive through the door and we had an issue with enough seating… it took a while for this to settle down. (Initially we were told that there would be 18 people in the group… throughout the course of the group running it grew to about 22 members).

Without hesitation, the first person to speak moved straight into sharing his memories of the friend and peer that had died. These were fond and gentle memories of someone who was a bit of a joker… a fun-loving and caring person who seemed to hold a very big place in his friend’s life. What followed were a flurry of various memories from other group members that ranged from their experience of him as a ‘brother’, a sometimes trouble maker that had changed in the last while and become a caring ‘good person’. What became clear and evident as each person spoke, was how popular and sociable he was, and how each person was clearly very affected by this apparently enormous loss. In the room, I could feel a great physical weight on my chest, this very heavy immovable and enormous loss as well as this great shock and disbelief – a sense of being frozen. One girl spoke about how they would travel to school together… they lived in the same community and came to school together every day. She reached a point where she was unable to contain her tears and cried. The group moved into a space of silence for a long while and it felt as though each person was recounting a special or personal memory they had of this boy in their own mind as a sign of respect for this loss. I spoke to the group about the weight and the difficulty in finding words at this point, when the feeling is so great, and suggested that everyone perhaps take some time to use the materials to explore what might be going on for them in that moment.

One of the co-facilitator community art counsellors suddenly suggested that before we begin using the materials, we do a breathing exercise. While this felt to me like a bit of an interruption in the flow of the group process, it didn’t feel as though I could stop it. It felt more like a reliance on sticking to the discussed plan – a response perhaps to the difficulty in holding the potential of the space and the anxiety that comes with this in the face of such tragedy and heaviness.

We did the breathing exercise, where some pupils chuckled through it and seemed to feel self-conscious, while others seemed calmed by it.

After the breathing exercise, we suggested that the group spend about 30 minutes engaging with the materials. This was a non-directive space and they could use the materials in any way they liked.  At this point I noticed just how many other educators, adults (interpreters, teaching assistants etc had come into the room and were watching and listening) the group didn’t appear to be affected by their presence, but it felt very difficult to ask them to leave, (having created a safe space without them) thinking about their need to have some kind of debriefing. (I later learned that the GDP psychologist who had come to work with the educators saw two individuals and then left because she said she was exhausted).

When we invited everyone back to the circle and for them to share their work/ thoughts/ process, it became evident as pupils were sharing, that most group members had created a letter or card, which they had then put into a decorated envelope. Some of these letters were addressed to the boy who had died, a kind of last goodbye and a recounting of the role he had played in their life. Some letters were addressed to his parents as a form of condolence, a great sorry for the loss of their son. There was a sense that these might even be letters of condolence to themselves as his friends, brothers and sisters etc… as a way of them acknowledging and bereaving their own loss. There was one boy who had created a portrait of the boy who died, although he decided he didn’t want to share anything about it.

When it came time to end, I wondered aloud what everyone might like to do with these letters and envelopes they had created. There was a group consensus that they would like to give these letters to this boy’s parents. I got up to fetch a brown paper bag – which on reflection happened to look like a postbag and placed it in the middle of the group. Without saying anything, one by one each letter, envelope, portrait was posted into this bag until everyone was sitting back down in a circle, empty-handed. Another huge silence fell, which was then punctuated by the class educator crying. It was time to end the group, which we did thanking everyone for their courage in sharing and wishing them well. I stood up to pick up the ‘post bag’ of envelopes and was very aware of how heavy it felt in my hand, and that the paper might tear… but it didn’t. I handed it to the class educator who the group agreed would make sure it was delivered to the parents, with the children when they visited the following day.

Throughout the group there was a very palpable sense of containment. From the circle, we sat in (and making sure that each new pupil that came into the room had a chair and the circle was made bigger), to us community art counsellors as containers of these enormous feelings, to the letters as containers of thoughts, memories, reflections, to the envelopes as physical containers of these letters, to the final brown ‘post bag’, which the group decided they wanted to use as the final container to give all their letters and pictures to the parents in. In some ways I was also struck by the idea of a burial and putting a body into a coffin, into the ground and each person paying their respects… in some ways this felt like a version of this … concentric circles of containment that seemed to allow them to navigate some of the complex layers of experiencing such a trauma in a kind of ritual that seemed to allow for some kind of beginning of the process of a goodbye.

I was aware only once during this process that we were working with a group of deaf children.

We had 20 minutes to pack up this classroom, plan the next session and move to the next classroom to set up for the group that followed.

I was facilitating on my own for this group, with a new interpreter (the same person who took us to the classrooms and seemed to have a much better sense of what had been going on). She took me to a computer room, where there were rows of desks with desktop computers and keyboards on them. Immediately, I asked her if we could use another space, as the one she was showing me would not be conducive to any kind of cohesive group experience. I said that it would be good if we could find a space where we could sit in a circle, and suggested the possibility of even working outside if we couldn’t find a classroom. Again, I was concerned about time and not giving this next group enough of it. She led me to a spot under a tree, but the grass had just been watered, so we wouldn’t be able to sit down. She said she would go and check another classroom, and come and call me if it was a possibility. A few minutes later, she called me and said we could use the art/ technology classroom and there would be enough space for everyone to sit in a circle. She said there would be 12 people in this class. I wondered if this might be the same experience as the last group, and felt quite panicked at the possibility of holding 12 or more people on my own.

We arrived at the art/technology classroom and the class educator was sitting at her desk in front of her computer checking Facebook. I assumed that she would be there until we had set up and then leave. I rearranged the furniture, moving large desks out of the way and arranging enough chairs in a circle in the centre of the classroom. While rearranging furniture, I decided to follow a similar structure to the first group, but to keep my mind open and see what they bring, considering they had experienced a double loss. At this point the interpreter then told me that this is the class educator whose pupil died in the train accident. Immediately I felt like we were in her safe space, and that it would be difficult to ask her to leave. I broached this with her, and said the pupils might need a safe space, without any knowing ears or eyes. The educator said that she didn’t think they would have a problem, and that they all know her well and she would remain in her seat. She appeared angry. The pupils came into the room and I invited them to sit down. I was aware of how they were looking at the educator sitting at her desk. My thinking was that perhaps it would be the same as the last group, were it felt like a support having educators in the room, and non-invasive, although she was on Facebook and not apparently part of the group, or present in any way. I introduced myself and spoke about why I was there, acknowledging the death of their class educator, and most recently a peer and friend of theirs and this was a space for them to bring whatever it was that they were feeling about these difficult things. I spoke about wanting the space to be safe enough for them to bring whatever they felt like they needed/ wanted to and mentioned confidentiality and non-judgement etc. I asked them what they needed for the space to be safe, and they all agreed that they needed the educator to leave her desk. The educator could hear the interpreter relaying this information to me, but she didn’t move. I got up from my seat, and said to her that the pupils would feel more comfortable of she wasn’t there. I acknowledged that this is her safe space, and that she too has experienced a loss and going through something difficult and that if she wanted some time to talk afterwards, I would make myself available. In quite an abrupt way, she said fine, and roughly packed her desk up and walked out the room, slamming the door behind her. This felt like a very difficult beginning.

After sitting down again, the group said that they now felt safe and “able to be free”. I verbally acknowledged the difficulty that everyone seemed to be going through during this time, even the educators. Much like the first group, the first person to speak, relayed a fond memory of the boy who died in the train accident. It was a story about them playing soccer together and how he always wanted to advise people how to be better at the game, in a brotherly and caring way. This pupil spoke about how sad he is and how much he is going to miss his friend. This moved into another story about how another group member remembered watching soccer games with this boy, and how excited he would get when his team scored a goal and how he would miss his advice with the game and his enthusiasm. For a while, memories of this boy and how soccer connected them all was the main point of discussion. Eventually, the only girl in the group shook her head in disbelief, saying, “not one, but two, how is this possible? I just can’t believe it. I don’t want to”. At this point, none of the pupils had spoken about the death of their class educator and her mentioning it in this way silenced everyone. After letting the silence have a space for a while, it felt like a good time to offer the materials and the space for the group to engage, since words seemed lost, or were hard to find.

One of the boys stood up and walked across the room to fetch a plastic folder and completely changed his posture and the look on his face. The interpreter said that he was acting like the educator that had died. To the group’s fond amusement, one member exclaimed that they didn’t want to draw, they wanted to do drama, they wanted to act. With that, began a succession of embodying both the boy who died in the train accident and their educator… as if a memory arose and it needed to find expression on an embodied and symbolic form. There were impersonations of the educator bending over his desk, making jokes with his learners, of him carefully looking over his note pad and reviewing his list of to-do’s, getting annoyed with one of the boys in his class for not doing their work, or talking too much, telling another pupil that he was very good at his work. Shouting and hands up in the air, mimicking the boy who died in the train accident, as though he was on a soccer field exclaiming his excitement for scoring a goal, telling jokes on the bus on his way home with his friends, being naughty in class and making fun of the educators, the action and body position he used to show his excitement for his soccer team scoring a goal… It was as though the group was bearing witness to these people being alive, just for a few more moments, in order to not forget, and to say goodbye, as well as being able to witness the fondness and love that each of these “actors” had for the friend and educator they are clearly going to miss (the suddenness with which the boy had died in the train accident and they had not seen their educator since the beginning of the school holidays and when they arrived back to school a week before, they were told he had died that day). Sitting in the group, it felt as though I was also able to get to know some parts of the people who had died (I could see that with different people impersonating the same person, it was discernible who of the two they were trying to encapsulate). I thought about how well they must know these people in order to act like them so well, and wondered about their senses and whether being deaf enabled them to more precisely capture or communicate physically… I thought about signing and how physical a form of communication this is. It then made sense that there was a comfort level with being able to act as a form of communicating that perhaps offered more comfort and ease then say drawing might. I verbalised how difficult it must feel to say goodbye to someone, or to somebodies especially in such quick succession and to even begin to mourn a loss, let alone two is so great. An urge to bring them back, even if it’s in another body or another form, to have one last moment feels so important. Everyone seemed to nod their heads, and again heavy silence fell upon the group.

It was nearing the end of our time, and I mentioned that we only had a few minutes left. One of the group members said that it will take time, but with help and support they will get through it as friends. I said that feeling confused and sad are all normal things and if they feel like they need to talk to someone, I would leave contact details with the psychologist. They all signed thank you, and I signed thank you back. It felt important to physically acknowledge the braveness with which they so physically entered and engaged with the space in my presence as a stranger. I felt enormously privileged.

We rearranged the furniture in the room so that it was back to how it looked when we entered the space, and it felt a bit like something quite magical and unbelievable had just happened… like if an adult came into the room they would never have been able to see the play that had just happened – as though it existed only in our imaginations. It resonated with how unbelievable such a double trauma seems, and the suddenness with which two lives became two deaths.

The interpreter led me to meet my colleagues, and on our way to the staff room, we bumped into the psychologist, who was rushing off. We had a 2 minute debrief with him in the parking lot, and said all went fine and explained how we divided the groups, and who we saw etc. He said there was some lunch still left for us in the staff room and that the interpreter I worked with in the second group would take us. He thanked us for our work. It also became apparent that there was some existing tension between the interpreter of my second group and the educator who I had to ask to leave the room. This was made evident by a comment that the psychologist passed about the interpreters “favourite person came to talk to me” in quite a sarcastic way. We were led to the staff room and decided to debrief amongst the three of us while we had something to eat. We were exhausted and found it quite difficult to find words, much the same that at times it was difficult to find words in the group.

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