I want to talk a little about my personal experience with trauma in the workplace by clients towards clinicians. Picture this; a male, approximately 205 pounds, solid, stocky, strong and psychotic, suddenly and viciously coming up behind you. He grabs the back of your neck and starts choking you, and this assaultive behavior escalates, charged with intensity. Well not only was I petrified, so were the other patients and it took an equally strong male staff who intervened to save me. I use this personal experience to underscore the severity of this problem, which is indeed pervasive and surely not a new phenomenon. Assaulted on the job by the very clients that we are there to provide care to. Like our clients, though, we are inevitably affected by trauma. DON'T BE A VICTIM; TWICE. When we experience a trauma we feel victimized. But the message I want to convey is don't be passive! Empowerment is key to addressing disaster trauma and danger in the workplace.

In social work practice, we advocate, make referrals and numerous telephone contacts and provide supportive therapy and psychotherapy for the clients that we serve. What happens to us when we are vicariously traumatized by a client? The trauma often overwhelmes our capacity to cope for a short or extended period of time. No matter how strong you may be, your body, mind and spirit are affected. The period of recovery can vary. Personal violence by clients towards clinicians has it own kind of grieving process. It can be as painful as grieving over death. The trauma you have experienced grips you with powerful feelings and if left unresolved, it burrows deep within. Violence often evokes feelings of fear, anger and environmental insecurity (safety). This can cause a true emotional crisis. For a while, you forget how to advocate. Yes, even for yourself and the aftershock causes a lot of self-reflection on your chosen profession.

Think about this for a moment; the transition from the life we had prior to attending graduate school to applying-getting accepted-doing the work-graduating, then deciding to enter the field and/or going on to an advanced degree. How rewarding it felt! Well after being assaulted on-the-job, your self-reflections become somewhat fragile and you ask yourself "IS THIS WORTH THIS KIND OF PAIN".

DON'T BE A VICTIM; TWICE. Overcoming trauma and trying to heal when one's optimal functioning level has temporary collapsed is indeed a challenge. Even the strongest people we know will often feel utterly vulnerable and helpless when they experience trauma in the workplace. Like most traumas, a healing process after such a assault does begin to take place, though initially you may have feelings of self doubt and insecurity about your ability to provide effective clinical practice and even about your own safety in the workplace.

Being assaulted evokes scary feelings that should not be left unresolved and unacknowledged. Don't trivialize the real day-to-day hazards of your work. Fear is a powerful emotion and your perception of risk does not signify that you are weak. Psycho-biological arousal is what is taking place with your emotions and eventually the high intensity subsides. Get in touch with your emotional core in order to start to heal.

I have found that not enough attention is paid to clinicians by those in charge.

We want to feel safe and supported in our work with our clients and a trauma in the workplace is very often a disruption of a relationship to one's clients as well as to those in charge. The healing process begins when we can do personal planning for our own physical and emotional well being. Once we begin to replan and return to an adjusted "operational mode", we begin to heal. The big picture here is DON'T BECOME A VICTIM; TWICE. You are going through a barrage of psychologically disrupted attachments and yes these thoughts and feelings are thoughts considered to be unacceptable, repugnant or inconsistent with our conscious or unconscious perceptions of ourselves. Consulting with colleagues is crucial; discuss the problem of violence in the healthcare industry. I am sure you will hear, as I did, other testimony about violence by clients towards social workers.

As a result of my ordeal, I met many wonderful people who were interested in disaster trauma in the workplace and they offered support. I learned what questions to ask in order to navigate my way through my mixed emotions. I discovered networks and organizations that have a commitment to a collaborative consensus process that features sharing of resources for preventing violence by clients against workers.

How did I work through the negative experience and the recovery process? I DID NOT REMAIN SILENT! My recovery started at home where I have always taught my children to be compassionate towards people with visible and not sovisible disabilities. After my trauma, I continued to speak those very words. My children, however, asked their father, my husband, " would he go and talk to the man who hurt mommy". I had to explain, "your father can't do that, because you can't talk rationally to an irrational person". Talking to my family was key to my emotional recovery. I will always remember the caring and concern my family gave to me when I would come home feeling distraught and drained. Their support encouraged me to build a new beginning.

Some of the resources I used to acquire information about supportive services were the NYS Public Employee Federation's Occupational Health & Safety Department. PEF staff sent literature to help me navigate the Worker's Compensation process. Also, I received help from a crisis intervention support team at South Beach Psychiatric Center. The team provides worksite counseling/debriefing to injured workers.

I don't have many answers as to how violence in the workplace can be prevented. I do know that in other professions, such as law enforcement or corrections, when a worker is assaulted on the job, swift action is taken. In the healthcare industry the same is not always true; support is SLOW IN COMING, IF AT ALL. Often, workers have to help themselves to get connected to support services.