The Sanctuary Model > The Sanctuary Model

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Who We are: Basic biographies, a paper about our overarching philosophy and a description of "sanctuary trauma"
- Sanctuary Philosophy
- Sanctuary Trauma
Development of the Sanctuary Model: Here we explore the historical underpinnings of the Sanctuary Model that go back to the 18th c. through the Vietnam War. We provide some detail for the original Sanctuary Programs, 1980-2001, and then describe the development from 2000 until the present.
- Moral Treatment: As part of the Enlightenment, Moral Treatment provided the underpinnings and experience for a different way of addressing the challenges faced by people with emotional disturbances.
- The Social Philosophers: Social philosophers, often seen now as early social psychologists and sociologists, made strong connections between individuals and society and developed ideas around the ways in which society influences and is even a causal agent in individual pathology.
- Psychodynamic Group Ideas: Freud, Jung, Adler, Meyer, Burrow all figure in the further development of our understanding of human beings. The recognition unconscious forces in individual and group behavior is vitally important for understanding and then changing patterns of repetitive behavior.
- Systems Theory: Understanding that all collective experience emerges from interactive, interconnected individuals and has different properties than the individuals separately is an outgrowth of 20th c. quantum physics and our deeper and growing understanding about the basic nature of reality. In practice it has led to thinking differently about all levels of organization from the family to entire societies and provided the necessary theoretical underpinnings for social psychiatry.
- Social Psychiatry: After the devastation of two World Wars, psychiatry recognized that the previous focus on the individual was not enough, that we can only understand people within their social context and ever-widening circles of influence. Social psychiatry gave birth to the Community Mental Health Movement and the Democratic Therapeutic Community.
  - Democratic Therapeutic Community and Therapeutic Milieu: The democratic therapeutic community movement started in the U.K. and then in the U.S., some of the ideas - but not all of them - were adopted by substance abuse programs and additionally, as general hospital inpatient programs like ours developed, a modified version known as the "therapeutic milieu" was instituted.
  - Maxwell Jones - A Scottish psychiatrist who worked in Scotland, England and the U.S., Jones was one of the founders of the democratic therapeutic community and extended his work to schools, prisons, and society as a whole.
  - Community of Communities: Accreditation program for Therapeutic Communities in the U.K. and overseas.
- Feminist Critique
- Traumatic Stress Studies: One of the more significant outcomes of the "war" in Vietnam was the development of an entire field of study and research related to the impact of trauma on individuals and groups. Traumatic stress studies and then our burgeoning understanding about adversity and development followed naturally from the findings of social psychiatry. This new understanding about human beings has provided the revolutionary - or evolutionary - drivers for change and for the development of the Sanctuary Model.
- Sanctuary Programs: Starting in 1980, a team of mental health providers began working on what formally became the Sanctuary program in 1991 - an inpatient, short-term psychiatric treatment program for adolescents and adults. That program lasted for another ten years but closed in 2001. This part of the website provides some details about the programs themselves.
  - Shared Assumptions: Original, trauma-based assumptions that emerged from the Sanctuary program
  - The Uninvited Guest: Presentation given in 1992, about what we were discovering
- S anctuary as a Movement: The Sanctuary Model is part of a wider movement toward trauma-informed, trauma-responsive, and trauma-specific treatment for all human service delivery systems.
The Sanctuary Model: F our Pillars: The Sanctuary Model is grounded in four shared pillars: Knowledge, Values, Language and Practice
- Pillar 1: Shared Knowledge: People in an organization who are adopting the Sanctuary Model need a wide knowledge base that includes some important knowledge about the complex nature of individual development as the multiple ways in which our development and level of function is affected by stress. If we are to help people to heal from overwhelming experiences, then we must have some ideas about what that recovery process looks like.
- But we must function at home, at work and in the community with other people and in groups, so it is vital that we know something about the way groups function and the ways that group function changes as a result of stress, particularly chronic stress. Similarly, we need to know how groups recover, since they are living systems not machines.
  - Knowledge About People
    - Evolutionary Biology: Many of the largest challenges that face humanity are related to the multiple ways in which we have adapted to an evolutionary environment that no longer exists
    - How We Think: Mental Models : We use models of the world all the time, but those models are so deeply embedded that we don't even know they exist. These mental models make us more efficient but pose problems when it comes to change. And then there is our divided mind, divided between conscious and unconscious function as well as divided into two different hemispheres that are often in conflict with each other.
    - The Role of Emotions: Until the last few decades, our emotional beings had very little attention from the research world, but now we know a great deal about the critical role that our emotions play in every aspect of human existence
    - Attachment: Similarly, until quite recently there was little existing knowledge or research about the complicated nature of human development, bonding and attachment
    - Our Social Nature: Human beings are the most social of all species and we need each other from cradle to grave
    - The Role of Loss: Because we attach to people, places, and things, loss has played a deciding role in human development
    - Habits and Repetition: One of the adaptations we made was to easily turn a sequence of thought or behavior into a repetitive sequence or a habit. But there are downsides to this development
    - Moral Development and Moral Systems: We need to make meaning out of all that happens to us but like every other part of us, our moral sense develops as well.
  - People Under Stress: Stress changes us in many ways, but there are different varieties of stress and not every stressor is traumatic.
    - Kinds of Stress: Definitions for Positive, Tolerable, Relentless, Toxic and Traumatic Stress
    - Adverse Childhood Experiences: The original ACEs study and some consequences
    - Disrupted Attachment: What we mean by "disrupted attachment" and why it matters
    - Betrayal Trauma: Adverse childhood experiences connected with betrayal of trust from beloved others
    - Trauma Bonding: What happens when the attachment system is paired with danger in the face of helplessness
    - Learned Helplessness
    - State-dependent Learning
    - Ordering Reality and Decision-making Under Stress
    - Psychobiology of Trauma: With a special emphasis on the fight-flight-freeze response, what it does to mind and body, and chronic hyperarousal
    - Dissociation: What it is and why it matters
    - Remembering Under Stress
    - Addiction to Trauma
    - Reenactment: What it is and why perhaps, we do it
      - Reenactment and Our Dramatic Nature: That we love theater in all its form may be our natural evolved response to trauma
    - Intergenerational Transmission and Epigenetics: Trauma may not just be in our lives but may become a part of our genes
    - Shattered Assumptions
    - Not Sick or Bad But Injured: What we are describing here is a different paradigm for understanding human beings and the different terminology that goes with it
    - Complex Responses to Toxic Events: Summary of how complex this topic is with some tables
  - Healing and Recovery in People
    - Stages of Change: People change but usually, we don't change all at once. Work on the stages that we typically go through in order to change is a useful way of thinking about a process of recovery, not a singular event.
    - Barriers to Recovery: There are many difficulties along the way in healing from repetitive trauma
    - The Process of Healing: The process of recovery is different for different people and depends on what we are recovering from but experts in the field understand that there are some general stages the people wrestle with in the process of healing from adversity and trauma.
    - The Role of the Family
    - Trauma-specific Treatment: Many people will need therapeutic measures that promote healing from the fragmentation and dissociation that typically accompanies overwhelming experiences.
      - TANT: Trauma Art Narrative Therapy: There are now many different types of trauma-specific treatment but this is one that has several decades of experience behind it and requires training that is not prolonged and very simple supplies. It can become a self-help tool for trauma survivors.
    - A Poem for Recovery by Portia Nelson
  - Knowledge About Groups: There are some basic principles that affect the way we function when we are in groups. This knowledge has been around, often for a long time, but is still not generally understood.
  - Groups Under Stress: In the world we live in, it is essential that we gain an understanding of the multiple ways in which groups are affected by stress, particularly chronic stress, and how that can play a determining role in helping people to heal and recover, or in creating catastrophe.
    - Organizations and Stress: Systems Under Seige
      
      Workplace Stress
      
      Normal Stressors
      
      Moral Dilemmas and Moral Distress
      
      Workplace Violence
      
      Workplace Bullying
      
      Terror Management
      
      Scapegoating
      
      Vicarious Trauma
      
      Lack of Basic Safety – Chronic Hyperarousal
      
      Loss of Emotional Management
      
      Emotional Contagion
      
      Emotional Labor
      
      Organizational Learning Disabilities
      
      Dissociation And Organizational Amnesia
      
      Impaired Decisions And Conflict Management
      
      Organizational Alexithymia
      
      Silencing of Dissent
      
      Disempowerment And Learned Helplessness
      
      Increased Authoritarianism
      
      Bogus Empowerment
      
      Organizational Injustice
      
      Organizational Aggression
      
      Organizational Reenactment And Decline
      
      Parallel Process
      
      Parallel Process and Organizational Stress (Table)
      
      Collective Disturbance
      
      Bystander Effect
      
      Group Reenactment
      
      Unhealthy Organizations and Toxic Leaders
  - Healing and Recovery For Systems: Groups can heal because they are alive. The Sanctuary Model is a method for promoting healing and recovery in a group environment - any group environment.
    - Barrier to Recovery in Systems
    - Sanctuary as Organizational Operating system
      - Computer metaphor
  - Consilience
Pillar 2: Shared Values:
- The second pillar of the Sanctuary Model are the Sanctuary Commitments - to Nonviolence, Emotional Intelligence, Social Learning, Open Communication, Democracy, Social Responsibility, Growth and Change.
Pillar 3: Shared Language
- The third pillar of the Sanctuary Model is the acronymn S.E.L.F. we use for Safety, Emotions, Loss and Future - the key domains for problem-solving and making change. In Sanctuary, S.E.L.F. is the language we use for many key functions; it is our shared language.
Pillar 4: Shared Practice
- Sanctuary Toolkit : The fourth pillar of the Sanctuary Model is the Sanctuary Toolkit, a wide-ranging set of strategies to help everyone in an organization become truly trauma-informed and trauma-responsive in day-to-day interactions
- Sanctuary Implementation
Outcomes
- Outcomes and Research
Public Health
Publications
News
- The Sandra Bloom House Dedication
Community
Products
- S.E.L.F. Group Curriculum
  - S.E.L.F. Manual Details

- - Fears Associated with Trauma-Informed Change
  - Bloom. ISTSS History Chapter

- Mental Models

Curriculum

A Trauma-Informed Psychoeducational Group Curriculum

S.E.L.F. represents the four nonlinear, key areas of recovery that provide an organizing framework for the complex problems presented by trauma survivors, by families with problems, and by chronically stressed organizations.