I first started experiencing symptoms of post-traumatic stress disorder around a month after being restrained for the first time. I was at a long-term residential treatment center (i.e., a “troubled teen” facility) in Utah at the time. I noticed feeling anxious around the staff who had restrained me. I started avoiding the places where a restraint had taken place. I began having nightmares that I would wake up from most mornings in a state of panic. Often, the staff who had restrained me were sitting five feet away from me as a 1:1, watching when this would happen.

Instead of being validated in my very real experience of these symptoms, I was told I was “attention-seeking.” I was told that since it was “my fault” the restraint had happened, there was no reason to be feeling scared. After all, the people who did it were “just trying to keep me safe”.

It took about five more years for someone to recognize for the first time that these symptoms were in line with a trauma response. At that point, I’d continued to be restrained in a variety of mental health settings, with the same symptoms worsening over time.

As a survivor and someone who now works in the social work field (sometimes with clients who have been restrained or secluded), I hope to change the ways in which we support people through seclusion, restraint, and other forms of psychiatric abuse.

Regardless of whether you have been secluded or restrained and what role you find yourself supporting someone else, listening is the first step. Most survivors I’ve spoken to blame themselves or minimize the impact their experience has had on them, often because they’ve heard similar things to what I mentioned above. A lot of survivors have also never had someone validate that being restrained or secluded can be traumatic.

Especially in survivors who may never have had someone validate their reaction, it may help to normalize what they’re feeling. You can validate that avoiding reminders of the seclusion or restraint incident is normal. Having time where you feel like you’re reliving is normal. Feeling outside of one’s body or dissociated from time to time is normal. Having difficulty trusting others, especially mental health professionals or healthcare workers, is normal. Not wanting to be touched is also normal. These are things that many survivors of seclusion and restraint experience, regardless of whether a formal diagnosis of PTSD is made.

I also want to share some ways others have helped me reframe the blaming and invalidating narratives I heard from others and then internalized. Supporting a survivor may look like reminding them of these things over and over. I know it still helps me to hear these things often.

No behavior, intentional or not, deserves abuse.

Of course, behavior is not as simple as intentional/unintentional or being a “choice.” There were many times when I was using behaviors because they were the only way I knew how to cope at the time or because I simply was not in control of my body or grounded in reality. This was not my fault.

Along those lines, no “choice” to engage in a maladaptive coping mechanism merits restraint being used for an excessive amount of time. It doesn’t merit the people doing it making fun of you, being excessively rough, or failing to ensure your basic dignity/human needs were met.

As a social worker who has been in a position of power to restrain, I know that there is no situation where I would treat a client how I was treated when being restrained. In an ideal world, restraint will never need to take place. If it does, there is no reason why these types of abuse should occur. In that situation, the blame lies on the perpetrator of the abuse, not the victim.

The responsibility for creating a seclusion and restraint free environment rests on the staff and clinicians, not on the patients. I can be accountable for my behavior and recognize that the more significant issue is untrained staff and a failing mental health system.

Being restrained is not a “normal” experience, even though it becomes somewhat normalized in mental health settings. A majority of people will never be secluded or restrained. These people have no way of knowing how they would react in that situation and, therefore, have no right to tell you how you should feel about it.

Trust the experience of other survivors over the experience of those who’ve never walked in your shoes.

My last suggestion would be to ask the person how you can support them. Specifically in this context it might be helpful to be aware of the survivor’s triggers. They may be sensitive to being touched and this would be important to ask them about. You could ask about what coping skills help them relax and regulate.

If you’re a professional (teacher, mental health, or other) working with a survivor, it may be helpful to reiterate either 1) you will never restrain or seclude them under any circumstances or 2) if there are circumstances that would be within your scope/job description, what policies are surrounding this. As a survivor, I like to have this information going into any healthcare setting. I also appreciate when a clinician works with me to build specific alternatives to seclusion/restraint into my safety plan.

On a finishing note, it’s often the little things that make a huge difference. Simply listening and expressing compassion may be all a survivor needs. Everyone interacting with survivors of seclusion and restraint has the power to reframe the narrative of blame and shame.