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| Preface | |
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| Prologue: October 1996 | |
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| Sanctuary Retreat, October 25, 1996 | |
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| Introduction: January 2010 | |
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| Sanctuary | |
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| "Aha" Experiences for Health and Human Services | |
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| Systems in Crisis: The Impact of Biological Reductionism | |
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| System Degradation: Systems in Crisis | |
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| New Mental Models | |
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| Organization as Machine | |
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| Organization as Living Being | |
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| Thinking About Operating Systems: A Useful Metaphor | |
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| Hardware, Software, and Operating Systems | |
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| The Human Operating System and the Virus That Disrupts It | |
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| Organizational Culture: The Organizational Operating System | |
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| Organizational Stress, Parallel Process, and Trauma-Organized Systems | |
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| A Word About Vocabulary | |
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| Chapter Summaries | |
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| A Cautionary Note | |
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| Human Service Organizations: Dead or Alive? | |
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| The Case of the Separated Garbage | |
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| Mental Models Shape Our World | |
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| Organizations as Machines | |
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| Health Care as Commodity: The Failed Balancing Act of U.S. Health Care | |
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| Mental Models of the Healing Professions | |
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| Aesculapian Authority | |
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| Community Responsibility | |
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| Health Care and the Threat of Communist Enslavement | |
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| Privatization Rules | |
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| Managed Care and Ethical Conflicts | |
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| Mental Models for U.S. Capitalism | |
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| Lessons Learned? | |
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| Mental Health: An Example of a System Under Siege | |
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| System as Machine | |
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| Social Engineering Cannot Address Adaptive Problems | |
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| Interlocking Crises | |
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| What Happened to the Social Psychiatry? | |
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| The Personal Is Political | |
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| A Biopsychosocial Model and General Systems Theory | |
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| The System Bites Back | |
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| Reductionistic Behaviorism | |
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| Deinstitutionalization and Deregulation | |
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| And That Brings Us to Today | |
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| The Economic and Human Burden on the System | |
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| Managed Care and Inadequate Payment | |
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| Transinstitutionalization and Inappropriate Care | |
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| Just Don't Ask About Trauma | |
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| Systems in Crisis | |
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| Conclusion | |
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| "I Gotta Get Out of This Place": Workplace Stress as a Threat to Public Health | |
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| It's All about Stress | |
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| Kinds of Stress | |
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| Allostatic Load | |
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| Adverse Childhood Experiences: A Public Health Nightmare | |
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| Adverse Childhood Experiences and the Workforce Crisis | |
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| Trauma Touches Everyone | |
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| Workplace Stress: Definitions, Scope, and Costs | |
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| "Normal" Sources of Workplace Stress | |
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| Downsizing and Turnover | |
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| Workload and Job Complexity | |
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| Role Definitions | |
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| Relationships, Diversity, and Health Disparities | |
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| Inadequate Training and Career Development | |
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| Regulation, Paperwork, and Corporate Compliance | |
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| Professional Values, Ethical Conflicts, and Burnout | |
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| Disruption in the Organizational Operating System | |
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| Lack of Mission Clarity | |
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| Lack of Innovation and Stagnation | |
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| Conclusion | |
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| When Terror Becomes a Way of Life | |
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| Attachment: The Human Operating System | |
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| Mirror Neurons: Wired at Birth for Social Relationship | |
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| Attachment in Adults | |
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| Social Support | |
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| Attachment to the Group | |
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| Group Cohesiveness | |
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| Trauma Disrupts Attachment | |
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| The Young Brain Organizes Around Trauma | |
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| Attachment Trauma and Betrayal Trauma | |
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| Disrupted Group Attachment Threatens Survival | |
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| Deindividualization and Ostracism as Disrupted Attachment | |
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| Disrupted Attachment, Stress, and Trauma | |
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| The Human Stress Response: What Does Everyone Need to Know? | |
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| When Terror Becomes a Way of Life | |
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| Individualism, the Common Good, and Modern Day Stress | |
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| Loss of Basic Safety and Chronic Hyperarousal | |
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| Loss of Emotional Management | |
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| Difficulties With Learning Memory, and Decision Making | |
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| Miscommunication, Conflict, and Alexithymia | |
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| Authoritarianism and the Danger to Democracy | |
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| Learned Helplessness | |
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| Punishment, Revenge, and Injustice | |
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| Addiction to Trauma, Trauma-Bonding, and Traumatic Reenactment | |
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| Grief, Reenactment, and Decline | |
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| The Germ Theory of Trauma and Public Health | |
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| Time-Binding Animals | |
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| Existential Terror and Terror Management Theory | |
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| Social Problems are Preventable | |
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| Who Deserves Empathy? | |
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| Science: Enemy or Ally? | |
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| Conclusion | |
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| Parallel Processes and Trauma-Organized Systems | |
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| Organizations as Complex, Adaptive, Emergent Systems | |
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| The Concept of Groupmind | |
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| General Systems Theory | |
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| Living Systems Are Characterized by Emergence | |
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| Not Sick or Bad, But Injured | |
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| Living Systems With Visible and Invisible Groups | |
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| Group Stress Responses | |
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| Group Emergency Responses to Threat | |
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| When Threat Becomes a Way of Life: Parallel Processes Emerge | |
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| Sanctuary Trauma | |
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| Sanctuary Harm and Collective Trauma | |
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| Social Defense Systems | |
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| Bion and Basic Assumption Groups | |
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| Jung and Shadow Groups | |
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| Menzies and Social Defense | |
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| Institutional Uncertainty | |
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| Institutional Trauma and Breakthrough Anxiety | |
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| The Social Defense System Operating Today | |
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| Parallel Process: A Trauma-Informed Understanding of Social Defensive Structures | |
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| What Is Denied Comes Back to Haunt Us | |
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| When Tragedy Strikes: The Impact of Chronic Stress and Collective Trauma | |
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| Conclusion | |
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| Lack of Safety: Recurrent Stress and Organizational Hyperarousal | |
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| Crisis in Human Service Delivery | |
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| Six Stages of Crisis Management | |
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| Violence in the Human Service Workplace | |
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| Dangerous Professions | |
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| Workplace Aggression and Bullying | |
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| Adult Psychiatric Inpatient Suicide | |
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| Working With Traumatized Children: Child Protection Workers | |
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| Chronic Crisis Equals Chronic Hyperarousal | |
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| Loss of Social Immunity | |
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| Thwarting Basic Needs | |
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| Triggering Mistrust | |
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| The Betrayal of Trust | |
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| The Blame Culture | |
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| The Silencing Response | |
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| Moral Distress | |
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| Unrelenting Systemic Stress | |
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| Conclusion | |
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| Loss of Emotional Management | |
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| Emotional Intelligence and Trauma | |
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| Emotional Resonance and Contagion | |
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| Emotional Labor | |
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| Economic Invisibility and the Legacy of Gender Discrimination | |
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| Emotional Labor and Job Requirements | |
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| Training for Emotional Numbing | |
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| Dehumanizing Caregiving | |
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| All You Do Is Talk to People | |
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| Managers and Emotional Labor | |
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| Organizational Emotions | |
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| Emotions and Organizational Crisis | |
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| Groupthink | |
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| Conformity | |
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| The Abilene Paradox | |
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| Chronically Fear-Based Organizations | |
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| Conflict in the Workplace | |
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| The Nature of Conflict | |
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| Conflict and Emotional Intelligence | |
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| Different Kinds of Conflict | |
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| Conflict Management Strategies | |
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| Conflict Management Under Stress | |
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| Chronic Conflict and Organizational Learning | |
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| Conclusion | |
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| Organizational Learning Disabilities and Organizational Amnesia | |
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| Organizational Learning Disabilities | |
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| Chronic Stress Interferes With Learning and Adaptation | |
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| What Is the Increase in Value We Are Aiming for? | |
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| No Time for Process-Failure of Integration | |
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| Wisdom Walks out the Door and Is Not Replaced | |
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| Labeling That Prevents the Expansion of Knowledge | |
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| Self-Fulfilling Prophecies: Setting the Trap for Reenactment | |
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| Filtering out Trauma | |
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| Organizational Memory and Organizational Amnesia | |
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| Failures in Memory Storage | |
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| Downsizing Memory | |
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| Organizational Amnesia and the Mental Health System | |
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| Those Who Cannot Remember the Past… | |
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| Factors Contributing to Loss of Knowledge | |
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| Trauma and Organizational Memory | |
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| Compromised Decision Making | |
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| Absence of Participation in Decision Making | |
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| Decision Making Under Stress | |
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| Stress and Group Performance | |
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| The Destructive Aspects of Silencing Dissent | |
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| Group Polarization: Why It Must Be Safe to Dissent | |
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| Dissent Is Rarely Welcomed | |
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| Conclusion | |
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| Miscommunication, Conflict, and Organizational Alexithymia | |
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| Patterns of Organizational Miscommunication | |
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| Different Lenses, Different Points of View | |
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| Different Theories, Different Mental Models | |
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| Inadequate Information Systems | |
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| The Ease of Miscommunication | |
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| Miscommunication in Systems | |
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| And Then There Is E-mail, Texting, Cell Phones, Blackberries, Twittering… | |
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| Size Matters: Communication and Group Size | |
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| Communication Under Stress | |
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| Poisoning the Grapevine | |
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| The Undiscussables and Organizational Alexithymia | |
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| Collective Disturbance As Organizational Dissociation | |
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| The Natural History of a Collective Disturbance | |
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| Chronic Collective Disturbance | |
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| Dehumanization and Bureacracy | |
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| Conclusion | |
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| Authoritarianism, Disempowerment, and Learned Helplessness | |
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| Exerting Control: An Adaptive Evolutionary Response to Fear | |
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| Everyone Wants to Be Powerful | |
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| Learned Helplessness and the Lust for Power | |
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| When People Become Poison Containers, the Poison Leaks Out | |
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| Trauma Is Inescapable Shock Learned Helplessness | |
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| Learned Helplessness and Blaming Others | |
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| Our Systems Promote Learned Helplessness | |
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| The Parallel Process of Organizationally Induced Helplessness | |
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| Risky Risk Avoidance | |
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| Risk and Risk Avoidance in the Mental Health System | |
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| Chronic Crisis, Centralized Control, and Terror Management | |
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| Chronic Crisis and Authoritarian Behavior | |
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| The Inherent Problem of Authoritarianism | |
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| Authoritarianism in Human Services | |
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| Dangers of Authoritarianism Under Stress | |
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| Bullying in the Workplace | |
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| Toxic Leaders and Petty Tyrants | |
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| Barriers to Empowerment in the Workplace | |
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| Bogus Empowerment | |
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| Conclusion | |
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| Punishment, Revenge, and Organizational Injustice | |
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| The Problem of Revenge | |
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| Development, Trauma, and Revenge | |
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| When Good People Do Bad Things | |
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| Obedience to Authority | |
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| The Lucifer Effect | |
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| Sanctioned Perpetration | |
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| The Dynamics of Violence and the Bystander | |
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| Bystanders Beware | |
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| Why Organizational Injustice Matters | |
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| Types of Organizational Justice | |
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| When Organizations are Perceived as Unjust | |
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| Justice, Trust, and Emotions | |
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| Organizational Injustice and Health | |
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| Impact of Organizational Injustice on a Group | |
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| Organizational Retaliation | |
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| Punishment in the Workplace | |
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| Is Punishment Effective? | |
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| Punishing Unconscious Reenactment | |
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| Punishment to Change Behavior or as Revenge? | |
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| Punishment and Performance | |
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| Ethical Paradigms, Ethical Dilemmas | |
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| Moral Development and the Ethical Organization | |
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| Conclusion | |
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| Unresolved Grief, Reenactment, and Decline | |
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| Loss of Attachment in the Workplace | |
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| Complicated Mourning | |
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| Ambiguous Loss | |
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| Disenfranchised Grief | |
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| Traumatic Loss, Chronic Loss, and Organizational Change | |
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| Traumatic Reenactment: Never Having to Say Goodbye | |
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| Enactment in Our Evolutionary History | |
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| Collective Reenactments | |
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| Costs of Not Addressing Normal and Complicated Loss | |
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| Vicarious Trauma, Secondary Traumatic Stress, Compassion Fatigue, and Burnout | |
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| Burnout | |
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| Organizational Decline | |
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| Successful or Permanent Failure: Is This the Future We Want? | |
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| Conclusion: Chronic Disaster | |
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| Restoring Sanctuary: Organizations as Living, Complex Adaptive Social Systems | |
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| There Is So Much at Stake | |
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| Sanctuary Model: A New Operating System for Organizations | |
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| Universal Commitment | |
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| S.E.L.F.: A Nonlinear Organizing Framework | |
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| The Sanctuary Institute | |
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| The Sanctuary Network and Sanctuary Certification | |
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| References | |
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| Index | |