Why are they Homeless? Lessons from San Francisco
I work at a methadone clinic in San Francisco. Methadone is a replacement drug for heroin to help alleviate the withdrawal symptoms of heroine. We operate a harms reductions program which means that we accept people as they come, many people use methadone to replace heroine and still use other illicit substances. Many of the people in the program are homeless, living either on the streets or shelters, others live in supporting housing such as SROs which are hotels that offer people independent rooms with shared bathing areas.
My job is counseling, I see around 40 people per week in an intimate setting. The clients share past experience, current hardships, stories from living on the streets, gossip about well known street characters such as the drug dealers, loan sharks and pimps, gossip about the people that help them such as doctors, building managers and case managers. HIPAA compliance forbids me from disclosing specific personal information about my clients. Every client is unique and has complex stories to share, I found some general commonalities and have conceptualized why people let themselves disintegrate and allow their bodies to lie on dirty streets, their rotting limbs charging the streets of San Francisco with repulsive stench.
Every single one of my clients without an exception has had extreme childhood trauma. The kind of horrors that they were subjected to from birth are beyond the scope of common imagination for most people. The stories of physical torture, emotional battering and humiliation that some adults can impose on children are worse than any contemporary horror film, and are beyond any literature that I have read. Adults can get horrifyingly imaginative when coming up with ways to impose pain on children, it’s baffling.
These rotting people that we see on the streets have been told and shown from the day they were born — No one loves you, no one needs you- you are a burden to me — at best you can repay me by walking the streets. I would rather spit on you than hug you. This is the message they have internalized. They believe that they are the worst people in the planet, they rarely blame anyone for their faults; for the life that they lead, they blame themselves, they believe that they are bad at the core, down to their bone, their very own existence is a never ending nuisance for someone.Their parents, their uncles and aunts, their grandparents send them a clear message. Society then punishes them. As soon as these kids are old enough, they become institutionalized. Through group homes, through juvenile facilities through jails and prisons. In those societal punishing centers, they are not bettered, they further deteriorate. Simple skills such as using the computer and phone are not taught and with the technology changing as fast as it is, they are behind with no real skills to be able to pick up from the missing years. They come out thinking that they deserve to rot on the streets and so they do. Rarely do they blame their parents or the adults in their life. Sometimes, they display anger and pain, but not blame, rarely do they blame society for perpetually punishing them for being born to an adverse environment, they only blame themselves. Did they ever have a chance at a normal life?
Crippled attachment styles, personality disorders, lack of social support and the worst of all the core belief of badness and unworthiness is what allows for people to rot on the streets. These people are children that never had a chance to grow up, that can’t fend for themselves because they don’t know how.
Attachment style forms at a young age and can fluctuate through a person’s life. The person’s attachment style dictates how they perceive the world and how they form relationships with other people. There are four main attachment styles — secure, anxious, avoidant and disorganized. When a person grows up in extreme adversity, the person learns to rely on oneself through the process of dissociation and self preservation learning that no one will take care of them and relying on oneself. Fluctuating between extreme need to be helped by others and retreating into themselves. When the caregivers impose cruelty upon the child, how can the child trust anyone? The child grows up to see the world as a cruel and malignant place, full of dangerous people, and obstacles. The child grows up to see oneself as intolerable, unlovable and unworthy. These are the schemas that the child develops and takes with him into adulthood. With these schemas it’s difficult to build relationships with other people.
Personality disorders weave themselves within the first 3 years years of life. Personality disorders have permanent prevalence in a person’s life, however, better functioning and mentalizing can be achieved through therapy. Personality disorders such as borderline personality disorder, histrionic and antisocial are frequently seen at the clinic. Borderline personality is s state in which people have a hard time mentalizing situations, especially in regards to how others think. Personality disorder is yet another symptom of trauma in childhood and causes for severe social malfunctioning. Maladaptive traits are developed for people to be able to somewhat function in the world, however steady employment and relationships are unlikely to be developed without therapy and social support.
The compound effect of mental disorders, lack of social support, felony records, lack of finances, poor education and a general lack of available city housing leaves these people rotting on the streets. Those commercials on television with helpless cats and dogs with flies around them? They evoke so much emotion, such a desire to help. The people on the streets of San Francisco are not much different. They cannot help themselves, they never asked to be born, they never asked to see the world as a dark, dangerous place, they did not choose this life, but they do believe they deserve it.
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