Responsibility

I struggle with an issue in the trauma realm. Most of the clients I work with fit in the "victim" category. Many victims struggle with "learned helplessness." On top of that they experience intrusive symptoms that result in avoidant behaviors. Some of them experience so much emotional, physical, and mental pain that they can become nearly incapacitated (that is an overgeneralized statement, but I used it for discussion only). Many of them begin to "become" their disorder or symptoms, thus completing their journey to learned helplessness. Once they get to that point it seems that their accountability and responsibility is out the window. When does pain resolution in trauma work and responsibility meet?