Sexual assault, intimate partner violence, and stalking are prevalent and insidious phenomena in the United States and across the world. Accessible services are not always available for survivors of sexual assault and intimate partner violence who are d/Deaf/Hard of Hearing (D/HH) or people with disabilities (PWD). Staff at anti-violence nonprofit organizations can be restricted by the communication that constrains work around an issue-based mission. This study takes the form of an ethnography at a regional, issue-based, anti-violence nonprofit organization in the southwestern United States, known here as the Western Crisis Center (pseudonym). Drawing on data gathered from 12-months in the field, this ethnography investigates dialectical tensions that restrict staff from supporting PWD and D/HH clients. Mandated accommodations disrupt ableist practices within the WCC and construct a knot of contradictions. In the knot, three dialectical tensions intersect with one another: (1) generalized vs. specialized support, (2) routine vs. non-routine practices, and (3) active vs. passive agents. The analysis demonstrates the competing demands of trauma- informed organizing practices, as staff attempt to be more inclusive and accommodating in their everyday talk, policies, and practices. Keywords: critical organizational communication, disability, deafness, sexual violence, dialectical tensions