Mental health and injury: Trauma, Rehabilitation and Recovery
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Mental health and injury: Trauma, Rehabilitation and Recovery

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The Power Point Program presented by Val Lougheed at the Mental Health and Injury conference on April 19th, 2011, in Winnipeg, Manitoba, for the Rehabilitation Return to Work Partnership

The Power Point Program presented by Val Lougheed at the Mental Health and Injury conference on April 19th, 2011, in Winnipeg, Manitoba, for the Rehabilitation Return to Work Partnership

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  • Northern Lights Vocational Services www.nlvs.ca 1-800-361-4642

Mental health and injury: Trauma, Rehabilitation and Recovery Mental health and injury: Trauma, Rehabilitation and Recovery Presentation Transcript

  • Val Lougheed Northern Lights Canada Mental Health & Injury: Rehab, Recovery and Return to Work Trauma, Rehabilitation and Recovery – ~ Keep Your Fork ~ 1-800-361-4642 * www.northernlightscanada.ca * vlougheed@northernlightscanada.ca
  • “ You don’t want your impairments to define you – you want them to inform you.” (Hanita Dagan, personal communication, 2005)
    • www.slideshare.com/vlougheed
    #NLCAN www.northernlightscanada.ca/about/about-val-lougheed/be-still
  • Agenda
    • Beginning …
    • Middle …
    • End …
  • Rehab, Recovery and Return to Work
    • What does it mean to recover?
    • What can I do to recover and return to a life that includes work?
    • What can we do to facilitate recovery and a return to work?
  • Rated PG-113 People Strongly Cautioned! May contain bad language, brief nudity, sexual overtones, and drug usage.
  • Beginning My Story
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  • Sept. 9, 2003 - morning
  • Sept. 9 – p.m.
  • Sept. 15 2003 – Jan. 19 2004 Journey Back to Life
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  • Research
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  • Dominant Themes
    • Narcotic Pain Killers
    • ABI
    • Pain
    • Trauma
    • Depression
    • Methods of Helping
      • Return to Work
      • Life
  • Foundation for Understanding Experience
  • Body-Mind Connection Psychoimmunoendocrine Network
    • The nervous, endocrine, and immune systems are functionally integrated – the brain is only one part of this non-hierarchical network
    • Memories, emotions, behaviours and physiology are all connected at the molecular level
    • (Candace Pert, 1997, p. 171 – 179)
  • February 2004 – Present Starting Point
  • Identity Disintegration and The Re-organization of Self March 2004
  • “ In the aftermath of traumatic life events … [the] sense of self has been shattered.” (Herman, 1992, p. 61) “ An existential crisis …” (Hanita Dagan, personal communication, 2005)
  • Sliding Down the Slope (Dalhousie, March 2005) Early 1900’s Oxycodone ™ developed in Germany 1995 Purdue Pharmacy (USA) launches OxyContin ™ – controlled-release formula 1996 Approved in Canada 2002 OxyContin ™ earns Purdue more than $1 billion U.S. 2003 OxyContin ™ is one of Canada’s 3 most-prescribed narcotic painkillers Nov. 2003 – Oct. 2004 783,762 prescriptions for OxyContin ™ dispensed in Canada
  • Sliding Down the Slope
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  • A Foothold
    • Mild – moderate ABI
    • Depressed (dysphoria)
    • Working memory problems
    • Hiding pain
    1 st Neuropsychological Assessment June 2004 -- Results
  • ABI – Measuring Loss “ Pre-morbid intelligence is a crucial variable …” Subjective Report – difficulty retrieving words and communicating ideas Objective Report – above-average performance on neuropsychological measures (Prigatano, 1999, p. 59)
  • Losing My Grip My IWRP August 2004
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  • Rescued in the Valley of Despair Head Injury Program Oct. – Dec. 2004
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  • HIP Oct to Nov – Full-time December – Part-time
  • GO TO WORK
  • GRTW – The Plan Jan. 3 – Feb. 7, 2005 (5 weeks)
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • GRTW – The Reality
  • Rescue Attempts
    • Case Manager
    • Job Coach
    • Colleagues/Friends/ Psychologist
  • Sliding Back Down Into The Abyss
    • Non-compliance
    • Malingering
    • Trying too hard
    • Not trying hard enough
    2 nd Neuropsychological Assessment May 2005 -- Edmonton
  • Test Results
    • Mild to Moderate ABI
    • Pain?
    • Depression?
    • Motivation?
    • “ a high flyer”
    • “ phobic avoidance”
    • Future plans – “live off dividends” [from company]
  • Lesson ASSUMPTIONS REVEAL BIAS
    • Mild – moderate ABI
    • Good prognosis
    • Post-Traumatic amnesia
    • Pain?
    • Depression?
    • “ Adjustment Disorder with Anxiety and Depressed Mood”
    3rd Neuropsychological Assessment August 2005 -- Calgary
  • Symptom Overlap (co-morbidity) (Michael Sullivan, Centre for Research on Pain and Disability, McGill University, September, 2006) Pain, Trauma, Depression, ABI
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  • Oct. 3 – Dec. 11
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  • Pain Research 1600’s – Rene Descartes (philosopher)
  • Pain Research 1950’s – Wilder Penfield (brain surgeon)
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  • Pain Research Patrick Wall (physiologist) Ronald Melzack (psychologist)
  • Pain Research
    • Gate Control Theory
    • Acute and chronic pain
    • Pain sensation travels up the central nervous system to the brain through a “gate”
    • “ Gate” – triggered by cell changes – sends descending messages that alter sensory input
    • Pain isn’t pain until it reaches the brain
    • Emotions, context, etc. affect pain sensations
    • Pain is a negotiable, individual experience
    • Pain centres in the brain – they just keep moving around
    • (Jackson, 2002, p. 21)
  • Pain – The Future SCN9A (Globe and Mail, March 24, 2007) Glia Cells (Scientific American, November, 2009) Poppy Genes (U of Calgary -- Calgary Sun, March 15, 2010)
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    • Limbic System
    • The centre for emotional expression
    • (Prigatano, 1999, p. 132)
    • Amygdala - attaches emotional tags to memories
    • (Dr. Suffield, personal communication, 2004)
    • Hippocampus - controls the laying down of new memories
    • (Ramachandran & Blakeslee, 1998, p. 15)
    • Hypothalamus – controls the outward expression of emotions
    • (Ramachandran & Blakeslee, 1998, p. 177)
    Trauma Research
  • “ In every encounter, basic trust is in question.” ( Herman, 1992, p. 92) “ Survivors feel unsafe in their bodies – and in any relationship with other people.” (Herman, 1992, p. 160) Rehab & Recovery
  • Trauma Personal Experience
    • Dissociation & Cocoon = Safety
    • System on High Alert Always = Survival
    • World is black & white = Trust
    Trust (Safety) = Love No Trust (Life Threatening) = Hate
  • Trauma Personal Experience
    • Listen to me
    • Understand me
    • Respect me
    • Are competent
    I trust (love, feel safe with, will try hard for) practitioners who:
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  • “… depression [caused by trauma] is not the same as ordinary depression.” ( Herman, 1992, p. 118) Depression
  • “ Emotions are not in the head – they are in every cell in the body.” (Pert (1995), in Bolen, 1996, p. 7) Pscyhoimmunoendocrine Network
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    • Affects more than IQ ….
    • We are sensitive to changes in higher cerebral functioning
    • Very important to a person’s sense of self
    • Touches core … of a person’s self-esteem
    • (Prigatano, 1999, p. 58)
    ABI
  • Back to Wilder Penfield – 1950’s ABI Localizationist
  • Paul Bach-y-Rita – 1934 – 2006 Scientist and Rehab Doctor Neuroplasticity - 1969
  • Michael Merzenich Neuroplastician Neuroplasticity
  • Harnessing the Power
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  • “ The words and attitudes of others … are potent. They help or hex healing and recovery.” “ Expectations are powerful.” “ Neutrality can be deadly.” (Bolen, 1996, p. 94) Body-Mind Connection
    • Hypothalamus
    • Peptides
    • Receptors
    • Biochemical Events
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  • Quantum Connection
    • The Living Matrix -- 1995
    • A type of energy exists that has previously gone unnoticed.
    • Cells/DNA influence matter through this form of energy.
    • DNA Phantom effect. Braden, 2007, p. 45
  • “ Loss of identity can evoke a personal crisis, creating a need for change.” (Ornelas, in Smith & Johnson (Eds), 1997, p. 172) The Re-Organization of Self Identity Research
  • Scaling the Canyon
  • Sept., 2005 Waskesiu
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  • Breast Cancer Reconstructive Surgery March 2006
  • Convocation M.Ed. -- June 2006
  • Back in “a” Saddle September 2007
    • Officially change role/ title
    • Re-organize NL
    • Work part-time
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  • Rehab, Recovery and Return to Work Resilience
    • Ability to return to original form after being bent (bounce back)
    • Thriving in constant change, ability to be:
        • Flexible
        • Creative
        • Adaptable
        • Learn from experience
    • http://www.resiliencycenter.com/articles/5levels.shtml
  • Rehab, Recovery and Return to Work Rehabilitation (habiter – to live inside) “ Rehabilitation is the learning to live inside not only one’s body, however it is after an injury or illness, but inside one’s very being.” (Kabat-Zinn, in Meili, 2003, p. 241)
  • Rehab, Recovery and Return to Work Recovery Crombez, October, 2003 Curing Focus on the illness/ impairment [outside] Healing Focus on the person [inside]
  • Be Still
  • Rehab, Recovery and Return to Work
    • What does it mean to recover?
    • What can I do to recover and return to a life that includes work?
    • What can we do to facilitate recovery and a return to work?
  • Keep Your Fork
    • Northern Lights Canada is a person-centred organization committed to providing innovative, responsive links to real work.
    • We offer 4 major divisions of service:
      • Vocational Rehabilitation Services
      • Employment Services
      • Employer Services
      • Corporate Training
    • For more information, please contact us:
    • 1-800-361-4642
    • www.northernlightscanada.ca
  • Voc Rehab Canada (VRCAN) is a national consortium of experienced regional vocational rehabilitation companies. VRCAN provides customers with single-point access to VR services anywhere they are needed in Canada, whether on an individual service or contract basis. Member companies include: For more information, please feel free to contact us at 1-800-361-4642 Argus Management Consultants, Inc. Sandra Preeper & Associates Advantage Rehabilitation Consultants Ltd. Rehabilitation Alternatives Limited / Vocational Alternatives Software OPTIMA Rehabilitation CVE Inc. Northern Lights Canada Occupational Rehabilitation Group of Canada (ORGOC) Western Rehabilitation Specialists Inc. Diversified Rehabilitation Group Genesis Rehabilitation Ltd. Rehabilitation Focus
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