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Val Lougheed Northern Lights Canada Mental Health & Injury: Rehab, Recovery and Return to Work  Trauma, Rehabilitation  an...
“ You don’t want your impairments to define you – you want them to inform you.” (Hanita Dagan, personal communication, 2005)
<ul><li>www.slideshare.com/vlougheed </li></ul>#NLCAN www.northernlightscanada.ca/about/about-val-lougheed/be-still
Agenda <ul><li>Beginning … </li></ul><ul><li>Middle … </li></ul><ul><li>End … </li></ul>
Rehab, Recovery and Return to Work <ul><li>What does it mean to recover? </li></ul><ul><li>What can I do to recover and re...
Rated PG-113 People Strongly Cautioned!  May contain bad language, brief nudity, sexual overtones, and drug usage.
Beginning My Story
 
 
 
Sept. 9, 2003  - morning
Sept. 9 – p.m.
Sept. 15 2003 – Jan. 19 2004 Journey Back to Life
 
 
 
 
Research
 
Dominant Themes <ul><li>Narcotic Pain Killers </li></ul><ul><li>ABI </li></ul><ul><li>Pain </li></ul><ul><li>Trauma </li><...
Foundation for Understanding Experience
Body-Mind Connection Psychoimmunoendocrine Network <ul><li>The nervous, endocrine, and immune systems are functionally int...
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 existent...
Sliding Down the Slope (Dalhousie, March 2005) Early 1900’s Oxycodone ™  developed in Germany 1995 Purdue Pharmacy (USA) l...
Sliding Down the Slope
 
A Foothold <ul><li>Mild – moderate ABI </li></ul><ul><li>Depressed  (dysphoria) </li></ul><ul><li>Working memory problems ...
ABI – Measuring Loss “ Pre-morbid intelligence is a crucial variable …” Subjective Report – difficulty retrieving words an...
Losing My Grip My IWRP August 2004
 
Rescued in the Valley of Despair Head Injury Program Oct. – Dec. 2004
 
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 <ul><li>Case Manager </li></ul><ul><li>Job Coach </li></ul><ul><li>Colleagues/Friends/ Psychologist </li><...
Sliding Back Down  Into The Abyss <ul><li>Non-compliance </li></ul><ul><li>Malingering </li></ul><ul><li>Trying too hard <...
Test Results <ul><li>Mild to Moderate ABI </li></ul><ul><li>Pain? </li></ul><ul><li>Depression? </li></ul><ul><li>Motivati...
Lesson ASSUMPTIONS REVEAL BIAS
<ul><li>Mild – moderate ABI </li></ul><ul><li>Good prognosis </li></ul><ul><li>Post-Traumatic amnesia </li></ul><ul><li>Pa...
Symptom Overlap (co-morbidity) (Michael Sullivan, Centre for Research on Pain and   Disability, McGill University, Septemb...
 
Oct. 3 – Dec. 11
 
Pain Research 1600’s – Rene Descartes (philosopher)
Pain Research 1950’s – Wilder Penfield (brain surgeon)
 
Pain Research Patrick Wall (physiologist) Ronald Melzack (psychologist)
Pain Research <ul><li>Gate Control Theory  </li></ul><ul><li>Acute and chronic pain </li></ul><ul><li>Pain sensation trave...
Pain – The Future SCN9A (Globe and Mail, March 24, 2007) Glia Cells (Scientific American, November, 2009) Poppy Genes (U o...
 
 
 
 
<ul><li>Limbic System </li></ul><ul><li>The centre for emotional expression </li></ul><ul><li>(Prigatano, 1999, p. 132) </...
“ In every encounter, basic trust is in question.” ( Herman, 1992, p. 92) “ Survivors feel unsafe in their bodies – and in...
Trauma Personal Experience <ul><li>Dissociation & Cocoon =  Safety </li></ul><ul><li>System on High Alert Always =  Surviv...
Trauma Personal Experience <ul><li>Listen to me </li></ul><ul><li>Understand me </li></ul><ul><li>Respect me </li></ul><ul...
 
 
“…  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) Pscyhoimmunoendo...
 
 
<ul><li>Affects more than IQ …. </li></ul><ul><li>We are sensitive to changes in higher cerebral functioning </li></ul><ul...
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
 
 
“ The words and attitudes of others … are potent. They help or hex healing and recovery.” “  Expectations are powerful.” “...
<ul><li>Hypothalamus </li></ul><ul><li>Peptides </li></ul><ul><li>Receptors </li></ul><ul><li>Biochemical Events </li></ul>
 
Quantum Connection <ul><li>The Living Matrix -- 1995 </li></ul><ul><li>A type of energy exists that has previously gone un...
“ Loss of identity can evoke a personal crisis, creating a need for change.” (Ornelas, in Smith & Johnson (Eds), 1997, p. ...
Scaling the Canyon
Sept., 2005 Waskesiu
 
 
 
 
Breast Cancer  Reconstructive Surgery March 2006
Convocation M.Ed. -- June 2006
Back in “a” Saddle September  2007 <ul><li>Officially change role/ title </li></ul><ul><li>Re-organize NL </li></ul><ul><l...
 
Rehab, Recovery and Return to Work  Resilience <ul><li>Ability to return to original form after being bent (bounce back) <...
Rehab, Recovery and Return to Work Rehabilitation   (habiter – to live inside) “ Rehabilitation is the learning to live in...
Rehab, Recovery and Return to Work Recovery Crombez, October, 2003 Curing Focus on the illness/ impairment [outside] Heali...
Be Still
Rehab, Recovery and Return to Work <ul><li>What does it mean to recover? </li></ul><ul><li>What can I do to recover and re...
Keep Your Fork
<ul><li>Northern Lights Canada is a person-centred organization committed to providing innovative, responsive links to rea...
Voc Rehab Canada (VRCAN) is a national consortium of experienced regional vocational rehabilitation companies. VRCAN provi...
 
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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

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  • Northern Lights Vocational Services www.nlvs.ca 1-800-361-4642
  • Transcript of "Mental health and injury: Trauma, Rehabilitation and Recovery"

    1. 1. 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
    2. 2. “ You don’t want your impairments to define you – you want them to inform you.” (Hanita Dagan, personal communication, 2005)
    3. 3. <ul><li>www.slideshare.com/vlougheed </li></ul>#NLCAN www.northernlightscanada.ca/about/about-val-lougheed/be-still
    4. 4. Agenda <ul><li>Beginning … </li></ul><ul><li>Middle … </li></ul><ul><li>End … </li></ul>
    5. 5. Rehab, Recovery and Return to Work <ul><li>What does it mean to recover? </li></ul><ul><li>What can I do to recover and return to a life that includes work? </li></ul><ul><li>What can we do to facilitate recovery and a return to work? </li></ul>
    6. 6. Rated PG-113 People Strongly Cautioned! May contain bad language, brief nudity, sexual overtones, and drug usage.
    7. 7. Beginning My Story
    8. 11. Sept. 9, 2003 - morning
    9. 12. Sept. 9 – p.m.
    10. 13. Sept. 15 2003 – Jan. 19 2004 Journey Back to Life
    11. 18. Research
    12. 20. Dominant Themes <ul><li>Narcotic Pain Killers </li></ul><ul><li>ABI </li></ul><ul><li>Pain </li></ul><ul><li>Trauma </li></ul><ul><li>Depression </li></ul><ul><li>Methods of Helping </li></ul><ul><ul><li>Return to Work </li></ul></ul><ul><ul><li>Life </li></ul></ul>
    13. 21. Foundation for Understanding Experience
    14. 22. Body-Mind Connection Psychoimmunoendocrine Network <ul><li>The nervous, endocrine, and immune systems are functionally integrated – the brain is only one part of this non-hierarchical network </li></ul><ul><li>Memories, emotions, behaviours and physiology are all connected at the molecular level </li></ul><ul><li>(Candace Pert, 1997, p. 171 – 179) </li></ul>
    15. 23. February 2004 – Present Starting Point
    16. 24. Identity Disintegration and The Re-organization of Self March 2004
    17. 25. “ 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)
    18. 26. 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
    19. 27. Sliding Down the Slope
    20. 29. A Foothold <ul><li>Mild – moderate ABI </li></ul><ul><li>Depressed (dysphoria) </li></ul><ul><li>Working memory problems </li></ul><ul><li>Hiding pain </li></ul>1 st Neuropsychological Assessment June 2004 -- Results
    21. 30. 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)
    22. 31. Losing My Grip My IWRP August 2004
    23. 33. Rescued in the Valley of Despair Head Injury Program Oct. – Dec. 2004
    24. 35. HIP Oct to Nov – Full-time December – Part-time
    25. 36. GO TO WORK
    26. 37. GRTW – The Plan Jan. 3 – Feb. 7, 2005 (5 weeks)
    27. 38. GRTW – The Reality
    28. 39. GRTW – The Reality
    29. 40. GRTW – The Reality
    30. 41. GRTW – The Reality
    31. 42. GRTW – The Reality
    32. 43. GRTW – The Reality
    33. 44. GRTW – The Reality
    34. 45. GRTW – The Reality
    35. 46. GRTW – The Reality
    36. 47. Rescue Attempts <ul><li>Case Manager </li></ul><ul><li>Job Coach </li></ul><ul><li>Colleagues/Friends/ Psychologist </li></ul>
    37. 48. Sliding Back Down Into The Abyss <ul><li>Non-compliance </li></ul><ul><li>Malingering </li></ul><ul><li>Trying too hard </li></ul><ul><li>Not trying hard enough </li></ul>2 nd Neuropsychological Assessment May 2005 -- Edmonton
    38. 49. Test Results <ul><li>Mild to Moderate ABI </li></ul><ul><li>Pain? </li></ul><ul><li>Depression? </li></ul><ul><li>Motivation? </li></ul><ul><li>“ a high flyer” </li></ul><ul><li>“ phobic avoidance” </li></ul><ul><li>Future plans – “live off dividends” [from company] </li></ul>
    39. 50. Lesson ASSUMPTIONS REVEAL BIAS
    40. 51. <ul><li>Mild – moderate ABI </li></ul><ul><li>Good prognosis </li></ul><ul><li>Post-Traumatic amnesia </li></ul><ul><li>Pain? </li></ul><ul><li>Depression? </li></ul><ul><li>“ Adjustment Disorder with Anxiety and Depressed Mood” </li></ul>3rd Neuropsychological Assessment August 2005 -- Calgary
    41. 52. Symptom Overlap (co-morbidity) (Michael Sullivan, Centre for Research on Pain and Disability, McGill University, September, 2006) Pain, Trauma, Depression, ABI
    42. 54. Oct. 3 – Dec. 11
    43. 56. Pain Research 1600’s – Rene Descartes (philosopher)
    44. 57. Pain Research 1950’s – Wilder Penfield (brain surgeon)
    45. 59. Pain Research Patrick Wall (physiologist) Ronald Melzack (psychologist)
    46. 60. Pain Research <ul><li>Gate Control Theory </li></ul><ul><li>Acute and chronic pain </li></ul><ul><li>Pain sensation travels up the central nervous system to the brain through a “gate” </li></ul><ul><li>“ Gate” – triggered by cell changes – sends descending messages that alter sensory input </li></ul><ul><li>Pain isn’t pain until it reaches the brain </li></ul><ul><li>Emotions, context, etc. affect pain sensations </li></ul><ul><li>Pain is a negotiable, individual experience </li></ul><ul><li>Pain centres in the brain – they just keep moving around </li></ul><ul><li>(Jackson, 2002, p. 21) </li></ul>
    47. 61. 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)
    48. 66. <ul><li>Limbic System </li></ul><ul><li>The centre for emotional expression </li></ul><ul><li>(Prigatano, 1999, p. 132) </li></ul><ul><li>Amygdala - attaches emotional tags to memories </li></ul><ul><li>(Dr. Suffield, personal communication, 2004) </li></ul><ul><li>Hippocampus - controls the laying down of new memories </li></ul><ul><li>(Ramachandran & Blakeslee, 1998, p. 15) </li></ul><ul><li>Hypothalamus – controls the outward expression of emotions </li></ul><ul><li>(Ramachandran & Blakeslee, 1998, p. 177) </li></ul>Trauma Research
    49. 67. “ 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
    50. 68. Trauma Personal Experience <ul><li>Dissociation & Cocoon = Safety </li></ul><ul><li>System on High Alert Always = Survival </li></ul><ul><li>World is black & white = Trust </li></ul>Trust (Safety) = Love No Trust (Life Threatening) = Hate
    51. 69. Trauma Personal Experience <ul><li>Listen to me </li></ul><ul><li>Understand me </li></ul><ul><li>Respect me </li></ul><ul><li>Are competent </li></ul>I trust (love, feel safe with, will try hard for) practitioners who:
    52. 72. “… depression [caused by trauma] is not the same as ordinary depression.” ( Herman, 1992, p. 118) Depression
    53. 73. “ Emotions are not in the head – they are in every cell in the body.” (Pert (1995), in Bolen, 1996, p. 7) Pscyhoimmunoendocrine Network
    54. 76. <ul><li>Affects more than IQ …. </li></ul><ul><li>We are sensitive to changes in higher cerebral functioning </li></ul><ul><li>Very important to a person’s sense of self </li></ul><ul><li>Touches core … of a person’s self-esteem </li></ul><ul><li>(Prigatano, 1999, p. 58) </li></ul>ABI
    55. 77. Back to Wilder Penfield – 1950’s ABI Localizationist
    56. 78. Paul Bach-y-Rita – 1934 – 2006 Scientist and Rehab Doctor Neuroplasticity - 1969
    57. 79. Michael Merzenich Neuroplastician Neuroplasticity
    58. 80. Harnessing the Power
    59. 83. “ 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
    60. 84. <ul><li>Hypothalamus </li></ul><ul><li>Peptides </li></ul><ul><li>Receptors </li></ul><ul><li>Biochemical Events </li></ul>
    61. 86. Quantum Connection <ul><li>The Living Matrix -- 1995 </li></ul><ul><li>A type of energy exists that has previously gone unnoticed. </li></ul><ul><li>Cells/DNA influence matter through this form of energy. </li></ul><ul><li>DNA Phantom effect. Braden, 2007, p. 45 </li></ul>
    62. 87. “ 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
    63. 88. Scaling the Canyon
    64. 89. Sept., 2005 Waskesiu
    65. 94. Breast Cancer Reconstructive Surgery March 2006
    66. 95. Convocation M.Ed. -- June 2006
    67. 96. Back in “a” Saddle September 2007 <ul><li>Officially change role/ title </li></ul><ul><li>Re-organize NL </li></ul><ul><li>Work part-time </li></ul>
    68. 98. Rehab, Recovery and Return to Work Resilience <ul><li>Ability to return to original form after being bent (bounce back) </li></ul><ul><li>Thriving in constant change, ability to be: </li></ul><ul><ul><ul><li>Flexible </li></ul></ul></ul><ul><ul><ul><li>Creative </li></ul></ul></ul><ul><ul><ul><li>Adaptable </li></ul></ul></ul><ul><ul><ul><li>Learn from experience </li></ul></ul></ul><ul><li>http://www.resiliencycenter.com/articles/5levels.shtml </li></ul>
    69. 99. 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)
    70. 100. Rehab, Recovery and Return to Work Recovery Crombez, October, 2003 Curing Focus on the illness/ impairment [outside] Healing Focus on the person [inside]
    71. 101. Be Still
    72. 102. Rehab, Recovery and Return to Work <ul><li>What does it mean to recover? </li></ul><ul><li>What can I do to recover and return to a life that includes work? </li></ul><ul><li>What can we do to facilitate recovery and a return to work? </li></ul>
    73. 103. Keep Your Fork
    74. 104. <ul><li>Northern Lights Canada is a person-centred organization committed to providing innovative, responsive links to real work. </li></ul><ul><li>We offer 4 major divisions of service: </li></ul><ul><ul><li>Vocational Rehabilitation Services </li></ul></ul><ul><ul><li>Employment Services </li></ul></ul><ul><ul><li>Employer Services </li></ul></ul><ul><ul><li>Corporate Training </li></ul></ul><ul><li>For more information, please contact us: </li></ul><ul><li>1-800-361-4642 </li></ul><ul><li>www.northernlightscanada.ca </li></ul>
    75. 105. 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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