This document provides information on building resilience in students through understanding trauma and mental health issues. It discusses how trauma like sexual assault can lead to conditions like post-traumatic stress disorder (PTSD) and discusses common myths about PTSD. It provides information on understanding trauma, PTSD symptoms, and how colleges can help students by educating them on these topics and promoting help-seeking behaviors and peer support. The document advocates for creating compassionate campuses where students feel empowered and supported regarding their mental health.

1. Hope Builds Resilience
An Empowered Approach to Mental Health and Sexual Assault
Awareness on Campus
Amy Oestreicher
www.amyoes.com
PTSD peer-to-peer specialist, artist, author, writer for The Huffington
Post, health advocate, Speaker for RAINN and TEDx, actress, playwright.

2. My Story
“My beautiful detour…”

3. Resilience
• What does resilience mean to you?
• What are three factors you feel build a resilient student?

4. Outcomes
• Understanding builds a resilient student
• Understanding PTSD and how it affects students
• Sexual Assault and PTSD
• Ways to help survivors
• Create an informed, compassionate campus with empowered to
mental health

5. What is PTSD?
• Currently, for a diagnosis of PTSD, the student must experience
atraumatic event in which he/she perceives a threat to either self or
others, and must experience distress (horror, fear, helplessness)” (Kataoka
et al. 2012). Traumatic events can range from childhood trauma, an assault,
a medical trauma, natural disasters, schoolbullying, a mugging or robbery,
an attack by an animal, a major car accident, and more. “The three
symptom clusters for PTSD include reexperiencing (for children, this can be
repetitive play or reenacting the trauma in play), numbing and avoidance
(such as avoiding traumatic reminders and talking about [the] trauma, not
participating in activities previously enjoyed), and hyperarousal (such as
irritability, anger, difficulty sleeping)” (Kataoka et al. 2012). Other
symptoms of PTSD that people experience are lack of concentration,
flashbacks, hypervigilance (sensitivity to sounds, light, and energy),
emotional extremes, and dissociation.

6. How you get PTSD
 Skills instruction
 Expected student behavior
 Engagement in the community
 Student self/other awareness
 Positive adult interaction
• College trauma
• 2009 more than 23 million students enrolled in 4500 colleges & Universities
• Approximately 15% -20% female college students raped in their lifetime
• Approximately 5% to 15% college males admit committing an act of rape
• Only 5% of rapes and attempted rapes are reported to police
• Men are twice as likely to be victims of campus crime
• 36% of LGBT students experienced some form of harassment in the past 12 months
• Underreporting of campus crimes leads these stats. suspect

7. Acute responses to trauma
 Acute responses occur during and immediately following crisis events.
 These are normal responses to abnormal events.
 The duration of these symptomatic responses are usually short lived
lasting just a few days up to approximately 3 months.
 Symptoms may vary and persist over a longer period of time depending
on the type event, individual factors and supports in the environment

8. Symptoms OF PTSD
• · Intrusive Memories, which can include flashbacks of reliving the
moment of trauma, bad dreams and scary thoughts.
• · Avoidance, which can include staying away from certain places or
objects that are reminders of the traumatic event. A person may also
feel numb, guilty, worried or depressed or having trouble
remembering the traumatic event.
• · Dissociation, which can include out-of-body experiences or feeling
that the world is "not real" (derealization).
• · Hypervigilance, which can include being startled very easily, feeling
tense, trouble sleeping or outbursts of anger

9. PTSD Myths…
PTSD is a complex disorder that often is misunderstood. Not everyone
who experiences a traumatic event will develop PTSD, but many
people do.
MYTH:
PTSD only affects war veterans.
FACT:
Although PTSD does affect war veterans, PTSD can affect anyone. Almost 70 percent of Americans will be
exposed to a traumatic event in their lifetime. Of those people, up to 20 percent will go on to develop PTSD.
An estimated one out of 10 women will develop PTSD at sometime in their lives.
Victims of trauma related to physical and sexual assault face the greatest risk of developing PTSD. Women
are about twice as likely to develop PTSD as men, perhaps because women are more likely to experience
trauma that involves these types of interpersonal violence, including rape and severe beatings. Victims of
domestic violence and childhood abuse also are at tremendous risk for PTSD

10. PTSD Myth
MYTH:
People should be able to move on with their lives after a traumatic event.
Those who can’t cope are weak.
FACT:
Many people who experience an extremely traumatic event go through an
adjustment period following the experience. Most of these people are able
to return to leading a normal life. However, the stress caused by trauma
can affect all aspects of a person’s life, including mental, emotional and
physical well-being. Research suggests that prolonged trauma may disrupt
and alter brain chemistry. For some people, a traumatic event changes
their views about themselves and the world around them. This may lead to
the development of PTSD.

11. PTSD Myth
MYTH:
People suffer from PTSD right after they experience a traumatic event.
FACT:
PTSD symptoms usually develop within the first three months after trauma but
may not appear until months or years have passed. These symptoms may
continue for years following the trauma or, in some cases, symptoms may subside
and reoccur later in life, which often is the case with victims of childhood abuse.
Some people don't recognize that they have PTSD because they may not
associate their current symptoms with past trauma. In domestic violence
situations, the victim may not realize that their prolonged, constant exposure to
abuse puts them at risk.

12. Why is it important to understand trauma?
 Enhanced awareness and sensitivity of the issues and concerns that
veterans and other trauma victims bring to campus will increase your
ability to effectively serve and respond to their special needs or provide
added accommodations.
 Creating an environment with compassionate, empathic and aware faculty
and staff will foster internal support networks that potentially enhance
performance and retention of traumatized students.
 Awareness of other “appropriate” professional supports (both internal
and external to the institution) that you can refer individuals to will go a
long way in retaining traumatized students with additional needs.

13. Why is it important to understand trauma?
• All supports and interventions are based on the recognition that
symptoms exhibited by survivors are directly related to the traumatic
experience.
• These experiences are the cause of many mental health, substance
abuse and behavioral health problems.
• Understanding trauma and the human responses associated with that
trauma are key to improving program effectiveness, educational
success, individual adjustment, transition success and/or recovery.

14. Trauma can lead to long-term issues
◦ Those with chronic histories of domestic violence, physical and sexual abuse and
other trauma experiences often develop
 Co-occurring disorders such as chronic health conditions
 Substance abuse
 Eating disorders
 HIV/AIDS
 Criminal justice involvement
 Physiological responses to stress are well documented in the literature
 Individuals with PTSD show a variety of changes in memory, emotion,
attention and concentration
 Individuals with PTSD experience changes in brain structure, chemical
functioning that impacts memory, emotions and executive thought
processes

15. PTSD and the Student Body
• “It is estimated that approximately 4 to 6 percent of youth in the
general population nationwide will meet criteria for a diagnosis of
PTSD following a traumatic event, including symptoms such as poor
concentration and intrusive thoughts, which can also severely
interfere with school functioning” (Kataoka et al. 2012). Instructors
should also learn about PTSD, and when their students seem anxious,
hypervigilant, zoned out, or lacking in concentration, instructors
should have a conversation with them in private, ask if they are okay,
give them a handout on PTSD, and refer them to a counselor.
• When students and instructors have the same goals—to create the
best learning environment possible and to understand and combat
PTSD—we will have a more thriving community.

16. UC Berkeley Graduate Student Survey - April,
2004
In the last 12 months:
• 45.3% experienced an emotional stress-related problem that
significantly affected their well-being and/or academic performance
• 67% felt overwhelmed; 54% felt so depressed that it was difficult to
function; 9.9% seriously considered suicide
• females were more likely to report feeling hopeless, exhausted, sad,
or depressed

17. Student Challenges - Summary
• Finances - living expenses; health insurance
• Social Life - dating; partnerships
• Marital Life - spousal job; postponing children?
• Race/Ethnicity/Gender Issues - inequalities; “glass ceiling”
• Developmental Issues - separation; individuation; ethical & moral principles; commitments; being self-reliant; working
alone
• Social/Coping Skills - working closely with faculty; peers
• Dissertation Woes
• Transitioning Into/Out of School - support; identity
• Career Identity - academia vs. “real world”
• Getting a Job
• Acculturation/Assimilation - international students; language
• Psychiatric Illnesses - including substance use and abuse

18. Why Don’t Students in Need
Seek Help?
> 25% of depressed young adults express “intent not to accept a diagnosis of
depression” due to:
• Negative beliefs and attitudes toward depression causation and
treatment
• Beliefs that depression should be hidden from family, friends, employers
• Lack of past helpful treatment experiences
Van Voorhees et al., Annals of Family Medicine, 2005

19. Barriers to help
• Sometimes hard because people expect to be able to handle a traumatic even on their own
• People may blame themselves
• Traumatic experience might be too painful to discuss
• Some people avoid the event all together
• PTSD can make some people feel isolated making it hard for them to get help
• People don’t always make the connection between the traumatic event and the symptoms;
anxiety, anger, and possible physical symptoms
• People often have more than one anxiety disorder or may suffer from depression or substance
abuse

20. How I became an advocate
• Clip of show goes here

21. Gutless & Grateful: Mental Health Advocacy
• Part 1) A 70-minute one-woman autobiographical musical – Gutless & Grateful –
a comedic yet poignant story on how I survived 27 stomach surgeries, organ
failure and sexual abuse. Through interwoven song and dialogue, I share a primal
piece of live-storytelling – a powerful message that it’s possible for students to
overcome physical and mental health obstacles.
•
• Part 2) An educational session/speech where I discuss an empowered approach
to mental health, how to develop a resiliency toolbox, how to cultivate hope, and
how to thrive in college with a physical or mental health condition.
•
• Part 3) A Q&A session to introduce students to a panel of counselors/faculty and
wellness resources on campus.The program can also be followed by smaller
breakout sessions among students to continue building confidence and
compassion through creative expression.

22. Long-term mindsets help us navigate detours
• About one-third of college students across the United States had
problems functioning because of depression in the last 12 months;
almost half said they had felt overwhelming anxiety in the last year,
20 percent said they had seriously considered suicide in their lifetime,
and 5.8 percent said they had attempted suicide.
• in a 2011 NAMI study, that 64% of college dropouts were
for mental health-related reasons, and that, of those, 50% never
accessed any mental health programs or services. 73% of college
students report having experienced a mental health crisis while in
college.

23. Four Secrets to Resilience
• Gratitude
• Creativity
• Hope
• Stories
• No quick fixes, but long-term mindsets

24. The Power of Gratitude
• Improved physical, emotional, and social well-being
• Greater optimism and happiness,
• Improved feelings of connection in times of loss or crises
• Increased self-esteem
• Heightened energy levels
• Strengthened heart, immune system, and decreased blood pressure
• Improved emotional and academic intelligence
• Expanded capacity for forgiveness
• Decreased stress, anxiety, depression, and headaches
• Improved self-care and greater likelihood to exercise
• Heightened spirituality -- ability to see something bigger than ourselves

25. The Secret to Finding Your Way on a Detour …
• Sharing your story.
• Are you a Detourist?
The more we share our detours, the more we realize we’re not alone.

26. Starting the Conversation on Campus

27. What can campuses do?
• Develop educational campaigns to encourage help-seeking for those
with mental health issues.
• Educate peers in addition to others on campus about how to respond
to a friend.
• Professional services must get word out that they are helpful and
available and confidential.
• Focus on life skills and community responsibilities.

28. What other colleges are doing…
• “To assist our students, we:
1. Refer them to mental health services on campus; we also offer a
health facility open to all students.
2. Listen to their problems and offer kind “advice” — no judgement
3. Refer them to Disability resources also on campus
4. Refer them to community services that are available FREE in our
area.”
• - College Professor on International Politics

29. Hampshire Knowledge Commons
• Helping to open the channel of communication between students and
resources
• At Hampshire College, “to know is not enough”. This philosophy underlies a
vision for the commons as providing a clear pathway to discovery,
knowledge acquisition and knowledge production.
• The Knowledge Commons, built flexibly and managed dynamically, will
bring together and nurture the unique Hampshire need for both the
individual/collective, known/ unknown, reflective (meditative)/active by
providing for collaborative and individual work in a technologically and
academic-resource-rich environment.
• The Knowledge Commons will foster community, creativity and curiosity,
supporting Hampshire’s student-driven curriculum and faculty’s intellectual
lives.

30. FMCC “ABLE” Club
• Abilities Beyond Limitation through Education is “a club for students
who wish to explore ways to make attending college easier for
students with disabilities.”

31. What can we do in the community?
• Community education/awareness
• Safety is an issue
• Community collaboration around mental health
• Social marketing
• Destigmatizing help-seeking for mental health problems
• Increasing social support
• Strengthening social networks
• Honor and support responsible help-seeking

32. Asking to Prioritize Mental Health
• Start the conversation
• What are students struggling with? How do they manage their
struggles? What help do students respond to? What advice inspires
them? What goals motivate them? Who do they feel comfortable
reaching out to, and under what circumstances? How do they support
each other?

33. Resilience on Campus
• Person vs. Environment
• Student Centered Approach
• Students already have these internal resources
• The Power of Asking
• Open the channel of communication
promote resiliency
promote life-enhancing skills
promote health maintenance

34. • OCD: Both have recurrent, intrusive thoughts as a symptom, but the
types of thoughts are one way to distinguish these disorders.
Thoughts present in obsessive-compulsive disorder do not usually
relate to a past traumatic event. With PTSD, the thoughts are
invariably connected to a past traumatic event.
• Depression after trauma and PTSD both may present numbing and
avoidance features, but depression would not induce hyperarousal or
intrusive symptoms
• General Anxiety Disorder

35. • It is important to ask all patients with mental health symptoms about
trauma, particularly women suffering from treatment –resistant
depression and those with general medical complaints, since patients
with PTSD often present with somatic symptoms.
Can J Psychiatry, Vol 51, Sppl 2 July 2006

36. Sexual Violence can lead to PTSD
• Post Traumatic Stress Disorder (PTSD)(17%-65%)
• Anxiety and panic disorders
• Depression
• Substance abuse
• Normal and expected reactions
• Responses are individual and a complex interaction between the individual and their environment)

37. Sexual Assault On Campus
• 1 in 9 college students are sexually assaulted while enrolled in school,
including 1 in 4 women
• Half of all students are sexually harassed while enrolled in school
• Less than 28% of sexual misconduct on campus ever gets reported

38. Sexual Assault: My Story
• Check all that apply:
• I feel dirty, like there’s something wrong with me
• Sometimes I think I’m crazy
• I feel ashamed
• I’m different from other people
• I feel powerless
• If people really knew me, they’d leave
• I have a hard time taking care of myself
• I don’t deserve to be happy
I don’t trust my intuition or my feelings
I’m often confused
I’m a failure
I use work to make up for empty
feelings inside
I don’t know what I’m feeling anymore
I can’t cry
anymore
I can’t express emotions
anymore
I’m rarely angry because anger scares
me
I have nightmares and panic attacks
I feel as if my body is separate from the
rest of me
I feel numb”

39. Gutless & Grateful: Sexual Assault
• video

40. Gutless & Grateful Sexual Assault
• Part 1) A 70-minute one-woman autobiographical musical – Gutless & Grateful –
a comedic yet poignant story on how I survived 27 abdominal surgeries, organ
failure, and sexual abuse. Through interwoven song and dialogue, I share a primal
piece of live-storytelling – a powerful message that it’s possible for students to
become empowered by their own identity and be secure in their choices.
• Part 2) An educational session/speech where I discuss a compassionate approach
to emotional well-being, how to develop a resiliency toolbox, how to cultivate
hope, foster understanding, build a supportive community, and be comfortable
reaching out to a support system. Individuals will learn tools for coming forward
as survivors and as visible allies and leaders for all students.
• Part 3) A Q&A session to introduce students to wellness and counseling staff,
discuss Title IX, and other sexual assault and wellness resources on campus. The
program can also be followed by smaller breakout sessions with student groups,
to continue building confidence and compassion through creative expression.

41. Waking the Tiger: The Freeze Response
• "All mammals automatically regulate survival responses from the
primitive, non-verbal brain, mediated by the autonomic nervous
system. Under threat, massive amounts of energy are mobilized in
readiness for self-defense via the fight, flight, and freeze responses.
Once safe, animals spontaneously 'discharge' this excess energy
through involuntary movements including shaking, trembling, and
deep spontaneous breaths. This discharge process resets the
autonomic nervous system, restoring equilibrium."

42. Share resources/groups that help survivors
• counseling center, advocacy office, the police, or a public safety group
• Helpful Sites, books
• Campus/Local Resources for Sexual Assault/Relationship Violence
• Campus Counseling Services
• Campus Women’s Center
• Campus Health Services
• Campus Police
• Athletic Psychologist
• Life Skills Director
• Hall Director if in the dorms
• Coaches/Athletics Directors

43. Did you know?
• You must have consent to engage in any and all sexual behaviors. Consent is hearing the
word “yes.” It is not the absence of hearing “no.” It’s the LAW!
• Up to 75% of the physical and sexual assaults that occur on college campuses involve the
abuse of alcohol by assailants, victims, or both.
• According to the UCR (Uniform Crime Report), in a study surveying more than 6,000
students at 32 colleges and universities in the US:
• More than 90% of sexual assaults are committed by people the victim knew (dating partner,
boyfriend, friend, classmate, etc.)
• Although the majority of sexual assaults are not reported to law enforcement, recent research
indicates that report rates are increasing.
• Less than 2% of reports to police are considered false reports.
• While men can be victims as well, the majority of sexual assault cases involved male
perpetrators and female victims.
•

44. • Combining mental health advocacy and sexual assault prevention
with autobiographical musical theatre, a talkback on resiliency, and a
student conduct Q & A, Gutless & Grateful shifts the college ethos
towards inclusion, educating participants on how to best educate the
student body on sexual assault awareness in a way that engaged and
empowers the community.

45. Know Your Rights

46. Start a conversation on victim-blaming and
how to stop it.

47. What can students with PTSD do?
• Expand your external resources by trying to get your instructors on
your side for support.
• reduce triggers from your study environment. Some people with PTSD
get too distracted by background sounds or the people around them,
while others thrive in that environment.
• Recognizing, being aware of how PTSD is affecting you
• can register with your school’s disability services for accomodations
• Disability staff/instructor relationship
• Self-soothing techniques

48. Create as many resources as possible
• . Many factors play into whether or not we develop symptoms, and
they usually depend on our internal and external resources at the
time of the trauma. Internal resources might be your coping skills,
strength, resilience, age (developmental stages are important; an
adult can make more sense of a situation than a three-year-old, for
example), and genetics, whereas external resources are anything that
is outside of you that provides you with support, strength, and
relaxation. External resources might be your network of friends, your
family, your instructors, and your community. Your exercise, eating,
and sleeping habits, and yourenvironment, such as your home and
the sounds you are surrounded with, are all important.

49. Self Soothing for Students
• make a list of what makes you feel good, balanced, grounded, and relaxed, and
do those activities more often. Perhaps listening to guided imagery CDs, such as
Belleruth Naparstek’s Healing Trauma CDs, might help you, as well as using a self-
help method called Emotional Freedom Techniques (EFT). EFT are tapping
techniques you use on your body that have shown to be very successful at
reducing distress and triggers. The website www.EFTUniverse(link is
external) offers free YouTube video instructions and research articles. Go to the
site and use the techniques when you are triggered in order to determine
whether EFT might reduce your anxiety or reactions.
• Find a Somatic Experiencing (SE) therapist at www.traumahealing.com(link is
external) to work on your trauma. SE works with your nervous system, which
often gets stuck in stress or trauma, keeping you in a hyperalert, survival mode.
Read books on trauma, such as In an Unspoken Voice by Peter Levine,
and Healing from Trauma by Jasmin Lee Cory and Robert Scaer. But most
important, don’t give up!

50. Host a Bystander Prevention Training
• Do you know someone who has been sexually assaulted?
• How would you react if it were your sister/mother?
• How does gender impact this situation?
• Is this a special issue for you as a student-athlete? If yes, how so?
• Are athletes negatively affected by the standards (to be tough, aggressive, etc.) set by coaches,
teammates, parents, and, most importantly, themselves? Do you believe aggression in sport
settings can lead to sexual assaults? Why and how?
• How do you define masculinity? Femininity?
• Does masculinity need to be “proved” more than femininity? Is there more pressure to act
masculine than to act feminine? What does it mean for a male to be “weak”?
• What kinds of things do people on your team or in the athletic community believe about rape and
abuse? Do they think it’s a real problem or that it’s exaggerated?
• Are there sexual assault cases currently in the news and what lessons are to be learned?
• Are there contradictory messages about sex in our society?

51. • . Make sure your school has a Title IX coordinator and that she or he
has updated resources.
• . Organize or participate in public awareness initiatives.
• Ensure that resources are made available for survivors of sexual
assault.
• Participate in faculty and staff training.
• Bring outside experts to campus.
• 1. Encourage educational and prevention programming on campus.

52. National Sexual Assault Resources
My program:
•Consent is Like a Cup of Tea
•Circle of Six App – Stop violence before it happens
•Other SmartPhone apps to help in sexual assault prevention
•NCAA Violence Prevention: www.ncaa.org/violenceprevention
•It’s On Us: http://itsonus.org
•The Power of Peers in Preventing Rape
•The Green Dot Program: http://livethegreendot.com/
•One Student: http://onestudent.org/
•The University of Arizona Campus Health Service Step UP! Program
•The Rape, Abuse & Incest National Network (RAINN) – www.rainn.org or 1-800-656-HOPE (4673)
•National Sexual Violence Resource Center – www.nsvrc.org or 1-877-739-3895 (toll free)
•California Coalition Against Sexual Assault – http://calcasa.org
•Male Survivor – www.malesurvivor.org or 1-800-738-4181
•Mentors in Violence Prevention – www.sportinsociety.org/mvp
•Men Can Stop Rape – www.mencanstoprape.org
•What Bystanders Can Do To Stop Rape – http://healthland.time.com/2013/01/11/what-bystanders-can-do-to-stop-rape/#ixzz2HgSCxbz

53. PTSD and Mental Health Resouces
• My college mental health program: