Trauma, rehabilitation and recovery -- the story of a practitioner who became the patient and what she learned about trauma, rehab and recovery.

1. Trauma, Rehabilitation and
Recovery
~ Keep your Fork ~
Val Lougheed
Northern Lights Canada
Real Work * Real People * Real
Results
1-800-361-4642 * www.northernlightscanada.ca * vlougheed@northernlightscanada.ca

2. “You don’t want your
impairments to define
you – you want them
to inform you.”
(Hanita Dagan, personal communication, 2005)

3. www.slideshare.net/vlougheed
#NLCAN
www.northernlightscanada.ca/our-company/our-president/
be-still

4. Agenda
• Beginning …
• Middle …
• End …

5. HOPE AND PLANNING
1. What does it mean to recover?
2. What can I do to recover and
return to a life that includes
work?
3. What can we do to facilitate
recovery and a return to work?

6. Rated PG-113
People Strongly Cautioned!
May contain bad language, brief nudity,
sexual overtones, and drug usage.

7. Beginning
1978

10. VIDEO CLIP
Val being
interviewed in
Minden

12. Sept. 9, 2003 - morning

13. Sept. 9 – p.m.

14. Sept. 15 2003 – Jan. 19 2004
Journey Back to Life

19. Starting Point
February 2004 – Present

21. March 2004
The
Re-organization
of Self

22. “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)

23. Sliding Down the Slope

24. Sliding Down the Slope

26. A Foothold
1st Neuropsychological Assessment
June 2004 -- Results
• Mild – moderate ABI
• Depressed (dysphoria)
• Working memory problems
• Hiding pain

27. ABI – Measuring Loss
Subjective Report – difficulty retrieving words and communicating ideas
Objective Report – above-average performance on neuropsychological measures
(Prigatano, 1999; p. 59)

28. Losing My Grip
My IWRP
August 2004

29. Video of Borg

31. Rescued in the Valley of
Despair
Head Injury Program
Oct. – Dec. 2004

33. GRTW – The Plan
Jan. 3 – Feb. 7, 2005
(5 weeks)

34. GRTW – The Reality

35. GRTW – The Reality

36. GRTW – The Reality

37. GRTW – The Reality

38. GRTW – The Reality

39. GRTW – The Reality

40. GRTW – The Reality

41. GRTW – The Reality

42. GRTW – The Reality

44. WSPE
Work-Site Performance
Evaluation©
Sue….with the graph pic

45. Sliding Back Down
Into The Abyss
2nd Neuropsychological Assessment
May 2005 -- Edmonton
• Non-compliance
• Malingering
• Trying too hard
• Not trying hard enough

47. Test Results
• Mild to Moderate ABI
• Pain?
• Depression?
• Motivation?
• “a high flyer”
• “phobic avoidance”
• Future plans – “live off
dividends” [from company]

48. Lesson
ASSUMPTION
S
REVEAL BIAS

49. 3rd Neuropsychological
Assessment
August 2005 -- Calgary
• Mild – moderate ABI
• Good prognosis
• Post-Traumatic amnesia
• Pain?
• Depression?
• “Adjustment Disorder with
Anxiety and Depressed Mood”

50. Pain, Trauma, Depression, ABI
Symptom Overlap
(co-morbidity)
(Michael Sullivan, Centre for Research on Pain and
Disability, McGill University, September, 2006)

52. Oct. 3 – Dec. 11

54. Pain Research
1600’s – Rene Descartes (philosopher)

55. Pain Research
1950’s – Wilder Penfield (brain surgeon)

57. Pain Research
Patrick Wall (physiologist)
Ronald Melzack (psychologist)

59. 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)

63. Rehab & Recovery
“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)

65. Trauma Research
DISSO
CIA
TION

66. Trauma Research
VIDEO CLIP
Adrenal ine:
Fl ight or Fight
Response

67. Fight

68. Freeze

69. Trauma Research
Limbic System and Memory
“Survival Central”
(Rothschild, 2000, p. 46)
• Amygdala - Implicit memory
• storage of emotions and sensory reactions
(Rothschild, 2000, p. 20)
• Hippocampus – Explicit memory
• creates memories of actual sequence of
events
(Rothschild, 2000; p. 28)

70. Trauma Research
Limbic System Under Threat
Stress Hormones
• Amygdala - Implicit memory
• storage of emotions and sensory reactions
(Rothschild, 2000, p. 20)
• Hippocampus – Explicit memory
• creates memories of actual sequence of
events
(Gunnar & Barr, 1998)

72. 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

73. Trauma
Personal Experience
I trust (love, feel safe with, will
try hard for) people who:
• Listen to me
• Understand me
• Respect me
• Are competent

76. Depression
“… depression [caused by
trauma] is not the same as
ordinary depression.”
( Herman, 1992, p. 118)

77. Psychoimmunoendocrine Network
Candace Pert, 1997; pp. 171 -- 179

80. ABI
Affects more than IQ
….
Touches core … of a
person’s self-esteem
(Prigatano, 1999; p. 58)

81. ABI
Back to Wilder Penfield – 1950’s
Localizationist

82. VIDEO CLIP Story of Paul
Bach-y-Rita’s dad
Paul Bach-y-rita
Neuroplasticity Video Clip;
link to Neuroplasticity –
YouTube; bren49764
00 – 2:20

83. Neuroplasticity - 1969
Paul Bach-y-Rita – 1934 – 2006
Scientist and Rehab Doctor

86. METHODS OF
HELPING

87. Body-Mind Connection
“The words and attitudes of
others … are potent. They help
or hex healing and recovery.”
“ Expectations are powerful.”
(Bolen, 1996; p. 94)

88. SCARF MODEL (Rock,
2008)

89. • Hypothalamus
• Peptides
• Receptors
• Biochemical Events

90. Video clip Addicted
to Love song

91. VIDEO CLIP
Esther
Sternberg
Dr. Esther Sternberg Demo
Reel – YouTube;
00 -- .36

92. Quantum Connection
The Living Matrix
(Braden, 2007; p. 45)

93. Cortisol and Immune
Cells
Sternberg, 2001; p. 112

94. Identity Research
The Re-Organization of Self
“Loss of identity can evoke a
personal crisis, creating a need
for change.”
(Ornelas, in Smith & Johnson (Eds), 1997; p. 172)

96. Scaling the Canyon

97. Waskesiu
Sept., 2005

102. Breast Cancer
Reconstructive Surgery
March 2006

103. Convocation M.Ed. -- June
2006

104. Back in “a” Saddle
September 2007
• Officially change role/
title
• Re-organize NL
• Home Office

106. Hope and Planning
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

107. Hope and Planning
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)

108. Hope and Planning
Recovery
Curing Focus on the illness/
impairment [outside]
Healing Focus on the person
[inside]
(Crombez, October; 2003)

109. Be Still

110. HOPE AND PLANNING
1. What does it mean to recover?
2. What can I do to recover and
return to a life that includes
work?
3. What can we do to facilitate
recovery and a return to work?

111. Keep Your Fork

112. 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

113. 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:
Argus Management Consultants, Inc. Sandra Preeper & Associates
Advantage Rehabilitation Consultants
Rehabilitation Alternatives Limited /
Ltd.
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
For more information, please feel free to contact us at 1-800-361-4642