This educational program explores the impact of trauma on adolescent learning. PTSD impacts social connection, relationship with educators, social skills, cognitive development and increases risk of drug use. This education program explores skills for educators to work with teens with trauma.

2. TEEN TRAUMA
THE STORY OF JANE
Jane is a bright 15 year old girl. You are excited that
she is coming to your class.
Over the summer Jane was out with her family and
was in a terrible car crash.
When Jane comes into your class at first she is
respectful, motivated, and participates in class.

3. TEEN TRAUMA
THE STORY OF JANE
Over the next three months Jane starts being more irritable in
class.
Her test scores are low. In class she fidgets a lot and
sometimes appears to be staring off into space at nothing.
When doors slam Jane jumps out of her chair.
Once in class another student raises his voice during an
assignment and Jane yells back and nearly hits the boy.
When asked about why she did that she stated that she did not
know. She said he made me mad and he is stupid.

4. TEEN TRAUMA THE STORY OF JANE
Jane’s parents call a conference and try to help Jane.
Jane becomes embarrassed about this meeting and starts
becoming more withdrawn at school.
As the year progresses she appears to be less able to
concentrate and starts to cut class.
You as a teacher try to reach out to Jane and she is irritated
and says things push you away. (make you feel stupid)

5. TEEN TRAUMA
THE STORY OF JANE
Parents report that Jane is withdrawn, irritable, yells
at her siblings for the smallest things, and no longer
listens.
Jane starts to spend time with kids who are getting
into trouble.
Some one states that they think Jane is drinking.

6. Why Trauma Matters: ACES

7. Trauma in the Teen Years…
Teen who have
Face Trauma Often
experience
Fear, Worry,
Sadness, Feeling alone
and apart from others,
Anger,
Feeling as if people are
looking down on them,
Low self-worth, and
Unable to trust others.
Teen who have Face Trauma
Often Display Dysfunctional
Behaviors
Increased aggression.
Out-of-place sexual
behavior.
Self-harm. Attempt suicide.
Abuse of drugs or alcohol.
Dropping out of school,
Risk of pregnancy at a
young age.

8. Externalizing Behaviors
The Hyperarousal Type
Increased Externalizing Behaviors (e.g. acting out)
Their anxiety and unregulated protective anger leads to many difficult
behaviors.
They can ruin their relationships with authority figures and at times
have difficulty tolerating friendship.
The ability to regulate their emotions is low.
Due to this they display more emotions. They can elicit more negative
emotions from teachers, parents and friends.

9. Externalizing Behaviors
The Hyperarousal Type
The child acts out their hurt on the external
world. Such as:
Disruptive behavior
Hyperactivity
Aggressive behaviors
Delinquency
Impulsivity.
These Children are often
referred to
as having conduct problems
Display antisocial behaviors
Appear under-controlled

10. Poly-Vagal Theory
The way it works… V.V.C. Brake Disengages
Sympathetic Nervous
system Engages
V.V.C Brake Engaged
at rest and Socially
Engaged.
DMNX Engages
Shutting Down
Consciousness

11. Hyperactivation
The hyperactivated individual floods with information from the body and
has less capacity to regulate the intense sensation.
Ruth Lanius Found in an fMRI Study…
Over activation in the insula (bringing extreme amounts of information from the
body’s interoceptive cues)
Under-activation of the anterior cingulate cortex (ACC) (area needed to regulate
the body sensations brought up from the insula)
Under-activation medial prefrontal cortex (mPFC) (area needed to regulate the
body sensations brought up from the insula)

12. Internalizing Behaviors
The Dissociative Type
Some teens implode and don’t explode.
Teens who are the most overwhelmed sometimes appear quiet,
withdrawn and isolated.
In trauma we discuss this as “acting-in” vs. “acting-out.”
These children can be ignored because they appear to be doing
well. They are not. They are highly shame sensitive and need
support.
They may never ask for it!

13. Internalizing Behaviors
The Dissociative Type
Increased Internalizing Behaviors:
With-drawing into their own world;
Acting and feeling anxious;
Being inhibited in normal exploration;
Feeling unsafe;
Depressed mood and behaviors.
Negative Emotions and beliefs.
Can appear “over controlled."

14. Poly-Vagal Theory
The way it works… V.V.C. Brake Disengages
Sympathetic Nervous
system Engages
V.V.C Brake Engaged
at rest and Socially
Engaged.
DMNX Engages
Shutting Down
Consciousness

15. Hypoactivation
For the hypoarousal type, only a small amount of interceptive cues
get into the limbic cortex and are quickly squelched by cortical
structures, leaving the individual feeling disconnected, emotionally
flat, and dissociated.
Ruth Lanius Found in an fMRI Study…
Down regulation of physical sensations from the insula cortex.
Hyperactivation activation in the anterior cigulet cortex (ACC).
Hyperactivation in the medial prefrontal cortex mPFC.

16. Working with the Traumatized Teen
Trauma can be a shattering life event. Teens are prone to feel
disconnected from society, adults and each other.
Traumatic events can lead to increased feelings of isolation.
This combination can be very detrimental to a teen.
Traumatic events are often caused by people who are trusted
by the teenager. That rupture and trust can make it more
difficult to the teen to move out of isolation and back into a
trusting relationship with authority figures.

17. Working With the Traumatized Teen
Affect instability, externalizing behaviors, lack of trust and avoidance
behaviors can lead a teenager to act in ways that damages important
relationships.
Working with an adolescent who has experienced trauma requires building
trust, tolerated acting out but supporting the teen to make safe choices and
their life.
Adults working with traumatized teenagers need to be very aware of the
subtle attachment behaviors that can alert the teen at the adult they are with
his safe.
It is also important for adults to know that subtle facial expressions, body
positions, behaviors, tones of voice, and interaction styles can trigger a fight
flight response.

18. Working With the Traumatized Teen
If a teenager has a fight flight response it’s important to assess if
there were triggers in the way a care provider was talking, behaving,
or displaying emotion and.
Trauma triggers are classically conditioned. This means they’re
often not logical, connected to things that we would expect, and in
response to the trigger is highly disproportionate to the event.
The disproportionate nature of the traumatic response to the event
trigger in response can be highly frustrating and confusing to the
adult care providers working with the traumatized teenager.

19. Working With the Traumatized Teen
Because the adult responses to a child’s externalizing
behavior can also be trauma triggers it imperative for care
providers to be able to tolerate, regulate, and redirect
highly emotional behavior.
Remember emotions are contagious! And the emotions of
trauma are extremely intense. Therefore it’s important to
learn some skills at regulating your own responses to
intense emotions.

20. Emotion Regulation Tools
Orienting: Is paying attention to the here and now through the
five senses.
Resourcing: Is accessing a previous memory or a current felt
experience of mastery, positive emotion, safety, or pleasurable
sensation.
Distress Tolerance: Is recognizing that life is often difficult,
and sometimes all you can do is tolerate a difficult. With more
practice it becomes easier to remain present even in the face of
a highly uncomfortable and stressful emotional event.

21. Emotion Regulation Tools
Breath: Breathing into your belly can be a powerful way to stabilize your
consciousness when you’re feeling of intense emotion.
Self soothing: This is the skill that can help increase your tolerance of
difficult emotions.
You can soothe with in the five senses: touch, sight, smell, taste, hearing.
You can soothe with your thoughts: positive self talk can help soothe a difficult
emotion.
You can soothe your imagination. Imagining a time when you felt good, safe,
loved or tolerated a difficult situation can help you learn to be with the most
difficult emotions.

22. Emotion Regulation Tools
Humor: Finding ways to be irreverent, take a difficult
situation lightly, and seeing the humor in challenge can
be a profound way to learn to tolerate emotions.
Half smile: Your face is connected into the
parasympathetic nervous system. When you put a half
smile on your face, you tell your body to your safe. This
can reduce stress, increase pleasure, and help you
tolerate challenging emotions.

23. Emotion Regulation Tools
Naming a Pattern: All people have patterns of behaviors.
Children do too. When you in a non-judgmental way name a
pattern it allows the other person to grow in awareness and have
a chance to reflect if that action matches their own goals.
Decoding Thoughts and Feelings: ToM or Theory of mind is
one of the core skills in emotional relatedness. All people have a
guess about the internal state of other people. Children who have
faced trauma often make guesses that are threatening and
inaccurate. In this skill you make a guess about the inner
experience of a child and how that is effecting their behavior but
then give them room to correct you.

24. Emotion Regulation Tools
Teflon mind: Is a practice of letting emotions and events roll
off your back. It’s like the thought can come and and the feeling
can be there but you let it go very quickly. This takes practice.
In the skill is one of the most vital in working with children who
have experienced trauma.
Mindfulness: Children and in particular children with trauma
have a feeling or a thought and react. This is the skills of
noticing the sensation in the body and building time in between
the feeling and the action.
Non-judgementalness: This is the skill of accurate, simple
and direct description of behaviors. It sounds easy but takes a
lot of skill.

25. The “Attitude”
The “Attitude” creates safety and lays the ground work for effective
teaching.
Calm: Stay calm ware the poker face and remain warm.
Firm: Stick to the rules while remaining kind and supportive.
Accepting: Accept the child fully not the actions.
Empathic: Your empathy helps the child grow empathy for ot
hers
Playful and Curious: Enjoyment is key for a child or
teen with trauma. Curiosity is the Hallmark of safety.

26. Attachment Behaviors
o Creating Social Bonds: Social bonds increase the impact of
the educational relationship.
STEPS:
1. Create Safety (eye contact – upper face working),
2. Approach Proximity (physical/ emotional closeness),
3. Establish Contact (physical/ emotional contact).
o Self-Empowerment: Uses positive emotions to build on
existing strengths.

27. Attachment Behaviors
• Your body talks: Your whole presence communicates safety.
• High Vocal Prosody: Reduces stress through increased social
engagement via changing tuning of inner ear.
• Eye Contact: Reduces stress response 1. Make sure type of eye
contact with in cultural norms, 2. Follow patient’s lead (trauma).
• Heart Face Connection: Core social engagement system. Seen in
contact between mother and child. Can be evoked through face to
face caring contact.
• Environment Matters: Small amounts of physical beauty impacts
stress.

28. Cognitive Behavioral – Triad
Thoughts, Feelings and Behaviors.
Thoughts
Cognitions, Ideas,
Beliefs, Values
Feelings, Emotions
(Happy, Sad, Fear, Anger,
Disgust, Surprise)
Behaviors
Actions or anything observable
from
the outside

29. Development of Emotional Regulation
Overview: The rupture repair cycle is one of the key tools
that grows emotional regulation. It also grows the
emotional regulation centers in the brain.
If there are small ruptures in the relationship that are
followed by repairs the relationship gets stronger.
If there are difficult emotions followed by positive
emotions and social engagement the ability to regulate
the emotions get stronger.

30. Development of Emotional Regulation
Validation – Validation is giving some one the experience of being
understood. Listening to some one and appreciating their emotions as
real is one of the key tools for validation. Validation is not agreeing!
Decoding – This is a three step process.
1. The first is noticing the other’s reaction.
2. The second is making a guess about what the reaction is to the
person.
3. The third gives the teen a chance to agree or disagree with your
interpretation.

31. Development of Emotional Regulation
Modeling acceptance – Difficult things happen to all
of us. At times it is important to be able to model the
ability to accept situations.
Resourcing – Helping the teen find a positive coping
skill, personal strength or identify something that
makes them feel good.

32. Balance of Love and Respect
For all of us we need to balance these factors. For teens it is
very important.
Their life stage is asking them to be independent. This means
they will push against authority figures.
They need to learn both from authority that this is simply time to
respect the adults and that adults care.
One of the most important lesson for teens to understand is to
connect love and caring with discipline. For this to be the case
discipline must happen in a context of respect and support.

33. Threat and Arousal in
Class Room Management
When a child becomes too angry the front brain shuts
down.
Their limbic system (mammal and lizard brain) kicks in.
The child or teen does not see the person but sees
people as a threat.
Teens are more susceptible to this then adults. When
adults see a face that is angry they use their front brain to
interoperate the emotions when teens do the same thing
they use the amygdale (fight-flight center).

34. Threat and Arousal in
Class Room Management
There is a fast acting circuit in the brain that
communicates threat. There is a slow acting circuit
that appraises threat but uses the front brain.
There is a way to speak to the fast acting circuit that
makes it feel safe.
Learning these tools can make you extremely
effective at defusing difficult situations.

35. Threat and Arousal in Curriculum
Threat shuts down the front brain. Lowers Ach a neural
chemical associated with learning and concentration.
Hyperaroused teens also often have significant numbers
of negative thoughts that distract them from focusing.
Curriculum can trigger threat itself. Learning is difficult. In
order to be able to learn one must be able to tolerate the
negative feelings and thoughts one has during the
learning process.

36. Threat and Arousal in Curriculum
Movies manage our threat arousal cycle very well. They scare us
and then make it ok. They use the “rupture repair cycle.” This is
important for children with PTSD as well as helping all kids learn.
Build learning around the four zones:
1. Safety Zone (easy work)
2. Stretch zone (slightly difficult work)
3. Growth Zone (difficult work)
4. Danger Zone (Overwhelm no learning possible)
If there has been too much stretch for too long it can be
overwhelming there needs to balance and a movement.

37. Threat and Arousal
in Student Behaviors
Recognizing threat is important.
Physical signs of fight/flight arousal:
Fidgeting, tense jaw, tight shoulders or fists, flush or
pale skin, pupils dilated, sweating, breathing
changes, defensive postures.
Vocal signs of fight/flight arousal:
Lack of musicality (vocal prosody), short clipped
sentences, angry tone or silence.

38. Key Points: Trauma in Teen Years
Teens with trauma often:
Display: Increased aggression, hyper-sexuality,
self-harm/suicide, drug and alcohol addiction,
drop out of school, pregnancy.
Feel: Fear, worry, sadness, feeling alone/isolated,
anger, feeling judged, low self-worth, and
mistrustful of others.

39. Key Points: Trauma in Teen Years
Externalizing: Impulsivity, These Children are often
referred to as having conduct problems, Display
antisocial behaviors, Disruptive behavior,
Hyperactivity, Aggressive behaviors, Delinquency.
Hyperactivation: The hyperactivated individual floods
with information from the body and has less capacity
to regulate the intense sensation.

40. Key Points: Trauma in Teen Years
Internalizing: Some teens implode and don’t explode. With-
drawing into their own world; Acting and feeling anxious; Being
inhibited in normal exploration; Feeling unsafe; Depressed
mood and behaviors. Negative Emotions and beliefs. Can
appear “over controlled.” These teens are highly shame
sensitive and they may never ask for help.
Hypoactivation: For the hypoarousal type, only a small amount
of interceptive cues get into the limbic cortex and are quickly
squelched by cortical structures, leaving the individual feeling
disconnected, emotionally flat, and dissociated.

41. Key Points: Trauma in Teen Years
Working with a Traumatized Teen:
The work can be frustrating. Before you confront regulate
yourself. Put on your own oxygen mask first.
Trauma triggers are classically conditioned. This means they’re
often not logical. The disproportionate nature of the traumatic
response to the event trigger in response can be highly
frustrating and confusing.
Building trust, tolerated acting out but supporting the teen to
make safe choices and their life.
Adults working with traumatized teenagers need to be very
aware of the subtle attachment behaviors that can alert the teen
at the adult they are with his safe.

42. Key Points: Trauma in Teen Years
Skills to teach:
Orienting: Is paying attention to the here and now through the
five senses.
Resourcing: Is accessing a previous memory or a current felt
experience of mastery, positive emotion, safety, or pleasurable
sensation.
Distress Tolerance: The ability to tolerate difficult emotions.
Breath: Breathing into your belly can be a powerful way to
stabilize your consciousness when you’re feeling of intense
emotion.

43. Key Points: Trauma in Teen Years
Skills to teach (cont.):
Self soothing: Soothing in the five senses, soothing with
thoughts, soothing with imagination.
Humor: Be irreverent, find humor in difficulty.
Half smile: Your face is wired to your emotions. You can change
your feelings by changing your face.
Naming a Pattern: Be clear describe with out judgment. Name
the outcome and see if the teen would prefer another outcome.

44. Key Points: Trauma in Teen Years
Skills to teach (cont.):
Decoding Thoughts and Feelings: Guess the feeling,
express non-judgmentally and check with the child to see
if you are right.
Teflon mind: Is a practice of letting emotions and events
roll off your back.
Mindfulness: Being aware of this current context builds
the ability to see through the trauma.

45. Key Points: Trauma in Teen Years
The “Attitude”: creates safety and lays the ground work
for effective teaching. Five parts: Calm, Firm, Accepting,
Empathic, Playful and Curious.
Building Emotion Regulation: Rupture repair cycle (Good,
Tuff, Good – Sandwich).
Five skills to build Emotion Regulation: Validation,
Decoding, Modeling Acceptance, Resourcing, “The
Attitude.”

46. Key Points: Trauma in Teen Years
Threat in Curriculum: Learning can trigger threat itself. Learning is
difficult. Threat shuts down the front brain making learning even more
difficult.
Choose your zone (Safety, Stretch, Growth and Danger) and watch the
physical signs of “stress.”
Threat in Classroom Management When a child becomes too angry the
front brain shuts down.
Their limbic system (mammal and lizard brain) kicks in. The child or
teen does not see the person but sees people as a threat.
There is a way to speak the language of the limbic system to help a
teen move from threat to safety.

47. Key Points: Trauma in Teen Years
Creating Social Bonds: Social bonds increase the impact of the
educational relationship. Five behaviors: Your body talks, High
Vocal Prosody, Eye Contact, (make sure type of eye contact
with in cultural norms), Heart Face Connection, Environment
Matters.
School attachment predicts educational success. You
are the key to school attachment!
Remember to balance love and respect both are
needed to help teens with trauma.