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Trauma.2020
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- 2. A traumatic experienceinvolves an unexpected threat to one’s physical or emotional well-being that elicits intense feelings of helplessness, terror, and isolation.
- 3. Events Experience Effects TheThree E’s in Trauma
- 4. • Effects oftrauma include adverse physical, social, emotional, or spiritual consequences.
- 5. Potential Traumatic EVENTS Abuse Adverseevents of childhood Violence: Physical, Sexual, or Emotional Witnessing violence Bullying / Stalking / Cyber Loss Death Abandonment or Neglect War, Disaster, Terrorism Accidents Stressors Medical: Illness, hospitalizations Poverty or Homelessness Racism & Historical Trauma Family member with substance use disorder
- 6. How can thesame event be traumatic for one person and not for another?
- 7. Early occurrence Perpetrator is trusted caregiver Being silenced or notbelieved Blaming or shaming
- 8. The Brain’s Reactionsto Fear
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- 10. Trauma Capsules The freezeresponse stores data in an isolated trauma capsule • EXTERNAL – colors, shapes, sounds, tones, smells, words, tastes • INTERNAL -- emotional state, core belief (making sense of it) When cues from the present match the information in the time capsule or the system is shocked or stressed, it may begin to “leak”
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- 12. Flashbacks or frequentnightmares Sensitivity to noise or to being touched Always expecting something bad to happen Not remembering periods of your life Feeling emotionally numb Lack of concentration; irritability Excessive watchfulness, anxiety, anger, shame or sadness
- 13. Up to 65%of all clients in substance abuse treatment report childhood abuse (SAMHSA, 2013) Up to 90% of women in substance abuse treatment report trauma histories (SAMHSA, 2009)
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- 16. Must feel physically andpsychologically safe within their relationships
- 17. Mentoring relationships need tobe trustworthy and conducted with transparency—be who you say you are and do what you say you’ll do. Trust
- 18. Peer support andmutual self-help are key for establishing safety and hope, building trust, enhancing collaboration, modeling recovery and healing, and maximizing a sense of empowerment. Peer Support
- 19. One does nothave to be a therapist to be therapeutic Healing happens in relationships
- 21. Peers (and theCRP) actively move past cultural & gender stereotypes and biases--leveraging the healing value of unique connections. Cultural and Gender Issues
Editor's Notes
- #2 Many factors effect the recovery path –some are events or activities that occurred prior to or during one’s active addiction days, some pop up along the path of recovery, and some are just consequences of living as a human being and the realities of who we are as individuals. Whether pre or post recover, complicating issues may influence and or need attention during a person’s recovery path
- #3 The trauma has lasting adverse effects on the individual’s functioning and well-being including their “identify”
- #4 The event that occurred is critical because it places the cause of trauma in the environment, not as some defect of the individual. This is what underlies the basic credo of trauma-informed approaches: “It’s not what’s wrong with you, but what happened to you.” The experience of trauma helps delineate that there are multiple ways in which people can be impacted by the event of trauma. This highlights the fact that not every child or adult will experience the same events as traumatic. Effects of trauma include adverse physical, social, emotional, or spiritual consequences. The identification of a broad range of potential effects reminds us that our response must be holistic—it’s not enough to focus on symptoms or behaviors. Our goal is to help the person to learn effective responses in order to live a satisfying life. (Think MIND, BODY, SPIRIT)
- #6 There is a very wide range of events that can potentially cause trauma. Trauma can be caused by events that the individual doesn’t remember, such as events that occurred in early childhood. Lots of research recently on the impact of adverse events of childhood Trauma can be caused by those closest to us (catching us unaware and shocked) DV, IPV, Sexual molestation Emotional (like mystification or psychological entrapment) Most sexual abuse occurs to young women under the age of 24 Digital -- revenge porn Trauma can be caused by unexpected and unintended losses (individual -- illness, death accidents, societal – war, terrorism, disasters) Trauma can be caused by life circumstances (poverty, homelessness, family illness, substance disorders in family) Trauma can be caused by events that are well-intentioned and necessary, such as medical procedures. (Use Cody’s open heart surgery) Trauma can be caused by an event that didn’t happen to the person but to a group that he or she identifies closely with—as in slavery or the Holocaust or the genocide of the Native American people. Over time, chronic stressors can accumulate to cause trauma.
- #7 Ask readers to think about why some events may be traumatic for one person but not for another.
- #8 The younger the age when trauma occurs, the more likely the consequences. We will discuss why this is true—even when the individual has no memory of the trauma—when we briefly discuss how trauma affects the brain, or the neurobiology of trauma. Shame and humiliation are core features of the trauma experience for many people. These emotions can be devastating and impede healing. One of the most important messages you can give a trauma survivor is that no matter what happened, it wasn’t their fault in any way. Sometimes trauma survivors are intimidated by their perpetrators into not telling what happened. Other times, when they do try to talk about what happened to them, they are ignored or disbelieved. One of the most important things you can do for trauma survivors is to give them the chance to tell their stories. Healing starts when a person’s personal experience is heard and validated. The impact of trauma is magnified when the perpetrator is a trusted figure—a relative, religious leader, coach, teacher, or therapist. This kind of trauma is often called “betrayal trauma” because the sense of betrayal can be so profound.
- #9 The “fire alarm” of the brain is located in the amygdala. It sounds the alarm about a threat and activates the fear response. When we feel threatened, 1) the amygdala activates the sympathetic half of our autonomic nervous system 2) our body sends blood to the arms and legs (fight or flight) and away from lower priority systems (digestive, mental, immune) 3) The frontal lobes of the cortex – shut down to make sure the person is focusing completely on survival. That’s why it is so hard to think when you are in a crisis! The area of the brain responsible for speech, called “Broca’s area” shuts down (besides the amygdala developed pre language for our species). So when people talk about “speechless terror” or “being scared speechless” they are not being metaphorical, they are describing a real response of the brain. In our work ,we often approach people in distress, asking them to tell us what is wrong, to stop and think, or tell us how we can help. Access to the thinking resources of the brain may not be possible in these moments. This has important implications for how each of us responds to crisis situations or to people who are responding to the present through the lenses of their past. Remembering trauma can re-activate the original trauma response. From the brain’s perspective, it’s like the threat is actually happening again.
- #10 William Canon, in his 1932 book, The Wisdom of the Body, first identified the fight/flight response to situations that were perceived as threatening. – short-term, adaptive Successful discharge increases resiliency – but human’s have a hard time “shaking it off” – in fact, they often FREEZE Trauma often stays with the person longer when we are not able to complete our Fight or Flight response and our Freeze Response is triggered. Look at response to interpersonal violence (during & post) Women and children are biologically programmed to freeze (due to less ability to survive with fight or flight)
- #11 Trauma capsule Information is stored in the unconscious sometimes (dissociated from now) but still impacting mind, body, and spirit. It is often stored like procedural memories (riding a bike) and may break apart with new happenings, aging, or major changes in coping mechanisms (i.e., stopping medicating with substances or behavioral activities). Truama is different from stress – stress is situational and may not have the perceived threat. Trauma is internalized and stored
- #12 Traumatic events impact the psychological structure of the “self,” the function of one’s body, the ability to attach to others, and the meaning a person attributes to safety within their community 1) Psychological -- People are traumatized when they face life events where they are helpless to effect the event or it’s outcome. Typical Responses: chronic tension, confusion, isolation, & “learned helplessness.” Physical -- Talk about Peter Levine’s work here – shaking to release the cellular store up. creates “unfinished” body responses 3) Spiritual -- Extracts the joy and possibility from life experiences. Creates a splitting and numbness from self. Existential existence has cracks 4) Relational – May inhibit bonding and/or trust, ability to feel safe with another,
- #13 None of these signs is always associated with trauma. Each of these signs can be adaptations to the neurobiological changes that we discussed earlier. Each of these behaviors can in fact play an important role in the person’s life—they may protect the person or help them to survive. Just being aware that what we sometimes call “symptoms” may be adaptations to underlying trauma can change the way we view people.
- #15 Principles of Trauma-Informed Approaches Begin to see things through a “trauma lens” • Need for system approach • Feelings of disconnection from the college/university community can undermine success • Welcoming, supportive communities can help students overcome these feelings and diminish trauma response Colleges and universities are systems Everyone is interconnected and interdependent • What happened/happens to students can affect everyone • The background of faculty/staff can affect everyone they teach; the other faculty and staff and the university itself
- #16 SAMHSA’s principles for trauma-informed approaches emerged from a year-long process involving trauma survivors, family members, practitioners, researchers and policymakers. During a public comment period, thousands of individuals wrote in with feedback on the definitions and overall approach. The goal was to develop a common language and framework. As more agencies and organizations work to become trauma-informed—and as more and more claim to BE trauma-informed—there needs to be some standard way to define and assess consistency with the approach. The principles are value-based. Unlike “manualized” models for specific treatment interventions, these principles can be applied in a wide variety of settings, in many different ways, using whatever resources are available. Implementing a trauma-informed approach requires constant attention and caring; it’s not about learning a particular technique or checking things off a checklist. Think about something as basic as respect or compassion. Can you do it once, implement a policy, and then check it off as “done”? Trauma-informed approaches are about a way of being, not a specific set of actions or implementation steps. Becoming trauma informed requires a culture shift—becomes a way of being and knowing
- #17 About 10 years ago, Laura Prescott, a trauma survivor and advocate, went on the wards of a psychiatric hospital and asked both patients and staff what it was that made them feel safe. What she found was very interesting. Point for point, staff and patients defined safety in almost completely opposite terms. In fact, it turned out that the very things that staff were doing to make the ward safer were making the patients feel less safe. So what can you do in a situation like this? First, just recognizing that safety may look different depending on your role and situation—or your personal history—is an important first step. The best thing you can do is to ask each individual what makes them feel safe and unsafe. This may mean rethinking what mean by safety.
- #18 Instructor Guidance: Show video on Trustworthiness and Transparency featuring Pat Risser (https://vimeo.com/107478500) and discuss.
- #19 Instructor Guidance: Show video on Peer Support featuring Cicely Spencer https://vimeo.com/107478502 and discuss.
- #22 Instructor Guidance: Show video on Cultural, Historical, and Gender issues featuring William Kellibrew (https://vimeo.com/107488464) and discuss.