WORKING WITH CAMPUS SEXUAL ASSAULT SURVIVORS:

Transcription

1 WORKING WITH CAMPUS SEXUAL ASSAULT SURVIVORS: Understanding the Neurobiology of Trauma Rebecca Campbell, Ph.D. Professor of Psychology Michigan State University

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4 Colleges & Universi.es Have A Legal Obliga.on To Protect And Help Their Students

5 BUT... Colleges & Universi.es May Not Have the Knowledge, Skills, & Tools to Respond Effec.vely to Survivors

6 Today s Presentation Describe how the brain & body react to trauma Describe how the brain & body react to SEXUAL ASSAULT Discuss implications & take home lessons

7 Today s Presentation Describe how the brain & body react to trauma Describe how the brain & body react to SEXUAL ASSAULT Discuss implications & take home lessons THE SCIENCE BEHIND TRAUMA BETTER INFORMED BETTER RESPONSE

8 < Intro to the Neurobiology of Trauma

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10 Cerebrum

11 Cerebrum

12 Cross Section Top to Bottom

13 Four Main Structures Impacted by Trauma

14 Our Story Begins Here One inch, almond-shaped

15 Two Key Functions PROCESSES EMOTIONAL REACTIONS PROCESSES MEMORIES

16 Two Key Functions PROCESSES EMOTIONAL REACTIONS PROCESSES MEMORIES THREATS TO THE SURVIVAL OF THE ORGANISM SOURCE: Roozendaal et al., 2009

17 Two Key Functions PROCESSES EMOTIONAL REACTIONS

18 Emotional Processing of Trauma HPA Axis Amygdala Hypothalamus Balances body following stress by releasing of various hormones/chemicals Pituitary Gland Adrenal Glands Kidneys SOURCE: Baldwin, 2013; Southwick et al., 2005; Woods et al., 2005

19 Emotional Processing of Trauma Catecholamines: Fight or flight response Amygdala Hypothalamus Cortisol: Energy available Opioids: Prevent pain Oxytocin: Promotes good feelings Pituitary Gland Adrenal Glands Kidneys SOURCE: Bracha, 2004; Southwick et al., 2005; Zoladz, 2014

20 Two Key Functions PROCESSES MEMORIES

21 How Memory Usually Works

22 How Memory Usually Works

23 How Memory Usually Works

24 How Memory Usually Works

25 BUT... Trauma Hormones Mess This Up

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27 The Neurobiology of Sexual Assault

28 What Happens During A Sexual Assault

29 What Happens During A Sexual Assault Amygdala Detects Threat Ac.vates Hypothalamus HPA Axis Kicks In Hormonal Flood SOURCE: Banks, 2002; Southwick et al., 2005; Woods et al., 2005

30 What Happens During A Sexual Assault Amygdala Detects Threat Ac.vates Hypothalamus HPA Axis Kicks In Hormonal Flood Impaired Ra.onal Thought Hyper/Jangled Flat Affect/No Emo.on Laughing/Joking SOURCE: Banks, 2002; Southwick et al., 2005; Woods et al., 2005

31 What Happens During A Sexual Assault Amygdala Detects Threat Ac.vates Hypothalamus HPA Axis Kicks In Hormonal Flood Can Trigger a Complete Shut Down in the Body SOURCE: Banks, 2002; Bracha, 2004; Southwick et al., 2005

32 Tonic Immobility (TI) n AKA: Rape-induced paralysis n Autonomic (uncontrollable) mammalian response in extremely fearful situations n Increased breathing, eye closure, paralysis n 12-50% rape victims experience tonic immobility SOURCE: Fuse et al., 2007; Heidt et al., 2005; Hagenaars et al. 2012; Marx et al., 2008

33 I was terrified. I couldn t do anything and I didn t know why. I didn t want to tell no one because what would I be able to say... No, I didn t fight back. No, I didn t yell for help. I just laid there. Wondering if I was going to die.

34 She just laid there, so she must have wanted it... So yeah, I closed it [the case]. Marked as unfounded. Nothing could be done. Law Enforcement Officer Who Took Her Report

35 What Happens During A Sexual Assault

36 What Happens During A Sexual Assault Increased Stress Hormones Impaired Func.oning in Hippocampus Memories Fragmented Memory Recall Can Be Slow & Difficult SOURCE: Koss et al., 1995, 1996; Roozendaal et al., 2009; Rubin et al., 2008

37 What Happens During A Sexual Assault Increased Stress Hormones Impaired Func.oning in Hippocampus Memories Fragmented Memory Recall Can Be Slow & Difficult Events of the Assault CAN Be Recalled Accurately SOURCE: Koss et al., 1995, 1996; Roozendaal et al., 2009; Rubin et al., 2008

38 He wouldn t let up, pounding me with question after question after question. Trying to trick me, trying to get me to mess up. I wanted to say, hold on, give me a minute to think. No, he kept coming at me.

39 It was classic good- cop / bad- cop. He stormed off and another detec.ve sat down next to me. He offered me a cup of coffee. Coffee? OK fine. How do I take it? WHAT? Why does he care how I take my coffee? Well, he did. He made me coffee. He gave me.me to just sit, collect my thoughts.

40 We talked it through. And I didn t feel ra]led and freaked out. I m sure I was incoherent and he just let it roll. He was pa.ent. I felt like I was piecing it together, like a puzzle, we were pu_ng together a puzzle. And drinking coffee.

41 I: So, why did you do that? (give her the coffee) R: It helps. Not the coffee so much, just the moment to let it all come together in their heads... Just let them talk I: What do you mean? R: I ve just noticed that over the years. If you give them a few minutes to breathe.... it starts to make more sense. I don t know why, it just does.

42 I: So, why did you do that? (give her the coffee) R: It helps. Not the coffee so much, just the moment to let it all come together in their heads... Just let them talk I: What do you mean? R: I ve just noticed that over the years. If you give them a few minutes to breathe.... it starts to make more sense. I don t know why, it just does. MEMORY FRAGMENTATION A DOCUMENTED NEUROBIOLOGICAL CONDITION

43 I: Were you worried that if you gave her some time, she d just make something up? R: Nah, not really. I mean, some victims lie, but most don t. Besides, if they re lying, we ll catch em at it eventually. I think it s just hard for victims to talk about and we just need to have a little patience.

44 I: Were you worried that if you gave her some time, she d just make something up? R: Nah, not really. I mean, some victims lie, but most don t. Besides, if they re lying, we ll catch em at it eventually. I think it s just hard for victims to talk about and we just need to have a little patience. MEMORY FRAGMENTATION A DOCUMENTED NEUROBIOLOGICAL CONDITION

45 Implications & Take Home Lessons

46 Take Home: Victims Emotions & Behaviors n HPA Axis activation elevated for 96 hours postassault (AND whenever memory is re-activated) Flat affect, strange emotions, emotional swings Irritable, argumentative, and difficulty concentrating Headaches, body pain, stomach/gi distress Increase alcohol & drug use (self medicating behaviors) SOURCE: McLean et al., 2012; Woods et al., 2005

47 Take Home: Victims Emotions & Behaviors n HPA Axis activation elevated for 96 hours postassault (AND whenever memory is re-activated) Flat affect, strange emotions, emotional swings Irritable, argumentative, and difficulty concentrating THERE ARE Headaches, body pain, stomach/gi distress NEUROBIOLOGICAL REASONS WHY VICTIMS Increase alcohol & drug use (self medicating behaviors) BEHAVE THE WAY THE DO THESE ARE SIGNS OF TRAUMA

48 Take Home: Victims Emotions & Behaviors n Provide caring emotional support à bring down the HPA n Provide informational support à give options & give victims time to make decisions n Connect victims to advocacy & support services à make specific referrals ( by name )

49 Take Home: Victims Memory n Trauma hormones created fragmented memories Story may come out fragmented or sketchy The content of the memory is accurate, just may take some time and patience for it to come together Misinterpreted as evasiveness or lying à police less likely to believe victims & less likely to investigate SOURCE: Campbell et al., 2015;; Roozendaal et al., 2009; Rubin et al., 2008; Shaw, 2014

50 So wait a minute. You mean what we re seeing isn t bullsh*t? I ve always believed it was bullsh*t... Well, how bout that. Real trauma looks like bullsh*t. Sex Crimes Unit Detective, 8 Years Experience

51 Take Home: Victims Memory n Don t make victims tell their stories over and over n Sleep helps memory consolidationà let them sleep! n Memory will come together over timeà patience n Use trauma-informed interviewing methods

52 Take Home: Victims Memory n Don t make victims tell their stories over and over n Sleep helps memory consolidationà let them sleep! n Memory will come together over timeà patience n Use trauma-informed interviewing methods ADDITIONAL TRAINING

53 Conclusions

54 Concluding Thoughts n Neurobiological reasons for victims behavior n New research findings can help improve investigations and victims health outcomes n We can USE these findings to create a VICTIM- CENTERED TRAUMA- INFORMED Campus Response to Sexual Assault

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56 Everything you say, everything you do is a chance to help me or hurt me. Make the choice to help. Please help me.

57 THANK YOU!! Questions & Discussion National Criminal Justice Reference Service YouTube Video of Training