Developing Trauma-Informed Systems for Family & Community Resilience. 90by30 Institute March 12, Elaine Walters

Transcription

1 Developing Trauma-Informed Systems for Family & Community Resilience 90by30 Institute March 12, 2016 Elaine Walters

2 Our Vision A community where any person or group impacted by violence, abuse or other trauma is supported to fully recover and heal. Promoting individual and community health & social justice through education, action research, and direct support for healing.

3 3 What do trauma-informed care and trauma healing have to do building resilience and ending child abuse? Everything.

4 But First Let s focus on connection. When we feel connected emotionally and physiologically to those around us, we can more easily: Stay present and grounded Listen Learn Integrate and apply what we learn So, please find a partner. 4

5 In pairs Decide who will listen and who will talk first. Listener stays curious and open. Briefly share: Your name A little something about a child in your (personal or professional) life who looks up to you or who depends on you. When I call time or you hear the beeper, switch. 5

6 Now Let s address discouragement. What s the problem? Discouragement impairs our ability to take action, and causes us to see things as too big or our ideas and efforts as too small or insignificant. Sound familiar? That s because it comes from our childhoods (with lots of reinforcement throughout our lives). Luckily, we can counteract it ~ with practice. 6

7 In a new pair Again decide who will go first, etc. Same guidelines as before Then share: Your name Something you noticed (heard, read, witnessed) recently that gave you hope about humanity. 7

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9 9 Now that you are all feeling (at least a little more) connected and hopeful, let s talk about traumainformed care and trauma healing and how they support the development of individual, family and community resilience and our work to end child abuse.

10 The Trauma Framework* Explains the intersections and connects us to each other Requires a shift in perspective from what s wrong to what happened Allows us to move away from an illness/deficit models towards an understanding and (potentially) a better way of tending to the injuries caused by violence and abuse Demands our own healing if we want change

11 How We Get Hurt Abuse: intentional / patterned Accident: things happen In Proximity: impacted by others hurts Oppression: institutional, systematic mistreatment of one group by another ~ The fundamental injury is disconnection.

12 A Working Definition of Trauma * Trauma is not a disorder but a reaction to a kind of wound. It is a reaction to profoundly injurious events and situations in the real world and, indeed, to a world in which people are routinely wounded. Trauma is a concrete physical, cognitive, affective, and spiritual response by individuals and communities to events and situations that are objectively traumatizing. On a simple level, for the most part, people feel traumatized or wounded because they have been wounded. ~ Bonnie Burstow

13 Trauma Specific vs Trauma Informed Trauma Specific Services Alleviate, reduce or prevent the negative effects of trauma on individuals, families or communities. Trauma Informed Care Thoroughly incorporates, in all aspects of service delivery, an understanding of the prevalence and impact of trauma and the complex paths to healing and recovery. Trauma-informed services are designed specifically to reduce stress and to avoid retraumatizing clients/patients and staff.

14 What it Doesn t Mean It doesn t mean excusing or permitting/justifying unacceptable behavior. Supports accountability, responsibility It doesn t mean just being nicer Compassionate care vs TIC Compassionate yes, but not a bit mushy It doesn t focus on the negative Skill-building, empowerment Recognizing strengths

15 Why Now Is it a Fad? Developmental neuroscience, interpersonal neurobiology. Enormous advances in neurobiology in the last two decades, brain imaging. Adverse Childhood Experiences Study (Kaiser & CDC) Link with mental, behavioral and physical outcomes. Compelling Evidence for Public Health perspective

16 Why It s Important Trauma is pervasive Trauma s impact is broad, diverse and often life-shaping Professionals & community members can provide care and attention that prevent further traumatization and that support and promote healing.

17 Adverse Childhood Experiences (ACE) Study - 17,421 adults in San Diego, California Adverse events: Physical abuse (28.3%) Emotional abuse (10.6%) Sexual abuse (20.7%) Emotional neglect (14.8%) Physical neglect (9.9%) Growing up in a household with: Household substance abuse (26.9%) Incarcerated family member (4.7%) Household mental illness/emotional distress (19.4%) Domestic violence (12.7%) Parental separation or divorce (23.3%)

18 Lane County Prevalence Total number of ACES % BRFSS respondents* Estimated prevalence of Lane County Residents One ACE 23.0% 81,286 Two ACEs 12.8% 45,237 Three ACEs 9.8% 34,635 Four ACEs 7.4% 26,153 Five or more ACEs 9.2% 32,514 *Extrapolated from Oregon Behavioral Risk Factor Surveillance System (BRFSS) by the Oregon Health Authority using statewide population numbers.

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20 The Cumulative Impact ACE study (scores 0-10) Score of 4 or more: Twice as likely to smoke 12 times as likely to have attempted suicide. Twice as likely to be alcoholic. 10 times as likely to have injected street drugs. Score highly correlated with: Prostitution, mental health disorders, substance abuse, early criminal behavior. Physical health problems, early death.

21 Are you still affected by the trauma you experienced? 60.4%/65% said yes.

22 How are you still affected? I still ache for the life I feel like could have been, and for the things that I still want to do, but I just know that it s I guess my soul has a limp. Hyper-vigilance, paranoia, triggered by any form of sexuality, many triggers in everyday life, delusions. I don't feel like I can trust people, abandonment issues. I grew up, you know, not thinking very good about myself. I mean it took me fifty some odd years, or whatever to realize how bloody intelligent and capable I am. And that s really sad. I still have nightmares sometimes, I can hear certain names and it affects me. I get traumatized by the word or the names, certain times noises can bother me because I had a lot of loud noises in my face. It shapes how you view the universe and how you treat others.

23 Trauma occurs in layers, with each layer affecting every other layer. Current trauma is one layer. Former traumas in one s life are more fundamental layers. Underlying one s own individual trauma history is one s group identity or identities and the historical trauma with which they are associated. Bonnie Burstow

24 Complex Trauma* Result of traumatic experiences that are interpersonal, intentional, prolonged and repeated. Often leads to immediate and long-term difficulties in many areas of functioning.

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26 Survival Response Can Become Patterned and Rigid (For Individuals & Communities) Denial or lack of memory Avoidance Altered belief systems Addiction/compulsion Depression/numbness Violence/aggression Risk taking Self-Abuse

27 However, there is an opportunity We learn and grow through engagement with survivors who have important insights and wisdom to share. Incorporating knowledge about healing and recovery improves outcomes and infuses hope in our lives and work. It can help mitigate and reduce intergenerational transmission and impacts of trauma. Trauma-informed people and systems are healthier and better for everyone.

28 The disease-oriented view of trauma is negative and misleading. It ignores the innate resiliency of the human organism to rebound and heal in the aftermath of overwhelming life events. It fails to recognize our capacity as human beings to support and empower each other in the process of transforming trauma. ~ Peter Levine, from In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness

29 A person, organization or system that is trauma-informed: Realizes the widespread impact of trauma and understands potential paths for recovery Recognizes the signs and symptoms of trauma in those around them Responds by fully integrating that knowledge, and Seeks to actively resist re-traumatization. ~ SAMHSA

30 In practice, this means: We recognize that traumatic experiences terrify, overwhelm, and violate the individual. We have a commitment not to repeat these experiences and, in whatever way possible, to restore a sense of safety, power, and worth.

31 What is required to Provide TIC? Secure, healthy adults; Good emotional management skills; Intellectual and emotional intelligence; Able to actively teach and be role model; Consistently empathetic and patient; Able to endure intense emotional labor; Self-disciplined, self-controlled, and never likely to abuse power. See

32 The Reality We regularly experience toxic stress. We absorb the trauma of those around us. We have our own unresolved histories. We live in an oppressive society. All of this has an impact As individuals and families we may have similar struggles to those faced by the people we would like to help.

33 The Beauty Recognizing there is no them separate from us gives us more motivation and leverage. Our own experiences with adversity and healing can provide a road map for action and change. Our capacity to heal = resilience. All! Protective Factors Healing Capacity

34 Emotional Healing as a Path Towards Resilience: A few assumptions We are built to heal Healing happens in relationships We can facilitate and accelerate healing

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36 Understanding & Practicing Healing Listening - being listened to (witnessed) moving - physically and emotionally emotional expression integration/reframing/meaning making

37 Our Role Enlightened Witness Partner vs. Expert Capacity to be Vulnerable & to be with Pain Takes Self-Reflection & Our Own Healing Takes Practice New/Different Focus & Skills Attending to Power/Situational Dynamics Deep Listening Working Early Staying or Getting Close/Sticking Together

38 The Hope! When survivors said they had been listened to with compassion they were 2.9 times more likely to report being mostly or completely healed. When survivors believed that people understood the impact of trauma on their lives they were 2.2 times more likely to report being mostly or completely healed. When survivors believed that people knew how to help them heal they were 2.3 times more likely to report being mostly or completely healed.

39 Thank you! For being here today and for taking care of yourselves and each other. Elaine Walters The Trauma Healing Project