TRAUMA INFORMED CARE IN ACADEMIA DR. NINA BEAMAN

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1 TRAUMA INFORMED CARE IN ACADEMIA DR. NINA BEAMAN

2 DISCLOSURES No conflict of interest has been identified

3 INTRODUCTION TO THE SPEAKER Dean of Nursing at Aspen University Forensic Nurse Dedicated to reducing violence in the community

4 OBJECTIVES Describe the ACE study findings, the impact of trauma in childhood on health and behavior, and the SAMHSA initiatives to encourage trauma informed care. Identify ways to use these research findings to improve education of previously traumatized students and move students and educators beyond the past to a meaningful future.

5 GOAL FOR TODAY Impress upon you YOUR role in reducing community violence and thus improving the health of children and the adults they will become, therefore improving the community

6 ADVERSE CHILDHOOD EXPERIENCES STUDY Kaiser and CDC did a study of over 17,500 beneficiaries Found a great deal of adverse childhood events Especially damaging during nonverbal years

7 REALITY ACCORDING TO BESSEL VAN DER KOLK 1 in 5 Americans were sexually molested as a child 1 in 4 were beaten by a parent to the point of a mark being left on their body ¼ of us grew up with alcoholic relatives 1/8 witnessed their mother being beaten or hit. 1 in 3 couples engages in physical violence

8 WHAT DO YOU THINK WOULD BE THE LONG TERM EFFECTS OF EXPOSURE TO THESE ISSUES? 1. Swearing, humiliation, insulting 2. push, grab, slap, throw something at you 3. touch, fondle, etc. sexually 4. feel no one in your family loved you or thought you were important or special 5. Did not have enough to eat, did not feel protected, parents too drunk or high to care for you 6. separated or divorced 7. was mother or stepmother pushed, grabbed, slapped, had something thrown at her... Etc. Threatened with gun or knife 8. Live with a problem drinker, alcoholic, or someone who used street drugs 9. Household member depressed or mentally ill, or attempt suicide 10. household member go to prison.

9 WAS THIS WHAT YOU EXPECTED? (VAN DER KOLK, 2014) Psychological Suicides Substance Abuse Depression Emotional and financial cost to individual, family, friends, and society Physical Respiratory Cardiac Neurological Endocrine Immune Emotional and financial cost to individual, family, friends, and society

10 RESILIENCE BOUNCING BACK OR FORWARD? Resilience some became Healthcare workers Comedians Activists Teachers Coaches Some are not Drug addicted, including opiates to numb Inability to express what happened to them Mentally ill Physically ill

11 LEFT OR RIGHT? Emotions and trauma are right brain Words are left brain So sometimes we have no words for the emotions we are feeling. We are do not think with our emotions we are emotional beings who sometimes think

13 WHY DO WE EXPOSE OUR CHILDREN TO VACCINES DURING CHILDHOOD?

14 THE OTHER SYSTEMS ARE BUILDING BASED ON EXPOSURE TOO!

s functioning and mental, physical, social, emotional, or spiritual well-being. Ask what happened to you?

15 SAMHSA Trauma is an event, series of events or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual s functioning and mental, physical, social, emotional, or spiritual well-being. Ask what happened to you? rather than what is wrong with you? Symptoms may be adaptations to traumatic events Healing happens in relationships

16 FIGHT FLIGHT FREEZE RATIONAL RIDER SEIZED BY UNRULY HORSE (VAN DER KOLK, 2014) Fight/Flight-Limbic PTSD Fragmented memories flashbacks Not a narrative therefore any piece can cause a flashback Brain rewires to be hypervigilant and anxious Groups can be helpful but also creates a we vs. them feeling and shame. Choose to blank out reptilian Emotional Numbing Fibromyalgia Tend to not be present, may not feel senses fully Crave affection from people that they think will harm them do not like touch Talk therapy useless brain not active

17 WHAT HAPPENS WITH HIGH ACE SCORE? 242% MORE LIKELY TO SMOKE 222% MORE LIKELY TO BECOME OBESE 357% MORE LIKELY TO EXPERIENCE DEPRESSION 443% MORE LIKELY TO USE ILLICIT DRUGS 1133% MORE LIKELY TO USE INJECTED DRUGS 298% MORE LIKELY TO CONTRACT AN STD 1525% MORE LIKELY TO ATTEMPT SUICIDE 555% MORE LIKELY TO DEVELOP ALCOHOLISM (CDC, n.d.)

18 BE CAUTIOUS OF TRIGGERS Many current problems may be related to traumatic life events and often very sensitive to reminders of the original event These reminders or triggers may cause a person to relive the trauma Trauma survivors access to services may be impacted by their trauma experience

19 UNIVERSAL PRECAUTIONS Assume everyone has previous trauma Safe, calm and secure environment Cultural competence and humility Consumer voice, choice, and self-advocacy Recovery, consumer-driven and trauma specific services Healing, hopeful, homes and trusting relationships Realize that obesity (fat protects against advances) and drug abuse (do not feel pain) may be linked to trauma

20 WISDOM Yelling at someone who is out of control can only lead to further dysregulation. Van der Kolk

21 BE CAREFUL ABOUT LANGUAGE

22 GOALS OF RECOVERY Establish Establish executive control of the mind Learn Learn from the past, and do not repeat it Move Move from aggressive action (Western) to calming action (Eastern) towards those who are dysregulated so they can do so as well Be Be mindful in the present Establish Establish helpful relationships Synchronize Synchronize with the rhythms of healing (previous quote) Experience Safely experience sensations (TMS vs. ECT)

23 SOLUTIONS (VAN DER KOLK, 2014) Mindfulness be in the present Befriend your body Move beyond past Action otherwise like feeling pain in surgery and cannot act on it EMDR (eye movement desensitization and reprocessing), hypnosis, Transcranial Magnetic Stimulation, acupressure and acupuncture, yoga and meditation Art, drama, music, etc. Ecstacy (MDMA) and psychotropic is not a good choice, learn to fully feel instead,

24 THAT IS WHAT HEALTHCARE IS DOING WHAT CAN YOU DO?

25 J. D. VANCE IN HILLBILLY ELEGY (ABOUT HIS LIFE GROWING UP IN APPALACHIA) Significant stress in early childhood.. Results in a hyperresponsive or chronically activated physiological stress response. Relationship instability like home chaos, is a vicious cycle. There is room for both anger at Mom for the life she chooses and sympathy for the childhood she didn t.

26 HOW DOES THIS PLAY OUT ACADEMICALLY They see themselves as losers They see us as uncaring They see struggle as personal weakness They use family as an excuse for not pursuing goals

27 WHAT IS OUR ROLE? Facilitate learning be approachable (create a safe space), read submissions carefully, offer suggestions for improvement kindly Make expectations clear Do not allow extensions for poor time management. The conversation should be centered around quality of work, not rules (QSEN) Teach, don t audit peers to do so, is incivil. Set your standard. Not to discuss other courses with your students. Would you enforce policies from a previous unit? Maintain your rigor, ethically. If someone told you to do something against your ethics, would you? Give quality feedback it shows you care and demonstrates that their work has value

28 HOW DO WE HELP THEM BECOME RESILIENT? Build relationships Therapeutic milieu with boundaries safe zone Motivational interviewing they own the problem, but you are there to help

29 APPLICATION TO EDUCATION How can we synthesize TIC into classes? How can we synthesize TIC into simulations? How can we synthesize TIC into clinical experiences? How can we synthesize TIC into our dealings with students?

30 LET ME KNOW HOW I CAN HELP--CONTACT ME Dr. Nina Beaman ninarn@yahoo.com Nina.Beaman@aspen.edu

31 BIBLIOGRAPHY Adverse childhood experiences Retrieved from Center for Disease Control and Prevention. (n.d.). Adverse childhood experiences. Retrieved from SAMHSA. Trauma informed care. Retrieved from Van der Kolk, B. (2014). The body keeps score. New York: Penguin. Vance, J. D. (2016). Hillbilly elegy. New York: HarperCollins.

Understanding and addressing trauma in the lives of those we serve..

Understanding and addressing trauma in the lives of those we serve.. Presented By: Joan Gillece, Ph.D. SAMHSA Promoting Alternatives to Seclusion and Restraint through Trauma-Informed Practices Important