Trauma & Vicarious Trauma, Part I ~~~~~ Presented by: Connie Ostis

Transcription

1 Trauma & Vicarious Trauma, Part I ~~~~~ Presented by: Connie Ostis

2 1. Create environment of safety and trust 2. Listen to remembrance of traumatic event 3. Mourning/acceptance 4. Integration/recovery Goals for the long run, in recovery: 1. Authority over the remembering process 2. Integration of memory and feelings 3. Affect tolerance (safely able to handle one s feelings) 4. Symptom mastery 5. Self esteem 6. Ability to engage in safe relationships 7. Making meaning out of the traumatic experiences M. Harvey, Impacted versus Traumatized or t vs T Depends on the individual not on the event Relationship with offender Resilience Coping skills/strengths Support from significant other SWO 384 & Empowerment Practices with Victims and Survivors, July

3 Symptoms of PTSD Ruminating thoughts Flashbacks Nightmares Heightened arousal Physiological impact (headaches, stomache aches, etc) Disruption in daily funtioning Potential Effect of Sexual Abuse on Children Sexuality Emotional/Mental Health Relationships Sexual abuse in the family Daily Functioning Sense of self/identity (c) 1999 Ostis SAFER/Connections Session 9 Thoughts, Feelings, Behaviors and Memories (c) 1999 Ostis SAFE R Connections Session 16 rev June 2008 SWO 384 & Empowerment Practices with Victims and Survivors, July

4 Memories are Held in Many Ways Skin memories Feeling memories Verbal memories Visual memories Family reactions Sexual responses Sexual thoughts or fantasies Feeling responsible: for telling or for not telling Angry feelings toward other parent for not protecting. Faulty feelings of guilt for: letting it happen, attracting the abuser, causing it to happen. (c) 1999 Ostis SAFE R Connections Session 16 rev June 2008 Why did he/she do it?: It s a puzzle (C) 1999 Ostis SAFE R/Connections Grouprev2008 Cognitive Trauma Treatment Identify and restructure negative beliefs that allow PTSD symptoms to persist Psychoeducation Narrative therapy Deconstructing Reconstructing Exposure EMDR DBT SWO 384 & Empowerment Practices with Victims and Survivors, July

5 Various Ways Abusers Engage their victims Specialness, loving kindness Grooming Thinking errors: to justify, persuade Favors/privileges Threats: to child, pets, or non abusing parents; suicide Force: physical and/or psychological (C) 1999 Ostis SAFE R/Connections Group Sess 6, rev2008 Definition of Thinking Errors Thinking errors (TE), also known as cognitive distortions, are thoughts twisted around the facts, for the purpose of avoiding responsibility or changing (distorting) the truth! (c) 1999 Ostis SAFE R/Connections Session 7 rev Jun08 Grooming in Child Sexual Abuse A gradual process of: gaining the child s trust and/or affection at the same time gradually increasing sexual stimulation, either visual or physical. A confusing, secret way of relating to the child so that: the child is not quite aware of what is happening, but the child knows to keep it secret. The abuser increases the level of touching or other stimulation as the child becomes more trusting. The abuser uses/teaches distorted thinking. (C) 1999 Ostis SAFE R/Connections Group Sess 6, rev2008 4

6 Some TE Child Sexual Abusers Use During Grooming This is part of our special relationship. No one else loves me like you do. It s our secret. All special relationships have special secrets. If your mother was good to me I wouldn t need to come to you like this. We must keep this secret. Mom won t understand. You know how she is. In other cultures brothers and sisters have sex it s how they learn! I m glad you really like doing this with me. It shows you care. If you don t keep this secret, our family will break up. I ll go to jail or you ll have to leave home or Mom and Dad will get a divorce. If you tell, Dad will be so angry at you. You will be in big trouble. If you tell, I ll say you re lying. They ll believe me over you any day. If you tell, I ll beat you up or kill you kill your pet kill myself. (C) 1999 Ostis SAFE R/Connections Group Sess 6, rev2008 TE Used by Some Abusers after Disclosure It was an accident. My hand fell there while watching TV. I was only trying to show affection. It only happened because I was drinking. It was only because my partner wasn t giving me any sex. I was just teaching him about his body and sex. She misunderstood I ll talk with her. We were just wrestling like all families do! But he likes to be tickled I ll be more careful next time. It s her fault. Look how she dresses. She s asking for it. He s lying just like he lies about everything. What are you accusing me of? You have a sick mind to think like that!! It wasn t all my fault. She came to me first. She likes it. (c) 1999 Ostis SAFE R/Connections Session 7 rev Jun08 It s like learning how a magician separates the brass rings it s no longer magic it no longer tricks us!! (C) 1999 Ostis SAFE R/Connections Group Sess 6, rev2008 5

7 Trauma and Vicarious Traum Part I Connie Ostis 2015 A Trauma Framework For Understanding Our Clients and Ourselves From Sidran Trauma Training Risking Connections, Trauma research, Education, and Training Institute, Inc. (TREATI), 22 Morgan Farms Drive, South Windsor CT ] The Trauma Cycle: Biology of Trauma and Memory Definition of psychological trauma: The unique individual experience of an event or enduring conditions, in which: o the individual s ability to integrate their emotional experience is overwhelmed; or, o the individual experiences a threat to life, bodily integrity, or psychic existence. The trauma cycle has a compulsive quality, driven by neurotransmitters. The brain can get stuck in a cycle of reactivity. Triggered by new stimuli Traumatic re experiencing: Psychic numbing Avoidance Amnesia Anhedonia (loss ability to enjoy pleasure) Flashbacks Nightmares Ruminating thoughts Hyperactivity: Excessive neurepinephrine increases heart rate and intensity of dreams; low levels of serotonin. Intense hyperarounsal: Epinephrine is released in fight or flight response Brain is overwhelmed by stimuli, can t produce enough serotonin to manage feelings. SWO 384 & Empowerment Practices with Victims and Survivors, June/July

8 The Effects of Traumatic Abuse: 6 Aspects of the Self Survivors of childhood sexual abuse have experienced both: the overwhelming arousal of abuse which can produce a state of hyperarousal the absence of adequate soothing and comforting which can produce a lack of skills in self soothing ( survivors may turn to substance abuse to block out feelings) 1. Feelings Managing feelings Connecting to others Feeling good about oneself 2. Judgment Ability to make good judgments, good choices, to perceive risk/danger 3. Beliefs about oneself and one s world: Safety in the world Trust of self and others Intimacy and connection to others Control: am I able to control my life, be effective 4. Frame of reference: how one interprets and sees self in relation to the world Identity : who am I? World view: is the world safe or unsafe? Spirituality: what do I believe? Is there hope or meaning in life? 5. Memory and perception: trauma disturbs how one perceives experiences: Narrative: the story of what happened is it clear? Visual images or pictures in the mind Sensory/somatic: sensations about what happened Affect: do emotions match what happened? Dissociation: memories are encoded in fragments, may appear as confusion, flashbacks, disconnected aspects of memory Dissociation is not complete: breakthroughs cause distress. 6. Body and Brain: how the person relates to and feels about his/her body and gender Can confuse sexuality when trauma is related to childhood sexual abuse Shame about bodily sensations and/or responses Can be preoccupation and/or somatization of stress SWO 384 & Empowerment Practices with Victims and Survivors, June/July

9 How Our Work Changes Us Indirect or Vicarious Trauma (VT) Experienced by Social Worker/other helpers when the [helper] is impacted by exposure to the client s trauma history and trauma effects, with [helper] developing psychological trauma effects as a result of this exposure. From McCann, I. L. & Pearlman, L.A. (1990) Vicarious traumatization: A contextual model for understanding the effects of traum on helpers. Journal of Traumatic Stress, 3(1), Helper can be affected in one s own self capacities: 1. Feelings 2. Judgment 3. Beliefs 4. Frame of reference 5. Memory and Perceptions 6. Body and Brain Problems in managing feelings may show up in: A sense of internal disconnection from those you love Disconnection from feelings of fundamental self worth. Lack of pleasure in life and in relationships Abuse of substances RISKING CONNECTION: The therapeutic alliance is the basic foundation of all our work, especially with trauma survivors. It contradicts survivors basic negative assumptions about relationships. It provides a secure base which helps to heal attachment wounds. It decreases survivors sense of isolation. SWO 384 & Empowerment Practices with Victims and Survivors, June/July