Families, Children, Attachment and Complex PTSD.

Size: px
Start display at page:

Download "Families, Children, Attachment and Complex PTSD."

Transcription

1 Families, Children, Attachment and Complex PTSD. Dr Felicity de Zulueta, Consultant Psychiatrist in Psychotherapy and Hon. Senior Lecturer at KCL Dr Walter Busuttil Consultant Psychiatrist and Director of Medical Services, Combat Stress

2 The legacy of war, terrorism and disasters Whereas loss, war, social dislocation and immigration are experiences most human beings seem able to overcome albeit painfully, some individuals develop Post Traumatic Stress Disorder (PTSD) as a result of the exposure to violence Grief due to loss, Depression and/or Anxietyare also common.

3 PTSD according to DSM-lV and ICD-10 For PTSD to be considered in DSM-lV: The person has been exposed to a traumatic event beyond the range of usual human experience in which both the following were present: The person experienced, witnessed or was confronted with event(s) that involved actual/threatened death or serious injury, or a threat to the physical integrity of self or others. (ICD-10: to cause distress to anyone) The person s response involved intense fear,helplessnessor horror. (Not in ICD-10)

4 Diagnostic Problems Most events qualifying for a diagnosis of PTSD are quite common and none are so powerful that exposure typically leads to PTSD (Kessler et al. 1999). Some people are more vulnerable than others ie people with psychological difficulties and previous mental illness. The most important risk factor is lack of social support(nice, 2005).

5 The case for PTSD as a Sensitisation disorder of the Attachment system Yehuda found that only victims of an RTA whose response led to a lower than normal release of cortisol, developed PTSD. She postulated that PTSD may reflect a biologic sensitisation disorder rather than a post traumatic stress disorder (1997). Wang attributes this sensitisation to changes in the attachment system ie suppression of cortisol levels observed by many in insecurely attached children (Wang, 1997).

6 Simple PTSD symptoms The persistent re-experiencing of the traumatic event: thro intrusive memories/images, nightmares, reenactment, intense distress and physiological reactivity. Persistent avoidance of reminders of the trauma, amnesia, detachment from others, reduced affect, sense of foreshortened future. Symptoms of increased anxiety and emotional arousal: sleep pbs, poor concentration, hypervigilance, exaggerated startle response and irritability. PTSD diagnosed if symptoms present for >1 month after event. Before, symptoms of Acute stress disorder.

7 Other common symptoms of PTSD Anger and irritability Guilt, shame or self blame. Substance abuse Feelings of mistrust and betrayal Depression and hopelessness Feeling alienated and alone Physical symptoms ie aches and pains eg: head aches.

8 Symptoms of PTSD in children and adolescents (1) Fear of being separated from the parents Losing previously acquired skills eg. Sleep problems and nightmares without a recognisable content Compulsive play in which aspects of the trauma are repeated.

9 Symptoms of PTSD in children and adolescents (2) Acting out the trauma through play and stories or drawings. New phobias and anxieties that seem unrelated to the trauma (ie fear of monsters). Aches and pains with no apparent cause. Irritability and aggression.

10 Complex PTSD in adults & Developmental Trauma in children DSM-lV acknowledges a constellation of symptoms usually seen in association with an interpersonal stressor: Childhood emotional, physical and sexual abuse and neglect, Domestic violence Incarceration as POW, concentration camp survivors Torture Hostage taking

11 Symptoms of Complex PTSD following prolonged childhood abuse (1) Impaired affect modulation Loss of a sense of a coherent self and Dissociative symptoms Self destructive/ impulsive behaviour often reenacting the trauma > re-traumatisation. Shame > ViolenceSomatic complaints Somatic complaints

12 Symptoms of complex PTSD -2 Feelings of helplessness, despair, Loss of previously held beliefs Loss of trust > Social withdrawal Impaired relationship with others Feeling constantly threatened > Social withdrawal Feeling permanently damaged> loss of self worth

13 Transmission of vulnerability to PTSD and the cycle of Violence Attachment research shows a 75% correspondence between a mother s attachment and that of her infant (Van Ijzendoorn et al. 1997). These findings show there is the potential for transmission of PTSD and trauma related violence in PTSD afflicted communities This underlies the importance of prevention and socially based treatment interventions.

14 The potential role of epigenetics in the transmission of a low cortisol response down the generations Low urinary cortisol levels have been found in adult holocaust survivors with PTSD and in their adult offspring (Yehuda, 1997, 2002). The Israeli soldiers whose parents were Holocaust survivors had higher rates of PTSD than their counterparts. Children of mothers who suffered from PTSD following the New York bombings also have lower levels of cortisol. Low cortisol levels predispose to PTSD in later life.

15 Attachment Research Our need for Social Supportwhen in a state of fear betrays humanity s essential attachment needs. Attachment research provides the Psycho-biological framework to understand both the origin and the symptoms of Post Traumatic Stress disorder and in particular complex PTSD. We therefore need to understand attachment disorders in order to treat patients suffering from PTSD.

16 Men and other mammals share the same emotions

17 PTSD as an attachment disorder involving the Right hemisphere Infants separated from their caregiver protest, despair and detach (Bowlby). Human infants are genetically predisposed to want access to an attachment figure when frightened! Without this attachment they die. When reunited with those we love, we have a nice warm feeling of safety largely produced by endogenous opiates: separation leads to a miserable state: We are all Opiate addicts

18

19 The Brain substrate of Attachment Behaviour Involves: A great part of the right hemisphere. PET scan and Broca s area. and part of the supra orbital areaof the brain which is crucial in enabling us to empathise with others. Partly mediated by: endogenous Opiates and oxytocin (feel good factor) dopamine (energised state of feeling) serotonin (linked to levels of dominance in hierarchy).

20 Programming the Brain Without Mum or caregiver Infants are not capable of: Regulating their hormones after birth. Soothing or comforting themselves. Regulating their arousal and emotional reactions - whether positive or negative. From birth to age 3 At birth baby s brain has 50 trillion synapses and by age 3 there are 1,000 trillion. During that time, new synapses are formed and hard wired whilst unused ones are dissolved or pruned.

21 Hierarchy of brain function

22 The limbic system

23 Limbic system: hypothalamus, amygdala and hippocampus (1-4yrs) Primary developmental goals Emotional regulation Empathy In traumatised childrenbrainstem and amygdala functions take charge: ie triggers release fear responses even when no danger. Persistent traumatic activation of the stress response leads to a persisting fear state or trait = a one time adaptive response to a chaotic and terrifying environment.

24 The Limbic system: amygdala Amygdala Monitoring of nearly all sensory stimuli and is involved in regulating fear and aggression. In charge of emotional learning in early life and somatic organisation of experience. Prepares organism for action in face of danger receiving input via neocortex or from rough fast thalamic input,activating fight, flight and freeze behaviour as in PTSD.

25 Hippocampus: integration and discrimination Enables remembering a sequences of events. Converts implicit memory into explicit mental images Integrates memories from different sensory modalities. Commits spatial and temporal dimensions to memory. Through its regulatory effect on the brain it greatly influences a person s mental state: eg a spider elicits a fear response in the amygdala but the hippocampus enables the person to remember it is harmless and regulate the arousal system.

26 Functions of the Orbitofrontal cortex Adjusts emotional responses and integrates the body s internal state with the environment. Regulates arousal (reticular activation system), the autonomic system (PS & SS and vagus nerve in brain stem). Inhibits impulses from the amygdala. Involved in the generation of object permanence at 7 to 12 months ie an infant experiencing negative emotions can thereby generate the image/internal mental representation of the caregiver s response to an act. Important for our sense of identity.

27

28 Attunement with baby Brain to Brain communication The caregiver respondsto the infant s signals by holding, caressing, smiling, feeding, stimulating or calming, giving meaning. Her empathicinteraction results in a child who can put himself in the mind of another and interact successfully This sense of security protects him or her from the effects of trauma.

29 Laying down the Templates for future interactions These daily interactions provide the memories that the infants synthesize into internal working models (Bowlby). These are internal representations or templatesof how the attachment figure is likely to respond to the child s attachment behaviour.

30 Early implicit memory In first year of life, it includes emotional, behavioral, perceptual, and perhaps bodily (somatosensory) forms of memory. Includes the generalizations of repeated experiences, called working models by Bowlby.

31 Representation of the Self and Secure attachments (63%) Is closely intertwined with the internal representation with the attachment figure. A securely attached child has a mental representation of the caregiver as responsive in times of trouble. These children feel confident and are capable of empathy and forming good attachments. The secure attachment is the primary defence against trauma induced psychopathology (Schore 1996).

32

33 Reflective Functioning The caregiver demonstrates reflective functioning by the capacity of giving meaning to the infants experiences, sharing and predicting his/her behaviour (Fonagy and Target, 1997). This enables people to understand each other in terms of mental states, to interact successfully with others and is key to developing a sense of agency and continuity. Empathic understanding from an outsider (teacher or relative) can compensate for effects of childhood abuse and protect against re-enactment and trauma.

34 Insecure attachments An insecure attachment is one in which the infant does not have a mental representation of a responsive caregiver in times of need. These infants develop different strategies to gain proximity to their caregiver in order to survive. There are 3 types of attachment behaviour: Group C:Anxious ambivalent type (12%) Group A: Avoidant type (20-25%) Group D: Disorganised (15%)

35 Anxious-Ambivalent Attachment (C) This infant is very upset when caregiver leaves the room and upon return she both clings to the caregiver and pushes her away. The caregiver is inconsistent in her respond to the infant s needs leading to angry clingy attachment behaviour. In adulthood this infant is classed as preoccupied in the AAI

36 Disorganised Attachment These infants show a disorganised response in relation to their caregiver (A+C). They freeze in trance like states like sufferers of PTSD. Their caregivers are frightening or frightened, suffering from PTSD, which may be triggered by the child herself. This behaviour leaves the child in a state of fear without solution (Main and Hesse 1992, 99) Reflective functioning is severely impaired: the more impaired, the more disturbed is the individual.

PTSD, Complex trauma and Disorganised Attachment

PTSD, Complex trauma and Disorganised Attachment PTSD, Complex trauma and Disorganised Attachment Implications for treatment Dr Felicity de Zulueta Emeritus Consultant Psychiatrist in Psychotherapy in SLaM and Hon. Senior Lecturer in KCL PTSD according

More information

The assessment and treatment of PTSD from an attachment perspective

The assessment and treatment of PTSD from an attachment perspective The assessment and treatment of PTSD from an attachment perspective Dr Felicity de Zulueta Emeritus Consultant Psychiatrist at Psychotherapy in South London and Maudsley NHS Foundation Trust Honorary Senior

More information

Dr Felicity de Zulueta

Dr Felicity de Zulueta Understanding PTSD within a neurobiological framework with implications for treatment Dr Felicity de Zulueta Emeritus Consultant Psychiatrist in Psychotherapy at the South London and Maudsley NHS FoundationTrust

More information

Trauma Informed Practices

Trauma Informed Practices Trauma Informed Practices Jane Williams & Elizabeth Dorado Social Worker & Academic Counselor Gordon Bernell Charter Rising Up! Taking Charters to New Heights 2017 Annual Conference What is Trauma? Traumatic

More information

Children, Young People & Trauma

Children, Young People & Trauma Children, Young People & Trauma 28 th May 2010 Belinda Cooley Lily Lee Workshop Outline Expectations of Workshop Definition of Trauma Attachment and Neurobiology Impact of Trauma Framework for Intervention

More information

Dr Angela Busuttil Head of Psychology in Physical and Occupational Health Sussex Partnership NHS UK

Dr Angela Busuttil Head of Psychology in Physical and Occupational Health Sussex Partnership NHS UK Dr Angela Busuttil Head of Psychology in Physical and Occupational Health Sussex Partnership NHS UK Richmond Foundation Malta October 2012 Definitions Overview of attachment theory and its developments

More information

ENTITLEMENT ELIGIBILITY GUIDELINE POSTTRAUMATIC STRESS DISORDER

ENTITLEMENT ELIGIBILITY GUIDELINE POSTTRAUMATIC STRESS DISORDER ENTITLEMENT ELIGIBILITY GUIDELINE POSTTRAUMATIC STRESS DISORDER MPC 00620 ICD-9 309.81 ICD-10 43.1 DEFINITION Posttraumatic Stress Disorder (PTSD) is a condition in the Diagnostic and Statistical Manual

More information

Silent ACEs: The Epidemic of Attachment and Developmental Trauma

Silent ACEs: The Epidemic of Attachment and Developmental Trauma Silent ACEs: The Epidemic of Attachment and Developmental Trauma Niki Gratrix, The Abundant Energy Expert http://www.nikigratrix.com/silent-aces-epidemic-attachment-developmental-trauma/ A 2004 landmark

More information

Attachment: The Antidote to Trauma

Attachment: The Antidote to Trauma Liberty University DigitalCommons@Liberty University Faculty Publications and Presentations Center for Counseling and Family Studies 9-24-2009 Attachment: The Antidote to Trauma Joshua Straub Liberty University,

More information

Recognising and Treating Psychological Trauma. Dr Alastair Bailey Dr Andrew Eagle -

Recognising and Treating Psychological Trauma. Dr Alastair Bailey Dr Andrew Eagle - Recognising and Treating Psychological Trauma Dr Alastair Bailey alastair.bailey@nhs.net Dr Andrew Eagle - andrew.eagle@nhs.net Normal Human Distress Risk of pathologising normal human behaviour It is

More information

The Impact of Changes to the DSM and ICD Criteria for PTSD

The Impact of Changes to the DSM and ICD Criteria for PTSD The Impact of Changes to the DSM and ICD Criteria for PTSD Jonathan I Bisson Institute of Psychological Medicine and Clinical Neursociences Cardiff University What is PTSD? Question Diagnosing PTSD DSM-IV

More information

Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV

Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV Post-Traumatic Stress Disorder (PTSD) Among People Living with HIV Milton L. Wainberg, M.D. Associate Clinical Professor of Psychiatry College of Physicians and Surgeons Columbia University mlw35@columbia.edu

More information

The Importance of Attachment in Adolescence. Lesley Bell Therapeutic Social Worker

The Importance of Attachment in Adolescence. Lesley Bell Therapeutic Social Worker The Importance of Attachment in Adolescence Lesley Bell Therapeutic Social Worker What is Attachment Attachment is a deep and enduring emotional bond that connects one person to another across time and

More information

Frozen The impact of ACES on early brain development.

Frozen The impact of ACES on early brain development. Frozen The impact of ACES on early brain development. Thursday 6 th April, 2017 Kinmel Manor Hotel, Abergele Chris Dunne Children s Service Manager, Powys 12 April, 2017 Recognising the symptoms of trauma

More information

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder Posttraumatic Stress Disorder History and Treatment June 6, 2017 Yves Newmen, Ph.D. DSM V (2013) Trauma, and Stressor-Related Disorders Reactive Attachment Disorder Disinhibited Social Engagement Disorder

More information

ENGAGING AND SUPPORTING FAMILIES IN SUICIDE PREVENTION

ENGAGING AND SUPPORTING FAMILIES IN SUICIDE PREVENTION ENGAGING AND SUPPORTING FAMILIES IN SUICIDE PREVENTION Luciana Payne, Ph.D. McLean Hospital Silvia Giliotti, Ph.D. NYS OMH Suicide Prevention Office Perry Hoffman, Ph.D. National Education Alliance for

More information

WELCOME 2011 MIDDLE BASIC TRAINING. History, despite its wrenching pain, cannot be unlived. need not be lived again.

WELCOME 2011 MIDDLE BASIC TRAINING. History, despite its wrenching pain, cannot be unlived. need not be lived again. WELCOME 2011 MIDDLE TENNESSEE TF CBT BASIC TRAINING This project is funded by the State of Tennessee, Bureau of TennCare History, despite its wrenching pain, cannot be unlived. But, if faced with courage,

More information

The Effects of Trauma. And How to Facilitate Recovery!

The Effects of Trauma. And How to Facilitate Recovery! The Effects of Trauma And How to Facilitate Recovery! Adverse Childhood Experiences (ACEs). 17,000 Surveyed 63% experienced at least 1 of the following categories: 11% experienced emotional abuse. 28%

More information

MODULE IX. The Emotional Impact of Disasters on Children and their Families

MODULE IX. The Emotional Impact of Disasters on Children and their Families MODULE IX The Emotional Impact of Disasters on Children and their Families Outline of presentation Psychological first aid in the aftermath of a disaster Common reactions to disaster Risk factors for difficulty

More information

Psychological First Aid

Psychological First Aid Psychological Symptoms and Psychological Preschool through Second Grade 2) Generalized fear 1) Helplessness and passivity 3) Cognitive confusion (e.g. do not understand that the danger is over) 4) Difficulty

More information

Effects of Traumatic Experiences

Effects of Traumatic Experiences Effects of Traumatic Experiences A National Center for PTSD Fact Sheet By Eve B. Carlson, Ph.D. and Josef Ruzek, Ph.D When people find themselves suddenly in danger, sometimes they are overcome with feelings

More information

DIFFERENTIATING DEVELOPMENTAL/COMPLEX TRAUMA FROM INCIDENT TRAUMA Part 1 of 2 parts

DIFFERENTIATING DEVELOPMENTAL/COMPLEX TRAUMA FROM INCIDENT TRAUMA Part 1 of 2 parts DIFFERENTIATING DEVELOPMENTAL/COMPLEX TRAUMA FROM INCIDENT TRAUMA Part 1 of 2 parts Alexandra (Sandi) Richman Consultant Clinical Psychologist EMDR Accredited Trainer Email: sandi@alexandrarichman.com

More information

Dr Elspeth Traynor Clinical Psychologist

Dr Elspeth Traynor Clinical Psychologist Dr Elspeth Traynor Clinical Psychologist Simple Trauma Dangerous, upsetting or life threatening event experienced or observed One-off Examples: car accident, house fire, assault, rape Complex trauma Complex

More information

Members Can Do. What Community. From the National Institute of Mental Health. Helping Children and Adolescents Cope with Violence and Disasters

Members Can Do. What Community. From the National Institute of Mental Health. Helping Children and Adolescents Cope with Violence and Disasters Helping Children and Adolescents Cope with Violence and Disasters For Teachers, Clergy, and Other Adults in the Community What Community Members Can Do From the National Institute of Mental Health Violence

More information

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder Teena Jain 2017 Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a disorder that some people develop after experiencing a shocking,

More information

The mosaic of life. Integrating attachment- and trauma theory in the treatment of challenging behavior in elderly with dementia.

The mosaic of life. Integrating attachment- and trauma theory in the treatment of challenging behavior in elderly with dementia. The mosaic of life Integrating attachment- and trauma theory in the treatment of challenging behavior in elderly with dementia. 1 2 Holistic point of view Holism : a Greek word meaning all, entire, total

More information

Trauma and Children s Ability to Learn and Develop. Dr. Katrina A. Korb. Department of Educational Foundations, University of Jos

Trauma and Children s Ability to Learn and Develop. Dr. Katrina A. Korb. Department of Educational Foundations, University of Jos Trauma and Children s Ability to Learn and Develop Dr. Katrina A. Korb Department of Educational Foundations, University of Jos katrina.korb@gmail.com Paper presented at the Capacity Building Workshop

More information

Trauma They MUST have it?? Foster Care Conference Hobart 2010 Bryan Jeffrey MOAT: Mental Health

Trauma They MUST have it?? Foster Care Conference Hobart 2010 Bryan Jeffrey MOAT: Mental Health Trauma They MUST have it?? Foster Care Conference Hobart 2010 Bryan Jeffrey MOAT: Mental Health Trauma Traumatic incidents plunge people into themselves; they become disbonded from each other They can

More information

Stress Disorders. Stress and coping. Stress and coping. Stress and coping. Parachute for sale: Only used once, never opened.

Stress Disorders. Stress and coping. Stress and coping. Stress and coping. Parachute for sale: Only used once, never opened. Stress Disorders Parachute for sale: Only used once, never opened. Stress and coping The state of stress has two components: Stressor: event creating demands Stress response: reactions to the demands Stress

More information

Definitions of primary terms and acronyms of trauma and shame disorders. [Draft ]

Definitions of primary terms and acronyms of trauma and shame disorders. [Draft ] Definitions of primary terms and acronyms of trauma and shame disorders. [Draft 7-23-2014] I welcome suggestions. Please email wteague@verizon.net Acronym Definition DSM- ACE Adverse Childhood Experiences

More information

Neurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D.

Neurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D. Neurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D. Neurological Response to a Stressor Information from the senses goes to the thalamus which sends the information

More information

Creating and Sustaining a Trauma Informed Approach. Re n e e D i e t c h m a n L e s l i e W i s s

Creating and Sustaining a Trauma Informed Approach. Re n e e D i e t c h m a n L e s l i e W i s s Creating and Sustaining a Trauma Informed Approach Re n e e D i e t c h m a n L e s l i e W i s s Meet the Facilitators Renee Dietchman, MA Licensed Psychologist Director of Clinical Services Leslie Wiss,

More information

Bridging Research and Practice: Our Clients Who Are Adopted and their Families. Norman E. Thibault, PhD, LMFT

Bridging Research and Practice: Our Clients Who Are Adopted and their Families. Norman E. Thibault, PhD, LMFT Bridging Research and Practice: Our Clients Who Are Adopted and their Families Norman E. Thibault, PhD, LMFT Thank You in Advance: Baylin, J. (2013). Behavioural epigenetics and attachment. The Neuropsychotherapist,

More information

3/9/2017. A module within the 8 hour Responding to Crisis Course. Our purpose

3/9/2017. A module within the 8 hour Responding to Crisis Course. Our purpose A module within the 8 hour Responding to Crisis Course Our purpose 1 What is mental Illness Definition of Mental Illness A syndrome characterized by clinically significant disturbance in an individual

More information

Resiliency and Recovery Post-Trauma

Resiliency and Recovery Post-Trauma Resiliency and Recovery Post-Trauma Texas Children s Health Plan CME November 18, 2017 Megan Mooney, Ph.D. Assistant Professor, Baylor College of Medicine Training Coordinator, Trauma and Grief Center

More information

Trauma and Stress- Related Disorders. Adjustment Disorder Post Traumatic Stress Disorder Reactive Attachment Disorder

Trauma and Stress- Related Disorders. Adjustment Disorder Post Traumatic Stress Disorder Reactive Attachment Disorder Trauma and Stress- Related Disorders Adjustment Disorder Post Traumatic Stress Disorder Reactive Attachment Disorder What is psychological trauma? Psychological trauma is an emotional response to a terrible

More information

CHILDHOOD TRAUMA AND ITS RELATIONSHIP TO PTSD.!! Andrea DuBose, LMSW

CHILDHOOD TRAUMA AND ITS RELATIONSHIP TO PTSD.!! Andrea DuBose, LMSW CHILDHOOD TRAUMA AND ITS RELATIONSHIP TO PTSD!! Andrea DuBose, LMSW "There are words that Never Show on the body that are deeper and more harmful than anything that bleeds" Laurel K. Hamilton, Mistral's

More information

Trauma and its Impact on the Developing Child

Trauma and its Impact on the Developing Child Trauma and its Impact on the Developing Child Melissa L. Hoffmann, Ph.D UT Center of Excellence for Children in State Custody Boling Center for Developmental Disabilities University of Tennessee Health

More information

SAMPLE OF LITERATURE REVIEW FOR PSYCHOLOGY CAPSTONE PROJECT

SAMPLE OF LITERATURE REVIEW FOR PSYCHOLOGY CAPSTONE PROJECT Abstract In the past one decade, there has been an increased concern about children being exposed to various traumatic events and violence. Most of them end up developing the post-traumatic stress disorder

More information

New Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality

New Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality New Criteria for Posttraumatic Stress Disorder in DSM-5: Implications for Causality Paul A. Arbisi, Ph.D. ABAP, ABPP. Staff Psychologist Minneapolis VA Medical Center Professor Departments of Psychiatry

More information

Individual Planning: A Treatment Plan Overview for Individuals with PTSD Problems.

Individual Planning: A Treatment Plan Overview for Individuals with PTSD Problems. COURSES ARTICLE - THERAPYTOOLS.US Individual Planning: A Treatment Plan Overview for Individuals with PTSD Problems. Individual Planning: A Treatment Plan Overview for Individuals with PTSD Problems. Duration:

More information

Reactions to Trauma and Clinical Treatment for PTSD

Reactions to Trauma and Clinical Treatment for PTSD Reactions to Trauma and Clinical Treatment for PTSD Cultural specific concerns and recommendations. Dr. K. Loan Mai AHSSC. October 19, 2012 Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder

More information

The Opiate Epidemic Collateral Damage The Impact on our children & families. Heather Gibson C.E.O. Danielle Ratcliff C.O.O.

The Opiate Epidemic Collateral Damage The Impact on our children & families. Heather Gibson C.E.O. Danielle Ratcliff C.O.O. The Opiate Epidemic Collateral Damage The Impact on our children & families. Heather Gibson C.E.O. Danielle Ratcliff C.O.O. Trauma Trauma Any experience that leaves a person feeling hopeless, helpless,

More information

PSYCHOLOGICAL DISORDERS Abnormal Behavior/Mental Disorders. How do we define these?

PSYCHOLOGICAL DISORDERS Abnormal Behavior/Mental Disorders. How do we define these? PSYCHOLOGICAL DISORDERS Abnormal Behavior/Mental Disorders How do we define these? Abnormality is identified from three vantage points: 1. That of society 2. That of the individual 3. That of the mental

More information

Annual Insurance Seminar. Tuesday 26 September 2017

Annual Insurance Seminar. Tuesday 26 September 2017 Annual Insurance Seminar Tuesday 26 September 2017 Dublin Dublin London London New New York York San San Franscisco Francisco Welcome Emer Gilvarry, Chairperson Dublin Dublin London London New New York

More information

Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I)*

Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I)* Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I)* Introduction The PTSD Symptom Scale Interview (PSS-I) was designed as a flexible semi-structured interview to allow

More information

Trauma Smart. Crittenton Children s Center

Trauma Smart. Crittenton Children s Center Trauma Smart Crittenton Children s Center Statistics Nationwide, 25% of children experience one traumatic event by age 4. Pre-K Expulsion Rates are 3X the national rate for K-12. Gilliam W.S. Pre-kindergarteners

More information

Working With Teens Who Have Experienced Trauma. Gloria Castro Larrazabal, Psy.D. Infant-Parent Program UCSF/SFGH

Working With Teens Who Have Experienced Trauma. Gloria Castro Larrazabal, Psy.D. Infant-Parent Program UCSF/SFGH Working With Teens Who Have Experienced Trauma Gloria Castro Larrazabal, Psy.D. Infant-Parent Program UCSF/SFGH Trauma Principles It is the child s experience of the event, not the event itself, that is

More information

Understanding Secondary Traumatic Stress

Understanding Secondary Traumatic Stress Understanding Secondary Traumatic Stress Introduction Each year, millions of children are exposed to some type of traumatic event including physical, sexual or emotional abuse, neglect, witnessing domestic

More information

The changing face of PTSD in 2013: Proposed Updates & Revised Trauma Response Checklist Quick Screener (Baranowsky, May 2013)

The changing face of PTSD in 2013: Proposed Updates & Revised Trauma Response Checklist Quick Screener (Baranowsky, May 2013) The changing face of PTSD in 2013: Proposed Updates & Revised Trauma Response Checklist Quick Screener (Baranowsky, May 2013) Dr. Anna B.Baranowsky Traumatology Institute http://www.ticlearn.com TRAUMATOLOGY

More information

Trauma & Therapies.

Trauma & Therapies. Trauma & Therapies #GetBackToLife @henmorehealth Trauma The impact of trauma occurs on various levels and can interfere with a person s ability to function in daily life, affecting relationships, work,

More information

Dr Lisa Bunting (Lecturer in Social Work, QUB) Mairead Lavery (title, SEHSCT) Nov 2017

Dr Lisa Bunting (Lecturer in Social Work, QUB) Mairead Lavery (title, SEHSCT) Nov 2017 Dr Lisa Bunting (Lecturer in Social Work, QUB) Mairead Lavery (title, SEHSCT) Nov 2017 STRUCTURE Defining Trauma and Adversity The Prevalence and Impact of Multiple Adversities How adversity causes poor

More information

Understanding Complex Trauma

Understanding Complex Trauma Understanding Complex Trauma Frightening events can have lasting effects Trauma and Homelessness Team Carswell House Dennistoun Glasgow G31 2HX Tel: 0141 232 0114 Fax: 0141 232 0131 General enquiries email:

More information

Responding to Traumatic Reactions in Children and Adolescents. Steve Minick Vice President of Programs

Responding to Traumatic Reactions in Children and Adolescents. Steve Minick Vice President of Programs Responding to Traumatic Reactions in Children and Adolescents Steve Minick Vice President of Programs stevem@fsnwpa.org 814 866-4500 TF-CBT at Family Services Trauma Types Served 760 Documented Physical

More information

CLAIMANT S FACTS ABOUT TRAUMATIC INCIDENT CAUSING PTSD These facts should be written in a narrative statement giving details about the following:

CLAIMANT S FACTS ABOUT TRAUMATIC INCIDENT CAUSING PTSD These facts should be written in a narrative statement giving details about the following: CLAIMANT S FACTS ABOUT TRAUMATIC INCIDENT CAUSING PTSD These facts should be written in a narrative statement giving details about the following: 1. The nature of the trauma such as military combat, sexual

More information

Attachment 10/18/16. Mary- Jo Land Registered Psychotherapist. Mary-Jo Land, R. P. 1. Developmental Trauma: The Brain, Mind and Relationships:

Attachment 10/18/16. Mary- Jo Land Registered Psychotherapist. Mary-Jo Land, R. P. 1. Developmental Trauma: The Brain, Mind and Relationships: Developmental Trauma: The Brain, Mind and Relationships: Mary- Jo Land, R.P. Priceville, Ontario Mary- Jo Land Registered Psychotherapist homeland@sympatico.ca 289-237- 7056 www.maryjoland.ca Attachment

More information

What s Trauma All About

What s Trauma All About What s Trauma All About Because early abuse impacts on the developing brain of these infants, it has enduring effects. There is extensive evidence that trauma in early life impairs the development of the

More information

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder "I was raped when I was 25 years old. For a long time, I spoke about the rape as though it was something that happened to someone else. I was very aware that it had happened

More information

PSY337 Psychopathology Notes

PSY337 Psychopathology Notes PSY337 Psychopathology Notes DSM Definition of mental s: clinically significant set of symptoms that result in some type of impact in an individual s life. No single rule, which captures a broad definition

More information

Something Has To Change

Something Has To Change Something Has To Change A Three-Strand Approach 1.Looking In 2. Looking Out 3. Looking At Theory Stress, burnout, depression, anxiety, compassion fatigue, secondary PTSD... It is important to safeguard

More information

7/26/2017 TRAUMA-INFORMED CARE. Presented by Karyn Harvey, Ph.D. Materials at: Pid.thenadd.org Books at Amazon.

7/26/2017 TRAUMA-INFORMED CARE. Presented by Karyn Harvey, Ph.D. Materials at: Pid.thenadd.org Books at Amazon. TRAUMA-INFORMED CARE Presented by Karyn Harvey, Ph.D. kharvey@thearcbaltimore.org Materials at: Pid.thenadd.org Books at Amazon.com 1 Sources of Trauma for Individuals with IDD Report on Abuse of People

More information

CHILDREN S RESPONSES TO TRAUMA REFERENCE CHART

CHILDREN S RESPONSES TO TRAUMA REFERENCE CHART CHILDREN S RESPONSES TO TRAUMA REFERENCE CHART Children s responses to disaster vary with the age of the child. These responses are considered normal if they are of brief (under 2 weeks) duration. *Although

More information

Caring for Children Who Have Experienced Trauma

Caring for Children Who Have Experienced Trauma Caring for Children Who Have Experienced Trauma Introduction Illustrations by Erich Ippen, Jr. Used with permission. Why a Trauma Workshop? Many children in foster care have lived through traumatic experiences.

More information

Trauma Informed Home Visiting

Trauma Informed Home Visiting Trauma Informed Home Visiting Presented by C. Lynne Edwards, LCSW Home Visiting Consortium October 28, 2014 Presented by C. Lynne Edwards, LCSW 1 THE IMPACT OF TRAUMA ON CHILDREN AND PARENTS Presented

More information

Reducing Risk and Preventing Violence, Trauma, and the Use of Seclusion and Restraint Neurobiological & Psychological Effects of Trauma

Reducing Risk and Preventing Violence, Trauma, and the Use of Seclusion and Restraint Neurobiological & Psychological Effects of Trauma Reducing Risk and Preventing Violence, Trauma, and the Use of Seclusion and Restraint Neurobiological & Psychological Effects of Trauma Module created by Glenn Saxe, MD: 2002 revised 2009, 2011, 2013,

More information

The ABC s of Trauma- Informed Care

The ABC s of Trauma- Informed Care The ABC s of Trauma- Informed Care AGENDA What do we mean by trauma? How does trauma affect people? What can we learn from listening to the voices of people who have experienced trauma? Why is understanding

More information

CHILD TRAUMATIC STRESS AND CHILD DEVELOPMENT

CHILD TRAUMATIC STRESS AND CHILD DEVELOPMENT CHILD TRAUMATIC STRESS AND CHILD DEVELOPMENT The Role of Trauma in Child Development The role of development in vulnerability to and responses to traumatic events is important to child welfare because

More information

Learning objectives: 2/21/18. Children s Research Triangle Wendy Kovacs Cortes, Ph.D., LMFT

Learning objectives: 2/21/18. Children s Research Triangle Wendy Kovacs Cortes, Ph.D., LMFT Wendy Kovacs Cortes, Ph.D., LMFT Learning objectives: Biological and relational components of intergenerational trauma. Epigenetics and ACES. How relational trauma is transmitted intergenerationally. How

More information

PTSD HISTORY PTSD DEFINED BY SONNY CLINE M.A., M.DIV. PA C. PTSD: Post Traumatic Stress Disorder

PTSD HISTORY PTSD DEFINED BY SONNY CLINE M.A., M.DIV. PA C. PTSD: Post Traumatic Stress Disorder PTSD BY SONNY CLINE M.A., M.DIV. PA C HISTORY PTSD: Post Traumatic Stress Disorder The term was coined in the mid 70 s during the anti Vietnam war protest. The condition was more pronounced in those returning

More information

DSM-IV-TR Diagnostic Criteria For Posttraumatic Stress Disorder

DSM-IV-TR Diagnostic Criteria For Posttraumatic Stress Disorder DSM-IV-TR Diagnostic Criteria For Posttraumatic Stress Disorder PTSD When an individual who has been exposed to a traumatic event develops anxiety symptoms, re-experiencing of the event, and avoidance

More information

What Is Child Traumatic Stress? 5/27/2016. Nebraska Resource Project for Vulnerable Young Children at the Center for Children, Families, and the Law

What Is Child Traumatic Stress? 5/27/2016. Nebraska Resource Project for Vulnerable Young Children at the Center for Children, Families, and the Law Jennie Cole-Mossman LIMHP Nebraska Resource Project for Vulnerable Young Children at the Center for Children, Families, and the Law Co-Directors: Jennie Cole-Mossman LIMHP Kelli Hauptman JD What Is Child

More information

Trauma: From Surviving to Thriving The survivors experiences and service providers roles

Trauma: From Surviving to Thriving The survivors experiences and service providers roles Trauma: From Surviving to Thriving The survivors experiences and service providers roles Building Awareness, Skills & Knowledge: A Community Response to the Torture Survivor Experience Objectives 1. To

More information

The Split Personality. and inner Healing

The Split Personality. and inner Healing The Split Personality Pablo Picasso: Dora Maar and inner Healing This presentation is available at www.franz-ruppert.de 1976 Psychology Behaviour Relationships Bonding Trauma Parts of personality Bonding

More information

Victims of the Khmer Rouge year visiting the Toul Sleng Genocid Museum in Phnom Penh

Victims of the Khmer Rouge year visiting the Toul Sleng Genocid Museum in Phnom Penh Victims of the Khmer Rouge year visiting the Toul Sleng Genocid Museum in Phnom Penh 21 Adapted from: David Satcher et al. (1999): Chapter 4.2, Mental health: A Report of the Surgeon General, in: http://en.wikipedia.org/wiki...last

More information

Session 4 BACKGROUND READINGS. Some Impacts on Children and Young People

Session 4 BACKGROUND READINGS. Some Impacts on Children and Young People Session 4 BACKGROUND READINGS Some Impacts on Children and Young People Section a CHILDREN S REACTION TO THE REFUGEE EXPERIENCE Becoming a refugee is always a traumatic experience for children, no matter

More information

Childhood trauma and it s impact. Breaking the Silence. 8 th June 2018

Childhood trauma and it s impact. Breaking the Silence. 8 th June 2018 Childhood trauma and it s impact Breaking the Silence 8 th June 2018 1 Trauma is not just what was done nor what it did but what was missing. Difference between stress and trauma! Resilience or compliance?

More information

2/28/2017. Attachment in Substance Use. Objectives. Social Attachments

2/28/2017. Attachment in Substance Use. Objectives. Social Attachments Attachment in Substance Use Kalpana Miriyala, MD Zero to Three Fellow 2016-2018 Asst. Professor, Child and Adolescent Psychiatry Marshall University School of Medicine Objectives To review the theory of

More information

Trauma FIRST RESPONDERS JADA B. HUDSON M.S., LCPC, CADC

Trauma FIRST RESPONDERS JADA B. HUDSON M.S., LCPC, CADC JADA B. HUDSON M.S., LCPC, CADC Trauma FIRST RESPONDERS Jada B. Hudson, M.S. Licensed Clinical Professional Counselor Certified Alcohol and Drug Abuse Counselor Operation Shattered Stars Clinical Consultant

More information

INTIMACY, SEX, & CHILD ABUSE

INTIMACY, SEX, & CHILD ABUSE INTIMACY, SEX, & CHILD ABUSE CHALLENGING CASE PRESENTATION MARCH 2018 LINDA MACKAY PHD Conventional trauma work Trauma is not as an event, but the subjective reaction by a person to that event.... only

More information

I Was Wired This Way

I Was Wired This Way I Was Wired This Way The Effects of Negative Life Events on Brain Development Negative life experiences in childhood can be a significant source of stress. Children and youth are especially sensitive to

More information

CHILDHOOD TRAUMA: THE PSYCHOLOGICAL IMPACT. Gabrielle A. Roberts, Ph.D. Licensed Clinical Psychologist Advocate Children s Hospital

CHILDHOOD TRAUMA: THE PSYCHOLOGICAL IMPACT. Gabrielle A. Roberts, Ph.D. Licensed Clinical Psychologist Advocate Children s Hospital CHILDHOOD TRAUMA: THE PSYCHOLOGICAL IMPACT Gabrielle A. Roberts, Ph.D. Licensed Clinical Psychologist Advocate Children s Hospital What is a Trauma? Traumatic event: Witnessing or experiencing a frightening,

More information

Posttraumatic Stress Disorder. Casey Taft, Ph.D. National Center for PTSD, VA Boston Healthcare System Boston University School of Medicine

Posttraumatic Stress Disorder. Casey Taft, Ph.D. National Center for PTSD, VA Boston Healthcare System Boston University School of Medicine Posttraumatic Stress Disorder Casey Taft, Ph.D. National Center for PTSD, VA Boston Healthcare System Boston University School of Medicine Overview PTSD Overview Neurobiology of PTSD PTSD and Relationship

More information

An introduction to providing trauma informed services

An introduction to providing trauma informed services An introduction to providing trauma informed services TIC - for volunteers 1. Why this presentation 2. Trauma, neglect and attachment 3. Working in a trauma informed way as a volunteer 4. Looking after

More information

Developing A Trauma Informed Community Jean West LCSW CTC-S CT What is trauma? 6/28/13. Experiences which can cause trauma

Developing A Trauma Informed Community Jean West LCSW CTC-S CT What is trauma? 6/28/13. Experiences which can cause trauma Developing A Trauma Informed Community Jean West LCSW CTC-S CT jean.west@sjsd.k12.mo.us What is trauma? A traumatic event is an overwhelming experience that is often sudden and unexpected. The experience

More information

Creating A Trauma Informed System. Al Killen-Harvey,LCSW The Harvey Institute

Creating A Trauma Informed System. Al Killen-Harvey,LCSW The Harvey Institute Creating A Trauma Informed System Al Killen-Harvey,LCSW The Harvey Institute Al@theharveyinstitute.com 619-977-8569 Goals and Objectives 1.Describe the attributes of the various forms of trauma 2.Delineate

More information

EMDR WITH COMPLEX TRAUMA. Alexandra (Sandi) Richman

EMDR WITH COMPLEX TRAUMA. Alexandra (Sandi) Richman EMDR WITH COMPLEX TRAUMA Alexandra (Sandi) Richman sandi@alexandrarichman.com www.emdr-training.com EMDR A therapeutic approach developed by Francine Shapiro to reduce the symptoms associated with PTSD

More information

5/12/2014. Trauma definitions & stats Trauma and impact on development Interventions Trauma-Informed Care Consortium of Central Texas Questions

5/12/2014. Trauma definitions & stats Trauma and impact on development Interventions Trauma-Informed Care Consortium of Central Texas Questions Austin Child Guidance Center Trauma definitions & stats Trauma and impact on development Interventions Trauma-Informed Care Consortium of Central Texas Questions 1 Community Impact of Trauma Child Abuse

More information

Adult Attachment Interview

Adult Attachment Interview Adult Attachment Interview Clinical applications Mario Marrone Memory systems Bowlby drew attention to the ways in which information is stored in distinct systems of memory. Memory Long-term Short-term

More information

PRISM SECTION 15 - STRESSFUL EVENTS

PRISM SECTION 15 - STRESSFUL EVENTS START TIME : PRISM SECTION 15 - STRESSFUL EVENTS Statement I.1: These next questions are about difficult or stressful things that can happen to people. It may be hard to remember everything about these

More information

INDIVIDUALS ARE COPING ALL THE TIME.

INDIVIDUALS ARE COPING ALL THE TIME. Coping Strategies INDIVIDUALS ARE COPING ALL THE TIME. COPING (CONTENDING) Coping: Is the behavior that protects us from becoming psychologically and physiologically disorganized. Usually incorporates

More information

Working with complex trauma: The impact on the therapist. Anne R Douglas 7 th March 2013

Working with complex trauma: The impact on the therapist. Anne R Douglas 7 th March 2013 Working with complex trauma: The impact on the therapist Anne R Douglas 7 th March 2013 anne.douglas@ggc.scot.nhs.uk Working with complex trauma the impact on the therapist Theoretical concepts which have

More information

PTSD Guide for Veterans, Civilians, Patients and Family

PTSD Guide for Veterans, Civilians, Patients and Family PTSD Guide for Veterans, Civilians, Patients and Family Overview There are a variety of PTSD booklets available, so with ours we wanted to hand-pick the content we felt our audience could use most. We

More information

TRAUMA: AN INTRODUCTION. Deborah A. Orr, RN, Ph.D. Director of Nursing The Refuge - A Healing Place

TRAUMA: AN INTRODUCTION. Deborah A. Orr, RN, Ph.D. Director of Nursing The Refuge - A Healing Place TRAUMA: AN INTRODUCTION Deborah A. Orr, RN, Ph.D. Director of Nursing The Refuge - A Healing Place WHAT CAN YOU EXPECT THIS MORNING? 1. You will understand how trauma is defined. 2.You will understand

More information

How Children Tell: Using Developmentally Sensitivity Methods to Enhance the Traumatized Child s Narrative

How Children Tell: Using Developmentally Sensitivity Methods to Enhance the Traumatized Child s Narrative How Children Tell: Using Developmentally Sensitivity Methods to Enhance the Traumatized Child s Narrative Paris Goodyear-Brown, LCSW, RPT-S www.parisandme.com paris@parisandme.com 615-397-9480 Trauma Narrative

More information

Trauma Informed Parents

Trauma Informed Parents Trauma Informed Parents Cheri J. Kahn Consultant Behavior/Discipline 210-370-5702 cheri.kahn@esc20.net 1 Why Is This Important? Trauma Facts for Educators 1 out of 4 individuals attending school has been

More information

Community based services for children and adults with learning disabilities

Community based services for children and adults with learning disabilities Community based services for children and adults with learning disabilities Bereavement and People with Intellectual Disabilities Dr Noelle Blackman CEO Historical perspective Belief that people with LD:

More information

Trauma-Informed Approaches to Substance Abuse Treatment in Criminal Justice Settings. Darby Penney Advocates for Human Potential July 8, 2015

Trauma-Informed Approaches to Substance Abuse Treatment in Criminal Justice Settings. Darby Penney Advocates for Human Potential July 8, 2015 Trauma-Informed Approaches to Substance Abuse Treatment in Criminal Justice Settings Darby Penney Advocates for Human Potential July 8, 2015 2 Goals of the Presentation: Define trauma and discuss its impact

More information

Boots in the Arena. On Combat. Warriors. Invisible Wounds of War

Boots in the Arena. On Combat. Warriors. Invisible Wounds of War Boots in the Arena the use of EAGALA-model Equine Assisted Psychotherapy in the treatment of Combat Trauma Eva J. Usadi, MA, BCD 2012 PATH, Intl. Conference November 2, 2012 Usadi 2012 On Combat War is

More information

Complex Trauma in Children and Adolescents

Complex Trauma in Children and Adolescents Complex Trauma in Children and Adolescents Sara Coffey, D.O. Assistant Professor Department of Psychiatry and Behavioral Sciences Oklahoma State University Center for Health Sciences Overview of trauma

More information