The Neurobiology of Trauma and the Impact on the Brain, Bonds and Behaviors. Debi A. Grebenik, Ph.D., LCSW Alia

Transcription

1 The Neurobiology of Trauma and the Impact on the Brain, Bonds and Behaviors Debi A. Grebenik, Ph.D., LCSW Alia

2 Goals To commit to self-awareness about trauma To commit to an understanding of the impact of historical trauma

3 Why Trauma Informed? We want clients to engage, retain, and participate in services. Trauma-informed vs. Trauma-specific Trauma-informed is not a fad; it s here to stay

4 Know Better Do Better...Be Better Know how trauma impacts the brain Do give grace & understanding Be present and flexible

5 How can we explain the behaviors? Let s start with knowing...

6 What is Trauma? Trauma is something that happens to you that makes you feel like you are at risk of dying or being killed.

7 Trauma can be Prenatal Preverbal Known Unknown Remembered Unremembered Intergenerational Historical/Cultural

8 Trauma s Imprint Trauma s imprint is indelible. The three defining characteristics of a traumatic event (or situation) are that it was: 1. Unpredictable 2. Overwhelming and 3. Created Powerlessness. Understanding this helps to explain vulnerability to trauma. Depends on the person and their response.

9 Trauma lives on for generations. Historical and Intergenerational impacts of trauma can be felt and seen for generations upon generations. It is not only what happens to us, but what happened to our ancestors that impacts us today.

10 A new question: Moving from: To: What s wrong with you? What happened to you? AND how do I do things DIFFERENTLY because of what s happened to you?

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12 So how does ACES affect the brain? Bruce Perry demonstrates brain of a normal three year vs. a 3 year old with significant neglect.

13 And then we have the amygdala Threat center of the brain. Activates the survival system Linked to cortisol release 3 F s

14 Trauma s Impact Lack of ability to process cognitively Trauma is stored in the right side of the brain We typically try to talk left brain to left brain Need to develop new pathways (synaptic connections) Want to prevent dendrites (tiny computers) from shriveling

15 Looking Through The Eyes of a Activated Person How it looks to Us.

16 How it looks to The Traumatized/ Activated Person

17 Behavioral Responses to Perceived Danger Trauma Event Danger Response Fight Flight Freeze Aggression Run Away Dissociate Verbal attack Substance Abuse Non-emotionality

18 Fight, Flight or Freeze Fight frustration, explosive, or aggressive; resistive, acting out, saying NO! Flight distractible, clowning, escaping, bored Freeze whiny, tearful, clingy, reluctant to separate or try new things, withdrawing, hiding, saying I can t

19 Fight Response Fight-discharge energy-waking the Tiger by Peter Levine (jumping, dancing, throwing, bouncing) 19

20 Flight Disassociative continuum Run-aways Substance use/abuse

21 She didn t know who to trust, so she pushed everyone away.

22 A Matter of Framing They are not manipulative, or disrespectful, defiant, rude, etc. They are surviving.

23 Attachment Attachments with primary caregivers form the template for all relationships in life Early caregiving may not be intact Attachment disruptions Provides safe containment for child s development Longing, unmet needs for love & affection Withdrawal into fantasy

24 Developmental Issues What is developmentally normative for this age? What developmental competencies were impacted? Current dependency needs History of early attachments

25 Human Trafficking & Developmental Trauma Disorder Developmental trauma as a precursor to trafficking Separation from caregivers during trafficking as developmental trauma Minor sex trafficking as developmental trauma

26 Words to Ponder "With abuse, you suffer loss of soul, loss of self and loss of meaning" "In the system, you must fight every day, every minute, to keep from feeling worthless - to keep your spirit alive" K.W. (Survivor)

27 Trauma-Informed Responses Trauma brain does forget short term memory gets high-jacked Confusion might set in Distortion of reality Fearful of punishment, of loss, of rejection What about trauma might explain this behavior?

28 FEAR Fear of something happening is as real to the brain, as the event actually occurring.

29 We must Respond to the need. Not react to the behavior Seek connection to get to compliance

30 Blame & Stay away from blame and shame Blame is a coping strategy (aren t lies sometimes a blaming reaction?) Blame says that I m unable to manage my own content; I can t keep it in any longer so I put it out on someone else Brene Brown on Oprah

31 The Arena Are you going to live in the arena or in the stands? What are the benefits of either choice? The costs of either choice? v=fi0ieobdrpq Daring Greatly by Brene Brown

32 Fears Respond to the fear with a kind voice tone Provide gentle and encouraging eye contact Be present in the moment, listen without distraction or multi-tasking

33 Acknowledging Fears Acknowledge the difficulties connected to testifying Verbally admit that it is scary to testify Encourage deep breathing Acknowledge bravery and effort; focus on the process, not the outcome

34 Language Engage in trauma-sensitive demeanor, language, and etiquette Avoid value-laden terms such as: Good or bad Right or wrong Positive or negative (based on whose values?) Why?

35 Power of words These value-laden words can cause anxiety related to feeling judged or devalued; rather, we can use behavioral specific terms such as Your choice did not include reviewing all of your options rather than You made a bad choice. Use of sarcasm is not an option ( looks to me like you already made your choice )

36 What we don t say Use affirming body language Use facial expressions to communicate support and affirmation Be willing to say "I'm sorry for what you have been through." Use kind gestures

37 Distrust Previous bad encounters w/ institutions that are supposed to help them Lies protect the little safety they have left; they are not lying because they like their situation or to push your buttons

38 System Re-Traumatization Exerting power and control over client - replicates power imbalance of original trauma Using diagnoses as labeling, - shames and stigmatizes, replicates abuse Misdiagnosis invalidating experience of survivor - leads to maltreatment and is re-traumatizing Protocols that make no sense and rules that are made and changed arbitrarily by providers - replicates environment of abuse

39 Challenges Running Self-injury Substance abuse Relationships Re-victimization/reenactments Relationship with family

40 Strategies Use 12 words or less when making a request of a person with a trauma history

41 Strategies Creating safety for the client includes showing them where the bathroom is Not hearing conversations they shouldn t hear Be transparent about processes (inclusive process) explaining the why brings down anxiety Give choice and voice

42 Strategies Allow people to check out if they need to; this might be their path to regulation Explain each question and finding Define the next steps and process Goal is to reduce anxiety Systematically ask for input Survivors need information give it compassionately

43 Strategies Relationship is one of the elements shown to be effective in calming a dysregulated survivor Trauma occurred in the context of relationship and trauma will be healed in the context of relationship

44 Strategies Pay attention to noise and distractions Predict security measures Pay attention to smells someone may be wearing the cologne of one of their abusers/pimps/clients Provide water Attend to unspoken ease address the issue Describe the process for the meeting, We will be doing this.then this and it will last about.. Be as detailed as possible

45 Question?????? What does a non-trauma informed system say about not showing up?

46 Answers Doesn t care Irresponsible Must not want her kids back Lazy Seems tense & nervous Can t settle in, can t focus Probably high Are you taking your meds? They don t respect my time

47 Trauma Informed Responses Scared to death Understand that I am a trigger Doesn t remember dis-associative continuum Make reminder calls Always something more than it appears Hyper-vigilance (may not feel safe) Scanning and assessing the environment

48 Question What does the non-trauma-informed system say about not telling the truth?

49 She s a liar She wanted it She forgot Answers

50 Client s Voice Calling a client "noncompliant", "treatmentresistant" etc. rather than taking responsibility for failing to help him or her, or for not knowing what to do or how to understand. Being overwhelmed causes them to shut

51 Why? Some contend that survivor participation can be therapeutic by giving survivors an opportunity to express their suffering, win acknowledgment (and perhaps modest reparations), and build a sense of solidarity and empowerment with other survivors. Dr. Yael Danieli has found that the ability to participate actively in the proceedings... may assist victims to take back control of their lives and to ensure that their voices are heard, respected, and understood. Voice and Choice!!!!

52 Take-Away What can you, your team, your colleagues, your court, and the system do to serve survivors in a trauma-informed manner? Ine thing

53 Resources Follow us on Facebook: Alia Innovations Debi Grebenik (719)