What s Trauma All About
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- Rodney Crawford
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1 What s Trauma All About
2 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 capacities of maintaining interpersonal relationships, coping with stressful stimuli and regulating emotion. Schore (2001)
3
4 Traumatic Events or PTSD?
5 BREAKING THE RULES Meanings
6 Children s Trauma Mental, Physical or Sexual Abuse Neglect Parental MH problems Painful medical procedures D.V., threats or conflicts witnessed by the child Discontinuity in the attachment process (death, adoption, hospitalisation)
7 PTSD DX DSM-V Exposure, either directly or indirectly, to traumatic events (Previously had to register intense fear at the event). Intrusive symptoms Persistent avoidance Hypervigilance or hyperarousal Persistent distorted cognitions re blame Persistent negative emotional state Reckless or self destructive behaviour
8 SYMPTOMS Intrusion Arousal Avoidance / numbing
9 WHAT S IMPORTANT? The Experience The Interpretation The Explanation The Reaction of the Environment, then and now.
10 Waking the Tiger
11 Negative appraisals What is appraised It happened It happened to me Anger outburst Flashbacks Concentration problems Other peoples reactions -VE Appraisal Nowhere is safe I attract bad things I am bad, I can t cope I m going mad, I ll never get over this My brain is damaged Others think I m weak No one can help
12 Radar Exercise: Attentional Biases
13 Internal Working Model The world as either safe or not, general view It helps shape personality and way of interacting with other people. This is continually being revised
14 Memory
15 Traumatic Memories
16 Brain Indigestion???
17 THE BODY KEEPS THE SCORE Trauma robs you of feeling you are in charge of yourself, the challenge is to recover your ownership of your body and your mind. Become calm and focussed Maintain this calm to triggers Be fully alive and engaged in the present Do not have to keep secrets from your self about how you survived. Bessel van der Kolk. (2014
18
19 Tasks for Grieving Children Experience the deep pain Accept the permanency Accepting the totality of the loved one (good and Bad) Converting the relationship from interaction to memory Incorporating aspects of the loved one into self identity Committing to new relationships Re-establishing health developmental trajectory Wolfelt (1991)
20 Separation from parents during childhood trauma predicts adult attachment security and posttraumatic stress disorder (Bryant et al 2017)
21 Childhood Traumatic Grief Unresolved Grief PTSD
22 Intrusive Images
23 Complex Trauma and Children Multiple or Chronic Events Developmentally adverse Interpersonal Often within the care giving system Developmental Trauma Disorder Trauma creates a vulnerability to learning, neurodevelopmental problems and adult Mental Health problems
24 Childhood Symptoms
25 SYMPTOMS Intrusion Arousal Avoidance / numbing
26 Triggers
27
28 THE ANSWER IS
29 Keep it all in You know your problem You keep it all in You know your problem You keep it all in Midnight, a husband getting ready to fight A daughter sleeps alone with the light Turned on, she hears but Keeps it all in Just like that murder in '73 Just like that robbery in '62 With all these things that have happened to me
30 Controversies / Urban Myths Traumatic events always cause PTSD Exposure to trauma is rare Children are too young to understand so wont be effected It is best to just avoid thinking about the trauma Your memory will just fade over time FALSE FALSE FALSE FALSE FALSE
31
32 What can I do? Be clear of the symptoms of trauma Do not offer debriefing Support family to reconnect with their life Offer psych-education re symptoms and maintenance factors. Offer trauma focussed intervention if available Protect yourself
33 References/resources Smith, P. et.al. (2010). Post Traumatic Stress Disorder. Cognitive Therapy with Children and Young People. London: Routledge Van Der Kolk, B. (2014). The Body Keeps the Score. London: Penguin cstressdisorder.aspx Emdrassociation.org.uk Levine, P. (1997) Waking the Tiger. CA: North Atlantic Books
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