Trauma Informed Practices

Transcription

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

2 What is Trauma? Traumatic experiences are those that are overwhelming, that tax the individual s coping resources, and that lead to initiation of biologically driven survival strategies and responses.

3 Universal Danger Response FIGHT FLIGHT FREEZE SUBMIT ATTACHMENT CRY

4 Nervous System Response Autonomic Nervous System includes: Sympathetic Nervous System: Activating Fight or Flight Response Parasympathetic Nervous System: Calming Maintains Homeostasis When we are able to self-regulate these two systems help keep us in balance.

5 Trauma and Fear Conditioning In a healthy individual, when the universal danger response system is activated, the nervous system steps in to aide in the body s response to the danger by shutting down non-essential tasks and activating either the sympathetic or parasympathetic systems In a traumatized individual, the alarm system is no longer working as it should. The stress response is unleased to neutral stimuli, or is not responsive to actual threats. I will do whatever it takes to feel safe.

6 Universal Danger Response: Fight Fight Hyperarousal Aggression Irritability and anger Battles with authority (Oppositional/Defiant, Conduct Disorders) Preoccupied with justice Desire for control Self harm Suicidal ideation and attempts

7 Universal Danger Response: Flight Flight Withdrawal, Dissociation Feeling trapped Running away the geographical cure Avoidance of other people Distrust Trouble concentrating Memory problems Sex, Drugs and Rock and Roll

8 Universal Danger Response: Freeze Freeze Frozen Hypervigilance Helplessness Feeling stuck Fear Alarm Startle Response Panic Constricted Internalize

9 Universal Danger Response: Submit Submit Compliance, Lack of boundaries Re-victimization, Re-enactments Identification with the perpetrator Over-compliance, Enmeshed relationships Self-sacrifice, Care-taking, People pleasing Lack of sense of self Depression, despair, shame, guilt, selfloathing Emotional numbing, disengaged, dazed, daydreaming

10 Universal Danger Response: Attachment Cry Dependency, Unmet Needs Lead to: Dependency Enmeshed relationships Sense of Emptiness Self-Loathing Frantic pursuit of intimacy Inability to be soothed

11 Infants in well-regulated parental systems become effective self-regulators in the face of stress; as young children they can separate from the Caregiver. (Sroufe, 1995) SELF REGULATION AND THE EARLY DEVELOPMENT OF THE BRAIN The first three years of life establish the blueprint for all of our future relationships. John Bowlby The ability of the brain and body to develop and allow us to regulate starts before we are born. The developing fetus has a vast number of experiences while developing inside the mothers uterus. We need ATTENTION AFFECTION ATTUNEMENT in order for our brains to develop effectively.

12 BRAIN SYSTEMS FUNCTIONS AND REACTIONS TO STRESS A CONSISTENTLY DISTRESSED INFANT BECOMES TRAUMATIZED LIMBIC System The amygdala releases stress hormones that if not smoothed flood the brain with CRF (cortico-releasing factor). CRF then impacts the ability of the Limbic System (thalamus, Hypothalamus and Hippocampus) to help us think clearly and rationalize situations. Stress will impact the functioning of the Limbic System and it will be difficult to know: How we feel What our risk is How to respond successfully to others. Over time, it impacts the ability of the brain to appraise our emotional responses. The Limbic System is not fully developed until the age of 36 months.

13 ORBITO-FRONTAL CORTEX: A region of the pre-frontal cortex. The orbito-frontal cortex is responsible for emotional processing and decision-making. We appraise our risk to situations, people, decide on appropriate behaviors, form abstract thought and relate successfully to others with this brain system. If the Limbic System is impaired then it is difficult to get clear, realistic messages to the orbito-frontal cortex: If it does not work, we are limited in the mental skills that help the brain organize and act on information TRAUMA SURVIVORS AND CHILDREN FROM ENVIRONMENTS OF PERVASIVE NEGLECT AND ABUSE: Due to the stressful impact on the Limbic System and orbito-frontal cortex they will have a decrease in their ability to understand their emotional experience, that of others, and self-regulate.

14 Single Incident Trauma vs. Complex Trauma PTSD One time event such as an accident, or a short term situation such as involvement in a natural disaster or violent historical event Complex Trauma Ongoing, habitual, repetitive traumatic experiences often perpetuated by individuals or groups that should theoretically be supportive Developmental trauma impacted by poverty, discrimination, community violence, multiple losses, lack of opportunities, or a negative feedback loop Could include attachment disturbances, emotional, physical, or sexual abuse, or prolonged neglect

15 Complex Trauma: Domains of Impairment Attachment Impairment Boundary problems Mistrust Social isolation Interpersonal difficulties Poor attunement Difficulty with perspective taking

16 Complex Trauma: Domains of Impairment Affect Regulation Poor emotional selfregulation Difficulty knowing internal states Difficulty labeling/expressing feelings Difficulty communicating needs

17 Complex Trauma: Domains of Impairment Behavioral Control Impulsivity Self-destructive behavior, aggression Sleep and eating disturbance Substance Abuse Excessive compliance or oppositional behavior Difficulty understanding / complying with rules Reenactment of trauma

18 Complex Trauma: Domains of Impairment Biology Disrupted sensorimotor development Analgesia (low pain perception) Coordination, balance, muscle tone problems Somatization Medical problems

19 Complex Trauma: Domains of Impairment Dissociation Alterations in states of consciousness Amnesia Depersonalization/ derealization 2+ distinct states of consciousness Impaired memory for sate based events

20 Complex Trauma: Domains of Impairment Cognition Difficulty with executive functions (attention, concentration, task completion, future planning) Problems processing novel information Lack of sustained curiosity Problems with object constancy, time and space Learning and language difficulties

21 Complex Trauma: Domains of Impairment Self-Concept Lack of continuous, predictable sense of self Poor sense of separateness Poor body image Low self-esteem Shame and guilt

22 Window of Tolerance for Emotional Distress Hyperarousal, Anxiety, Distress Hypoarousal, Emotional Numbing, Dissociation

23 Window of Tolerance for Emotional Distress Hyperarousal, Anxiety, Distress Trauma Hypoarousal, Emotional Numbing, Dissociation

24 Window of Tolerance for Emotional Distress Hyperarousal, Anxiety, Distress Contain Trauma Healing from Trauma Ground Hypoarousal, Emotional Numbing, Dissociation

25 Have Difficulty Perceiving the Reality of Events or Situations It is important to: Contain Hyperarousal Reduce anxiety and distress Introduce activities that encourage calming, focusing, distracting Ground Hypoarousal Reduce emotional numbing and dissociation Introduce activities that encourage arousal, engagement, movement

26 Best Practices: Working with Trauma Help students build trusting relationships with an invitation, not coercion, provide choices Clear and Consistent Rules and Limits Words matter What we say and what we don t say Recognize what s going right, don t energize the negative- power struggles Require Short and Clear Directions Be aware of your own window of tolerance and your own need to self-regulate responses calm, normal tone of voice Use of I Statements

27 Best Trauma Informed Practices Give students practice making choices trauma is about an extreme lack of choice Both physical and relational When you are upset, please use one of your choices, you can do.or.. Create shared authentic experiences not saying one thing and doing another Keep your word, be consistent Increase present moment experiences interoception

28 Best Trauma Informed Practices Awareness self and child Mindfulness M & M s Breath work 4-Square, Diaphragmatic Meditation Focus on your Breath Body-based interventions - Yoga DBT Life Skills Program

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30 In all things concerning a child, the task of the adult charged with his or her care, is to see oneself in the moment. The ability to be mindful; when we see clearly our own internal state of being, including emotions and thoughts, we hold the greatest ability for impacting our environment in a positive manner. This will force us to look beyond the mere simple bounds of behaviors to the driving forces of emotion and stress. This task, in the final analysis, makes all the difference in a child s life. Bryan Post

31 Contact Information Jane Williams & Elizabeth Dorado Gordon Bernell Charter School