Trauma responses: Looking at resistance, resilience and recovery

Transcription

1 Trauma responses: Looking at resistance, resilience and recovery Associate Professor Lou Harms Department of Social Work, The University of Melbourne CIMA 6 th Biennial Conference, Melbourne Tuesday 15 November 2011

2 Aput = snow on the ground Gana = falling snow MacTla = snow burgers ertla = snow used by teenagers for exquisite erotic rituals! Sources: Yahoo & Wikipedia!

3 Trauma responses What does human well-being look like? What are the disruptions of traumatic life events? What are the layers of our inner worlds really like? Can virtual relationships be just as satisfying as face to face ones? What is community? How do we tell the stories collectively of various events that have occurred? How do we think about uncertainty and risk? How do we understand the political aspects of traumas?

4 Theoretical approaches (Harms 2010) Psychoanalytic Cognitive Narrative Existential Cognitive behavioural Neurobiological Ecological

5 Trajectories (Bonanno, Westphal& Mancini 2011 p. 514)

6 Response trajectories after trauma Resistance Resilience Recovery

7 Resistance

8 Resistance as: the force required to displace the system from equilibrium (Norris et al 2008 p. 129)

9 Resistance as protective factors

10 But... protective factors have limitations

11 'there is no doubt that the resistance of the conscious and unconscious egooperates under the sway of the pleasure principle: it seeks to avoid the unpleasurewhich would be produced by the liberation of the repressed (Freud 1984 p. 290 )

12 Healthy avoidance Dissociation and relief through laughter and physical exercise

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14 Resistance as political, rights-based action

15 Protection is not limited to securing the survival and physical security of those affected by natural disasters. Protection encompasses all relevant guarantees civil and political as well as economic, social and cultural rights attributed to them by international human rights and, where applicable, international humanitarian law (Brookings-Bern Institute, 2008,pp.7-8) The need to: Ensure non-discriminatory disaster relief Inform and consult Monitor

16 Resilience

17 Resilience as a quality of Community? Individuals?

18 Resilience as a metaphor When applied to people and their environments, resilience is fundamentally a metaphor. With roots in the sciences of physics and mathematics, the term originally was used to describe the capacity of a material or a system to return to equilibrium after a displacement. A resilience material, for example, bends and bounces back, rather than breaks when stressed (Norrisetal2008p.127)

19 Resilience Our world has changed and we must change with it. There is no going back. A more apt metaphor for resilience might be bouncing forward to face an uncertain future. This involves constructing a new sense of normality as we recalibrate our lives to face unanticipated challenges ahead (Walsh 2002 p. 35)

20 Resilience: the ability to adapt and cope successfully despite threatening or challenging situations Resilience is sustained competence in response to demands that tax coping resources Agaibi and Wilson (2005 p. 198) bouncing back or bouncing forward?

21 Attributes associated with individual resilience Cognitive abilities (IQ scores, attentional skills etc) Self perceptions of competence Temperament and personality (adaptability and sociability) Self regulation skills (impulse control, affect and arousal regulation) Positive outlook on life Masten and Powell (2003)

22 Community resilience as a set of capacities (Norris et al 2008) 1. Economic development resource volume and diversity, resource equity and social vulnerability 2. Social capital network structures and linkages, social support, and community bonds, roots and commitments 3. Information and communication systems and infrastructure for informing the public, communication and narrative 4. Community competence collective action and decision-making, collective efficacy and empowerment

23 Belief systems: Make meaning Positive outlook Transcendence and spirituality Family resilience (Walsh 2007) Organizational patterns: Flexibility to adapt and re-stabilize Kin and community connectedness Economic and institutional resources Communication and problem solving: Clear, consistent information Open emotional expression Collaborative decision making and problem solving

24 Resilience dimensions Social dimensions of resilience: Safe neighbourhoods Perceived and received social support Structural dimensions: Community resources and facilities High quality human services including social and health services Adequate safety nets around housing, financial, and employment needs Cultural dimensions: Non-stigmatizing, anti-discriminatory attitudes towards individual experience A broad sense of coherence and meaning around life transitions -through rituals etc

25 ordinary magic What began as a quest to understand the extraordinary has revealed the power of the ordinary. Resilience does not come from rare and special qualities, but from the everyday magic of ordinary, normative human resources in the minds, brains, and bodies of children, in their families and relationships, and in their communities (Masten 2001 p. 235)

26 Recovery

27 Recovery For me to recover from the accident I d like to have been as I was before the accident. Yeah, that s changed because like if you d first asked me that, I would have said recovery is getting back to exactly the way you were before (laughs) and now it sort of means learning to meet the challenges that you do have and try and do as many things as you want to do and not let the injuries get in the way of that. well I used to think that recovery would mean a full recovery. I ve come to realize now that recovery means as long as you ve got two arms, two legs and a heart beat and you can get out of bed in the morning, you re not too bad.

28 Recovery The core experiences of psychological trauma are disempowerment and disconnection from others Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections (Herman 1997 p. 133)

29 Positive outcomes (Tedeschi and Calhoun 1996, and onwards) Post-traumatic growth: Enhanced relationships with others Enhanced sense of self Enhanced philosophy of life

30 The elements of well-being (Seligman 2011 p. 16) Positive emotion Engagement Meaning Accomplishment Positive relationships

31 Five principles of practice (Ungar 2009 pp.35-36) 1. An ecological, multi-level approach to intervention 2. A focus on the strengths of individuals and communities 3. There are many pathways to success 4. A focus on social justice is foundational to successful development 5. Diversity of culture and context

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33 References Agaibi, C. & Wilson, J. (2005). Trauma, PTSD, and resilience: A review of the literature. Trauma Violence Abuse, 6(3), pp Bonanno, G., Brewin, C., Kaniasty, K.& La Greca, A.(2010). Weighing the costs of disaster: Consequences, risks and resilience in individuals, families and communities. Psychological Science in the Public Interest, 11, Bonanno, G. (2004). Loss, trauma and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events?. American Psychologist, 59(1), Bonanno, G., M. Westphal, et al. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7, Brookings-Bern Institute (2008). Human rights and natural disasters: Operational guidelines and field manual on human rights protection in situations of natural disaster. Available at: Burstow, B. (2005). A critique of Posttraumatic Stress Disorder and the DSM. Journal of Humanistic Psychology, 45(4), Cork, S. (Ed) (2010). Resilience and transformation: Preparing Australia for uncertain futures. Collingwood: CSIRO Publishing.

34 Cox, R. & Perry, L. (2011). Like a fish out of water: Reconsidering disaster recovery and the role of place and social capital in community disaster resilience. American Journal of Community Psychology. Early online access. Connor, K. & Davidson, J. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, Harms, L. (2010). Understanding human development: A multidimensional approach. South Melbourne: Oxford University Press. Herman, J. (1997). Trauma and recovery. New York: Basic Books. Levine, S., Laufer, A., Stein, E., Hamama-Raz, Y. & Solomon, Z. (2009). Examining the relationship between resilience and posttraumatic growth. Journal of Traumatic Stress, 22(4), pp Luthar, S., Cicchetti, D. & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), pp Masten, A. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), Norris, F., Stevens, S., Pfefferbaum, B., Wyche, K. & Pfefferbaum, R. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, Seligman, M. (2011). Flourish. North Sydney: William Heineman.

35 Tedeschi, R., Calhoun, L. & Cann, A. (2007). Evaluating resource gain: Understanding and misunderstanding posttraumatic growth. Applied Psychology: An International Review, 56(3), pp Ungar, M. (2008). Resilience across cultures. British Journal of Social Work, 38, Ungar, M. (2009). Resilience practice in action: Five principles for intervention. Social Work Now, August. Walsh, F. (2007). Traumatic loss and major disasters: Strengthening family and community resilience. Family Process, 46, Werner, E. & Smith, R. (2001). Journeys from childhood to midlife: Risk, resilience and recovery. Ithaca: Cornell University Press. Westphal, M. & Bonanno, G. (2007). Posttraumatic growth and resilience to trauma: Different sides of the same coin or different coins?. Applied Psychology: An International Review, 56(3),