Being Sanctuary Trauma Theory

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Being SanctuaryTrauma Theory

• Parsons Child Family Center

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Objectives

• The Participant will be able to
• Name two (2) types of traumatic stress.
• Identify symptoms of Post Traumatic Stress
  Disorder (PTSD).
• Describe the effect that trauma has on the
  childs brain function.

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Trauma Theory

• Many of the kids we struggle to serve and work
  with have been victims of trauma
• Chronic stress, long term conditions, relational
  trauma such as physical or sexual abuse
• Immediate stress, unexpected extreme
  circumstances such as incidents of gang and youth
  violence, accidents, life-threatening illness

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Trauma Theory

• When any of the factors cause
• gaps in development
• attachment issues
• unsafe situations
• high levels of stress
• Then trauma is a likely reason for their
  difficulties in daily life ,in school, and in
  their interpersonal relationships.

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Trauma Theory

• Traumatic stress
• Knows no ethnic boundaries
• Affects both genders
• Can strike the young and the old
• The risk increases with chronic or multiple
  experiences
• Recovery is more difficult with extended exposure

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Trauma Theory

• Sadly, there may be no end to the list of
  things that can create trauma for children today
• The death or serious illness of someone close to
  a child
• Exposure to family violence
• Violent crime
• Sexual abuse
• War and conflict
• Can all play a significant role in the
  development of a traumatic stress reaction

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Trauma Theory

• There is no completely accurate predictor for
  who will suffer from trauma, but research is
  beginning to give us a picture of just what has
  happened to the traumatized youth that we serve.

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Trauma Theory

• One of the difficulties in talking about
  traumatic stress is in the diagnosis and labeling
  of people suffering from the disorder.
• Creating a benchmark of symptoms like the DSM-IV
  that works for children was not so easy.

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Trauma Theory

• Clinicians typically require of adults the
  following symptoms to make a diagnosis of Post
  Traumatic Stress Disorder, PTSD
• at least one re-experiencing symptom,
• three avoidance symptoms,
• two symptoms of hyper-vigilance

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Trauma Theory

• Difficulty in diagnosing young children
• Determining avoidance and numbing symptoms from a
  childs self-report is difficult at best
• Kids also have such a partitioned life that
  caregivers and teachers, may never observe
  behaviors that manifest themselves at home and
  vise versa
• Often children are unable to report their
  psychological reactions unless asked very pointed
  questions by trained interviewers.

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Re-experiencing Symptoms

• Recurrent and intrusive memories of the traumatic
  event which may be manifested by repetitive play
  with traumatic themes (role playing similar
  dramas with dolls or playmates)
• Involving themselves in similar, repetitive
  conflict situations where they follow routine
  responses with unfortunate and predictable
  outcomes.

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Re-experiencing Symptoms

• Do you have kids/incidents that fit this
  pattern?

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Re-experiencing Symptoms

• Re-experiencing may also include frequent
  frightening dreams, re-enactment of the traumatic
  event (for example, sexual acting out of the
  sexually abused child), and intense distress at
  reminders or representations of the trauma.

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Avoidance

• In the case of avoidance, a person will often
  exhibit amnesia for an aspect of the trauma, and
  avoid all talk or references to the trauma.

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Avoidance

• What might trauma do to upset our expectation
  of clear communication from our kids?

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Avoidance

• Many traumatized children will refuse to
  participate in normal activities as a way to
  avoid memories of the trauma. Normal activities
  can include something as simple as taking off a
  coat, or sitting at a certain spot.

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Avoidance

• Can you understand the conflict with a kid
  whose trauma is causing them to withdraw?

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Avoidance

• Avoidance behavior also includes having
  thoughts of decreased life span or limited
  future, as well as engaging in medicating the
  trauma with drugs or alcohol.

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Avoidance

• When a person suffers from traumatic stress it
  can also manifest itself in physical reactions
  the child suffers somatic symptoms like
• headaches, stomachaches, fainting spells, and
  tics.
• This has a link to frequent absences from school
  or time spent in the doctors or nurses office.

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Hyper-Vigilance

• Traumatized children also become hyper-vigilant
  always watchful for danger, and acutely reactive
  to changes in their surroundings.
• Changes can be subtle, and no matter how routine
  or regular, they create the same stress for these
  children.

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Hyper-Vigilance

• How many critical incidents get their start in
  a change in routine or staff? Or perhaps at
  transition times of the day? Or even during
  periods of less structure and predictability,
  like lunch or dinner?

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Hyper-Vigilance

• These may be some of the easier signs to spot,
  but they remain only one third of the larger
  picture of the traumatized child.

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Symptoms of Trauma

• How many of the children in your care can you
  identify with these characteristics?

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Trauma Theory

• For some of us, this we can digest the
  information in this lecture, but it is only made
  more powerful if we can help evoke the feelings
  that these conditions generate. So lets try an
  activity to help you experience the loss and
  disruption that is similar to many of our
  traumatized kids.

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Activity
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Trauma Theory

• Proper recognition of the trauma and
  appropriate response to the traumatic symptoms
  can go a long way toward helping these young
  people regain control of their lives, experience
  success in school, and heal.

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Universal Precaution

• A term often heard in medical circles, refers
  to a level of safety and procedure designed to
  keep workers as safe as is possible given the
  potential risks of their profession.

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Universal Precaution

• To consider the very real possibility that most
  of the difficult children we deal with every day
  are traumatized is really a universal
  precaution against responding to them in a way
  that will repeat or strengthen their trauma.

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Trauma Impacts the Brain

• Concerning the impact of childhood trauma on
  the developing brain, Dr. Bruce Perry and others
  They have discovered evidence that
• The traumatic event generates fear
• Our bodies neurophysiological responses to that
  fear
• Altering the development of young brains
• Resulting in changes in emotional, behavioral,
  cognitive and social functioning

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Trauma Impacts the Brain

• Because our brains function in a sort of
  user-responsive fashion, those parts of the
  brain that get activated the most will change and
  develop the most.
• So youngsters with patterned, regular stimuli
  will develop corresponding parts of their brains.

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Trauma Impacts the Brain

• For example, a child who is read to as a
  youngster has the speech and language parts of
  their brain activated regularly. These children
  develop better and earlier commands of language
  and communication skills than those children who
  are not exposed to this type of early
  stimulation.

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Trauma Impacts the Brain

• Likewise, however, a child who is exposed to
  repeated traumatic, stressful events where their
  more primitive, reflexive, instinctive brain is
  operating in the flight or fight mode develops
  more impulsive, aggressive and violent reactions
  to their world.

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Trauma Impacts the Brain

• Normally, as our brain develops, we grow from
  that state where the lower, more primitive and
  impulsive brain controls much of our responses to
  the place where our higher, more thoughtful and
  reflective brain centers kick in.

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Trauma Impacts the Brain

• It is this correlation of brain function and
  behavior as it relates to children suffering from
  trauma that is elemental in our understanding of
  these kids
• many of the most difficult behaviors that they
  engage in are not willful acts, but rather
  patterns of responses that have developed out of
  their inability to cope with the trauma.

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Trauma Impacts the Brain

• The primary functions of our brains are to
  process and store new information, and then
  categorize that data in light of what we already
  know. To do this, we must cognitively process
  each new experience.

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Trauma Impacts the Brain

• For most of us, it happens at a sub-conscious
  level and we slowly and automatically acquire
  experiences, habits, values and skills.

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Trauma Impacts the Brain

• When a child is traumatized, they are
  experiencing situations which they most likely
  have no reference for, and so the information can
  become fragmented or split off from existing
  mental schemes.

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Trauma Impacts the Brain

• For most of us, learning takes place when we
  are in a state of attentive calm. This requires
  higher parts of our brains to engage. But
  traumatized children receive information from the
  world differently, since they cannot achieve this
  state of attentive calm.

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Trauma Impacts the Brain

• It is not uncommon for traumatized children to
  be mislabeled as learning disabled. That is
  because caregivers, teachers and others around
  them judge them to be bright, but unable to
  learn.

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Trauma Impacts the Brain

• They fail to understand that the child is
  often utilizing a more primitive, less mature
  style of problem solving due to the fact that
  more reflexive parts of their brain are
  dominating their thought processes.

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Trauma Impacts the Brain

• Sometimes for these children, the aggression
  they engage in is simply a tool to get what they
  need, rather than a targeted response to a
  situation.

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Trauma Impacts the Brain

• Even the basic process of communication is
  affected by trauma. Traumatized children often
  have difficulties due to their state of flight
  or fright that result in many miscues and
  misunderstandings.

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Trauma Impacts the Brain

• This should have significant impact on how and
  what you try to communicate to traumatized
  children. They have altered senses of time, due
  to their aroused state. They cannot think about
  months or weeks from now, they must function in
  the present or very near future.

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Trauma Impacts the Brain

• So immediate reward is the most reinforcing to
  them any strategy utilizing delayed
  gratification is doomed to failure.

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Trauma Impacts the Brain

• Consequences of behavior become concepts beyond
  their grasp. Reflecting on their behavior is
  practically impossible.
• The logical, processing part of their brain is
  shut down. Their brain activity is stuck in the
  impulsive, aggressive mode.

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Trauma Impacts the Brain

• Even eye contact, a key part of communication
  can become threatening to them and too long a
  period of eye contact will prompt them to react
  usually impulsively and often aggressively.