CHILDREN EXPOSED TO TRAUMA IMMEDIATE AND LIFELONG IMPACTS

  • Slides: 51
Download presentation
CHILDREN EXPOSED TO TRAUMA: IMMEDIATE AND LIFELONG IMPACTS ARE COMMON Angela Keen Survivors, Inc.

CHILDREN EXPOSED TO TRAUMA: IMMEDIATE AND LIFELONG IMPACTS ARE COMMON Angela Keen Survivors, Inc.

Trainer Angela Keen ◦ Supervisor of Direct Services, Survivors, Inc. ◦ Victims’ Services Professional

Trainer Angela Keen ◦ Supervisor of Direct Services, Survivors, Inc. ◦ Victims’ Services Professional with 17 years experience ◦ Keystone Crisis Intervention Team (KCIT) Certified Trainer ◦ KCIT Team Member since 2005 KCIT 2015 2

Survivors, Inc. Envisions an end to domestic violence and sexual assault. OUR MISSION: Domestic

Survivors, Inc. Envisions an end to domestic violence and sexual assault. OUR MISSION: Domestic violence and sexual assault violate the sanctity and the safety of our relationships, homes, and communities. We provide comprehensive services and advocacy to those seeking lives free of violence.

RESOURCE QUICK response to hospital or police department 24 hour hotline 717 -334 -9777

RESOURCE QUICK response to hospital or police department 24 hour hotline 717 -334 -9777 or 800 -787 -8106 Secure Shelter Safety Planning individualized & can include PFA

SERVICES Supportive Individual & Group Counseling Legal Advocacy Bilingual & Bicultural Staff Children’s Support

SERVICES Supportive Individual & Group Counseling Legal Advocacy Bilingual & Bicultural Staff Children’s Support Group & Activities Significant Other Support Emergency Shelter Transitional Housing Community Education

Participants will: Articulate physical and emotional reactions to trauma Recognize trauma impacts on learning,

Participants will: Articulate physical and emotional reactions to trauma Recognize trauma impacts on learning, physical health and human development Be familiar with the ACE Study Make connections between individual trauma exposure and community health Identify trauma informed practices to implement in community work

Trauma Is Common “Knowledge about the prevalence and impact of trauma has grown to

Trauma Is Common “Knowledge about the prevalence and impact of trauma has grown to the point that it is now universally understood that almost all of those seeking services in the public health system have trauma histories. ” (SAMHSA)

Trauma Individual Trauma: A “blow to the psyche that breaks through one’s defenses so

Trauma Individual Trauma: A “blow to the psyche that breaks through one’s defenses so suddenly and with such force that one cannot respond effectively. ” - Kai Erickson, In the Wake of a Flood, 1979 Collective Trauma: A “blow to the tissues of social life that damages the bonds attaching people together. ” - Kai Erickson, In the Wake of a Flood, 1979 8

Fluctuating Equilibrium Normal Stress Eu-stress Distress 9

Fluctuating Equilibrium Normal Stress Eu-stress Distress 9

Impact of Trauma on Equilibrium 10

Impact of Trauma on Equilibrium 10

Sensory Path: Everyday Functioning Brain Cortex- Neo Cortex Thalamus Amygdala Hippocampus 11

Sensory Path: Everyday Functioning Brain Cortex- Neo Cortex Thalamus Amygdala Hippocampus 11

Trauma is a sensory experience It is not cognitive! 12

Trauma is a sensory experience It is not cognitive! 12

Sensory Path: Traumatized Brain Cortex- Neo Cortex Thalamus Amygdala Hippocampus 13

Sensory Path: Traumatized Brain Cortex- Neo Cortex Thalamus Amygdala Hippocampus 13

During a Traumatic Event The pathways between the right and left brain experience a

During a Traumatic Event The pathways between the right and left brain experience a disconnect. Right Brain • Memory • Sensory • Affect Regulation Left Brain • • • Making Sense Problem Solving Decision Making Language Impulse Control 14

Fight, Flight, or Freeze? http: //www. youtube. com/wat ch? v=39 i 89 NJNCRQ 15

Fight, Flight, or Freeze? http: //www. youtube. com/wat ch? v=39 i 89 NJNCRQ 15

Crisis Reactions Frozen Fright Numbness Deer in the Headlights Disorientation Confusion EMOTIONAL Shock –

Crisis Reactions Frozen Fright Numbness Deer in the Headlights Disorientation Confusion EMOTIONAL Shock – Disbelief – Denial Can’t believe this is happening Feeling helpless Questioning Loss of control BEHAVIORAL Withdrawal Inability to move Inability to make decisions Staring into space Inability to speak Time slows or stops Problem communicating thoughts Unresponsive to others KCIT 2015 PHYSICAL 16

Crisis Reactions PHYSICAL EMOTIONAL Fight, Flight or Adapt Cataclysm of Emotions Heart rate increases

Crisis Reactions PHYSICAL EMOTIONAL Fight, Flight or Adapt Cataclysm of Emotions Heart rate increases Senses more acute Adrenalin rush Urination Defecation Regurgitation Tunnel vision Muffled hearing Autonomic System takes over Not Linear – Mixed Fear/Terror Anger/Rage Confusion/Frustration Guilt/Self Blame Grief/Sorrow BEHAVIORAL Ready to Fight or Run Survival behaviors Decisions not moral or values based Regression in some learned behaviors Somatic complaints Poor problem solving Overly sensitive Emotional outbursts Disassociation Controlling Loss of appetite Exaggerated startle response 17

EMOTIONAL BEHAVIORAL Exhaustion Reconstruction Yesterday-Today. Tomorrow Time begins anew as they Getting back to

EMOTIONAL BEHAVIORAL Exhaustion Reconstruction Yesterday-Today. Tomorrow Time begins anew as they Getting back to a new start life after the traumatic state of equilibrium event Past-Present-Future Exhaustion sets in Creating more adrenalin Under activity Possible long term reactions Anxiety Depression Numbing Less trusting Disassociation Surviving or Coping Insomnia Irritability Poor problem solving Drug or Alcohol Eating disturbance Sexual dysfunction Obsessive Compulsive Behaviors KCIT 2015 PHYSICAL Crisis Reactions 18

Maslow’s Hierarchy of Needs Self Actualization Self-esteem Love and Belonging Cognitive Functioning Safety and

Maslow’s Hierarchy of Needs Self Actualization Self-esteem Love and Belonging Cognitive Functioning Safety and Security Basic Survival Needs KCIT 2015 19

Loss of Equilibrium in Trauma Stressors Adaptive Capacities Self Actualizatio n Self-esteem & Meaning

Loss of Equilibrium in Trauma Stressors Adaptive Capacities Self Actualizatio n Self-esteem & Meaning Love and Belonging Cognitive Functioning Safety & Security Basic Survival needs 20 KCIT 2015

Stressors: Good and Bad KCIT 2015 21

Stressors: Good and Bad KCIT 2015 21

Trauma is any event that leaves a person feeling hopeless, helpless, fearing for their

Trauma is any event that leaves a person feeling hopeless, helpless, fearing for their life and/or their safety. 22

Trauma is the unique individual experience of an event or enduring condition, in which:

Trauma is the unique individual experience of an event or enduring condition, in which: • • The individual experiences a threat to life, bodily integrity, or sanity The individual’s coping capacity and/or ability to integrate his or her emotional experience is overwhelmed

TRAUMA IMPAIRS • • • Feeling internally connected over time to caring others Experiencing

TRAUMA IMPAIRS • • • Feeling internally connected over time to caring others Experiencing oneself as deserving and worthwhile Managing Feelings: § Recognize, tolerate, modulate, integrate feelings

POTENTIAL IMPACT OF REPEATED TRAUMA Decreased ability to… • Manage feelings • Utilize feelings

POTENTIAL IMPACT OF REPEATED TRAUMA Decreased ability to… • Manage feelings • Utilize feelings • Self-soothe • Connect with others • Thoughtfully plan • • Develop Empathy Trust others/reach out for and respond to help

POTENTIAL IMPACT OF REPEATED TRAUMA Increased… • • Tension, anxiety, emotional unpredictability/over reaction Need

POTENTIAL IMPACT OF REPEATED TRAUMA Increased… • • Tension, anxiety, emotional unpredictability/over reaction Need for control, aggressive behavior • • • Avoidance, constriction, dissociation Use of drugs, alcohol, other addictions to manage feelings Risky behaviors

TRAUMATIC STRESS Shifts people away from emotional safety, emotional balance and predictability. Disrupts the

TRAUMATIC STRESS Shifts people away from emotional safety, emotional balance and predictability. Disrupts the ability to return-to-center.

Human Development Across the Lifespan Erikson ◦ Psychosocial Stages defined by successful completion/mastery of

Human Development Across the Lifespan Erikson ◦ Psychosocial Stages defined by successful completion/mastery of developmental conflicts. Piaget ◦ Cognitive development progressive reorganization of mental processes; biological and environmental influences. Maslow ◦ Hierarchy of Needs Refer to Handout

Maslow’s Hierarchy of Needs Maslow, A. H. (1943). A theory of human motivation. Psychological

Maslow’s Hierarchy of Needs Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370 -396. doi: http: //dx. doi. org/10. 1037/h 0054346

Developmental Impact of Trauma Children develop sense of trust in world from relationships with

Developmental Impact of Trauma Children develop sense of trust in world from relationships with early caretakers Learn from trusting others to internalize feelings of trust & safety When mistreated, sense of self affected, world viewed as unsafe

Developmental Impact of Trauma Neurobiology disrupted; Ability to comfort & protect oneself impaired Systems

Developmental Impact of Trauma Neurobiology disrupted; Ability to comfort & protect oneself impaired Systems of meaning, feelings about self & ability to trust in others & oneself deeply affected

ACE Study More than 17, 000 adult participants 25 studies since 1998 CDC &

ACE Study More than 17, 000 adult participants 25 studies since 1998 CDC & Kaiser Permanente’s Department of Preventative Medicine in San Diego Partnership Average 57 80% White; 10% Black; 10% Hispanic/Latino “solidly middle class”

Adverse Childhood Experiences Emotional Abuse Physical Abuse Sexual Abuse Mother abused Raised in single

Adverse Childhood Experiences Emotional Abuse Physical Abuse Sexual Abuse Mother abused Raised in single parent family Household member incarcerated

Adverse Childhood Experiences Household member abusing drugs/alcohol Household member chronically depressed, suicidal, mentally ill,

Adverse Childhood Experiences Household member abusing drugs/alcohol Household member chronically depressed, suicidal, mentally ill, psychiatric hospitalization Emotional/Physical Neglect Not raised by both biological parents

ACE Study Results Ø Ø Trauma is far more prevalent than previously recognized. The

ACE Study Results Ø Ø Trauma is far more prevalent than previously recognized. The impacts of trauma are cumulative and often occur in clusters. That unaddressed trauma underlies a wide range of health problems and social problems. ACEs are related to risky health behaviors in childhood and adolescence.

1 or More ACEs Increase Risk of: Cancer Heart disease STDs Liver disease Smoking

1 or More ACEs Increase Risk of: Cancer Heart disease STDs Liver disease Smoking Alcohol abuse Obesity Drug dependence IV Drug Use Early intercourse, pregnancy

1 or More ACEs Increase Risk of: Depression Anxiety disorders Hallucinations Sleep disturbances Memory

1 or More ACEs Increase Risk of: Depression Anxiety disorders Hallucinations Sleep disturbances Memory disturbances Anger problems Domestic violence risk Job problems Relationship problems

ACE Study Results Exposure to ACEs is associated with increased risk of depressive disorders

ACE Study Results Exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence. 54% of women and 36% of men with depression had ACE score of 4 or higher ◦ Compared to 18% of women and 10% of men with 0 ACE Score

ACE Study Results 20% to 70% increased likelihood of alcohol use initiated during mid

ACE Study Results 20% to 70% increased likelihood of alcohol use initiated during mid adolescence (15 -17 years). 7 to 10 fold more likely to report illicit drug use problems. Physical abuse and verbal abuse were most strongly associated with body weight and obesity.

ACE Study Results Childhood trauma has long-term, damaging consequences.

ACE Study Results Childhood trauma has long-term, damaging consequences.

Trauma exposure impacts community health.

Trauma exposure impacts community health.

How can you help?

How can you help?

Trauma Informed Care Most individuals seeking public behavioral health services and many other public

Trauma Informed Care Most individuals seeking public behavioral health services and many other public services, such as homeless and domestic violence services, have histories of physical and sexual abuse and other types of trauma -inducing experiences. (SAMHSA)

Trauma Informed Programs/Services are: • • based on an understanding of the vulnerabilities or

Trauma Informed Programs/Services are: • • based on an understanding of the vulnerabilities or triggers of trauma survivors so that these services and programs can be more supportive and avoid re-traumatization

CHANGING LENSES What’s wrong with you? vs. What’s happened to you?

CHANGING LENSES What’s wrong with you? vs. What’s happened to you?

Resiliency & Coping Resiliency: A person’s inherent capacity to moderate and recover from a

Resiliency & Coping Resiliency: A person’s inherent capacity to moderate and recover from a traumatic experience. KCIT 2015 46

Resiliency & Coping: When a person constantly changes cognitive and behavioral efforts to manage

Resiliency & Coping: When a person constantly changes cognitive and behavioral efforts to manage specific extern/internal demands that are taxing or exceeding the resources of that individual. KCIT 2015 47

Resiliency & Coping Biological Vulnerabilities + Perceived Stressors – Coping = Severity of Impact

Resiliency & Coping Biological Vulnerabilities + Perceived Stressors – Coping = Severity of Impact KCIT 2015 48

“The solution of adult problems tomorrow depends in large measure upon the way our

“The solution of adult problems tomorrow depends in large measure upon the way our children grow up today. ” Margaret Mead

RESOURCES National Center on Domestic Violence, Trauma & Mental Health www. nationalcenterdvtraumamh. org •

RESOURCES National Center on Domestic Violence, Trauma & Mental Health www. nationalcenterdvtraumamh. org • Substance Abuse & Mental Health Services Administration www. samhsa. gov/nctic/ • Keystone Crisis Intervention Team www. kcitpa. org • Centers for Disease Control www. cdc. gov •

Contact Information Angela Keen, Supervisor of Direct Services angela@enddvsa. org Esther Waybright, Community Education

Contact Information Angela Keen, Supervisor of Direct Services angela@enddvsa. org Esther Waybright, Community Education Specialist esther@enddvsa. org Survivors, Inc. 717 -334 -0589