Just Some of What I Learned at the Trauma Center Summer Institute

I just got back from the Trauma Center Summer Institute that takes place in Cape Cod every July.  I highly recommend if for anyone who is doing trauma-informed services or treatment.  The faculty from the TraumaCenter at Justice Resource Institute was excellent. 

I will probably incorporate what I learned into some more detailed posts in the future but just wanted to pass on a few snippets of things that I learned or re-learned while there. 

The majority of the impact from childhood trauma is delayed –

When physical or emotional abuse occurs in childhood, the effects of this abuse may take years to show up.  If the abuse occurs during early childhood the effects may not be seen until adolescence.  Trauma that occurs in early childhood and adolescence has a greater impact than if it occurs during the latency period between 6 and 12 years of age.  This is because there is more growth occurring in the brain during these two period of development and therefore the brain is more vulnerable to trauma.

Trauma that occurs during the pre-verbal period of development (ages 0-2) can be recalled and described once language or other means of communication is available – During the week I took part in a sand tray therapy workshop and the facilitator described at least two incidents and showed pictures of the trays in which a 3 or 4 year old was able to recreate a traumatic event in the sand tray that took place when the child was less than one year old.  This does not mean that a sand tray should be used as a way of forcing the child to tell their story.  The story comes out in the natural process of using the sand tray.

Vicarious Trauma is an STD!!!  STD = Sensitivity Transmitted Disease. Basically, if we don’t “care”, we don’t catch it.  However, like a sexually transmitted disease it is:

-      Easy to catch

-      Painful

-      Shameful

-      Hard to get rid of

-      Tends to keep coming back

-      Leads to justified ambivalence about continuing to engage in being sensitive

 How can we be sure to never catch an STD?  Abstinence – live on a mountain top in the Himalayas, quit our jobs, disconnect from the media, minimal contact with the world.  

Traumatic stress is a virus – contagious, can lay dormant, and we can build immunity to it.  It is transmitted physically, through our auditory senses, emotionally and cognitively.  If we don’t build up our immune system through good self care, we can catch vicarious trauma and then spread it to others with whom we are working.  It can become an epidemic and eventually a pandemic – infecting the whole agency.

Polyvagal Theory explains the freeze response. Click here for more information. 

This is just a sample of what I learned!!

Respond to the Emotions Beneath the Behaviors

I recently completed a webinar presented by the Florida Council Against Sexual Violence called  Trauma Informed Care for Foster and Adoptive Parents of Sexually Abused Children. The training was produced by Laurens Kids, Inc. and Florida Council Against Sexual Violence for the State of Florida, Department of Children and Families, Office of Child Welfare.  You can find the 3-hour webinar here .

There were three things that stood out for me in the webinar. 

First of all, it included a 20 minute video by the National Child Traumatic Stress Network called The Promise (of Trauma Informed Care).  This video outlines the three major components of providing trauma informed treatment for children who have been sexually assaulted:  parental involvement, coping skills and the traumatic narrative.  The video made the point that putting a child into counseling alone without the parent(s) being included can make the child feel as if there is something wrong with him/her and that the family somehow blames him.  Coping skills should be taught within the sessions which can then be reinforced and used by the parents at home.  Through the combination of parental support and coping skills, the child will then be able to unravel the traumatic narrative, be able to tell the story of the assault in small stages and receive valuable feedback that the assault was not her fault.

Secondly, I was moved by the focus on teaching the parent rather than changing the child.  When the focus is on teaching the parent to engage with the child in a positive, strength based and supportive approach the relationship between parent and child will eventually change, resulting in changes in the child’s behavior.  Often parents (and some teachers) feel that the focus needs to be on the child’s behavior.  Children cannot regulate their emotions without support and care from the adults in their lives.  I encourage you to check out the Circle of Security program for more information on how focusing on the parents’ responses to the child impacts the parent/child relationship leading to a more emotionally regulated child.

Finally, when I heard this statement I wrote it down and have been thinking about it ever since, “respond to the emotions beneath the behavior.”

The webinar had a panel of foster parents discussing some of the behaviors that were present in the children they were fostering or adopting.  They had been watching a role play of a teenager who had stayed out past curfew and was being confronted by her foster mother.  In the first role play, the mother was angry and the teen became defensive.  In the second role play, the mother focused on the feelings of fear of abandonment the teen was feeling and was able to join with the teen in trying to work through the problems that they were facing together.  The foster parents who viewed the video were struck by how focusing on the teen’s underlying emotions changed the energy of the conversation.

I think that as advocates we can also remember this statement when we are working with adults.  Often we have our own internal responses to the behaviors of people with whom we are working, but when we seek to understand the underlying emotions and take the focus off of the behaviors (which may just be skills they are using to manage their trauma response) we may be able to start a new healthier and more productive relationship.  It takes practice and an ability to be able to calm our own internal responses but it is well worth it in the long run.

How to Tell if a Therapist is Trauma-Informed

The growing knowledge of the effects of trauma on people's lives has increased the need for trauma-informed services.  In addition, a number of treatment models have arisen that address the needs of trauma survivors.  In response to this increased need a number of therapists have started identifying themselves as trauma-informed or providing trauma treatment when they are basing this solely on the fact that they have a number of clients who have identified themselves as trauma survivors.  It is important to be able to sort out which therapist are actually trauma-informed and are knowledgeable in treatment modes that meet the needs of survivors and do not inflict further re-victimization.

The Sidran Institute at http://www.sidran.org/  as excellent information on what to look for in a therapist and the type of questions you should ask a therapist before engaging in therapy.  Clink here to access their web page on What to Look For and How to Choose a Therapist.

The Pennsylvania Coalition Against Rape  has an excellent document on locating a trauma therapist.

For a list of current treatment models click here.