Monday, July 21, 2014

Posttraumatic Growth

There has been some new research coming about on something called posttraumatic growth.  During a presentation last week I mentioned this and very few people in the audience knew about it.  It is primarily a result of resiliency studies in people who have been able to recover from traumatic incidents or even from long term interpersonal trauma.  In order to educate readers about this I have taken the following directly from the University of North Carolina, Charlotte, website.  http://ptgi.uncc.edu/what-is-ptg/

After you read this,  I am sure that you will know of people with whom you have worked who have experienced posttraumatic growth.   In fact, you may also have experienced posttraumatic growth. 

What is PTG?

What is posttraumatic growth? It is positive change experienced as a result of the struggle with a major life crisis or a traumatic event. Although we coined the term posttraumatic growth, the idea that human beings can be changed by their encounters with life challenges, sometimes in radically positive ways, is not new. The theme is present in ancient spiritual and religious traditions, literature, and philosophy. What is reasonably new is the systematic study of this phenomenon by psychologists, social workers, counselors, and scholars in other traditions of clinical practice and scientific investigation.

What forms does posttraumatic growth take? Posttraumatic growth tends to occur in five general areas. Sometimes people who must face major life crises develop a sense that new opportunities have emerged from the struggle, opening up possibilities that were not present before. A second area is a change in relationships with others. Some people experience closer relationships with some specific people, and they can also experience an increased sense of connection to others who suffer. A third area of possible change is an increased sense of one’s own strength – “if I lived through that, I can face anything”. A fourth aspect of posttraumatic growth experienced by some people is a greater appreciation for life in general. The fifth area involves the spiritual or religious domain. Some individuals experience a deepening of their spiritual lives,however, this deepening can also involve a significant change in one’s belief system.


Some Clarifications

Most of us, when we face very difficult losses or great suffering, will have a variety of highly distressing psychological reactions. Just because individuals experience growth does not mean that they will not suffer. Distress is typical when we face traumatic events.

We most definitely are not implying that traumatic events are good – they are not. But for many of us, life crises are inevitable and we are not given the choice between suffering and growth on the one hand, and no suffering and no change, on the other.
Posttraumatic growth is not universal. It is not uncommon, but neither does everybody who faces a traumatic event experience growth.


Our hope is that you never face a major loss or crisis, but most of us eventually do, and perhaps you may also experience an encounter with posttraumatic growth.

Here are some links to other articles on posttraumatic growth:




Monday, July 14, 2014

Teens, Trauma and Relationships

Adolescence is a scary period but even more so for teens who are trauma survivors.    Trauma can make it difficult to parse out what could be normal adolescent development, with all the angst and struggles to separate and mature, versus what impact the history of trauma may be having on the teen.  However, I am going to try and provide some insight into what may be going on and how it impacts teens’ ability to develop healthy relationships. 
Development
In his recent book, Brainstorm: the power and purpose of the teenage brain, Dr. Daniel Siegel describes the overall movement of the teen’s brain to becoming more integrated.  Integration means that more areas of the brain are becoming specialized and interconnected to one another in more effective ways.  This specialization takes place through a process of pruning.  Pruning is the remodeling of the brain, letting go of connections in the brain that are not needed or haven’t been used.  From a trauma perspective, this means that neural pathways that have been strengthened to manage safety or that have been developed as a response to trauma will remain while other pathways that have been ignored due to trauma will be pruned away. 
Dr. Siegel explains that if there is any vulnerability in the brain’s makeup during childhood, adolescence can reveal those brain differences because of the pruning down of the existing but insufficient number of neurons and their connections.  The impact of adverse childhood experiences such as abuse and neglect may become more noticeable because the pruning is unmasking the vulnerabilities that have been lying being the surface.  This also is why major psychiatric disorders (which may be responses to trauma) may express themselves for the first time in adolescence.
Trauma Responses
When the flight, fight or freeze responses engage in adolescents it can lead to long term difficulties.  The fight response is a teen’s struggle to gain or hold onto power, especially when they feel they are being coerced.  The flight response can be seen when a teen disengages, runs away and/or checks out emotionally. The freeze response occurs when a youth gives into those in positions of power and does not or is unable to speak up (Adolescent Health Working Group, 2013, www.ahwg.net).
Teens living in households with ongoing abuse and neglect have probably not been able to learn effective ways to manage their outward emotions and their internal responses.  They may blame themselves for the abuse and feel ashamed about what they have experienced.  They may engage in behaviors to manage their trauma responses in unhealthful and dangerous ways such as with alcohol and drug abuse, self-harm, unhealthy relationships, isolation, and high-risk actions.
Their school performance may be impacted by either under-performing, conflict with school personnel, or skipping classes.  The ability to complete tasks or understand school work can be greatly affected by learning disabilities or impairments that cannot be explained by anything other than the impact of witnessing or experiencing trauma.  Being unable to relate to peers and not feeling able to perform adequately in a school environment can lead to feels of shame and isolation.
Impact on Relationships
As you can well imagine, the above trauma responses would influence relationships that a teen may have during adolescence. There may be ongoing conflict with family members or detachment and isolation in order to avoid more conflict.   They may isolate from their peers because of the shame and guilt they feel about their circumstances and also affiliate with persons who reinforce the bad feelings they have about themselves and/or who are also engaging alcohol/drug use and other risky behaviors in order to validate their own sense of loss, shame and isolation.  Relationships may be modeled after what they have seen in their lives and lead to further abuse.
Interventions
The good news is that strong sustained attachments to safe and nurturing adults and peers can improve a teen’s life.  Within these relationships an adolescent can learn the skills necessary for identifying, expressing, and modulating feelings that arise when he/she is triggered or trying to manage the developmental tasks common to this age group having to do with identity and roles in society.  In addition, teens need to feel competent and be able to plan for and have feelings of control about the future.  Engaging in positive activities that help them discover and nurture latent talents can help increase resiliency and lead to a healthy adulthood.

For more information go to :  http://www.ahwg.net/