Understanding and Responding to Trauma

1. 2014 Understanding and Responding to Trauma Ian Finck and Laura Watts

2. Speaker Introduction Ian Finck Volunteer Laura Watts Volunteer/Employee

3. By the end of the preso we’d like you to… • Understand the basics of trauma • Understand the stress response and how it relates to people experiencing trauma • Understand the relationship between homelessness and trauma • Develop a better understanding of trauma through hearing a personal experience of trauma • Understand the recovery journey • Feel equipped with the tools and knowledge to support visitors experiencing trauma • Ask us questions!

4. Class Introduction

5. What is trauma? • Any event that involves exposure to actual or threatened death, serious injury or violence AND where the person's response involved intense fear, helplessness, or horror has the POTENTIAL to be traumatic. • “Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.” Judith Herman AIHW.GOV.AU

6. Trauma is Different

7. Interpersonal Trauma and Attachment • Involves the use or abuse of power or betrayal by one person (or group of people) over another person (or group of people) • Trauma that occurs at the hands of another person (or group of people) has the potential to impact on the way the person understands and forms other relationships throughout their life, including relationships with services.

8. Symptoms

9. Symptoms Behavioural • Physical • Emotional • Cognitive Emotional Behavioural

10. Understanding the Stress Response • Understanding the stress response is important in understanding the traumatic stress response. Biologically hard-wired Essential for survival Threat detection Hard to unlearn

11. The Brain

12. The Body brain stress activates hypothalamus which stimulates other glands

13. Response to Threat: Low Road Activation Information Forwarded Sensory Data Thalamus Stimulus Thalamus Amygdala Threat perceived Flight/fight activated Hypothalamus Pituitary Adrenal Axis Accelerator SNS

14. Response to Threat: High Road Activation Sensory Cortex Interpret possible multi meanings Hippocampus Sensory Data No danger Thalumus Stimulus Amygdala Hypothalamus Pituitary Adrenal Axis

15. Flight or Fight Hand Model

16. Trauma and Homelessness • ?% of homeless adults in inner Sydney reported at least one major trauma in their lives (?% of the general Australian report one lifetime trauma) • ?% had experienced two or more traumatic events (average six trauma experiences) • ?% experienced trauma prior to 16 years old • Homeless people also report traumatic experiences during homeless episodes • Homelessness itself can be considered traumatic Robinson 2010, Taylor and Sharpe 2008

17. A Local Perspective Trauma experience of homeless adults in inner city Sydney Sharpe 2008

18. Cycle of Homelessness and Trauma

19. A Personal Experience of Trauma Rob Holt Volunteer

20. The Healing Process

21. Neurogenesis and Neuroplasticity

22. What is “Recovery?”

23. Frames and Recovery

24. Frames and Recovery A person’s own understanding of their experience influencestheir: BEHAVIOURS

25. There Are Many Frames • Biological • Abuse or trauma • Environmental • Spiritual or philosophical • Political • Creative • Developmental • Cultural • Social and emotional wellbeing • and more…

26. Biological Frame The ‘problem’ is: • Biologically based • Medical “mental illness”, “mental disorder” • Disordered brain chemistry • Genetic vulnerability The effect is: • a loss of cognitive ability and social functioning Recovery might involve: • Acceptance and education about the disease and ‘treatment’ • Competent providers such as psychiatrists • Finding the right medication(s) • Integrating illness into self‐concept • Acknowledging limitations and finding connections which accommodate limitations

27. Abuse or Trauma Frame The problem is: • history of severe (often childhood) abuse or trauma The effect is: • Results in loss of sense of self • Loss of self creates behaviour which others diagnose as mental illness or disorder • Mental health services ‘treatment’ become further sources of abuse or trauma Recovery might involve: • Reclaiming a sense of self • Taking control over one’s life • Finding ways (externally and internally) • to confront the abuse and trauma

28. Safety is Necessary for Healing • Safety in environments (Physical safety) • Safety within your own body (Intrapersonal safety) • Safety in relationships (Interpersonal safety) • Safety in systems (Justice and systemic safety)

29. Physical Safety • Many visitors are homeless • Many visitors are abused • Wayside provides a safe daytime environment

30. Intrapersonal Safety • Triggers • Any cue that elicits a memory • Blood, noise, smells, behaviours etc. • Memory of trauma can intrude without warning • People may not be aware of what their triggers are • Learning your triggers can provide power over them

31. Interpersonal Safety Trauma informed supportive relationships are R.I.C.H. • Respect is conveyed and felt • Information is shared and transparent • Connection is negotiated • Hope is felt and conveyed

32. Safe Systems • Transparency • Justice • Power is not abused

33. The Role of Volunteers

34. Understanding • Visitors may be anywhere in the recovery process • Behaviours are symptoms, not personally directed • How the visitor “frames” their experience, their beliefs • Be consistent – show up and be present • Boundaries and capacity (passing to community worker)

35. Applying the Knowledge • Group Activity • Read the scenario • Based on what you’ve heard today, discuss how you, as a volunteer, would respond to the situation • Explain your response to the group

36. What’s Your One Takeaway?

37. Thank You