Trauma and our students

1. Trauma and our students SarinaKot, Ph.D., R.Psych. RPT-S

2. Topics: • Adverse Childhood Experiences • Trauma and Loss • Children and youth’s brain • Application • Self-care

3. Adverse Childhood Experiences (ACEs) • Research started in 1995 • Centers for Disease Control and Prevention • Kaiser Permanente • N = 17,000

4. ACEs • Abuse • Neglect • Witnessing domestic violence • Growing up with substance abuse, mental illness, parental discord, or crime in the home

5. Common • ACEs are common. • 28% reported physical abuse • 21% reported sexual abuse.

6. Cluster • ACEs cluster • Almost 40% of the Kaiser sample reported two or more ACEs and • 12.5% experienced four or more.

7. Powerful • Cumulative ACE score • Not any particular ACE • strong relationship to numerous health, social, and behavioral problems throughout their lifespan

8. Mechanism • Neurodevelopment disrupted • Impacts child’s ability to cope • During adolescence, adopts dysfunctional coping mechanisms (e.g. substance use) • Contributes to disease, disability and social problems

9. What helps • Simply acknowledging the past trauma • Asking about and listening to a patient's story

10. Doctor visits • Doctor: Can you tell me how this adverse childhood experience has affected you later in your life? • 35 percent reduction in doctor visits • 11 percent reduction in emergency room visits during the year following

11. Felitti • If a medication were producing these kinds of positive results, the drug would be mandated. www.acestudy.org www.humanstress.ca (Sonia Lupien)

12. What is trauma • Extremely stressful • Life threatening • Beyond one’s ability to cope

13. Trauma • Is about the event • Is about the person (brain, nervous system)

14. Inside the Brain • Amaygdala processes emotional events • Regular emotional events: processed and move on • Traumatic experience: too much info, cannot process the info fast enough

15. Inside the brain • Overwhelmed, cannot file away • Once triggered, feels like things are happening at the present time

16. Trauma’s Aftermath • Re-experiencing: flashbacks/nightmares • Avoidance: fear of reminders • Hyper-arousal : can’t sleep, hypervigilence, anger

17. What we may see • Withdrawn, disengaged • Aggressive, angry and oppositional • Tired, falling asleep

18. Children and Youth • Resilient? Vulnerable?

19. Most kids bounce back When home and school: • Provide safety, routine, calmness • Accept and understand youth’s reactions • Provide opportunities for making sense of the trauma

20. Physical activity

21. Problem solving

22. Overcoming fears

23. What really hurt kids • Lack of support from adults • Maybe adults are traumatized too • Chaos and danger repeated • A series of extremely stressful, life threatening events that are beyond youth’s ability to cope

24. Impact • Worse to have repeated trauma • Danger is the norm • Re-experiencing: see threats everywhere • Avoidance: dissociative • Hyper-arousal: opposition

25. Face recognition research Feeling faces are blurred gradually Abused kids can figure out an angry face when it is blurred beyond recognition Survival skills to see anger in others

26. Over-sensitive? Adaptive behaviour in a dangerous environment Unnecessary in the new and safe environment Safety has to be felt New learning

27. Another way to look at it Trauma hurt youth: • mentally (to focus or to attend), • emotionally (to calm themselves) and • situationally (to be aware of others or their environment).

28. Brain research • Experience is the sculptor • Plasticity • Relationship

29. Brain plasticity • Neurons that fire together wire together • Neurons that fire apart wire apart • Neurons that are out of sync fail to link

30. Relationship • Resilience: one secure relationship with an adult who knows the kid • Need connection to people who are present, kind, and sensitive

31. Best trauma treatment • Provide safety • Meaningful relationships • Help youth calm themselves • Process the trauma in manageable chunks

32. Self-regulation • Fancy way to describe - “calm yourself” • Breathing • Positive self-talk • Walk away

33. Process trauma • Notice triggers: Sensory reminders • Provide comfort/calming • Receive the student’s story

34. If a student tells you You are helping by listening: • Talking involves activating the pre-frontal cortex • Talking calms the amygdala • Making sense/filing

35. Quick tips • Don’t be afraid • Give brief responses to show understanding • End the conversation at a safe place • Thank the kid for sharing “That was scary. I am glad you are ok now.”

36. Talking, writing, drawing.. • Serve similar functions: making sense • Prefrontal cortex • Receive the information • Show understanding

37. Follow up The talk with you is sufficient Risks: suicide, hurt others, family problems Tell the youth that you will check in/get someone else to join in Share with a relevant colleague

38. Do we want kids to forget? • No, history is important • Transform memory: bad memory belongs to the past • Different parts of the brain

39. Self-care Why? Cost to helping • Empathic connection to our traumatized students • Student may treat you as someone else

40. Self-care How? • Discharge • Recharge through empathic connection

41. Just a reminder • Social support • Our own attachment figure • Seek help • Remain hopeful • Spirituality/Meaning