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Empowerment 101: Understanding and Treating Trauma

Empowerment 101: Understanding and Treating Trauma. Misty McIntyre Goodsell , LCSW Chris Adams Hill, LCSW. Objectives. Increase awareness of Large T and little t trauma Increase awareness of symptoms of PTSD Tools and techniques for working with survivors

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Empowerment 101: Understanding and Treating Trauma

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  1. Empowerment 101: Understanding and Treating Trauma Misty McIntyre Goodsell, LCSWChris Adams Hill, LCSW www.southvalleytherapy.com

  2. Objectives • Increase awareness of Large T and little t trauma • Increase awareness of symptoms of PTSD • Tools and techniques for working with survivors • Increase tools and understanding for building empowerment www.southvalleytherapy.com

  3. Empowering the Therapist www.southvalleytherapy.com

  4. PTSD: Prevalence • 7%-8% of US population will have PTSD at some point in their lives • Combat soldier and assault victims have rates as high as 60% • About 5.2 million adults have PTSD during a given year • Women are more likely than men to develop PTSD: 10% vs. 5% during their lifetimes www.ptsd.va.gov www.southvalleytherapy.com

  5. Stages of Recovery www.southvalleytherapy.com

  6. Pre-Step: Disclosure • Education www.southvalleytherapy.com

  7. Stage 1 • Establishing Safety and Security • Assess Risk • Assessing Strengths • Installation of Hope • Symptom Reduction • Skill Building • Mindfulness • Assess Impact of Trauma • Identify Trauma-Based Beliefs www.southvalleytherapy.com

  8. Stage 2 • Reprocessing Trauma • Work Through Grief / Mourning • Challenging Trauma-Based Beliefs • Replace trauma-based beliefs with positive reality-based beliefs and/or affirmations = EMPOWERMENT www.southvalleytherapy.com

  9. Stage 3 • Build Resiliency • Increase the support system • Increase sense of self-worth • Increase sense of self-efficacy • Self-Care • Build/Strengthen spiritual self • Build / Participate in community www.southvalleytherapy.com

  10. BIG T or little t www.southvalleytherapy.com

  11. BIG T • DSM criteria for PTSD www.southvalleytherapy.com

  12. Small t • They don’t meet criteria for PTSD • Usually not life-threatening • Terror and fear • PTSD symptoms less than 5 of the criteria • Examples • Divorce • Bullying • Neglect • Car Accident • Loss of a pet • Medical Crisis • Verbal Abuse www.southvalleytherapy.com

  13. PTSD: Signs and Symptoms • Intrusive thoughts about the event • Nightmares or distressing dreams • Acting or feeling as if the event is reoccurring • Illusions, hallucinations, flashbacks • Intense psychological distress at exposure to internal or external triggers • Physiological reactivity to triggers www.southvalleytherapy.com

  14. PTSD: Signs and Symptoms • Persistent avoidance of stimuli associated with the trauma • Persistent symptoms of increased arousal (not present before the trauma) • Difficulty falling or staying asleep • Irritability or outbursts or anger • Difficulty concentrating • Hyper-Vigilance • Exaggerated startle response www.southvalleytherapy.com

  15. PTSD Risk • Event factors • Intensity and duration of exposure to the event • Extent of brutality • Sense of betrayal • Threat of dying: not actual threat, perceived threat • Degree of unpredictability • Injury • Being trapped • Cultural Context Naparstak, B (2000) “ invisible Heroes, Survivors of Trauma and How They Heal” www.southvalleytherapy.com

  16. More likely to develop PTSD if: • ACES • Struggle with other mental health issues • Have family members with mental health issues • Environmental • Few friends or support network • Recently loss of a loved one (grief and loss) • Recent stressful life changes • Heavy Drinker • Are a woman • Poorly educated • Younger www.southvalleytherapy.com

  17. Survivor Response • Shame • Shame is a painful feeling about oneself as a person • Guilt • Guilt is a painful feeling of regret and responsibility for one’s actions • Fear • PTSD Responses www.southvalleytherapy.com

  18. THE BUNNY RABBIT www.southvalleytherapy.com

  19. Secondary Survivor Response Common Reactions • Helplessness • Fear • Confusion • Desire for Revenge • Self Blame • Overprotection • Loss of routine and intimacy • Shame • Frustration • Guilt • Distraction • Code of Silence www.southvalleytherapy.com

  20. Empowering The Survivor www.southvalleytherapy.com

  21. Empowerment • Listen and believe • Focus on the survivor’s reactions and feelings • Assist the survivor in regaining a sense of control over their life • Act as an advocate when dealing with police, medical or legal systems • Avoid projecting your feelings www.southvalleytherapy.com

  22. Empowerment Phrases • “You’ve been through so much AND you are here” • “You’ve accessed your strengths (example) and talents (example). Look how resourceful you are” • “You’ve already survived it. The work we are going to do is about acknowledging your feelings and taking away the power and changing the meaning” • “You are safe in this room” (if true) www.southvalleytherapy.com

  23. Role of Power and Control • Main issue in trauma • Diagnostic criteria • Healing is allowing the survivor to have as much control as they can in a healthy way • They have the power to choose/change the meaning they make of their traumatic experience www.southvalleytherapy.com

  24. LANGUAGE MATTERS www.southvalleytherapy.com

  25. Do NOT Say Things Like • I understand… • I’m glad you can share those feelings • You are lucky that… • Don’t worry, it’s going to be alright • It’ll take some time, but you’ll get over it • I can imagine how you feel • Calm down and try to relax • Try to be strong for your children www.southvalleytherapy.com

  26. Do Say Things Like • You are safe now (if true) • I’m sorry this happened • I’m glad you are talking to me now • I’m glad you are here with me now • It’s not your fault • Your reaction is common • You’re not going crazy • Things may never be the same, but they can get better • I’m here to support you through this www.southvalleytherapy.com

  27. Working With Secondary Survivors • Help them to predict what to expect emotionally for the survivor • Help them place blame on the assailant or situation not themselves or the survivor • Explore positive coping mechanisms • Model crisis intervention and empowerment • If they are also survivors, assess their need for counseling www.southvalleytherapy.com

  28. Self-Care • How do you care for yourselves? www.southvalleytherapy.com

  29. Q&A www.southvalleytherapy.com

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