TRAUMA & ADDICTIONS

1. TRAUMA & ADDICTIONS Training, Consulting & Therapy twalkertraining@gmail.com 647-876-5613

2. GOALS • Gather a better understanding of the individual with co-occurring trauma and addiction concerns • Support client’s to choose realistic goals and timelines • Develop therapeutic relationship while modelling appropriate boundaries within

3. OBJECTIVES • Recognize the symptoms & characteristics of clients impacted by trauma including how trauma can negatively influence a, • Person’s ability to modulate emotions without using substances to cope with (anger, stress, frustration…) • Person’s ability to access problem-solving skills • Person’s ability to access their impulse control • Teach client’s various methods of self modulation

4. Types of Trauma • Developmental Trauma • Living in adverse conditions that affect the nervous system of the child • Shock Trauma • An unexpected event that is sudden and can be extreme (May include medical procedures) • Relational Trauma • Can be on the continuum of war, bullying, domestic violence to sexual assault or abuse by someone we know

5. Post-Traumatic Stress Disorder • Condition where physiological and psychological processes are in a state of disequilibrium, altered by trauma impact. • Involves intrusive symptoms with subjective loss of control and lack of awareness of trauma triggers, but fear of them.

6. Trauma and Dysregulation • Early trauma leads to affect dysregulation due to excess stimulation of Central Nervous System (CNS). • Youth have problems learning how to regulate the intensity of feelings and impulses. • Results in a wide array of problems- physical and mental. • Inability to identify specific emotions. • Hard to live in body (somatic reactions occur).

7. Symptoms Psychological symptoms such as: • Anxiety • Low mood • Irritability • Emotional ups and downs • Poor concentration • Isolation • Difficulty falling asleep/staying asleep • Hyper-vigilance • Difficulty concentrating, and Difficulty trusting.

8. Symptoms (continued) Physical symptoms such as: • Feeling palpitations without knowing why; • Feeling sick; • Numbing out when everything seems okay; • Overreaction to sounds, smells; • Chest pain; • Headaches; • Stomach pains and; • Breathing difficulties.

9. Symptoms (continued) • Overwhelming fear and helplessness; • Belief that adults are dangerous and fail to protect; • Inability to concentrate; • Lower Intelligence Quotients (I.Q.’s); • Low self-esteem; • Self-defeating styles of relating to others; • Affective volatility.

10. Attachment • Clients who suffered attachment issues as children are unable to mollify their emotions • They do not have any access to their endogenous opioids • As a result, they seek out drugs or engage in behaviors that may stimulate these opioids • Can lead to anger management issues and other behavioural difficulties including criminalized behaviour

11. Psychophysiology of Early Childhood Trauma/Neglect Creative Analytical Imaginative Logical General Precise Intuitive Repetitive Conceptual Organized Big picture Details Heuristic Scientific Detached Empathetic Literal Figurative Sequential Irregular

12. Non use Experimental Use Occasional Use Dependent/ Chaotic Use Before Long You Need to Use to Get Back Here Regular Use We start here – Non Use WE DEVELOP A NEW NORMAL

13. Understanding How People Change & Why They May Be Ambivalent • Precontemplation Nah….. • Contemplation No Issue? Hmm… • Maintenance Doing it! • History • Environment • Rituals • Preparation • Self Talk/Beliefs • Communication • Action Now what?

14. Treating Trauma & Addictions • Stabilization and safety • Bottom-up: settle autonomic responses • Increase relative safety in current life • If relational trauma – relationship with worker is more important • Separating past from present and future • Develop language for emotion and sensation Expand flexibility and ability to adapt / cope • Rebuilding balance • Self confidence, self-esteem; Healthy connections

15. Stabilization and Safety Structure, predictability Educate about trauma Stabilization / regulation tools Awareness of sensation Self-care & basic needs Dealing with other stressors

16. AROUSAL LEVELS • When exposed to repetitive crisis; • Our arousal begins to rise; • Hyper or Hypo arousal becomes the constant State; • This influences positively and negatively how we deal with conflict?

17. S & S:If You Want to Teach Efficient Coping Strategies • Explain the approach • Confirm the client understands the approach • Give time to ask questions & give consent, and • Confirm that the client can stop if needed.

18. Safe Place Visualization/Filmmaking • So let’s go to your “happy place.” • Tell me - can you see… ? • What is _____ doing? • What are you doing? • What do you… • The job of the worker is to have discussed something that the person enjoys and work to have them visualize the experience. • Please use the template to assist you.

19. S & S - Body/Breathing • 3 – 6 Breathing • Many people who have suffered, are typically chest breathers. • They typically only breathe in their chest and rarely down into their stomach. • The object of this exercise is to get people breathing into their stomach. • Our work is to help them see that they can de-escalate themselves through a very simple process of breathing.

20. Breathing Exercises • Sipping – have your client pretend to be taking deep breaths through a straw. Inhale is through the straw, exhale is through the nose. • Three to Six breaths – have your client inhale deeply to the count of three and exhale for up to six seconds. • Contraindication – this could make people feel lightheaded.

21. When Over-Reaction is a Theme Teach them about the brain Help them learn how to think when getting angry Teach them skills to do that: Emotional Freedom Therapy (EFT) Find out what worked; Use distractions in the moment… What have you used???

22. Grounding Techniques Movement - Dance – Exercise (with focus on releasing the negative energy) Assertiveness training – BIO – Behaviour – Impact – Options or what Outcome do you want Rituals – coping card – what has worked in class when you are mad Write out what you are mad at – read it – write it again – read it – write it – until you figure out how to deal with it “well”

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24. Groups of three • Attempt to teach your colleague and do one of the safety exercises

25. Putting Theory to Action. • How you know you learned is: • If you feel differently; • Think differently; • Act differently. • Name three areas where you will use the skills; • BRAINSTORM.

26. Training, Consulting & Therapy twalkertraining@gmail.com 647-876-5613