Thursday, August 04, 2016

Traumatic Memory ~ Talking Doesn't Always Help

In The Neuroscience of Traumatic Memory, Bessel van der Kolk and Ruth Buczynski explore how trauma affects the brain and how traumatic memory differs from other memories.

They note that some of the best therapy to address trauma is non-verbal.

Traumatic memory is formed and stored very differently than everyday memory.

Dr. Van der Kolk: If a person was abused as a child, the brain can become wired to believe, “I’m a person to whom terrible things happen, and I better be on the alert for who’s going to hurt me now.” 

Those are conscious thoughts that become stored in a very elementary part of the brain.

When trauma occurs: The brain becomes overwhelmed. That’s because the thalamus shuts down and the entire picture of what happened can’t be stored in their brain. “Instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.”

So instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context. And certain sensations just become triggers of the past.

Dr. Van der Kolk: You see, the brain continually forms maps of the world – maps of what is safe and what is dangerous. That’s how the brain becomes wired. People carry an internal map of who they are in relationship to the world.

Implicit memory system: Rather than being stored verbally, traumatic memory is a much more elementary, organic level of a single sensation triggering the state of fear.

Dr. Van der Kolk: It’s important to recognize that PTSD is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.

That’s why the main focus of therapy needs to be helping people shift their internal experience or, in other words, how the trauma is lodged inside them.

Talking can be less effective than nonverbal therapy: Talking can actually distract a patient from feeling, and from taking stock of what's going on inside.

Dr. Van der Kolk: All too often, when people feel traumatized, their bodies can feel like they’re under threat even if it’s a beautiful day and they’re in no particular danger. So our task becomes helping people to feel those feelings of threat, and to just notice how the feelings go away as time goes on.

This won't be forever: It’s important to help a patient learn that, when a sensation comes up, it’s okay to have it because something else will come next. This is one way we can help patients re-establish this sense of time which gets destroyed by the trauma.

Dr. Van der Kolk:  Once a patient knows that something will come to an end, their whole attitude changes. Sensations and emotions become intolerable for clients because they think, “This will never come to an end.” But once a patient knows that something will come to an end, their whole attitude changes.  

Thursday, September 11, 2014

An excellent reminder not to define young people by a behavior they might be struggling with...

Pam Parish wrote an excellent article on this topic.
Here are some quotes (below).

Wednesday, August 27, 2014

Needing something so bad you don’t know how to get it

How do I make healthy connections? 
What does it look like when relationships slowly build over time? 

As foster care youth, we often lack that secure base of knowing that someone will always love us and be there for us.

Walking around without that comfort and reassurance is like walking around with a missing piece inside.

This is an unmet need that we live with every day, until we are able to establish safe, secure, and lasting relationships in our lives.

Because we grow up lacking the security of that connection, I've noticed that foster youth can sometimes go to extremes: trusting either too quickly or too slowly.

It's ironic - this sense of needing something so badly that you don't know how to get it.

Tuesday, December 03, 2013

Comprehensive Overview of Trauma-Informed Child Welfare Practice

The Center for Advanced Studies in Child Welfare has compiled a comprehensive overview of Trauma-Informed Child Practice for Winter 2013.

Quoting from page 26, referring to No Way Home: Understanding the Needs and Experiences of Homeless Youth in Hollywood” (Rabinovitz, Desai, Schneir,and Clark, 2010):
  • Approximately half (48%) of the youth surveyed (n=389) reported previous or current involvement with the child protective services system (CPS); forty percent of youth reported having been removed from their homes by CPS. The mean age when youth reported having been removed by CPS was 9.3 years old. 
  • Almost all (95%) of the youth who had been removed from home had been placed in a group home at some time, and close to one-third of the youth reported they had been in 6 or more group homes.
  • Clearly, our child welfare system has not been effective in finding these children and youth the safe and permanent housing they require for healthy development.

Parent-Child Interaction Therapy

The National Center for Injury Prevention and Control's Division of Violence Protection has recently released a publication entitled: Essentials for Childhood: Steps to Create Safe, Stable and Nurturing Relationships.

One of the evidence-based programs they recommend is Parent-Child Interaction Therapy: PCIT improves the quality of parent-child relationships and changes how parents and children interact with one another. Parents learn specific skills to build a nurturing and secure relationship with their child. Coaches work directly with parent-child pairs to help them learn new skills.

Saturday, May 25, 2013

Trauma Informed Child Welfare Practice

What does it really mean to have trauma-informed child welfare practice? 
The Center for Advanced Studies in Child Welfare has recently published a comprehensive look at this prevalent child welfare issue.


Toolkit on Court-Involved Youth Exposed to Violence

Research shows that most youth entering the juvenile justice system are estimated to have been exposed to violence and other traumatic events, oftentimes having experienced multiple types of victimizations.

Youth in the juvenile justice system already face significant challenges related to their incarceration and justice involvement, including separation from their families, communities, education and other positive social networks.

Having a trauma-informed justice system is critical to promoting the well-being of the child, their families and the community.

Developed in partnership with the American Bar Association (ABA) Center on Children and the Law, Child and Family Policy Associates and the Chadwick Center for Children and Families, this collection of resources offers practice tips for juvenile defenders, children's attorneys and GALs, judges, and CASAs and provides guidance on policy reforms and other considerations for trauma-informed advocacy in the courts.

Polyvictimization of Children

Polyvictimization refers to having experienced multiple victimizations such as sexual abuse, physical abuse, bullying, and exposure to family violence.

Parental Exposure to Trauma

Wednesday, January 16, 2013

Consumer Voice and Trauma Treatment

SAMSHA has identified three trauma treatment principles that evidence-based treatments should embody:
  • First, behavioral health treatment providers must understand the dynamics and impact of trauma on children’s lives.  
  • Secondly, children and their caregivers receiving treatment should be involved in the design, delivery, and evaluation of the services. 
  • Third, providers should be culturally sensitive when offering services.

Volume 95 of the Virginia Child Protection Newsletter (VCPN) focuses on evidence-based treatments for childhood trauma.

This publication:
  • Provides information about specific evidence-based treatments, the impact of trauma on children, what child welfare workers can do to offer trauma-informed services, and resources. 
  • Includes a listing of questions to ask treatment providers
  • Highlights State Practice Improvement Projects in North Carolina and South Carolina
  • Discusses INVEST for Children: A Community-Based Learning Collaborative in Virginia

Monday, December 17, 2012

Impact of Trauma on Child Development

The National Center for Mental Health Promotion and Youth Violence Prevention recently released a publication on “Childhood Trauma and Its Effect on Healthy Development.”

Infants and Toddlers:
  • Rely heavily on their parents to protect them and interpret the meaning of social interactions and novel events.
  • Are in the process of acquiring verbal and communication skills and developing a sense of self. 
  • Are still acquiring the skills needed to adjust their behavior adequately in response to changes in the environment.
School Age Children are in the process of developing:
  • A defined sense of right and wrong
  • The ability to empathize with others
  • The interpersonal skills to form relationships with adults and peers
Adolescents are:
  • Experiencing physical and social changes
  • Gaining more independence
  • Establishing their personal identity

Emotional Aftermath of Abuse

The emotional aftermath of abuse can include shame, anger, feelings of powerlessness, and post-traumatic stress disorder.

Without treatment, Post-Traumatic Stress Disorder (PTSD) can generate physical and emotional hyper-arousal -- often characterized by emotional swings or rapidly accelerating anger or crying that is out of proportion to the apparent stimulus.

The Child Welfare Information Gateway has released an information brief on Trauma-Focused Cognitive Behavioral Therapy for Children Affected by SexualAbuse or Trauma.

Trauma-focused cognitive behavioral therapy (TF-CBT) is ”an evidence-based treatment approach shown to help children, adolescents, and their caregivers overcome trauma-related difficulties.”

Promoting Resiliency In Foster Care Youth

Jim Casey Youth Opportunities Initiative recently released a news brief on “Promoting Development of Resilience among Young People in Foster Care.

The Core Principles they recommend, in order to support the process of developing resilience for young people in foster care include:
  • Optimism:  There is no “point of no return,” from which a young person cannot return. As long as young person is living and breathing there is hope.  
  • Strengths-based approach:  Look for the young person’s areas of competency and strengths. It’s not enough simply to remove one or more risk factors in their life – the next step is focusing on Developmental Assets.
  • Community partnerships: Effective intervention will include awareness of resources in the local community.

In addition, when it comes to building resilience, the brief recommends both strengths-based and process-focused strategies:
  • Strengths-based strategies refers to improving the number and quality of internal and external assets (i.e. tutoring, mentoring, community-based youth activities, parenting education for young parents, recreational activities and adult role models)

  • Process-focused strategies focus on  helping young people develop the skills to adapt to various situations (i.e. coping strategies, interpersonal relationships, cultural traditions and building self-efficacy – belief in their own ability to succeed)