TLC GUEST BLOGGER: Barb Dorrington, MEd
Almost everyone chooses to come up with a New Year’s resolution. For myself, I’ve identified two goals, one for work and one for my personal life. My work resolution is to once again examine all the resources TLC has to offer. There are some new books, online courses and podcasts. Two exciting new resources that come to mind include “Brave Bart and the Bully,” which speaks to the issue of bullying with a focus on communication and skill building, and the Life Events Checklist, a screening tool that helps identify potentially traumatizing life events. Podcasts are also available like TLC Founder Bill Steele presenting on the role of private logic. This podcast will help us make sense of a child’s choices, especially when they do not make sense to us.
And how am I putting the “new” in new year personally? For me, “new” stands for notice, experiment and wonder. My personal resolution is to show more compassion for myself, especially when I forget things or when things drop out of my hands from growing arthritis. Is this a self-centered resolution? Not really. Brain research is showing that if we can be compassionate with self, we open the door to compassion for others. Compassion is about being connected to others with an inclination toward action. Relationships are essential to feeling safe, calm, useful and hopeful about the upcoming new year.
Empathy also has a lot more to do with the emotions and thoughts of others. Noticing others without judgment and seeing a situation with a “beginner’s mind,” as Jon Kabat-Zinn, founding director of the Center for Mindfulness in Medicine, would say, allows one to be positively curious. And curiosity fosters hope. Experimenting has to be with allowing oneself to make mistakes. By definition, an experiment is designed to determine an outcome, so there is no right or wrong here. My experiment this year is to demonstrate being more loving toward others. Not only do they benefit, but it is like putting on my own oxygen mask and loving myself. Finally, showing wonderment in a mindful way also allows me to be curious and imaginative in a non-judgmental way. Ultimately it is all about compassion for myself and others. This is exactly the recipe for the positive attachment and support we want to promote when working with children with traumatized histories.
So where does singing come in? Well it is kind of like a social experiment. When we sing, we trigger our brain to hear calming and self-regulating sounds. As Stephen Porges, a professor of biological psychology and psychiatry at the University of Chicago, notes, in singing, we do everything right for our social engagement system. We connect, especially if we sing in a group, we listen, we breathe in and exhale in a controlled way, and we are using our all important mouth muscles. Porges referred to this as “yoga for our social engagement system.” More ideas like this are interwoven in the many courses and resources TLC offers.
TLC GUEST BLOGGER: Cherie L. Spehar, LCSW, RPT-S, CTS, CTC
In earlier articles, we’ve discussed the impacts of secondary wounding and self-secondary wounding. We covered some important interventive strategies for healing from this aspect of the trauma experience and how an individual can work within his or her own recovery process to overcome the effects of secondary wounding. Now, we take this a step further by examining how secondary wounding affects healing families.
Family systems are already disrupted and shaken by trauma. It is a time when families search for meaning, context and reason. Well intentioned people in the victim’s circle will say things that meaning to themselves, while inadvertently creating an atmosphere of blame for the victim (e.g., “Well, that makes sense because she was walking home alone in the dark”). To the victim, it implies that people think she did something wrong, and in the context of a traumatic event, that point no longer matters.
Often, effective psychoeducational guidance and support can relieve a family of the pain and guilt associated with this dynamic. At other times, it complicates the healing journey in unexpected ways, and additional supports may need to be considered. Let’s explore the sensitive issue of the traumatized family system, how trauma recovery can be supported or compromised, and some ideas to help.
How Secondary Wounding Impacts Families
When secondary wounding happens in a recovering family system, it can further destabilize it and cause issues with guilt, shame, anger and more.
Guilt – Most secondary wounding that occurs is not intentional. Yet, when family and friends learn about this aspect of trauma and the potential role they had in re-wounding, they are often faced with immense guilt at contributing to the victim’s experience and may berate themselves and blame themselves for “hurting someone I love so much.”
Shame – Like guilt, once a family is introduced to the idea of secondary wounding, it can create a profound sense of shame. With shame, many people, understandably, may not have considered that their words of support could have hurt, and they shame themselves by starting to believe there is something wrong with them to not have known how to support the victim. A person can begin to think they are an unfit parent or friend for doing something that further hurt their child or friend.
Anger – The victim, once learning about secondary wounding, may also feel a temporary sense of anger at his or her perception of having been blamed or at fault. While this calms with continued, gentle psychoeducation, a sting may persist for some time as all family members integrate their understanding of this aspect of trauma.
How It Affects Trauma Recovery
Estrangement – I have worked with families who, because the secondary wounding was so severe, became emotionally, mentally and even physically estranged from one another. This is one of the most serious effects and takes a long time to heal. Victims will focus so heavily on this aspect of their trauma experience that they become stuck and are less able to work through the traumatic experience itself.
Distrust – Trauma already causes a disruption in a person’s ability to trust the world and the people in it. With secondary wounding, this can become exacerbated because by perception, the people they trusted to help them feel better inadvertently created shame, blame and minimization of their pain. Because a person’s view of the world is distorted after a trauma, regaining this trust can be a delicate process.
Extended recovery time – When secondary wounding is very prominent in a family system, or if it is perceived by the victim as particularly hurtful, this will certainly impact the time spent in trauma recovery. Family members may need to learn and relearn more helpful responses, and they in turn will also need their own level of support for their own healing, and to be as present for the victim as possible. Other supportive healing measures must accompany and integrate with the TLC Trauma Intervention Programs.
Integral part of trauma narrative – Because secondary wounding becomes part of the trauma experience, it also becomes part of the healing trauma narrative. It can be used in a positive way to make meaning of the event and how the family attempted to heal.
Psychoeducation – One of the most helpful measures a clinician can take to ease the perceptions that come about from secondary wounding is to share the following information:
- What secondary wounding is
- It is rarely intentional
- It is not irreparable
- Help to normalize and relieve guilt the family may be experiencing by indicating that they didn’t know what they didn’t know
Family Therapy – When secondary wounding is of particular prominence, it can impact a victim’s experience of the trauma themes and create a sense of being “stuck.” Family therapy specific to this issue can be most helpful. Sometimes, this can be as minimal as incorporating supportive adjunct family sessions to review secondary wounding as a family unit and facilitate a communicative process that allows for apologies, forgiveness and understanding. At other times, moving temporarily to a family therapy—Contextual Family Therapy is often my intervention of choice—that integrates well with other forms of family therapy to address deeper issues becomes necessary. Be sure to seek consultation about when each is most appropriate with any given case.
Secondary wounding in families, while presenting additional obstacles, can also make space for opportunities of bonding, closeness and healing. Families who navigate this situation well are noted to have a wide range of system resiliency factors such as fairly healthy existing interpersonal relationships with each other, a method of overall respectful communication, and a desire to remain close, connected, interested and engaged with one another.
It is important to note some dynamics that are especially difficult when healing from secondary wounding. There are some situations in which the process of secondary wounding is actually abusive, controlling or even intentional. There may be verbal or emotional abuse already occurring in the family system, and secondary wounding may be “standard practice” in the family’s interactions.
Also, with some of the victim’s supports, it may be quite difficult to generate an awareness or understanding of how and why secondary wounding is detrimental to a victim’s experience and healing. Victims may feel unheard and unsupported when family members have trouble with this insight and continue to engage in secondary wounding during their interactions.
As we have shared together in this series of articles, it is easy to see that secondary wounding is faceted, potentially complex, and in need of specialized attention. In my work, assessing and exploring secondary wounding is an integral part of trauma healing, not only in its acknowledgement, but in incorporating and addressing it as a treatment issue. Watch for new changes in the “Adults in Trauma Intervention Program,” which will specifically offer a process for doing this that weaves seamlessly into the familiar structured sensory interventions!
Cherie L. Spehar, LCSW, CTC-S, RPT-S
Founder and Director at Smiling Spirit Pathways
TLC Guest Blogger: Jean West, LCSW, CTC-S, CT
In working with survivors of trauma, there has always been one difficult question: How do we know when they are ready to fly on their own? I have used the SITCAP® program with over 100 children within the last four years with extraordinary results. One adolescent boy sticks out in my mind. I met with him about a month ago for our debriefing session. His father had been very abusive to him and his brothers when he was little, leading to his incarceration. After our session, with tears in his eyes, he said, “You know, I have never really told my story like that ever before.” This boy has had at least five years of counseling from professionals, and in our first session, he gained a new sense of relief from being able to truly tell his story because I was a safe, curious witness to what he had gone through.
I could write for days on children’s stories I have worked with, but what I want to focus on is how I pull it all together and know when I am through with my work. I use the SITCAP® pre- and post-test (CAQ), which shows me how far their anxiety levels and PTSD symptoms have dropped. If they are still high in a specific area, such as anger, I will pull out more from the “One-Minute Interventions” material and dig further. I use play-based sensory interventions to go along with the program. For example, the Self Esteem Shop sells a tiny kit called “Think-ets Games,” which I use with families, individual sessions with children, and even in trainings. The kit consists of 15 tiny objects, ranging from an elephant to a wrench. There are several different activities you can do with this kit. The main activity I use is to take turns telling a story using the objects. One 13-year-old girl I am working with told the story of how lonely the elephant was and how much the elephant missed her brother and sister. This girl’s father had committed suicide over a year ago, and each of the three siblings have been separated, going from relative to relative, as mom is unable to care for them due to active substance abuse and homelessness. This activity helped me know where to go as a practitioner to further the healing process.
This is an example of a play-based assessment, like those that will be presented at TLC’s Training and Certification Conference in San Antonio, TX, Feb. 21-24, 2013. Everything from “Sensory Interventions” with William Steele to “Advanced Structured Sensory Interventions” with Caelan Kuban and Sarah Slamer will be offered, so any level of practitioner will benefit from attending. I am especially excited about Cherie Spehar’s new training on “Putting it all Together: Trauma Assessment, Practice Points and Trauma Integration” because that is where I feel like I am at in my walk with SITCAP® . Learning more play-based assessment techniques, exploring secondary wounding and its effects on trauma recovery, and most of all learning trauma-focused closure interventions that support the new survivor as they fly on their own! I can’t wait to go and hope to see you there!
TLC Guest Blogger: Annette Miner, CWY, CTC-S, CYC
“We have given our child everything; so much love, a great home, everything she could ever want, but it doesn’t seem to matter. We have done everything we can think of. We have read every book on child rearing, tried everything to get this behavior under control, and nothing has worked. We don’t know what else to do! We love her, but we don’t know how much longer we can do this.”
Sound familiar? There may be different families or different ways of expressing deep emotion, but basically the same story is told over and over again by parents who have adopted children with histories of trauma.
Various studies have been done on adoption disruption with statistics fluctuating on their findings. One publication, “Adoption Disruption and Dissolution,” Child Welfare Information Gateway, states that adoption disruption on average ranges from as low as 6–25 percent, depending on the population studied, and various other factors. It went on to break down results found in various populations studied. Although this was not a national study, the information gathered is worth reviewing from a trauma-informed perspective.
Adoption disruptions pointed to traumatic experiences being demonstrated through behavior. Here are some examples:
- Children having a history of sexual or emotional abuse
- Children with physical disabilities and emotional or behavioral problems
- Each additional year of age increased the likelihood of disruption, which went up by 6 percent
- Children who entered the child welfare system due to lack of supervision or environmental neglect
- Adoptive parents feeling they had a lack of information on where to go for appropriate services as well as the cost of services
- And many other factors
Often by the time an adoptive family comes for help, they are emotionally exhausted and feeling quite helpless and oftentimes hopeless. They may have sought help from books or other well-meaning support systems, but often resources given for dealing with behavioral issues in general are in the form of behavior modification. These approaches simply do not work. In fact, they often compound a child’s trauma experiences.
It must be a relief for adoptive families who are struggling when they are able to receive trauma-informed care for their families and education on trauma and trauma responses, as well as being given strategies and ways in which to help their child feel safe. Having a trauma specialist/consultant who understands what is happening at a deeper level within their child provides parents with the hope that their child will finally have the help he or she needs to find relief from and completion/resolve of their traumatic event(s).
TLC offers a number of excellent training options to practitioners on providing trauma-informed care to these children and their families.
- TLC core certification courses, such as Children of Trauma and Structured Sensory Intervention, provide basic information needed to understand how traumatic experiences effect children from a sensory perspective, as well as offering information on how to provide trauma-informed care for these children
- Numerous online courses to choose from that provide information for working with specific populations (i.e. Zero to Three and Domestic Violence)
- Level-1 and Level-2 Trauma and Loss eCertification. All courses are offered online so you can receive full certification right from your own home
- Attendance at TLC’s Childhood Trauma Practitioners’ Assembly, then completing certification online from home
- TLC will come and train in your agency
TLC offers many tools and resources as well for practitioners to use with families when explaining trauma. TLC also offers exceptional trauma intervention tools to help children work through their traumatic experiences.
- Booklets: What Parents Need to Know, A Trauma is Like No Other Experience and After a Traumatic Loss
- Programs: Trauma Intervention Program and What Color is Your Hurt
I cannot help but believe statistics will change if adoptive parents are given education and tools on trauma and trauma response as part of their pre-placement training, as well as post-adoption, trauma-focused support once adoption has taken place. Adopted children and their new families deserve to have the best start they can as they begin their journey together!
TLC GUEST BLOGGER: Barb Dorrington, MEd
Suicide. As a school social worker, the sound of the word catches my attention immediately. When I learn that a student has died by suicide, my thoughts turn to worries for the contagion effect in a school building. Research statistics suggest at least one in 10 students have had serious thoughts about suicide or made an attempt.
We cannot forget how environmental factors affect our biology. Abuse and a history of trauma leave a biological footprint on the brain. Recent research out of Montreal, Canada compared the brains of males who had died by suicide. Changes in DNA cells in the brain uncovered a link between childhood trauma and suicide. This only confirms what we already knew– that trauma has biologically profound effects. Trauma awareness and suicide training programs, such as the ones TLC offer, are crucial for mental health literacy, especially in a school setting.
With the impact of this research, strategies to shift the brain from negative to neutral to positive thought are extremely important. Students, as well as educators, need to take the secrecy and stigma out of mental illness and educate staff and students on signs and symptoms and how to help.
Surviving friends of a teenager who has died by suicide experience a devastating level of powerlessness and helplessness, which in turn siphons off hope. As an art therapist, I learned that if one can draw, one can imagine. If one can imagine, one can hope. I have watched with curiosity how teens, when motivated to act in a helpful and kind way, show gratitude for what they have and respond to a new hope arising out of tragedy. They do better when they “do.” Dr. Bessel van der Kolk supports this approach. He speaks of the brain being an “action organ” and suggests people are physically organized to respond to things that happen to them with some kind of action.
Trauma debriefing, following a suicide in a school, has its own unique difficulties as educators look to organize adequate follow up in order to contain a contagious reaction in the school building. Working with a suicide protocol like the one TLC teaches in an online course provides intervention plans and strategies for assisting staff in schools.
Additionally, teens look to each other for support. Finding ways to foster hope is crucial. Providing mandalas for drawing as a way of encouraging mindful reflection, organizing a memorial, writing letters to the grieving family, creating a memory board and journaling all support a return to positive thought, action and clear thinking. Social networking sites have been known to be a breeding ground for posting suicidal comments and create havens of negativity. Yet, educators often learn too late about the postings of such comments.
An Ontario, Canada school board recently had a series of suicides in their schools, and their action plan was to create a powerful video called “Peel Schools Stand Up for Student Mental Health.” This four-minute video is now posted on YouTube. Stand up for mental health and take a TLC course, learn all you can about how brain science impacts suicide, and be part of the change towards reducing the statistics on teen suicide.