TLC GUEST BLOGGER: Barb Dorrington, MEd
Hurricane Katrina changed our society. Our sense of complacency fell unguarded, while we watched reports of survivors being left without food and water, living in shelters, and sometimes looting to survive. After eight debriefing trips over three years, I watched the struggle to survive first hand.
Katrina also changed me as a trauma debriefer. Not long before Katrina, I had just completed another level of training with TLC. Debriefing in a large-scale disaster location requires a unique skill set and is different than debriefing a single incident trauma, the kind that often happens in a school, agency or business setting. Armed with organized protocols and learning about large-scale disasters, I was able to make a real difference, along with another trained debriefer, Barb Desjardins. We were new at this, and sometimes we telephoned back to TLC for advice.
Fast forward to this 7th anniversary of Hurricane Katrina, I asked survivors how their lives have changed. “What are you grateful for since Hurricane Katrina?” Many factors influence how resilient a person is, including neurobiology.
One woman in her 80s was grateful for her house being spared. She offered Sunday dinners, complete with white linens and crystal, for friends who were not so lucky. Seven years later, she still hosts dinners and the linens and delightful food still appear. She is grateful for connection. A man in his 50s notes that he felt guilty when a casino seeking land bought his destroyed home for more than 10 times its value. His daily acts of kindness helping others make him appreciate family and friends.
What of the younger people and their families? One 23-year-old woman has completed a degree and is raising a baby with the help of her family. Her home is currently being built after a long battle with government as to whether the cyclonic winds did the damage or whether the water from the levee break was to blame. This family tried to live in the condemned house, but toxic mold made it unlivable. The woman does not focus on this. She is grateful for the love of her family, her community and her church. Triggers remain such as the Green Day song called, “Wake Me Up When September Ends,” a song that played repetitively right after the storm. She is grateful for her toddler’s laugh and plans to become a doctor.
Seven years ago, I watched survivors teach younger children how to play basketball outside a shelter. Seven years later, I watch a Louisiana friend come to terms with the news her ex-husband conspired to have her killed. This was a man hailed as a hero for saving the lives of people and had wrongfully been jailed as a looter himself. The toll on this family was huge, but the woman, now in hiding, talks calmly about how her life dramatically changed after the storm. She was cut off from supportive social contact, but once again she has found her voice and speaks out on domestic abuse. She is grateful for just being alive and being able to hug her children.
Gratitude can be practiced as well as experienced. Dr. Robert Emmons, a California psychologist, researches gratitude and has discovered that either journaling about gratitude or writing a letter of gratitude in appreciation and then reading it to that person can change one’s health and level of happiness. Katrina survivors have learned this first-hand.
As for me, I still rely on TLC programs and annual training. TLC has become a frontrunner in training responders to be on the front lines of disasters, including the tsunami that affected Japan and 9/11, as well as a recent tornado in Goderich, Canada. I am grateful for the connection and community support of TLC. Such training continues to be timely, given the recent rash of mall and school shootings. TLC continues to offer leading-edge training and resources to communities all over the world. With that commitment to helping victims of trauma, TLC and its certified professionals will continue this wonderful and much-needed work.
TLC GUEST BLOGGER: Cherie L. Spehar, LCSW, CTS, CTC
We are approaching the time of year when there are many natural transitions in a child’s life. New teachers, new classrooms and new schedules can create tension and apprehension. Apart from that, many kids are facing additional transitions that can be particularly difficult. These include things like visitation schedules, moves, peer changes and more. Consistency is important when children are adapting to new schedules. How to say goodbye is often overlooked and should be included in transition planning.
What Makes Transitions Hard?
One of the hardest parts about transitions, even if they are positive, is that with every change, some form of loss occurs. This is true even for what we perceive as positive changes. Something is given up when a change happens, and many children report transitional experiences as the most stressful encounters aside from other traumas. Other factors complicating transitions are those children who are particularly sensitive to routines, children who have already been traumatized, age, emotional development, and the intensity and amount of change to which they are already accustomed. When you consider this combination of factors, it becomes easily apparent that providing preparation and consideration for the “last times” is really a resilience-based option to enter into a new time.
Some Things to Try
Whenever I have a child or family going through a transition – which is often part of the reason they seek out assistance – we want to tap into their natural resilience and address their connection to their former place. With that in mind, one of the first things we go through together is how to say goodbye to an old place, a former routine or a person. Here are some simple but powerful ways to help bring gentle closure to the past so the future can begin with less angst.
- Farewell Rituals: Where and when possible, I offer assistance to parents in creating a trauma-informed “Pacing Plan” to ease the experience. Here, we create a list of things, people and places that are important to the child. Next, create a loose timeline for including an experience with each “one last time” before the change happens. For example, go to favorite places one more time, ask them to breathe in the smell and pay attention to what they see, and then say goodbye to the place either in their head or out loud. If moving from a home, school or camp, walk through the current place and say farewell to each room. Help them pick one thing from each room that they will remember. For example, one young boy in my care once recounted that, to feel safe, he would stare at a crack in on his bedroom wall. He liked this crack in the wall because “it never changed.” We made sure that he said goodbye to this one feature that he connected with most.
- Give Time Markers: As many parents recognize, even day-to-day transitions from play to dinner, dinner to sleep and so on, go much smoother when kids are prepared. Again, to the extent that you can, provide time markers for a child. Use a calendar to cross off days together, offer verbal reminders at month, week and day markers, or use a gem jar or other creative way to mark the time so it does not come as a surprise.
- Follow the Feelings: It will be important, of course, to pay special attention to feelings and to help the child make space for them. Encourage the child to draw, play out scenes with puppets or stuffed animals, or use toys that symbolize movement (trains, cars, boats, skates). Ensure the child understands that they have safe places and people to share their feelings, and acknowledge that sometimes we can hold many feelings at once that seem to cancel each other out.
We all know that change is not always something we can plan for. These techniques are a way to “trauma-proof” difficult changes when we know in advance of their occurrence. When unexpected and swift change happens, a child may benefit from a different level of care. However, I have found that most of these can be adapted post-change to still offer relief, connection and bridge the goodbyes and hellos with less fear and anxiety.
May you find the tools of the heart to bridge the changes in your lives or the lives of those with whom you are walking the “Healing Path.”
Cherie, Smiling Spirit Pathways
Shelter Within a Shelter
TLC Guest Blogger: Jean West, LCSW, CTC-S, CT
When children move from an unsafe living environment to a domestic violence shelter we breathe a huge sigh of relief. However, we must remember that their inner working model will likely perceive the home environment as “normal” and the new “safe” environment as “scary and strange.” The majority of mom’s entering a shelter have not only their current situation to work through, but also past traumas which may never have been addressed. According to The National Child Traumatic Stress Network, more then ninety percent of sheltered and low-income mothers have experienced physical and sexual assault over their lifespan. Our efforts are more effective when we are able to work with both the parent and child from a trauma-focused lens.
The first step in dealing with families exposed to trauma is for providers to become trauma-informed. Staff must be trained to recognize the basics of trauma reactivity in mothers and children of different ages in order to respond appropriately. Understanding that children must be approached according to their developmental age, not chronological, is of vital importance. It is also imperative that staffs understand that the mothers may be reacting from their own traumatic experiences, and desperately need trauma-informed services surrounding them. An effective shelter creates an environment that is safe, supportive and structured by providing trauma specific care. Trauma specific care for these families includes:
- Supporting caregiver’s roles in restoring a sense of stability to the family
- Providing assessments for parents which include screenings for past traumas
- Assessing whether a child’s development has been interrupted by trauma
- Training shelter staff and community health care workers to understand the link between traumatic experiences and adverse health/mental health outcomes
- Identifying and collaborating with community services that are trauma informed
The National Center on Family Homelessness has developed a toolkit to help shelters become trauma informed. In particular, they have developed a “crisis plan” that is a valuable tool to use with families. It helps families identify triggers that may cause them to react, and strategies they can use to help regulate their emotions and feel safe. This can be found at www.familyhomelessness.org.
At the TLC Summer Assembly two presentations will offer the opportunity to learn more about working with victims of domestic violence. Gretchen Miller will present “Finding A Safe Place: Creating Safety for Domestic Violence Through Art” Gretchen will address safety issues with both child and adult survivors of domestic violence. Participants will learn creative interventions to help survivors of domestic violence establish a sense of safety.
Also, Tina Bryant will present “Trauma Work with Children Exposed to Domestic Violence” Tina will specifically address the posttraumatic stress symptoms of children exposed to domestic violence, and will discuss evidence-based skills that can be used to help with these often complex situations.
Come join us at the TLC Summer Assembly July 10-13 and learn more about how to work from a trauma-focused perspective! You won’t be disappointed!
Resources
Bassuk, E. and Friedman, S. (2005) Facts on Trauma and Homeless Children. National Child Traumatic Stress Network. Retrieved from: http://www.NCTSNet.org
Resilience Soup
TLC GUEST BLOGGER: Carmen Richardson, MSW, RSW, RCAT, REAT
Come shop for the just right ingredients for “Resilience Soup” this July at the TLC Summer Assembly. Whether you attend a full-day Level 1 or 2 training or a half-day training focused on PTSD & eating disorders or animal assisted therapy, you will find a variety of ingredients to create your own special soup for you and your clients.
While traumatic happenings are part of life, so is resilience. Resilience is our ability to bounce back from stressful and traumatic experiences. Trauma can be experienced by devastating events such as child abuse, car accidents and natural disasters and by seemingly ordinary events such as falling off a bike, dental procedures and medical interventions. However, we can find ways to build up a child’s confidence and teach skills that help to mitigate the effects of a traumatic experience.
Peter Levine and Maggie Kline wrote, “Trauma-Proofing Your Kids: A Parents’ Guide for Instilling Confidence, Joy and Resilience” (2008). They believe that parents can support their children in specific ways in order to reduce the impact that a traumatic event can have on their child. While feeling identification, boundaries and body awareness are important skills to learn, one that is less commonly taught is sensory awareness skills. These skills are a key component when strengthening a child’s sense of resilience. I believe it is important as adults, parents or therapists that we take time to really know what sensations are and how they are different from feelings. Further, it is important that we also practice these skills to ensure that we engage with our young clients/children with a calm and reassuring presence. Some exercises that Levine and Kline identify are listed below:
Sensation Vocabulary Box
Together with your child or client, make a list of feelings; then make a list of sensations. Sensations are very different words than feelings. Some sensations include shudder, prickly, full, empty, shaky, wobbly, jittery, still and so on. Continue thinking of more words to describe sensations, and notice where in the body you experience them. Play with moving between feelings and sensations by noticing and identifying each in the body.
Sensation Treasure Chest
The whole family can be involved with making a sensation treasure chest. Gather a variety of objects, and put them in a box. Choose objects with different textures, including fleece material, feathers, sandpaper, peeled grapes, gummy worms and smooth or heavy objects. Without looking and only touching, encourage the child to pick an object from the box and identify what it is. Then experiment with touching it against the skin and describe with words what it feels like. You may compare and contrast different sensations such as weight, texture and temperature.
Rhymes
Levine and Kline offer a variety of rhymes in their book that are used with children and some younger teens. Many include animals and their characteristics in order to help children discover or re-discover their own inner resources. Often, the verses offer grounding and empowering images as well as actions to engage with your client in a playful and curious manner. Drawing images of the animals can also be part of exploring these resources. If interested, it is worth purchasing the book, especially when working with young and vulnerable children who could use support with developing these resources to increase resilience.
Drawing Sensation Maps
There are many variations with this exercise. One that I enjoy teaching uses an eight inch cardboard image of a person. I invite my client to think of an upsetting event, mapping out on one side of the cardboard body their thoughts, feelings and sensations using words, images, and colors. I then invite my client to think of a happy event, and on the other side of the image, map out thoughts, feelings and sensations in the same manner. We then move from one side to another, experiencing both sensations of joy and sadness, which teaches them that they can learn to tolerate their uncomfortable feelings, that their bodies don’t stay upset, and that they are powerful and can change their body experience.
In the course I will be teaching this summer, “Trauma-Informed Expressive Arts Therapy: A Sensory-Based Approach to Treatment,” we will be actively involved with engaging in a variety of expressive arts interventions that support the development of these very important skills. There are so many ways to teach and help heal the hurt from trauma experiences, and there will be plenty of exciting workshops at the summer assembly that will give you the ingredients needed to make your own variety of “Resilience Soup.”
And remember:
“The best and most beautiful things in the world cannot be seen or even touched. They must be felt with the heart.” - Helen Keller
In honor of my late cat Mico, who has has taught me the most about what sensory experiences are, how they can support one through the ups and downs of life, and how even the memory of such resources brings a sense of calm and softening in the body. He will be dearly missed.
Carmen Richardson MSW, RSW, RCAT, REAT
TLC GUEST BLOGGER: Cherie L. Spehar, LCSW, CTS, CTC
What is Mindful Self-Compassion?
Mindful Self-Compassion creates a space for all parts of a person to be held gently and without judgment and integrated into a person’s being with loving kindness. It teaches that all parts and feelings of a person are important and valuable. Drawing from many principles of mindfulness “brain training,” we advance the concept of mindfulness by applying it directly to a sense of self and well-being.
We know that mindfulness is a very useful component for sensory regulation and awareness. Mindful Self-Compassion is particularly helpful in assisting adults to be lovingly aware of these feelings and sensations, while responding to them with gentleness, kindness and understanding. It is comprised of several easy-to-learn ideas that build on principles of neuroplasticity and healing.
How is it important to trauma work?
When creating a sense of self as a survivor, a traumatized person often struggles with feelings of inadequacy, self-doubt and uncertainty in the process of recreating feelings of worth. It is important for a person to be able to hold these feelings in a way that is loving to themselves, instead of further perpetuating a sense of judgment and evaluation.
One can see how this is a powerful adjunct to the trauma healing process. It solidifies the intensive work they have accomplished and enhances the trauma narrative to not only survive but thrive. Trauma survivors often have difficulty in restructuring their identity as a “healed” individual. Their trauma defined them for so long that a sense of self hardly existed. Mindful Self-Compassion teaches them to tune into aspects of themselves previously unknown, hidden or rediscovered.
Finally, it also aids in helping with private logic issues, especially those related to when a person has believed negative things about their role in the trauma. Mindful Self-Compassion directly aids a person’s growing, healthier perspective.
When is it integrated?
When using the TLC Trauma Intervention Program, I find that it is most apt to introduce this extra intervention strategy when either Self-Secondary Wounding is discovered or toward the latter part of treatment when working on Survivor Plans, self-care and establishment of a new, stronger identity. I would, however, add the important caution that when using any form of mindfulness in trauma work, we must be very certain that the person is ready to be fully present with those feelings. Mindfulness interventions of any sort should usually be introduced only in the latter part of trauma work and only when other healing conditions and readiness have been met. This is especially true for Mindful Self-Compassion.
Another option is to add some solidification and identity sessions after the full Survivor Plan has been completed. I find that adding just a few sessions to the program at this point helps a traumatized adult move gently in the direction of rediscovering his/her own value in a way that honors all the parts of his/her experience and “Self,” even the ones he/she may not have liked much. It solidifies all of the survivor’s efforts in a way that helps bring empowerment and closure to his/her work.
How can I learn more?
There are several resources available to learn and incorporate Mindful Self-Compassion in your trauma care. A great place to start would be “The Mindful Path to Self-Compassion” by Christopher Germer. (http://www.amazon.com/The-Mindful-Path-Self-Compassion-Destructive/dp/1593859759) There are also several online resources, and you may even find some local practitioners who offer free classes in this area. It is definitely a resource you might want to consider adding to your tool kit, as the principles and practice of Mindfulness directly support the valuable process of the TLC Trauma Intervention Program. May you be well and mindfully supportive and supported in your ongoing efforts to help parents, adults and children!
Cherie L. Spehar
www.facebook.com/smilingspiritpathways
Experience Matters
TLC Guest Blogger: Annette Miner, CWY, CTC-S, CYC
“You want to relate to trauma as an experience, not as a diagnostic category.” – Dr. William Steele
“Trauma is not in the event, but in the experience of the event. It is not the understanding of trauma that heals, but the addressing of the experience of the trauma that heals.” – David Grill, MFT
“Trauma is not in the event itself. Rather, trauma resides in the nervous system.” – Peter A. Levine
This year’s theme for the TLC Trauma Practitioner’s Assembly is “Experience Matters.” This is a very fitting theme since it encapsulates the whole principle behind sensory trauma intervention. The traumatic situation should not be the primary focus when providing trauma intervention. Instead, focus on how the child perceives he or she experienced the event. Using the exact intervention technique is not what brings the most healing. It is the experience of the intervention and trauma specialist.
Child’s Experience of Trauma
Not every child that is exposed to a potentially trauma-inducing situation will be traumatized. In fact, two children can be exposed to the same traumatic event, resulting with one child being traumatized while the other is not. A potentially trauma-inducing situation is only traumatic if the child’s experience is one of terror, feeling totally unsafe and powerless to do anything about the situation they found themselves in (freeze). Furthermore, two children exposed to the same potentially trauma-inducing event may both be traumatized, yet their traumatic experience of the event is different. It all depends on how the child experienced that traumatic exposure from a sensory perspective. Again, it is not the event that is the trauma, but it is the experience of that event.
Experience of the Intervention
There is not one trauma intervention that fits every child. Trauma intervention is to be personalized to fit the needs of each child. We know that every traumatized child comes into our offices with an underlying emotion of terror being experienced at a sensory level. It is, therefore, imperative that the trauma specialist provide safety at a sensory level during each session in order for the trauma intervention to be effective. Each session must begin and end in a “safe place” for the child, with the middle portion of the session addressing the trauma themes while empowering the child. When safety is felt at a sensory level, the traumatized child can truly begin to share the fuller experience of his trauma, making the trauma specialist a witness to what he or she experienced. Only when a trauma specialist can see the trauma situation through the child’s sensory experience can he or she integrate the most effective sensory and cognitive components of the intervention in order to promote the most healing.
Final Comments
In 2004, I attended my first Childhood Trauma Practitioner’s Assembly. Back then, sensory intervention was a new concept to me, one that would eventually enhance all that I do in my practice. This year will be my eighth year of attendance at the Assembly. I look forward each year to all four days of training. It is a great time to refresh what I already know, learn new strategies and techniques, as well as network with colleagues.
If you have not yet attended a Childhood Trauma Practitioner’s Assembly, I encourage you to come out and join us this summer! For those of you who are returning, I look forward to getting together and chatting with you once again!
Annette
Experience Matters!
TLC GUEST BLOGGER: Carmen Richardson, MSW, RSW, RCAT, REAT
The 2012 TLC Childhood Trauma Practitioner’s Assembly is fast approaching, and experienced trainers are getting ready to offer their wisdom and insights for another week of great learning.
Eight Great Reasons to Attend the July 10-13 TLC Assembly
1. Up to Date Information
Keep on top of your field by attending this year’s assembly! Providing a trauma-informed practice is essential when striving to offer your clients the best treatment possible. TLC takes much care and attention to providing top-notch training grounded in research-based interventions that are clinically relevant and practical.
2. Build Your Own Community
The assembly is a great place to meet new colleagues from all over the world and renew/maintain connections with both participants and TLC staff from past trainings.
Each person that attends comes with their own skills and knowledge. Each of these people are potential resources. The TLC assembly provides a wonderful opportunity to create a network of professionals that you can consult with even after the assembly.
3. Professional Integration
Bring what you already know! As professionals, we are constantly learning new methods of intervention in an ever-growing field. Come to the assembly to learn fresh, practical interventions to integrate into your current practice. This means integrating all your previous knowledge and experience with current, up-to-date clinical information.
4. Get Inspired!
Inspiration is an essential companion on our journey as practitioners. I have found her, “Inspiration”, hanging around the halls during breaks. She throws herself out during presentations, and she captures our hearts as we gather new ideas and fresh interventions. She is the light that keeps us going when we return to our offices, schools and work places. She is the energy to keep believing. She will find her way into your suitcase as you pack up to go home at the end of the week.
5. Rejuvenate and Refresh!
Rejuvenation is a close relative to Inspiration. You will meet her as well at the assembly as you take time away from your practice to gather new information and affirm what you already know, as this is both refreshing and rejuvenating. She will sneak up on you at your table as you sink into the experiential activities that are often part of the workshops or as you enjoy the nutritious meals that are provided. You will be so pleased to reacquaint yourself with Rejuvenation!
6. Empowerment
One of the key components of trauma therapy is building resources to help empower the lives of the ones we journey with. As practitioners, we too need to feel empowered in our work. Learning the specifics of trauma-informed care is empowering to professionals at all levels. When we become empowered and alive in our work, we can pass that on to our clients. As we see the results in our clients, we all are empowered!
7. Increased Confidence/Competence
The assembly is a way of learning the “map” of working effectively with trauma-exposed clients, thus increasing competence. Attending can help with preventing burn out by increasing our confidence in our practice. When we have trusted professionals teaching, we can rest assured that we are offering cutting-edge assessment and trauma treatment approaches to our clients.
8. Certification = Increased Professionalism
And if those weren’t reason enough to come, you will gather more courses to earn your Level 1, 2 or 3 Certification as Trauma Experts! Having these Certifications helps to build your specialization in the field, sharpens your professional profile and adds to your marketability in the field.
See you there!
Carmen Richardson
