by: Rebekah Wilson

Trauma

Trauma Definitions

● “ a deep distressing or disturbing experience…. Emotional shock following stressful event or a physical injury, which may lead to long-term neurosis” (Oxford dictionary)

● “ a disordered psychic or behavioral state resulting from mental, or emotional stress of physical injury” (Webster Dictionary)

What is Trauma?

Trauma can be defended as a reaction to an unexpected profound event, which occurs in a person’s life, causing an unhealthy involuntary and uncontrollable physical, mental, and/or emotional response. This response causes the traumatized person to feel emotional,

physical and/or mental instability.

Potential causes of Trauma

Significant relationship breakup, natural disasters, sudden death of a loved one, serious injuries (sports, physical abuse, falling, car accidents), childhood

traumatic event (neglect, domestic violence, abuse- sexual, verbal, physical, serious illness, parental separation, dangerous and/or insecure atmosphere.),

surgery, war, witness horrific injury (Robinson) family member vanish, homelessness, basic needs unmet for a long period of time, witness the loss of a

loved one, forced to violate their personal morals, living in an unsafe environment for a long period of time, rape, witness parents struggle with communication,

attending a school in an unknown language and different norms, natural disaster, unnatural disaster (house fire, 9/11)

Reactions that can cause Trauma

● Shock ● Stress

What is shock?

“ a sudden upsetting or surprising event or experience: ….a feeling of disturbed surprise resulting from a sudden upsetting event....[mass noun] an acute medical condition associated with a fall in blood pressure, caused by such events as loss of blood, severe burns, allergic reaction, or sudden emotional stress, and marked by cold, pallid skin, irregular breathing, rapid pulse, and dilated pupils: he died of shock due to massive abdominal haemorrhage....a violent shaking movement caused by an impact, explosion, or tremor: earthquake shocks [mass noun]: rackets today don’t bend or absorb shock the way wooden rackets do” (Oxford dictionary)

Different types of shock

● “Hypovolemic or Hemorrhagic shock- a type of shock that is described as insufficient blood volume resulting from hemorrhage, dehydration, or loss of plasma because of burns or third spacing” (Hardaway)

● Traumatic Shock- a type of shock produced by multiple tissue damage incident. This type of shock has disseminated intravascular coagulation (DIC) present. (Hardaway)

● Septic Shock- shock related to with viral and bacterial infection. type of shock has disseminated intravascular coagulation (DIC) present(Hardaway)

What is Stress?

“...state of mental or emotional strain or tension resulting from adverse or demanding circumstances: he’s obviously under a lot of stress [in combination]: stress-related illnesses.... [count noun] something that causes a state of strain or tension: the stresses and strains of public life” ( Oxford Dictionary)

How stress and Shock is associated with Trauma?

● Stress: an over abundance of stress can cause trauma to occur. (example: child in a new school with different language and norms)

● Shock: is a response to, during and after a traumatic event. Shock has been know to walk hand and hand with trauma since the 18 century, known as wound shock.

Symptoms and reactions of a traumatized person

Emotional Psychological Physical

Guilt Depression Memory lapse Distracted Low energy denial

Mood swings confusion Difficulty concentrating

Feeling out of control

muscle tension eating disorder

Feeling helpless Feeling out of control

Strong emotional ties ( person causing the trauma and/or people of safety)

ADHD symptoms insomnia chronic and unexplained pain

disbelief Compulsive behavior Feeling helpless disbelief Memory lapse, sleeping dysfunction

Withdrawn sad Withdrawn sad body aches Sexual dysfunction,

Spontaneous crying Shame Spontaneous crying Shame Distracted nightmares

Fear numb Fear numb difficulty concentrating

easily startled,

Irritable Self-blame Irritable Self-blame fatigue, racing heartbeat,

dissolution flashbacks dissolution Guilt nerviness, ADHD symptoms,

Depression Flash backs

Symptoms of a traumatized child

Symptoms a child is suffering from trauma could have

School phobias, mood disorder, nightmares, separation anxiety, substance abuse, poor concentration, suicidal thoughts or behavior, anger, aggression, withdrawn, afraid of loud noises (loud TV, fire alarm, yelling, sirens), protectionism, appear fearless and seeking out danger, impulsiveness, rapidly eating and sloppily, irritability, feeling of isolation, self-mutilation, self-harm, language struggles, inability to identifying emotions, lacking executive functions

Who can experience Trauma?

Trauma is not limited by age, race, ethnicity, cultural status, class or any other social stratifications. Trauma can happen to children as well as adults. However when a child experiences Trauma it can effect their development.

The Neurobiology of trauma

The human brain is not fully understood and how trauma is still being researched. However, some of the areas trauma could effect are listed below along with how they might affect each area. Keep in mind the information is subject to changed based on future research discoveries.

Brainstem- Part of the brain that controls blood pressure, body temperature, heart rate, and breathing when trauma occurs that effects the brainstem it will alter the brains wireing causing excessive reactions to threat ( ex: your fight or flight response will happen more frequently).

Diencephalon (midbrain or reptilian brain)- is the transmission station in the brain. This area controls the following: Facial sensation, hearing, equilibrium, taste, appetite, salivation and smell. When trauma occurs the wiring in the diencephalon can cause a greater stimulation on the areas controlled by this region.

Limbic system-is the section of the brain that is active by the amygdala involving the expression and experience of emotions. When this area is influenced by trauma expressive and /or explosive behaviors can occur.

Amygdala- Found within the limbic system. Working with the limbic system it regulates emotions and router of data (ex: fear) throughout the different sections (brainstem, midbrain, limbic or cortex) of the brain. When trauma occurs this section can be over stimulated and has a hard time regulating emotions which can result in a person feeling hyper arousal which is uncontrollable ( teacher book and children…)

The Neurobiology of trauma

The human brain is not fully understood and how trauma is still being researched, However, some of the areas trauma could effect are listed below with how they might effect each area. Keep in mind that information is subject to changed based on research discoveries.

Cerebral Cortex- is the thinking part of the brain such as the sensory perception, conscious, thought, language, and spatial reasoning. Once disturbed by trauma (over stressed) a shutdown can occur resulting in poor judgment.

Hippocampus- a section in the brain that stores, transfers, retrieve and encodes memories within the brain. This section of the brain works with the amygdala in deciding how one’s brain will react to a situation. When this part of the brain is disturbed the balance of the hippocampus responsibilities can be reduced and possibly result in compromised memory.

Corpus Callosum- two separate parts of the brain connected by axons helping coordinating work by the functions each part of the brain displays. When this section of the brain is affected by trauma it creates an abundance amount of stress and can cause a shift in how a person pays attention, and behaves.

Cerebellar Vermis- is the part of the brain which regulates linguistic, cognitive, emotional, and social behavioral in the brain sending outputs to the brain stem.

Different types of trauma

● Complex Trauma

● Post-Traumatic Stress disorder- PTSD

● Developmental Trauma

Post-Traumatic Stress disorder

PTSD- is an anxiety disorder a person experienced after a tramatic event.

3 categorical symptoms of PTSD

● Hyper arousal- occurs when an individual feels constant expectation of present or non-present danger.

● Intrusion- is a symptom known to manifest a reenactment of the previous trauma to the person who is experiencing PTSD.

● Constriction- can be described as a paralyzing stare preformed by a traumatized individual.

Complex Trauma

Complex trauma can be defined as the unpredictable cluster disturbance within a child’s family environment that is prolonged and episodic. These events influence a child’s sense of safety and

stability causing them to present poor learning skills in school.

Developmental Trauma

Unconscious trauma is inflicted on an infant from a caregiver who is unaware that a child has social and emotional needs. Typically this type of trauma and stress is not malaciously intended by the care

giver. (ex: babies in a the system)

What a traumatized person needs from you and how can I help?

Needs and how you can help

A person experiencing trauma needs to feel safe. You can help a person with that journey through doing a simple random acts of kindness which will initiate a trusting relationship. Show them that you care.

They need to feel you respect their boundaries. So remember that when they want time alone or untouched; respect that and give that to them what they need. They need to know their wishes matter.

Needs and how you can help

Feel untapped- some people who have experienced trauma felt they were trapped so make them feel as free as possible to help them (don’t block doors, meet in areas that has windows)

Accepted- affirming their values and carry a non-judgmental attitude will help a traumatized person feel they are not being judged.

Remember your presence is an important asset they need

How do I interact with a tramatized person

● Simple is always better- a simple introduction and casual conversation is important. Speak calmly and clearly. Do not bring up the event unless they have talked about it. Allow them to become comfortable. Remember be patient!

● Listen- display active listing skills, people who have experienced a traumatizing event need to be listened to.

● Let the survivor lead- they need to feel in control of their own lives.

● Allow the person to tell their story and do not judge their story

● It is important to reassure them they are okay and their environment is safe. Keep in mind that sometimes the elderly may be disconnected and disoriented for a little while after a traumatic experience.

● Ask passive questions

● Never force the client to talk

● If a person feels overwhelmed help them think about a less traumatic topic

● Help the person realize there are resources available to them to help them through this painful experience. Let them know you respect their boundaries (SCHMOOKLER)

● Let them know that you will assist them in finding a safe environment to stay.

● Show you are human too. Sometimes a traumatized person needs to know that another person has experienced a traumatic event. You goal in doing this is to help the person open up and share their feelings.

What a traumatized person needs from you and how can I help?

How do I interact with a traumatized child?

Children view the world as a safe place so once a traumatic event happens their world is upside down. Children tend to become afraid the traumatic event will repeat.

To help a child recover faster do some of the following:

Try and return to your normal routine

Take care of your personal needs (drink a lot of water, sleep well, eat well)

Think, speak, and react positively to events around you

Avoid loud noises and/or limit your exposure

Acknowledge how you are feeling and get help if needed

Do something fun with your family, and realize that to fully recover will take some time

Reassure your child that everything will be okay. ( ARC)

Treatments for Trauma

● Individual Psychotherapy

● Behavioral or cognitive Behavioral Therapy (CBT)

● Eye movement Desensitization and Reprocessing ( EMDR)

● Group Therapy

● Psychotropic Medication

– Anxiolitic●Antidepressants

●Adrenergic

● Hypnosis

● Counseling and Psychological service (CAPS)

Thank you

Reference● American Red Cross (n.d.). Picking up the Pieces after the Fire: Important steps fir your sate and seedy Recover. Retrieved from

http://www.redcross.org/www-files/Documents/pdf/getting_assistance/pickingupthepieces_fire.pdf

● Hardaway, Robert M. "Traumatic Shock Alias Posttrauma Critical Illness." American Surgeon 66.3 (2000): 284-290. Academic Search Premier. Web. 17 July 2012.

● Hardaway, Robert M. "Traumatic Shock." Military Medicine 171.4 (2006): 278-279. Academic Search Premier. Web. 17 July 2012.

● Lisak, David (2002) The Neurobiology of Trauma. (unpublished article) retrieved from http://www.legalmomentum.org/assets/pdfs/neurobiology.pdf

● Lisa, Fontes A. (2009). Interviewing Clients across Cultures A Practitioners Guide. New York, New York: The Guilford Press, Inc.

● National Institute of Mental Health Transforing the understanding and treatment of mental illn ess through research. (n.d.). What is post-traumatic stress disorder, or PTSD?. In The National Institute of Mental Health . Retrieved August 1, 2012, from http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/what-is-post-traumatic-stress-disorder-or-ptsd.shtml.

● Office of Superintendent of Public Instruction (OSPI) Compassionate Schools. 16 July 2012. <http://www.k12.wa.us/CompassionateSchools/pubdocs/TheHeartofLearningandTeaching.pdf>.

● Remembrance of lies past: A comparison of the features andconsistency of truthful and fabricated trauma narratives. By: PEACE,KRISTINE A.; PORTER, STEPHEN. Applied Cognitive Psychology. Apr2011,Vol. 25 Issue 3, p414-423. 10p. 3 Charts, 2 Graphs. DOI:10.1002/acp.1708.

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● Robinson Lawrence, Smith, Melinda, and Segal, Jeanne . "Healing Emotional and Psychological Trauma Symptoms, Treatment, and Recovery ." Help Guide: a trusted non-profit resource. June 2012. .Web. Helpguide.org. 15 July 2012. <http://www.helpguide.org/mental/emotional_psychological_trauma.htm>.

● Santa, Barbara. "Emotional and Psychological Trauma: Causes and Effects, Symptoms and Treatment Psychological or Emotional Trauma is Much Broader Than Current Definitions of PTSD; it has many faces.." Healing Resources.info Preventing and Healing Stress Related Problems. 2005. Insitute Center for Clinical Studies and Research and L.A. County Early Idenification and Intervention Group. Web. 15 July 2012. <http://healingresources.info/emotional_trauma_overview.htm>.

● Schmookler, Edward. L., Trauma treatment Manual (n.d.) Retrieved from http://amsterdam.park.org/Guests/Stream/trauma_manual.htm

● "Trauma Fact Sheet." National Institutes of Health National Institute of General Medical Science Basic Discoveries for Better Health. 14 March 2012. National Institutes of Health National Institute of General Medical Science. 17 July 2012. <http://www.nigms.nih.gov/Education/Factsheet_Trauma.htm>.

● Tronick, Edward. (2007) Still face Experiment [youtube video] Retrieved from http://www.youtube.com/watch?v=apzXGEbZht0

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● Undefined . "Trauma Informed Treatment in Behavioral Health Settings." Ohio Legal Rights Service. 2007. Legal Rights Service (LRS). Web. 16 July 2012. <http://www.olrs.ohio.gov/trauma-informed-treatment>.

● Unknown. (2012). Shock. In Oxford Dictionaries: The World's most trusted dictionaries. Retrieved August 13, 2012, from http://oxforddictionaries.com/definition/english/shock.

● Unknown. (2012). Stress. In Oxford Dictionaries: The World's most trusted dictionaries. Retrieved August 13, 2012, from http://oxforddictionaries.com/definition/english/stress?q=+stress.

● Unknown. (2012). Trauma. In Oxford Dictionaries: The World's most trusted dictionaries. Retrieved August 13, 2012, from http://oxforddictionaries.com/definition/english/stress?q=+stress.

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● van der Kolk, Bessel. A. (June 1989) The Compulsion to Repeat the Trauma Re-enactment, Revictimization, and Masochism. Psychiatric Clinics of north America, Volume 12, Number 2, Pages 389-411, Retrieved from http://www.cirp.org/library/psych/vanderkolk/

● Vassar, Gerry. (September 27, 2011). How Trauma impacts parts of the brain. In A Child's Brain on Trauma. Retrieved June 5, 2012, from http://lakesideconnect.com/trauma-and-trauma-informed-care/a-child%E2%80%99s-brain-on-trauma/.

● Volpe, Joseph. S. (1996). Traumatic Stress: An Overview. In American Academy of Experts in Traumatic Stress . Retrieved August , 2012, from http://www.aaets.org/index.html.

● Weinhold, Janae. B. and Weinhold, Berry. K.. (n.d.). What is Developmental Trauma?. In Healing Developmental Trauma. Retrieved August 6, 2012, from http://www.weinholds.org/devtrauma/what-is-developmental-trauma.html.

● Wolpow, Ray. Johnson, Mona M, Hertel, Ron and Kincaid, Susan O. "." The Heart of learning and Teaching: Compassion, Resilisency, and Academic Success. 2009. Washington State Office of Superintendent of Public Instruction (OSPI) Compassionate Schools. 16 July 2012. <http://www.k12.wa.us/CompassionateSchools/pubdocs/TheHeartofLearningandTeaching.pdf>.

● http://www.fit.edu/caps/documents/TreatmentforTrauma.pdf

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Reference