TRAUMA OVERVIEW

Complex Care & Intervention Program (CCI)

Imagine

What is your Reaction?

Your emotions?

Your thoughts?

Your behavioural response?

Your awareness?

Amygdala

• The amygdala is a part of the limbic system involved in processing emotional responses.

It is like a smoke alarm of the brain. Our children are extremely sensitive. Any stress can put them into a state of alarm.

What if the spider was always there?

Complex Trauma

The National Child Traumatic Stress Network

Trauma has a profound affect on a developing brain, particularly before age 5.

Leads to dysregulation of several systems (emotions, body, behaviour, reasoning & thinking, relational, self-esteem and self- concept).

Effects are cumulative and overlapping.

How Brain Maturity Influences Behaviour

Survival Brain Survival Brain

Emotion & Relational Brain

Emotion & Relational Brain

Logical Brain Logical Brain

Dr. Chuck Geddes, 2011

Mature Brain Immature Brain

Pre-natal Infancy Early Child Teen Adult

Dr. Chuck Geddes, 2011

Typical

Simple Trauma

Early/Persistent Maltreatment

Developmental Trajectories: Effects of Maltreatment &Trauma

Level of

Functional

Development

7 CCI Developmental Domains

1) Neurological & Biological Maturity

2) Over-reactive Stress Response

3) Emotional Regulation

4) Attachment and Relationships

5) Identity Development

6) Behavioural Regulation

7) Cognitive & Language Development

No One Eats Apples In BC

Neurological & Biological Maturity

Generally refers to how trauma effects the brain development and physiological development of the child.

Neurological & Biological Maturity

Doesn’t recognize sleepiness, tiredness, hunger, temperature?

If awake at night, difficulty going back to sleep?

Sensitive to tastes, textures, smells?

Overwhelmed by stimulation?

Difficulty with using small objects?

Clumsy & uncoordinated?

Tics, spasms, seizures?

Over-reactive Stress Response

Generally refers to how trauma effects the sensitivity of the child to stress.

Over-reactive Stress Response

Alert, Wary, Vigilant, Anxious?

Reacts quickly to fight or flight?

Seems lost in space? Frozen & uncooperative?

Difficulty with transition to new tasks?

Frustrated when things don’t go as planned?

Alert

Careful Anxious Tensing

Calm

ZEN

Vigilant

Getting scared On edge Sensing danger

Engaged

Interested

Flight

Fight

Freeze

Flood

Stress Staircase Leading to Fight, Flight & Freeze

Wanda Smith & Dr. Chuck Geddes, 2012

“Zero to 60” Kids

O 60

Alert

calm

Vigilant

Freeze

Fight

Flight

30

15 45

Over-reactive Stress Response

Wanda Smith & Cristal Biela, 2012

Emotional Regulation

Generally refers to how trauma effects the emotions of the child and their ability to regulate their moods.

Emotional Regulation

Extreme mood swings?

Emotional age appears much younger than real age?

Anger?

Difficulty returning to calm state?

Depressive mood?

Difficulty identifying emotions?

Attachment and Relationships

Generally refers to how trauma effects the child’s desire and ability to connect with others (adults and peers).

Attachment and Relationships

Avoidant/ Dismissive

Independent, Cool or distant?

Push Away?

Unable to trust adults?

Rigid boundaries?

Preoccupied /Clingy

Weak boundaries?

Enmeshed?

Gets along better with younger kids?

Difficulty with transitions

Preoccupied or clingy?

Insecure Attachment Continuum

Avoidant/Dismissive Often neglected

“You don’t exist” (Purvis)

Independent

Emotionally cool

Push away

Need engagement

Preoccupied/Angry Often enmeshed/volatile

“I don’t like you” (Purvis)

Dependent/overly sensitive to relational cues

Emotionally reactive: Push-Pull

Need non-reactive adult presence

Identity Development

Generally refers to how experience affects the child’s core beliefs about themselves.

Identity Development

Low Self Esteem?

Doesn’t have a sense of personal mastery

Seems to live in shame?

Breaks toys?

Extreme denial of wrongdoing?

Cohesive life story?

Behavioural Regulation

Generally refers to how trauma effects the child’s ability to regulate their behaviours.

Behavioural Regulation

Is impulsive or inattentive?

Is oppositional, aggressive, destructive

Can’t follow instructions?

Acts younger than their age?

Can’t delay their gratification?

Struggles for control?

Acts bossy?

Cognitive & Language Development

Generally refers to how trauma effects the learning, language and thinking ability of the children affected by maltreatment.

Cognitive & Language Development

Doesn’t understand what you say?

Do they use ‘pat’ sayings?

Do they lose track of directions?

Struggle to learn new information?

Concrete, rigid, black & white.

Overloaded by too much information

Trouble solving problems.