Download - Trr svetlana's course #3 2013
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Val LougheedNorthern Lights Canada
Real Work * Real People * Real Results
Social Construction of Disability and Health
Trauma, Rehabilitation and Recovery –
~ Keep Your Fork ~
1-800-361-4642 * www.northernlightscanada.ca * [email protected]
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“You don’t want your impairments to define you – you want them to inform you.”
(Hanita Dagan, personal communication, 2005)
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www.slideshare.net/vlougheed
#NLCAN
www.northernlightscanada.ca/our-company/
our-president/be-still
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Agenda
•Beginning …
•Middle …
•End …
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Social Construction of Disability and Health
1. What does it mean to recover?
2. What can I do to recover and return to a life that includes work?
3. What can we do to facilitate recovery and a return to work?
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Rated PG-113
People Strongly Cautioned!
May contain bad language, brief nudity, sexual overtones, and drug usage.
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Beginning
1978
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VIDEO CLIP Val being
interviewed in Minden
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Sept. 9, 2003 - morning
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Sept. 9 – p.m.
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Sept. 15 2003 – Jan. 19 2004
Journey Back to Life
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Dominant Themes
• Narcotic Pain Killers
• Pain
• Trauma
• Depression
• ABI
• Methods of Helping• Return to Work
• Life
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February 2004 – Present
Starting Point
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The
Re-organization
of Self
March 2004
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“In the aftermath of traumatic life events … [the] sense of self has been shattered.”
(Herman, 1992, p. 61)
“An existential crisis …”
(Hanita Dagan, personal communication, 2005)
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Sliding Down the Slope
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Sliding Down the Slope
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A Foothold
• Mild – moderate ABI
• Depressed (dysphoria)
• Working memory problems
• Hiding pain
1st Neuropsychological Assessment
June 2004 -- Results
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ABI – Measuring Loss
Subjective Report – difficulty retrieving words and communicating ideas
Objective Report – above-average performance on neuropsychological measures
(Prigatano, 1999; p. 59)
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Losing My Grip
My IWRPAugust 2004
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Video of Borg
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Rescued in the Valley of Despair
Head Injury ProgramOct. – Dec. 2004
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GRTW – The Plan
Jan. 3 – Feb. 7, 2005
(5 weeks)
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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GRTW – The Reality
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WSPE
Work-Site Performance Evaluation©
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Sliding Back Down Into The Abyss
• Non-compliance
• Malingering
• Trying too hard
• Not trying hard enough
2nd Neuropsychological Assessment
May 2005 -- Edmonton
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Test Results• Mild to Moderate ABI
• Pain?
• Depression?
• Motivation?
• “a high flyer”
• “phobic avoidance”
• Future plans – “live off dividends” [from company]
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Lesson
ASSUMPTIONS
REVEAL BIAS
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• Mild – moderate ABI
• Good prognosis
• Post-Traumatic amnesia
• Pain?
• Depression?
• “Adjustment Disorder with Anxiety and Depressed Mood”
3rd Neuropsychological Assessment
August 2005 -- Calgary
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Symptom Overlap
(co-morbidity)
(Michael Sullivan, Centre for Research on Pain and
Disability, McGill University, September, 2006)
Pain, Trauma, Depression, ABI
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Oct. 3 – Dec. 11
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Pain Research
1600’s – Rene Descartes (philosopher)
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Pain Research
1950’s – Wilder Penfield (brain surgeon)
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Pain Research
Patrick Wall (physiologist)Ronald Melzack (psychologist)
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Pain – The Future
SCN9A(Globe and Mail, March 24, 2007)
Glia Cells(Scientific American, November, 2009)
Poppy Genes(U of Calgary -- Calgary Sun, March 15,
2010)
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“In every encounter, basic trust is in question.” ( Herman, 1992, p. 92)
“Survivors feel unsafe in their bodies – and in any relationship with other people.” (Herman, 1992, p. 160)
Rehab & Recovery
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DISSOCIA
TION
Trauma Research
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VIDEO CLIPAdrenaline: Flight or Fight Response
Trauma Research
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Fight
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Freeze
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“Survival Central”(Rothschild, 2000, p. 46)
•Amygdala - Implicit memory• storage of emotions and sensory
reactions (Rothschild, 2000, p. 20)
•Hippocampus – Explicit memory• creates memories of actual sequence
of events(Rothschild, 2000; p. 28)
Trauma ResearchLimbic System and Memory
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Stress Hormones
•Amygdala - Implicit memory• storage of emotions and sensory
reactions (Rothschild, 2000, p. 20)
•Hippocampus – Explicit memory• creates memories of actual sequence
of events(Gunnar & Barr, 1998)
Trauma ResearchLimbic System Under Threat
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TraumaPersonal Experience
• Dissociation & Cocoon = Safety
• System on High Alert Always = Survival
• World is black & white = Trust
Trust (Safety) = Love
No Trust (Life Threatening) = Hate
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TraumaPersonal Experience
• Listen to me
• Understand me
• Respect me
• Are competent
I trust (love, feel safe with, will try hard for) people who:
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“… depression [caused by trauma] is not the same as ordinary depression.”
( Herman, 1992, p. 118)
Depression
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Candace Pert, 1997; pp. 171 -- 179
Psychoimmunoendocrine Network
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Affects more than IQ ….
Touches core … of a person’s self-esteem
(Prigatano, 1999; p. 58)
ABI
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Back to Wilder Penfield – 1950’s
ABI
Localizationist
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VIDEO CLIP Story of Paul Bach-y-Rita’s dad
Paul Bach-y-rita Neuroplasticity Video Clip;
link to Neuroplasticity – YouTube; bren49764
00 – 2:20
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Paul Bach-y-Rita – 1934 – 2006
Scientist and Rehab Doctor
Neuroplasticity - 1969
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METHODS OF HELPING
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“The words and attitudes of others … are potent. They help or hex healing and recovery.”
“ Expectations are powerful.”
(Bolen, 1996; p. 94)
Body-Mind Connection
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VIDEO CLIP Esther
SternbergDr. Esther Sternberg Demo
Reel – YouTube; 00 -- .36
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Cortisol and Immune Cells
Sternberg, 2001; p. 112
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•Hypothalamus
•Peptides
•Receptors
•Biochemical Events
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Video clip Addicted to Love song
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Quantum Connection The Living Matrix
(Braden, 2007; p. 45)
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“Loss of identity can evoke a personal crisis, creating a need for change.”
(Ornelas, in Smith & Johnson (Eds), 1997; p. 172)
The Re-Organization of Self
Identity Research
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Scaling the Canyon
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Sept., 2005
Waskesiu
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Breast Cancer Reconstructive Surgery
March 2006
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Convocation M.Ed. -- June 2006
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Back in “a” SaddleSeptember 2007
• Officially change role/ title
• Re-organize NL
• Work part-time
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Social Construction of Disability and Health
Resilience Ability to return to original form after
being bent (bounce back)
Thriving in constant change, ability to be:
• Flexible
• Creative
• Adaptable
• Learn from experiencehttp://www.resiliencycenter.com/articles/5levels.shtml
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Social Construction of Disability and Health
Rehabilitation (habiter – to live inside)
“Rehabilitation is the learning to live inside not only one’s body, however it is after an injury or illness, but inside one’s very being.”
(Kabat-Zinn, in Meili, 2003; p. 241)
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Social Construction of Disability and Health
RecoveryCuring Focus on the illness/
impairment [outside]
Healing Focus on the person [inside]
(Crombez, October; 2003)
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Be Still
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Social Construction of Disability and Health
1. What does it mean to recover?
2. What can I do to recover and return to a life that includes work?
3. What can we do to facilitate recovery and a return to work?
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Keep Your Fork
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Northern Lights Canada is a person-centred organization committed to providing innovative, responsive links to real work.
We offer 4 major divisions of service: • Vocational Rehabilitation Services • Employment Services • Employer Services• Corporate Training
For more information, please contact us: 1-800-361-4642
www.northernlightscanada.ca
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Voc Rehab Canada (VRCAN) is a national consortium of experienced regional vocational rehabilitation companies. VRCAN provides customers with single-point access to VR services anywhere they are needed in Canada, whether on an individual service or contract basis.
Member companies include:Argus Management Consultants,
Inc. Sandra Preeper & Associates
Advantage Rehabilitation Consultants Ltd.
Rehabilitation Alternatives Limited / Vocational Alternatives Software
OPTIMA Rehabilitation CVE Inc.
Northern Lights Canada Occupational Rehabilitation Group of Canada (ORGOC)
Western Rehabilitation Specialists Inc.
Diversified Rehabilitation Group
Genesis Rehabilitation Ltd. Rehabilitation FocusFor more information, please feel free to contact us at 1-800-361-
4642
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