Understanding and Responding to Trauma

Ian Finck and Laura Watts

2014

Speaker Introduction

Ian FinckVolunteer

Laura WattsVolunteer/Employee

By the end of the preso we’d like you to…

• Understand the basics of trauma

• Understand the stress response and how it relates to people experiencing trauma

• Understand the relationship between homelessness and trauma

• Develop a better understanding of trauma through hearing a personal experience of trauma

• Understand the recovery journey

• Feel equipped with the tools and knowledge to support visitors experiencing trauma

• Ask us questions!

Class Introduction

What is trauma?

• Any event that involves exposure to actual or threatened death, serious injury or violence AND where the person's response involved intense fear, helplessness, or horror has the POTENTIAL to be traumatic.

• “Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.” Judith Herman

AIHW.GOV.AU

Trauma is Different

Interpersonal Trauma and Attachment

• Involves the use or abuse of power or betrayal by one person (or group of people) over another person (or group of people)

• Trauma that occurs at the hands of another person (or group of people) has the potential to impact on the way the person understands and forms other relationships throughout their life, including relationships with services.

Symptoms

Symptoms

Behavioural EmotionalBehaviouralCognitiveEmotional Physical

Understanding the Stress Response

• Understanding the stress response is important in understanding the traumatic stress response.

Biologically hard-wired

Essential for survival

Threat detection

Hard to unlearn

The Brain

The Body

brainstress activates hypothalamus which stimulates other glands

Response to Threat: Low Road Activation

Threat perceive

dFlight/fight activated

Stimulus

Hypothalamus Pituitary

Adrenal AxisAccelerator SNS

Sensory Data

Thalamus Information

Forwarded AmygdalaThalamus

Response to Threat: High Road Activation

Amygdala

Thalumus

Hippocampus

Hypothalamus Pituitary Adrenal Axis

Stimulus

Sensory Data

Sensory CortexInterpret

possible multi meanings

No danger

Flight or Fight Hand Model

Trauma and Homelessness

• ?% of homeless adults in inner Sydney reported at least one major trauma in their lives (?% of the general Australian report one lifetime trauma)

• ?% had experienced two or more traumatic events (average six trauma experiences)

• ?% experienced trauma prior to 16 years old• Homeless people also report traumatic

experiences during homeless episodes• Homelessness itself can be considered

traumaticRobinson 2010, Taylor and Sharpe 2008

A Local Perspective

Event %

Seriously physically attacked or assaulted 76.8

Witnesses someone being badly injured or killed 75

Threatened with a weapon, held captive or kidnapped 64.3

Involved in a life-threatening accident 60.7

Sexually molested 44.6

Involved in a fire, flood or other natural disaster 42.9

Raped 33.9

Tortured or the victim of terrorists 12.5

Any other extremely stressful or upsetting event 10.7

Direct combat experience in war 3.6

Suffered great shock due to one of the events above happening to someone close

44.6

Trauma experience of homeless adults in inner city Sydney Sharpe 2008

Cycle of Homelessness and Trauma

A Personal Experience of Trauma

Rob HoltVolunteer

The Healing Process

Neurogenesis and Neuroplasticity

What is “Recovery?”

Frames and Recovery

Frames and Recovery

A person’s own understanding of their experience influences their:

BEHAVIOURS

There Are Many Frames

– Biological– Abuse or trauma– Environmental– Spiritual or philosophical– Political – Creative – Developmental – Cultural – Social and emotional wellbeing– and more…

Biological Frame

The ‘problem’ is:– Biologically based– Medical “mental illness”, “mental disorder”– Disordered brain chemistry– Genetic vulnerability

The effect is:– a loss of cognitive ability and social functioning

Recovery might involve:– Acceptance and education about the disease and ‘treatment’– Competent providers such as psychiatrists – Finding the right medication(s)– Integrating illness into self‐concept– Acknowledging limitations and finding connections which

accommodate limitations

Abuse or Trauma Frame

The problem is:– history of severe (often childhood) abuse or

trauma

The effect is:– Results in loss of sense of self– Loss of self creates behaviour which others

diagnose as mental illness or disorder– Mental health services ‘treatment’ become

further sources of abuse or trauma

Recovery might involve:– Reclaiming a sense of self– Taking control over one’s life– Finding ways (externally and internally) – to confront the abuse and trauma

Safety is Necessary for Healing

• Safety in environments (Physical safety)

• Safety within your own

body (Intrapersonal safety)

• Safety in relationships (Interpersonal safety)

• Safety in systems (Justice

and systemic safety)

Physical Safety

• Many visitors are homeless

• Many visitors are abused

• Wayside provides a safe daytime environment

Intrapersonal Safety

• Triggers– Any cue that elicits a memory– Blood, noise, smells, behaviours

etc.

• Memory of trauma can intrude without warning

• People may not be aware of what their triggers are

• Learning your triggers can provide power over them

Interpersonal Safety

Trauma informed supportive relationships are R.I.C.H.

• Respect is conveyed and felt• Information is shared and transparent• Connection is negotiated• Hope is felt and conveyed

Safe Systems

• Transparency• Justice• Power is not abused

The Role of Volunteers

Understanding

• Visitors may be anywhere in the recovery process

• Behaviours are symptoms, not personally directed

• How the visitor “frames” their experience, their beliefs

• Be consistent – show up and be present

• Boundaries and capacity (passing to community worker)

Applying the Knowledge

• Group Activity• Read the scenario• Based on what you’ve heard

today, discuss how you, as a volunteer, would respond to the situation

• Explain your response to the group

What’s Your One Takeaway?

Thank You