When Trauma and Loss Enter Your Classrooms

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When Trauma and Loss Enter Your Classrooms

• Presented by
• Maryann Williams, M Ed
• Ft. Bragg Schools

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Trauma

• A sudden, unexpected, dramatic, forceful or
  violent event which involves emotional shock and
  mental confusion.
• The overwhelming, uncontrollable experiences that
  psychologically impact victims by creating
  feelings of helplessness, vulnerability, loss of
  safety, and loss of control.

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• Conservative estimates of the number of children
  exposed to trauma exceeds 5 million in the United
  States each year.
• Exposure includes
• Surviving
• Witnessing
• Being related to the victim
• Listening to details

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Grief vs Trauma

• General reaction Sadness
• Grief reactions stand alone
• Grief reactions are recognized by the public
• Grief does not disfigure our identity
• In grief, guilt says, I wish would have
• In grief, pain is related to the loss
• In grief a childs anger is not usually
  destructive

• General reaction Terror
• Trauma reactions include grief reactions
• Trauma reactions are largely unknown by the
  public
• Trauma attacks, distorts, and disfigures our
  identity
• Trauma guilt says, It was my fault. I could
  have done something.
• In trauma, pain is related to an overwhelming
  sense of fear and powerlessness
• In trauma, a childs anger often becomes assultive

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Trauma and the Brain

• Triune Brain
• Experienced in the midbrain and brain stem
• Instinct takes over
• Fight, Flight, Freeze
• Dissociation
• Infants disrupts development overdeveloped
  midbrain, underdeveloped frontal lobe
• Explicit and implicit memory

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Trauma and the body

• Somatization The body remembers
• Part of Implicit memory
• Energy to assure survival
• Arousal state
• Energy is generated and mobilized to assure our
  physical survival
• If not utilized by completing the appropriate
  defense actions, it is held in the nervous system
  and is unable to dissipate or release

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Arousal State

• Readiness on alert
• Arousal too strong, indiscriminate
• Slow to recuperate
• Rest only when exhausted
• Animals
• Shake it out
• Allows nervous system to regain balance
• Humans often fail to move through response
• Responses seek completion
• Excess energy becomes bound in the body seeking
  release

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DSM-IVPTSD

• 1. Re-experiencing
• Intrusive thoughts
• Recurring nightmares or bad dreams
• Reenactments of the traumatic events
• Physical reactions
• 2. Avoidance
• Cognitive, Emotional, Physical

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DSM-IV (cont)

• Hyperarousal
• sleep disturbances
• irritability or outbursts of anger
• difficulty concentrating
• hypervigilance or overprotectiveness
• exaggerated startle response
• attachment reactions

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Additional behaviorsseen in young children

• Fails to finish things started
• Difficulties concentrating, paying attention
• Inattentive, easily startled
• Daydreams or gets lost in thought
• Impulsive or acts without thinking
• Difficulty following directions
• Fails to carry out assigned tasks
• Afraid to or not wanting to sleep alone
• Regression in learned behaviors
• Sad, withdrawn, detached
• Easily startled or fearful without good reason
• Seems worried
• Clings to adults, acts whiny, has temper tantrums
• Cries without good reason

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Trauma mistaken for other problems

• Depression
• ADHD
• Oppositional like behaviors
• Daydreaming
• Aggressive behaviors
• Anxiety
• Bipolar

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Specific Trauma Themes

• Fear
• Terror
• Worry
• Hurt/Withdrawal
• Anger
• Revenge
• Rejection/Guilt
• Accountability
• Absence of a sense of safety
• Powerlessness
• Hopelessness
• Helplessness
• Victim mentality

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Dealing with TraumaVan der Kolk (1996)

• Traumatic memories need to become like memories
  of everyday experience, that is, they need to be
  modified and transformed by being placed in their
  proper content and restructured into a meaningful
  narrative.

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• Trauma memories must be reactivated in order to
  be modified. The ability to decrease fear or
  anxiety is dependent upon the controlled reliving
  of fear in a safe environment so as to be able to
  diminish the response
• Corrective information must be provided so that
  they victim can form a narrative or meaning that
  places the traumatic memory to the place and time
  it occurred as opposed to generalizing that
  experience to everyday life. (Steele,2001)

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A victim thinks

• I dont expect much good to happen in my life.
• I am always going to feel sad, angry, depressed
  and confused.
• You cant trust anyone except a few friends.
• I feel guilty for many things, even things I know
  are not my fault.
• I am afraid to do something new for fear I will
  make a mistake.
• Most times I think things will never get better.
• I tend to see people as either for me or against
  me.
• I am never going to get over what happened to me.
• I have very few choices in life.

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A Survivor Thinks

• I expect a lot of good to happen in my life.
• I may feel sad, angry, depressed and confused
  today, but I will not always feel this way.
• I have people I can trust.
• I am only responsible for myself. I cannot
  control everything.
• Everyone makes mistakes, that is how we learn.
• I am in control of my life. There are things I
  can do to make my life better.
• People are supportive of me. I trust my inner
  self to make good choices.
• Each day I get a little stronger. I will get
  over this.
• I have many choices in my life.

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Drawing Activity

• Draw a picture of a person who died, was killed
  or victimized
• Think about that person
• Check your body sensations your breathing, your
  heart, your muscle tensionvisit those areas
• What do you think they were thinking when this
  happened? If they could talk, what would they
  say, or what did they say at the time?
• Trace any part of your drawing for at least 2
  minutes let anything you want come to your
  mind.
• Check your body sensations breathing,
  heartbeat, muscle tension, stomach, head
• Of all the things that happened that day, what
  was the worst part for you?
• What is the worst part for you now?
• Check your body sensations your breathing, your
  heart, your muscle tensionjust visit those
  areas.
• What was this experience like for you on a
  sensory, emotional and cognitive level?

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Drawing Activity

• Draw what a happy line would look like
• Think about a happy time in your life
• See it
• Hear it
• Smell it
• Feel it
• Who was there, what were you doing?
• Feel it in your body sensations your breathing,
  your heart rate, your stomach and head, your
  muscles, stay with it

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Drawing

• Trauma is experienced at a sensory level
• Psychomotor activity intervention
• Triggers sensory memories
• Helps to accomplish externalization
• Connects a bridge to visualizations
• Provides an impetus to tell their story
• Provides a method for accessing traumatic
  memories and bringing them into consciousness
• Distances self from painful memories
• Defuses overwhelming feelings
• Gives control to the event

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Interview Process

• Ask the child to draw a picture they can tell you
  a story about.
• Draw a picture about what happened
• Ask questions about the drawing
• What is this?
• Why is this bigger?
• Ask them where they are.
• Ask them to draw larger on different paper if
  necessary

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Trauma Questions

• What were you doing?
• Are there any sounds, smells, sights that you
  recall?
• Who else was there?
• What was the worst moment for you?
• Where in your body did you feel the most hurt?
• What made you most afraid then?
• What scares you now?
• What do you do when you get scared?

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Process continued

• What was the first thing you thought?
• What did you do?
• Is there anything you wish you could have said or
  done?
• What would you like to see happen to this person?
• What do you think ___ was thinking when this
  happened?
• What scares you about this person?
• What makes you mad now?
• What do you do when you get mad now?
• Can you imagine what else could have happened?

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Process cont.

• Can you draw me a picture of what ____ looked
  like dead?
• Tell me about your dreams.
• Has anything like this happened before?
• Have you had feelings like this before?
• What do you think will happen now?
• What other things worry you now?
• What would you like to happen?
• As you think about it now, what surprised you the
  most about how you acted, what you thought?

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Process continued

• When this happened did you freeze?
• When this first happened where do you remember
  feeling the hurt/fear the most in your body?
• Draw me a picture of what that fear/hurt looks
  like?
• If your hurt/fear could have a name, what would
  it be?
• If your hurt/fear could talk, what would it say?
• What would you say back?

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Ending the interview process

• Process usually takes 60 90 minutes
• Go back to the drawings see if they want to add
  anything
• Focus the child on positive memories
• Normalize reactions give list if age
  appropriate responses
• Educate
• Ask what they would like to do in the future.
• Ask if it is different.
• Encourage them to see you again tell them how
  to seek help

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The National Institute for Trauma and Loss in
Children

• A Program of the Childrens Home of Detroit
• William Steele, Director
• 877-306-5256
• Fax [phone]
• www.tlcinstitute.org

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• Child Trauma Academy
• www.childacademy.com
• Online courses free
• The International Society for Traumatic Stress
• www.istss.org