Pathways to Healing

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Pathways to Healing
Impact of Trauma on Children and Families Part
One

• Presented by
• C. Lynne Edwards, LCSW
• Home Visiting Consortium
• October, 2013

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Myths

• 1 The effects of abuse/neglect, removal and
  other traumas that occur when children are young
  have fewer consequences than for older children.
• 2 There is nothing that parents or caregivers
  can do to change the impact of their childs
  early traumatic experiences.
• 3 Childrens behaviors can best be managed by
  rules and consequences.
• 4 Parent education classes are the most
  effective way to teach parents how to keep their
  children safe and meet their needs

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What We Now Know

• Feeling safe positively
• affects the nervous system
• and provides
• stimulation for
• healthy
• development.

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Types of Trauma

• ACUTE
• CHRONIC
• COMPLEX

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Complex Trauma

• Multiple, chronic and prolonged, developmentally
  adverse events
• Often of an interpersonal nature with early life
  onset
• Effects are cumulative
• Toxic stress

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Response to Trauma Affected by

• Childs chronological age and developmental stage
• Childs perception of the danger
• Whether the child was a victim or witness
• Childs past experience with trauma
• Childs relationship to the perpetrator
• Presence/availability of adults to help

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Child Traumatic Stress

• The physical and emotional responses of a child
  to events that threaten the life or physical
  integrity of the child or someone important to
  the child.
• Traumatic events overwhelm a childs capacity to
  cope and elicit feelings of terror, helplessness,
  powerlessness, and out of control physiological
  arousal.

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Experience of Trauma

• Trauma is experienced through the body, mind and
  spirit and has a long term impact.

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Long Term Impact

• Adverse Childhood Experiences Study
• Adverse childhood experiences
• are a major health issue
• result in social, emotional and cognitive
  impairment
• linked to higher risks for medical conditions
  (heart disease, severe obesity, COPD)
• linked to higher risk for substance abuse,
  depression and suicide attempts

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Long Term Impact

• Studies with antisocial youth have found
  self-reported trauma exposure ranging from 70 to
  92 (Greenwald, 2002)
• Antisocial youth have a high rates of Post
  Traumatic Stress Disorder (Greenwald, 2002)
• Research suggests that anger and violent acting
  out often are symptoms of PTSD (Chemtob, Novaco,
  Hamada, Gross, Smith, 1997)
• Study of Foster Care Alumni revealed higher
  levels of PTSD in the alumni than in war
  veterans. (NC Childrens Practice Notes, Vol.10,
  No 3, June 2005)

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DOMAINS OF IMPACT

• BRAIN DEVELOPMENT
• BIOLOGY
•  
• MOOD REGULATION
•  
• COGNITION AND LEARNING
•  
• BEHAVIORAL CONTROL
•  
• DISSOCIATION
•  
• MEMORY
•  
• ATTACHMENT
•  
• SELF CONCEPT AND WORLD VIEW

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Brain Development

• Neurological pathways or patterns that begin
• to form are based on what infants SEE, HEAR,
• TOUCH, SMELL and
• FEEL
• Your first set of associations
• becomes your template

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Biology/Sensory Integration

• Physical sensations such a rapid heart rate,
  trembling, dizziness or loss of bladder or bowel
  control
• Movement and sensation
• Hypersensitivity/insensitivity
• Coordination, balance and body tone
• Unexplained physical symptom
• Increased medical problems

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Mood Regulation

• Difficulty knowing and describing their feelings
• Brain cant shift from feeling to thinking
• State dependent responses to experiences
• Communication impaired

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Cognition and Learning

• Focusing on and completing tasks
• Anticipating and planning for future events
• Absence of cause and
• effect thinking
• Range of learning
• difficulties
• Adaptive develop-
• ment impaired

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Behavioral Control

• Childrens behavior is state dependent-fear
  driven
• Its a message-an indication of an unmet,
  underlying emotional need
• Interventions require the use of relational
  rather than confrontational approaches
• Behavior problem is a relationship problem

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Dissociation

• The younger the trauma, the more likely to use
  dissociation, rather than the flight or flee
  response
• Babies cant do either

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Memory

• Lack cognitive memory of events
• Memory of trauma stored in the senses, the body
• State dependent memory

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Attachment

• Rooted in biology
• Mutual psychological process
• Learned after birth

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The Attachment Cycles
Trust/Need
Needs
Arousal Displeasure
Relief Relaxation
Gratification eye contact
touch smile movement feeding
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The Attachment Cycles
Initiating Positive Interactions
Parent Initiates Positive Interaction
Gratification Child Responds
Gratification Parent Responds
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Positive Interactions
Structure
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(No Transcript)
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Self-Concept and World View

• Lack of a continuous, predictable sense of self
• World is not a safe place to be
• Im a bad child everything bad is my fault
• People who love you, hurt you and/or abandon you
• My feelings dont matter
• No one listens

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Whats happening in the brain
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Whats happening in the brain
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What this looks like in children

• Pervasive feelings-Fear and anxiety
• Core issues-grief, loss, rejection, attachment,
  control, guilt, identity
• Internalized beliefs-Im a bad kid, I cant trust
  adults, people who say they love you, hurt and/or
  leave you, the world is not a safe place to be,
  etc.
• Control issues-children feel so out of control
  they try to control everything in whatever way
  they can

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What this looks like in children

• Sensory issues-sensitive to touch, loud noises,
• Delayed adaptive development
• Regulation of emotions-their brains can not shift
  from their emotions to their thought processes
• Pull/Push-come close, now go away afraid of
  getting close
• High risk behaviors

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• Childrens learned solutions become caregivers
  problems

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What this looks like in parents

• Pervasive feelings-Fear and anxiety
• Core issues-grief, loss, rejection, attachment,
  control, guilt, identity
• Internalized beliefs-Im a bad person/parent, I
  cant trust adults, the world is not a safe place
  to be, etc.
• Control issues
• Delayed adaptive development
• Regulation of emotions
• High risk behaviors

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What this looks like in parents

• PLUS
• Parents ability to make appropriate judgments
  about safety is compromised
• Trauma reminders presented in childrens
  behaviors trigger extreme reactions.
• Tendency for parents to personalize their
  childrens negative behavior which challenge
  attachment and can lead to ineffective or
  inappropriate discipline.

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What this looks like in parents

• Parents capacity to regulate their emotions is
  impaired.
• Parents executive functioning is impaired which
  results in poor decision-making, problem solving
  or planning.
• Parent is more vulnerable to other life
  stressors.

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What this looks like in parents

• Its hard for them to form and maintain secure,
  trusting relationships
• Disruptions in relationships due to negative
  feelings about parenting, personalizing
  childrens negative behaviors
• Challenges in relationships with caseworkers,
  foster parents and services providers

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• Parents learned solutions to their situation
  are our challenges in working with them

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5 Survival Behaviors of Complex Trauma Victims

• Manipulation
• Triangulation
• Aggression
• Control
• Resistance

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• The brains of children who experience trauma
• are wired differently
• and
• the impact carries
• into adulthood.

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• So what?

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Resources

• Child Welfare Information Gateway Supporting
  Brain Development in Traumatized Children and
  Youth http//www.childwelfare.gov/pubs/braindevtra
  uma.cfm
• National Child Traumatic Stress
  Network-newsletter and developed the Child
  Welfare Trauma Training Toolkit.
  http//www.nctsnet.org/
• nctsn.org/products/child-welfare-trauma-training-
  toolkit-2008
• Creating Trauma-Informed Child Welfare Systems A
  Guide for Administrators http//www.chadwickcenter
  .org/CTISP/images/CTISPTICWAdminGuide.pdf
• Child Trauma Academy http//childtrauma.org/

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Resources

• Adverse Childhood Experiences
• cds.gov/ace/pyramid.htm
• Child Welfare Trauma Referral Tool
  http//www.nctsnet.org/products/child-welfare-trau
  ma-training-toolkit-2008q4
• Trauma Symptom Checklist for Children
  www.johnbriere.com/tsc.htm
• Zero to Three http//zerotothree.org/
• Brain Connection http//brainconnection.positscien
  ce.com/

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Resources

• Resilience Trumps Aces http//resiliencetrumpsaces
  .org/
• Trust Based Relational Interventions developed by
  Dr. Karyn Davis and Dr. David Cross at the TCU
  Institute of Child Development
• http//www.child.tcu.edu/training.asp

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Contact Information

• C. Lynne Edwards, LSCW
• Trauma and Attachment Therapist
• Consultant and Trainer
• LynneEdwardsC2_at_gmail.com
• 804-221-4658
• What we do today can help improve others
  tomorrow.