Family Psyc-Role of parents in healing from trauma.pdf

The role of parents in helping children and young people heal from trauma. Catherine Gallagher Clinical Practice Manager START Caveats – This is a huge topic and the 2 lectures that we have to together are just a beginning – This is potentially sensitive information and so please take care – Ther...

The role of parents in helping children and young people heal from trauma. Catherine Gallagher Clinical Practice Manager START Caveats – This is a huge topic and the 2 lectures that we have to together are just a beginning – This is potentially sensitive information and so please take care – There is a lot of wisdom in the room…difference between opinion, experience and research backed knowledge – Different opinions are compulsory and let’s try and make space for them. (often easier said than done….) Who here is judgmental? That’s right…we all are! • The brain takes in 4 billion bits of data a second and so some kind of filtering system is essential. • As soon as something can be ‘put in a box’ as having been seen, sorted, and experienced before and the brain can come up with a plan for what to do next…our nervous system settles. This is a great system …till it’s NOT! – We are inherently judgmental – We squeeze data into what we already know as sitting in the unknown feels like a threat – We behave based upon these judgments and this can have impacts on both us and those around us So what can we do? – Try really hard to be NON judgmental??? Try holding your breathe and see how far that gets you!! Or… – Acknowledge, understand and challenge these judgements/assumptions with new information, and try and hold them lightly Let’s start at the very beginning (as understanding things helps the NS settle as we know what to expect) – Brains were designed with an alarm system to notice and respond to threat – This job trumps all the other brain functions…for no amount of clever thinking benefits us…if we are being chased by a tiger – We judge quicker when we are stressed/in danger How does this look in real life? Not all stress is dangerous and to be avoided? – Stress is part of everyday life and without it we don’t learn, strive, keep safe. – Our nervous systems were actually designed to pulse and we were born ‘knowing’ dysregulation much more than regulation – The alarm system plays a role not just in creating safety, but also responding to stress caused through things that are unexpected and unknown (aka change) – The purpose of this isn’t to avoid such things…but to activate and prepare the body and brain to manage them. It also helps us signal for support if needed Window of tolerance - Things generally work well when the stress/threat we face is in kilter with the resources that we have to cope – BUT…we come in to this world with very few resources. WHY? – To adjust to environment and to do all the learning that is required…we needed a lot of raw material and a whole lot of potential – Evolution had a plan to protect us while our higher cognitive functions were doing the important job of building connections and pathways… Attachment The biological, psychological and behavioural mechanisms that operate within the infant/caregiver dyad to create a relationship where safety is created, needs are met, cuddles are given…etc But wait there’s more… – The attachment relationships formed between infants and their caregivers were also designed to help infants deal with stress and challenge through helping them down regulate their stress response and stay (for increasing periods of time) within their window of tolerance – If we have too much stress we become dysregulated and overwhelmed and that’s where that FFF alarm can start to create havoc…especially if gets triggered too intensely or too often – The brain and it’s tendency to adjust to what it knows can cause unintended consequences for those who have experienced a lot of stress/early, as stress/threat/danger can actually become ‘organizing’ and so people can seek them out to experience their own version of ‘normal’ – It’s interesting to note that this tendency to look to others to see how safe we are stays with us. – Stress and calm are both contagious as our NS’s talk to each other! (earthquake eg, hanging out with classmates before and after a test!!) The ‘language’ of regulation… translated What helps you feel safe?? Important to start with the basics - Maslow’s hierarchy - food, water, actual safety Parents need to be regulated…ish – So a child can get pulled into their calm and not get pulled into their storm – We need to find our inner ‘warm rock’ - Paying attention (rupture and repair) - Tone and volume of voice – Movements matching the child’s dysregulation (‘rock the baby’) – Telling the baby what they are experiencing (mirroring) – Meeting the need…ish (often through a process of elimination!) – Tolerating some distress as children need to build awareness and skills Age appropriate support – As a child grows, the type of support they might need changes. – Exposure to bite sized chunks of stress/frustration and being supported through it (NOT rescued from it) is important. – It IS our job to create a scaffold so that the child or young person can experience the ‘uncomfortable’ with greater comfort – Slowly but surely over time, the child/young person is able to internalize the strategies and beliefs about themselves that allows them to flexibly deal with challenges and big emotions as they occur (MOST of the time ☺). – Of course, an important strategy remains the ability to reach out for additional support when the stressor is too big or their internal resources aren’t sufficient to cope. What happens if the stressor is overwhelming…aka TRAUMA – Trauma is when a person is exposed to a situation when their lives or the lives of someone they love is in danger and/or they are completely overwhelmed by a situation. NB. It’s not just about being really scared or anxious. How do we normally lay down memories? The impacts of trauma – Our memory of events is affected by both the high arousal experienced at the time and the pain of remembering.…it lacks integration and context. – Our brain keeps trying to process the experience and bring order to it…and learn the ‘wise lesson’ This can create distress and lead to efforts to avoid anything that reminds us of what happened. – We can feel hypervigilant and unsafe in the world. Aka. The f/f/f alarm keeps getting tricked and we can feel dysregulated A LOT. – Our brain is a meaning making machine and we are always trying to interpret our experience. This meaning can be influenced by our developmental stage and the messages we received from others around us and previous experience. It is also made harder when we are dysregulated as our ‘thinking’ part of the brain is switched off. – The brain (and body) has a natural drive to heal itself and most people will work through these experiences and in time feel better. – If we are able to stay within (or bring ourselves back to) our window of tolerance and access the thinking part of the brain then this processing and healing process is made easier – For some, the overwhelming nature of the experience and the presence of other complicating factors can mean that they may develop POST TRAUMATIC STRESS DISORDER. – Wherever the person is on this continuum, support is vital and there are things we know that can help. What are some complicating factors? Not all alarm systems are ‘equal’ Trauma/stressors Genetics Early environment Reactions/Resources of others Resources What has happened to us before Trauma effects are cumulative If it’s a loved one who hurts us – We know that humans are social beings and connection is vital to our survival. – We know that when scared or hurt, our first response is normally to look to people, especially parents or caregivers to create a sense of safety and help us regulate ourselves. – If we are hurt by the people who were meant to keep us safe, this confuses and – unsettles these core attachment and regulation systems and can even – make feeling of trust and love feel unsafe Not all wounds involve having things ‘done’ to us – Neglect not only creates its own wounds, but it also make a child less able to heal from other wounds they might be exposed to How will you know if a child is traumatized? – You might not! – Some children will be traumatized by events that you will never know about – Some children will experience ‘traumatic events’ and not be traumatized – Some children will have been traumatized and not show it – Some children will show you extreme distress and not be traumatized – Some children will do OK and it will be their ‘grown ups’ who are traumatized. – ….. Advice for parents and budding psychologists…DON’T PANIC! – We are all doing the best we can – The biggest things to look out for are changes in behavior and reactions that seem out of kilter. – Be curious and interested in the lives of children and ask if you notice something that bothers you (and ask again…and again…) (NB but manage your anxiety…otherwise this can start to look like stalking ☺) – Provide information and options for the child (aka plant a few seeds) – Identify other safe adults that the child might want to talk to. – Honour the complexity, but try and not be overwhelmed by it – We might be seed planters and NOT tree growers Whatever has happened…it’s important to remember we each have a super power Safe and meaningful social connection is the antidote for stress Effectively processing traumatic memories is aided when a ‘lack of safety is re-experienced within safe relationships’ All distressed children/young people benefit from having adults who are: – Keeping them safe – regulated (most of the time) and taking care of themselves…aka BREATHING! – Interested in them, – Paying attention to reactions and coming close when needed and giving space when needed (ish) – Showing them care and affection in tolerated/patterned/repetitious amounts – Being consistent with boundaries and doing what they say they are going to do – Keeping regular routines where possible – Seeking out support from others when needed – Allowing the child to have control over some things…but not the big things (in other words…TRAUMA INFORMED CARE) Children who are hurt by people can still heal within safe relationships… - But this can be a slower and complicated process for children who experienced neglect and/or have been hurt by people who were supposed to be safe - Trust might be low (quite rightly) - Being with a ‘safe’ person and wanting to trust them might feel triggering for a child - The nervous system has been ‘injured’ and it makes it’s own decisions around how to keep safe - There is more need for patterned/repetitious experiences of safe interactions - The younger the age when harm happened, often the more diffuse and far reaching the impacts What helps the ‘safe’ adults? – Knowledge and understanding of what is going on, so they are less likely to take this personally – Resources and support that acknowledge that this will be a long process – Having a plan for WHEN challenges arise – Having someone who has THEIR back and model regulation – Self care! – Realistic expectations…for child and grown ups How many of us plan for the day we think we SHOULD have? Makes much more sense to plan for the day you are actually going to have! Hope also helps when it feels overwhelming From ACE to PACE (these things have been proven to make a REAL difference). – Able to talk to family about feelings – Family stood by you during hard times – Participated in community traditions – Felt a sense of belonging at school – Felt supported by friends – 2 adults (not parents) who took an interest in you – Felt safe, protected by adult at home To recap – Children grow up ‘well’ if they have attuned adults in their worlds who help keep them physically and emotionally safe…ish. – When stressed a child needs these adults to help them regulate their experience, until they can learn to do it for themselves. – Exposure to trauma means a child existing strategies are often overwhelmed and so their need for support is increased. This support isn’t ‘a one size fits all’ and so it requires adults to ‘know’ the child they are supporting. – Although this stuff can be complicated…there are some key things that parents and caregivers can do that WILL make a difference. – Both the children and their significant adults need information and support – Children CAN and DO heal from traumatic experiences A final thought… a traumatized child needs support from more than just parents –