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Trauma in the Brain:

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Cindy Lemberg

on 5 July 2016

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Transcript of Trauma in the Brain:

Trauma and the Brain:

Children Aged 0-2 Exposed to Traumatic Stress May:
Trauma: "a deeply distressing or disturbing experience"
Abuse
Abandonment
Neglect
Witness D/V
Death/loss of loved one
Natural Disasters (including house fire)
War
Why behaviors aren't always a choice.
By Cindy Lemberg MSW, LCSWA
Personal Attack
Bullying
Medical Procedure/Illness/Surgery
Chronically Chaotic Environments
Community Violence
What Does Trauma Look Like?
What does that mean?
"Animal Brain"
"Thinking Brain"
Thinking Brain:
* Personality * Individuality
* Decision-Making
Takes action based on sensory information
Animal Brain:
* Can't think, just react *Heart beat
* Breathing * Digestion
SURVIVAL
SURVIVAL:
Fight, Flight, or Freeze
Attack the danger
Escape the danger
Body shuts down and can't respond
Stress = Animal Brain releases CORTISOL, triggers immediate response to stressor
Animal Brain DOESN'T THINK only REACTS
Animal Brain is FASTER than Thinking Brain
Animal Brain learns that SURVIVAL = "ON ALERT"
Animal Brain does not reflect on consequences


What Happens in the Brain During This Time?
Meanwhile.......
The Thinking Brain can't develop
Delays in cognition and decision-making
Act withdrawn
Demand attention using + and - behaviors
Have poor verbal skills
Have excessive tantrums
Have aggressive behaviors
Have memory problems
Show regressive behaviors
Have sleep issues
Be fearful of adults
Have a poor appetite/digestive problems
Scream/cry excessively
Be irritable, sad, or anxious
Be easily startled
Children Aged 3-6 Exposed to Traumatic Stress May ALSO:
Act out in social situations
Be fearful/avoidant
Be unable to trust others or make friends
Be verbally abusive
Blame themselves for the trauma
Develop learning disabilities
Have stomach aches/headaches
Have a fear of separation
Imitate the traumatic event
Lack self-confidence
Have poor overall skill development
What if this was your life? ALL THE TIME
All these behaviors occur because the traumatized child's brain was not able to develop
Decision-making
Emotional Regulation
Judgement
Impulse Control
Attachment
Ability to Trust
Ability to get needs met
Untreated traumatized kids become untreated traumatized adults. The brains might get older, but the damage remains the same!
So, what do we do?
Once calm, focus on the NEED the child was attempting to meet. Create a plan for how the child will meet that need in a different way next time.
De-escalate the outburst
Emotional regulation
Don't ask child to make choices while escalated
Other Tools
A way to measure trauma and predict it's impact.
ACES
Adverse Childhood Experiences Study
Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue. Much of the foundational research in this area has been referred to as Adverse Childhood Experiences (ACEs).

Adverse Childhood Experiences have been linked to

risky health behaviors,
chronic health conditions,
low life potential
early death

As the number of ACEs increases, so does the risk for these outcomes.
Center for Disease Control and Prevention, 2016.
The ACES Questionnaire measures trauma through 10 yes/no questions about:
1. Verbal abuse by parent/caregiver
2. Physical abuse by parent/caregiver
3. Sexual abuse
4. Emotional support/connection within family system
5. Neglect by parent/caregiver
6. Parent/caregiver divorce, separation, absence
7. Exposure to domestic violence
8. Exposure to substance use/abuse
9. Exposure to mental illness including suicidal gestures/attempts in family
10. Family member/caregiver legal involvement
Why do these things matter???
Children who experience ACEs in childhood struggle with these as adults:
Alcoholism and alcohol abuse
Pulmonary disease
Depression
Fetal death
Illicit drug use
Liver disease
Poor work performance
Financial stress
Risk for intimate partner violence

Multiple sexual partners
Sexually transmitted diseases
Smoking
Suicide attempts
Unintended pregnancies
Early initiation of smoking
Early initiation of sexual activity
Adolescent pregnancy
Risk for sexual violence
Poor academic achievement
We can't erase the traumatic events, but we can build RESILIENCY.
* The capacity to recover quickly from difficulties *
Teach concrete skills
Instead of asking "Why?" ask "How?"
Avoid talking in catastrophic terms
Let mistakes and natural consequences happen
Improve PROBLEM SOLVING skills
Promote CONNECTIONS
CONNECT TO YOURSELF
Understanding and managing emotions
Building Self-esteem
Increasing confidence
CONNECT TO OTHERS
Understanding emotions in others
Strengthening family
Positive social relationships
Rhythm and Repetition
Exercise
Dance
Yoga
Drumming
Scrapbooks
Crisis PREVENTION
Individual Therapy
Family Therapy
10-20-10
During a Crisis:
For behaviors to change, there must be trust
Honesty
Predictability
Reliability
Empathy
Watch out for pitfalls...
We assume all kids react the same to trauma
We use too many words!
We assume kids understand the correct choice.
We expect them to be calm when we can't stay calm ourselves.
We take their behavior personally.
Family Scrapbooking
Genograms
Group Therapy
CONNECT TO COMMUNITY
Learning about your culture
Cultural Competency
Giving Back
References
Centers for Disease Control and Prevention (2016). "ACE Study". https://www.cdc.gov/violenceprevention/acestudy/about.html.
Psych Central (2015). "10 Tips for Raising Resilient Kids". http://psychcentral.com/lib/10-tips-for-raising-resilient-kids/.
Charlotte * Gastonia * Winston-Salem *
Greensboro * Rockingham * West End * Raleigh
Services:
Intensive In-Home, Family Centered Treatment, Therapeutic Foster Care, Specialized Foster Care, Outpatient Therapy, Comprehensive Clinical Assessments, Medication Management
Presented by Cindy Lemberg, MSW, LCSWA, Director of Quality Assurance and Training
cynthia.lemberg@pinnaclefamilyservices.org
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