Treating Trauma: What works?

Hi, everyone. Welcome to teacher training. Number two.

For this training, we're going to do treating trauma. What works.

So, in the first video, we looked at Trauma and Aces in this video,

I wanted to talk a little bit about how we treat trauma.

I know that when I was in grad school and we

talked about trauma and did tons of education on trauma.

It was also one of those things where they were like, OK,

I get like all this trauma is happening but like what do we do about it?

So I wanted to go into that in a little bit more detail for this um training this month.

Um The first most basic ones we have are trauma focused,

cognitive behavioral therapy, trauma focused, dialectical, behavioral therapy

and trauma focused Act.

Um trauma focused C BT

is really focused on psychoeducation with clients.

So that's kind of one of the unique things about

um C BT is there's a big focus on psychoeducation after psycho education,

they move into managing behaviors and learning coping skills and

then they talk about um the trauma and do more dialogue

with D BT.

There's a focus on mindfulness, um which is like grounding exercises, breathing,

becoming aware of sensations in the body, moving into dis distress, tolerance,

moving into emotional regulation and managing those emotions.

And then interpersonal effectiveness is a big one for D BT D BT

and developing healthy relationships with other people.

Trauma focused act is trauma focused, acceptance and commitment therapy

Act. Um I'm a little biased because I really like act. Actually, the

um it's one of my modalities that I enjoy

and Act is focused on the continuum of emotional experience.

There's a big focus on quality of life and values,

incorporating values and being aware of our values in life.

Um And then they work into, you know, psychological flexibility, being able to

um not be so rigid in our thinking.

And our thoughts Act also um is a good one because it can address many issues at once.

It isn't like a one topic at a time kind of

um therapy where it's focused on that sort of a thing.

Um

So next that I want to dig it into with some more stuff about trauma,

some of their ideas, some of their modalities.

Um There is the body keeps the score which I know we talked about last time.

It's a great book. If you haven't read it,

there's also the boy who was raised as a dog.

Um and other stories from a child psychiatrists notebook

is what that one is by Bruce Perry.

Um These are two very excellent books for learning about

trauma in Children and the effects of those trauma,

the big things that come out of those books,

the big suggestions that they have are emotions and calming,

um is one of the really big ones.

So Vander Kolk and Bruce Perry both really focus on the idea um

that

there's a disconnection between it,

knowing what those emotions are and being able to calm the body down.

trauma really creates a disconnect.

So a lot of times when kids, when we ask kids, like,

what's going on, how do you feel?

And they're like, I don't know, and they get frustrated.

The answer is that they really don't know.

Um your body has numbed things in a certain way

that when they do get certain sensations in the body,

they really don't know what it means and what it's telling them,

there's also a big focus on um the idea of

meditation under grounding exercises that they believe is really beneficial.

So

meditation can be pretty hard for some people.

It doesn't have to be true meditation.

It could be,

you know, sitting and being really aware of what's around you. And um

you know, focusing in on the body and just that calm, quiet, breathing time,

grounding

exercises are a form of meditation. And then there's yoga.

Um Van Der Kolk

really believes in yoga um because he believes

that it like connects you with your body,

you're really listening to the body, you're moving the body,

you're feeling sensations within the body.

However, he does give a disclaimer here that it's really, really important for

people who have been victims of sexual abuse,

that they do yoga in a safe environment, maybe not a public environment.

And also for them to like choose

how quickly they want to get involved with that.

It really needs to be um careful because sometimes those body movements

can also trigger um trauma.

Um Art,

music and dance is a big one that they emphasize as being like really important.

So engaging in art, um enjoying music, doing dance and theater.

Um Theater was one of Vander Kolk, big suggestions for people with trauma.

He in New York City started like a group uh for teens with trauma doing theater.

Um It was a chance for them to really express what

was going on in a way that was less threatening.

Um

Then, you know, having like really intimate conversations,

sometimes a really great start to get started with connecting

with the body and also being able to express yourself.

And then he also believed very much in teaching self advocacy

and giving kids that ability to say what they need um

when they need it and giving them a voice enhancing confidence.

Um

Here's a little quote here. I wanted to read. I thought it was really wonderful.

Um So if you've been hurt, you need to acknowledge and name what happened to you.

I know from personal experience as long as I had

no place where I could let myself know what it

was like when my father locked me in the cellar

of our house for various three year old offenses,

I was chronically preoccupied with being exiled and abandoned.

Only when I could talk about that little how that little boy felt.

Only when I could forgive him for having been as scared and submissive as he was.

Did I start to enjoy the pleasure of my own company,

feeling listened to and understood changes our physiology,

being able to articulate the complex feeling and having our feelings recognized,

lights up our limbic brain

and creates an aha moment

in contrast, being met by silence and incomprehension kills the spirit

or as John Boby. So memorably put it

what cannot be spoken to the other cannot be spoken to the self.

And this really leads into

the next one I really wanted to talk about, which is exposure therapy.

So exposure therapy um has proven to be a

very effective form of treatment for um trauma,

PTSD, developmental trauma.

Um I think people like hear exposure therapy

and they automatically think that it's like,

you know, throwing spiders on someone because they're scared of spiders.

Um And that's actually really not true. The idea of exposure therapy

is very much so focused on that quote that we just read

the idea of coming back to it and talking about it thinking about it.

Um, imaginal exposure is very much so,

um,

you know, you're not dealing with anything tangible. You're just,

you know, maybe closing your eyes and recalling a memory.

You're bringing it into the imagination, but you're doing it in a safe space.

It's also something that, um,

is, should be done after,

um, the client has become grounded.

Um, and good at controlling those emotions, recognizing those emotions,

you wouldn't want to jump into this when they

still are like completely disconnected from the body.

Um But it's been shown time and time again

that talking about it really does change our ability to process

um what we experienced and talking about it in therapy. Um

So

exposure therapy has proven to be a successful form

of treatment for PTSD with an 86% success rate.

So it really has shown again and again in research that it's very effective.

Um So one more thing I wanna,

I guess say about this um is that

reintegration of traumatic memories into the conscious mind.

So that's really what exposure therapy is about and just a really quick story. Um

An example of this was

um during my internship experience, I had a client who had experienced um

a lot of trauma growing up, a lot of domestic violence in the home

and an activity that I did with this person that was a form of exposure therapy.

I've been working with them for several weeks at this point.

Um

But we one day just kind of talked about an earliest memory and they told me

that they had a memory of being in the car um during a

really bad storm and mom and dad were fighting in the front seat,

they said that they were maybe like four or five years old and

they were screaming and crying and wanting mom and dad to stop.

And dad started physically assaulting mom

in the front seat of the car.

So what we did is we talked about this experience

and then I asked the client to visualize that,

that five or six year old version of himself had just walked into

the room and sat down on the floor in front in between us.

And I asked them what they would want to say to that,

you know, child, like what would be the things that they would want to say

to that child in order to let them know that they were like, OK,

or that they were being heard and acknowledged

and it was a really powerful experience. I will say it was really powerful.

The client um was very

against crying.

You know, they were someone that was like, I don't cry in front of people.

That's not something I do,

but they cried. And what they identified really

was that they, you know,

didn't really have words as much as they would just pick up that child and hold them.

And I think that,

that's an example of exposure therapy in the sense

that that client was able to take that old memory

and reintegrate it into their conscious mind in

a way that it wasn't so terrible anymore.

They were able to find some sort of resolution

so that when they think about it, they can also think about the comforting side of it.

Um,

as well, they can take some power back.

I guess it's kind of like what they

were able to do through that reintegration process.

Um

So next, just a few things we have are Samsa and

the NCTSN dot org um website.

So Samsa tip 57 we have talked about this last

time and we'll talk about it in the future.

Um This is just uh

the trauma informed care.

They, in this text, they list a lot of information about what trauma is,

resources and everything else and this one also helps

lead to the National Trial Traumatic Stress Network.

I think it's one of them that they mentioned in the text that you can go in and look at

this website contains um tons of programs that are available for kids. Um

So there's really tons of different methods and ways

that you can work with kids on trauma.

Um This is a great place to go.

Just look and see what appeals to you or what you think might be helpful.

Um I know you guys aren't a therapist so

you wouldn't necessarily be doing like true therapy.

Um But it's always helpful to kind of know

what models are out there for working with people.

Um

And then I figured I couldn't end this training

without just talking a little bit about eye movement,

desensitization and reprocessing.

So, E MD R,

that's a buzzword

right now. It's really popular. A lot of people have heard of it.

Um And E MD R is um

pretty interesting one.

It's a technique that was specifically developed for addressing trauma.

Um

And the whole function of that is that the brain stunts processing based on trauma.

So there's kind of like a halt that happens

and it makes it hard to process information.

Um It makes,

makes it hard to process the experience and what they have found through E

MD R is that by doing the eye movement back and forth really fast,

it's similar to what we experience during sleep

and it connects the right and the left brains and it improves um processing.

So we're able to detach from those memories and

view those memories more like watching a movie.

So I talked to a veteran

who um came back from Iraq with um PTSD and he talked about E MD R and he said

it really was like the closest thing he had

ever had to a psychedelic experience without there ever,

you know, being any psychedelics.

Um

And he said it was just like, really interesting. It's hard to explain how it works.

Um But it really does work and it

allows people to view these memories and process them

in a way that's detached and doesn't trigger stress within the body.

So, thank you guys for viewing this training today. Um That's all I have for this one.

Please don't forget to do the pre quizzes and the post quizzes

and I really appreciate your participating.

Um And next time we will talk more about trauma informed care

and what trauma informed care looks like bringing it into the system.

So we're gonna tie in all of these concepts and

um, see how we can apply it to the school. All right. Thank you.

Treating Trauma: What works?

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