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Minnesota Human Trafficking Task Force
July 24, 2017
Trauma, Community, and
Healing|
What we need to know about the
future of Prevention
Karina Forrest Perkins
In troduction
Self Care and Reflection
Safety and Self-care is our highest priority.
If you would like to speak with someone about what you heard today, or if you would like a moment to step
away from the presentation, please do so.
The new context regard ing stress
The Bra in | Reg iona l C om m and C enters
1. SURVIVALAutomatic Functioning | Autonomic Response | Threat
Response | Oldest | First to Develop | Strongest
Neuropathways
2. MIDBRAIN
3. CORTEX | Pre-Frontal
Emotional Control | Neuro-Transmitter Control |
Sensory Perception | Vision | Hearing | Motor Control
| Sleep-Alert System | Temperature Control |
Intellectual Function | Judgment | Planning |Course
Correction | Moral Assessment | Future Planning |
Imagination |Executive Function
Human DesignWe have multiple regions and functions of the brain that impact us daily.
Today we will focus on only three.
1
Surviva l
2 3
M idBra in C ortex
The in ten t is tha t w e use a ll th ree:
To stay (Surv iva l) Safe and alive so we have experiences…
To (Em otiona l) Feel and sense our experiences…
To (Cogn itive) Think about, plan for, and make meaning of our experiences…
Survival
Region
Limbic
Midbrain
Region
Frontal and
Pre-Frontal
Cortex
Directiona l grow th patte rns
• M ost prim itive to m ost
advanced
• C onception to -28
• Re-organ iza tion Betw een
ages 12-14
• C oncre te Th ink ing to
Abstract Th ink ing
• Prio ritizing
• Neuro-Genesis life long
Grow th Patte rns
7
The Bra in | Environm enta l Im pact
1. Arborization
2. Utilization
3. Pruning
What do you use?
What does not appear to be as necessary?
Selection | Atrophy | Myelination
You retain and invest in what your brain perceives is
necessary
Adaptive versus Mal-Adaptive
1
Arboriza tion
2 3
Utiliza tionReview
Prun ing|
M ye lina tion
More neuro-synaptic connections than you will need
1
2
3
IM PAC T
1. The reg ions w e deve lop and use
m ost often have a bearing on our
hum an in te raction ; on our ab ility to
be spiritua l; on our learn ing sty les;
on how connected we fee l in the
w orld ; and how we va lue se lf and
others.
Basica lly how we deve lop de term ines
how we “are” in the world and how we
deve lop our w orldv iew.
>Are we an im portan t part of th is w orld?
>Or do w e be lieve tha t w e have to
surv ive the world…endure the w orld…?
10
Sta tus during ages 12 -14No trauma, CD/MI
One
Tw o Three
PUBERTY
RE-ORGANIZATION
PRUNING
1
2
3
Our Body and StressPhysiology
Deve lopm enta l
H is toryThreat
PerceptionDefense
M echan ismW orld
View
Regardless of where we come from:
our ethnicity, our race, our gender,
our place of birth, our preferences….
We all experience stress and
we all have the same type of response
to the accumulation of stress….
‘Human Biology of Stress’
Our responses to th rea t…
Aud ience exam ple
Sim plified description of Stress Response
Survival
Mechanism
Stress hormones keep us
safe…
We are built to withstand
approx. 20” of stress
And we adapt so that we know
how to function in the
environment we spend the
most time in…
Stress (perception of
th rea t) ca ta lyzes the
production of
Adrena line… [1]
Adrena line ca ta lyzes
the production of
cortiso l… [2]
Cortisol
C ogn itive Shut-Dow n…
1
2
3
A simple way to
understand or explain
it…
#3 goes first
#2 goes second
#1 is what is left alert as
long as possible in order
to keep you safe.
Cortisol
The Amygdala and Learning
Sensory
Input
AmygdalaPrefrontal
Cortex
Conscious
Response
and
Learning
Amygdala
From The MindUp CurriculumFlight, Fight or Freeze (See former slide)
Prefrontal
Cortex
16
C ogn itive Shut-Dow n…
The m ore prepared you becom e fo r danger, the less your body perce ives you
need, would want to value, or would be able to engage re la tiona l sk ills so the less
capable you w ill becom e in accessing the m ore sophis tica ted parts o f the bra in .
The m ore upset w e becom e, the less sophis tica ted our th ink ing becom es . The
m ore we have had to survive the qu icker our bra ins are able to s low or shu t
dow n. If we have to survive th is is very he lpfu l! If we do no t, then it is po ten tia lly
unhe lpfu l.
If we are triggered by a conversa tion w ith som eone a t work/hom e, tha t is no t so
he lpfu l. W e m ay say som eth ing designed to de fend ourse lves instead o f
m a in ta in ing our best th ink ing fo r the good o f the re la tionsh ip. This w ill have
socia l consequences.
SELF-M ANAGEM ENT
The Sign ificance of M anag ing Triggers
In the m om ent . . .
w e have 8 to 15 seconds to stop the trigger…
In the afte rm ath . . .
it takes 6 to 8 hours to re tu rn to norm al leve ls…
This is why we must practice new patterns of behavior when we do not need them
so we can access them quickly when we do.
Genetics v Epigenetics
Epigenetics…w hat is th is?
Our Chromosomes…
Our DNA…Our Telomeres…
Neuro-Synaptic
Rate o f Deve lopm ent
Neuro-Synaptic Deve lopm ent
1. At birth a human infant has ~100 billion neurons with 50 trillion connections or synapses.
2. In the first three months of life the synapses multiply more than 20 times.
3. At one year the brain has up to 1,000 trillion synapses.4. On average between the age of 0-5, children produce up to
20,000 connections per second (250k to 1.2m per minute)5. In adulthood we produce ~400 connections per day.
Psychology Today. 2014.Harvard Center on the Developing Child. 2016.
Prevention
When individuals who have grown up with high stress accumulation
do not receive the supports they need to balance or remedy this condition;
then they transmit the same problem
onto the next generation and the accumulation process
starts all over again.
We all pay for this lack of investment. It shows up in our lives, our families, our schools, our communities, our
treatment centers, our workforce, our cities, our prisons, our counties, our states, our emergency rooms, our
cemeteries, our nation and beyond.
Billions (>120B) of dollars annually support strategies that do not intervene early enough.
This is not saying that we do not provide good care but the care that we do provide is too late, is not enough,
is spilling into the next generation, is many times contributing to stress, is using out of date science and
system delivery, is not long or intense enough, and, misses too many people who would benefit from it.
W hat w e just rev iew ed is no t suggesting som eth ing is wrong w ith the bra in…On the
con tra ry, it says m ore about w hat is happen ing in the environment.
GARDENING EXAM P LE
Prevention as a StrategyBuilding Patterns
What would prevent an accumulation of stress?
What would interrupt the transmission of stress passing to the next generation?
What strategies might be helpful as we incorporate this newer science into our prevention models?
How do we reach people before a problem has manifested?
How do we create norms that no longer tolerate this phenomena?
How do we incorporate the assumptions behind epigenetics into this picture? How do we address the scientific basis building re: Historical Trauma into our dialogue?
What are you ALREADY doing that is prevention oriented?
QUESTIONS!
29
Thank you!!
Karina Forrest Perk ins M H R LADCBush Foundation Fellow 2017
Principal | FTL Consulting
CAPT | SME
CEO | Wayside House
Phone651.600.7442
790px x 400px
Resources – Authors - M ajo r C ontribu to rs
People to research and learn from: Robert Anda MD, Bessel van der Kolk MD, Sandra Bloom MD, Bruce
Perry MD, John Briere, Christine Courtois
Articles:
Understanding Interpersonal Trauma in Children: Why We Need a Developmentally Appropriate
Trauma Diagnosis
D'Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., van der Kolk, B., 2012, Vol. 82, No.2, 187-200.
The Heart of the Matter: Complex Trauma in Child Welfare
Spinazzola, J., Habib, M., Knoverek A., Arvidson, J., Nisenbaum, J., Wentworth, R., Hodgdon, H., Pond,
A., Kisiel, C., CW360 Trauma-Informed Child Welfare Practice-Winter 2013, CASCS, University of
Minnesota, pp. 8-9, 37.
Disorders of Extreme Stress: The Empirical Foundation of a Complex Adaptation to Trauma, Journal of
Traumatic Stress
van der Kolk, Roth, Pelcovitz, Sunday, and Spinazzola, 2005, , Vol. 18, No. 5, October 2005, pp. 389–
399
Posttraumatic Stress Disorder Treatment Outcome Research: The Study of Unrepresentative Samples
Spinazzola, Margaret Blaustein, and van der Kolk, 2005, Journal of Traumatic Stress, Vol. 18, No. 5,
October 2005, pp. 425–436
Phenomenology and Psychological Assessment of Complex Posttraumatic States
Briere and Spinazzola, 2005, Journal of Traumatic Stress, Vol. 18, No. 5, October 2005, pp. 401–412
Anda, R. F., Felitti, R. F., Walker,]., Whitfield, C., Bremner, D.]., Perry, B. D., Dube, S. R., & Giles, W. G. (2006). The enduring effects of childhood abuse and related experiences: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatric and Clinical Neuroscience, 256(3), 174-186.
Barfield, S., Gaskill, R., Dobson, C., & Perry, B. D. (submitted). Implementing the Neurosequential Model of Therapeutics© (NMT) with Filial Therapy in a therapeutic preschool setting: Implications for work with children with serious emotional disturbance.
Perry, B. D. (2001) The neuroarcheology of childhood maltreatment: The neurodevelopmental costs of adverse childhood events. In K. Franey, R. Geffner, &
R. Falconer (Eds.), The cost of maltreatment: Who pays? We all do (pp. San Diego: Family Violence and Sexual Assault Institute.
Perry, B. D. (2006). The Neurosequential Model of Therapeutics: Applying principles of neuroscience to clinical work with traumatized and maltreated children. In N.
B. Webb (Ed.), Working with traumatized youth in child welfare (pp. 27-52 ). New York: The Guilford Press.
Perry, B. D. (2008). Child maltreatment: The role of abuse and neglect in developmental psychopathology. In T.
P. Beauchaine & S. P. Hinshaw (Eds.), Textbook of child and adolescent psychopathology (pp. New York: Wiley.
Richard Davidson’s The Emotional Life of The Brain
Daniel Goleman Emotional Intelligence
InsideOutcomes.biz Emotional Intelligence for Leaders Course
The Whole Brain Child – D. Siegel, MD
Building Resilience in Children and Teens – AAP, K. Ginsburg MD
The Four Agreements – M. Ruiz
National Scientific Council on the Developing Child
Childstats.gov offers easy access to federal and state statistics and reports on children and their families, including: population and family characteristics, economic security, health, behavior and social environment, and education. http://www.childstats.gov/
http://www.nctsn.org/ National Child Traumatic Stress Network
The International Society for Traumatic Stress Studies (ISTSS), founded in 1985, provides a forum for the sharing of research, clinical strategies, public policy concerns and theoretical formulations on trauma in the United States and around the world. ISTSS is dedicated to the discovery and dissemination of knowledge and to the stimulation of policy, program and service initiatives that seek to reduce traumatic stressors and their immediate and long-term consequences.
ISTSS60 Revere Drive, Suite 500Northbrook, Illinois 60062 USAPhone: 847/480-9028; Fax: 847/480-9282http://www.istss.org
Centers for Disease Control and Preventioncdc.Gov
Prevent Child Abuse America 200 S. Michigan Avenue, 17th Floor Chicago, Illinois 60604-2404 (800) CHILDREN Tel: (312) 663-3520 Fax: (312) 939-8962 [email protected]
Child Welfare League of America440 First Street, NW, Third FloorWashington, DC 20001-2085Tel: (202) 638-2952Fax: (202) 638-4004http://www.cwla.org/
APSAC
407 South Dearborn Stree t Suite
1300
C hicago, IL 60605
http://w w w.apsac.o rg /
The National Center for PTSD
http://w w w.dartm outh .edu/dm s/ptsd/
Websites and Online Learning:
www.acestudy.gov American Psychiatric Association, Diagnostic and Statistical Manual of
Mental Disorder, Revised (DSM IV-R) 4th ed. Washington, DC: APA, 2000) Version Five (V) coming out 2013.
Lise Addario, Six Degrees from Liberation: Legal Needs of Women in Criminal and Other Matters (Research and Statistics Report) (Ottawa: Department of Justice, 2002)
Bruce Perry MD, www.childtrauma.orgPlease feel free to research this website and Dr. Perry’s online course in trauma and brain development.
Sandra Bloom MD, www.sanctuaryweb.com Family Policy Council – Washington State
