Trauma & DevelopmentRose Messina, LCSW

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Outline For the Day

• Introductions

• Intentions, mine & yours

• Material: Lecture, Video, Table Discussion

• Break (around 10:30-10:45)

• Material: Lecture, Video, Table Discussion

• Lunch provided (12:30-1:00)

• Material: Lecture, Video, Table Discussion

• End at 3:30

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Intention For the Day

• Brain & Neruoplasticity

• Understand how trauma “works”

• Better understand what trauma does to the body, relationships,

thinking, behavior

• Refine/consider means of intervention:

• How we currently intervene

• How we’d like to intervene

• Discuss protective factors

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What Each of Us May Need

• Take care to notice how you are doing

• Fidgets

• How you typically participate in training

• Notes for follow up practice/drills

• Who we are in the room

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• My Intro:

• Quick introduction exercise: Why a trauma

training? Paired sharing

• Who is in the room, which FRC, County

• Grounding ourselves to go deeper

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Setting the Tone for How We

Engage

• Cleveland Perspective video

• https://www.youtube.com/watch?v=cDDWvj_q-

o8&noredirect=1

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–Laura van Dernoot Lipsky

“All of the wisdom you are about to encounter

is known to you already. This text is simply to

help you remember.”

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Early Brain Development

• We develop from the brain stem up

• First order of development is regulation

• Close behind is attachment (parallel)

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Neuroplasticity

• The brains ability to change in response to

repeated stimulation (both positive & negative)

• The brain’s potential to adapt is a result of genetics

& experience

• Historically, theory suggested a very limited

window (0-5 or 0-12)

• Current research: The Brain That Changes Itself,

Norman Doidge, M.D.

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The Body

Keeps the

ScoreBessel van der Kolk 2014

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Metabolizing Experience

The brain takes experiences and

processes them, much like the digestive

system processes food. That is, if an

experience is properly “digested,” it is

integrated into the system and supports

healthy growth. If a traumatic experience

is not integrated because of how it is

stored in the brain, a person can suffer,

both physically and emotionally

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The Attachment and

Biobehavioral Catch-Up (ABC)

• Mary Dozier, Ph D

• Nurturance even when children do not appear to

need it

• Mutually responsive interactions in which

caregivers follow children’s lead/need

• Care that is not frightening or overwhelming to

children, adults regulating themselves

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Why Discuss Trauma?

• ACEs: Adverse Childhood Experience Study

• www.ted.com/talks/nadine_burke_harris_how_chi

ldhood_trauma_affects_health_across_a_lifetime

• The cost of not knowing, not speaking

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Post ACEs video

discussion

What stood out?

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• ACEs calculator (handout)

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What is Trauma?

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“Trauma is not an event in itself but, rather, a

response to an experience that is so stressful

that it overwhelms an individual’s capacity to

cope.”

-Susan Craig (2008) Reaching and Teaching

Children who Hurt

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Understanding Trauma &

Intersection with Attachment

• Parental separation

• Parental unavailability

• Harm at the hands of parents/caregivers

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Taking Care of Ourselves

• Time for a stretch

• Connecting to our own resilience

• How do you build this into your day?

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Attachment & Why it Matters

• One thing we share with other species is an

evolutionary-based instinct to seek protection

from a parent or caregiver when we experience

danger.

• The development of attachment is especially

important for the human infant, since it is a

considerable time before we are able to move,

feed, or defend ourselves.

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• Attachment processes are social and psychological

in nature, yet are based in the biology and

chemistry of the child’s developing brain.

• Brain development is profoundly influenced by

attachment experiences

• The young brain is like a super sponge, absorbing

every experience into its neural architecture.

• If the sponge is drenched in challenging

experiences, that is what takes up the space

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How Does Attachment

Develop?• Infants and parents are programmed to attune

to each other

• Infant’s primary tasks in the first 3 years are to

learn self regulation, engagement,

intentionality, sense of self, express emotional

ideas

• A parent’s primary task is to teach this

regulation to their baby

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Attachment continued

• Secure attachment develops when a parent

responds with sensitivity and attunement

• What starts as parent’s regulation of baby

evolves into the child’s internal regulation

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Early Development of

Memory

• Repeated experiences strengthen a neuronal

pathway, becomes encoded

• Creation of an Internal Working Model of the

World & Self for survival & Growth (Bowlby)

• Implicit memory

• Explicit memory & language development

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Internal Working Model

• The early caregiving relationship provides a

relational context in which children develop a

model of self, other, and self in relation to

others

• The infant, then, is not simply acquiring an

internal memory of events, but is storing

information about events and then actively

makes predictions based upon a model of the

external world (Bowlby)

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Working Model & Attachment

Secure Attachment

Self = lovable, worthy, good

Others = helpful, trustworthy, good

World = safe and predictable

Insecure Attachment

Self = unlovable, unworthy, bad

Others = hurtful, untrustworthy, coercive

World = dangerous, chaotic

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The Intersection of delay in

development experienced as traumatic

• When one’s biology/physiology is confronted by an

environment that is too much or not enough

• Processing or attentional deficits often lead to

children feeling barraged by environmental demands

• Inability to respond “appropriately” can be interpreted

as willful “behavior”

• Part of human development is learning to notice less

than we are able to see-filtering

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Developing Executive

Function• Categorization

• Relies on the development of time and space

perception (vestibular, auditory, visual,

hippocampus)

• Problems solving capacity is the root of higher

levels of executive functioning

• “As long as you can imagine how things can be

different you will be OK” -Bessel van der Kolk

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Trauma Types

• Developmental Trauma (van der Kolk)

• A traumatic event

• Intergenerational Trauma

• Traumatic experience as a result of

environmental “overwhelm” developmental delay

• Chronic Stress

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• Harvard video on The Impact of Early Adversity on Children’s Development

http://developingchild.harvard.edu/resourcecatego

ry/multimedia/36

Complex Trauma

Complex Traumatic Exposure: refers to

children’s experiences of multiple traumatic

events that occur within the caregiving

system- the environment that is supposed to

be the source of safety and stability in a

child’s life.

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Impact of Trauma on Self-

Regulation

• Difficulty concentrating

• Aggression with peers and adults

• Clinging behavior

• Selective attention to cues of danger

• This is critical when the child’s developmental

task involves learning to modulate affect

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Impact of Trauma on

Readiness to Learn

• Clinginess leads to decreased exploration of the

environment

• Selective attention to danger cues means that

other relevant information is missed

• Inability to concentrate and focus attention

decreases persistence with new tasks

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Adaptations to Complex

TraumaProblems with:

• Regulation of affect and impulses

• Cognitive functioning/ Dissociation

• Somatization

• Sense of self

• Relationships

• In the absence of talking, children often make inaccurate

meaning out of what happened

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Drawing the Unspeakable5 y.o.

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What Causes One’s Brain to

Flip the Lid?• Transitions

• Changes

• Feelings of shame, guilt, vulnerability

• Sensory overload

• Intimacy, strong connection

• Confrontation

• The unknown

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Common Mistakes We Might

Make

• Missing that the person may be having a trauma

response

• Miss our own triggers & react from our feelings

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Addressing Defensive

Behavior• Notice when a person may be triggered

• First person to calm is self

• Connect & redirect

• Provide two options for shifting behavior

• Only provide options that you can provide

• Clear, simple, visual directions

• Body language

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Lisa 911

• Introduce Audio, with transcript.

• www.liveleak.com/view?i=8aa_1359117135

• What do you imagine was happening for the 6

y.o. child, baby?

• What do you imagine was happening for the

mother?

• What do they need?

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Ghosts In The Nursery

(Fraiberg)• Becoming a parent brings back memories of what it

was like to be a child

• Fears & worries that the past may repeat

I might not be a good enough parent

Will I harm my baby?

Will my baby harm me, take over my life, not choose

me?

• Unconscious repetition of the past in the present

• For many parents, their parents were fighting a battle

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Angels in the Nursery

• Lieberman & Van Horn

• Benevolent experiences also last a lifetime

• Importance of bringing up good memories

• Sometimes angels are hidden

• Look for ports of entry

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Breaking the Cycle

• What predicts whether the parent’s past will be repeated

with the child?

• Remembering saves the parent from repeating

Remembering allows the parent to identify with the child

• Those who connect emotions to experience are less

likely to repeat

• Developmental Guidance & Seeing Benevolence

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Unwittingly, we write the story of our future from

narratives based on the past...Mindful awareness

can bring into consciousness those hidden, past-

based perspectives so that they no longer frame

our worldview.’Choice begins the moment you

disidentify from the mind and its conditioned

patterns, the moment you become present…Until

you reach that point, you are unconscious.’ …In

present awareness we are liberated from the past.”

-Gabor Maté, In the Realm of Hungry Ghosts: Close

Encounters with Addiction

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The Protective Factors Framework

Center for the Study Of Social Policy

• Research supports that when these Protective

Factors are well established in a family, the

likelihood of child abuse and neglect

diminishes.

• These Protective Factors also promote optimal

child development.

• They intersect & overlap

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Parental Resilience

• Resilience is the ability to manage types of

challenges that emerge in every family’s life

• Finding ways to solve problems

• Building & sustaining trusting relationships

• Knowing how to seek help when necessary

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Social Connections

• Community in a broad manner

• Emotional support, problem

solving, parenting support

• Opportunities to give back

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Concrete Support in Times of

Need

• First meet basic economic needs (Shelter,

food, clothing, health care)

• The type of support a family needs can really

vary

• Ask about crisis times (past/present)

• If we don’t ask, who will?

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Knowledge of Parenting &

Child Development

• Help parents see the strength, need and

developmental stage

• A parent’s childhood experience often

influences their lens (may have a desire to

be like my family or NOT like my family)

• Developmental guidance/exploration allows

for more conscious parenting

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Social & Emotional

Competence of Children

• A child’s capacity to regulate &

effectively communicate has profound

impact on their relationships.

• Early identification and services critical

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4 cases

What might the child & parents need from us?

• Adam -Complex trauma

• Joseph -Vestibular & hence environment

• Oscar -Neuro-atypicality & MH of parent

• Edwin -Accident & medical trauma

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Common Developmental

Guidance Themes

1) Crying and proximity-seeking are the young child’s

most basic communication tools, and children develop

a healthy sense of competence and self-esteem when

the parent responds by offering comfort

2) Young children have a strong desire to please their

parents, although parents are often unaware of it

3) Separation anxiety is an expression of love and fear

of loss rather than a manipulation

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Common Developmental

Guidance Themes (cont.)4) Young children fear losing their parent’s love and

approval

5) Young children imitate their parents because they

want to be like them

6) Children blame themselves when their parent is

angry or upset (cognitive egocentrism)

7) Young children believe their parents can do

anything

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Common Developmental

Guidance Themes (cont.)

8) Children feel loved & protected when their parents

enforce rules about safety & danger, right & wrong

9) Toddlers & preschoolers use the word “no” as a

way of establishing a sense of autonomy not out of

disrespect for their parents

10) Babies & young children remember, preceding

their capacity to speak. May be more about what they

learned than what they remember

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Common Developmental

Guidance Themes (cont.)

11) Young children feel intensely, but don’t yet

know how to regulate their emotions. They can then

express this intensity in socially unacceptable ways

12) Conflicts between parents & children are

inevitable due to different goals, personalities, &

developmental stage. This can serve a valuable

function in coming to resolution (i.e. sleep)

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Peter Levine

“In the case of trauma patients, we have a

person who is locked in the fight-or-flight

response. A person who is functioning

primarily in the brainstem, and the language

of the brainstem is the language of

sensations. So if you are trying to help the

person work with the core of the trauma

response, you have to talk to that level of the

nervous system.” –Peter Levine

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Peter Levine

“…because the overwhelm and the fight-or-flight

are things that happen in the body, what I would

say is the golden route is to be able to help people

have experiences in the body that contradict those

of the overwhelming helplessness.”

-Peter Levine

http://www.psychotherapy.net/interview/interview-

peter-levine

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Important to Focus on Typical

Developmental Areas too

• Once there is a trauma, not all

experience is influenced by this

• A parent’s grief or shame related

to the trauma can impede their

sense of efficacy to parent

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Trauma Informed Approach

According to SAMHSA’s concept of a trauma-

informed approach, “A program, organization,

or system that is trauma-informed:

Realizes the widespread impact of trauma and

understands potential paths for recovery;

Recognizes the signs and symptoms of

trauma in clients, families, staff, and others

involved with the system;

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Trauma Informed Approach

(continued)

Responds by fully integrating knowledge about

trauma into policies, procedures, and practices; and

seeks to actively resist re-traumatization."

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SAMHSA’s Six Key Principles of

a Trauma-Informed Approach

• Safety

• Trustworthiness and Transparency

• Peer support

• Collaboration and Mutuality

• Empowerment, Voice, and Choice

• Cultural, Historical, and Gender Issues

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As practitioners, we have been

socialized in ways that many others

may not agree with.

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Example of Cultural Assumptions,

Ghosh-Ippen

• Young children remember their experiences

• Traumatic experiences are encoded in the brain and body

• Caregivers are the best people to help children make

meaning of their experiences

• It is good to process and talk about your past experiences

• Young children communicate through behavior and play

• It is good to express your feelings

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Treatment Options

Not all treatment is the right for everyone:

• ABCs of BioBehavioral Catch Up, Mary Dozier

• Child Parent Psychotherapy

• EMDR

• Neurofeedback

• Yoga

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Trauma Has a Tendency to

Fracture & Divide

• What resources does the family need?

• What level of support does the family need to

access these resources?

• What level of coordination across service

systems is needed?

• Encouraging family competency & use of

community

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Keep Learning What is Out

There

• Early Start

Neighborhoodearlystartneighborhood.ning.com

• CSEFEL

• Tolaris Institute

• First Five workshops

• Title IVE workshops

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How we can continue to take Attachment

and Trauma Theory into Account:

• Creating intentional & meaningful processes

• Reflect upon own personal, familial and cultural

experience

• Consult, consult, consult

• Supporting families in getting the culturally and clinically

appropriate services they need

• Ongoing training, support, and education

• Advocate at every level (IEPs, School Districts, Vote)

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–Angela Davis

“I’m no longer accepting the

things I cannot change…I’m

changing the things I cannot

accept…”

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