Making It Better Without Making It Worse

Angela Keen, Keystone Crisis Intervention Team

Crisis Intervention Association of Pennsylvania Annual ConferenceNovember 12, 2015

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Attendees will be able to:

• Describe the neurobiology of trauma reactions

• Idenitfy how empathy contributes to traumatic stress reactions that may be categorized as vicarious victimization, compassion fatigue and burnout

• Recognize their own traumatic exposure responses and learn self-soothing techniques to build resiliency and healthy coping skills

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Trauma

Individual Trauma:A “blow to the psyche that breaks through one’s defenses so suddenly and with such force that one cannot respond effectively.”

- Kai Erickson, In the Wake of a Flood, 1979

Collective Trauma:A “blow to the tissues of social life that damages the bonds attaching people together.”

- Kai Erickson, In the Wake of a Flood, 1979

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Trauma is any event that leaves a person feeling hopeless,

helpless, fearing for their life and/or their safety.

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Fluctuating Equilibrium

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Impact of Trauma on Equilibrium

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Remember…

• Trauma is a sensory experience

• It is not cognitive!

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Sensory Path in the Non- Traumatized Brain

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Cortex- Neo Cortex

Thalamus

AmygdalaHippocampus

Sensory Path in the Traumatized Brain

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Cortex- Neo Cortex

Thalamus

AmygdalaHippocampus

During a Traumatic Event

• Right Brain Left Brain

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The pathways between the right and left brain experience a disconnect.

• Memory• Sensory• Affect Regulation

• Making Sense• Problem Solving• Decision Making• Language• Impulse Control

Remember…

• Trauma is a sensory experience

• It is not cognitive!

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TRAUMA IMPAIRS

• Feeling internally connected over time to caring others

• Experiencing oneself as deserving and worthwhile

• Managing Feelings: Recognize, tolerate, modulate, integrate feelings

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POTENTIAL IMPACT OF REPEATED TRAUMA

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POTENTIAL IMPACT OF REPEATED TRAUMA

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TRAUMATIC STRESS

Shifts people away from emotional safety, emotional balance and predictability.

Disrupts the ability to return-to-center.

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Stress Reactions of Caregivers K

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Burnout: a chronic state of stress

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Signs of Burnout

• Exhaustion of mind and body

• Frustration, cynicism, negative thoughts

• Feelings of ineffectiveness and lack of accomplishment

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Contributing Factors to Burnout

• Emotional and physical drain of providing continual empathy

• Ambiguous successes

• Erosion of idealism

• Lack of expected rewards

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Burnout Causes Havoc with:

• Your health (poor sleep, illness)

• Your personal life

• Maintaining self-care

• Job performance

• Cognitive abilities (concentration, problem solving, decision making)

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Vicarious Victimization

• Counter-transference• A recent or similar trauma in the

caregiver’s life (does not have to be directly related to the current disaster)

• Similarities between victim and caregiver• Physical and emotional fatigue

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Compassion Fatigue

• Caregivers experience trauma by:• Listening to the story of the event

• Through empathetic contact with victims or survivors

• When they can’t distance themselves from the event

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Taking Care of Ourselves

• What activities do you do to take care of yourself?• Emotionally• Physically• Spiritually

• Identify your support system• Personal life• At work

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Exercise

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Nutrition

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Humor

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RESILIENCY

AND

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RESILIENCY

Resilience refers to a person’s

inherent capacity to moderate

and recover from traumatic

experience.

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RESILIENCY

Helps to:Prevent stress related disorders

Recover faster

Maintain peak performance

Perform optimally during a crisis

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RESILIENCY ASSUMPTIONS

Everyone has some

Skills can be taught and learned

Starts in childhood

It’s never too late to learn

One can prepare for specific, expected crises

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Resiliency Factors

Attitudinal

Emotional

Behavioral

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Resiliency Traits Include:• Easy temperament• Social competence• Creative problem-solving skills• Ability to tolerate frustration and manage emotions• Clear and consistent boundaries• Belief in one’s effectiveness• Persistence in the face of failure• Optimistic outlook• Ability to build friendships and seek out support• Sense of humor

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Latipha Cross : A Story of Resiliency

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What are your sources of resiliency?

1. What resources have you relied upon since the event that has supported your recovery?

2. Identify individual, family and community resources which could support your recovery?

3. What personal strengths have you utilized to assist in your recovery?

4. Are there things you can learn now to improve your recovery?

5. What steps can you take to achieve a sense of recovery?

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What are your sources of resiliency?

6. What can you identify as steps to take to achieve your family’s recovery?

7. What steps can you take to help your community achieve its recovery?

8. What will resiliency look like for you, your family, your community?

9. What needs have you identified since the event?

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Community Resilience

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CopingExpending conscious effort to solve or tolerate personal or interpersonal problems, stress or conflict.

SkillThe ability to do something from training, experience, or practice.

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Why Teach Coping Skills?

When faced with a problem people first: A. Define the problem

B. Try to solve the problem

C. Try to live with the problem

D. Try to hide from the problem

E. Quit trying all togetherCoping skills are used in helping people try to solve the problem and live with the problem

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Why Teach Coping Skills

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Coping

Active Coping thinks about a situation to improve or adjust to it

Avoidant Coping seeks to keep the situation out of awareness

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Types of Coping

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SPECIFIC SKILLSDefense Mechanisms4 Square BreathingDeep Muscle RelaxationThought StoppingJournalingMindfulnessDistractionGuided ImageryExercisePetsCognitive Restructuring

Relaxation TechniquesSelf NurturingPrayerProblem SolveHumorMeditationMusicVolunteeringSharing (Venting)Letter or Recording to SelfPositive AffirmationsArt

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Preparation, Preparation, Preparation

4 Elements of a Safety Plan

1) Outline healthy behaviors to help prevent crises. 2) Identify risk factors that may increase stress. 3) Identify symptoms that indicate a problem may be approaching. 4) Outline what to do in a crisis situation.

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Wrap Up

We all use skills to get us through the rough times. What other ideas do you have?

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