Day Three of the Childhood Trauma Conference took us on a slightly different journey as most of the day was focused on professionals presenting papers from their work and quite frankly, there were so many amazing examples of practice to choose from that I wasn’t sure where to start. I decided on Session One Trauma Informed Practice In Schools and Session Two, Working With Traumatised Adults. Each session presented three papers but I chose to pick one example from each session to share with you to keep this post at a readable length.
Before all the paper presentations Jennifer Freyd gave a keynote on betrayal titled Moving from Institutional Betrayal to Institutional Courage. I was a little worried about listening to this as betrayal is one of those experiences that you never ever forget, even if it invokes that internal response “that will never ever happen to me again” because it is so painful.
Betrayal Blindness – unawareness and forgetting is a crucial element in developmental betrayal because attachment is what we need to survive and at least betrayal is attachment. It is pervasive and toxic accounting for a whole host of negative outcomes. Interestingly it is also quite gendered (towards females) even though trauma isn’t.
Institutional trauma (institutions harming those dependent on the institution) might be genocide (systemic), sexual assault not responded to, or children being separated at the border as we’ve seen recently in the US for example. As soon as you love something, you are risk of not receiving that love and being betrayed so betrayal blindness sets in as a form of protection. REFLECTION – This makes so much sense if we think about children wanting to return to families that have abused and/or neglected them.
Freyd’s study found that Institutional Betrayal exacerbates trauma symptoms; such as anxiety, dissociation, sexual problems, sexual abuse symptoms. In other words, where there has been no response to a disclosure, the trauma is very much added to.
Family Betrayal was another area researched. It doesn’t measure the abuse itself but rather how the family responded it. Often the non abusing parent is the parent a person is more angry with than the abusing parent as they were seen as betraying them by not protecting them.
Institutional Courage – how do we prevent Institutional Betrayal
(1) Comply with laws and go beyond mere compliance
(2) Respond sensitively to victim disclosures… call out DARVO (Deny Attack Reverse Victim Offender) when you see it
(3) Bear witness, be accountable and apologise
(4) We need to cherish the whistle blower
(5) Engage in self study/self reflection/actively asking
(6) Conduct anonymous surveys
(7) Make sure that the leadership of the institution and community is educated about sexual violence/the trauma
(8) Be transparent
(9) Use the power of your institution to address the societal problem and then disseminate it
(10) Commit resources
Trauma Informed Practice In Schools
Session One – The first organisation was Marist 180, based in Sydney and today focused on Trauma Informed Practice in a High School in Sydney. They have adopted the Attachment Regulation and Competency (ARC) Model because it is evidence informed and the evidence base is growing. Attachment – the first step is getting people to manage their own emotions which is one of the greatest challenges. Learning to listen with our eyes and be proactive in recognising triggers and escalation in young people. Also consistency. The next step is regulation and learning to recognise emotions, learning to regulate emotions and learning to articulate emotions. Next is competency focusing on executive function and finally trauma experience integration, no longer being a victim of the trauma. Training teachers is crucial (music to my ears of course as I train on trauma informed approaches in schools a lot) as a level of understanding about development, trauma, childhood disruption etc. is so important to start the process of trauma informed environments. Some really good ideas in this model although ARC uses a consequences strategy which is not aligned with much of what I have read and experienced around using consequences (red/amber/green chart) with children/young people who have experienced trauma.
Working With Traumatised Adults
Session One – Dr Roby Abeles. This session was all about a strategy called Brainspotting. It is brain based, body inclusive, highly attuned, gentle, collaborative and can be interwoven into the existing therapeutic work (and an add-on not an instead of). Dr David Brand discovered ‘Brainspotting’ in 2003 having been trained in EDMR and Somatic Experiencing. When following the moving pointer held in the hand in EDMR, the idea is to notice a subtle movement in the eye, a reflexive movement like blinks or wobbles or eyebrow raises (a brainspot) and let the hand/pointer freeze with the eye movement rather than keep moving the hand (as in EMDR). A brainspot is a physiological system holding an emotional experience in memory form. It appears to feel a sense of connection and attunement that the neocortical brain doesn’t understand. Totally driven by the client. The therapist is just there to stay deeply connected and attuned….. Roby tells them, “Your brain is the warrior that is going to carry you out of this war.” It uses the bottom up approach to start (Bruce Perry neurosequential model does this) and then the end of the session is top down. Brainspotting is always working on attachment repair. Far from EMDR not least because it is client led not therapist led.
The final part of the day was a panel comprised of Peter Fonaghy, Allan Schore and Ed Tronick (three rather old, albeit interesting, white men. Was disappointing not to have a more diverse panel this evening. However, 140 years worth of experience between them is not to be sniffed at).
Joe Tucci asked “how would you describe the therapeutic process”. Allan replied “…a form of opening up to one another and therefore opening up to oneself inwardly. Who am I in the world and what does that mean. It’s a joint process.” Ed responded “…a messy and stressful process that is worked on in co-creative fashion to create meaning about the world. Taking ap art what was there and creating something new.” Peter answered “… there is a challenge in answering this. Therapy encompasses a very great number of processes. Much of what is therapeutic is not part of therapy. Freud commercialised ‘sharing’ (the audience chuckles)… so what aspects of human interaction are beneficial not toxic and unhelpful. It is more about what a person does and how they change their relationships with those outside of the therapy room.”
The next question was asked via the audience…. what is the role of intuition in relationships? Allan… “…intuitive process, right brain processes, based incidentally in maternal intuition and being able to read babies states, plays a much bigger role than we have previously thought.” (REFLECTION – Think about how services in the UK have had intuition battered out of them over the years as immeasurable, yet such an important part of all the work we do where relationships are the healing modality of itself). Ed… Intuition is intriguing as an idea. It comes out of a set of processes that are no longer intellectual, we’re experiencing something in our bodies. An experience which is gaining information largely out of awareness which at some point becomes conscious… but we have no accounting of it.” Peter… “reflective and reflexive ways of thinking/being enables an individual to move between different modes of thinking, a natural motion between the two that good therapy encourages.”
A complex discussion took place about what I might describe as knowing the not knowing which was rather too challenging to take notes on.
A question from the audience is posed “if you could go back in time, what advice would you give your younger self?” Allan… “humility is key as I made so many discoveries about myself as a therapist that I didn’t necessarily want to learn.” Peter… “not to take my knowledge too seriously and treating myself with a respect that I no way deserved. I would have told myself to calm down.” Ed… “simply not to be so sure that you really know what it is that is going on. It really is complicated (audience chuckles).”