Trauma: Toolkit I Found

I found this toolkit made in 2013 that has helped me to come to terms with what Trauma is and how it affects you. This booklet has a lot of helpful information about Trauma and how to recover from it. I printed it so i could have it handy and I have many sections highlighted to go back and re-read when I feel the need.

As it says, “recovery is the ability to live in the present without being overwhelmed by thoughts and feelings of the pastand this is always my goal.

I will never be free of post-traumatic effects, the house fire I had in 1991 has shown me that as I live with memories of that every day, I can get to the point where the memories don’t take over my mind anymore and I can be present in where I am, and what I am doing, in that moment. Just as I did after the house fire and the Trauma of that experience.

Recovery is the primary goal for those who have experienced trauma, their families and their care providers. Recovery does not necessarily mean complete freedom from post-traumatic effects. Rather, it is an individual experience that will look and be different for everyone.

In general, recovery is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.

My Traumas do not determine who I am, I do. As I gained a new perspective over the house fire I was in, I have also gained a new perspective over the Bullying I was a target of.

Just as I gained a new perspective over time from having Cancer, Arthritis, Cervical Stenosis, Fibromyalgia, Diabetes, Hypertension, Cushing’s Disease, and the rest of my physical issues and their many symptoms and treatments.

These are all things I have, they do not determine who I am as a person! Trauma is a part of my Story, but I am no longer living in it or from it. I live in the present these days!

Mindfulness has taught me to stay in the moment, and take in all that is around me, not get stuck in the thoughts of the past and this smear campaign against me. The rollercoaster of words stopped a long time ago now, as I got off by concentrating on myself and healing myself, rather than wondering why they do what they do.

I am finally putting all my focus on what is important, me! I am doing all I can to release all this from my mind, and my life and I will one day, when all the websites they have containing my name, are gone for good. In the meantime, I am still healing. It is amazing what you can tolerate when you put your mind to it!! I have a lot of determination!

When they are able to see the things that happened to them and understand that those events do not determine who they are, many people who have experienced trauma are able to gain a different perspective and meaning of the traumatic experiences. The trauma is no longer the organizing principle of their lives. It becomes part of their story, but they are not living in it or from it.


https://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf

What is Trauma?

A traumatic event involves a single experience, or enduring repeated or multiple experiences, that completely overwhelm the individual’s ability to cope or integrate the ideas and emotions involved in that experience.

Recent research has revealed that psychological emotional trauma can result from such common occurrences as an auto accident, sudden job loss, relationship loss, a humiliating or deeply disappointing circumstance, the discovery of a lifethreatening illness or disabling condition, or other similar situations.

Traumatizing events can take a serious emotional toll on those involved, even if the event did not cause physical damage.

This can have a profound impact on the individual’s identity, resulting in negative effects in mind, body, soul and spirit.

Regardless of its source, trauma contains three common elements:
● It was unexpected.
● The person was unprepared.
● There was nothing the person could do to stop it from
happening.

Simply put, traumatic events are beyond a person’s control.

It is not the event that determines whether something is traumatic to someone, but the individual’s experience of the event and the meaning they make of it. Those who feel supported after the event (through family, friends, spiritual connections, etc.) and who had a chance to talk about and process the traumatic event are often able to integrate the experience into their lives, like any other experience.

What is Trauma?

The Trauma-informed Toolkit, second Edition 10
“Trauma is when we have encountered an out of control, frightening experience that has disconnected us from all sense of resourcefulness or safety or coping or love.”
Tara Brach, 2011

Traumatic events often cause feelings of shame due to the powerlessness they create, which can lead to secrecy and further embed the experience of shame. It then becomes something to be greatly feared and avoided. It is at this point that negative coping behaviours may start and may continue until a person decides to face the difficult emotions that surround the traumatic experience.

The impact of these events does not simply go away when they are over. Instead, traumatic events are profound experiences that can shape the way a person sees themselves, others and the world.

Because the traumatic experience was so terrible, it is normal for people to block the experience from their memory, or try to avoid any reminders of the trauma; this is how they survive.

However, the consequences of these survival mechanisms are a lack of integration of the traumatic experience, such that it becomes the experience in a person’s life, rather than one of many. The trauma becomes the organizing principle from which the person lives their life always trying to cope with and/or avoid the impact of the trauma.

This can be both a conscious and unconscious awareness/experience. This lack of processing of the trauma means that it is ever-present for the individual, and they feel as if the trauma happened yesterday when it could have been months or many years since.

The Effects of Trauma
The effects of being traumatized are very individual, and people who have experienced trauma are impacted physically, emotionally, behaviourally, cognitively, spiritually, neurobiologically and relationally.

Trauma can result in:
● Changes to the brain
● Compromised immune systems
● Increased physical and mental stress
● Decreased trust
● Attachment difficulties and conflictual relationships
● Hyperarousal and hypervigilance
● Rigid or chaotic behaviour

Service providers most often see hyperarousal and hypervigilance, but may not relate back to trauma and could be misinterpreted. This misinterpretation or misunderstanding of behaviour, and failing to recognize fight, flight and freeze responses, can contribute to judgmental behaviour on the part of a service provider, and lead to the development of conflict or adversarial relationships. It is important to remember that trauma impacts the manner in which a person does or does not approach helping relationships and their interactions with service providers. The effects of trauma are felt across the life span.

According to a Canadian study, PTSD is “associated with several physical health problems including cardiovascular diseases, respiratory diseases, chronic pain conditions, gastrointestinal illness and cancer” (2007). It is important to recognize that experiences of trauma can have negative effects on a person’s health, regardless of a diagnosis of PTSD.

This further supports the ACE (Adverse Childhood Experiences) study that identified the direct connection between adverse childhood experiences and the increase in
serious physical and mental health problems (1998).

The ACE study identified that the more adverse the experience, the greater the increase in risk for the following:
● Alcoholism and alcohol abuse
● Chronic obstructive pulmonary disease (COPD)
● Depression
● Fetal death
● Health-related quality of life
● Illicit drug use
● Ischemic heart disease (IHD)
● Liver disease
● Risk for intimate partner violence
● Multiple sexual partners
● Sexually transmitted diseases (STDs)
● Smoking
● Suicide attempts
● Unintended pregnancies
● Early initiation of smoking
● Early initiation of sexual activity
● Adolescent pregnancy
Emotional:
● Depression
● Feelings of despair, hopelessness and helplessness
● Guilt
● Shame
● Self-blame
● Self-hatred
● Feeling damaged
● Feeling like a “bad” person
● Anxiety
● Extreme vulnerability
● Panic attacks
● Fearfulness
● Compulsive and obsessive behaviours
● Feeling out of control
● Irritability, anger and resentment
● Emotional numbness
● Frightening thoughts
● Difficulties in relationships
Behavioural:
● Self-harm such as cutting
● Substance abuse
● Alcohol abuse
● Gambling
● Self-destructive behaviours
● Isolation
● Choosing friends that may be unhealthy
● Suicidal behaviour
● Violence and aggression toward others
Cognitive:
● Memory lapses, especially about the trauma
● Loss of time
● Being flooded by and overwhelmed with recollections of the trauma
● Difficulty making decisions
● Decreased ability to concentrate
● Feeling distracted
● Withdrawal from normal routine
● Thoughts of suicide
Spiritual:
● Feeling that life has little purpose and meaning
● Questioning the presence of a power greater than ourselves
● Questioning one’s purpose
● Questioning “Who am I,” “Where am I going,” “Do I really matter”
● Thoughts of being evil, especially when abuse is perpetrated by clergy
● Feeling disconnected from the world around us
● Feeling that as well as themselves, the whole race or culture is bad
Neurobiological:
● An overproduction of stress hormones that do not return to normal after being activated, and can endure for hours or days in ways identified below:
◆Jittery, trembling,
◆Exaggerated startle response
● Alarm system in the brain remains “on,” creating difficulty in reading faces and social cues, misinterpreting other people’s behaviour or events as threatening, difficulty sleeping, avoiding situations that are perceived as frightening
● Part of the brain systems change by becoming smaller or bigger than they are supposed to be
● Fight, flight, freeze response (which may look different from person to person)
● Responses are involuntary
Relational:
● Difficulty feeling love, trusting in relationships
● Decreased interest in sexual activity
● Emotional distancing from others
● Relationships may be characterized by anger and mistrust
● Unable to maintain relationships
● Parenting difficulties

It should also be noted that there are overlaps between the categories.

Trauma Recovery
Recovery is the primary goal for those who have experienced trauma, their families and their care providers. Recovery does not necessarily mean complete freedom from post-traumatic effects. Rather, it is an individual experience that will look and be different for everyone. In general, recovery is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.

In a trauma-informed system, it is acknowledged that everyone plays a role in supporting recovery, from the person at
reception to the CEO.

What May Help
It is impossible to sweep the world clean of triggers. There will always be difficult problems to solve, events that are unsettling and experiences that are unpleasant. It is a much better strategy to enhance our ability to cope. We now know that even deep patterns of neural firing can be changed through the ability of the brain to change itself (Davidson, 2003).

Through the nurturing of healthy relationships, attending to basic physical needs (i.e., sleep and nutrition), having adequate housing and food security, people have a greater opportunity to engage in trauma recovery. The mind, body and spirit will respond to these positive factors, which maximizes the potential for healing.

In addition, the practice of mindfulness can also play a significant role in trauma recovery by helping to restructure parts of the brain that have been the most compromised by trauma. Mindfulness is paying attention in the present moment to body sensations, emotions and thoughts without judgment
(Williams et al., 2007).

Mindfulness is a skill based on thousands of years of practice in various meditative traditions. The most popular modern versions are Mindfulness Based Stress
Reduction, yoga, and qi gong.

Definitions of Recovery
“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” (SAMHSA)

“Mental health recovery is a journey of healing and transformation for a person with a mental health condition to be able to live a fulfilling and meaningful life in
communities of his or her choice while striving towards personal goals.”

Safe relationships and the development of mind/body practices calm the limbic system. Recent studies that look at changes in the brains of people who have been practicing meditation, even for a short time, show that their limbic systems are less reactive and the neural connections between the prefrontal cortex (thinking brain) and the limbic area (reactive brain) had increased (Davidson, 2012). These changes show that meditators are more likely to pause before reacting and, when
stressed, choose a wiser course of action.

Other studies have shown that cognitive behavioural therapy combined with mindfulness practices can help prevent a relapse in people prone to clinical depression (Williams et al., 2007), obsessive compulsive disorder (Schwartz, 1996) and addictions (Marlatt, 2010).

Not all mindful practices involve sitting still. Bessel van der Kolk’s team at his centre for people impacted by trauma in Massachusetts showed that women with “treatment resistant” PTSD improved after participating in several weeks of yoga.

Almost half of them no longer had the symptom requirements for a diagnosis of PTSD (see yoga article at www.traumacenter.org ). While these are early days, the
emerging literature would suggest that there are many ways to heal from trauma.

Important Aspects of Trauma Recovery
Dr. Judith Herman (1992) conceives trauma recovery to proceed in three stages:
● Safety and stabilization
● Remembrance and mourning
● Reconnection

Safety and Stabilization
The central task of recovery is safety. Clients may feel they lack control over their emotions and other issues that stem from the unresolved trauma. Helping clients to realize what areas of their life need to be stabilized, and how that will be accomplished, will help the client move toward recovery. For example:
● A person who has experienced trauma may struggle to regulate difficult emotions in everyday life, which they might not necessarily associate directly to the trauma.
● A service provider can help the client learn to regulate these emotions.
● They work together as a team to stabilize the emotions so the individual who has experienced trauma can move on with the recovery process. This process takes time and varies from person to person.
● Some people who experienced trauma, particularly complex trauma, find that speaking about their experience or about the impact of their experience emotionally overwhelming. Recently, both therapists and researchers have been exploring nonverbal ways to foster emotional regulation. Several studies have suggested that Mindfulness Based Stress Reduction (MBSR) groups and the use of acupuncture for clients with PTSD reduce negative emotions and promote a calmer appraisal of life situations (Hollifield, 2007; Davidson et al., 2003). These practices work well with more traditional talk therapies and allow greater stability throughout recovery.

Auricular acupuncture has the added advantage of reducing cravings for alcohol and drugs, as well as promoting better sleep and clearer thinking among clients who receive it regularly (Stuyt, 2005). It is also well suited for supporting work with refugees and immigrants in that it is nonverbal and closer to the methods of traditional medicine found in their own cultures.

Metaphor for creating safety:
“The experience of emotional overwhelm is similar to that of a shaken bottle of soda. Inside the bottle is a tremendous amount of pressure. The safest way to release the pressure is to open and close the cap in a slow, cautious and intentional manner so as to prevent an explosion.” Rothschild, 2010

Remembrance and Mourning
When clients feel stable, the task shifts to recounting the trauma, putting words and emotions to it, and making meaning of it. This process is usually undertaken with a counsellor or therapist in individual and/or group counselling. It might not require or be necessary to spend a lot of time in this phase. It is necessary, however, to continue to attend to safety during this phase.

Attending to and establishing safety allows the client to move through this phase in a way that integrates the story of the trauma, rather than responding to it from a fight, flight and freeze response.

Pacing and timing are also crucial, and the point is neither to “re-live” nor avoid the trauma. This phase also includes exploring the losses associated with the trauma, and providing space for the client to grieve and experience the sadness associated with these losses.

Reconnection
The final stage of recovery involves redefining oneself in the context of meaningful relationships. When they are able to see the things that happened to them and understand that those events do not determine who they are, many people who have experienced trauma are able to gain a different perspective and
meaning of the traumatic experiences. The trauma is no longer the organizing principle of their lives. It becomes part of their story, but they are not living in it or from it.

In many instances, people who have experienced trauma find a mission through which they can continue to heal and grow, such as talking to youth or peer mentoring.

Successful resolution of the effects of trauma is a powerful testament to the resiliency of the human spirit.

Other Aspects of Trauma Recovery
● Assist the client in connecting with services that are central to recovery, such as health and mental health services, addictions services, therapeutic services, crisis services, culturally appropriate/relevant services and traditional healing services.
● Partner with the client as they define what recovery means to them.
● Consider the client’s cultural context and include social supports that help them connect to the community.
● Encourage and assist the client in connecting in a meaningful way with themselves, safe family members, friends, culture and community.
● Assist clients in identifying activities that would provide a sense of purpose and meaning


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