2What is Trauma?Experiences or situations that are emotionally painful and distressing, and that overwhelm an individual’s ability to copeChronic adversity (e.g., discrimination, racism, oppression, poverty)Healing the Hurt: Trauma Informed Approaches to the Health of Boys and Young Men of Color, 2009
3The Impact of Trauma Trauma is cumulative Trauma affects the developing brainTrauma increases likelihood of health risk behaviors (smoking, drinking, overeating) as means of copingTrauma is directly related to mental health symptoms, substance abuse, chronic physical illness, early mortalityAdverse Childhood Experiences Study, 2009The ACE study and other research has given us a pretty clear picture of the impact of trauma and toxic stress. Go over slide.
4What Everyone Should Know The history and the level of violence towards black people in America is shockingThe earlier and more deliberate the violence, the more devastating the impactMost trauma among black people is not a singular occurrenceBlack people are resilient and healing is a natural human processSometimes black people are unaware that their challenges relate to trauma
5The Central Role of Trauma School Problems, IncarcerationHomelessness, Relationship & Job ProblemsViolence andTraumaMental Health ProblemsSubstance Abuse, Parenting ProblemsSuicidePTSDDepressionSchizophreniaHistorical Trauma
6Black TraumaTrauma occurs after an individual hears, witness, or experiences internal wounds that are hard to forget.Over time, become numb and cold about their own life, they feel detached, isolated in a crowd, and even use humor as a way to avoid the impact of the wound.Emotional detachment makes domestic violence, poverty, unemployment, fights, deaths (gang/violent), drug and/or drug use almost a commonplaceUntreated trauma can significantly impair the person’s daily life. The combined drama and chaos has all the signs/symptoms of trauma.
7Black TraumaTrauma is often rooted in childhood and/or adolescence stemming from unhealthy family systems. Many relive the experience and have difficulty moving on with their lives. With this trauma, you experience nightmares, flashbacks, nausea, headaches, and some have difficulty sleeping. Emotions are unpredictable.Many poor black neighborhoods, a war is raging; war on drugs, black on black crime, stop and frisk, driving while black.Trauma combined with poor education and poverty, only make the problem worse. Many don't see a way out. The Remedy for many individuals is self medicating with negative behaviors (drug usage) and/or criminal involvement.
8Black Trauma Prevalence Posttraumatic stress disorder (PTSD) and depression are common outcomes of trauma exposure and are understudied in black communityBlacks people of all ages are more likely to be victims of serious violent crime than are non-Hispanic whites. One study reported that over 25% of Black youth exposed to violence met diagnostic criteria for post-traumatic stress disorder (PTSD)Black people are 20% more likely to report having serious psychological distress than non- Hispanic whitesU.S. Department of Health and Human Services Office of Minority Services , 201030% of inner city kids suffer from PTSDCenter for Disease Control, 2014
9Racism is TraumaIt involves negative, rejecting, and/or demeaning societal messages that undermine self esteem (Butts, 2002)Internalized racism as the way in which members of the stigmatized group begin to accept the negative messages about themselves that they see in the world and to reflect that negativity in their behavior (Jones, 2000)Stress related to racism has been linked to hypertension, cardiovascular disease, diabetes and infant mortalities (American Public Health Association, 2010)
11ResiliencyThe excessive rates of family violence, child welfare problems, premature death, depression, poverty, poor health, inability to access health care, unemployment, loss of personal and cultural identity, family & community conflict, and lack of community unity can be attributed to historical trauma.
12Strengths of Black Americans Assume that every Black American individual, group, family, and community has strengthsAssume that trauma, abuse and struggle, may not only be devastating but can also be sources of challenge and opportunities for growth and development
13Post Traumatic Slave Syndrome Dr. Joy DeGruy Residual impacts of generations of slaveryHow the black community can use the strengths gained in the past to heal in the presentA form of slavery predicated on the belief that African Americans were inherently/genetically inferior to whites, followed by institutionalized racism which continues to perpetuate injury
14Post Traumatic Slave Syndrome Dr. Joy DeGruy Vacant Esteem Insufficient development, along with feelings of hopelessness, depression and a general self destructive outlook.Marked Propensity for Anger and Violence Extreme feelings of suspicion perceived negative motivations of others. Violence against self, property and othersRacist Socialization and (internalized racism) Learned Helplessness, literacy deprivation, distorted self- concept, antipathy or aversion for the following:-The members of ones own identified cultural/ethnic group-The mores and customs associated ones own identified cultural/ethnic heritage-The physical characteristics of ones own identified cultural/ethnic group
15Black Trauma Withdrawal/Non-Verbal Incoherence/Distrust SIV/ Self DestructiveLack of RelationshipLack of Motivation
16Secrets/Untold Stories Disempowerment/Abuse Black TraumaCoping MechanismsFeeling UnsafeSecrets/Untold StoriesCoping MechanismsDisempowerment/AbuseHopelessness
17Trauma-Specific Vs. Trauma-Informed Trauma-specific services. Services designed specifically to treat the actual sequelae of sexual or physical abuse and other psychological trauma. Trauma specific services should be trauma-informed for optimal outcomes…but they are not necessarily so. Includes evidence-based and emerging best practices treatment models. Trauma-informed: essentially addresses the environment and manner in which services and supports are provided. A trauma informed system or organization is one in which all components of the system have been reconsidered and evaluated in the light of a basic understanding of the role that violence plays in the lives of people seeking mental health and addictions services. A trauma informed system or organization may or may not provide trauma-specific services, but is able to support and/or link to such services in an integrated, coordinated manner based on the needs of those served.
18SAMHSA’s Definition of a Trauma Informed Approach: The Three R’s A program, organization or system that is trauma- informed realizes the widespread impact of trauma and understands potential paths for healing; recognizes the signs and symptoms of trauma in staff, clients, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, practices, and settings.
19Principles of a Trauma-Informed Approach SafetyTrustworthiness and transparencyCollaboration and mutualityEmpowermentVoice and choicePeer support and mutual self-helpResilience and strengths basedInclusiveness and shared purposeCultural, historical and gender issuesChange process
20Trauma-Informed Peer Support Sees coping strategies, not “symptoms”Helps survivors examine the totality of their life situation to make sense of how they are coping and survivingCreates a safe space to consider new coping strategiesUses everyday “human experience” languageRelates directly to survivor’s experiences and the meaning they make of their livesEngaging Peer in TIC peer support:Universal Expectation: Assume anyone peers engage with is likely to be a trauma survivorOne task of trauma-informed peer support is to foster trust and reconnectionFeelings of safety and control come from relationships where power is shared
21A new technical assistance document from the SAMHSA-funded National Center onTrauma-Informed CareAvailable for download at:Purpose:To help make trauma-informed peersupport available to women who aretrauma survivorsTo serve as a resource on integratingtrauma-informed principles into peer supportrelationships and into independent peersupport groupsTo provide peer supporters—both male and female—with the understanding, tools, and resources to engage in culturally responsive, trauma-informed peer support relationships with women trauma survivors.
22Engaging Women in Trauma-Informed Peer Support – Topics Covered Section 1. Fundamentals:Basics of trauma and trauma-informed practicesPeer support basicsGender politicsSection 2. Cultural Considerations:Culture and traumaReligion, spirituality and traumaTrauma issues across the lifespanSection 3. Moving Into ActionTrauma and peer support relationshipsSelf-awareness and self-careOrganizational context: working in systemsTrauma-informed storytelling and other healing practicesSelf-inflicted violence and peer supportReclaiming power through social actionTrauma impacts our relationships and connections to ourselves and others: spiritually, socially, physically……Trauma often creates a profound feeling of isolation and can alter our sense of self and relationship to the world around us.The experience of abuse and neglect often fosters a lack of safety or trust……Violence raises inherently spiritual questions, such as “why me?
23The Trauma Recovery and Empowerment Model (TREM) TREM and M-TREM are fully manualized group interventions for women (TREM) and men (M- TREM) who are trauma survivorsdeveloped at Community Connections in the 1990s by clinicians led by Dr. Maxine Harris3 major parts: empowerment, trauma education, and skill-buildingTopics of sexual, physical, emotional, and institutional abuse, and women explore and reframe the connection between abuse experiences and other current difficulties
24Self-CareExamples of self-care strategies to manage stress, replenish compassion and motivation, and promote growth:Physical: exercise, dietIntellectual: learning, reading, conversationsEmotional: friendship, art, musicSpiritual: yoga, mediation, prayerBe clear about sense of belonging and personal successes outside of the work
25Trauma Narrative The traumatic event(s) The impact on one’s life The meaning one has made out of what happenedThe beliefs one carries about who one is and who one is capable of becomingoften we assume that the story is the event alone. But there is a great richness contained….even without her discussing with you the story itself, she can possible talk about these other aspects forming the basis of a healing relationship.25
26Story-Telling and Healing Personal narratives:organize experience, help us make sense of what has taken placelay the groundwork for survivors to develop hope about the futurecan also be told through spoken word, music, dance or movement, drumming, art, and writing26
27There is no greater agony than bearing an untold story inside you. Healing and RecoveryThere is no greater agony than bearing an untold story inside you.Maya Angelou
28Healing and Recovery Humor Prayer Faith Praise Music -King David played the harp
29Religion and Spirituality A sanctuary for blacks who seek refuge from the day to day pressures of life.the focal point of virtually every movement for change that affects their communities.Extremely important in terms of spiritual resilienceHealing in Times of TraumaChurch Family
30“In God Or a Higher Power We Trust” People with strong spiritual beliefs are healthier, heal faster and live longer than those without them. Studies have begun to document the role of prayer in healing.The study detailed Americans' deep and broad religiosity, finding that 92 percent believe in God or a universal spirit -- including one in five of those who call themselves atheists. More than 57% of Americans polled pray at least once a day. 42% attended church in the last weekWashington Post - June 24, 2008I ADDED HIGHER POWER BECAUSE THIS ISN’T JUST ABOUT GOD
31Challenges for Providers Become aware of the historical and current experiences of being a black person in AmericanMust be trained to be culturally relevantBlack clients may experience psychological trauma due to racismMany Blacks may be hesitant to address trauma issues directly in cross-racial treatmentBe sensitive to spiritual values and the value of the family and the church
32Challenges for Providers Consider the client’s challenge and possibilities in the large context. Include extended family, other significant individuals and the communityRisk re-traumatizing the client by ignoring or not recognizing their perception of traumaManifestations of trauma are often subtle and can easily be deniedThe desire to debate the client’s perception of trauma and racismAllowing the space to express their anger at racism in our sessions with them