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Angela Keen Survivors, Inc..  Angela Keen ◦ Supervisor of Direct Services, Survivors, Inc. ◦ Victims’ Services Professional with 17 years experience.

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Presentation on theme: "Angela Keen Survivors, Inc..  Angela Keen ◦ Supervisor of Direct Services, Survivors, Inc. ◦ Victims’ Services Professional with 17 years experience."— Presentation transcript:

1 Angela Keen Survivors, Inc.

2  Angela Keen ◦ Supervisor of Direct Services, Survivors, Inc. ◦ Victims’ Services Professional with 17 years experience ◦ Keystone Crisis Intervention Team (KCIT) Certified Trainer ◦ KCIT Team Member since 2005 KCIT 20152


4  QUICK response to hospital or police department  24 hour hotline or  Secure Shelter  Safety Planning individualized & can include PFA

5  Supportive Individual & Group Counseling  Legal Advocacy  Bilingual & Bicultural Staff  Children’s Support Group & Activities  Significant Other Support  Emergency Shelter  Transitional Housing  Community Education

6  Articulate physical and emotional reactions to trauma  Recognize trauma impacts on learning, physical health and human development  Be familiar with the ACE Study  Make connections between individual trauma exposure and community health  Identify trauma informed practices to implement in community work

7 “Knowledge about the prevalence and impact of trauma has grown to the point that it is now universally understood that almost all of those seeking services in the public health system have trauma histories.” (SAMHSA)

8 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,

9 Normal Stress Eu-stress Distress 9

10 10

11 Cortex- Neo Cortex Thalamus Amygdala Hippocampus 11

12 It is not cognitive! 12

13 Cortex- Neo Cortex Thalamus Amygdala Hippocampus 13

14 Right BrainLeft Brain The pathways between the right and left brain experience a disconnect. Memory Sensory Affect Regulation Making Sense Problem Solving Decision Making Language Impulse Control 14

15 ch?v=39i89NJNCRQ 15

16 PHYSICAL Frozen Fright Numbness Deer in the Headlights Disorientation Confusion EMOTIONAL Shock – Disbelief – Denial Can’t believe this is happening Feeling helpless Questioning Loss of control BEHAVIORAL Withdrawal Inability to move Inability to make decisions Staring into space Inability to speak Time slows or stops Problem communicating thoughts Unresponsive to others KCIT

17 PHYSICAL Fight, Flight or Adapt Heart rate increases Senses more acute Adrenalin rush Urination Defecation Regurgitation Tunnel vision Muffled hearing Autonomic System takes over EMOTIONAL Cataclysm of Emotions Not Linear – Mixed Fear/Terror Anger/Rage Confusion/Frustration Guilt/Self Blame Grief/Sorrow BEHAVIORAL Ready to Fight or Run Survival behaviors Decisions not moral or values based Regression in some learned behaviors Somatic complaints Poor problem solving Overly sensitive Emotional outbursts Disassociation Controlling Loss of appetite Exaggerated startle response 17

18 PHYSICAL Exhaustion Yesterday-Today- Tomorrow Past-Present-Future Exhaustion sets in Creating more adrenalin Under activity EMOTIONAL Reconstruction Time begins anew as they start life after the traumatic event Possible long term reactions Anxiety Depression Numbing Less trusting Disassociation BEHAVIORAL Surviving or Coping Getting back to a new state of equilibrium Insomnia Irritability Poor problem solving Drug or Alcohol Eating disturbance Sexual dysfunction Obsessive Compulsive Behaviors KCIT

19 KCIT 2015 Self Actualization Self-esteem Love and Belonging Cognitive Functioning Safety and Security Basic Survival Needs 19

20 Adaptive Capacities Stressors KCIT 2015 SelfActualizationBasicSurvivalneeds Safety &Security CognitiveFunctioning Love andBelonging Self-esteem& Meaning 20


22 Trauma is any event that leaves a person feeling hopeless, helpless, fearing for their life and/or their safety. 22

23 The individual experiences a threat to life, bodily integrity, or sanity The individual’s coping capacity and/or ability to integrate his or her emotional experience is overwhelmed

24 Feeling internally connected over time to caring others Experiencing oneself as deserving and worthwhile Managing Feelings:  Recognize, tolerate, modulate, integrate feelings

25 Decreased ability to… Manage feelings Self-soothe Thoughtfully plan Develop Empathy Utilize feelings Connect with others Trust others/reach out for and respond to help

26 Increased… Tension, anxiety, emotional unpredictability/over reaction Need for control, aggressive behavior Avoidance, constriction, dissociation Use of drugs, alcohol, other addictions to manage feelings Risky behaviors

27 Shifts people away from emotional safety, emotional balance and predictability. Disrupts the ability to return-to-center.

28  Erikson ◦ Psychosocial Stages defined by successful completion/mastery of developmental conflicts.  Piaget ◦ Cognitive development progressive reorganization of mental processes; biological and environmental influences.  Maslow ◦ Hierarchy of Needs Refer to Handout

29 Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), doi: /h

30  Children develop sense of trust in world from relationships with early caretakers  Learn from trusting others to internalize feelings of trust & safety  When mistreated, sense of self affected, world viewed as unsafe

31  Neurobiology disrupted; Ability to comfort & protect oneself impaired  Systems of meaning, feelings about self & ability to trust in others & oneself deeply affected

32  More than 17,000 adult participants  25 studies since 1998  CDC & Kaiser Permanente’s Department of Preventative Medicine in San Diego Partnership  Average age 57  80% White; 10% Black; 10% Hispanic/Latino  “solidly middle class”

33  Emotional Abuse  Physical Abuse  Sexual Abuse  Mother abused  Raised in single parent family  Household member incarcerated

34  Household member abusing drugs/alcohol  Household member chronically depressed, suicidal, mentally ill, psychiatric hospitalization  Emotional/Physical Neglect  Not raised by both biological parents

35  Trauma is far more prevalent than previously recognized.  The impacts of trauma are cumulative and often occur in clusters.  That unaddressed trauma underlies a wide range of health problems and social problems.  ACEs are related to risky health behaviors in childhood and adolescence.

36  Cancer  Heart disease  STDs  Liver disease  Smoking  Alcohol abuse  Obesity  Drug dependence  IV Drug Use  Early intercourse, pregnancy

37  Depression  Anxiety disorders  Hallucinations  Sleep disturbances  Memory disturbances  Anger problems  Domestic violence risk  Job problems  Relationship problems

38  Exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence.  54% of women and 36% of men with depression had ACE score of 4 or higher ◦ Compared to 18% of women and 10% of men with 0 ACE Score

39  20% to 70% increased likelihood of alcohol use initiated during mid adolescence ( years).  7 to 10 fold more likely to report illicit drug use problems.  Physical abuse and verbal abuse were most strongly associated with body weight and obesity.

40 Childhood trauma has long-term, damaging consequences.

41 Trauma exposure impacts community health.


43 Most individuals seeking public behavioral health services and many other public services, such as homeless and domestic violence services, have histories of physical and sexual abuse and other types of trauma-inducing experiences. (SAMHSA)

44 based on an understanding of the vulnerabilities or triggers of trauma survivors so that these services and programs can be more supportive and avoid re-traumatization

45 What’s wrong with you? vs. What’s happened to you?

46 Resiliency: A person’s inherent capacity to moderate and recover from a traumatic experience. KCIT

47 Coping: When a person constantly changes cognitive and behavioral efforts to manage specific extern/internal demands that are taxing or exceeding the resources of that individual. KCIT

48 Biological Vulnerabilities + Perceived Stressors – Coping = Severity of Impact KCIT

49 “The solution of adult problems tomorrow depends in large measure upon the way our children grow up today.” Margaret Mead

50 National Center on Domestic Violence, Trauma & Mental Health Substance Abuse & Mental Health Services Administration Keystone Crisis Intervention Team Centers for Disease Control

51 Contact Information Angela Keen, Supervisor of Direct Services Esther Waybright, Community Education Specialist Survivors, Inc

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