CHILDREN & TRAUMA

CHILDREN & TRAUMA

Shelley Kaufman Ph.D. Licensed Psychologist

CEO & Clinical Director Kaufman Integrated Healthcare LLC

(602)257-0560

What Do Superheroes and Villains Have in Common?

What We Will Learn!! • What do Superheroes and Villains have in common?

• What is Trauma?

• What is Addiction?

• What is Codependency?

• What is the role of attachment and bonding in trauma?

• What is the role of negative beliefs that come from unprocessed trauma?

• What happens to the body during and after trauma?

• What is the ACE study?

• What is one way to measure the impact of an upsetting life event?

• How do we address the aftermath of trauma?

• What is EMDR?

• How can EMDR help process life trauma?

What Do Superheroes and Villains Have in Common?

Superheroes

&

Villains

Loss of control of

environment

Loss of their home

Loss of Family Members

What Do They Have in Common??

TRAUMA

Superman

Trauma

Loses his birth mother

and birth father

Loses his planet

Loses his adoptive

father

Does not fit in with his

peers

General Zod

Trauma

Loses his entire team

Loses his planet

Loses the “Hope for

the future of his people”

Lost his life

The Nature of Trauma

TRAUMA is defined as any perceived threat to a person’s physical and/or psychological safety.

• Trauma leads to a feeling of loss of control over a person’s destiny.

• Loss means that the grieving process will be initiated. Loss is emotionally characterized by sadness, anger and fear.

• These emotions are processed by the brain over the course of time.

• The trauma leads a person to want to regain a sense of control over their destiny.

• Healthy adjustment to life means we take control over our own thoughts, feelings and behavior.

• There are functional ways of handling emotions that are trauma-based that enhances a person’s sense of self.

• Unhealthy adjustment means we try to take control of other people’s/entity’s thoughts, feelings and behavior.

Addiction

Addiction is essentially using an unhealthy behavior/relationship that is a distraction from the emotional pain of unprocessed trauma emotion and beliefs.

Common types of addictions include alcohol, drugs, work, relationships, sex and food.

Codependency

Codependency means that a person is trying to take responsibility for other people’s thoughts, feelings and behavior.

This happens as a direct result of not processing emotions from previous psychological trauma.

There are dysfunctional ways of handling trauma-based emotions.

Self –Report Attachment Style

L. Bartholomew and L. Horowitz

Attachment Styles Among Young Adults:

A Test of a Four Category Model

Journal of Personality and Social Psychology, 61, 226-244

Attachment and Bonding Styles

Secure Attachment

“It is easy for me to become emotionally close to others. I am comfortable depending on others and having others depend on me. I don’t worry about being alone or having others not accept me.”

Attachment Styles

Preoccupied

“I want to be completely emotionally close with others, but I often find that others are reluctant to get as close as I would like. I am uncomfortable being without close relationships, but sometimes worry that others don’t value me as much as I value them.”

Attachment Styles

Fearful

“I am uncomfortable getting close to others. I want emotionally close relationships, but I find it difficult to trust others completely or to depend on them. I worry that I will be hurt if I allow myself to become too close to others.”

Attachment Styles

Dismissing

“I am comfortable without close emotional relationships. It is very important to me to feel independent and self-sufficient. I prefer not to depend on others or have others depend on me.”

Negative Beliefs

Eye Movement Desensitization and Reprocessing (EMDR)

Second Edition: Basic Principles, Protocols and Procedures

Francine Shapiro, Ph.D.

Negative Beliefs

• So, here are some of the negative beliefs that people take with them after they go through a trauma….

• These beliefs can stay with someone for their entire life.

• These beliefs can heavily influence important decisions that people make for their future.

Negative Beliefs – I am defective

I don’t deserve love. I do not deserve.

I am worthless. I am a disappointment.

I am not good enough. I am different/don’t belong.

I am ugly. I am terrible.

I am insignificant. I am not lovable.

I deserve to be miserable. I am permanently damaged.

I am a bad person. I am stupid.

I am shameful. I am not smart enough.

I deserve only bad things. I deserve to die.

Negative Beliefs - Responsibility

• I should have done something.

• I did something wrong.

• I should have known better.

Negative Beliefs - Vulnerability

• I cannot be trusted.

• I cannot trust anyone.

• It is not OK to feel/show emotions.

• I cannot trust myself.

• I cannot protect myself.

• I cannot stand up for myself.

• I cannot trust my judgment.

• I am in danger.

• I cannot let it out.

Negative Beliefs – Control & Choices

• I am not in control.

• I cannot get what I want.

• I have to be perfect.

• I am powerless and helpless.

• I am a failure or I will fail.

• I am weak.

• I cannot succeed.

Upsetting Feelings

Sadness

Anger

Fear

The ACE Study

Centers for Disease Control and Prevention

Kaiser Permanente’s Health Appraisal Clinic

The Relationship of Adult Health Status to Childhood Abuse and House Dysfunction

American Journal of Preventive Medicine

1998, Volume 14, pages 245-258

The ACE Study

17,337 participants were volunteers from approximately 26,000 consecutive Kaiser Permanente members. About half were female; 74.8% were white; the average age was 57; 75.2 had attended college; all had jobs and good health care, because they were members of the Kaiser HMO.[5] Participants were asked about 10 types of childhood trauma that had been identified in earlier research literature: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, mother treated violently, household substance abuse, household mental illness, parental separation or divorce, and incarcerated household member.[6] About two-thirds of individuals reported at least one of these events.

The ACE Study Questionnaire

While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household often or very often... Swear at you, insult you, put you down, or humiliate you?

Or

Act in a way that made you afraid that you might be physically hurt? Yes/No If yes enter 1

2. Did a parent or other adult in the household often or very often... Push, grab, slap, or throw something at you?

Or

Ever hit you so hard that you had marks or were injured?

Yes/No If yes enter 1


3. Did an adult or person at least 5 years older than you ever... Touch or fondle you or have you touch their body in a sexual way?

Or

Attempt or actually have oral, anal, or vaginal intercourse with you? Yes/No If yes enter 1

4. Did you often or very often feel that ... No one in your family loved you or thought you were important or special?

Or

Your family didn’t look out for each other, feel close to each other, or support each other?



5. Did you often or very often feel that ... You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?

Or

Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?


6. Were your parents ever separated or divorced? Yes/No If yes enter 1


7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her?

Or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?

Or Ever repeatedly hit at least a few minutes or threatened with a gun or knife? Yes/No If yes enter 1

8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? Yes/No If yes enter 1

9. Was a household member depressed or mentally ill, or did a household member attempt suicide? Yes/No If yes enter 1

10. Did a household member go to prison? Yes/No If yes enter 1


Total your number of times you entered YES.

This is your ACE Score:

A whopping two thirds of the 17,000 people in the ACE Study had an ACE score of at least one –

87 percent of those had more than one. Eighteen states have done their own ACE surveys; their results are similar to the CDC’s ACE Study.

http://www.acestudy.org/yahoo_site_admin/assets/docs/ARV1N1.127150541.pdf






The ACE Study

• The higher the ACE score, the higher the risk of disease, social and emotional problems.

• Risks of problems increase especially with an ACE score of 4 or higher.

The Long Term Effects of Trauma on the Physical Body - The ACE Study

How Upsetting Was The Event???

The Impact of Events Scale

Assessing Psychological Trauma and PTSD

A Handbook for Practitioners

Chapter 15: The Impact Scale-Revised

by: Daniel S. Weiss PhD and Charles R. Marmar, MD. Department of Psychiatry, University of

California, San Francisco & PTSD Program, San Francisco VA Medical Center

0= Not at all 1= A little bit 2= Moderately 3= Quite a bit 4= Extremely

Impact of Event Scale

Any reminder brought back feelings about it? 0 1 2 3 4

I had trouble staying asleep. 0 1 2 3 4

Other things kept making me think about it. 0 1 2 3 4

I felt irritable and angry. 0 1 2 3 4

I avoided letting myself get upset when I thought/reminded of it. 0 1 2 3 4

I thought about it when I didn’t mean to. 0 1 2 3 4

I felt as if it hadn’t happened or wasn’t real. 0 1 2 3 4

I stayed away from reminders about it. 0 1 2 3 4

Pictures about it popped into my mind. 0 1 2 3 4

I was jumpy and easily startled. 0 1 2 3 4

I tried not to think about it. 0 1 2 3 4

0= Not at all 1= A little bit 2= Moderately 3= Quite a bit 4= Extremely

Impact of Event Scale

I was aware I still had a lot of feelings about it, but I didn’t deal with them.

0 1 2 3 4

My feelings about it were kind of numb. 0 1 2 3 4

I found myself acting or feeling like I was back in that time. 0 1 2 3 4

I had trouble falling asleep. 0 1 2 3 4

I had waves of strong feelings about it. 0 1 2 3 4

I tried to remove it from my memory. 0 1 2 3 4

I had trouble concentrating. 0 1 2 3 4

Reminders of it caused me to have physical reactions, such as sweating or trouble breathing.

0 1 2 3 4

I had dreams about it. 0 1 2 3 4

I felt watchful and on-guard. 0 1 2 3 4

I tried not to talk about it. 0 1 2 3 4

Scoring Information

• Avoidance Subscale = mean of items 5,7,8,11,12,13,17,22

• Intrusion Subscale= mean of items 1,2,3,6,9,16,20

• Hyperarousal Subscale= mean of items 4,10,14,15,18,19,21

Impact Of Event Scale- Revised

• Emotional Resilience

• Physical Resilience

• Social Resilience

• Intellectual Resilience

So What Do We Do To Help Ourselves After Trauma?

Resilience

What Is EMDR?

• EMDR is an eight-phase process. The treatment approach targets past experience, current triggers, and future potential challenges.

• The goal is to eliminate distress from disturbing memories.

• Processing disturbing memories results in improved self image and resolves present and future triggers.

• We prepare disturbing memories for processing by evaluating associated negative beliefs, emotions and uncomfortable body sensations.

Basics

EMDR

EXERCISE

GET ENOUGH SLEEP

EAT RIGHT AND DRINK ENOUGH WATER

LOVE AND MAINTAIN HEALTHY AND POSITIVE RELATIONSHIPS

STAYING HEALTHY

Additional Information

• Thank you so much for attending today’s presentation.

• How to Reach Dr. Kaufman with Additional Questions:

E-Mail – [email protected]

Telephone – 602.820.9398

Website – KIH-AZ.com

Smiles!!

mailto:[email protected]



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CHILDREN & TRAUMA