Transcript acquired brain injury as a result of unregulated stress

Understanding Trauma
(1) About trauma
 Trauma means injury
 In the context of recent research on brain function, trauma has
a specialised meaning – it means acquired brain injury as a
result of unregulated stress
 Usually stress is good for us – when we can regulate stress, it enables
us to function at our best
 But when for some reason we are not able to regulate stress we receive
an overdose of stress hormones that is toxic to the brain – traumatic
stress
 Changed blood supply to key brain areas then leads to lasting injuries,
from which we will need to recover
 Trauma is a normal part of human life
© Kate Cairns Associates 2011
(2) The impact of trauma
 Traumatised people may find it difficult to:
 Self-regulate – stress, mood, impulses
 Process information accurately – make sense of the world around them
and of their inner world of feelings
 Make and maintain relationships – understand and be interested in the
inner world of others
 These difficulties have an impact on everyone involved
 In addition, those who live and work with the traumatised
person may be affected by secondary trauma
 Attitudes and behaviour may change
 The network around the victim of trauma may disintegrate
© Kate Cairns Associates 2011
(3) What leads to unregulated stress?
 Two key factors
 The extent of the stress
 Our vulnerability – how able we are to self-regulate
 Some stress is so great that anyone would be injured by it
 Some people are so vulnerable that any stress may injure them
 Everyone is vulnerable to trauma
 Resilience and vulnerability change constantly
© Kate Cairns Associates 2011
(4) What makes us vulnerable?
 Being physically or emotionally depleted
 Health
 Grief and loss
 Other external stresses
 Lacking resilience
 Chronic depletion – health, prolonged duress, multiple losses
 Previous trauma
 Unmet attachment needs from early childhood
© Kate Cairns Associates 2011
(5) Attachment and resilience to trauma
 Humans are not born with the ability to regulate stress
 Babies 'catch ' this ability from their carers by patterning
 Attunement between the baby and the carer is the key to
developing stress regulation
 When the baby is stressed the baby cries
 This causes stress in the carer
 As the adult soothes the baby their own acquired stress modifies
 The attuned baby follows the change in physiology in the adult
 This creates a brain pattern linking soothing with relaxation
 This is the basis for stress regulation for life
© Kate Cairns Associates 2011
(6) Vulnerable people ..
 .. may be less able to self-regulate stress
 They may quickly become hyperaroused
 They may dissociate and be switched off
 They may alternate between these extremes
 They may be driven by unmet baby needs to generate stress in others
around them, especially those with whom they have an attachment
relationship
 .. are more likely to be traumatised
 Being unable to self-regulate they can be injured by stresses that would
not injure someone more resilient
 They may be driven to seek out high-risk situations
 They may be targeted by perpetrators of harm
© Kate Cairns Associates 2011
(7) The impact of being traumatised
 Regulatory disorders – challenging behaviour
 Stress – hyperarousal and dissociation
 Impulse – inability to manage or account for behaviour
 Shame – hypersensitivity to criticism or apparent lack of remorse
© Kate Cairns Associates 2011
(8) The impact of being traumatised
 Processing disorders – impaired understanding of:
 The world around them – difficulty making sense of sensory information
 Their inner world – difficulty making sense of feelings
© Kate Cairns Associates 2011
(9) The impact of being traumatised
 Social function disorders – social exclusion
 Understanding others – difficulty with empathy
 Feelings of worthlessness – difficulty with self-esteem
 Anhedonia – loss of the capacity for joy
© Kate Cairns Associates 2011
(10) Recovery phase one: Stabilisation
 Three levels of intervention to promote stabilisation
 Physiological: establishing safety
 Cognitive: teaching about trauma
 Emotional: teaching words for feelings
© Kate Cairns Associates 2011
(11) Recovery phase two: Integration
 Three levels of intervention to promote integration
 Physiological: teaching physiological self-management
 Cognitive: enabling cognitive restructuring
 Emotional: Enabling emotional processing
© Kate Cairns Associates 2011
(12) Recovery phase three: Adaptation
 Three levels of intervention to promote adaptation
 Physiological: teaching social responsiveness
 Cognitive: building self-esteem
 Emotional: enabling the development of the capacity for joy
© Kate Cairns Associates 2011