Transcript SAMHSA Powerpoint Template
Black Trauma
Darryl Turpin, MPA, CADC Co- Principal, The Pinwheel Group Louisville, Kentucky
What is Trauma?
• Experiences or situations that are emotionally painful and distressing, and that overwhelm an individual’s ability to cope • Chronic adversity (e.g., discrimination, racism, oppression, poverty) Healing the Hurt: Trauma Informed Approaches to the Health of Boys and Young Men of Color, 2009
The Impact of Trauma
• • • • Trauma is cumulative Trauma affects the developing brain Trauma increases likelihood of health risk behaviors (smoking, drinking, overeating) as means of coping Trauma is directly related to mental health symptoms, substance abuse, chronic physical illness, early mortality Adverse Childhood Experiences Study, 2009
What Everyone Should Know
• • • • • The history and the level of violence towards black people in America is shocking The earlier and more deliberate the violence, the more devastating the impact Most trauma among black people is not a singular occurrence Black people are resilient and healing is a natural human process Sometimes black people are unaware that their challenges relate to trauma
The Central Role of Trauma
School Problems, Incarceration Homelessness, Relationship & Job Problems Substance Abuse, Parenting Problems
Violence and Trauma
Mental Health Suicide PTSD Depression Problems Schizophrenia Historical Trauma
Black Trauma
• • • • Trauma 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 commonplace Untreated trauma can significantly impair the person’s daily life. The combined drama and chaos has all the signs/symptoms of trauma.
Black Trauma
• • • Trauma 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.
Black Trauma Prevalence
• • • Posttraumatic stress disorder (PTSD) and depression are common outcomes of trauma exposure and are understudied in black community Blacks 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 whites U.S. Department of Health and Human Services Office of Minority Services , 2010 • 30% of inner city kids suffer from PTSD Center for Disease Control, 2014
Racism is Trauma
• • • It 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)
Historical Trauma
• 250 Years- Enslavement/ PTSD • 100 Years- “Jim Crow” Legalized Discrimination • 40+ Years – Integration/ Desegregation
Resiliency
• The 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 .
Strengths of Black Americans
• • Assume that every Black American individual, group, family, and community has strengths Assume that trauma, abuse and struggle, may not only be devastating but can also be sources of challenge and opportunities for growth and development
Post Traumatic Slave Syndrome
Dr. Joy DeGruy • Residual impacts of generations of slavery • How the black community can use the strengths gained in the past to heal in the present • A 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
Post 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 others •
Racist 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
Black Trauma
Withdrawal/Non-Verbal Incoherence/Distrust SIV/ Self Destructive Lack of Relationship Lack of Motivation
Black Trauma
Feeling Unsafe Coping Mechanisms Secrets/Untold Stories Coping Mechanisms Disempowerment/Abuse Hopelessness
Trauma-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.
SAMHSA’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.
• • • • • • • • • •
Principles of a Trauma-Informed Approach
Safety Trustworthiness and transparency Collaboration and mutuality Empowerment Voice and choice Peer support and mutual self-help Resilience and strengths based Inclusiveness and shared purpose Cultural, historical and gender issues Change process
• Sees coping strategies, not “symptoms” • Helps survivors examine the totality of their life situation to make sense of how they are coping and surviving • Creates a safe space to consider new coping strategies • Uses everyday “human experience” language • Relates directly to survivor’s experiences and the meaning they make of their lives
A new technical assistance document from the SAMHSA-funded National Center on Trauma-Informed Care Available for download at: http://www.nasmhpd.org/EngagingWomen.cfm
• • • Purpose: To help make trauma-informed peer support available to women who are trauma survivors To serve as a resource on integrating trauma-informed principles into peer support relationships and into independent peer support groups To 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.
Engaging Women in Trauma-Informed Peer Support – Topics Covered
Section 1. Fundamentals: • Basics of trauma and trauma-informed practices • • Peer support basics Gender politics Section 2. Cultural Considerations: • Culture and trauma • • Religion, spirituality and trauma Trauma issues across the lifespan Section 3. Moving Into Action • Trauma and peer support relationships • • Self-awareness and self-care Organizational context: working in systems • • • Trauma-informed storytelling and other healing practices Self-inflicted violence and peer support Reclaiming power through social action
The 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 survivors developed at Community Connections in the 1990s by clinicians led by Dr. Maxine Harris 3 major parts: empowerment, trauma education, and skill-building Topics of sexual, physical, emotional, and institutional abuse, and women explore and reframe the connection between abuse experiences and other current difficulties
Self-Care
• Examples of self-care strategies to manage stress, replenish compassion and motivation, and promote growth: ▫ ▫ ▫ ▫ ▫ Physical: exercise, diet Intellectual: learning, reading, conversations Emotional: friendship, art, music Spiritual: yoga, mediation, prayer Be clear about sense of belonging and personal successes outside of the work
25
Trauma Narrative
• • • •
The traumatic event(s) The impact on one’s life The meaning one has made out of what happened The beliefs one carries about who one is and who one is capable of becoming
26
Story-Telling and Healing
•
Personal narratives:
▫ organize experience, help us make sense of what has taken place ▫ lay the groundwork for survivors to develop hope about the future ▫ can also be told through spoken word, music, dance or movement, drumming, art, and writing
Healing and Recovery
There is no greater agony than bearing an untold story inside you.
▫ Maya Angelou
•
Humor
Healing and Recovery
•
Prayer
•
Faith
•
Praise
•
Music -King David played the harp
Religion 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 resilience Healing in Times of Trauma Church Family
“
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 week Washington Post - June 24, 2008
Challenges for Providers
• • • • • Become aware of the historical and current experiences of being a black person in American Must be trained to be culturally relevant Black clients may experience psychological trauma due to racism Many Blacks may be hesitant to address trauma issues directly in cross-racial treatment Be sensitive to spiritual values and the value of the family and the church
Challenges for Providers
• • • • • Consider the client’s challenge and possibilities in the large context. Include extended family, other significant individuals and the community Risk re-traumatizing the client by ignoring or not recognizing their perception of trauma Manifestations of trauma are often subtle and can easily be denied The desire to debate the client’s perception of trauma and racism Allowing the space to express their anger at racism in our sessions with them