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1.The biological and neurological mechanisms on mental health as they relate to Crisis experience involve the reptilian brain, the limbic system, the neo cortex, and the amygdala. According to our video (Trauma and the Brain, 2015) during crisis, the primitive part of our brain overrides the conscious part. We then can have three responses: fight, flight, or freeze. When a crisis (threatening) situation occurs, “an alarm goes off then blood and oxygen are diverted to muscles, adrenalin floods the body and all systems that are not crucial to survival are switched off” (2:14 mark).
Vicarious trauma was discussed as well. When working with victims who have been traumatized the mere discussion of traumatic events can affect the listener. Also mentioned is complex PTSD when individuals experience trauma again and again; without help this can become a debilitating cycle of reexperienced trauma when a trigger (sight, sound, smell, taste, sensation, etc.) occurs. I once worked with a family who witnessed the violent suicide of a family member. The father/husband in this family drank heavily, experiencing blackouts frequently. He had threatened suicide before when drinking, but had not attempted until one evening when an argument ensued. The man retrieved a handgun from his pickup truck and completed the suicide. Two family members (mom, daughter) witnessed the event and three other male children were inside the home. Much of the work done with this family was trauma focused, of course, but mindfulness and progressive relaxation were introduced as well. In my opinion, it is likely he would not have completed the suicide if not drinking. The daughter developed an aversion to the smell of alcoholic beverages; this triggered the memories of smelling the alcohol on her father’s breath just before the suicide. The alcohol smell triggered her limbic system and she would reexperience the sight of her father’s death along with physical sensations felt at the time of trauma and just after.
Some of the symptoms of PTSD can include depression, shame, nightmares, dissociation, the development of a strong startle reflex, among others. I read of an interesting treatment developed at the University of Pennsylvania to treat PTSD. The treatment called Prolonged Exposure, or PE, is a cognitive behavioral therapy. The therapy is designed to assist individuals in overcoming fears, associated stress, and anxiety. A meta-analysis (Powers, MB, et al. 2010) of PE shows promise stating that “the average PE-treated patient fared better than 86% of patients in control conditions at Post-treatment on PTSD measures” indicating PE may be very effective and helpful in treating PTSD.
2. As our speaker Dr. Megan McElheran said, and to which I agree, an important factor in resiliency “is the drive to not only survive but thrive” (1:17 minute marker). As Dr. McElheran remarks how she expected that potentially her clients may be damaged beyond repair, so “broken by the experiences they had endured in their young lives” (1:31 minute marker). I searched for another unassigned source and read from apa.org, The Road to Resilience. The article questions how people deal with difficult and life changing events such as death, illness, job loss, and daily danger threats. When many of us experience some type of life-changing events we are usually flooded with many strong emotions. Emotions that are unpleasant and usually unwanted. Many people, I included, try to minimize the impact of these emotions by compartmentalization. The difficulty arises though when those compartmentalized situations are not processed, and the emotional effect begins to creep through in daily life. Resiliency is defined as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress” (apa.org, 2019).
Showing resiliency means people affected bounce back. It may be hours, days, months or in some cases years, however, people can and do bounce back once again finding their true north. If someone feels generally able to cope with life’s stresses and does so then life seems generally OK. The everyday stresses we all face are taken in stride; managed in ways that work. If a child is shown helpful ways to cope, as they mature, they continue to use what works. Nan Henderson (Hard-Wired to Bounce Back, 2007) indicates that from research we learn people are born with “an innate self-righting ability” that if fostered will be available when needed. Henderson also states that assisting people to know their own strengths and their available resources can help people “to overcome difficulties, achieve happiness and attain life success”. And isn’t that all we want anyway – a successful life both personally and professionally? Henderson discusses that we all have “protective factors” (internal qualities), or “buffers” that outweigh day to day or crisis stresses and are stronger than “risks or traumas or stress” that “fuel the movement towards healthy development”.
Henderson (Hard-Wired to Bounce Back, 2004) then discusses characteristics that can add “protective factors” to our lives. She states these factors are present in “successful educators and counselors, the best parenting, and the companies identified as the best places to work in America”. The first factor involves assisting people to adopt a can-do attitude. Helping people see they have what it takes to get through life’s difficulties. Sometimes all it takes are those few people who tell us we can do it – we can survive whatever life throws in our path. Secondly is a “strengths perspective”. One of the most important things is the recognition of our own strengths and ways in which we can use those frequently. Often, we overlook how we have survived difficulties in the past; we forget life hasn’t been one big bowl of cherries to this point. Assisting individuals to recognize what strengths they have used goes a long way in empowering future progress. Next Henderson talks about a “resiliency wheel” first developed in 1996. This resiliency wheel is the sum-total of “environmental protective conditions” everyone can use in their lives. Providing self-care is discussed first. When I had my first hip replacement, just after I stood up after surgery/recovery, the prosthetic fell apart inside my body. I had to have the replacement done again but then experienced nerve and muscle tissue damage. For months I had a severe burning sensation just below the surface of my skin from my hip to my toes. I could do little more than try to soothe the intense pain by providing what self-care I could. Our bodies must be able to rest and be relatively free of physical pain. Our emotions must rest as well, and we must find ways to nurture the emotional pain from life’s problems. Using what has worked before is important – it feeds into the can-do attitude. Assisting our clients in doing this is important to their bouncing back. Henderson next discusses setting realistic expectations for success and providing ways to have “meaningful contribution”. Assisting clients in knowing what their boundaries are and in seeing how they can give back to others is important. In many 12-step programs folks are encouraged to give back to others. Giving back is important to feeling a sense of accomplishment, and, giving back helps the giver from dwelling on their own problems. One phrase I have learned from the 12-step programs is “my mind is like a bad neighborhood; I shouldn’t go there alone”. We all feel depressed, lonely and afraid at times but dwelling in the emptiness these emotions create is a bad place – one best not experienced alone.
Finally, Henderson discusses the concept of giving time time. We must assist our clients in realizing things take time. Healing especially takes time. If we convince ourselves that we are over a problem or situation, a crisis or tragedy, before we truly are then we run the risk of those unresolved emotions thoughts and feelings affecting us in negative ways. The compartmentalization of emotions mentioned earlier can be helpful in the moment, but must, over time, be resolved.
Henderson (Hardwired to Bounce Back, 2019) then discusses “Personal Resiliency Builders” that can help saying “each person develops a cluster of three or four” to be used when faced with problems. Assisting clients by asking which of several listed factors they use most, how these factors can be built upon, whether they can use any factors with current situations and whether they can name others is important in the journey from surviving to thriving. Knowing one has personal reserve available in times of distress can go a long way during those times when one feels defeated and unable to continue. The journey from simply surviving to thriving can be difficult
- Henderson, Nan. (2007). Resiliency in Action. Hard-Wired to Bounce Back. Retrieved from http://www.resiliency.com/free-articles-resources/hard-wired-to-bounce-back/
- McElheran, Megan. (April 21, 2011). Trauma Change Resilience. Retrieved from: https://www.youtube.com/watch?v=P8nMgY5dkTs
- NHS Lanarkshire. (April 30, 2015). Trauma and the Brain: Understanding abuse survivors Responses. Retrieved from https://vimeo.com/126501517
- Postinstitute. (March 12, 2013). Trauma, Brain & Relationship: Helping Children Heal. Retrieved from https://youtube.com/watch?v=jYyEEMIMMb0
- Powers, MB, Halpern JM, Ferenschak MP, Gillihan SJ, Foa EB. (August 30, 2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20546985
- The Road to Resilience. (2019). Retrieved from https://www.apa.org/helpcenter/road-resilience
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