Friday, December 28, 2012

Mindfulness Based Stress Reduction Group

Drew Prochniak, one of my staff, is going to offer a mindfulness-based stress reduction group beginning in mid-January.  View our website to email him for more information.  www.traumacenternw.com.

Thursday, December 27, 2012

Craving the Mundane

Anytime something that shakes us up happens, we crave the return to the mundane.  It is so comforting to engage with what we don't think about, perhaps because trauma can consume what feels like every inch of our cognitive and emotional capacity.  The smells associated with simplicity can bring feelings of warmth and comfort; coffee in the morning, our bed linens, the smell of our children (okay these are the things that comfort me).  All things home and familiar are what we want most when confronted with disaster.  Perhaps this is part of the draw of isolation for survivors; avoiding the outside world keeps us connected to comfort.  Predictability is a form of fortune telling; if I know what happens in the next few hours or days, things will be fine.  At least it feels that way.

The mundane, the boring, the thoughtless and otherwise seemingly empty parts of our lives are actually so profound.  This is what we are drawn to in response to the unbearable.  I find myself thinking of this anytime my mind wanders to Newtown.  Newtown followed a violent public shooting here in Oregon, thus the locals here were managing two atrocities in two days.  As I go to each event in my mind, particularly to the children, almost immediately I want the comfort of my routine, of what and who is familiar.  This is a major source of regulation of emotion.  Recent events are highlighting the significance of what we rely on for comfort.

Many of the advice givers (myself included) advise re-engaging with routine following tragedy, although there isn't much examination or discussion as to why.  Perhaps examination is unnecessary because our pursuit of the familiar is so intuitive; we needn't be told to do that because it's what we want to do.

Thus, the predictable return to the strengths and resilience of people and trauma survivors... Survivors know what to do to feel better much of the time, and if it isn't clear what to do, there is often a persistence of  trying to figure it out.  Sometimes the answer to this particular question (what to do to feel better) leads to addiction, to avoidance, or other forms of escape.  Sometimes, if we stick with our pursuit of the mundane, we are lead back to it through a meandering, undefined path that demands our trust in our own capacity.

Thursday, December 20, 2012

Saturday, December 15, 2012

Connecticut, Grief, and Hope, & What My Clients Have Taught Me

I have a six, almost seven year-old boy.  His eyes are big and brown; his lashes long and luxurious.  He  calls me "mama" in his sweet voice, and each time I hear him say it I feel warmth in my heart.  I look at him now and wonder so many things that I am certain everyone is wondering too; how does one disturb that kind of innocence, ignore it, destroy it?  And the pain the parents in CT are left with seems unbearable.  I have to grieve with them and for them and recognize what kind of risk one takes in loving someone in that way (a risk well worth it).  So, like many others, I find myself searching for something~information, understanding, insight, and most certainly I would like some hope for those in the midst of such unbearable grief and horror.

I hear a lot of stories in the work that I do.  So many things that seem insurmountable, and yet, day after day I see my clients and listen to them tell me their stories.   It's a thing I have said before~that trauma survivors are heroes.   That doesn't mean there is no suffering or grief, that recovery is easy, and I wouldn't be so naive as to say that time heals all wounds.  However, what I continue to learn from them  is that each person, within the context of their own experience, is in those moments of horror, coping with it in some way.  The coping isn't visible-we learn of it later when words can be paired up with events.  Part of the truth I hear from survivors, over and over, is how they survived...what they did on the inside to manage what was happening on the outside.  My little tidbit of hope is that for each and every victim and survivor of a victim there is and was coping.  There is family, there is community, there is an entire nation grieving with them, and there is no doubt of the gravity of their pain.

Essentially, what I hope to remind myself of is that thing I have learned in the work I do; that we do have a capacity to care for ourselves in nuanced ways.  It's difficult to talk about hope without sounding  as though I don't understand or that I am naive.  Perhaps this is my own coping~I can't be certain.  I can, however speak to what I have seen and be thankful to those who have invited me into their lives.  There is some light in having felt the truth of the human spirit's capacity to save itself in the face of the unspeakable.




Thursday, December 13, 2012

Tips for parental response to community-based trauma

In response to the shooting on Tuesday (12.11.12) at Clackamas Town Center, one of my staff, Jessica Boldt, LICSW, wrote an article on ways in which parents can help their kids & teens recover.  I have cut and pasted it below:


Traumatic events, such as the tragic account at Clackamas, impact all of us in unique ways including children and teens. Parents are often worried regarding the affect it will have on their child and are unsure as to how to help them. We hope that this information will assist parents feel relieved in having concrete tools to assist support their child during this time, and know the one may exhibit that indicate a need for greater resources.

An important thing to remember is that youth are often highly resilient even after extreme duress. A child or adolescent’s reaction to stress, even catastrophic, is usually brief in duration and symptoms of trauma are often a healthy indicator of one’s efforts to stabilize. Parents should also consider that the impact may affect teens in a unique way as the mall is often viewed as a safe place for youth, and one that represents belonging and socialization.  It’s likely helpful for teens to process with other peers and discuss how this event likely altered the perception of this meeting place they find comfort in. Teens should be encouraged to visit the mall when they, and parents feel stable enough to cope with the “triggers” of the event. Teens are also likely to feel strong and secure in numbers, so going to the mall with another teen may be encouraged. Also, making “baby steps” into this environment is something that may assist a teen with feelings of anxiety. For example, making the first trip with friends to one store may be more manageable for a teen that wants to go to the mall, but is having some reservation.  It’s also important to note that teens may want to go directly back into the mall environment, which may be their way of healing. Whatever process your child feels comfortable in, make consistent efforts to monitor behavior and mood and discuss their best efforts to move forward.

Directly following trauma, it is expected that children and teens may exhibit agitated or confused behavior.  They also may show through behavior, play, or in verbal communication intense fear, helplessness, anger, sadness, horror or avoidance. Parents may experience their child having increase in behavioral outbursts, mood swings, fear of being alone or “clingy” behavior, or isolation. While seeing your child in these states can be difficult, these are indicators that one is working to process the event.

While a parent cannot “make the event go away,” a parent can assist the child work through their feelings by maintaining the child’s structure. The child needs to regain their sense of safety and parents are the best at doing that. Parents are able to do this by:

·      following the household daily routine
·      gentle encouragement to participate in their normative activities to assist them regain normalcy
·      engagement with positive supports such as family and teachers, 
·      practicing self-care for themselves to assure emotional and mental stability with them, providing positive outlets to discharge some of the energy following trauma such as talking a walk or a bike ride,
·      limiting exposure to pictures or adult conversations of the event,
·      monitoring stimulus (maybe reconsidering attending some of those holiday parties),
·      doing mood “check ins.”  Parents may do this via a play activity with small children where the family to family charades to explore moods and prevent focusing on “negative” moods.
·      discussing the event if your child chooses. For smaller children, it’s important to use age-appropriate language, and pictures or play maybe most appropriate.

Parents want to make sure to follow a child’s lead in the conversation to avoid them from getting overwhelmed. Teens are often more able to verbally communicate though may feel agitated when a parent asks to many questions. As a parent, you likely know what your child has needed from you most to feel comforted in the past when they have been hurt. It’s wonderful to glean information from these previous experiences to assist them manage the current event.
Though stress reactions are usually brief and recover without further problems, a child or adolescent who has experienced a catastrophic event does have the possibility of developing posttraumatic stress disorder (PTSD). Signs that your child may be having difficulties include the following behaviors occurring for more than two weeks or if they increase in severity: 
  • loss of interest in activities and isolation
  • ongoing physical symptoms such as headaches and stomachaches
  • ongoing extreme emotional reactions and sudden shifts in moods
  • ongoing problems falling or staying asleep                  
  •  problems concentrating or new school related concerns
  • ongoing regression of age or intense fear of being alone
  • ongoing increased alertness to the environment or inability to adapt in new environments
  • repeating behavior or play themes that reminds them of the trauma
  • worrying about dying or others
If your child exhibits these signs it does not necessarily indicate that your child has PTSD. However, it is recommended that parents and their child meet with a qualified professional to best assist in area of assessment and providing families increased tools to mobilize your child from a place of fear to happiness. 

Written by: Jessica Boldt, LICSW
Jessica Boldt is a licensed clinical social worker specializing in trauma related work and clinical work with children and teens. She currently practices at  Integrative Trauma Treatment Center with locations in Portland, OR and Vancouver, WA. 

 

Thursday, December 6, 2012

Trauma Center is Open!

Finally, all has come together and we are good to go.  I have two amazing staff people, Jessica Boldt, LICSW and Drew Prochniak, LPC who share my passion for working with survivors and who definitely keep me on my toes.  Our website is up and running (and is gorgeous-I must say)~the address is www.traumacenternw.com.

I wanted to create a place that is warm and has a non-clinical atmosphere and that works from an authentic place of respect, honor and optimism.  I also wanted to have a micro and macro perspective on the work that we do, specifically in treating people individually but also expanding to national and international disaster relief and trauma treatment.  I also want to continue to develop our community partnerships, to provide advocacy, and education to the community.

Some upcoming offerings likely this winter:

Street Yoga for Survivors
Relapse Prevention for Survivors
Seeking Safety Group

and we'll see what else!