week 10 sch

Introduction

  • Speaker: Janelle Cuddy, proud Illawadri woman, PhD candidate focusing on intergenerational trauma in remote Aboriginal communities.

  • Background:

    • Over 10 years of experience in child protection and health.

    • Previous roles in psychiatric rehabilitation and public health operations during COVID.

  • Observations in child protection highlighted overrepresentation of Aboriginal and Torres Strait Islander families and ineffective Western-based interventions.

Context of Research

  • Child protection interventions often based on Western perspectives:

    • Example: Adopting interventions from the UK or US, modifying with symbolic cultural elements without true cultural appropriateness.

  • Result: Continuous increase in child protection notifications for Aboriginal children since 2011, indicating ineffective practices.

  • Connection to health outcomes: The Closing the Gap initiative addresses social determinants of health experienced by Aboriginal and Torres Strait Islander peoples.

Lecture Objectives

  1. Define trauma and trauma-informed practice, including intergenerational trauma.

  2. Discuss mechanisms for intergenerational transfer of trauma.

  3. Identify signs and symptoms of trauma.

  4. Explore practice implications in a trauma-informed manner.

Understanding Trauma

Definition

  • Trauma can be described as an event that overwhelms an individual's psychological capacity.

  • Key elements:

    • Involves real or perceived threats to well-being.

    • Results in intense fear, horror, or helplessness.

    • Children may exhibit disorganized or agitated behavior.

  • Quoting Judy Atkinson: "Trauma refers to an event that is psychologically overwhelming for an individual."

Important Concept: Residue

  • Trauma leaves an emotional, psychological, and physiological residue from heightened stress accompanying threats or violence.

  • Analogy:

    • Cleaning an oven analogy illustrates trauma residue accumulation over time, resulting in exacerbating outcomes from minor events.

  • Practitioners should recognize and respond to the residue of trauma in their patients.

Framework of Trauma-Informed Practice

Core Principles

  1. Realize the widespread impacts of trauma.

  2. Recognize trauma symptoms in patients.

  3. Respond appropriately to alleviate symptoms.

  4. Resist retraumatization of individuals.

Practical Application

  • Creating emotional and psychological safety in practice.

  • Building trustworthy and transparent relationships with patients.

  • Encouraging peer support and collaborative approaches.

  • Empowering individuals by centering their voices and choices.

  • Understanding cultural, historical, and gender issues that affect individuals.

Signs and Symptoms of Trauma

Common Responses to Trauma

  • Dysfunctional and frightening behaviors include:

    • Avoidance behaviors

    • Aggression

    • People-pleasing tendencies

    • Withdrawal and self-harm

    • Defiance and resistance to authority

Types of Trauma

  • Simple Trauma (Acute): One-off events (e.g., accidents).

  • Complex Trauma: Ongoing, pervasive; often involves victim blaming.

  • Interpersonal vs. Impersonal Trauma:

    • Impersonal: Natural disasters.

    • Interpersonal: Abuse from others.

  • Collective Trauma: Shared experiences within groups (e.g., Aboriginal experiences).

  • Secondary or Vicarious Trauma: When witnessing others' trauma affects an individual.

Internal Working Models

  • Internal working models shape one’s perceptions and trust in the world.

  • Positive vs. Negative Models:

    • Positive: Beliefs of self-worth and trust in others.

    • Negative: Beliefs of unworthiness and distrust in others, often formed through trauma.

  • Practitioners need to adjust questioning techniques to accommodate these models, utilizing more open, curious language.

Stress Response System

Fight, Flight, Freeze Response

  • The amygdala plays a key role in the stress response and reacts faster than rational thought processes.

  • Example: Jump scare reaction in horror films illustrates heightened stress responses.

Implications for Practice

  • Practitioners need to maintain a calm environment with low emotional arousal to support patients with trauma histories.

  • Normalizing reactions (both theirs and yours) helps ease tension and builds trust.

Intergenerational Trauma

Definition and Example

  • Intergenerational trauma refers to the transfer of trauma’s effects across generations.

  • Historical Context: Studies on Holocaust survivors showed psychiatric symptoms in children and grandchildren due to inherited trauma from those experiences.

  • Epigenetics explores how stress at a genetic level can affect descendants even if they do not experience the original trauma directly.

Mechanisms of Transmission

  1. Learned Behaviors: Imitating caregivers’ behaviors formed under trauma.

  2. Vicarious and Secondary Trauma: Exposure to the trauma of others affects you emotionally and mentally (e.g., witnessing a parent’s trauma).

  3. Dysfunctional Internal Models: Behavioral expectations set by the trauma experiences shape perceptions.

Epigenetics

  • Describes changes in gene expression through environmental factors, essentially muting or activating certain traits potentially affecting future generations.

  • Misconceptions about trauma directly changing DNA clarified; trauma impacts gene expression through mechanisms of stress and environmental factors.

Conclusion and Practice Integration

  • Trauma-informed practice must be adapted to support all patients as many share backgrounds of trauma, especially Aboriginal and Torres Strait Islander peoples.

  • Emphasizing the universal applicability of trauma-informed principles leads to better health outcomes.

  • Ongoing commitment to understanding trauma, both generational and direct, is crucial for high-quality health care across various fields.

Q&A

  • Open floor for questions and discussions following the lecture.