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The Mortality of Authority

A few days ago, I was sitting in my office when a co-worker came in.  We began a conversation when he noticed a copy of Christopher Browning’s Ordinary Men sitting on my desk.  He looked at the book, picked it up, and asked, “What is this about?”  For a moment, I found myself voiceless.  I recalled every piece of information contained, and yet it was as if I could not formulate a narrative.  After a brief moment or so, I found myself humbled with definition.  With silence I replied, “mortality.”   

Browning’s book is can be summarized by the title.  It questions how ordinary men became such ruthless killers of war.  Throughout this course, we have learned a great deal of information into the depths of behavioral psychology and trauma.  In order to look to studies on behavior and authority, many scholars look to Stanley Milgram and Phillip Zimbardo and the experiments that they conducted.  Milgram and Zimbaro’s experiments have allowed us to see scientific approaches to human behavior and their compliance within authority.  In summary, both these experiments reflect one single word, conformity.

Stanley Milgram’s experiment demonstrated the human desire to conform to authority. In short, he tricked test subjects into pressing a button that they believed was causing another person pain.  Even though they believed the person was suffering at their hands, they proceeded to press the button when told to do so.   Phillip Zimbardo’s experiment at Stanford University demonstrated the human desire for authority.  He placed college students into roles of prisoners and correctional officers.  In a mock prison setting, Zimbardo filmed most of the interactions with the guards and inmates.  

While each experiment was vastly different, they are closely correlated.  Milgram demonstrated that once a person acquires a role or a position, they believe they must carry out what is expected of them.  Even if they are being made to do something that has consequences. The same goes with Zimbardo’s experiment of the prison guards.  This directly relates to Browning’s understanding of the role of Reserve Battalion 101 during the Holocaust.  Within the battalion, these men were trained to believe that they must follow orders at all costs.  As Browning discusses, these men received detailed and clear instructions.  The amount of structure provided a sense of purpose or mission to be achieved.  “Mass killing on such a scale required planning and preparation” (Browning, 1992:137).  It is important to note that the men of Battalion 101 did no go out and randomly commit acts of mass murder.  This was a well thought out and successfully planned mission.   In order to achieve this result, a person must be made to separate themselves from their own person.  They must identify themselves within their role, as an officer in this case.  Forget everything they know about themselves.  Every feeling, everything they have ever learned as a person and immerse themselves within their role.    

Zimbardo’s experiment is one of the most famous behavioral scientific studies.  Although heavily scrutinized, It demonstrated how if you take perfectly normal human beings and provide them with roles, they are going to act within that role.  He explained how a person carries out their mission.  In his book, Browning discusses how the guards were classified within the experiment.  In a sample of eleven guards, about one-third was classified as cruel and tough.  They went above and beyond the mission in order to harass and enjoy their newfound power (Browning, 1992:168). The next group was classified as tough but fair.  They played by the rules and carried out the mission as needed (Browning, 1992:168). The last and least populated category was those described as good guards, or those who chose not to punish the prisoners (Browning, 1992:168).  

Browning goes on to compare Zimbardo’s classifications within the ranks of Reserve Battalion 101.  He describes the enthusiastic killers who went out of their way for murder, the next and larger group of those who simply did as they had to, and then those few who refused and attempted to evade (Browning, 1992:168).  From Browning and Zimbardo’s work, you see that the person identifies within the role and carries out the mission in direct reflection of their personality. 

You have to respect what Zimbardo, Milgram, and Browning have done here.  Within their own ways they have provided a scientific approach for human behavior within atrocity.   It is easy to reflect on actions of those from hundreds or even thousands of miles away, but when a person is indoctrinated with beliefs, or simply provided to perform within a certain role, how can they be judged?  Is it fair to judge the actions of the prison guards any differently than those of Battalion 101?   This area of study directly separates the human factor from argued learned behavior. Is the person acting within their role or as themselves? 

What we see here and what I propose for discussion is why do you believe humans have a desire for authority?  Why as people are we willing to lose ourselves or risk so much just to be able to have control?  If this is the case, if this is fact, then do we really ever have control at all? 

Browning, C. R. (1992). Ordinary Men. New York: Harper Perennial.

The importanance of self-care

This class has opened my eyes and made me realize that some of the activites I incorporate into my daily routine, are part of my strategy for self-care. I never truly realized that when I worked out I was doing/enjoying it because it was relieving stress. Most of the time, in my situation when one of my sisters and I ran into family problems at home we immediately took our emotions and problems to the BU gym. We knew that the gym environment alone automatically made us feel better, not even going in with the intentions of trying to lose weight. Not only did it quickly make us feel better but it made us ten times happier. Even though endorphins do have a play in the fact that we felt better, it was the idea of the gym being our sanctuary. Before our violence and trauma class, I never noticed that our gym sessions were not only making me physically healthier, but mentally as well. I started realizing how important it was to take care of yourself when we learned about the various strategies others use for self care. Especially in this field of work, the importance of incorporating your own self care strategies in order to stay healthy and take care of yourself is extremely necessary, so you can safely continue on with your job.                        
      Another form of self care I tend to use is swinging! My sister and I started to take our stress to the swings a lot this year. We started going to this one park late at night which overlooks Boston. We called this our form of therapy before I even understood that people actually do small activities like this when needed. Even though it sounds silly to do at this age, I feel like I never appreciated swinging when I was younger. I was just doing it as a form of play. I was always trying to compete with my friends or siblings, seeing who can get higher, who can twist and turn and so on. But doing it now, all I feel is complete relaxation. The reason we go at night is because the silence surrounding us and the breeze flowing through us is almost like it is allowing us to let go of what ever is bothering us at the time and reach a clear my mind. I started to focus on my breath more allowing me to calm down and reach a zen like envrionment.
Lastly, my puppy Nico has really been one of the best self care strategies out there. I could tell my family was starting to take a turn filling up with a lot of pent up anger, even the first dog we got was looking a bit bored with life. But my sisters and I decided to disobey our parents wishes and bring home another a dog. Nico has brought the life and happiness back into our lives and has given my other a dog a play mate. It is not hard to realize that when you heard 'petting a dog makes you live longer' as a kid, it only makes more and more sense as you grow up. Dogs are always there to return the love with a wagging tail and a warm greeting. I noticed that Nico has allowed my parents a chance to step away from reality and enjoy the constant positive vibes he sends off. He is there to watch T.V with my parents after a long day at work, and is there to keep us all company when we get lonely. Thinking about the trained therapy dogs which is not something I hear much about, I believe getting a puppy or even visiting some is really a great self-care strategy people should utilize.
Furthermore, learning about all the many types of self care strategies people use such as yoga, meditation, painting, and even focusing on your breathing, has made me realize everyone has a different approach to finding their therapeutic activity, there is not just one way to do it. There are so many different ways people can do to find what helps them feel at ease with their struggles and gain happiness, it does not just have to be what you hear about that works best for others. I understand much clearer now that self-care is a necessity in your life. While taking care of others we have to remember to take care of ourselves because at the end of the day, no one can truly understand how we are feeling except ourselves.

Self- care

Self care is very important. Without it we can not take of others nor ourselves. Taking that extra time to de-stress and do something for yourself whether it be exercise, a walk, reading a favorite book, talking with a good friend, crocheting, karaoke, or just going for a joy ride can help us to regather our thoughts and feelings. We can breathe and close our eyes for a minute and let the normal everyday stress we experience, just float away.

If we do not take care of ourselves when we should then we are taking a big risk that can ruin so much. By not paying attention to minds and bodies we are more apt to make mistakes; ones like saying things we don't mean, messing up our responsibilities at our job, increasing the likelihood that we will get sick, increasing our chances of depression or aanxiety, having more aches and pains, subjecting ourselves to feeling like there is no light at the end of the tunnel.

I know from personal experience that when I do not take care of myself I feel terrible. I often will become very aggravated, exhausted feeling, I find myself being snappy to anyone that talks to me. I get aches and pains, it becomes a chore to do anything, because I need a break and I failed at taking one, so now my body and mind are letting me know that I'm boiling over. I try to use my ride to work as time I can "escape" from all my duties and I just turn up the radio and sing and have fun. I put everything else to the side for 30 mins each morning and I do the same every evening on my drive home. That is my "me time". I'm sure once my kids get older I'll have more "me time" but for now I have an hour a day, Monday through Friday. I consider myself to be lucky since a lot of stay at home mom and dads do not get that. I know this because I was a stay at home for 9 years.The sad part is, this world is so busy all the time and everyone is rushing around like they are late for everything. No one is getting proper amounts of sleep so we feel tired all the time. Some people take medicine to sleep and then take medicine to stay awake. We rush to get ready to go to work every morning, then rush home, rush to make dinner, rush to eat, rush to run errands, rush to get kids in bed, and then we are so exhausted and we still have more to do before bedtime. It is like a neverending cycle. I also have a tendency to feel bad for taking time for myself if I do. I think about well... "I should be doing something with the kids or my husband, I should be washng clothes and dishes, the house really needs cleaned up...". I will talk myself out of any downtime I may have had planned. I think a lot of us do this. Our daily schedules are so packed with things to do and there just aren't enough hours in the day.

Things we can do in order to regroup and charge ourselves back to 100% are:

• Meditation
• Yoga
• Walking
• Running
• Reading
• Visiting with a friend
• Going on a weekend getaway
• Go on a long drive
• Listen to your favorite music
• Go out for karaoke
• Eat healthy balanced meals and snacks
• Drink plenty of water
• Take the scenic route to work
• Focus on your breathing
• Take a longer hot shower or bath

Listening to our bodies is the key to staying healthy and energized. Energy shots or drinks will not help, they only make it worse by overloading your body with sugar and caffiene and then dropping us into exhaustion like a star faling from the sky. The right way to achieve energy and balance is to eat right and get the right amount of sleep. Getting between 7 and 9 hours can do a body good. Try to at least do some stretches in the morning to get your body unstiffened and ready for the day, make a balanced meal for lunch, a lite dinner and try 20 mins of exercise like yoga. Take that last hour before bed to relax your mind and body. Read a book, watch a show, write in your journal. Those are all great ways to keep yourself from drowning in the pool of stress. Even though for some of us this sounds much easier to read then actually do, we could at least give it a shot and do our best because it is important. It really makes a difference to ourselves and those around us. We all have people who count on us whether it is a spouse, our kids, our family, our patients or clients, and most of all we need ourselves.

Do You Care Enough About Yourself? Do You Practice Self-Care?

Trauma does not discriminate. Anyone can experience a traumatic event regardless of who they are and where they come from, and we have to be aware that this trauma affects people differently. Society today has to acknowledge that these traumatic experiences can take an emotional and psychological toll on anyone, especially for those who work within the criminal justice system. For this very reason, people within the criminal justice field (whether that is a survivor, advocate, law enforcement officer, etc) need to get involved with trauma-informed care programs that encourage healing and empowerment. The Department of Justice refers to these as “programs [that] identify and limit potential triggers to reduce their retraumatization and protect mental and emotional health” (2014) – I honestly cannot think of anything more important than protecting our health, regardless of if you work within the criminal justice field or not.

Unfortunately, in today’s world, there is a very strong pre-disposition against admitting the fact that people in the criminal justice field need help. We are the ones that are supposed to be strong and the ones that should be able to handle anything and everything that comes our way, but often times, we forget about taking care of ourselves. Unfortunately, there is a common stigma that says that if we are willing to publicly admit that we need help due to the stress imposed by our jobs, then we are not able to perform them in the way we are expected to and we are simply deemed “weak”, “pathetic”, or “disappointing”. This very thought imposes reluctance in us to seek assistance and therefore makes it impossible to encourage other people to take care of themselves too.

Let’s be real – our jobs are tough. Our jobs are difficult on us and the people around us. Our jobs, as rewarding as they are, are exhausting and strenuous. We need to realize that coping strategies are key in our lives, or we could ultimately turn to negative coping methods, such as self-medication and thrill-seeking behaviors, that could lead us into an even more negative path (like depression, PTSD, suicide, alcoholism, bankruptcy, divorce...).

Every workplace is a different environment, so we also need to realize that the coping skills and self-care methods that work for one workplace may not work in another. However, these are some self-care ideas that I have witnessed from experience that I believe will encourage positivity and help in most work places within the criminal justice system:

1. Take a break – Do not spend 24 hours a day 7 days a week at work, or you will lose perspective of your life and the real world. Being in the field and forgetting that you are an actual person who needs to do other things will cause you to forget about the fact that you matter just as much as the people that you are helping and protecting. If you do not help yourself, who will?!
2. Read – Reading can provide us with an alternative world that is not as traumatic as the one we work in every day. It gives us the opportunity to learn and to enjoy other topics that we may not get a chance to explore otherwise. It also encourages us to ignore social media for a bit, which also tends to be very negative. Social media networks are quick to make us believe that we are not doing our jobs well, and we may even end up believing this if we do not put them to the side more often.
3. Exercise and a proper diet – This applies to everyone! Fitness is crucial, not only so that we can keep up with the physical requirements in our jobs, but it also helps us be aware of our bodies and our strength. It allows us to release stress and fuel ourselves with the right things that will spark a higher energy in us. We have to keep our bodies healthy, as well as our minds. Exercise and a good diet allow for both.
4. Sleep – As much as we would love to some times, we are not robots and we need to rest and recharge, or we will not be able to do our jobs successfully. Actually, there are many studies that show how sleeping improves memory, attention spans, and your overall mood (this link talks more about the benefits of sleep for law enforcement officers: http://www.copsalive.com/the-importance-of-sleep-to-police-officers).
5. Counseling – Find a safe space for you to be able to decompress, vent, and express your true feelings within the job. Many times, we are afraid to do this with our co-workers or family members because of the fear that they will look down on us for admitting we need help dealing with our stress or simply want to talk about the negative aspects of our jobs. Counseling, regardless of if you have a mental health issue or not, is a healthy way to release those emotions and gather yourself and receive feedback. I believe this should be mandatory in all workplaces, especially in the criminal justice field.
6. Look out for our peers – be proactive and ask your co-workers about any of their concerns. Be willing to not only notice any negative attitudes or behaviors, but also be willing to point them out so they can address them. Those negative attitudes and behaviors may very well be the result of a situation they were not ready to admit or get help for. Be the friend and co-worker you would want to have.

Do not forget how important balance is and recognize that the trauma we are exposed to is not the norm. These traumatic experiences we go through can affect all of us negatively if we are not careful. It is OKAY for this field to take a toll on us and it is OKAY to seek help to deal with how this trauma affects us. If we cannot take care of ourselves, we cannot take care of anyone else!

Reference:

https://www.justice.gov/ovw/blog/importance-understanding-trauma-informed-care-and-self-care-victim-service-providers

Self-care

Self-care is so important, but some people think that it has to take a lot of effort to do. Sometimes it does; sometimes it doesn't; it depends what you're doing. Self-care is taking care of the body and mind. You can do many things to do this.

The most common thing recommended is to exercise, to just get yourself moving. This doesn't mean you have to go bike or run long distances though. You could lift weights, but you have to go to the gym to workout. You can go on a leisurely bike ride or skateboard an a path, or even just go for a relaxing walk. If you were to do things outside, which is self-care in itself, it would be best to do so as outside of a city or urban environment as you can. In Boston or DC, for example, it may take a little while to get outside of the city or urban environments, but there are so many paths along the rivers with beautiful sites, and trees and grass and flowers. Getting yourself moving outside in nature is a great way to self-care.

Something else that's highly recommended is yoga. You can do it in your room, with friends, or in a studio. You can do it with calming music or without. Along with yoga comes meditation, breathing, and mindfulness. These seem daunting, but by no means do they have to involve a lot. Meditation can be right when you wake up in the morning for just 5, 10, or 15 minutes. It's advised to do this in a place where you feel safe and comfortable, and where you can just let go of yourself. Breathing can be done wherever and whenever you need it. Typically it's associated with meditating, but there are so many different kinds of breathing that can help you it's its own category. Mindfulness also doesn't have to be a lot. It can be just paying attention to your body, how it feels in certain situations, and how things make you feel in situations as well. It can be just recognizing what you're feeling, and accepting it. Mindfulness can be paying more attention to your friends, roommates, or people around you and simply recognizing what they do for you and being grateful, and letting them know that you're grateful. Doing things for other people and letting them know you care and you appreciate them can go a long way not only for you, but for them as well. 

Something else that you can do for self-care is cleaning your room. I've found that if my room is messy, so is my mind. By cleaning your room you can give yourself space to breath. A leg off of that is putting away the pile of clothes that always sits on your bed or chair, and only leaving out what you wear every day like a sweatshirt or sweatpants. Another thing that helps, which doesn't really make sense until you actually do it, is making your bed. Having your bed neat and clean ties in with the cleaning your room part, but having a made and tucked in bed that you can crawl into after a long day just makes going to bed that much better.

Self Care and Love

Trauma is not exclusive to any particular person. It happens to everyone in any shape or form. Trauma can be mental, physical, emotional, and even environmental and it can range in severity as well. People handle trauma in many different ways but one thing that people should all have and I encourage them to practice is self-care when dealing with trauma. What is self-care one might ask? Well depending on whom you are it can mean a lot of different things however; ultimately it is the practice of having a positive and healthy mind, body, and soul.

The greatest thing about self-care is that it’s not a one size fits all kind of deal. There are many different ways a person can partake in self-care which include but are not limited to meditation, yoga, support groups, breathing exercises, physical exercise/hobbies, talk therapy, and engaging in artistic hobbies like cooking for example to name a few. Being involved in such activities as I described allows for one to get in tune with themselves which thus allows for greater connection with others among so many other great things.

Feminist and online personality Shelah Marie uses her online platform to promote meditation among other things. She uses her own traumatic stories to educate others about self-care and self-love. One thing meditation has taught her is that you need to take care of yourself first. She states in one her blog posts about mediation is that “no one is coming to save you. You will not get anything you need/want that you first don’t give yourself.” I think that this is very powerful statement because it could mean that you’re finally putting yourself first despite all the problems you might face. It’s similar to being on a plane. They always say put on your own oxygen mask before anyone else’s. I interpret that as meaning how effective can you be in a traumatic situation if you can’t take care of yourself to help the next person.

I myself participate in cross fit as a form of self-care although lately with the demands of school and an even more demanding full time job it has been extremely difficult to participate in it the way I would like to. However, it is definitely something I anticipate getting back to. When I did go to classes, I felt great mentally, emotionally, and physically. I was motivated to do more things in my day to day life and I got great sleep. I was able to think more clearly and if I was going through a stressful time I found that I was more motivated and determined to seek a positive outcome of any situation. I didn’t hold onto to negative energy and cross fit did all of that for me. I also wrote poems which, helped just as much as cross fit did. When I wrote down what I was thinking it became something real that I couldn’t suppress which, allowed for me to deal with things and not let them linger and turn into something bigger.

In the end, everyone in one way or another has experienced trauma in some form or fashion. In order to not lose oneself and have have a healthy mind, body, and soul I encourage self-care and self-love.

(Shelah Marie)

Trauma-Related Psychology Experiments

Trauma-Related Psychology Experiments

Trauma Informed Spiritual Assessment

After reading Shelly Rambo’s Spirit and Trauma (2010), I have been reading about spirituality and trauma, especially in terms of spiritual care’s effect on mental health. One of the studies I read compiles some research showing spirituality is related to various improvements and resiliencies in mental health. The protective function of spirituality is measured in decreased in negative mood, a greater sense of personal growth and resolution of interpersonal violence “by mediating pathways of hope and self-acceptance,” decreased depressive symptoms, decreased suicidal thoughts and behaviors, decreased substance abuse behaviors, “increased psychological well-being including life satisfaction, positive affect, and higher morale” (Hipolito et al, 2014). Spirituality is “empowering,” they declare. Empowerment from a trauma-informed perspective “reflects people’s ability to successfully access the skills and resources needed to effectively cope and grow in the post-trauma period (Johnson, Worell, & Chandler, 2005)” (Hipolito et al, 2014).

The problem is that there’s not a lot of research as to how “spirituality influences well-being in the post-trauma period” (Hipolito et al, 2014). I wondered this myself. It sounds nice to say that spirituality helps, but how does it help? There are various theories and measures of spiritual fitness, often referencing connection to transcendence, morality, and an increased ability to construct hope. The Encyclopedia of Trauma: An Interdisciplinary Guide describes the five components of spiritual intelligence as “the capacity to transcend the physical and material, the ability to experience heightened states of consciousness, the ability to sanctify the everyday experience, the ability to use spiritual resources to solve problems, and the capacity to be virtuous” (Figley, 2012).

In the study I’m referencing here, they measured participants’ spirituality by their responses to questions like, “How often do you pray?” and their perception of the “transcendent (God, the divine) in daily life by reviewing statements like, “A feeling of deep inner peace or harmony (Hipolito et al, 2014). Both the Encyclopedia’s definition and the study’s way of analyzing spirituality are problematic however. First, they seem explicitly biased toward Christian spirituality. Can we compare Buddhist meditation, Muslim salah, and praying a Catholic rosary? Is the mere act of commitment to prayer the beneficial part or is there something intrinsic to the type of prayer that is beneficial? Furthermore, they qualify the perception of the transcendent in terms of experiences of “peace” and “harmony,” which just sounds like an extremely limited understanding of transcendent experiences.

It just seems clear that the frameworks have been designed ahead of the research. There are numerous models for spiritual assessment, but I don’t know of any that are specifically related to mental health outcomes. First it seems necessary to research the influence of spirituality on specific mental health issues (e.g., moral injury, depression, anxiety, PTSD, etc.), rather than broadly to mental health. Second, we need to find ways of assessing why prayer and meditation are effective so that spiritual caregivers can know what sorts of spiritual practices to encourage.

All of this will be extremely useful for chaplains creating a spiritual care plan. Once the spiritual assessment has been made, the chaplain needs to decide how to best support this person, and this needs to come from a place of peer-reviewed research that is also trauma informed.

An example of trauma informed spiritual care would be resisting the urge to ask the careseeker to retell their trauma history. Part of being a chaplain is offering a non-judgmental presence, and this presence may encourage a person to open-up. The chaplain may unknowingly encourage a survivor to re-tell their story and may unwittingly re-traumatize them. Chaplains may also encourage patients to close their eyes or they my try to hold their hand while praying, unaware that this might be an unsafe physical action for them.

All to say, it is encouraging that spirituality is correlated with resilience and improvements in mental health, but there is much research to be done. We need to know what aspects of or what types of spirituality are most effective, assess why they are effective, and then use that data combined with trauma informed care in order to provide chaplains the most effective form of spiritual assessment and care planning.

Bibliography

Figley, C., & Ebrary. provider. (2012). Encyclopedia of trauma an interdisciplinary guide (Gale virtual reference library). Thousand Oaks, Calif.: SAGE.

Hipolito, E., Samuels-Dennis, J., Shanmuganandapala, B., Maddoux, J., Paulson, R., Saugh, D., & Carnahan, B. (2014). Trauma-Informed Care: Accounting for the Interconnected Role of Spirituality and Empowerment in Mental Health Promotion. Journal of Spirituality in Mental Health, 16(3), 193-217.

Rambo, S. (2010). Spirit and trauma : A theology of remaining (1st ed.). Louisville, Ky.: Westminster John Knox Press.

Trauma Touch Massage Therapy

My junior year of college my best friend went through a series of difficult events and sicknesses which eventually triggered and lead to the uncovering of suppressed childhood trauma. I still remember the night that she had her first painful and fully embodied flash back. Following that night, she had fairly severe PTSD. I remember driving to therapy sessions with her and her boyfriend—now husband. We would sit in the waiting room during her sessions and then afterward the therapist would invite us in to teach us different strategies to intervene in helpful ways during difficult flashbacks and nightmares. We learned grounding techniques and breath practices, and I am forever thankful for that experience. I am additionally thankful that my friend trusted me to walk through that journey with her. She is still my dearest friend.

The reason I mention that is because—though she never fully recovered the details of her trauma— the trauma she experienced took the shape of repeated abused by a woman close to her, though not a family member. During some of her more difficult flash backs I was unable to sit near her or touch her in any way because it sent her into further panic. It took many weeks of therapy and yoga for her to begin to feel safe in her own body again, and to feel comfortable with another female touching her. It was difficult not being able to hug my best friend; not being able to rub her back or hold her hand when she couldn't catch her breath.

After one of my friend’s therapy sessions the therapist talked to me and mentioned that my friend wanted to begin to work on experiencing safe touch again, and because she trusted me she wanted me to enter into that work with her. The therapist gave me some articles on abuse survivors and the recovery to trusting touch again, but she also pointed me in the direction of a method that has fascinated me ever since. She told me about a massage therapy certification program called Trauma Touch Therapy. Though the program is still only offered at a select number of schools around the country, I was fascinated by the literature around it. The program website states that the program itself is “designed to train massage therapists to work at an advanced level with individuals who have experienced trauma and abuse” (http://www.csha.net/advanced/trauma.html).

Though I am not a licensed massage therapist—which is a requirement for the further Trauma Touch licensing—I became extremely interested in the fact that there were methods outside of the confines of the talk-therapist’s office or the pharmacy for dealing with PTSD. At this point in my education I was very unfamiliar with trauma and had not studied it at all. The concept of trauma being stored in the body as we have read in Bessel van der Kolk (Van Der Kolk 2014) was absolutely revolutionary to me. One article that I first encountered says, “People who have been traumatized are no longer at home in their bodies. Talk therapy alone does not always adequately address the fear and mistrust that has been encoded into their bodies. In a multidisciplinary context, massage therapy can help bring clients back into themselves by increasing their ability to feel safety and mastery in the world, to be freely curious without fear, to feel comfortable with their body, and to experience boundaried intimacy with another human being.” (Dryden 2000)

I still hope to someday (hopefully soon) become a licensed massage therapist and become certified in Trauma Touch therapy. Though my friend and I were able to walk through her PTSD journey in different ways and recover her sense of embodiment and non-threatening touch, Trauma Touch therapy is a skill that I would love to have to be able to legally extend that healing to many more people.

Dryden, T., M.ED.,R.M.T. (2000, March 21). Recovering Body and Soul from Post-Traumatic

Stress Disorder. Retrieved April 21, 2017, from https://www.amtamassage.org/articles/3/MTJ/detail/1817

Van Der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of

Trauma. NY, NY: Penguin Books.

Importance of Trauma-Informed Interventions

Studies have proven that severe mental health problems are more closely related to emotional abuse than physical abuse because emotional abuse is often times not taken as seriously because of its relative “invisibility” in comparison to physical abuse, resulting in delay in recognition and action (Rees 2009). This is reflected in the low political priority in developing prevention and intervention programs for emotional abuse, and the lack of funds allocated for resources and training (Rees 2009). In this way, the inadequate methods for providing children with resources to cope with emotional abuse, are seen to contribute to its longevity and permanency in affecting the lives of at least a quarter of American children.  The most important aspect of treatment for children that have experienced emotional abuse is its timely start, because of the magnitude of long term effects of trauma that can develop. In The Body Keeps Score Bessel van der Kolk (2014) proposes that “child abuse’s overall costs exceed those of cancer or heart disease” and that “eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three quarters” (pg. 150). As the number of ACEs increases so does an individual’s overall healthcare utilization, which makes federally funded insurance policies and private insurance policies more expensive to maintain, eventually resulting in increased tax rates for all (Felitti, & Anda, 1998). In addition, when early intervention techniques are facilitated it leads to an overall healthier environment that encourages positive relationships in society.

Psychological maltreatment is considered a form of abuse on its own but it also often stems from other forms of maltreatment such as neglect, physical abuse, and sexual abuse. When children grow up in a home where their parents are aggressive or incompetent, the psychological abuse that they experience puts them at risk for a myriad of consequences as they mature. There is a strong correlation between the frequency, severity, and proximity of the trauma and the health risk behavior and disease risk in later adulthood. One of the largest conclusive studies about child abuse and neglect and later life health and wellbeing was conducted in Southern California in 1995. This investigation measured the amount of adverse childhood experiences (ACEs) in participants lives. The scores that participants got in three categories: abuse, household challenges, and neglect, represents their cumulative childhood stress. As the number of ACEs goes up so does the risk for substance abuse, depression, heart disease, financial stress, risk for intimate partner violence, risk for sexual violence, poor academic achievement, and many more health related difficulties (Felitti & Anda, 1998). Data collected from this study shows that almost two thirds of participants reported at least one ACE and more than one in five reported three or more ACEs. This shows that although it is fairly common for children to have adverse experiences growing up, their long term effect is determined by the child’s supports and resiliency (Felitti & Anda, 1998).

When a child experiences a traumatic event the overstimulation of their autonomic nervous system can trigger permanent changes in the development of their neural pathways and cause chronic dysregulation of their endocrine systems which alters the epigenetic profile of their DNA. Further, the repeated activation of the hypothalamic- pituitary- adrenal axis (HPA axis) decreases neurogenesis, and therefore decreases the brain’s neuroplasticity, or ability to repair itself (Kiyimba, 2016). The repeated activation of the HPA brought on by childhood stress also elicits pro-inflammatory tendencies which result in the etiology of many chronic diseases. When the stress occurs at such a crucial point in development, the childhood, it begins to dictate how certain body systems develop, notably the immune cells of the body. By allowing children to experience traumatic stress so young and not providing prevention efforts, the government is in effect perpetuating this cycle of abuse twofold, since it becomes engrained in their genes and will be passed down through generations in their DNA and in the way they parent their future children (Kiyimba, 2016). 

Trauma- Focused Cognitive Behavioral Therapy (TF-CBT) combines many theoretical approaches, including family systems, development theory, attachment theory, and client- centered therapy as a means of support for children after experiencing trauma and has been proven as the strongest evidence based treatment (Timmer & Urquiza, 2014). TF- CBT is structured, short- term, components based treatment which involves the child and their non-offending caregivers, this form of therapy is thought to relive some of the negative impact of the emotional abuse, as well as improve parenting skills, parental support, and  decrease parental distress. Including non offending caregivers in this therapy has its foundation in attachment theory, since parents have such a large influence in providing support and a safe environment for their child, it is important that they are included in the healing process. TF- CBT’s main goal is to provide the child with the appropriate skills and cognitive processes to begin to live a productive life after experiencing trauma (Toth & Manly, 2011).

Following a traumatic event, children develop negative associations for things they experience at the time of the trauma, so they are often afraid when they think of the abuse, so they avoid thinking about it. While this may seem effective at the time, prolonged avoidance of the trauma will make its emotional impact even larger (Reece & Hanson, 2014). Through TF-CBT a therapist can gradually expose children to reminders of the trauma they experience so they can slowly disassemble how they are feeling and cope with the trauma without being re-traumatized. There is strong support for this model of therapy and as more research is done it can be modified to provide further benefits for children and families affected by emotional abuse. 

Overall, the most effective forms of intervention are the ones that involved a variety of professionals all working together to help the child. A therapist would be the first step to uncover the depth of the trauma and recommend further treatment. A psychiatrist or pediatrician could prescribe medications if behaviors are severe enough. Social workers can help the family move forward and access appropriate support (Timmer & Urquiza, 2014). Having many different professionals working together as a team allows comprehensive treatment for the child, in hopes to rehabilitate them in all aspects of their lives. When pediatric primary care physicians are able to develop professional and meaningful relationships with the parents of their patients they are able to gain greater insight to the etiology of their health conditions and provide resources and support when necessary.

Community based prevention programs are becoming more widespread as politicians and educators are realizing that children who have experienced emotional abuse, or are currently experiencing it, require support and guidance from all spheres of their life. Communities That Care (CTC) is a prevention program designed to be implemented in the community to reduce mental, emotional, and behavioral problems that result from any challenges that children may face in their childhood (Salazar et al., 2014). This program identifies risk factors for each individual child such as family conflict, early behavioral problems, and delinquency. By identifying these factors as early as possible, it is likely to decrease the long- term effects of emotional abuse. In order to make this program as effective as possible, it was designed with a high level of collaboration with the child welfare system and other leaders in the community where it is implemented. Studies have shown that prevention programs based in the community tend to have the most positive effect because of the high degree of support. Before Communities That Care can be implemented more widely more trials need to be performed to assure its effectiveness and the proper training of leaders (Salazar et al., 2014).

References

Felitti, V. J., Anda, R. F., Nordenberg, D, et. al (1998). Relationship of Childhood Abuse and Household Dysfunction to Many Leading Causes of Death in Adulthood. American Journal of Preventative Medicine, 14(4), 245-258. Retrieved April 17, 2017.

Kiyimba, N. (2016). Developmental trauma and the role of epigenetics. Healthcare Counseling & Psychotherapy Journal, 16(4), 18-21.

Reece, R. M., & Hanson, R. F. (Eds.). (2014). Treatment of Child Abuse: Common Ground for Mental Health, Medical, and Legal Practitioners (2nd Edition). Johns Hopkins University Press. Retrieved April 17, 2017.

Rees, C. (2009). Understanding Emotional Abuse. Archives of Disease in Childhood, 95(1) 59-67. Retrieved April 17, 2017.

Salazar A, Haggerty K, Lansing M, et al (2014). Using communities that care for community child maltreatment prevention. American Journal Of Orthopsychiatry, 86(2):144-155. Retrieved April 14, 2017.

Sterling, J., & Amaya- Jackson, L. (2008). Understanding Behavioral and Emotional Consequences of child abuse. Pediatrics, 122, 3rd ser., 667-673. Retrieved April 16, 2017.

Timmer, S., & Urquiza, A. J. (2014). Evidence-based approaches for the treatment of maltreated children: Considering core components and treatment effectiveness. Dordrecht, NY: Springer. Retrieved April 14, 2017.

Toth, S. L., & Manly, J. T. (2011). Bridging research and practice: Challenges and successes in implementing evidence- based preventative intervention strategies for child maltreatment. Child Abuse and Neglect, 35(8), 633-636. Retrieved April 14, 2017.

Van der Kolk, B., (2014). What's love got to do with it? In The body keeps score: the brain, mind, and body in the healing of trauma (pp. 139-170). New York City, NY: Penguin Books.