Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / How Trauma Stays In The Body

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How Trauma Stays In The Body · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: This is Kim Lee from the Children's Consultancy, and I am introducing a new series which has to do with understanding and helping children who are suffering with post-traumatic stress disorder or post-traumatic stress reactions.
• 0:19
  SPEAKER_00: Many years ago I was involved with an organization called the Trauma Recovery Trust, and at that time much of the work that they did was focused on adults.
• 0:32
  SPEAKER_00: They asked me to help them in teaching students about the experiences of children, how the traumatic responses and or traumatic stress disorders began to manifest and how they could be treated.
• 0:51
  SPEAKER_00: As part of that process, I did some studying into the subject and looking at its origins, and that took me into the sort of early first thoughts about trauma before it was called post-traumatic stress or post-traumatic stress disorder.
• 1:12
  SPEAKER_00: And it took me back to the history of the First World War and something that was described as shell shock syndrome.
• 1:23
  SPEAKER_00: And that is that soldiers in the trenches were being bombarded with all manner of missiles and bombs and grenades.
• 1:34
  SPEAKER_00: And what began to happen was that their central nervous systems uh were constantly alert, waiting for the next attack and the next sound.
• 1:45
  SPEAKER_00: Fast forward to the Vietnam War, and American soldiers very often presented once they had returned back to the US with a whole variety of very, very distressing symptoms.
• 2:02
  SPEAKER_00: And so the understanding of this began to evolve, and the American Psychiatric Association made the formal diagnosis of post-traumatic stress disorder.
• 2:14
  SPEAKER_00: Now, at that time, treatment was pretty crude.
• 2:19
  SPEAKER_00: One of the main treatment techniques was to inject the patient with something called sodium pentathol, and the treatment process was known as drug ab reaction.
• 2:30
  SPEAKER_00: And in those treatments, patients would be injected with this essentially truth serum so that their psychological defenses were not available and they would be guided through the traumatic events and essentially would be reliving them.
• 2:49
  SPEAKER_00: It was a pretty crude approach.
• 2:58
  SPEAKER_00: And in in Wales, and she had been symptom-free for many, many years, and then somehow, almost out of nowhere, nowhere, she began to have nightmares, flashbacks, the most terrifying uh mental health symptoms.
• 3:17
  SPEAKER_00: And I watched the video of her being treated with this particular drug, and it was very, very distressing.
• 3:25
  SPEAKER_00: Fortunately, understanding of PTSD has evolved considerably, and many, many very skilled and devoted researchers and clinicians have explored this in a way which now results in a greater understanding of both the mechanisms that are responsible for PTSD, but also the treatment approaches.
• 3:56
  SPEAKER_00: Now I I think people use words like trauma, saying that something was traumatic rather easily.
• 4:06
  SPEAKER_00: Strictly speaking, a trauma or a traumatic event is something which is outside of the range of ordinary human experience.
• 4:17
  SPEAKER_00: It is something which leaves the victim feeling powerless, sometimes humiliated, fearful for their own lives or the lives of others.
• 4:30
  SPEAKER_00: And these kinds of events are very, very shocking because they are unexpected, they are emotionally, physically, and if you like, existentially threatening.
• 4:45
  SPEAKER_00: And sometimes that can come from witnessing something.
• 4:49
  SPEAKER_00: It could be seeing a car accident, it could be seeing some kind of dramatic event.
• 4:56
  SPEAKER_00: So we can we can kind of understand that, yes, of course, it would have some kind of psychological impact.
• 5:04
  SPEAKER_00: Now, quite often what will happen is that the mind's reaction to this will be to replay it, to keep revisiting it, to talk about it.
• 5:16
  SPEAKER_00: And this is this is like a form of psychological processing.
• 5:22
  SPEAKER_00: It's almost as if the mind is trying to make sense of what's happened by talking about it.
• 5:28
  SPEAKER_00: And in therapy, we talk about debriefing, and what that means is that as soon after the traumatic event as it's possible, we want to help the patient to tell us what happened, but we're facilitating the processing.
• 5:45
  SPEAKER_00: And of course, this is painful and we have to do it very sensitively.
• 5:50
  SPEAKER_00: Nonetheless, what we're doing is trying to facilitate this thing that we call spontaneous recovery.
• 5:59
  SPEAKER_00: Now, the other part of this whole process is concerned with when spontaneous recovery hasn't occurred.
• 6:12
  SPEAKER_00: And what that means is that the event and the memory of the event, the details, become suppressed.
• 6:21
  SPEAKER_00: They essentially go underground.
• 6:23
  SPEAKER_00: And sometimes people encourage others not to talk about what's happened, which of course is exactly the opposite to what we as therapists do.
• 6:32
  SPEAKER_00: And this is understandable because we're sort of trying to protect the individual from more psychological pain.
• 6:39
  SPEAKER_00: But in fact, what we're doing is we're we're suppressing and we're holding back the recovery process.
• 6:46
  SPEAKER_00: Now, if you think about it inside a family, the way that children process trauma is strongly influenced by the way that the adults facilitate or manage it themselves.
• 6:58
  SPEAKER_00: We can model it's okay to talk about what happened.
• 7:02
  SPEAKER_00: Tell me what happened.
• 7:03
  SPEAKER_00: Can you remember, you know, and and whatever, whatever the approach is, but it's permissive and it is part of the recovery.
• 7:11
  SPEAKER_00: So in my work, many of the patients I see who have suppressed traumatic experiences have never spoken about them.
• 7:21
  SPEAKER_00: I'm thinking about maybe a child or young person who's experienced physical or sexual abuse, things which they can't speak about yet.
• 7:33
  SPEAKER_00: The memory and the fears and the associations are still there and they will find expression.
• 7:40
  SPEAKER_00: But they will find expression through behavior.
• 7:43
  SPEAKER_00: And as regular listeners will know, I regard behavior as a communication.
• 7:49
  SPEAKER_00: So it could very well be the case that I start working with a patient and I notice that something about their behavior and the way they present indicates the possibility that they have experienced something which is traumatic.
• 8:08
  SPEAKER_00: But the other thing that we have to remember is that sometimes trauma can be complex, and we call this CPTSD, where perhaps the person has been exposed to repeated traumatic events.
• 8:23
  SPEAKER_00: So the cumulative effect has begun to shape the mind in ways which have very noticeable features.
• 8:33
  SPEAKER_00: This is more complicated work, but nonetheless it is work that we pay attention to because essentially what we're trying to do is to help the patient to recover from what's happened so that it becomes possible for them to describe it, to not be overwhelmed when they do, to reach that position where they can refer back to it as something which happened, but the psychological processes are no longer activated as if it still is happening.
• 9:08
  SPEAKER_00: It's a fascinating subject, but as I'm sure listeners will appreciate, it can be intensely painful for people to go through this recovery process.
• 9:20
  SPEAKER_00: And indeed, as a as a as a clinician, I have encountered some of the most painful stories of what what people have been through, the kinds of things which are really quite shocking.
• 9:36
  SPEAKER_00: And the only thing that I would say about that is that we we do have to be careful and quite discerning because trauma has a common quality, inasmuch as a traumatic event could be seen as something which is without doubt likely to cause great distress.
• 9:58
  SPEAKER_00: But sometimes trauma is more subtle, particularly if it's frequent, and we have to remember that the traumatic experience, the way that's internalized, the way in which that finds expression is strongly influenced by the age of the child or young person.
• 10:17
  SPEAKER_00: And I'm going to stay with children and young people, but if you if you think about it, a four-year-old is going to experience a traumatic event or an event in a very different way to an eight-year-old.
• 10:32
  SPEAKER_00: And what that means is that we have to think about how psychologically equipped the child may be according to their age.
• 10:42
  SPEAKER_00: And certainly below the age of six, we can expect all kinds of other mechanisms to be in place.
• 10:49
  SPEAKER_00: There are also the psychoneurological mechanisms, the way in which the brain is impacted by events, and particularly if they're repeated, something changes.
• 11:02
  SPEAKER_00: So in this series, I'm going to go through this step by step.
• 11:08
  SPEAKER_00: I do appreciate that perhaps this introductory episode might feel a little complex, but don't worry, we'll go through it bit by bit.
• 11:18
  SPEAKER_00: And I also appreciate that in talking about this subject, some listeners may be touched because of their own experiences, because of things that they have encountered, things which they've been unable to talk with anyone about.
• 11:38
  SPEAKER_00: And I would say to you, if that's the case, it's not too late.
• 11:42
  SPEAKER_00: It is still possible to recover.
• 11:46
  SPEAKER_00: And trauma means wound.
• 11:51
  SPEAKER_00: And I'll be saying this later on in the series.
• 11:54
  SPEAKER_00: But if we think about a wound, and we think about it from a physiological point of view, a wound has to heal.
• 12:04
  SPEAKER_00: Now, if a wound hasn't been addressed, if it hasn't been taken care of, it will heal, but it won't heal well.
• 12:15
  SPEAKER_00: And what that means is that scar tissue will form.
• 12:21
  SPEAKER_00: And scar tissue becomes sensitive.
• 12:26
  SPEAKER_00: So every time the original wound was touched or is touched, the reaction may very well be disproportionate.
• 12:35
  SPEAKER_00: The same is true in the mind.
• 12:38
  SPEAKER_00: If the mind has been wounded, it doesn't automatically heal well.
• 12:45
  SPEAKER_00: It needs in spontaneous recovery that's a bit different.
• 12:49
  SPEAKER_00: But when the mind has been wounded, it will also form scar tissue, which means that there will be parts of the self, indeed parts of the brain that become activated by seemingly insignificant things.
• 13:07
  SPEAKER_00: So we'll go through this in some detail, and I do hope that you will find it helpful.
• 13:15
  SPEAKER_00: So episode one will be coming soon.
• 13:18
  SPEAKER_00: Thank you for listening.