Trauma and Disabilities

Dr. Emily Kerner

So today’s training is on trauma and disabilities, specifically from a neurodevelopmental perspective. So to introduce myself to start off the presentation. I am a licensed psychologist and consultant to the DPSS team. My name is Dr. Emily Kerner. I completed my master’s and Ph.D. in counseling psychology from McGill University, where I also lectured and supervised graduate students while I was there.
I have been working in private practice for about 11 years, and until joining the Cree Health Board in fall of 2022, I was the staff psychologist at a residential addictions treatment centre. Since 2020, I’ve been certified as a clinical trauma specialist through the Trauma Institute International, which is located in Arizona. My clinical expertise are in adult ADHD and neurodivergance in general, developmental, or what we also call complex trauma, addiction, recovery, anxiety, mood disorders and life transitions, which include things like stress and burnout.

Over the last few years, I’ve also been a member of several different online global communities that are working to heal our collective trauma as societies. Through the use of somatic or body based ways of connecting to ourselves and one another. So these online spaces in their communal practices have helped me to see and notice the intergenerational traumas that I and my immediate family aunts, uncles, siblings, parents hold as a result of antisemitism my Jewish ancestors likely lived through through these group experiences. I’ve also learned about and come to feel in my own body the trauma that White culture has caused to all of us. For example, by emphasizing individuality over community, prioritizing work over rest, or teaching us to disconnect from our bodies and emotions. So while this topic could and maybe should be a presentation in itself, I simply wanted to name that this personal awareness, along with my clinical training as a psychologist, are the perspectives that I bring to this training today.

So while I have had these diverse set of experiences learning about trauma and trauma healing methods, I want to clearly state at the start of today’s presentation that the presentation is rooted in a scientific and neurodevelopmental perspective. As a non-Indigenous white psychologist, I don’t believe that I’m the appropriate or the right person to provide you with a Cree point of view on trauma. However, I do believe that both perspectives should be honoured and maybe even integrated at some point. So if you are looking for an Indigenous perspective on trauma, I encourage you to reach out to the men and women who team and some of the traditional healers who work there.

So before we dive in today, I want to remind you all that any presentation of trauma has the potential to trigger an emotional reaction. This may happen even without warning, as trauma and its reactions can often be very unpredictable. So please listen to yourself and your body throughout today’s presentation. Step away if you need to turn off the sound. Leave the room at any point. It’s very important that you take care of yourself and make sure that you’re listening to what you need. Please don’t override any discomfort that you’re feeling through today’s presentation. This can only make it more difficult to focus and to learn. So do check in with yourself throughout the presentation. Make sure that you’re taking care of yourself and doing what you need.

So we’ll start today’s presentation with a video. And this is a California pediatrician whose name is Dr. Nadine Burke-Harris And I will play this video and then we will discuss.

[VIDEO STARTS]
https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime

Dr. Nadine Burke-Harris

In the mid-nineties, the CDC and Kaiser Permanente discovered an exposure that dramatically increased the risk for seven out of ten of the leading causes of death in the United States in high doses. It affects brain development, the immune system, hormonal systems, and even the way our DNA is read and transcribed. Folks who are exposed in very high doses have triple the lifetime risk of heart disease and lung cancer. And a 20 year difference in life expectancy. And yet doctors today are not trained in routine screening or treatment. Now, the exposure I’m talking about is not a pesticide or packaging chemical. It’s childhood trauma.

[VIDEO ENDS]

Dr. Emily Kerner

So as Dr. Burke Harris said, the effects of childhood trauma and physical and mental health are significant. The more exposure a person has to trauma in childhood and really throughout their lives, the greater their risk is of developing things like heart disease, high blood pressure, autoimmune diseases, mental health conditions like depression, anxiety and ADHD, substance abuse, and attempting or even completing suicide.

Importantly, when we’re talking about people with disabilities compared to those without disabilities, individuals who do have a disability are at a greater risk of being exposed to childhood trauma. For instance, individuals with disabilities are four times more likely to be victims of crimes as non-disabled people. Children with Autism spectrum Disorder or ASD experienced sexual abuse twice as often as that of the general population, and just being exposed to the disability service system can increase a person’s risk of abuse by 78%. So these are pretty significant statistics and they show us why it’s so important to know about trauma when working with someone who has a disability. Although we can’t assume that every single person with a disability also has a history of trauma, it is safe to say that they likely experienced some level of traumatic stress. So for this reason, it is essential that you were well equipped to work with trauma. If you regularly interact with and work with people who have disabilities. So that’s really what this presentation is today. And as the writer Maya Angelou has said, when you know better, you do better. And so helping you today to know better and therefore do better is really the goal of the presentation. So when you know better and do better, you can help clients with trauma and the people who support them. While there will eventually be more detailed training all about trauma informed care for working with disabilities, today’s training is really an introduction to this topic and kind of an overview of the topic. So if you only take one thing away from today’s training, I hope it’s this: Trauma stops people from feeling and believing that the world is safe. When people don’t feel safe and they’re always living in fear that something bad will happen to them. It’s very hard to listen, follow rules, play, explore the world ,the or even show affection and love. So trauma informed care is care that understands the importance of feeling safe. It’s care that focuses on helping people feel settled, connected, and empowered so that they can participate, learn, and grow.

So the goal of trauma informed care is to help people move from what would be considered surviving to thriving. So the whole presentation today is really framed in this sense of trauma informed care and how to work with people from with disabilities, from a trauma informed approach. So with that overview, here are a few specific goals for today’s presentation. So by the end of the training today, you will be able to explain psychological trauma and how it changes the brain and body. You’ll be able to understand the similarities and differences between trauma and a neurodevelopmental disorder, and you’ll be able to apply and use different strategies to support someone to heal from trauma. So we will actually go through and practice some exercises together and try out different things and use our body in different ways that help us feel settled and can help somebody that you’re working with to feel more settled in their own bodies as well.

Before we get into the details of today’s training, I want to offer you a few minutes to check in with how you’re doing and what you’re feeling. So this will really help you to orient yourself to time and space as well as your body’s relation to each of them. So I’ll ask you just to take out a piece of paper and some pens, maybe pencil those markers, anything that you feel you want to use to to draw or write today. And when you have your piece of paper, you can just draw an image that looks somewhat like one of these images. However, you might best represent your own physical body. So you can take a moment and draw in any way you want. A representation of your physical body can even be a stick figure if that’s more comfortable for you. Once you have this drawing, just take a moment and indicate in any way that you like, draw in any way that you like what you’re feeling in your body right now. And where if you can’t connect to any feelings in this moment, that’s okay. Just note that in some way for yourself, you can write a little note, draw a little symbol, anything that just helps you remember what is happening in your body or what you can connect to or not in this moment.

So hopefully you had a chance to mark off how you’re feeling today. And so here is our outline for today’s presentation. First, we will ask the question “What causes trauma?” Next, we will move to “How does trauma change the brain?” We’ll talk about how it actually changes our brain and bodies when it happens to us.

We will also learn how to recognize the signs of trauma in people with disabilities. We’ll see how changes to a person’s emotions, thinking patterns, behaviours and relationships can be important indicators of past trauma, and very importantly, will not only learn about, but experience and practice together how you can support people who have trauma. We’ll also learn how to use these strategies to become a safer person and to reduce the chance of causing more harm as we move through the training. Today, I will approach each of these actions in the same way. So first I’ll ask the question. Next, I’ll give you a brief one sentence answer to that question, and then we’ll spend some time going in more detail to explain the answer. So I encourage you to pause the video after each section, if you like, and take a brief moment to let the information sink in before moving on. You can write down some notes if you like. Whatever helps you to hold the information in your mind. So our first question for today is “What causes trauma?” And the quick answer to this is trauma is caused by exposure to traumatic events. So traumatic events are events that are life threatening or ones that we might believe in that moment to be life threatening. What’s really important to know when we’re talking about traumatic events is that not every person will experience the same event to be traumatic.

So two people might live through the exact same event. One person might experience trauma from that event and another person might not. There’s a lot of different reasons why that can be the case, which we won’t go over in detail today. But it is important to note that it’s a person’s individual experience of that event that causes the trauma and not the specific event itself. So just to give you an example of this from my own family and my younger sister, who struggled with a lot of separation anxiety as a child, would often react with pretty intense fear. Every time our mother would leave the house, even if it was just to run a short errand. So most likely, my sister’s young developing brain feared that my mother would never return when she would leave the house. And maybe my sister would also feel that she would be unable to function without her mother if she didn’t return. I, on the other hand, really remember feeling fearful of my mom not returning home when she would go out, or that my survival was threatened in any way by her leaving the house. So this is an example of my sister and I living through the exact same event, our mother leaving us at home with a babysitter. But my sister experienced this is pretty traumatic while I didn’t. So again, we lived through the same event. One of us experienced it as traumatic. The other one did not. So trauma is caused by the exposure to a traumatic event. And when we experience a particular event to be traumatic. So let’s review some examples of events that are likely to cause trauma if somebody does experience them.

So the first kind of category of traumatic events is what we call acute or single event trauma. So these are the types of traumatic events that people will typically think of when we talk about a traumatic event. So they might be things like a natural disaster, for example, a house fire, a flood, a tornado, a hurricane. Another example might be something like a vehicle accident, a car accident. Other examples of single event or acute trauma are things like being physically attacked or sexually assaulted by another person. In all of these examples, a person who lives through these events will most likely feel a sense of terror and fear, possibly even believing that they might die.

Another type of traumatic event is what we call chronic or repetitive trauma. So this is trauma that’s caused by events that are ongoing or that happen over and over again. So this is when we are consistently or repeatedly exposed to a traumatic event. In these instances, we probably aren’t at risk of dying from the event or dying in that instance. But we do feel threatened and scared that at any moment we could be harmed, yelled at, made fun of shamed, rejected, excluded. Some examples of this type of trauma are domestic violence. Sometimes also called intimate partner violence. And this can occur across all cultures and in all types of romantic relationships. Some other types of chronic or repetitive trauma are physical, emotional or sexual abuse. This type of traumatic event can be acute. So it can happen on one occasion. But if it happens to somebody more than once, if they experience sexual abuse many times over the period of six months or a year, or if they’re living in an abusive home where one parent is consistently scary or physically aggressive, this is something that they will be living over a long period of time. That’s when it would be considered chronic type of traumatic event. Living with a chronic illness or a disability can also be a form of chronic or repetitive trauma. For many people with autism, for example, the world can feel overstimulating and like it’s too much at any given moment and throughout most of the experiences that they have. So they might constantly feel overwhelmed and unable to settle. And this can really make living in the social world pretty traumatic every day. So you can imagine that if somebody is consistently feeling that the world is too much and too overstimulating can be really hard to settle and feel safe.

Some other examples of chronic or repetitive trauma are things like systemic oppression or colonization and racism. These are traumas or legacies of trauma as that are lived everyday.o some examples of this type of trauma is, for example, significant intergenerational trauma that has resulted from residential schools, which have led to the loss of culture, the loss of language, the loss of traditions and healing practices. Some other examples are just generally the bigger theme of colonization and more recent forms of institutional racism that’s led to the loss of Indigenous land and Indigenous claims to land. Some other examples are the embeddedness of white culture into our social and cultural systems, and this has caused and continued to cause significant trauma to black, indigenous and other people of colour. So some examples of this kind of trauma are things like the behavioural expectations that we have for children at school, for example, that they sit still or that learning must happen from a book. Some other examples are the focus on individuality versus community, a separation of cultural values and traditions from academics and things like history books that prioritize the colonizer perspective and teach children, for example, that North America was discovered as though the land and the indigenous people who lived there had not existed before they were found. Some other examples of systemic oppression or racism and colonization that would be considered chronic or repetitive trauma are police violence or the threat of police violence for black and indigenous men in particular, as well as daily microaggressions and things like white cultures, use of indigenous symbols as mascots for sports teams or Halloween costumes. So these are examples of ways that a white culture has created this chronic and potentially repetitive trauma for black, indigenous and other people of colour.

So the last category of traumatic events is what we call acts of omission. This is when there’s some kind of care or attention that somebody should be receiving that they’re actually not receiving. So it’s committed in their experience. This can be things like experiencing a lack of care, a lack of attention or emotional connection from a person who is supposed to be offering those things. So some examples of this might be physical or emotional neglect, so children can be emotionally or physically neglected. When a parent is addicted to drugs and alcohol, maybe depressed, anxious, or dealing with another mental illness. In these cases, the parent may not properly feed or clothe their child. Maybe the parent doesn’t take the child to medical appointments or forgets to take them to school or other sports activities or extracurricular activities that they might be signed up for. This kind of trauma can happen when a parent is struggling to care for a child with a disability as well. For example, maybe the child has behaviours the parent doesn’t know how to deal with, or maybe the child has so many medical appointments that mom or dad feels too overwhelmed to keep track of. In these situations, mom and Dad can become so stressed that they’re not able to keep to get up, maybe not even properly care for their child. Maybe mom and dad are struggling financially because of the cost of treatments, the cost of therapy or cost of medications. So they’re unable to pay for new clothes and other things that the child might be needing or asking for. Maybe mom and dad even drink or use drugs to cope with all of that stress. So what’s important to note with this kind of trauma is that it’s not necessarily the parents fault. They’re really trying to cope. But if the family doesn’t get help and the parents don’t get help to be able to cope better, the child might continue to be exposed to and experienced trauma as a result of not having their needs met daily and over a period of time. So we’ll look at a little model here that helps us understand a little bit more about how traumatic events lead to trauma.

So when a person is exposed to a traumatic event or a series of events like the ones that we just reviewed and discussed, they may experience what we call a traumatic stress reaction. So traumatic stress is our bodies automatic survival strategy gone wrong. So too much stress or stress that stays in the body for too long can lead to problems like difficulty, concentrate eating, maybe acting out in anger, feeling numb in your body, or having a lot of emotions that you can’t manage. So traumatic stress that lingers and never gets metabolized or broken down by the brain and body is really what causes what we call trauma. So you can think of this almost like food poisoning. It’s a bit of a yucky example, but trauma is also kind of yucky. So we’ll use this as a way to understand a little bit of what trauma is. So if we compare it to food poisoning, the traumatic event here would be eating the food that’s full of the yucky bacteria. Your stomach might try its best to digest it, but it just can’t properly break it down and use it for energy. So at some point, probably not too long after you eat the food, you’ll start feeling pain, cramps, nausea, a buildup of kind of yucky ness in your body and a bunch of other symptoms that we don’t necessarily need to name we’re talking too much detail about. So that’s really the trauma, the unpleasant symptoms experience when the body can’t properly digest or kind of make sense of the stress you’re experiencing after a life threatening event.

So this leads us to question number two. “How does trauma change the brain and body?” So the quick answer to this is it wires the brain for survival because a traumatic event makes you highly aware of the possibility of not surviving. A traumatized brain is always on high alert. It’s searching the environments for signs of danger and the best and fastest way to stay alive. So as you can imagine, if the brain is wired to see things in terms of life and death, you’ll probably have a hard time believing that someone has your best interest in mind and you most likely won’t even really care to learn why one plus one equals two, because you’re really just so focused on making sure that you stay safe and that you stay alive. So experiencing a traumatic event causes a traumatic stress reaction in the body and then wires the brain to be on the lookout for danger and how to survive it. So let’s take a closer look at how the brain actually gets wired this way In order to understand how the brain gets wired for survival, it is important to understand a little bit about the brain first, in general, all parts of the brain are designed to keep us safe and make sure that we survive.

The human brain grows in parts or levels like the blocks in this tower on the side of the the image here. So the first part of the brain to grow, which is while we’re still in the womb before where we’re born, is called the brain stem. This is what we sometimes call also the lizard brain, because it’s the most primitive or basic part of the brain that all animals, even reptiles, have. The brain stem is kind of like our brains housekeeper. It manages all the functions that keep the body alive. For example, things like breathing, sleeping, waking up from sleep, hunger. You can think about the fact that all of these brain functions are things that we don’t have to tell our brain to do. It just does them to keep us alive. So you can think about it. We don’t tell ourselves that we have to breathe. Sometimes we might have to remind ourselves to check in and breathe, but generally throughout the day, we’re not having to tell our bodies to breathe. It’s just naturally happening without us thinking about it. We generally don’t have to teach ourselves how to fall asleep. Our bodies, when they become tired enough, will fall asleep on their own. And this is all those functions that get regulated and managed by the brain stem. The second part of our brain that develops during the first six years of life is called the limbic brain. This is the part that we share with all other mammals. So all other animals that lives that live in groups and care for their young, The limbic brain is like the brain’s map. It takes the information in from rat from the world around us and organizes it so that we can navigate and make sense of the world around us. It helps us to orient to our surroundings, to know where we are and how to move about and move around in that place. This is a part of the brain also that functions without us having to actively think about it or tell it what to do. The limbic brain is also formed based on how we use it. So if we feel loved and safe, the limbic brain becomes really good at things like playing, exploring cooperation, connecting to other people. If we generally move through the world and we feel unloved or unsafe because of experiences that we are currently having or that we’ve had in the past, the limbic brain becomes an expert in making sure that we don’t feel those things.

So what might happen is we start avoiding relationships with people or we might start staying away from the place that once felt scary. Maybe a crowded mall, a dark alley, or maybe even school for for people who have had not great experiences with school. So the limbic brain really adjusts and grows based on the experiences that we have and that we lived through. The brain stem and the limbic brain together make up what we call the emotional brain. This is in contrast to the thinking brain or the prefrontal cortex, which is the last part of the brain to develop. And it’s the part that’s thicker in humans than in all other animals. The prefrontal cortex is not fully developed until the age of 25, so it continues to develop throughout childhood and adolescence and up until about the age of 25. So this is the part of the brain that we use to plan, organize, remember, things, create stories about our experiences, and it’s the part of our brain that we use to have empathy and understanding for other people. We also know that this is the part of the brain that’s most affected by neurodevelopmental disorders like autism, ADHD and FASD. So that’s just an important piece to note about the prefrontal cortex. So now that we have a bit of an understanding about the different parts of the brain, this will help us understand more about traumatic stress reactions and trauma and how it affects the brain and how the brain processes traumatic events. So during any event that we perceive as life threatening, we will have a survival or stress reaction.

And here’s how that works. So when a threat is near, our senses will pick up on it. Our eyes, ears, nose and even skin take in information from the world around us and start to signal some kind of sense of danger. For example, if we notice that there’s a fire that’s starting in the kitchen, we’ll see the fire. We might hear the sound, We might smell smoke. Our skin might start to feel warm because there’s heat coming from the fire. So all of this information is going to tell us something needs to be attended to. There’s something happening here. We might be in danger. So these sensations then become registered by a part of the brain called the thalamus that’s inside the limbic brain. The thalamus acts as the brain’s cook. It takes in all the ingredients that your senses just gathered, and it turns it into an autobiographical soup. So an integrated or coherent narrative or story of the experience that’s happening to us. So in other words, our body will start to have the understanding that this is what’s happening to me in this moment. These body sensations or these feelings are then passed on and actually passed down into a part of the brain called the amygdala. So this is deep in there, unconscious limbic part of the brain. This happens really fast. Those messages getting passed from the thalamus to the amygdala happens very, very fast. And then when the amygdala receives that information, it really signals danger loudly, like a fire alarm. This fire alarm signals our body to kick into survival mode, and we’ll have what we call the fight or flight response. So actually, it’s more complete Name is fight flight or freeze response, because we go into either fight flight or freeze when we are in some kind of life threatening or dangerous situation. What happens during this response in our bodies in with fight or flight is our heart rate starts to increase. Our breathing starts to speed up. Our bodies will release stress hormones called adrenaline and cortisol. Our pupils will dilate so that our vision can become sharper and we can pay attention to what we need to pay attention to so we stay safe. Our digestive system slows down, and this is actually really to help us so that we don’t need to eat, we don’t feel hungry. We can really just focus on staying safe. Blood gets pumped to our muscles, mostly our arms and legs, so that we can fight harder if we need to or run faster. So all of this happens in order to get our bodies ready to keep us safe by either fighting whatever the danger is, or fleeing and running away. So we can also have a freeze response. And this is almost like you can think of it sort of like playing dead. So our bodies will stop moving to stop trying essentially to to not draw attention to ourselves. That doesn’t mean our bodies aren’t experiencing the internal stress and that threat response internally, but we are not showing it on the outside. And this is a way to seem like we are not a threat to whatever is happening outside of us. It can also sometimes be almost like a full shut down response. So sometimes when people experience this freeze response, they will actually faint.

Other people might experience that as really a disconnection from their body. And actually almost like they can’t feel anything in their bodies when this is happening. So a good example of the freeze response is a client of mine who is on the autism spectrum. And what happens with with this client is that sometimes when their brain and body starts to think that they’re about to say something that will cause them or someone else some kind of harm or maybe embarrassment, they actually become unable to speak in sessions. They’ll almost literally go mute and freeze. And this happens quite a bit for this client. And this can also happen often if there’s some kind of change in their daily schedule or they become overstimulated by loud noises or bright lights, they will really just go into this freeze response. They almost don’t hear what’s being said to them. And it can take a little bit of time for them to start to feel safe enough to come out of that freeze response and speak and sometimes even realize that that that it’s happened and sometimes it takes them a little time to come back to the present moment.

So this is an example of how this might show up for somebody with a disability in this typical or non traumatic stress reaction. First, the amygdala sends signals to kick off that fight flight or freeze response. And then what happens is a few milliseconds later, the sensations are also sent upwards in the brain to the frontal lobe, which is where the prefrontal cortex is. So the frontal lobe or the thinking brain is kind of like the watchtower, observing everything from up high. So as long as you’re not too upset by the situation or the event, the frontal lobe can make sense of what’s happening and can help you make a decision about how to escape danger. And what will happen then is that you’ll be able to store that memory as an experience that you can remember and tell to other people. So it’s a story that you’ll be able to explain with a beginning, a middle and an end. So it all kind of makes sense in your frontal lobe, and the prefrontal cortex helps you to make sense of that life threatening experience or that scary experience that you just went through. So something important to note that I also mentioned a little bit earlier is that this frontal lobe, part of the brain is also the area that’s most impacted by intellectual disabilities or neuro divergences like autism or ADHD. And at this point, we don’t have a lot of research to help us understand all the similarities and differences between trauma and neurodevelopmental disorders. But we do have some idea that the frontal lobe in the prefrontal cortex is an important piece of the puzzle. So I just want to make sure to name that so that you understand that there’s some overlap there.

Okay. So to summarize, if we have a scary moment, but our prefrontal cortex is able to stay online and help us to understand what’s happening and make sense of it with language and memories, we will actually be able to go back to feeling calm and safe after the event and after the danger has gone away. And what will happen is will actually be able to tell other people what happened without feeling too much distress. We might still feel a little bit anxious and stressed telling other people about what happened to us. But we will actually be able to talk about that event becoming completely overwhelmed. So essentially the danger is over and we can go back to what we’re doing. But what about when the prefrontal cortex isn’t given a chance to make sense of the experience? So this happens when the amygdala keeps sending out that alarm signal, sometimes long after the threat or danger has gone away with that fire alarm still going off, we’re going to stay in a state of fear. Our bodies will stay what we call activated. And our prefrontal cortex never really a chance to come online. So when this happens, the traumatic stress stays in the body and danger will seem like it’s still everywhere.So if think you about it, if you do have that kitchen fire like I was talking about earlier and you put it out, but the fire alarm in your house is still going off. You’ll probably keep searching the house maybe for more smoke and flames. You’ll wonder why is this fire alarm still going off? There must be a fire somewhere. Is smoke still coming from somewhere? And you probably won’t be able to rest until that alarm stops blaring until it shuts off. So when this happens in our brains and bodies, we might think that we’re making good decisions. But because we’re still acting from emotional brain, in reality, we’re making choices or our bodies are kind of moving in ways that are still based in that fight or flight survival response.

So I’ll offer and share a personal example of this and how we’re still operating from emotional brain, even though the traumatic event has has ended. So this person an example is that I injured my back. I herniated a desk a couple of times, actually two times in the last two years. So the second time was actually a re-injury of the first time, but it ended up actually causing much more compression on the nerve that runs from my lower back all the way down my right leg. So this actually led to so much pain that I wasn’t able to stand up on my own for a couple of days and I actually couldn’t really walk well or move around much for about six weeks. And it took many months actually to be able to function again and move around without constant pain. What’s important with this is that both times that I injured my back were cause this was caused by movements that I did during a yoga class. So it’s about one year later now. I am able to run again and I’m actually training for a 10 K race, but I still have trouble returning to yoga and yoga movements. So my physiotherapists keep telling me that I’m physically able to do yoga, but my emotional mind and my emotional brain is having a hard time the guard down so I can feel myself kind of tensing up and getting a little bit nervous. Any time I do a stretch that feels similar to movements that cause the injury. So with this example, what I wanted to highlight is that even though the threat is over, my body is back to a place where I probably could do yoga. My emotional brain is still firing those signals, saying “Danger, watch out, don’t do this.” So when we stay in emotional brain like this, it causes the thalamus to break down. So the thalamus can no longer filter the sensory information that that it took in in a helpful way, rather than head up to the frontal lobe and become a story that we can make sense of, he traumatic event actually stays in the limbic brain as a kind of series of disconnected or separate sensory fragments. This might be images, sounds or even physical sensations in the body.

So it becomes these kind of fragmented pieces and not something that kind of makes sense as a whole. So these sensory fragments can also come with intense emotions. Usually those emotions are terror or helplessness. So the next time that we see, hear, smell, even taste something that’s the same or reminiscent of the original threat, we’ll experience what we call a flashback. So any sensory trigger can cause a person to re-experience the trauma without warning. So what’s important to remember is that a flashback is not a cognitive or thought based memory. Instead, it’s a sensory experience that takes us right back into the traumatic event. So we’ll actually experience the sensations and the emotions exactly as we did when the event happened. So, for example, if there was a song playing on the radio while you experienced a serious car accident, months or even years later, you could be walking through the grocery store, the mall over at somebody’s house and hear that song come on, and all of a sudden you might be transported back to the car crash as if it’s actually happening to you again right there in that moment. So without warning, what might happen is you can lose your sense of time and place. You feel maybe even some of the same sensations, some of the same emotions that happened at that time. That’s the flashback. So it’s not a memory that you can make sense of. It’s your body almost re-experiencing the sensory information in the senses that you experienced and the emotions that you experienced when the event happened.

Okay. So let’s talk a little bit now, in a bit more detail, of what actually happens when we experience trauma and how does it really changed our brain and what are some of the maybe sort of almost signs and symptoms that we might see in someone who has experienced trauma? So when trauma doesn’t get digested or metabolized by the frontal lobe, it stays at the level of the brain stem and the limbic brain. It’s really going to impact the housekeeping functions like we talked about earlier. So we might experience insomnia or we might actually sleep more than we normally do if we’ve experienced a traumatic event and we have that traumatic stress in our bodies. We might feel much more or much less hungry than we usually do. Our breathing can start to become more shallow or quit, not just in a specific moment, but all the time. So actually what happens is a lot of people who have experienced either a traumatic event or more of that chronic repetitive trauma will actually tell you that they have a really hard time taking a deep breath. So they always kind of breathe in a more shallow way from from up here. Trauma can also cause a more constant state of muscle constriction and fear. So if you think about that fight or flight or even freeze response, we’re going to be tightening everything so that we can stay safe. What happens if we experience trauma is that our muscles never feel like they can relax. So we stay in a constant kind of state of constriction and tight muscles. The brain’s timekeeper also goes offline when we experience trauma, so we might actually have a really hard time making sense of time, almost as if there’s no difference between past, present and future.

So if you think about the flashback explanation that I was giving to you just a moment ago when the flashbacks happen, it’s really hard for somebody to understand, is this happening right now, in this moment? Was this something that happened in the past? So there’s almost no difference between past, present and future for a lot of people when they experience trauma. So although we still don’t know if this is exactly the same mechanism, this difficulty keeping time or knowing what time somebody is in is actually kind of similar to something that’s called time blindness that people with ADHD experience. So for people with ADHD, time sometimes often is not past, present and future, but it’s typically experienced as either now or not now. So this is why planning and organizing can be so difficult for people with ADHD and why they so often procrastinate and can only get things done at the last minute because it’s really the things aren’t even thought about until they have to happen right now. So people with trauma will often experience time in kind of a similar way.

So to give you an example of what this looks like in real time, I’m going to show you a short video clip from a movie called “Soldier”. So in this science fiction movie, the main character is a soldier who was selected and trained from birth to kill other people while feeling no emotion. So you can imagine that in this training process, he was exposed to some pretty significant trauma from a very early age.I’ll play the clip, and before I do, I encourage you to take out a piece of paper and write down here. As we go through the video, you can write down your reflections and pick whatever you pick up on as you watch the video. So specifically, I want you to pay attention for signs of like the things that we just talked about.So see if you can pick out examples of this character from the movie being in two times or two places at once. See if you can pick out instances of him not feeling fully present in the moment. See if you can notice examples of him being triggered by sensory information and see if you can pick out examples of flashbacks or those sensory fragments that we talked about earlier. And if you need to pause the video and go back and review those those four points, please do so. And we’ll play the video now.

[VIDEO PLAYS]

Dr. Emily Kerner

Okay. So take a moment if you haven’t already, just to jot down a couple of things that you might have noticed in this video that highlight some of the ways that trauma might have affected this person. So as you probably noticed, he shows kind of very little range of emotion. His body looks stiff for a lot of this clip and he’s pretty easily brought back into a past experience. So when that clown kind of character jumps right in his face, it triggers this response where all of a sudden he’s hearing sounds that are not happening at this party. We can hear the helicopter, we see the flashes of the fire in the flashes of these other kind of visual senses and things that are happening. We can have the sense that he’s really easily brought right back into that past experience. And you can see him stand up and look around as if he’s not quite sure what’s happening in this party or what might be happening behind him. So it’s the sense that he’s at this party, but there’s also a sense that he might be somewhere else as well. So it’s almost like time for him is both slowing down and then speeding up so we can see a few examples of that. And the noises and sights almost seem louder and brighter for him as well. So these are some examples of trauma or traumatic stress reactions.

So that was the overview of how trauma happens and what it does to the brain. But how does all of this relate to disabilities and neurodevelopmental disorders? Well, trauma that is experienced during childhood while the brain and body is still very rapidly developing can actually have a pretty huge impact on how that development unfolds. So as we heard in the in the video earlier today, the first video with Dr. Nadine Burke Harris, there was a study done in the mid to late nineties that discovered that traumatic events that occur in childhood can have really big impacts on a person’s health and well-being. And these traumatic events are what we call Adverse Childhood Experiences or ACEs. So ACEs can really disrupt neurodevelopment or the way that the brain develops during childhood. So the major categories of ACEs are emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, a mother being treated violently in the home and a child witnessing that. Someone in the household struggling with substance abuse, someone in the household struggling with a mental illness, parental separation or a divorce of parents or a household family member, someone who lives in the home or who did live in the home being incarcerated or in prison. At the bottom of the slide here, there’s a link to more information about the ACE study, as well as a lot of the research that’s come out of that. So if you are interested in learning more about ACEs and the study and even taking the ACE questionnaire yourself or accessing it for your work, this is the link that you can follow and you can actually go through it, take the the ACE questionnaire and find out a little bit more about your own ace history if you’re interested. So in addition to causing a whole host of risks for medical or physical illnesses, ACES can also lead to developmental delays that look a lot like developmental disorders. So a developmental delay. Firstly, just to define that so that that’s clear for you is typically identified when a child is not meeting the expected developmental milestones in one of the following areas.

So in physical development, social development, emotional development, intellectual development, speech and language and adaptive development. So what’s important to note is that developmental delays are not always or not only caused by developmental disorders, but delays can also be caused by trauma. And what’s really important to know is that delays that are caused by trauma can be improved or even reversed if we treat the trauma early enough. So some other important pieces of understanding about developmental delays is that this is when a child is performing at 25 or 30% below what’s expected of their age. And so we want to pay attention to if a child is really struggling to develop in some way. But we also want to understand if this is a delay and something that may actually be caused by trauma or some adverse childhood experiences and can maybe be reversed or improved, or is this something that is a bit more chronic and severe which would then be considered developmental disorder? So a developmental disorder, by contrast, causes impairment or symptoms that will continue throughout a person’s life and are ones that can’t be reversed. So it’s chronic and severe, will typically see this impairment by the age of 22. And like I said, it’s likely to continue. These symptoms are likely to continue throughout the lifespan of the person and they will cause limitations in three or more major areas of life activity. So for example, in daily functioning, in social interactions, language development, so these are really symptoms that are chronic or longstanding and we can intervene and improve the functioning or life experience of a person with a developmental disorder. For example, we can help them learn social skills or even how to communicate using language if that’s something that they struggle with, if that is something they’re not able to develop, we might be able to help them use other tools to communicate, but we won’t be able to cure them of the delays that the disorder causes and we won’t be able to reverse the delays, but we can support them.

So if you take a look here, there’s an image here that compares and shows you the differences between a healthy developing brain and the brain of a child who’s experienced some pretty significant abuse. So I want to show this to you so that we can understand a little bit more about how trauma impacts brain and brain development. So in what you can see here is the healthy brain compared to the brain of a Romanian orphan who was institutionalized, raised right after birth and didn’t receive the physical touch and emotional attention that they would have needed to develop healthy relationships, healthy attachments to people. So you can see that in the healthy brain, there’s a number of areas in the brain that are active. So the active parts are going to be the ones that are darker in colour, more red and orange. So you can see, especially at the front of the brain there, there’s quite a bit of activity happening and. Therefore, these are the areas that are really able to grow and develop. There’s lots of activity, lots of things happening there. If you compare this to the image of the abused brain, there’s much less activity happening, especially in the temporal lobes. So you can see where the temporal lobes are, where there’s the the circles, the white circles that compare , so a lot more activity in the healthy brain compared to actually almost none in the brain of the abused child. So this is really the area of the brain, actually the temporal lobes that manages emotion and receives information from our senses. So likely the child on the right, the the one who has been abused and hasn’t received the attention that they need is going to be suffering from some cognitive and emotional deficits as this part of their brain hasn’t really developed or has failed to develop because of the experiences that they’ve lived through.

So what does this maybe look like in practice or what does this look like, something that we might be able to observe? When trauma occurs during these key developmental stages, the task that that child should develop at that age is going to be affected. So, for instance, we might see that a nine month old who should be smiling and playing peekaboo with mom or dad is not engaging with the adult with mom and dad at all, and maybe instead is just sort of sitting still on the mat. This might look like the 15 month old who developmental these should be meeting the milestone of showing another person affection and showing mom and dad affection but doesn’t do this and instead maybe push his mom or dad away. Cries screams. If mom or dad gets too close or any adult gets too close, or maybe they actually ignore and somebody who’s sitting next to them. And almost as if they don’t realize that they’re there, they’re just not interested. This might also look like an 18 month old who’s living an abusive household and doesn’t point to or show mom or dad something interesting when this is something that they should be able to do at that time. Maybe this is happening because that child didn’t learn this because they felt that if they did point at something or they did try to get mom or dad’s attention, they would be hit or ignored or yelled at. So what might happen if this is what they’re experiencing, is that their brain kind of learns to shut down. And so they may actually start to not find things outside of them to be very interesting. And if that child has really been held or played with their motor skills, might not develop to the point where they can actually point to something or pick up something in the way that we might expect them to.

So if we don’t know that the children that I just described have significant ACE histories, you might start wondering if they’re showing early signs of a disability like autism, for example, how that affects their social interactions, their motor skills or their speech. So this again, is a major reason why understanding trauma is so important when we’re working with disabilities. If we assume that all delays are caused by a developmental disorder, we might end up missing key opportunities to reduce the traumatic stress in a child’s environment and also the traumatic stress that they’re feeling in their bodies that would actually then allow them to start developing normally. On the other hand, if we assume that all delays are caused by trauma, we might miss the signs of an underlying disorder. If we catch that disorder early enough and start putting the right supports place, we can actually help that child more and reduce their risk of experiencing other traumas that may be caused by living with their disorder. SO understanding what’s causing the delays is really important so that we can intervene and support the child in the ways that are going to be most helpful to them.

So that brings us to our next section. And this is a good time. If you feel like you are needing a little bit of a break, this would be a great time to take one so you can pause the video, take ten or 15 minutes to move around, get a snack, take care of yourself, whatever you might feel that you need and take as long as you need. And then we’ll see you when you return. We’re back. Hopefully you feel rested and ready to keep going after taking a little bit of a break. So before the break, we talked about how trauma can affect development and lead to delays that might look a lot like a disability. But living with a disability can also be its own source of trauma. So that’s the next question that we’re going to explore together is what does trauma look like in a person with a disability? So again, our short answer, we’ll start with that. Our short answer to that question is trauma looks like emotional or behavioural problems. It can cause a whole host new behaviours that can be hard to understand for somebody observing them. And it can actually be really hard for the person to see or even tell you about when it’s happening to them. So firstly, as I touched on earlier, I just want to review some of the ways that people with disabilities might be at greater risk for trauma or might experience certain types of trauma compared to people without disabilities, individuals with disabilities are a greater risk of exposure to trauma, so they’re more likely to be victims of crimes, more likely to be sexually and physically abused, more likely to experience poor care, social rejection and exclusion.

Maybe get a lack of attention from parents, teachers or other people in their lives who are supposed to be caregivers. And often what happens with for people with disabilities is that they get viewed as different or even weird. And so we can imagine that if this is someone’s experience, then they are being exposed to traumatic events and may be experiencing quite a bit of traumatic stress throughout their daily lives. People with neurodevelopmental disabilities can also experience a lot of difficulty with communicating and a lot of language barriers. So for example, a person with autism or another intellectual disability may not be able to tell you if they’re feeling scared or uncomfortable or in danger. And so they may also struggle to communicate if they have been harmed. And if that’s the case, then that actually increases their risk of being harmed again. So when someone is not getting the support that they need after experiencing something traumatic, they are actually more vulnerable to and more likely to experience trauma again in the future. Although most of what we’re talking about today is really related to the intellectual disabilities and neurodevelopmental disorders, I do just want to mention that if somebody does have a physical disability, that can also lead to additional trauma for that person. So they may need to seek a lot of medical consultations or have repeated medical procedures, maybe be hospitalized and may have to meet a lot of different doctors or professionals, be asked a lot of different questions, maybe uncomfortable questions. And this can also obviously be the case for somebody who has to go through neuropsychological assessments and through a process of getting diagnosed with a neurodevelopmental disorder. They will have to meet lots of different people, talk about their experiences, and this can be really uncomfortable. So this can be this experience can be really disruptive as well as actually scary, especially for young children. If they have to see and meet lots of adults who are asking them difficult questions. Some children with disabilities may end up in foster care or have nurses or aides who help them in or around them quite a bit. Sometimes these caregivers may be kind of rough with the child, especially if the care, if the nurse or the aides or the caregivers are frustrated or overworked themselves. And it can also be really hard for kids if they have caregivers who change, often, as in they come for six months and then they leave. And then the child has to adjust to a totally new person helping them out. And this can be especially difficult for kids with autism because change and creating new relationships can be incredibly difficult and overwhelming. And just those transitions can cause a lot of stress. People, especially children with disabilities, often aren’t believed when they disclose a traumatic event. So, so often our perception of someone with a disability is that they can’t comprehend things as well, or that their comprehension is limited. Sometimes this is the case, sometimes it’s not. But even if it is, and they do struggle to comprehend or even to explain and use language to tell us about what’s happening, their bodies are still registering the trauma like we talked about earlier. So that trauma still does get stored in the body and the emotional brain. So even if someone has little comprehension, it doesn’t mean that they’re not aware in some way that a trauma has happened to them.

They may not be able to think about it or tell you about it, but their body knows that it happened. So a person’s body will always show signs of trauma if the signs are there. So this might be a stiffening of the muscles around specific people, maybe less eye contact than usual or maybe even more frequent or aggressive outbursts of anger or aggressive outbursts or displays of anger. So those are some things that we really want to look for that might tell us that somebody has experienced trauma, especially if they’re not able to tell us about it. So some other specific things to watch for. If we’re looking for signs of trauma in somebody with a developmental disorder or and a disability is specifically changes in behavior, some of the things that we might notice are more aggression from that person than usual. Or maybe it’s the opposite. Maybe it’s them withdrawing or isolating more. It could also be things like them being more irritable, having a shorter temper, being more likely to react quickly with anger or frustration. And so if these are things that the person has already been experiencing or already been showing you because it’s part of their disability, for example, what we’d want to look for is are there changes in this behavior? Are we seeing more aggression than we were seeing before or aggression more often or all of a sudden? Is this person withdrawing all the time and they never want to leave their room or they they all of a sudden don’t want to go into school when school was a place that they had an easy time going into before. Maybe there’s a person that they all of a sudden don’t want to see anymore or they get really scared when they see that person. So we want to see and look for changes in behaviour. A person with a disability who’s experienced trauma might also show some physical complaints. So things like headaches, maybe stomachaches, changes in appetite. Sometimes what can happen is that children will start to experience more nightmares if they’ve had some kind of traumatic event happen to them.

And so we want to pay attention again to are these things new to somebody all of a sudden have more headaches? And often for kids, they’re not able to even tell you exactly what is happening in their body. But they might just say, my tummy hurts or my head hurts. They’re not always able to describe it exactly, but we want to kind of pay attention. Are they all of a sudden feeling more yucky in their body or just not as not as physically? Well, some other things to notice and look for would be changes in how the person is playing. So we might notice more trauma themes in how they play or even more repetitive play. So the same theme or the same thing over and over. So this can be typical of kids with autism that they that they do sort of a lot of repetitive play already. So we might want to look. Is there a different way that they’re doing that repetitive play? Is it about something different? Are things banging into each other more than they might have been before? Is there more aggression? Is there more fear in some way that’s coming out of the the themes that this person is is playing? Something else to look for would be a loss of skills. So this would be, for example, if somebody was able to dress themselves before and now all of a sudden can’t or they really struggle with that or they just don’t want to. That might be some examples of losing some of the skills in their daily functioning. We want to look also is there a loss of social skills. So even if somebody really struggled with social skills before, but all of a sudden they’re no longer able to use some of those new tools that they’d built up or some of the new ways that they were starting to ask people questions to get to know them. If we find that somebody did have those ways of trying to connect with someone before and all of a sudden they’re saying to you, I don’t know how to talk to people, I don’t know what to do, or you just notice them freeze in social situations. So that would be an example of loss of some of those skills.

Maybe somebody actually shows a loss of motor skills, so they become a little bit clumsier if they can’t move their physical bodies as well as they were able to before. So again, we’re looking for a loss of the skills or a change in how somebody was functioning before. Maybe there’s new communication difficulties. So again, even if somebody struggled to communicate in certain ways before, now we’ll see them struggling even with the ways that they were able to communicate. So a loss of some communication skills. And lastly, we want to pay attention and see if there’s any signs of any cognitive changes. So more forgetfulness than usual, more confusion, more disorganization. So I want to again compare the person to what we were seeing before. And if all of a sudden we’re seeing more of this, more forgetfulness, more memory difficulties, more disorganization, and those might be signs that somebody has experienced something traumatic or is experiencing a lot of traumatic stress in that period of their have their life.

Okay. So we’ll now look at a few examples, few video examples of a non-verbal autistic teenager to help take a look at and pick out that fight flight or freeze response that we talked about earlier in the presentation today. So the goal in watching these videos is really to better understand what a traumatic stress response might look like in a person with a neurodevelopmental disorder. So obviously a stress response might look completely different in a person with autism versus one with ADHD versus one with FSD. So obviously we we understand that those things might looks differently. There will actually be some future trainings dedicated to trauma and some of these specific disabilities. But today I’m just using this this example of autism as a way to understand a little bit of what the stress response might look like in someone a disability. So this is just an example. We’re using autism as an example just for for this presentation today. So also, I just want to mention before we watch this video, that it is a video of not, like I said, a non-verbal autistic teenager and his mother. You don’t see the mother on the video, but you can hear her. And so I do want to point out that the video is not to criticize.

The point of watching the video is not to criticize mom, but to understand that fight flight, freeze response. And so we will discuss this a little bit more in in a moment. But you’ll see that mom is actually feeling some pretty strong emotions in the situation. She’s feeling frustrated and she she is doing her best. So we want to understand that and and not blame mom or not criticize her. But we do want to understand a little bit of the interaction between mom and her son. So as you watch this video, I want you to look for any fight or flight behaviors. So some questions to think about is what triggers this response in the the teenager, his name is Kreed. So what triggers this response in Kreed? What do you think he might be feeling? I also want you to pay attention to what you think mom could have done differently. Maybe what signs of his body language did she miss? So take a few minutes. You can pause the video and write down your observations. Pause the video as as much as you need us. As you go through and see what you can pull out.

[VIDEO STARTS]
https://www.youtube.com/watch?v=W_HuUPUF8Hk

Kreed’s Mother

You just had your last snack. Listen to me and it is near bedtime and you listen to me. Kreed. That’s not how we act. You need to try again. You need to try again. You do. You need to try again. Listen to me. Look, look at the clock. It’s 11:39. It is almost midnight. It is near bedtime. So you asked me for one last shower by lifting your shirt. You need to tell me.

Kreed
I need to wash up.

Kreed’s Mother

Sure you can wash up. Sure. I’m not saying that. So what do you say? Kreed? Kreed?

[VIDEO ENDS]

Dr. Emily Kerner

So take a moment. And if you haven’t done this already, just jot down a couple of observations, any fight or flight behaviours that you saw. What do you think Kreed might have been feeling during this video? If you are watching this in a group, you can take a few moments and have a discussion, see what other people have noticed as well.

So some things to pay attention to. So did you notice that Kreed’s behaviour indicated some fear and some frustration? His his voice went up. He started to his body tensed up a little bit more. He actually ran away a little bit, started hitting himself. And so I suspect that he didn’t want to act in this way, but was actually probably fearful, maybe even overstimulated. It’s also important to to note I forgot to mention this earlier that this video was also quite late at night. So he was probably quite overstimulated by a full day already. But he did react with some anger, frustration, running away, hitting himself. So these might be some examples of that kind of build up of stress and a bit of a traumatic stress response in his body. And you can hear mom’s tone of voice is also pretty frustrated and harsh. And so this might have also escalated on how Kreed was feeling. And as Kreed starts to run away and get more frustrated, Mom was probably getting more frustrated as well. So we can kind of see that they’re escalating each other’s stress levels. And so you can think about to what signs did did mom miss and was there a way that she could have interacted with him differently if she had been able to settle her own body and feel more relaxed? Maybe she could have stepped back and, just let him have the reaction that he was having rather than continually asking him to respond. Those might be some examples of how she could have helped decrease some of that stress. But again, we’re not here to criticize her. We can understand this is probably a very frustrating and difficult exchange for her as well.

So here’s another clip. The same the same two people in the same event, essentially the same the same time, but a couple of minutes later. So this time I want you to pay attention to how mom speaks to Kreed. So listen to her tone of voice and just pay attention to what do you think she’s what do you think her tone of voice is communicating and how do you think Kreed is feeling? How would you feel listening to her? Would you feel emotionally safe or unsafe if you were Kreed? And again, what if you were mom? You can think about how she might be feeling. So if you need again, you can pause the video and take a few minutes to write down your answers to these questions. After you’ve watched some of it.

[VIDEO STARTS]
https://www.youtube.com/watch?v=W_HuUPUF8Hk

Kreed’s Mother

You did. You threw stuff. You acted like that. You threw yourself on the floor. You bit yourself when you do those things, you don’t get the things that you want. So instead of a shower, you’re just going to go straight to bed. Okay? Okay. Okay. Now what did I say? Do you get a shower? No, you can’t do anything because you already did.

Kreed

What can I do?

Kreed’s Mother

So you say No, No, you don’t get a shower. That’s right. No. Instead you’re going to go straight to bed. It is bedtime. So I want you to go downstairs. Okay? And we’re going to head to bed. I’ll be down there in a minute. I will be down there in a minute.

[VIDEO ENDS]

Dr. Emily Kerner

So you probably picked up on and noticed Mom’s kind of harsh, critical tone. Likely this would have caused Kreed’s amygdala to keep signalling danger. What we actually see in his body language, in his behaviour, is he kind of shuts down a little bit. He gets a little bit quieter, looks like he’s kind of disengaging and shutting down. So what do you think a safer tone of voice would sound like to basically how else do you think mom could speak to Kreed that might help calm his fear instead of triggering it? That might calm him instead of triggering to kind of distance and disengage and actually have more of that almost freeze response. So take a moment and think about that.

Yeah. So had Mom had a softer tone of voice, had she been able to settle herself enough to ask him questions, maybe or to him kind of in this tone that I’m speaking now, likely we wouldn’t see him disengaging and having more of that freeze kind of reaction. So remember, as I said before, we’re not here to criticize mom, but really to understand what happens when everyone’s emotions are running high. So we can probably guess that, mom, maybe was in her own fight or flight response, her own overwhelmed kind of place. So she may have actually been acting from her emotional brain to, as I said before, she probably really could have used some help to settle her own body, the activate her own nervous system and some support for her would have been really helpful. And so probably what’s happening here is that both of them are acting from emotional brain and just kind of heightening the emotions and escalating things quite a bit. So the point of taking a look at this is both to understand what the stress response and that traumatic stress response might look like in someone with a disability and to start thinking about what might de-escalate a situation that helps, that can help then everyone to feel safer, calmer and actually more able to connect.

Which brings us to our final question for the day. What can you do to support trauma healing? So the short answer to this is the trauma heals in safe and trusting relationships. So essentially being trauma informed and focusing on building connection and safety for the people that we’re working with is a really important part of healing trauma and helping people to feel more safe.

Okay, so how do we do this? So one of the ways that we can do this is actually by starting to understand person’s trauma and understand if they’ve experienced trauma. So we want to screen for trauma. We want to understand if there is actually trauma in the person’s childhood or even trauma that’s happening to them currently in their present experience. Something really important to remember when we’re talking about trauma and working from a trauma informed approach is never to ask somebody or even to think about somebody’s behaviour in terms of what’s wrong with you, what’s wrong with them. We really want to ask the question instead, “What happened to you?” When we ask “What’s wrong with you?” We actually essentially assume that the person is responsible for what happened to them and that they should be able to use thinking brain at times when actually their emotional or limbic brain has taken over. So really, it’s actually not fair to ask the question, “What’s wrong with you?” And that person may not be able to manage or change their behaviour in any way because this part of their brain that they’re not able to manage and be in control of is what’s causing them to act in these ways. And it can be really stigmatizing to blame somebody for how they’re acting. If it’s coming from traumatic stress. So we always want to ask that question, “What happened to you?” That helps us see the bigger picture and to understand more about what somebody might be experiencing, why they’re acting that, the way of why they’re acting, the way they’re acting. So I was mentioning earlier the ACE study and the ACE questionnaire that you can actually take there’s a link again here to that ACE questionnaire. And this is something that you can actually use to understand more about whether or not someone has experienced trauma. So I’ve here adapted some of the questions from the ACE questionnaire to be a little bit easier to ask people and to find out about their trauma and to do it in a way that helps people feel a little bit more comfortable to tell you about what they might have experienced.

So these are some ways that that I might change the actual ACE questionnaire questions so that they’re a little bit comfortable, maybe even for you to ask somebody. So I won’t go through all of them. You can take a look at the slides and pause if you need to, and read some of them yourself. I’ll just pick out a couple of examples to demonstrate to you how you might be able to find out about or ask about some of these aces with people that you might be working with.

So for example, if we want to know more about whether or not somebody has experienced physical abuse at home, we might ask “How would your parents or caregivers discipline you if you did something wrong?” Or if this is happening currently, we want to know if it’s happening currently we can say “How do your parents or caregivers discipline you if you do something wrong?”

An example of emotional neglect might be a question like “Did you ever feel that no one in your family thought you were important?”Pick out one more. An example of finding out, wanting to find out if somebody in that person’s house is struggling with substance abuse. We can ask, “Was anyone or is there anyone in your household who drank too much or who drinks too much?”

So these are some ways that we can start to understand and ask for screen for whether or not somebody is experiencing trauma or an adverse childhood experience. So as you may have experienced or you may already know, many autistic clients or someone with maybe lower comprehension might actually become overwhelmed by emotion. If we ask some of these. So if it’s a person who that might be the case for, or they might actually struggle to verbalize their answers to you, we can have somebody else help answer these questions. So it may be a parent or another adult who’s supportive and has a positive relationship with the child. So obviously, if the trauma is happening in the home and it’s being caused by one of the parents, that may not be the best person to ask some of these questions from. But there might be a teacher or somebody else, an aunt and uncle, somebody else in that child’s life who can answer some of these questions and help understand a bit more the child’s experience. You can also access maybe the medical file or talk to a social worker or a counsellor who may already know the person. That’s kind of a first. A good line practice. If if the person themselves is not able to or not willing to answer some of these questions. If you can ask the person directly, that’s probably the best place to start. And then you have these other options. If that becomes more challenging or something else, if you really don’t have somebody directly that you can ask these questions to, you can also look for some signs or noticeable signs of whether or not any of these things might be happening at home or in a person’s life. But if they are able to sit with you and answer those questions, you can try some of these different questions that I have here.

So a second way that we can actually become a safer person for someone who has experienced trauma is to learn how to be present ourselves. So to calm our own nervous system so we can help somebody else calm theirs as well. So we don’t want to override the nervous system. We don’t override what we might be feeling and try to get too quickly to the thinking brain. We want to be able to settle our own body so that the thinking brain can then come online. We can feel safer. The person sitting across from us can feel safer. And so it’s really about being present and practicing. Being present. So let’s talk about a couple of ways that we can do that. So one of the important ways that we can demonstrate that we’re present is to actually show that you care. And a couple of ways that we can do that are the following. So one important way that we can show someone we care is by giving them options. So when we’re working with a person who is on high alert and always in protection mode, it’s really helpful to give them options. This helps to increase their sense of safety.

So if you think about earlier in the presentation when we did that body map, I gave you a couple of different options for that. You can draw the person in any way that represented you. You could indicate how you were feeling using images or symbols or words. And so you can think about what helped you to feel a little bit safer, more comfortable to do that activity if it actually helped to feel like you wanted to do the activity because you could do it in your own way. Generally when we give people options and give them different choices, this they feel a lot more safe to be able to do whatever you are asking them to do or just to feel that you care. So one example of this from my own practice is the client that I was telling you about earlier who is on the autism spectrum. We figured this out. It took us quite a few sessions to figure this out, but when they draw in sessions, they are much more able to focus. They feel a lot less shut down. They feel a lot less anxious and and unsafe in sessions. And so I always give them the option to draw. They always have the option to figure out what they need to draw, what they want to draw. They take a few minutes at the start of every session to look on there and find something that they want to draw and giving them this place in this space to do things their own way has really helped for them to feel more safe in therapy sessions with me. Another really important way that we can show people that we care is to ask questions. So rather than assuming that we know why a person is acting a certain way or why they’re doing what they’re doing is to find out more. Ask questions, show them that you’re interested, and that you want to understand things from their perspective rather than deciding in advance you think is going on for them. It’s important to be consistent.This is another way that we show that we care. So people who have trauma and people with disabilities really thrive on structure and consistency. Knowing what will come next and what to expect really creates a sense of safety and a sense of control. So we really want to be consistent and this shows that we care. Finally, if you’re reliable and you do what you say, you really help build trust with your client. Again, this helps them to feel safe with you. When people feel safe, their thinking brain can come back online. Obviously, if they’re thinking brain is more online and they feel safe, they’re more able to cooperate, they’re going to be participating in what you’re doing with them. They’re going to feel like it’s okay and safe to engage with you.

So really do what you say. If you say you’re going to do something with them, follow through with it. So some important ways to communicate that you care just summarize are lots of repetition, making sure that you’re being consistent, predictable, and reliable. And then another piece that we’ll move into talking about next is being really settled in your own body. This is another way to show that you care. So another person, even if they’re verbal language and comprehension, is impaired in some way by a disability, for example, their body can sense if the body seated across from them is settled or not. So we can use our own bodies to help other people and their bodies feel settled. So that’s what we’ll do now. Our bodies communicate so much about how we feel and what we can offer to someone else in that moment. And we’re working with someone who has trauma and someone who has a disability and trauma. We want to, as best we can, communicate that we are safe, that we’re open, that we’re interested and we’re caring. We can that with all the ways that I just described, we can also do that through our bodies.

So let’s explore together how to feel all of these things simply through how we hold and position ourselves. So now I’m just going to ask everybody to get out of your chairs can stand up, move, move a little bit. Shake. We’ve been sitting for a little bit of time, and as we’re just talking about, one of the ways that you can communicate that you are a safe person or to help somebody else feel safe is actually to get up and use your body and. So it’s important to experience what safety feels like in your own body so that you can communicate that to someone else. So we’re going to do a little bit of practice with this together and you can follow along and pay attention to me and just kind of mirror what I’m doing as well as watching the images that you can see. And we’re just going to copy those and use our body to express that. So if you take a look at the the picture on the left, it’s the girl kind of in this position. So she’s going to ask you to go in this position as you see, and just hold this for a moment and just notice what this feels like in your body as you do this. You can also look at me as I’m doing this and see what that communicates to you. So just take a moment and reflect. So think about that. What does that feel like in your body? Does that feel safe? Does that feel unsafe? Do you think somebody else would experience that as safe? Probably not. Right? When we’re like this, we’re in more of a defensive or fighting kind of stance. Well, probably not communicating so much safety to someone else. Okay. So let’s try the other one on the other side, the woman who’s standing sort of like this and just go into that position and see what is what does this communicate, do you think? What does this feel like? So you might feel dismissiveness maybe, or like you’re not paying attention, maybe in your own experience and not necessarily thinking about the person or even noticing if there’s somebody else in the room with you? So again, this is probably not going to communicate safety to another person; might feel good in your body if you kind of like to be in that more reflective place, but it’s not necessarily going to communicate safety to somebody who’s sitting across from you. So now we’ll just try something different and see what this feels like so you can grab your chair, you can take your chair again and just let’s mirror the the man in the centre picture here and just get into that position, lean forward back meters and just see how this feels in your body. You can also take a look at me sitting this way and again, see how this might feel for you if you were sitting across from me in a room. This probably feels more safe, right? This probably feels a little more open. Like you can talk to me. You can express things more versus if I am kind of in this position, right.

So holding our bodies with our shoulders open, leaning forward, these are always we can communicate to somebody that we’re listening, we’re there, We are understanding what they’re saying, or at least that we’re interested in what they’re saying. And this is a really way to use our bodies to communicate safety to someone. And also, as I was guiding you through this, pay attention to what felt safe in your own body. So there might actually be a different position that you feel safe in, that you feel comfortable in. And the more safe and comfortable and settled you are in your body, the more likely it is that somebody else is going to feel safe with you. So really, this is just an exploration of what feels safe. What do you think someone else would feel safe with and really using our bodies, communicate and create safety with someone else. So one important thing to note about using these different embodiment strategies is that you always want to ask the other person if they want to try them and to tell them that they can stop at any time. If they don’t like it, if they feel scared, if they feel fearful, if they feel uncomfortable if their body is just telling them know in some way stock, there’s no reason to keep going with it if somebody doesn’t feel safe and doesn’t feel comfortable.

So some of those strategies that we explored together, you can use those with your own clients or the people that you work with and teach them some of these strategies. If they don’t like it, it’s okay for them to stop. And one of the ways that you can recognize this, like we talked about earlier, is there is through their body posture, if they’re stiffening or constricting because of how you’re sitting or because of what they’re or how they’re holding their body, stop, move, shift positions, find another way to sit, help them sit in a different way that helps their body seem more relaxed. So another way that we can be present, that we can practice being present and settled in our own bodies is through breathing, is through managing our breath, paying attention to our breath. So what I’ll ask you to do while you’re sitting is just to take one hand and place it on your chest. Just like this here. And another one just lower down right around your belly button and you don’t have to change your breathing in any way. There’s nothing that you need to do differently, but just hold your hands here and notice what this feels like. Notice how you’re breathing, notice if one hand is moving more than the other. If they’re moving together, if they move at different rates. And while you’re doing this, you can just practice playing around with the amount of pressure that you place on your chest and belly with each of the hands. So you don’t want to press too hard or create too much discomfort or pressure, but just play around with pressing a little harder is half a little with both hands and just find the place, the amount of pressure that actually feels nice and good in your body, and once you find that, just settle in and breathe. If you want to close your eyes as you do this, please feel free to do so.If you’d prefer to keep them open as you have them now, just find a spot in front of you and you can just focus gently there, whatever feels most comfortable to you and just settle in eyes closed, eyes open and just breathe. And next, what I’ll ask you to do is just to notice the area under where your bottom hand and really on the next inhale. Pay attention to expanding that area of your body where that lower hand is. So you don’t want to push your belly out, but you do to think about expanding front and back side to side. If it helps, you can think about that area as a balloon that you’re blowing air into. And then as you exhale, you let some of that air out. You can imagine that there’s a strap or a belt tied around that part of your body not too tightly, just enough that you can feel when you expand your breathing into that belt or strap. And as you’re breathing out, you’re just loosening it just enough. And then again, inhale breathing into that belt or strap and exhale, letting it so you can do a few more breaths like that.

If you’re enjoying this and you want to keep doing this, you can just press a quick pause on the video and and keep going. If this feels like enough settling and breathing, then you can follow along with me and keep going. But before we do, just take a moment and notice how this feels in your body, what this feels like. What sensations are there? Do you feel more settled, more relaxed? Was this actually uncomfortable for you? Was there anything that didn’t feel good? So just notice that. Ideally this helps to helped you to settle just a little bit, and this is something that you can do any time of day to help settle your own body. This is something absolutely that you can do if you know you’re going to be interacting with another person who might have experienced trauma, someone with a disability for going into a situation where there might be heightened emotions.

This is a great way to practice settling our bodies before we have to enter into a stressful situation or situation where we know that we want someone else to feel safe with us, that when we’re settled, they can settle too. Okay, so another little exercise for us to try here. But before we do that, I just want you to take a look at these two images and see you can figure out what might be some differences between these two. So other than that, one is cooked and the other is not what else might be different. So you might have thought that one is kind of hard and straight, the other one is a little bit floppy and sort flexible, right? So if you look at the uncooked noodles, if you imagine bending them, they’re going to snap. Maybe even some pieces are going to fly off. And if you bend that cooked noodle, it’s pretty flexible, it’s bendy, it’s going to wiggle, it’s going to move, right? There’s more flexibility there. So one of the ways that we can bring more relaxation, less constriction into our bodies is to be like this flexible, wet noodle. So we’re going to do a very brief little exercise here just to get that feeling into our bodies. So as we do this, I just want you to think in your brain, wet noodle, you can bring up this image if you keep your eyes closed. Just picture that, that image of the wet noodle. And so we’re just going to do this really briefly. So again, you can just kind of settle into your chair, make sure that you are comfortable enough feet flat on the floor, body straight, and don’t worry about letting everything go. You’re not going to fall off your chair. And if you do, it’s okay, you will be able to get back up. But your bones and your skeleton are going to hold you up. And when I guide you to, I just want you to think wet noodle and to let everything go. Okay? So if you’re ready for a little, do this starting now, Think wet noodle. Let everything go in body All the muscles go for five, four, three, two, one. So hopefully you were able to let some of the muscles go there and just let go a little bit. If this was really hard for you, that’s no problem. That just means that you might need a little bit more practice with this. And one of the ways that you can do that is actually to practice constricting and tightening the muscles first and then relaxing and letting everything go. And that helps to feel the difference between tight muscles and relaxed muscles. So if this was a hard exercise for you, you can just keep practicing and get used to it by tensing and relaxing. And this is an exercise that I was introduced to by a training that I participated in that was run by someone named Eric Gentry. And this is something that he uses very quick, very brief exercise that’s a really excellent one to help clients manage the stress that comes up in their bodies when they’ve experienced trauma. But it’s also a really good one if you are working with other people to help relax and and let go so that they can feel safer and more comfortable with you and that you can feel relaxed and ready to receive whatever they bring.

So I’m going to show you a quick video. Do you remember Kreed, who we saw earlier? This is another video of him. And I want you to compare this video to the earlier ones that we watched. So some things that I want you to notice or pay attention to is how differently mom is speaking to him now versus how she was speaking to him earlier and notice his body language versus what his body language looked like in the other video, the earlier videos we watched. I think this demonstrates that mom has learned to be a bit of a safer person for Kreed. She’s less frustrated and she can guide him gently instead of with force. And so this video is actually one that comes later in his life and later in their relationship. And we can see, I think, that mom has learned how to manage her own stress a little bit better. And so see if you can pick out those things as well.

[VIDEO STARTS]
https://youtu.be/Wu-k9QHLrPk

Kreed’s Mother

You have autism, right? Okay, come here. I always confirm it. Do you have autism, yes or no?

Kreed

Yes.

Kreed’s Mother

Yes.

Kreed

Yes.

Kreed’s Mother

You do. Now, do you know that autism makes you not be able to speak with your mouth? Yes or no? Do you understand that? Yes or no?

Kreed

Yes.

Kreed’s Mother

Okay. Then let me ask you this. How does it make you feel not being able to talk out of your mouth? How does it make you feel?

Kreed

I’m sad.

Kreed’s Mother

It makes you sad to not be able to talk out of your mouth. How does it make you feel that you have your device that you can talk with? How does that make you feel?

Kreed

That’s sad.

Kreed

I am really happy. I am really happy.

Kreed’s Mother

How does it make you feel that you can talk with your device? Steady your hands please. Makes you feel…

Kreed

I am really happy.

Kreed’s Mother

I thought so. How does it make you feel when the doctors come in and they talk to me and Mom, but they don’t talk to you? How does that make you feel? How does that make you feel? Oh, go ahead.

Kreed

I hate it.

Kreed’s Mother

You hate it?

Kreed

I hate it.

Kreed’s Mother

I’m sorry. I’m sorry they do that. How does it make you feel when you have a nurse or somebody that does talk to you and ask your opinion? How does that make you feel?

Kreed

I love it.

Kreed’s Mother
You love it and you can talk. How does it make you feel when other people like teachers and stuff, don’t talk to you and they only talk to us. How does that make you feel? I can see it on your face. What makes you feel? So how does it make you feel and people ignore you.

Kreed

I’m mad.

Kreed’s Mother

It makes you mad. You should be mad about that. I will try to have your device out every time. Okay. And you say exactly what you want. How does it make you feel when when you can talk? When anybody comes in the room, how does that make you feel? Makes you feel?

Kreed

I am really happy.

Kreed’s Mother

Makes you feel happy?

Kreed

I am really happy.

Kreed’s Mother

Good. Good job, buddy.

[VIDEO ENDS]

Dr. Emily Kerner

So we hear mom being more encouraging here. Obviously, in this video it’s a different scenario. It’s a different setting, but it’s a good example of her asking him a lot of questions, right? She’s asking him how he feels. She’s asking him to tell her how she how he feels in different situations and different scenarios. And you can see there’s less sort of aggression in his body. There is fewer vocalizing. And he’s he’s able to use his voice to communicate, which I can imagine helps him and mom actually to feel a lot less frustrated. But mom also offers him quite a bit of empathy and she seems like she’s able to tune in and notice how he might be feeling or even to comment on what it’s like for when he has situations that he doesn’t feel good. And so we can see here it’s a contrast to what we were watching before. She’s more tuned into him. She’s showing in these different small but probably big, these small ways that have a big impact on him. She really cares. So a way that we can really help somebody to feel more safe around us and to simply we can help people heal from trauma is to help them to self-regulate. And this is really important for clients with disabilities and trauma. So this is again, about helping them feel safe and just right in their own bodies. So there is another training that is specifically on the sensory system and sensory awareness. And in that training we learned about people being on just right versus being too high or too low in terms of how they’re feeling in their bodies and their sensory system. So for clients with trauma and disabilities, when their sensory system is on high or low, they will be looking for safety. So this is the priority, not whatever might be happening around them. So we really want to help them get to that just right place and regulate their nervous system so that they can participate in whatever is happening.

So some ways to do that is you can have fidgets and other sensory toys that people that you’re working with can use sitting with you. You can let them play with these toys and feel that can until you can see that that body has settled in, that they just they feel just right. So having access to all these different sensory tools and toys is is really, really helpful. And it also gives people a choice. They can choose any any of these different types of fidgets or sensory toys that work best for their body. Creating sensory safe spaces is also incredibly helpful for people who have experienced some trauma. If you think about their nervous systems being activated in a high, if they can be in a sensory safe space, this can help them settle and deactivate their nervous system. So let them find a safe corner, hide under pillows, maybe even throw pillows if that feels comfortable. So an example of this from my own practice again is I have a neurodivergent client who has ADHD as well as just is a highly sensitive person, often needs the lights off during our sessions because the overhead lights in the office are quite overstimulating for her. So actually in the winter months sometimes we would almost sit in the dark because it was after sunset. But this was a way that she felt safer and able to participate in the sessions, especially at the end of the day and at the end of the week. So this is an example of the ways that we can create a sensory safe space for someone who needs that.

So again, we’re going to watch another video of Kreed, and I want you to notice again the difference in his body and body language as he’s riding in this go kart with his mom. Also, again, I want you to pay attention to mom’s face. I think in this video she looks more settled. She’s having more fun. She’s smiling.

[VIDEO PLAYS]
https://youtu.be/7xXsAPIP4ys

Dr. Emily Kerner

And we can also see that they’re connecting, which helps both of them feel much safer. So, again, you can see in this video, I want you to pay attention to the connection between the two of them and also pay attention to what in the environment might actually be helping Kreed to feel more settled in his body. So you may have noticed that he has kind of a little fidget toy in his hand. He puts it in his mouth at one point. This is probably a very way that he’s regulating himself with this toy in a sensory way. The go kart movement is probably helping quite a bit for him to feel settled, maybe even for mom to feel settled. And there’s the sound, which for him probably doesn’t seem to be overstimulating. So maybe, actually that sound is can be helping his three system kind of manage and settle as well. And while this smiling mom’s talking, Mom’s engaging. So we can assume that both of them actually are feeling quite settled, smiles at one point. So there’s an action and there’s this sensory regulation that’s happening in their environment as well. So an important way that we can help people and support people to heal from trauma is to move at create. So it can be incredibly healing for people with trauma because trauma is often associated with the lack of movement, especially if someone is more prone to that freak thing Shutting down or disconnecting kind of way of reacting to trauma movement helps to release that sore release tension. It helps to move the body from constriction to space and expansion. And that’s what we want. When we have more air, like more space, we feel more expansion and more expanded then we can really release all of that tension and this traumatic stress that’s been trapped in our bodies. So one important way that we can do this and there’s a couple of links here to help with this is is yoga.

So studies have actually shown that yoga is even better than some other more traditional psychotherapy methods at lowering emotional arousal, increasing mood and decreasing or lowering people’s tendency to dissociate when they have post-traumatic stress disorder. And it also helps to improve their breathing. And so is an incredibly helpful way of moving people out of that survival mode and into a more settled body.

Studies have also shown that karate and martial arts can have huge benefits for healing trauma. So if there is access to karate and martial arts, this can be another really helpful way of using the body and movement to heal trauma for anyone with a disability. If this is accessible for people within their own bodies as well as in their communities, sports and exercise are really great ways of using the body and movement to heal and dancing. So this family looks like they’re having quite a bit of fun dancing in their living room. I know in my own family we used to do, we don’t do it as much anymore, but we used to do Friday night dance parties and you put on some music and you just let your body move. It’s part of connecting. It’s the music, it’s the movement and it’s just having fun. And so this can be another great way of getting to people who are kind of stuck in their bodies. And that traumatic stress has created that stuckness to just release it and and actually have fun doing it. Art and art therapy are also really great ways of using movement and creation to heal trauma. So art therapy, music therapy, drama are great, are can be great alternatives to talk therapy, especially if someone lower comprehension or has difficulty with communication, they can actually demonstrate some of what they are feeling or even just release some of what they’re feeling through art and creation.

And another really important way that we can support people to heal from trauma if they’ve a disability and from trauma in general is to use rhythm and community. And so some of the ways to do this is actually improv. So improv acting. This is something that can actually be really helpful drama, acting movement. So it gets us out of our own experience. It helps us move our bodies. It can actually activates and creativity. We have to come up with a story. We have to follow along with other people what story they’re creating and jump in and kind of find a way to continue the story that they’ve already created. And it also helps us to link stories that have a beginning, a middle and an end, right? So that’s something that trauma stops us from being able to do, and this can give us an experience of actually creating some of that. But in a group, in a setting where we’re interacting with other people and so doing some improvisation and acting can be a really fun way of supporting healing from trauma. Another way is swaying and we’ll get up and do this together.

So another way that we can practice settling our bodies in more communal way, or in a group that also brings a bit of rhythm to help settle is again, I’m going to ask you to stand up and just you can follow along with me. We’re just going to sway back and forth so you can follow in the same direction that I am moving in and if you are actually in a group and you are all in the same room, you can just follow along with one another. And if you’re not all moving at the same pace, maybe just pick one person in the room and they don’t have to know that you’re looking at them necessarily, but just follow along with them and see if you can match their rhythm. So we’re just going to keep doing this. If you’re by yourself, just try to follow along with me and match your body and your rhythm with mine. And just notice as we’re doing this, how this feels. So not only does this help us, actually the movement can help to settle your own body, but when we do this in a group, when you do this with other people, there’s this synchronicity, this connection that can happen because we’re all moving together. And again, this is a really great way of helping people settle their bodies and helping bring more connection and kind of rhythm, which we know a lot of research supports that this is really helpful in healing trauma. Chanting and singing are other great ways of using rhythm and community and connection with other people to settle the nervous system. And this can be really helpful with actually feeling. If we chant, we can and even singing, we can feel that vibration in our chest and that can help to settle the body. But we if we do this with other people, there’s also that synchronicity of voice and other vibrations that we can feel and see and hear when we’re singing or chanting in connection in community with other people. And drumming can have this same kind of effect where we can feel that vibration and we can do that in a community and not just on our own. So bringing that rhythm and connection in is really helpful.

So just to get a bit of a sense of what this might look like, again, we’re coming back to Kreed and this is someone who’s working with him, with a bowl a singing bowl that creates some sound and vibration.

[VIDEO STARTS]
https://www.youtube.com/shorts/ohX0Htlbd6o

Dr. Emily Kerner

So it’s quiet. At first you will hear the sound a little louder. Just pay attention to his body so you can hear that sound. And just notice if that is something that actually helps you feel a little bit more settled. But in this video, we see her placing the bowl on different parts of his body, most likely bring some of that vibration into his body and you can see that his body is settled. He’s barely moving. He is calm and he’s receptive. He doesn’t flinch or move too much when the bowl gets placed in different parts of his body. So likely this is really having a nice calming effect on him. And it’s and it’s coming from somebody else creating this for him. So there’s a bit of that connection and community as well.

[VIDEO ENDS]

Dr. Emily Kerner

Okay. So we’ve essentially reached the end of the presentation. But before we conclude, I just want to guide you to return to your body map from earlier. So if you still have it near you, you can pull it back out and just take a few moments to notice and then mark on the body that you’ve drawn here, you can draw a new one if you if you prefer, and just mark on that space, that body, however you’ve drawn it, what you’re feeling now, has anything changed from earlier when you started this presentation today?

Where do you feel sensations of any kind in your body now and just notice and mark off or draw in any way that you want, what those sensations are? So this is also a tool that you can use with clients or caregivers or support workers that you work with or consult with. So as I mentioned earlier, with any activity, you can always tell the person that if they want to stop at any point, they can. Watch for their their body language. If they stiffen, you can stop. If they appear, if they appear relaxed and engaged, their body is probably communicating safety. So if this is something that people you work with seem to be responding to when you introduce it to them, that’s great. This could be another great activity to help people pay attention to what’s happening in their body. If not, this can just be something that you use for yourself to notice what’s happening for you if this works for you. But just for now, you can pay attention to. Was there any change in how you felt or what was happening in your body at the start of the training today compared to now. Okay.

So before we officially end for today, I just want to review a couple of key points that I hope you take away from today’s presentation. So the first is that trauma is the body’s reaction to a traumatic event, the traumatic event itself is not the trauma. It’s how our body reacts to that trauma. And secondly, trauma can cause developmental delays. So it’s really important for to understand if somebody who is showing that they’re having some developmental delays, if there is actually some trauma in their background or trauma that’s happening to them in the present day, we want to be able to make to understand if there’s a difference between the delays that they’re experiencing that are resulting from trauma or if there are actually delays that are resulting from a disability. So we want to understand how traumas contributing to some delays that somebody might be experiencing. It’s also important to remember that a person with a disability most likely has some trauma. So another reason why it’s really important to understand trauma and work from a trauma informed approach when you’re working with people with disabilities because most likely they have some traumatic stress that they’re holding in their body.

Another key point is that a safe relationship is the best thing that you can offer to somebody who has experienced some trauma when they feel safe, they can settle. They’re thinking brain can come back online and they can participate. They can feel able to explore and play and learn and grow. And so when we can offer and create that safe relationship, we’ve done an incredibly important thing for somebody who’s experienced trauma. And lastly, something really important is that all bodies hold wisdom. So even if somebody has a body that has been impacted by a disability or neurodevelopment mental disorder or trauma in some way, that body is still holding and feeling and experiencing what it has been through. And can it can express that or show that in some way. So we always want to prioritize and pay attention to what the body is holding and what the body can show us.

Okay, So before you end the recording, before you in the presentation, I just want you to take a few minutes and answer these questions for yourself. So what is your biggest takeaway from today’s presentation? And then I’d like you to write down three steps that you’ll take to be more trauma informed in the work that you do, so you can take a few minutes as we end this presentation and just reflect on that. Write that down for yourself and maybe keep that somewhere so that you can come back to it and remember what you took away from today. And then a couple of steps that you’ll take to continue to be and work towards being more trauma informed as you move forward in your work. And thank you very much for your attention and your participation and your interest in this topic and in this presentation today.

I hope you take away some important information and that you feel more knowledgeable to see trauma in people that you work with to work with that trauma if it’s there, and to create more safety in your own body and in the bodies of the that you work with. So thank you very much.