karla bauer burnsville family resource center coordinator 360 communities
TRANSCRIPT
CRISIS INTERVENTION AND THE TRAUMA OF VICTIMIZATION
Karla BauerBurnsville Family Resource Center Coordinator360 Communities
Objectives
Identify the dimensions of trauma and the potential reactions to crisis.
Differentiate between the short and long term impact of trauma on victims of crime
Recognize the role of an advocate and determine when further mental health referrals are appropriate
Name the three steps in effective crisis intervention
Good crisis intervention, like good mental health treatment, is a serious professional activity calling for creativity and adaptability to changing conditions of the therapeutic moment.
What you can do?
Understand Trauma Examine How You Respond to
Trauma Survivors Develop Trauma Informed Care
Best- Practices Develop Protocols Caring for the Caregiver –
Understanding Vicarious Trauma
“Trauma is a fact of life. It does not, however, have to be a life sentence. Not only can trauma be healed, but with appropriate guidance and support, it can be transformative. Trauma has the potential to be one of the most significant forces for psychological, social, and spiritual awakening and evolution. How we handle trauma (as individuals, communities and societies) greatly influences the quality of our lives. It ultimately affects how or even whether we will survive as a species.” Trauma Therapist Peter Levine (Waking the Tiger, 1997, p.2)
People exist in a state of equilibrium
The equilibrium may be relatively even (moderate highs and lows)
The equilibrium may include dramatic highs and lows
Normal Stressors
Both positive and negative events cause stress
Getting a new job Getting fired Getting married Getting divorced Having a baby Losing a loved one
What is Trauma?
“Traumatic events are extraordinary, not because they occur rarely, but rather because they overwhelm the ordinary human adaptations to life.”
Processing Traumatic Stimuli1. Stimuli enters2. It is perceived threatening by the
Thalamus3. Then emotions trigger physical
reactions and override the cognitive processes
4. Scattered emotional information interferes with the cognitive process.
Trauma and Equilibrium
Trauma can affect the ability to re-establish balance
Re-established balance may never return to the level it was prior to the experience
Equilibrium may be effected differently by the duration of the trauma- if it is chronic or acute
Psychological Trauma
Extreme stress that overwhelms a person’s ability to cope
Also can have a physiological impact
Individual’s subjective experience that determines whether an event is traumatic
Psychological Trauma
Unique individual experience of an event or enduring conditions, in which: The individual’s ability to integrate
her/his emotional experience is overwhelmed, or
The individual experiences (subjectively) a threat to life, bodily integrity, or sanity
Psychological Trauma
Psychologically, the bottom line is that trauma is overwhelming emotion and a feeling of utter helplessness
It is very personal and subjective 2 people could go through the
same event or series of events and one is traumatized and the other is not
Single v. Multiple
A single event can be very traumatic
The most serious mental health issues generally come from prolonged and repeated traumatic experiences
Natural v. Human Made
Prolonged stressors, deliberately inflicted by people, are far harder to bear than accidents or natural disasters
Situations involving interpersonal relationships and most specifically the parent-child relationship may be more impactful
Stress Reaction
Initial crisis reaction- Short term Long term stress reactions
Both physical and emotional
Short Term Stress Reactions 3 F’s
Fight Flight Freeze
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Fight, Flight or Freeze
Freeze: orienting response (What is happening? I need to be afraid)
Flight: I need to get away – can I?
Fight: Couldn’t outrun the panther; can’t fight off the larger person
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Short-term Psychological Trauma: During the Crime Shock, surprise, terror Feelings of unreality; think it
can’t be happening High levels of physiological
anxiety (e.g., rapid heart rate, rapid breathing)
Cognitive symptoms of anxiety (e.g., feel helpless, fear being killed)
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Common Short-term Reactions Preoccupation with the event High anxiety May or may not look distressed Disturbed concentration and
difficulty performing simple mental tasks
Concerns about safety Avoidance
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Common Short-term Reactions (continued)
Sleep disturbances Concerns about whom to tell Concerns about being
believed Concerns about being
blamed
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Tonic Immobility
“Play” dead/state of complete paralysis
Not a conscious choice Body functions shut down All of those used during flight and fight
Respiration Heart beat Vocal chords
Same whether real or perceived entrapment
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Fear System
All about self preservation Learning/Experience of trauma
creates new neural pathways that serve self preservation
“Firefighters still have nightmares about what they saw when they stumbled through the smoke into the Happy Land Social Club on an early Sunday morning one year ago today. There on the dance floor, dozens of partygoers dressed in night-on- the-town clothes lay slumped on the ground, not burned but covered in a fine layer of soot. People still sat at the bar, holding drinks. Couples embraced. There was not a life left to be saved. Some firefighters vomited. Some just wandered, dazed.”
“Smoldering Memories: A Year After the Happy Land Fire, Unfulfilled Promises and an unresolved Case,” Laurie
Goldstein, The Washington Post, March 25, 1991.
Short Term Continued
Physical shock Numbness Disorientation Involuntary bodily reactions Heightened awareness of senses Eventual physical collapse
Short Term Emotional
Anger or rage Fear and terror Frustration, helplessness,
powerlessness Confusion Guilt and Self Blame Grief and Sorrow Reconstruction of equilibrium
Long Term Stress Reactions
Victims may continue to experience crisis reactions over long periods of time
These reactions are usually caused by triggers
Long-term Psychological Problems
PTSD
Major depression
Suicidal thoughts and attempts
Alcohol and drug use problems
Relationship problems28
Post-Traumatic Stress Disorder (PTSD)
Must involve a traumatic event
Usually involves multiple events over a prolonged period of time
Usually involves human made events
Symptoms
Intrusive Re-experiencing of the trauma (flashbacks, reliving experience or abreaction)
Avoidance of anything that might remind them of the traumatic experience -- may avoid people, places or feelings that remind them. May resort to numbing out.
PTSD Symptoms (continued)
Arousal could be psychological or physiological
arousal. Varies -- jumpy, easily startled, irritable
and sleep disturbances May seem constantly on guard and may
find it difficult to concentrate Panic attacks, shortness of breath,
difficulty breathing
Dissociative Disorder
Numbing Spacing Losing Time Inability to Concentrate Addictive Automatic Response
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Other Long-term Psychological and Behavioral Problems
Changes in lifestyle and restrictions in behavior
Changes in pre-crime beliefs and attributions about the world
Increased risk of future victimization
Triggers
Hearings, trials, appeals Identification of an assailant Anniversaries Holidays, birthdays, significant
events Media stories about the event or
similar crimes
Crisis Intervention
Good News: What You Do Does Help!
Reduce the severity of the crisis
Assist the victim in gaining control over the crisis
Reduce chances of repeated victimization
Three Techniques
Safety and Security
Ventilation and Validation
Prediction and Preparation
Safety and Security
Physical safety of the victim
Helping the victim feel safe
Helping victims be safe
Safety and Security
Respond to the need for nurturing
Help victims re-establish a sense of control
Ventilation and Validation Allow victims to tell their story
Ventilation may be verbal, musical, artistic, active etc.
Validation is achieved by providers assuring victims that most reactions to traumatic events are normal
Validation should reinforce that most reactions of anger, fear, frustration, guilt, and grief do not mean the victim is abnormal, immoral, or bad.
On the wall of Brasenose College at Oxford University hands a letter from President Abraham Lincoln as a model of ‘purest English.” It is a model of a written response to a grieving Mother:
Dear Mrs. Bixby,
.
I have been shown in the files of the War Department a statement of the Adjutant General of Massachusetts that you are the mother of five sons who have died gloriously on the field of battle. I feel how weak and fruitless must be any word of mine which should attempt to beguile you from the grief of a loss so overwhelming. But I cannot refrain from tendering you the consolation that may be found in the thanks of the Republic they died to save. I pray that our Heavenly Father may assuage the anguish of your bereavement, and leave you only the cherished memory of the loved and lost, and the solemn pride that must be yours to have had so costly a sacrifice upon the alter of freedom
Yours very sincerely and respectfully,
A. Lincoln
Prediction and Preparation Victims need information about the
crime and what happens next
This is a way to help the victim regain control
Victims need to know how to cope on a day-to-day basis
Victims need practical information
Victim Behaviors that Contribute to Blaming and Doubting Victims
A confused or disorganized presentation
Behaviors or emotions that differ from how we think a ‘real’ victim should act or feel
Statements that are not chronological (i.e., do not start at the beginning and give a blow-by-blow account of what happened in sequence) and/or that are not told exactly the same way every time.
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Questions
What do we think about the truthfulness of victims who are confused and have trouble remembering details of what happened?
How do we feel about victims who were attacked when they were intoxicated or engaged in other risky behavior?
What do we think about victims who have been victimized repeatedly and/or who won’t get out of bad relationships?
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