Trauma Informed Care in the Schools

Trauma Informed Care is catching on. Today, I had the privilege of spending several hours with about 40 fellow staff members (Teacher's Assistants) at work. We talked about Trauma Informed Care. Most had never been exposed to these concepts, but the entire group seemed to soak in the information.

It is an honor to work in a school district that is thinking about Trauma, and its impact on the kids we serve.

School is starting up again - and I haven't had much time to blog. I've got a few more topics in the hopper. Once things settle down a bit, I'll post more.

One thing I've been thinking about a lot lately is how easy it is to "preach" the concepts of Trauma Informed Care - but how hard it is to implement. Something I want to work on - for sure.

More soon.

The "Invisible Suitcase" - Part 3

Unpacking and repacking the Invisible Suitcase is a very
challenging, but extremely critical process in healing.

Repacking the Suitcase

In my previous posts, we introduced the idea of the "Invisible Suitcase" and talked about the reenactment cycle. 

In this post, we will discuss how we can begin to unpack the Invisible Suitcase, and help children re-pack the suitcase with helpful, positive truth - or better yet - put the suitcase away.

The challenge with helping a child unpack their suitcase is that there are some very, very deeply held beliefs. They are deeply held, because they have been proven over, and over again.

So, where do we begin? 

The Key is You

The only person you can control is you. If we look at the Reenactment Cycle again, we see that the child is in control of 3/4 of the cycle. But, you are in control of your response. If you give the child the response they are expecting - anger, yelling, violence, etc - the cycle continues. The suitcase gets heavier.

But, if you can give them a completely unexpected response - or no response at all - you have just shattered categories - and unpacked a small piece of their Invisible Suitcase.

If the child is caught cheating on a test - yet again - and they are expecting to be kicked out of the house - and you respond by making pancakes - what message does that send? It sends the message to the child that you are able to control your emotions - and for maybe the first time - they feel safe - even though they did something wrong.

Should there be consequences for bad behavior? Absolutely. But, with the suitcase in mind - we can balance correction with praise, and deliver consequences in a way that does not trigger the reenactment cycle all over again. More on that in another post.

Timing is Key
Kids who are carrying a full Invisible Suitcase will sometimes let you know exactly what is in their suitcase. For the kid who was caught cheating on a test - when you attempt to talk with the child about the issue, they may say things like "I'm just a liar." Or "I'm a terrible person." You know -a child will argue with you until they are blue in the face - and doesn't it seem that the more you argue, the more they are convinced they are right?

I would suggest that these "episodes" are not the best time to present "positive reinforcement" to the child. Arguing with the child about whether or not they are a terrible person will likely further prove elements of their Invisible Suitcase. And, that is counterproductive.

If not then, when? And how?

In a future post, we will discuss cognitive development in children who experience trauma - including what parts of the brain are active and when. But - in short - when kids who have been traumatized experience stress, it can cause their lower brain to activate. The lower brain is in charge of the "Fight, Flight or Freeze" response. The Cortex is also known as the "thinking cap." In terms of brain function, the Cortex is generally in charge of logical thought and processing.

When a child is under stress, primary brain function changes to the lower brain - and logical thought is difficult if not impossible.

Much more on that later.  In the next post - we will talk about some ideas for how to re-pack the Invisible Suitcase.

The "Invisible Suitcase" - Part 2

The Invisible Suitcase is a collection of a child's beliefs about how the world works.[1]

In my last post, I introduced the topic of the "Invisible Suitcase." This suitcase is the collection of beliefs that one has about the world, caregivers, and themselves. In the case of traumatized children, this case is often filled with negative beliefs that have been gained through experience.

These negative beliefs that fill the child's suitcase seep into every aspect of a child's life. Because this suitcase is so integrated into the life of the child, it makes sense that it travels with the child anywhere they go.

Today, we are going to investigate what is called the "Reenactment Cycle" and explore how understanding the beliefs packed into the invisible suitcase can help caregivers identify the root cause of behaviors.

Reenactment is the process of recreating old relationships with new people. This process happens when kids behave in ways that evoke the same reactions from their current caregivers as other adults. The reactions from caregivers can be familiar - and provide some sense of normalcy - even if the reactions are negative.

Reenactment Cycle - Adapted from Delaney, 1998 [2]

Why does this happen? The Invisible Suitcase contains essentially the worldview of the child. "No one loves me." So, some event happens, or a behavior escalates that tests the patience of the caregiver - and the caregiver reacts negatively. This creates a reenactment scenario where the caregiver has, for example gotten mad and yelled. The reaction from the caregiver proves, in the child's mind, that they are unlovable, which further solidifies the themes in the Invisible Suitcase.

It's a devastating circle.The Invisible Suitcase says "You're just going to give up on me or hurt me like everyone else, so let's just get this over with." A child will ratchet up the behaviors just waiting for the caregiver to react - and prove them right. Sadly, most caregivers do exactly that. They give up.

Understandable, right? Absolutely - if you don't know about the child's invisible suitcase.

The good news is there is hope. We can help kids unpack their Invisible Suitcase - and repack it with the truth. It takes patience - but in the end - the work is worth it.

More on that next time.

Words of Wisdom
It's important to remember that even though you are the "target" of the behavior - the behavior is almost certainly not about you. It's not personal. It's about the kids processing what is in their Invisible Suitcase - and working very hard to make sense of the world.

References
[1] This graphic was borrowed from a presentation by NCTSC. titled Caring for Children who have experienced Trauma - A Workshop for Parents. http://www.nctsc.org
[2] Delaney, Richard, (1998) Fostering Changes: Treating Attachment-Disordered Foster Children. 2nd Edition, Oklahoma City, OK; Wood 'N' Barnes Publishing.

The "Invisible Suitcase"

I've heard it so many times, it drives me crazy. "Think of all the baggage those kids bring with them." Or, "I'd rather adopt a baby because they won't have as much baggage."

Have you ever heard that? What were your thoughts when you heard that? Did it resonate with you?

Children who have been through trauma take their invisible suitcases with them to school, into the community, everywhere they go. They have learned through painful experience that it is not safe to trust or believe in others, and that is it best not to give relationships a chance.

It is true, kids who deal with the effects of trauma do have baggage. We call it the "Invisible Suitcase." Everyone has one. Not just kids who have been hurt.

Here's the idea. Every person carries around a suitcase that is packed to the brim. In it are folded the beliefs we have - about ourselves, our friends, our caretakers, the world around us. In most cases, those beliefs are extremely positive.

We have a good outlook on life - are generally optimistic about our future. The world is a generally good place - yeah, there's some aspects of it that are totally screwed up, but in my corner of the world, it's pretty good.

But kids who have experienced trauma come with an Invisible Suitcase that is dramatically different than ours. For children who have experienced trauma - particularly complex trauma - they come with a suitcase that is often filled with overwhelming negative beliefs and experiences. [1]

These suitcases can contain beliefs like "I'm not worth loving." Or, "I'm not a safe person." Or, "I'm powerless." Or, "I'm just a body for people to hurt." They also contain beliefs about caregivers and world - "The world isn't safe." "Adults can't be trusted." "Police and Social Workers only want to break up families."

Beliefs like these are not simply passing - no, they are dug in - core beliefs that have formed the worldview of the kids who hold them. It's important to remember that we didn't create this suitcase. Often, they didn't create this suitcase by choice.

Oh - and they don't leave this suitcase at home when they leave for school - or go with you to the store - or go to see the doctor - or...

This suitcase is their companion - the one thing that remains constant for them. And - in time - in their experience - everyone they encounter proves that what is in their suitcase belongs there.

But, that doesn't mean there isn't hope. We can work to help them re-pack.

We will spend the next several posts discussing the reenactment cycle, and how to re-pack the suitcase.

References

1. The Invisible Suitcase: Behavioral Challenges of Traumatized Children - http://www.nctsn.org/sites/default/files/assets/pdfs/cwt3_sho_suitcase.pdf