KCIT 2015
Making It Better
Without Making It
Worse
Angela Keen, Keystone Crisis Intervention Team
Crisis Intervention Association of Pennsylvania Annual
Conference
November 12, 2015
• Describe the neurobiology of trauma
reactions
• Idenitfy how empathy contributes to
traumatic stress reactions that may be
categorized as vicarious victimization,
compassion fatigue and burnout
• Recognize their own traumatic exposure
responses and learn self-soothing
techniques to build resiliency and healthy
coping skills
KCIT 2015
Attendees will be able to:
Individual Trauma:
A “blow to the psyche that breaks through one’s
defenses so suddenly and with such force that one
cannot respond effectively.”
- Kai Erickson, In the Wake of a Flood, 1979
Collective Trauma:
A “blow to the tissues of social life that damages the
bonds attaching people together.”
- Kai Erickson, In the Wake of a Flood, 1979
KCIT 2015
Trauma
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Trauma is any event that leaves
a person feeling hopeless,
helpless, fearing for their life
and/or their safety.
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Fluctuating Equilibrium
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Impact of Trauma on
Equilibrium
Remember…
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• Trauma is a sensory experience
• It is not cognitive!
Sensory Path in the
Non- Traumatized Brain
Thalamus
Amygdala
Hippocampus
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Cortex- Neo Cortex
Sensory Path in the
Traumatized Brain
Thalamus
Amygdala
Hippocampus
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Cortex- Neo Cortex
During a Traumatic Event
• Right Brain
• Memory
• Sensory
• Affect Regulation
Left Brain
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Making Sense
Problem Solving
Decision Making
Language
Impulse Control
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The pathways between the right and left
brain experience a disconnect.
Remember…
KCIT 2015
• Trauma is a sensory experience
• It is not cognitive!
• Feeling internally connected over time to caring
others
• Experiencing oneself as deserving and
worthwhile
• Managing Feelings:
Recognize, tolerate, modulate, integrate
feelings
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TRAUMA IMPAIRS
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POTENTIAL IMPACT OF
REPEATED TRAUMA
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POTENTIAL IMPACT OF
REPEATED TRAUMA
Shifts people away from emotional safety,
emotional balance and predictability.
Disrupts the ability to return-to-center.
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TRAUMATIC STRESS
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Stress Reactions of
Caregivers
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Burnout:
a chronic state of stress
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• Exhaustion of mind and body
• Frustration, cynicism, negative
thoughts
• Feelings of ineffectiveness and
lack of accomplishment
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Signs of Burnout
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• Emotional and physical drain of
providing continual empathy
• Ambiguous successes
• Erosion of idealism
• Lack of expected rewards
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Contributing Factors to
Burnout
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• Your health (poor sleep, illness)
• Your personal life
• Maintaining self-care
• Job performance
• Cognitive abilities (concentration,
problem solving, decision making)
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Burnout Causes Havoc with:
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Vicarious Victimization
• A recent or similar trauma in the
caregiver’s life (does not have to be
directly related to the current disaster)
• Similarities between victim and caregiver
• Physical and emotional fatigue
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• Counter-transference
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Compassion Fatigue
• Listening to the story of the event
• Through empathetic contact with
victims or survivors
• When they can’t distance
themselves from the event
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• Caregivers experience trauma
by:
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Taking Care of Ourselves
• Emotionally
• Physically
• Spiritually
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• What activities do you do to take
care of yourself?
• Identify your support system
• Personal life
• At work
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Exercise
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Nutrition
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Humor
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RESILIENCY
AND
COPING
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Resilience refers to a person’s
inherent capacity to moderate
and recover from traumatic
experience.
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RESILIENCY
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RESILIENCY
Prevent stress related disorders
Recover faster
Maintain peak performance
Perform optimally during a crisis
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Helps to:
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Everyone has some
Skills can be taught and learned
Starts in childhood
It’s never too late to learn
One can prepare for specific, expected
crises
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RESILIENCY
ASSUMPTIONS
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Resiliency Factors
Emotional
Behavioral
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Attitudinal
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Easy temperament
Social competence
Creative problem-solving skills
Ability to tolerate frustration and manage emotions
Clear and consistent boundaries
Belief in one’s effectiveness
Persistence in the face of failure
Optimistic outlook
Ability to build friendships and seek out support
Sense of humor
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Resiliency Traits Include:
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Latipha Cross : A Story of
Resiliency
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1. What resources have you relied upon since
the event that has supported your recovery?
2. Identify individual, family and community
resources which could support your
recovery?
3. What personal strengths have you utilized
to assist in your recovery?
4. Are there things you can learn now to
improve your recovery?
5. What steps can you take to achieve a
sense of recovery?
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What are your sources of resiliency?
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6. What can you identify as steps to take to
achieve your family’s recovery?
7. What steps can you take to help your
community achieve its recovery?
8. What will resiliency look like for you, your
family, your community?
9. What needs have you identified since the
event?
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What are your sources of resiliency?
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Community Resilience
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Page 371
Expending conscious effort to
solve or tolerate personal or
interpersonal problems, stress or
conflict.
KCIT 2015
Coping
Skill
The ability to do something from
training, experience, or practice.
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Why Teach Coping Skills?
A. Define the problem
B. Try to solve the problem
C. Try to live with the problem
D. Try to hide from the problem
E. Quit trying all together
KCIT 2015
When faced with a problem people first:
Coping skills are used in helping people try to solve the problem
and live with the problem
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KCIT 2015
Why Teach Coping Skills
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Coping
Avoidant Coping seeks to keep the
situation out of awareness
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Active Coping thinks about a situation to
improve or adjust to it
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Types of Coping
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Defense Mechanisms
4 Square Breathing
Deep Muscle Relaxation
Thought Stopping
Journaling
Mindfulness
Distraction
Guided Imagery
Exercise
Pets
Cognitive Restructuring
Relaxation Techniques
Self Nurturing
Prayer
Problem Solve
Humor
Meditation
Music
Volunteering
Sharing (Venting)
Letter or Recording to Self
Positive Affirmations
Art
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SPECIFIC SKILLS
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Preparation, Preparation, Preparation
1) Outline healthy behaviors to help prevent
crises.
2) Identify risk factors that may increase stress.
3) Identify symptoms that indicate a problem may
be approaching.
4) Outline what to do in a crisis situation.
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4 Elements of a Safety Plan
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Wrap Up
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We all use skills to get us through the
rough times. What other ideas do you
have?
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