4/04/2019

1

Vicarious Trauma

CEWASt Mary’s Catholic College Secondary 2019

Alexa Duke

childhood.org.au

The Australian Childhood Foundation

acknowledges Aboriginal and Torres Strait Islander people as the traditional custodians of this land and we pay our respect

to their Elders past, present and future.

Welcome!

• 8:30 – 2:30

• Break times

• Look after yourself and each other

• “Pass”, observe

• Signal for your attention

4/04/2019

2

childhood.org.au

Introductions

• Which symbol reflects your experience of working with students who’ve been affected by trauma?

https://innovativeresources.org/resources/card-sets/symbols/

Activity

What are the indicators that you are “travelling well”?

• What are the indicators that you are not “travelling so well”?

• What do you notice in your mind and in your body?

Invitation to share your reflections.

Context – Why is this important?

30-50% of teachers leave their profession after the first five years

• Difficult to manage behaviour• Work cover claims• Lack of mentorship and support (Henebery, 2016)

<10% of principals “saw their primary support as coming from their employers or education departments” (AEU News, Feb 2017).

4/04/2019

3

Risk Factors in Education

• 26% of year 7-10 teachers are teaching a subject out of field.

• 15% of teachers in years 11 & 12 are teaching in a subject area they have not studied above first year.

• “Those at the start of their careers more likely than their experienced colleagues to be teaching a subject they haven’t specialised in.”

(Weldon, 2016, p.8)

When colleagues aren’t travelling well

What do you notice with regard to their behaviour, thinking, physically, etc.?

Generate a list of what you see and experience with those you bring to mind.

Have a table group discussion and share what you notice.

Activity: How do you define these terms?

Trauma

Vicarious Trauma

Other Terms

4/04/2019

4

Defining Trauma

TraumaTrauma

One-off or cumulativeOne-off or cumulative

Overwhelms our capacity

to cope

Overwhelms our capacity

to cope

Long term impacts

Long term impacts

Abnormal or prolonged

stress response

Abnormal or prolonged

stress response

Real or perceived

threat

Real or perceived

threat

Simple or complexSimple or complex

The human brain

What are the unmet needs?

4/04/2019

5

Activity: Qualities

• Consider the reasons why you entered the profession.

• What personal qualities do you bring with you to your job role? What do you notice about your list?

• How would you like your students to remember you?

Defining Vicarious Trauma

Vicarious Trauma

Trauma reactions in response to

another person’s trauma

After witnessing or hearing

someone else's trauma

Is based in the relationship that connects us to

our students and each other

Can profoundly change the educators

sense of self

Cumulative transformative

effect

Contextualising Vicarious Trauma

• Not everyone working with traumatised children, young people and their families will experience vicarious trauma. However, all teachers and school staff have the potential to be vicariously traumatised.

• Those who experience VT are naturally affected by their work and do not have a personal failing or weakness.

• The response is based in the relationship that connects us to our students and their families.

4/04/2019

6

Contextualising Vicarious Trauma

• Vicarious trauma is a combination of organisational, professional and personal contributors.

• Vicarious trauma is serious and can impact on teachers and school staff.

• Repair from vicarious traumatisation requires a holistic response - which equally addresses the layers of impact.

Effects

• You are affected by the stories of your colleagues, students and their families.

• The effects of VT are present in the staff member’s professional and personal life (Sexton 1999).

• There is significant evidence that suggests that a negative workplace culture has a detrimental effect on workers, which increases the intensity of VT.

Key Message

VT is not done to workers

nor does it reflect the level of competence of the worker, it is an inevitable effect

of working with survivors of trauma.

(Pearlman and Saakvitne, 1996, p. 31)

4/04/2019

7

Indicators

Indicators of vicarious trauma

• There are multiple impacts of vicarious trauma that can affect us physically, sensorially, emotionally, cognitively and reflectively.

• Not all indicators in isolation will determine vicarious trauma, however, experienced collectively can have significant impact on the individual, the staff and organisation.

Indictors of Vicarious Trauma

• Decreased communication - staff putting notes up to advise of things.

• Decreased ability to accept change or adapt

• Decreased ability to try new things/explore

• Increased sick days• Decreased focus on tasks

• Memory issues

• Fatigue

• Impaired immune system

• Sleep and appetite disturbances

• Anxiety

• Hyper vigilance/control issues• Decreased self esteem

• Loss of interest in tasks

4/04/2019

8

Neurobiology of Vicarious Trauma

• All of us have subcortical activity.

• Need this activity to survive.

• “If a person is suffering from trauma and does not ‘metabolise’ this trauma, then the subcortical activity takes attention away from day-to-day actions therefore leading to:• Poor quality work, • Misjudging situations,• Making unsafe decisions,• Memory gaps• Cognitive difficulties” (Dr Siddharth Ashvin Shah)

Types of Memory

Explicit memory• Factual/semantic memory• Episodic and narrative memory

Without cortical functioning (being able to think)our short term and long term memory isimpacted which in turn affects our functioning inthe workplace.

.

Implicit memorysensory memory

Activity

Very happy getting up in the morning looking forward to work –Very hard to motivate yourself to get to work.

My work offers me new and interesting challenges often –My work feels monotonous and too predictable.

I am motivated by the changes I see in clients and families –I am motivated by praise from others.

I manage the balance between work and personal life well – What personal life?

My beliefs about self-care match my practise – my beliefs about self-care are not reflected in my practise.

4/04/2019

9

Cognitive indicators

• Fallacy of fairness

• Blaming

• Shoulds

• Emotional reasoning

• Fallacy of change

• Global labelling

• Always being right

• Heaven’s reward fallacy

• Black and white thinking

• Mind-reading

• Filtering

• Catastrophic thinking

• Over-generalising

• Jumping to conclusions

• Personalisation

• Control fallacies

https://psychcentral.com/ – 15 Common Cognitive Distortions

Workplace Symptoms

4/04/2019

10

4/04/2019

11

Parallel process

Clients

• Feel unsafe• Aggressive• Helpless• Hopeless• Hyperaroused• Fragmented• Overwhelmed• Confused• Depressed

Staff

• Feel unsafe• Punitive• Helpless• Hopeless• Hyperaroused• Fragmented• Overhwhelmed• Confused• Demoralized

Organisation

• Is unsafe• Punitive• Stuck• Missionless• Crisis driven• Fragmented• Overwhelmed• Valueless• Directionless

(Bloom & Farragher, 2013, p.21)

Emotion affects decisions

• Narrowing of attention

• Failure to search for new alternatives

• Tendency to take more risks

• Simpler decision strategies and

• More extreme judgements

• More creative problem solving

• Better integration of information

• Tendency to deliberate longer

• Better use of more information

• More re-examination of outcomes

Negative emotion produces: Positive emotion produces:

(Bloom, 2013, p.196)

4/04/2019

12

Mirror Neurons

Image source: https://www.psych2go.net/what-are-mirror-neurons/

Emotional Contagion

“All emotions are contagious – both the ones that are pleasant and the ones that are unpleasant” (Rothschild, 2006, p. 9).

Empathy and the brain

ACTIVITY

Somatic empathy (Rothschild 2004)

(Body responses, physiological responses)

Limbic resonance

(Emotional response)

Cortical empathy

(Thinking about their stories, reversing roles)

4/04/2019

13

Exploring somatic empathy

• Reflexive mirroring of posture and facial expression can lead to that person feeling those emotions themselves (this is one way actors produce real emotions).

• Somatic markers for emotion (e.g. a smile for happiness) send messages back to the brain via the afferent nerves, leading to the person feeling signs of that emotion.

Exploring somatic empathy

• Awareness of mirroring is vital for teachers & school staff – lack of awareness can lead to the teacher or school staff member carrying this emotion after a class, a session or an individual interaction.

• Practice awareness of mirroring and monitoring your own emotions.

• Mirroring can work both ways – the teacher/counsellor can also influence the student’s emotions.

Polyvagal Theory

Cues of risk and safety are continually monitored by our nervous system.

Before we can engage in social behaviour and learning we must first feel safe. (Porges, 2015, p.115).

Image source: http://medical-dictionary.thefreedictionary.com

4/04/2019

14

Polyvagal theory and protective responses

(Porges, 2012)

Regulated ArousalFreeze Physically immobilized, frozen, tense musculature

Window of Tolerance

Fight or Flighthyper-vigilant, action-orientated, impulsive, emotionally flooded, reactive, defensive, self-destructive

Submit Collapsed, weak, defeated, flat affect, numb, empty, helpless, hopeless

Sympathetic Hyper-arousal

Parasympathetic Hypo-arousal

Ogden, Minton, Pain 2006

Social Engagement

Dysregulated Arousal

Freeze Physically immobilized, frozen, tense musculature

Window of Tolerance

Fight or Flight Hyper-vigilant, action-orientated, impulsive, emotionally flooded, reactive, defensive, self-destructive

Submit Collapsed, weak, defeated, flat affect, numb, empty, helpless, hopeless

Sympathetic Hyper-arousal

Parasympathetic Hypo-arousal

Ogden, Minton, Pain 2006

4/04/2019

15

Still Face Experiment – Dr Edward Tronik

• Repeated exposure to threatening experiences “teaches” the brain to inhibit the activation of neuronal pathways that lead to protective responses in the first place.

• This process minimises inefficiency by avoiding the need to respond to each individual cue that could trigger a traumatic memory state.

• It allows the brain to move to a generalised protective and defensive state.

How does the brain respond to repeated trauma?

The Educator Reward System

hypothalamus

ventral tegmental area

nucleus accumbens

dopamine

4/04/2019

16

Our Dopamine Reward System

Dopamine

Blocked Care

• Blocked care is a way of describing the suppression of an educator’s potential to nurture a child, especially if the child is slow to reciprocate.

• Unmanageable stress associated with the experience of teaching, and often related to the educator’s own attachment history, is the primary source of interference with caregiving.

Image: beaconhouse.org.uk

Blocked Care and the dopamine crash

1. Chronic

2. Acute

3. Child Specific

4. Stage Specific

The educator reward system is based on us coming to expectsatisfying interactions with student.

If an educator approaches a child and the experience is less than expected, the reward-driven dopamine system can crash, and the educator could suddenly experience a defensive response rather than an approach-driven response.

4/04/2019

17

The shield of shame

Rage‘’You always blame me”

Minimise“It wasn’t so bad”

Lie“I didn’t do it”

Blame“It’s his fault”

(Golding, Turner, Worrall et al., 2016 cite Golding & Hughes, 2012)

Attention to the behaviour shield.

Empathy helps to regulate

feelings of shame shield

and behaviour.

Shield of Shame

Understanding vicarious trauma in the helping relationship

Connections and safety – The development of internal working models of relationships

Attunement

Acknowledgement/Validation

ConnectionResponsiveness/Modulation

Exploration

Self regulation

Self awareness

Relational experience Self experience

Contributions and risk factors

4/04/2019

18

OrganisationalContributors to Vicarious Trauma

• Large class sizes with high numbers of complex and traumatised students.

• Lack of clear reflective ‘supervision’ model and process.

• Stigmatising and blaming organisational culture.

• Low commitment to professional development.

• Limited understanding of the impacts of vicarious trauma.

• Systemic contributors?

• School contributors?

Professional contributors to VT

Lack of experience and training with children & young people who have experienced trauma.

Working with students where concrete signs of success are few.

Over-empathising with student’s experiences and not holding to strong boundaries.

Not accessing supervision and utilising its benefits in the most effective way.

Hearing stories of children’s trauma and abuse.

Working with those children and young people without having effective supports.

Personal contributors to VT

Having limited self-awareness regarding

levels of anxiety, stress and physical fatigue.

Blurring the lines between home and

work.

Bringing non-integrated personal

experiences of trauma into your work with

students and families.

Forgetting to take time or undertake activities

that are pleasurable, relaxing or fun.

Maintaining an imbalance between

work and life outside of the school context.

Perceived lack of ‘support’ from school

leadership team.

4/04/2019

19

Vicarious trauma and organisations

• “Trauma affects organisations as well as individuals. Caregiving organisations whose members have pronounced, ongoing difficulty in maintaining useful working relationships may be traumatised. Trauma can thus be collective, it can be a property of the organisation itself or specific units, not simply of individual members.” (Kahn 2003)

Vicarious Trauma Reflection Points

All staff with the capacity for

empathy have the potential to experience VT.

Trauma reactions can occur in response to

witnessing or hearing about

student’s trauma.

This response is based in the

relationship that connects us to

our students and their families.

Results in profound

changes to core elements of the educators self. (Pearlman &

Saakvitne 1998)

Protective Factors

4/04/2019

20

Audit Activity

What structures do you have in place within your workplace,

both formal and informal?

Protective Factors

Protective factors

Humour

Flexibility

Acceptance of VT potential

Shared meaning

Enabling environment

Policies & procedures

4/04/2019

21

Protective factors • Factors that contribute to an effective organisational culture:

• Purpose

• Empowerment

• Decision making

• Belonging

• Trust and confidence

• Excellence

• Recognition and reward

• Caring

• Integrity

• Diversity

4/04/2019

22

Vicarious TraumaReflection Points in Education

Trauma-specific education assists with the awareness and management of VT.

Encouragement of shared learning about VT in staff & team meetings.

Open discussion about VT during interview and induction educates new employees.

Awareness of multiple modalities and interventions enables workers to address client’s trauma which assists with the prevention of VT.

Thought monitoring Healthy thought

I don’t have the skills for this! It’s ok to ask for help.

You know the older brother?

She’s never going to change.

I’ve tried everything and nothing works.

The single most important factor in the success or failure of trauma work relates to the attention paid to the experience and the needs of the helper.

We cannot meet the needs of our clients when we are overriding our own. (Saakvitne et al. 2000)

4/04/2019

23

Exteroception Interoception

Self-awareness is a protective factor

Vicarious Trauma Reflection Points: Environment

Teachers need to have personally meaningful items in their work space:

• Photos

• Inspirational quotes, scenes, posters

• Collective Creation of shared spaces - lunch rooms, waiting rooms, meeting rooms.

(Focus on sensory awareness)

This assists the organisation to balance the personal with the professional.

2 ways to regulate emotions

TOP DOWN

“through strengthening the capacity of the watch tower to monitor your body’s sensations”

BOTTOM UP“through breathing, movement and touch”

(van der Kolk, 214, p.63)

4/04/2019

24

Help for the Helper

• Side of legs

• Hold elbow

• Purposefully uncoupling mirrored posture

• Decreasing proximity

• Clothing

• Sensory anchors

• Controlling empathic imagery(Rothschild, 2006)

Activity: Organisational, professional and personal responsibilities

Discuss 3 new actions within your school for each category that could be a focus for your staff (irrespective of resourcing issues!)

• Oganisational - peer/peer, support staff/peer, leader/teacher, director/principal

• Professional • Personal

MindMatters: top tips to manage work stress at school

• Identify your triggers in the workplace.

• Take note of your ‘self-talk.’

• Learn to say 'no.'

• Include short-term coping strategies in your day.

• If you're feeling stressed or anxious, try to postpone major life changes.

• Set aside time for the things you enjoy.

• Speak up early if you’re feeling overwhelmed.

https://www.mindmatters.edu.au/about-mindmatters/news/article/2017/05/17/top-tips-to-manage-work-stress-at-school

1 you’re good at?1 you’d like to be better at?

4/04/2019

25

Self-care practices

• Turn off computer and mobile 1 hr before bed.

• Eat breakfast daily, including complex carbohydrate or protein.

• Eat a snack mid-morning and mid-afternoon.

• Engage in a mindful exercise 30 mins at least once during the week.

• Prioritise a “to-do” list.

• Exercise for 30 mins 3x during week, Mon-Fri.

• Engage in supervision (not evaluation), peer collaboration or mentoring at least every 2 weeks.

(Steele, 2017, p,138)

1 you’re good at?1 you’d like to be better at?

Professional self-care assessment

1. Complete the survey

2. Re-read your survey and circle one item under each heading you’d like to build into your daily routine.

3. Complete the self-care reflection.

Self-care Card

Drawing on your self-care assessment:

- 3 three things you can do at home

- 3 things you can do at school.

4/04/2019

26

Juggling 5 balls

Imagine life is a game where you are juggling 5 balls:

work, family, health, friends and spirit.

References

ACER. (2016). How to stop teachers leaving the profession. Teacher Magazine. Retrieved from: https://www.teachermagazine.com.au/article/how-to-stop-teachers-leaving-the-profession?utm_source=Campaign%20Monitor&utm_medium=bulletin&utm_content=October%204%202016

Bloom, S. L., & Farragher, B. (2013). Restoring sanctuary: A new operating system for trauma-informed systems of care. Oxford University Press.

Bloom, S. L. (2013). Creating sanctuary: Toward the evolution of sane societies. Routledge.

Henebery, B. (2016, January 19). Teachers leave as student numbers surge. Retrieved from: http://www.educatoronline.com.au/news/teachers-leave-as-student-numbers-surge-210675.aspx. Accessed 9 June 2017.

Kahn, W. A. (2003). The revelation of organizational trauma. The Journal of Applied Behavioral Science, 39(4), 364-380.

Porges, S. W. (2015). Making the World Safe for our Children: Down-regulating Defence and Up-regulating Social Engagement to ‘Optimise’the Human Experience. Children Australia, 40(02), 114-123.

Rothschild, B. (2006). Help for the helper: The psychophysiology of compassion fatigue and vicarious trauma. WW Norton & Co.

Saakvitne, K. W., & Pearlman, L. A., & Staff of TSI/CAAP. (1996). Transforming the Pain: A Workbook on Vicarious Traumatization. New York: W.W. Norton.

Steele, W. (2017). Optimizing Learning Outcomes: Proven Brain-centric, Trauma-sensitive Practices. Taylor & Francis.

Van der Kolk, B. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin: New York

Weldon, Paul R. (2016). Out-of-field teaching in Australian secondary schools. (Policy Insights ; n.6). Melbourne : Australian Council for Educational Research (ACER).

4/04/2019

27

childhood.org.au

Want more professional learning?

• Surviving to learn or learning to

survive: the biological

imperative to feel safe

• Understanding family violence

• Vicarious trauma and

professional self-care

• Regulation: observation &

understanding response

• Trauma sensitive positive

behaviour support

• Sensory interventions

• Neuroscience of

mindfulness

• Leadership trainings

• Problem sexual

behaviours

• Safety and stability in

the classroom

• And more …

Thank you for your participation today!

Facilitator: Alexa

To find out more about the

Australian Childhood Foundation

please visit our website:

www.childhood.org.au

training@childhood.org.au

Phone: 1300 381 581

Please complete your evaluation form before leaving.