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Copy of How Trauma Affects Kids in School

Tue, 01 Dec 2020 00:29:34 GMT

Ongoing exposure to neglect, abuse, homelessness or violence causes learning and behavior problems in children. Signs of trauma and tips for helping kids who've been traumatized.

We tend to think of trauma as the result of a frightening and upsetting event. But many children experience trauma through ongoing exposure, throughout their early development, to abuse, neglect, homelessness, domestic violence or violence in their communities. And it’s clear that chronic trauma can cause serious problems with learning and behavior.

Trauma is particularly challenging for educators to address because kids often don’t express the distress they’re feeling in a way that’s easily recognizable — and they may mask their pain with behavior that’s aggressive or off-putting. As Nancy Rappaport, MD, a child and adolescent psychiatrist who focuses on mental health issues in schools, puts it, “They are masters at making sure you do not see them bleed.”

Identifying the symptoms of trauma in the children can help educators understand these confusing behaviors. And it can help avoid misdiagnosis, as these symptoms can mimic other problems, including ADHD and other behavior disorders.

In brief, the obstacles to learning experienced by these children include:

Trouble forming relationships with teachers
Poor self-regulation
Negative thinking
Hypervigilance
Executive function challenges

Trauma and trouble forming bonds

Children who have been neglected or abused have problems forming relationships with teachers, a necessary first step in a successful classroom experience. They’ve learned to be wary of adults, even those who appear to be reliable, since they’ve been ignored or betrayed by those they have depended on.

“These kids don’t have the context to ask for help,” notes Dr. Rappaport, a school consultant and associate professor of psychiatry at Harvard Medical School. “They don’t have a model for an adult recognizing their needs and giving them what they need.”

Many of these children haven’t been able to develop secure attachments to the adults in their lives, adds Jamie Howard, a clinical psychologist and head of the Trauma and Resilience Center at the Child Mind Institute. They need help to let other adults into their lives. “Kids who’ve never developed that early template that you can trust people, that you are lovable and that people will take care of you,” Dr. Howard explains, “need support to form that kind of relationship.”

One of the challenges in giving that support is that when kids misbehave, our schools often use disciplinary systems that involve withdrawing attention and support, rather than addressing their problems. Schools have very little patience for kids who provoke and push away adults who try to help them.

Instead of suspending children, Dr. Rappaport argues, schools need to work with them on changing their behavior . When a student is acting up in class, she explains, teachers need to recognize the powerful feelings they are expressing, if inappropriately.

Rather than jumping right into the behavior plan – deducting points or withdrawing privileges or suspending — Dr. Rappaport stresses the importance of acknowledging the emotion and trying to identify it. “I can see that you are REALLY angry that Andrew took the marker you wanted!” she suggests. “If you’re wrong about what the student is upset about, he’s likely to correct you.”

Acknowledging and naming an emotion helps children move towards expressing it in a more appropriate way. Communicating that you “get” him is the necessary first step, she explains, to helping a child learn to express himself in ways that don’t alienate and drive away people who can help him.

Poor self-regulation

Traumatized children often have trouble managing strong emotions. As babies and toddlers, children learn to calm and soothe themselves by being calmed and soothed by the adults in their lives, Dr. Howard notes. If they haven’t had that experience, because of neglect, “that lack of a soothing, secure attachment system contributes to their chronic dysregulation .”

In the classroom, teachers need to support and coach these children in ways to calm themselves and manage their emotions. “We need to be partners in managing their behavior,” Dr. Rappaport explains. “Co-regulation comes before self-regulation . We need to help them get the control they need to change the channel when they’re upset.” They need coaching and practice at de-escalating when they feel overwhelmed, she adds.

Related: What’s ADHD (and What’s Not) in the Classroom Negative thinking

Another challenge to traumatized kids is that they develop the belief that they’re bad, and what’s happened to them is their fault. This leads to the expectation that people are not going to like them or treat them well. As Dr. Howard puts it, “I’m a bad kid. Why would I do well in school? Bad kids don’t do well in school.”

Traumatized kids also tend to develop what Dr. Howard calls a “hostile attribution bias” — the idea that everyone is out to get them. “So if a teacher says, ‘Sit down in your seat,” they hear it as, ‘SIT DOWN IN YOUR SEAT!’” she explains. “They hear it as exaggerated and angry and unfair. So they’ll act out really quickly with irritability.”

As Dr. Rappaport puts it: “They see negative where we see neutral.” To counter this negative thinking, these students a narrative about themselves that helps them understand that they’re not “bad kids.” And learning to recognize their negative patterns of thought, like black and white thinking, is a step towards being able to change those patterns.

Dr. Rappaport notes that children from abusive homes are sometimes unable to participate in classroom activities because they are paralyzed by fear of making a mistake, and that can make them appear to be oppositional. “A mistake that might seem trivial to us becomes magnified,” she explains, “if their experience has been that minor mistakes incurred adult anger or punishment.”

They need not only support to have incremental successes they can build on in the classroom, but help to see that in this setting, making a mistake is considered a necessary part of learning.

Hypervigilance

One of the classic symptoms of trauma is hyper-vigilance, which means being overly alert to danger. “It’s physiological hyper-arousal,” explains Dr. Howard. “These kids are jumpy, they have an exaggerated startle response. They can have some big, out-of-control seeming behaviors, because their fight or flight response has gone off.”

This can look like hyperactivity, she adds, leading kids who have been traumatized to be misdiagnosed with ADHD . Being chronically agitated can lead to difficulty with sleeping and chronic irritability.

In workshops, Dr. Rappaport coaches teachers on how to help kids to settle down when something in the classroom triggers an emotional outburst. When a child is escalating, the key, she says, is to “match their affect, but in a controlled way.”

The goal is to connect to their big feeling. “If you can connect with what they’re trying to tell you, they may settle. It can work even if you just make a guess — you don’t have to be right, they can correct you.

Stigma Regarding Mental Illness among People of Color

Sun, 27 Sep 2020 12:57:40 GMT

Communities of Color

One of the remaining taboos in many communities of color is the stigma around mental illness. Whether it’s depression or anxiety (or, the worst-case scenario, suicide), there is a longstanding belief in these communities that such concerns are taboo, and their impact is the problem of “the other.” Though communities of color, because of socioeconomic challenges, may be at higher risk for poor mental health, this stigma contributes to a reluctance to recognize the need for the help of a physician or therapist.

For many in the African American community, our story is one of perseverance and resilience. After all, we survived slavery; surely, we can survive “sadness” or “anxiety.” In this mindset, anything less would be considered spiritual or moral weakness. The problem, in part, is that we often fail to recognize that mental illness is much more than feeling melancholy or anxious, it is not a sign of weakness, and it does not discriminate based on skin color. We fail to recognize mental illness as an “illness,” as we would cancer, diabetes, or high blood pressure.

According to the National Alliance on Mental Illness,[i] approximately 1 in 5 adults in the United States experience mental illness in a given year. This is irrespective of race, creed, or color. In addition, according to the U.S. Department of Health and Human Services Office of Minority Health,[ii] adult Black/African Americans are 20 percent more likely to report serious psychological distress than adult Whites. Despite this, African Americans are less likely than Whites to seek out treatment and more likely to end treatment prematurely. On the one hand, this is due in part to long-held beliefs related to stigma, openness, and help-seeking, which can make African Americans and other people of color hesitant to reach out. On the other, we professionals in the healthcare community must do the work to establish ourselves as credible, reliable sources of support.

As healthcare providers in this age of “whole person care,” it is incumbent upon us to determine how to address and overcome this stigma. If we are to address the social determinants that impact health in communities of color, we must first understand not only the challenges but the attitudes and norms regarding these challenges. We must own up to the fact that underserved communities are underserved for a reason: The reason is that we (healthcare providers) haven’t been there.

It is arrogant to believe that we can decide to focus on communities that have gone underserved and be embraced and trusted, without earning that trust. We must start by listening and seeking to understand not only communities of color but all underserved or inappropriately served communities, including the LGBTQ and socio-economically disadvantaged communities. We must also change the narrative from a conversation about mental illness to a conversation about mental wellness. Mental health is, after all, more than depression, anxiety, or a bipolar disorder diagnosis. It is your overall emotional and mental wellbeing, including both positive and negative elements.[iii]

Communities of color are no different than any other community in that everyone wants to live a healthy life: physically, mentally, spiritually, and emotionally. The challenge for communities of color and healthcare providers alike is defining what a healthy community looks like through the prisms of stigma and historical adversity, which includes race-based exclusion from health, educational, social, and economic resources. It is only by working together collaboratively as fully engaged partners that we can overcome this challenge.

Mental Health Resources for the Black Community

Thu, 04 Jun 2020 15:33:48 GMT

ADAA Stands Against Racism

The Anxiety and Depression Association of America’s (ADAA) mission is more critical than ever. Since ADAA’s founding 40 years ago, we have been committed to ensuring that everyone who struggles with an anxiety disorder, depression or PTSD can obtain the resources they need to live healthier and more productive lives.

Over the last few months, we have seen that many of our poorest neighborhoods and communities of color have suffered disproportionately from the spread of COVID-19. Many of these same marginalized communities are also grappling with economic uncertainty, and now with the recent killing of George Floyd following so many other killings of African Americans, with increased mental health issues. ADAA’s mental health experts understand that exposure to these pervasive racial traumas and stressors are detrimental to one’s mental health. We also know that many people of color who suffer from mental health issues also experience less access to care and services . Read the full statement here .

Facts and Statistics

Although anyone can develop a mental health problem, Black Americans sometimes experience more severe forms of mental health conditions due to unmet needs and other barriers. According to the Health and Human Services Office of Minority Health, Black Americans are 20% more likely to experience serious mental health problems than the general population. Black youth who are exposed to violence are at a greater risk for PTSD by over 25%.1 Black Americans are also more likely to be exposed to factors that increase the risk for developing a mental health condition, such as homelessness and exposure to violence.

In the Black community, people often misunderstand what a mental health condition is and therefore the subject is uncommon. This lack of understanding leads many to believe that a mental health condition is a personal weakness or a form of punishment. Many Black Americans have trouble recognizing the signs and symptoms of mental health conditions such as anxiety and depression, which leads to them underestimating the effects of mental health conditions. Black Americans may also be reluctant to discuss mental health issues and seek treatment because of the shame and stigma still associated with such conditions in their community.2

Choosing a Provider

It is important to find a provider who demonstrates cultural competence - which describes the ability of healthcare systems to provide care to patients with diverse values, beliefs and behaviors and taking into account their social, cultural and linguistic needs.3 Unfortunately, research has shown lack of cultural competence in mental health care, which results in misdiagnosis and inadequate treatment. When meeting with your provider, ask questions to get a sense of their level of cultural sensitivity, such as whether they have treated other African Americans, received training in cultural competence, and how they plan to take your beliefs and practices into account when suggesting treatment. Learn more about finding the right therapist .

NAMI’s Statement On Recent Racist Incidents And Mental Health Resources For African Americans

Thu, 07 Nov 2019 13:52:47 GMT

The National Alliance on Mental Illness (NAMI) today released the following statement from CEO Daniel H. Gillison, Jr., regarding recent racist incidents across the country and their impact on mental health:

“The effect of racism and racial trauma on mental health is real and cannot be ignored. The disparity in access to mental health care in communities of color cannot be ignored. The inequality and lack of cultural competency in mental health treatment cannot be ignored.

“Our nation’s African American community is going through an extremely painful experience, pain that has been inflicted upon this community repeatedly throughout history and is magnified by mass media and repeated deaths. We stand with all the families, friends and communities who have lost loved ones senselessly due to racism. And, with more than 100,000 lives lost to the coronavirus pandemic - disproportionately from minority communities - these recent deaths add gasoline to the fire of injustice.

“While there is much we need to do to address racism in our country, we must not forget the importance of mental health as we do so. Racism is a public health crisis.

“As the nation’s largest grassroots mental health organization, it is our responsibility to serve all. While as an organization we are still early in our intentional Diversity, Equity and Inclusion journey and have much to do, we have renewed our commitment to our values. We continue to strive to deliver help and hope to all who need it.

“NAMI stands in solidarity with everyone impacted across the country. You are not alone.”

Black Mental Health Resources

There are a variety of mental health resources available for people of color, but we have provided a few examples below.

Please note: The resources included here are not endorsed by NAMI, and NAMI is not responsible for the content of or service provided by any of these resources.

Black Emotional and Mental Health Collective (BEAM)
Group aimed at removing the barriers that Black people experience getting access to or staying connected with emotional health care and healing. They do this through education, training, advocacy and the creative arts.

Black Men Heal
Limited and selective free mental health service opportunities for Black men.

Black Mental Health Alliance - (410) 338-2642
Provides information and resources and a “Find a Therapist” locator to connect with a culturally competent mental health professional.

Black Mental Wellness
Provides access to evidence-based information and resources about mental health and behavioral health topics from a Black perspective, as well as training opportunities for students and professionals.

Black Women’s Health Imperative
Organization advancing health equity and social justice for Black women through policy, advocacy, education, research and leadership development.

Boris Lawrence Henson Foundation
BLHF has launched the COVID-19 Free Virtual Therapy Support Campaign to raise money for mental health services provided by licensed clinicians in our network. Individuals with life-changing stressors and anxiety related to the coronavirus will have the cost for up to five (5) individual sessions defrayed on a first come, first serve basis until all funds are committed or exhausted.

Brother You’re on My Mind
An initiative launched by Omega Psi Phi Fraternity, Inc. and NIMHD to raise awareness of the mental health challenges associated with depression and stress that affect Black men and families. Website offers an online toolkit that provides Omega Psi Phi Fraternity chapters with the materials needed to educate fellow fraternity brothers and community members on depression and stress in Black men.

Ebony's Mental Health Resources by State
List of Black-owned and focused mental health resources by state as compiled by Ebony magazine.

Henry Health
Provides culturally sensitive self-care support and teletherapy for Black men and their families. Currently in pilot program available only to residents of MD, VA and DC. Residents of other states can join their waiting list and will be notified when Henry Health is available in their state.

Melanin and Mental Health
Connects individuals with culturally competent clinicians committed to serving the mental health needs of Black & Latinx/Hispanic communities. Promotes the growth and healing of diverse communities through its website, online directory and events.

Ourselves Black
Provides information on promoting mental health and developing positive coping mechanisms through a podcast, online magazine and online discussion groups.

POC Online Classroom
Contains readings on the importance of self care, mental health care, and healing for people of color and within activist movements.

Sista Afya
Organization that provides mental wellness education, resource connection and community support for Black women.

Therapy for Black Girls
Online space dedicated to encouraging the mental wellness of Black women and girls. Offers listing of mental health professionals across the country who provide high quality, culturally competent services to Black women and girls, an informational podcast and an online support community.

The SIWE Project
Non-profit dedicated to promoting mental health awareness throughout the global Black community.

The Steve Fund
Organization focused on supporting the mental health and emotional well-being of young people of color.

Unapologetically Us
Online community for Black women to seek support.

Self-Care For People Of Color

We recognize that many mental health conditions are being triggered as a result of the coronavirus, the economic crisis and repeated racist incidents and death.

Learn more about mental health conditions including anxiety disorders , depression and posttraumatic stress disorder .

Article on coping with anticipatory grief
Article on coping with traumatic stress
Article on Racial Battle Fatigue

Treatment Directories

Educational Resources On Racism And Inequality

Understanding The Context Of Racism And Recent Events

Video on understanding racism and the reactions to the death of George Floyd and many others
Video on understanding the perspectives of your colleagues of color
Article on “White Privilege: Unpacking the Invisible Knapsack”
List of Anti-Racism resources

Understanding The Context Of Racial Inequality That Impacts Mental Health

APA Best Practices on working with Black patients
APA Mental Health Facts for Black Americans (2017)

Understanding And Addressing The Social Determinants Of Health That Impact Mental Health

Article on improving the health of Black Americans and the overdue opportunity for social justice
Video on understanding the social determinants of health and toxic stress
Video on the social determinants of toxic stress, specifically race and ethnic toxic stress
APA Stress & Trauma Toolkit for treating Black Americans in a changing political and social environment
The Robert Wood Johnson Foundation Page on Achieving Health Equity – Information about why health equity matters and what you can do to help give everyone a fair shot at being as healthy as they can be.

Ways To Take Action As An Ally Or Champion For People Of Color

Article on being a white ally through word, actions and power
Article on being a white ally for racial justice
Community based organizations to partner with: Color of Change , Black Lives Matter , Change Zero , The Innocent Project

Books To Read

White Fragility: Why It's So Hard for White People to Talk About Racism by Robin DiAngelo, PhD
How To Be An Antiracist by Dr. Ibram X. Kendi
Eloquent Rage: A Black Feminist Discovers Her Superpower by Dr. Brittney Cooper
Me and White Supremacy by Layla F. Saad
So You Want to Talk About Race by Ijeoma Oluo
The Fire Next Time by James Baldwin
The New Jim Crow: Mass Incarceration in the Age of Colorblindness by Michelle Alexander
The Next American Revolution: Sustainable Activism for the Twenty-First Century by Grace Lee Boggs
The Warmth of Other Suns by Isabel Wilkerson

When Affirmative Action Was White: An Untold History of Racial Inequality in Twentieth-Century America by Ira KatznelsonThe new season is a great reason to make and keep resolutions. Whether it’s eating right or cleaning out the garage, here are some tips for making and keeping resolutions.

Stages of Trauma Recovery: What It Means to Be a ‘Survivor’

Thu, 07 Nov 2019 13:52:47 GMT

I was recently reading a blog post and noticed that someone in the comment section asked the question: “What does it mean when we refer to someone as a survivor?” We hear about “survivors” of domestic violence and “survivors” of sexual assault all the time, but what does it mean when we refer to people in this way? I thought this was a good question to explore.

The description provided by the National Crime Victim Law Institute states a survivor is “a person who endures adversity, moves through it, and perseveres, or a person with resiliency who remains undefeated.” I like that definition. Below, I describe how this definition applies to the four stages that trauma survivors might experience as they heal.

STAGE 1: SILENCE

People who experience adverse situations, such as a traumatic event involving actual or threatened danger, face incredible challenges. The initial stage following a traumatic event is often a time of silence for the victim. It’s common for recently victimized people to refuse to talk about what happened. This may be due to a number of things, including stigma, isolation , shame , guilt , confusion, or denial about the event.

A person emerging from trauma may have low self-esteem at first and may feel overwhelmed and disconnected from the rest of the world.

STAGE 2: VICTIMHOOD

Eventually, the traumatized self may start to long for change as the ongoing suffering interferes with daily life tasks and a need to grow and recover begins to form. As this need grows, it allows the person to begin exploring ways to move through the trauma. According to available research, there is often a tug-of-war taking place within the individual between a need to be safe and protect emotions and a need to grow and confront the traumatic memories .The person may feel compelled to talk openly with everyone about what happened and the suffering he or she experienced. Some people will likely be more willing than others to listen. For people working their way through the stage of victimization, having someone to listen and support them as they process the event can be critical to their ability to move forward into survivorhood. Many people find support groups helpful during this stage and may seek counseling or other support.

STAGE 3: SURVIVORHOOD

Once a person processes the traumatic event and continues transitioning away from the victim experience, he or she often begins identifying as a survivor. During this stage, a person has had an opportunity to talk about his or her experience and has gained some sense of clarity. He or she may begin to identify the ways in which he/she persevered and the strengths that helped make moving forward possible. The person hasn’t forgotten the event, but he or she has a greater understanding about what the event means and the impact it has made on his or her life.

Reaching the stage of survivorhood doesn’t happen overnight. It may take months or even years to work through the victim stage and reach the point where one feels that the wounds are healing and a sense of relief is possible. Also, the process of healing is not linear. Survivors take one step forward and two steps back sometimes, and moving through it all and persevering may coincide with feeling hopeful one day and damaged and wounded the next. People in the survivor stage tend to spend less and less time feeling wounded as they continue learning new tools and recognizing themselves as resilient.

STAGE 4: THRIVING AND TRANSCENDENCE

Most people I’ve worked with seem content reaching the stage of survivorhood. They feel like they are managing challenges better and have a greater awareness about themselves and their experiences. Other people,

The person hasn’t forgotten the event, but he or she has a greater understanding about what the event means and the impact it has made on his or her life.

however, have told me they’re not done growing, and some of them have even said they don’t want to be called a survivor.

This group becomes the thriving group, people who transformed their experiences into a meaningful personal narrative and will not be defined by their adversity. They feel healed and safe, and take appropriate risks in seeking connection with others, such as asking a new neighbor out for coffee. They don’t feel the need to tell their stories unless it benefits someone else. “Thrivers” feel motivated to take part in the community and may seek out volunteer opportunities or other ways to help others.

Of course, this is only one model of healing and one definition of what it means to be a survivor. Every person who experiences a distressing event may have his or her own ideas about what it means to pull through a traumatic time or event. There are so many good reasons to communicate with site visitors. Tell them about sales and new products or update them with tips and information.

How Do Our Brains Respond To Trauma?

Thu, 07 Nov 2019 13:52:47 GMT

Our brains are amazing. They are the control centers for our whole body, and they make us who we are. But for some people, it can feel like they are fighting a constant battle with their brain. People who have experienced trauma, such as violence, abuse, a serious injury or a natural disaster, are at risk for developing a condition called Post-Traumatic Stress Disorder (PTSD). PTSD impacts the way in which a person’s brain functions.

There are three specific areas of the brain that are impacted by traumatic events. The first is called the amygdala. The amygdala’s job is to help control emotions, survival instincts, and memory. This is the area of the brain responsible for our “fight or flight” response. For someone who has experienced trauma, the amygdala can become hyperactive, making the person intensely aware of everything around them. This is the brain’s way of making sure that the person is able to get away from people, places or events which might cause them harm. This can make it very difficult for someone to relax, sleep or find joy in activities outside of their “comfort zone.”

The second area of the brain that is impacted is called the hippocampus. This area of the brain aids in learning and memory. Studies have shown that people who have experienced traumatic events may have a smaller hippocampus than those who haven’t. Research has shown that this may be due to hormones that are released when someone experiences frequent, high levels of stress. Prolonged exposure to these hormones can damage or destroy cells in the hippocampus. People with PTSD may have a hard time forming memories, but may have vivid memories of the trauma they have experienced. Situations that remind people of their trauma can cause feelings of extreme panic and fear.

The third area of the brain that is impacted is called the prefrontal cortex. This part of the brain is responsible for regulating emotions. The prefrontal cortex helps to control the activity of the amygdala. For people who have not experienced significant trauma, their prefrontal cortex will signal to the amygdala that certain situations or people are safe. This will calm down the “fight or flight” response. However, in people who have experienced trauma, the prefrontal cortex will have a hard time regulating fear and other emotions. This can lead to frequent feelings of panic and anxiety as well as dysfunctional reactions to situations that are not harmful.

So what does this all mean? For people who have experienced trauma, their brains have developed a way to help keep them safe. They become hyper-aware of their surroundings and feelings of fear often keep them from situations they perceive as dangerous. Unfortunately, this also means that people with PTSD may experience frequent fatigue, restlessness, fear and miss out on enjoyable activities. The good news? These changes in the brain are not permanent! There are different types of therapies that have been shown to help people overcome the impact PTSD has had on their life. Desensitization Therapy and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) are just two types of treatments which have been shown to be successful in helping to combat symptoms of PTSD. Certain medications have also been shown to be helpful for people who have experienced trauma. If you or someone you know has experienced trauma, please reach out for assistance. Your primary doctor or care coordinator can be a great source of information and can help refer you to someone who can help. You can find joy and peace again!