Trauma Informed Teaching

In recent years it has become widely accepted that trauma can have devastating consequences on the mental health and performance of individuals.  Much of our work at Frew Consults Group is underpinned by our understanding of the effects of early childhood trauma and we are finding an increasing number of professional development programs offered to schools that market themselves as being ‘trauma informed’.  It needs to be acknowledged that there is a potential danger of those delivering these programs.  Trauma, and the resulting Post Traumatic Stress Disorder (PTSD) is a very complex mental health injury and it is critical that those delivering these courses and the teachers that participate do not over-step their professional responsibilities and to exacerbate the psychological injury already suffered by these children.

 

Trauma occurs when events challenge the very foundations of our expected survival.  We all function with the expectation that we will endure and this gives us the confidence to plan and act within our community.  However, there can be times when these expectations are shattered through the experience of:

• Unexpected life-threatening events such as car accidents, earthquakes, severe illness, the death of a loved one, anything that threatens your stable view of the world.
• You come face to face with human vulnerability, you witness the injury to another person that demonstrates the fragility of life, in an instant the world changes through events that are out of your control.
• You come face to face with the capacity for others to preform what can only be called evil in the world.  History is littered with such events, take a tour of any of the more than 1,000 Nazi prison camps created in the period between 1933 to 1945 or visit the ‘killing fields’ of Cambodia.  Just visiting such places fills or at least should fill one with an overwhelming sadness.  You can only imagine being an inmate of such a facility.

 

The damage done by any such traumatic event is the result of the chronic level of stress that is experienced, it is so powerful it overwhelms a person’s ability to cope or integrate the emotions involved.  This inability to defend one’s self against these threats means that the individual is unable to discharge the energy that the fight/flight/freeze response has generated.  This leaves the individual is a state of constant readiness with their brains awash with a chemical cocktail including adrenaline, catecholamines and especially norepinephrine.  Amongst these chemicals is cortisol which is linked to the healthy discharge of the energy but if this does not occur than the constant presence of cortisol has an erosive effect of the very structure of the brain.

 

This inability to defend themselves means they are constantly ready for action.  They exist in a state of neuromuscular readiness, primed for action; tapped in a highly aroused state.  This situation results in the following experiences:

• Intrusive Thoughts - the individual may experience vivid flashbacks of the events, suffer nightmares or develop false memories to protect themselves from the truth of their experience.
• Avoidance – People will consciously or even unconsciously avoid situations that are associated with the traumatic event or even just avoid any stressful situation as they don’t trust their ability to cope.
• Hyperarousal – these victims are always ‘ready’ they are constantly scanning the environment for potential threats.

 

 

This very brief description of trauma is simplistic, the intricacy of this psychological injury is overwhelming.  In practice trauma is described in three ways:

• Acute – this is often associated with a single event such as a car crash or witnessing a serious accident.  This type of trauma can usually be successfully treated by a qualified mental health expert.
• Chronic – this is linked to multiple, long-term and/or prolonged exposure to traumatic events.  Things like domestic violence, bullying, serving in war zones or working in frontline services like police, ambulance personnel and even teaching in a dysfunctional school.  Chronic trauma is much more difficult to treat.
• Complex – This is particularly relevant to our work because it describes multiple exposure to traumatic events and can be coupled with childhood neglect.  These are the conditions for the children that are the focus of our work.  They are by far the most difficult and dealing directly with the child’s trauma must remain with the health professionals.

 

There is real structural damage to these children’s brains. Such alterations are:

• The amygdala which is that part of the brain that initiates the fight/flight/freeze reaction to stress is increased in size making the child more predisposed to being set off by imaginary threats
• The hippocampus, that part of the brain associated with memory formation and therefore learning.  This is reported to have a 12% reduction in size
• The prefrontal lobes, the executive part of the brain where our working memory functions are 20% smaller and have lesions on the surface.
• The cerebellum, which is critical for the interpretation of the environment’s potential threat is reduced in size
• There is a reduced efficacy of the corpus callosum which hinders the coordination between the brain’s hemispheres

The result is a real and permanent intellectual disability.

 

Students with early childhood trauma have rarely had positive experiences in forming healthy relationships.  They will:

• Minimize or misinterpret any positive stimuli – they don’t trust compliments
• Are hypersensitive to negative social cues – they expect the worst 
• Find it extremely difficult to understand or read the non-verbal cues of others 
• Have a high propensity to be overwhelmed by the emotional content of any incoming stimulus

 

Compounding these problems is the damage done by persistent neglect in early childhood.  The brain is developed though its response to incoming stimulus.  The most graphic example of the need for a stimulus at the time the brain is acquiring a proficiency is for sight.  If a child, born with cataracts does not have them removed within the first year, the lack of incoming light to the brain is not present and so the child does not learn to see.  If the cataracts are removed at a later time, it will be too late because the neural material in the pertinent part of the brain has been removed, pruned to improve the efficiency of the brain.  This phenomena takes place for all learning tasks.  It is particularly important in the formation of attachments and the lack of appropriate stimulus; a mother’s appropriate attention leads to problems associated with connection.

 

An extreme example of the real damage that occurs to children who suffer from early childhood complex trauma is illustrated by the comparative MRI’s of two children, one from a healthy environment and the other from a child rescued from the infamous Romanian orphanages founded under the reign of Nicolae Ceausescu in the 1980’s.

 

 

You can see not only the significant reduction in size of the orphan but also there is an increase representation of the black areas which illustrate areas of their brain damage.

 

It is the complexity of the damage done to children that makes treatment extremely multifaceted and challenges the most qualified of the medical profession.  The skills needed are well beyond the qualifications and experience of the best teachers. This is why any training under the guise of ‘trauma informed’ must emphasis that trying to directly assist any child suffering from PTSD is potentially damaging.  The only approach, as is always the focus of our work is to provide an environment that is:

• Structured - so the student can begin to trust their ability to predict what will happen
• Predictable – The students know what to expect when they choose to behave in a certain way or safely anticipate the behaviour of others
• Built on Healthy Relationships – the relationship between the teacher and student is the most important feature of any education setting that has children who have been exposed to complex trauma. 

By providing such an environment you allow the child to begin to trust themselves to take control of their lives.