Independent Consultant Working with Adults in Childrens Lives 1 Mike Mawby Consultancy Limited SC509365 What do you see 2 Mike Mawby Consultancy Limited SC509365 What do you see 3 Mike Mawby Consultancy Limited SC509365 ID: 429422
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Mike MawbyIndependent Consultant
Working with Adults in Children’s Lives
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Mike Mawby Consultancy Limited SC509365Slide2
What do you see?
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What do you see?
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The Dress Debate!
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What do you see?Mike Mawby Consultancy Limited SC509365
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Risks before and at birth
Adversity before and at birth can result in lasting developmental impairment and impaired brain
function
Such adversity can also have an impact on the capacity of the child to benefit from the attachment process
Kate Cairns (
Akamas
)
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Mike Mawby Consultancy Limited SC509365Slide7
Impairment may be caused by:Mike Mawby Consultancy Limited SC509365
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Adverse genetic inheritance
Maternal exposure to illness, extreme deprivation, extreme trauma, toxic substances
At birth: head injuries, lack of oxygen, complications of prematurity or low birth weight
Kate Cairns (
Akamas
)Slide8
Developmental trauma
Trauma means injuryUnregulated stress causes injury to the brain
Children with unmet attachment needs often cannot regulate stressInjuries acquired through stress
dysregulation
because of unmet attachment needs may be described as developmental trauma
Kate Cairns (
Akamas
)
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Emotional trauma
Once children can process feelings and can think, they may be injured through exposure to terrifying eventsSuch events lead to extreme stress which injures the brainInjuries acquired through exposure to overwhelming fear or horror may be described as emotional trauma.
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Post Traumatic Stress
The child feels overwhelmed, out of control, terrified.
The child is living in a traumatised mind where the sense of threat is CURRENT.Memories of the trauma intrude and flashbacks are like reliving a film clip. They feel overwhelming and real.
The mind dissociates in an attempt to avoid reliving the emotions.
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Trauma and
stress
pile-up: Allen 2001
PAST TRAUMA: afraid and alone
Sensitised nervous system
CURRENT STRESS: reminders of trauma
Unbearably painful emotional states
RETREAT
isolation
dissociation
depression
SELF-DESTRUCTIVE
ACTIONS
substance abuse
eating disorders
self-harm
suicidal ideation
DESTRUCTIVE
ACTS
aggression
violence
rages
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Impact on the Developing Brain
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Traumatised Children
Children’s
responses to trauma are complex and different to those of an
adult ...
... But ...
the trauma doesn’t disappear once children become adults!
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Spectrum of Dissociation
Daydreaming
Autopilot e.g. motorway hypnosis
Emotional
shutdown hearing of trauma
Crisis
experienced/observed
Dissociation
to survive
(
depersonalisation
/
derealisation
)
With repeated trauma –
dissociation
becomes a way of life
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Impact on the adult brain
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How common is trauma?
97% of homeless women with mental illness (Goodman et al,1997)
82% of adolescents in an inpatient setting (LeBel
et al, 2004)
51
% of State Hospital female patients had history of
Child Sexual Abuse
(
Craine
et al, 1988)
67
% of female outpatients had history of abuse (
Muenzenmaier
et al,1993)
Adults with schizophrenia 85% history of Child Sexual Abuse or Physical Abuse (Holowka,2003)
Female outpatients with schizophrenia 78% had history of Child Sexual Abuse (Friedman,2002)
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Consequences of Trauma
These
fall into four major categories:
Persistent fear state
Disorders of memory
Dysregulation
of emotion
Avoidance of intimacySlide20
Within a traumatised population
there is likely to be an increased incidence
of:
Mood disorders
Suicidal ideation
S
ubstance
misuse,
Personality disorders
Dissociative disorders
Psychotic disorders
S
elf-harm
, eating disorders and anxiety disorders
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So why do we need to think about trauma in the context of adults caring for children?
Across psychiatric diagnosis, patients with childhood trauma
have earlier first admissions, more admissions, more seclusion, more self-mutilation, more suicide attempts, more successful suicide attempts, more medication, and higher global symptom severity
(Read
, 2005)
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Age
Secure/optimal
development
Sub-optimal/
Insecure/trauma
etc
Intervention
eg foster/
residential care.
Emotionally intelligent
best friend
Attuned, psychologically
minded teacher,
drama/music therapy
David Howe 2009
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