Intro to Vicarious Trauma

[Music] a little pleasure to be here I'm just I think why I want to start I know where I want to start what I'll be telling you today is that the most important aspect of what we do with the population a very challenging population that you work with as I should have nothing to do with what we do the most important asset of what we do is not what we do what is the most important aspect anybody can tell me it's who we actually are it's what we actually bring to the present situation in the present moment right and in there so I don't get the doctor anymore I for last three or four years I just been too busy traveling and speaking and doing this kind of work but of the family practice consultant to the psychiatric service at st. Paul's Hospital and cooter so looked after the medical needs of people hospitalized for psychiatric mental illness and sometimes people are brought in you know in straightjackets and forcibly by the police and then put into these rubber rooms and when a doctor goes in to interview these people who are violent then we're always advice to the hospital security personnel with us you know there's big burly people that can restrain somebody in case they should act out and I always said I don't want any security people who they just let me in there and I found that if I go in there not with no fear with no suspicion of the intentions of that individual I just went in there just wanting to see them as human beings there was never any violence there was never any problem and not once did I feel installed in any danger whatsoever not once did I perceive myself as being threatened by anybody and there was never a single incident but if I went in there with two burly guys ready to jump I know I'd be creating a problem so this is before I even spoke a word so what I'm saying is that the people you work with who are very volatile people who carry a lot of trauma and a lot of suppressed and charged emotion it's not so much what you do but how you present yourself that makes the hugest difference are they going to react you know what they're going to do and that means that the first person you have to come to terms with before you interact with these people is not band with you so what's going on inside here what do I carry because I can also tell you that in my work with the addicted population in downtown east side of Vancouver these people are heavily into crack heroin and crystal meth whatever they're into there is something so it wouldn't go very well at all when everybody would be nasty and and aggressive and just attention and when I thought about those days the hell why the way that would be so lovely these days but today you know when I found out it was me if I show up in a certain way in a given day tense and I'll say more about this later but tense or stressed me reading at breakfast that morning I didn't sleep enough or maybe I was up to stuff in my life that wasn't that good in subs can feel guilty whatever was going on if I showed up on a job in a stress say they'll be mirrored by everybody that would interact with me naturally I wouldn't see that as my fault my son as their problem and given and I'm the authority figure and the doctor it is you know I could make it their problem because you know in any fight or any argument you know to ramification who wins well if the patient has no power of the people that I work with marginalized oppressed mentally ill people in any argument they don't land I win every time just as the authority that I have in a position but that doesn't make me right and what I found was that on days when I could be calm and present there'd be no problem and even if somebody would be in my face like this much away from my face screaming at me if I stayed calm if I wasn't threatened they would relax if in a second and or they'd be hacking Hasson are apologizing but if I was tense if I wasn't aggressive and now the whole day would be like that so that would be the theme today really is to look at what's inside here what's inside here so that's what I want to begin with is just to look at ourselves but maybe you don't maybe you understand what I'm saying already maybe you don't quite sure what I'm saying at the moment but I am saying that it all begins right here and so what we bring to this work has the major influence on the quality of the work but not just what's out there it's what's in here so I'd like to begin with that with a mindful awareness exercise so I'll ask you to all of you to put your pens down and just sit in your chairs we have a bit of a meditation if you don't feel like meditating just sit there please quietly I don't care it's your call I can't tell you what to do but I'm inviting you to join me in a meditation exercise so how you do this you sit with your feet on the ground so that you grounded your your back straight against the chair so that your back is not slumped forward or leaning back but straight head in the shoulders ice towards the ground eyes either closed or looking down whatever you comfortable bit head straight your hands on your lap left hand holding the right like this or your hands on your lap if you wish and just breathe follow your breath in and out and stay mindful of your breath and if you've mind and if you notice that your mind is wandering which it will by the way then just come back to it just come back to the breath whenever you can remember just let the thoughts go come back to the bath when the mind wanders again when you notice it just don't be frustrated yourself just just come back to the breath and so going to put on some chant right now meditative chant and we're just going to breathe to that each of us just being aware of ourselves okay [Music] okay thank you so I'm going to talk to you a little bit about the population that you work with first of all I may not be telling you much that you don't already know but I'm just going to summarize it a bit I first became interested in what happens to young people when I was myself diagnosed with attention deficit disorder at age 54 what I didn't know at the time because movie taught me medical school and it still don't teach this in medical school is that the human brain actually develops in interaction with the environment so that a lot of the things that happen in the brain are not because of genetics they're not because of bad hereditary programming but actually because of what happens to people in life particularly in the first few years so that many of the problems that you deal with in the youth shelters the clients that you deal with they're actually coping mechanisms that these kids developed which became then fixed in their brains and later on these early coping mechanisms become sort of a problem because there was a one-year-old if I tuned out if there's a lot of stress going on does the coping mechanism but then if I tuned out later on that becomes a problem when I can't pay attention and I won't be able to follow instructions so what becomes as a coping mechanism later on becomes a problem if you take a small child at birth who's got perfectly good eyes and he could see as much as a baby can see which is not much but you know I can see some stuff but if you put that child in a dark room for five years so he never sees life he'd be blind to actor for the rest of his life because the circuits of vision require light waves to develop so the kid to see light that even the surface that are present at earth will actually die and new ones will not develop and that kid is blind thereafter for the rest of his life because of a vision you need the stimulation of light waves if you look at the problems of the young people that you deal with what areas the identified provinces of first all day for impulse control whatever occurs to them to blurt it out if their acted out if their guests said they'll act it out if they're upset they'll scheme at somebody so there's no impulse control there's nothing up here that says you shouldn't do this right now don't do it you may feel like screaming but don't scream you know impulse control is I see this muffin over here and I really like it the way it looks and I'm a grad it's a blueberry muffin and I really like blueberry muffins I'm gonna grab it and eat it well that's my impulse is to grab that nothing but something up here says not a good idea it's not your muffin belongs to somebody else besides you in the middle of giving a speech right now this is no time to be eating muffins and if you do that they might not invite you back again you know so it's not there's nothing wrong with the impulse to grab the muffin but there'd be something wrong with me acting it out up here in my brain right where I'm pointing actually behind the right eye is a part of the gray matter of the brain that is supposed to regulate impulses stop me from acting out being appropriate impulse these kids that you're dealing with they don't have any boss regulation that part of the brain never developed for many of them and that's about you that's one of the features of a DD by the way is for impulse control another brain circuit that needs to develop is stress regulation so that when I'm stressed I can handle it I can call myself down I don't have to act it out I don't have to reach for substance because you know I mean substances drug drug use is all about or at least in 6 ohm range is about controlling stress so that when you raise stress that's the number one and and if you have an eating problem for example its when you're stressed and you only need a bunch of cookies or if you have a drinking problem it's when you're stressed that you know go on and drink a lot or act out whatever addiction that you go out if you don't have stress regulation motivation incentive our ability to do things or drive to do things in a focused kind of way that's another brain circuit that has to develop people who are addicted to crystal meth for example when I was treated for ADHD what was I given I was given dexedrine or adderall one of these medications what do these medications do they elevate the level of a chemical in the brain called dopamine the dopamine is an is an important brain chemical that's essential for incentive and motivation to feel more alive and to feel curious and and vibrant there's been an experiment with mice when you take this little mouse in a laboratory and you put some food in his mouth and he eats it and you choose it and he swallows with me likes it but if you put the food down a few inches away from his nose you won't budge the leader in fact will start to that rather than to eat why because genetically they knocked out his dopamine receptors so this brain chemical of incentive the dopamine just isn't there for him therefore it's not motivated to do anything but photos for the brain circuitry have motive and dopamine's brain chemical to develop you also need the right conditions so I'm not going to go through all the brain history here except to tell you that the important brain circuits that regulate human behavior and emotional self control and incentive and motivation all need the right environment just like you need the right environment for vision you also need the right environment for these other circuits to develop the opiate addicts like the kids who are into oxycontin or heroin or morphine luhan's opiate drugs well we also have an opiate apparatus in our brain we have a natural opiate apparatus these natural opiates are called endorphins endorphins endogenous morphine like substance we have our own opiates why do I want opiates anybody know why we're aware of this what do they do what do peas do in general is that manage pain opiates are the most powerful pain regulators that we have so heroin morphine and codeine you know these are powerful painkillers we have our own and the reason that the opiates work in our brain is because we have receptors for them you have chemical sites in our brain where these external chemicals can bind the reason we have these chemical sites in our brains is we have our own internal it's an internal opiates they do three things for us they regulate our pain own natural opiates the regulator pain secondly they give us a sense of reward and pleasure so whenever you're happy whenever you related people that go bungee jumping for example make sure to measure their endorsement levels the higher the endorphin level the greater the elation the greater the joy so whenever you feel joy and happiness it's because you've got endorphins flowing in your brain so that's the second thing that they do firstly thing control the third thing that they do is the most important they actually make possible the experience of love so that my love is really important when I say love I mean the buoy sentimental romantic feeling of love I mean the connection the attachment between mother and child it's it's because the infant and the mother both have endorphins in their brains that they're able to connect with each other so if you take infant mice and you knock out their endorphin receptors genetically they will not be crying for their mothers if you separate them from their mothers and what would that mean in the wild what would happen to a small mouse in the wild if she didn't cry for the mother on separation what would happen to that Mouse well they become free they they die because only the mother protects the child so that the opiate addict the oxycontin addict the the heroin addict what are they looking for they're looking for pain relief they're looking for a sense of pleasure and reward and they're looking for a sense of connection so sex trade worker once said to me she was 27 through the heroin addict and after what heroin did for her she said the first time I did heroin it felt like a warm soft hug the warm side likely to give you an experience of love but those circuits have to develop in our veins and the people they're prone to addicted are the ones in whom these surfaces didn't develop but why not why not give the conditions were right so just as you need light for the stimulation of the visual circuit to develop for the circuits of self-regulation and emotional regulation balance stress regulation pain relief pleasure and reward love and connection incentive and motivation you also need the right environment and the necessary environment for those circuits is the presence of parenting caregivers who are emotionally available consistently available non-stressed non-depressed in the tune to you keep a capable of connecting with you so the necessary condition for the development of these key brain circuits is the presence of non-stress non-depressed emotionally available consistently available attuned panting caregivers my kids don't have that that brains don't develop the right way and then they're prone to suit themselves and drugs and then they're prone to act out impulsively and not to be able to regulate their their emotions and then to be aggressive and so on and so forth in other words the kids that you're all dealing with are people who didn't have the right conditions and not only didn't have the right conditions for development so the none of what they're doing what they're doing is not delivered behavior in that part there's no choice in the matter it's that their brain don't give them the capacity to behave any differently so you're actually dealing with people who have been traumatized because under conditions of trauma these circuits don't develop I can tell you that in a done tiny state of Vancouver with the drug-addicted population or a group with all of them have been traumatized every scene one has been traumatized the women are all being sexually abused and they're all been physically abused male/female emotionally neglected and abandoned and that meant two things it meant three things actually probably meant many things but the three major things it meant is number one the sense of the world was that this is not a world that I can trust and especially I can't trust caregivers good caregivers hurt me because most of the time that kids are traumatized it happens in the families of origin so the people are supposed to look after me the people are supposed to care for me the people are supposed to nurture me I can't trust them guess what they don't trust you because you're the authority figures that is supposed to help them and care for them and look after them why would they trust you the experience is that you can trust these people they will hurt you so they will look at you with suspicion they offer nothing you do not you deserve this decision but because that's how they see the world that's the first thing the second thing is that well I mentioned that when I was diagnosed with a DD I was given dexedrine now what are the DEXA didn't do that saline elevates the level of dopamine in the brain dopamine of course gives you more incentive motivation and focus it's a stimulant what else elevates dopamine caffeine does it's a stimulant nicotine does it's a student cocaine does it's a stimulant and crystal meth does it's another stimulant a lot of these people are self-medicating a lot of these kids who are into crystal meth are actually sus medicating any deets they're trying to give themselves more dopamine up here so these people were very much reformed to be stuff medicating someone with self-medicate with the opiates some of them uh sub- cigarettes or alcohol or whatever these are all stuff medications and the third thing is they have raped for self-control because the service except control did not develop in their lives so they don't trust you they self-medicate and they have poor impulse control what that means you've got a real job on your hands don't you well the reason I'm telling you this is because sometimes there's a tendency to take the behaviors of our clients personally it's not personal to you this is them given their history and they can't really help it so the challenge is audio work with a population who's been traumatized and who act out their trauma sometimes in ways that are very difficult to deal with and we don't trust you to start with and how do you do that without being traumatized yourself because the focus of this day is actually what's been called the curious drama the the trauma that comes from being with or working with people who are themselves dramatized so I'm gonna stop here and I'm gonna ask each of each table here or whoever you can speak with for the person next to you just maybe have a three-minute conversation and the other question I'm gonna ask you is that what is the biggest challenge or what is the biggest upset for you and working with the population that you work with and I like your some of those answers so I'm gonna ask you to discuss with each other just to listen to each other and and to articulate what are the biggest difficulties upsets or challenges that you deal with in working with this population okay I will come back in about five minutes okay please have that conversation

Channel: Paloma Foundation

Views: 97,327

Keywords: Paloma Foundation, Gabor Maté, Vicarious Trauma

Id: A1i7m1By8Nw

Length: 24min 51sec (1491 seconds)

Published: Sun Apr 09 2017