Relaxation, Resilience and Recovery: Take a Deep Breath and Change Your Brain

Did you know that just learning to relax is key to trauma-informed intervention, resiliency and recovery from a variety of disorders? Dr. Roger Klein, expert on the impact of relaxation training with children and adolescents, presented a workshop “Helping Children and Teens Self-Regulate Using Imagery and Relaxation” at a recent trauma conference. In this presentation, Klein underscores that that there are many ways children and teens can learn to regulate their responses to stress and traumatic events. Additionally, using imagination along with relaxation activities and resilience-focused thinking, young people can learn to minimize their responses to every day stress and traumatic experiences.

Relaxation is a state of being in which there is an absence of tension and hyperarousal, two common reactions to stress or traumatic events. Roger Klein and other experts on trauma propose that practicing relaxation skills over time is a highly effective way to mediate and reduce the effects of stress on the body and mind. Without the ability to relax, we may stay locked in a “fight or flight” response; the latter leads to chronic feelings of anger, depression, panic, and burnout and even stress-related medical conditions. In other words, there are many benefits to practicing relaxation including reduced susceptibility to disease, improved concentration and most of all, increased happiness and life satisfaction.

Meditation is one form of relaxation and is often defined as a form of mindfulness, the bringing of one’s complete attention to the present experience on a moment-to-moment basis. Mindfulness meditation has been studied for several decades and has proven to be effective in the treatment of pain, anxiety, stress and even addictions. Many trauma specialists now regularly apply some form of mindfulness practice in work with clients of all ages, including children, because of the outstanding evidence indicating that meditation actually “changes” our brains in positive ways. Mindfulness expert Jon Kabat-Zinn developed a now widely used protocol called Mindfulness-Based Stress Reduction (MBSR) to treat chronic stress and the illnesses that repeated exposure to psychological trauma causes, including high blood pressure, heart disease and weakened immune system functioning.

Just recently researchers at University of California at Los Angeles (UCLA) found that certain areas in the brains of individuals who meditated for many years were larger than those individuals who did not engage in regular meditation. They also found that those people who meditate have more gray matter and show less age-related brain atrophy (weakening), suggesting that meditation may be good for everyone because our brains naturally shrink in size over our lifespan. In follow-up studies, these researchers found that the benefits of meditation are not isolated to one part of the brain, but involve many parts including the cortex, limbic system and brain stem.

When it comes to children, some readers may ask, “Well, how do we successfully adapt what is known about meditation, mindfulness and relaxation to young people?” One popular technique I have used with children for many years is called “Lion’s Breath” and uses an imaginative metaphor (the lion’s roar) to help young people learn the same relaxation skills that teens and adults may learn through traditional methods and yoga breathing:

“I am going to teach you about a way to let go of worries or thoughts that might be bothering you. It’s called the Lion’s Breath and I want you to imagine you are a lion. Remember, a lion has a really, really big roar—can you roar? Now I want you to sit up with your legs crossed; if you feel more comfortable sitting up against a wall with your legs crossed, go ahead and do that (some children feel safer with their backs against a wall). Now, get ready to make your roar! Let’s try one all together as a group (we all roar in unison).

Before we roar again, let’s all think of a worry that we would like to let go off.  For a minute I want you to watch me and see how I roar. First, I am going to take in a really, really deep breath through my nose and then let my roar out through my mouth, sticking my tongue out at the same time and stretching out my arms out as far as I can in front of me. Let’s all try it together, okay?” (Leader and children perform the breathing and roaring together, sticking out their tongues and stretching out arms) (Malchiodi, 2000, p. 14).

Repeat this activity several times; inevitably the deep breathing, roaring and stretching lead to a child-friendly (and fun) form of relaxation. For more information on relaxation with children and teens, visit Roger Klein’s website.

Be well,

Cathy Malchiodi, PhD, LPAT, LPCC

References

Malchiodi, C. (2000). Creative activities manual for children from violent homes. Salt Lake City, UT: WIJ Publications.

TLC's Children and Trauma Annual Conference: Trauma-Informed, Resiliency-Focused

A little sandtray therapy at the Assembly

It’s time to make your plans to attend the 2011 TLC’s Childhood Trauma Practitioner’s Assembly from July 12 to 16th! The Assembly will be held at the Macomb County Intermediate School District’s (MISD) new Educational Service Center. MISD is located at 44001 Garfield Road, Clinton Township, Michigan 48038-1100. This year’s program is about practices that are both trauma-informed and resilience-focused; some are evidence-based, others evidence-supported, as not all evidence-based interventions are appropriate for all traumatized children. Here are some of the leading edge presentations this year:

Relationship & Neurobiological Integration Part 1 Many children of trauma experience changes in brain structure and brain chemistry. This workshop is focused on providing strategies through the caregiver’s relationship to create new pathways for the healing of a child’s body and mind system. We will look at how behavioral approaches discriminate against children with neurodiversity issues. A relational paradigm will then be introduced, and you will be provided with several strategies including: co-regulation, time in, the three A’s (attunement, affection and attention), self exploration, playfulness and humor, acceptance, presence, containment, being a sensory detective, physical affection, entering pain pathways, limbic resonance, the neurophysiological feedback loop, transitional time in, multi-sensory feedback, rupture and repair, collaborative communication, non-verbal communication and many more. Here are just a few of the offerings at this summer’s Assembly:

Group Strategies and Interventions with Youth Exposed to Domestic Violence Participants will learn practical tools and important themes to consider when working with youth exposed to domestic violence. In addition, content presented will help participants gain a trauma-informed understanding about how these strategies and interventions promote safety, emotional expression, coping, validation, and normalizing related to working with youth from violent homes. Participants will also engage in activities and experientials to enhance their awareness and insight about the benefits of using hands-on and creative interventions in group work with traumatized youth.

What Really Gets Worked Out in the Sandtray? Sand, images and the sandtray help create a “safe and protected space” for the builder. This psychodynamic process can be part of a nondirective or directive experience. Participants will see video clips including “Sandtray Storytelling” and a clip of how sandtray was utilized in schools with children whose parents worked in the Twin Towers as shown on the New York cable show, Frontiers in Psychotherapy.

No Bullies-No Victims: Trauma-Informed Bullying Prevention for K-12 This presentation will explore the bullying happening in schools and on the internet and explore specific, effective strategies at the organizational and student levels. Participants will be provided with a workbook outlining those strategies that can then be transferred to their organization or counseling practice. Emphasis will be on building students’ strengths by giving them the skills and strategies they need to prevent the bullying from happening and to deal with it when it does. Participants will also be given strategies for managing the environment and working with school staff and parents in order to help this transformation.

And of course, we hope you will join us for the keynote and full-day courses [to be described in a future post] to become certified in the use of TLC’s school and agency-based SITCAP® programs or, if already certified, to learn additional strategies presented by practitioners in a variety of 3-hour workshops.

Be well,

Cathy Malchiodi, PhD, LPCC, LPAT

Trust and Respect as Trauma Informed Practices

As many of you know, Dr. William Steele and I are in the middle of completing a book titled Trauma Informed Practices with Children and Adolescents. Here is a teaser from our chapter on “Trauma Informed Relationships,” on the topic of “trust and respect” in relationships between helping professionals and young clients:

“Trust and respect are central to any therapeutic relationship, including trauma informed relationships. Trust and respect are earned in part from creating a sense of safety between the client and the practitioner; these values can also be conveyed in other ways. For example, practitioners convey respect when allowing children to make decisions about participation in an activity or even responding to questions. Providing adequate information about sessions and activities in developmentally appropriate ways is also helpful because it suggests what will happen and what to expect. Being trauma informed means a sense of shared power and responsibility in the relationship is communicated, with the goal of empowering individuals to move from being victims to survivors to eventual thrivers. The long-term goal is to help children and adolescents become individuals who can trust not only the helping professional, but also find the experience of secure attachment in others. Here are some statements reflecting the shared relationship:

• In this room (playroom, office, recreation room), we will be working together.
• When we are together, we can do many things you like to do. Sometimes you will be the boss and decide what we will do. Sometimes I will decide what we will do. We will take turns being the boss.
• Sometimes when we work together, you will be able to play or draw pictures on your own. Sometimes we will play or draw together or just talk. We will decide together if we will play, draw or talk each time we meet.
• If we play this game (do this activity, use these puppets), you can be the one to tell me what to do.

In order to create a sense of safety, trust and respect, a few ground rules are also necessary to establish an effective trauma informed relationship between the helping professional and the child or adolescent. For example, a practitioner might say the following:

• In order to help you and other children feel safe in this room, there are a few rules. There is no hitting or breaking toys or games. No hitting or hurting yourself or me.
• Sometimes children wonder if I will tell your parent (foster parent, caretaker, teacher) what you say while you are here. I promise not to tell anyone what you tell me unless you are hurting someone else or yourself or somebody is hurting or might hurt you. If you might be hurt or hurt someone else, I will need to tell someone (case worker, social worker, etc) about it because I want to make sure you are safe and okay. Before I tell someone else, I will always tell you first.

These statements do not have to be made at the start of the session; they are actually more effective if helping professionals weave them into conversations during the initial and subsequent meetings. Because many children may not immediately understand these rules, it is important to repeat them over several sessions. In conveying any rules for safety and respect, remember to consider cultural preferences for eye contact, proximity to the helping professional, and talking. In addition to culture, children who have experienced neglect, abuse or chronic trauma have developed an idiosyncratic worldview because their experiences. For example, neglected children may be used to inattention and can remain still for long periods of time or play by themselves without interacting with adults. In this case, it may be helpful to sit by side rather than confronting face-to-face and making gentle, non-judgmental comments about what they are doing or creating. The goal is to lay the groundwork for security and to establish that there will be consistency and reliability in the relationship as much as possible.

Finally, as narrative therapists say, “the person is not the problem, the problem is the problem.” Many children and adolescents have come to believe that they are “defective” and they are problems that others respond to with frustration, hopelessness, or confusion. When working from a trauma informed perspective, it is important to communicate to young clients that they are more than the sum of what has brought them to therapy, counseling or treatment. Reinforcing a sense that problems are separate from the person is central to developing an atmosphere of respect for the individual as unique and capable of change. It also conveys and facilitates a trust in the process of working together to solve problems without blame or shame, two emotional beliefs that many traumatized individuals internalize.”

And we are looking forward to getting the manuscript to the publisher soon! Until then…

Be well,

Cathy Malchiodi, PhD, LPAT, LPCC

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