Relationships key to healing from trauma

SEELEY LAKE – Traumatic events like the Rice Ridge fire affect everyone differently. According to licensed, clinical social worker Stacy York, a person's response and feelings are what make it traumatic.

"The way that we heal is through relationship. That is the only way," said York during her presentation on how trauma affects children, Nov. 15 at Seeley Lake Elementary. "If we are not in relationship, we can't heal."

York's presentation intertwined her personal stories and audience questions with the science of body physiology and brain development to help attendees understand children's response to stress and traumatic events. She also provided tools to be more effective while interacting with children and work towards healing.

York identified that historically people used to live in community as a large tribe. Over time families have become small and houses have added barriers to community. While the United States culture has resulted in material wealth, it is in poverty of social and emotional opportunity.

"The result on a community is divisions based on the haves and have nots and a need to connect socially and emotionally," said York. "The way I see the world is does my kid have a strong relationship with their parents? Does my kid have a place where they feel safe? Does my kid have a home where they are getting fed every day? Does my kid have a place where they can laugh and connect and play? That is the haves for me versus the have nots."

York said 90 percent of the brain is organized in the first five years of life. Experiences in the first two years of life have more impact on development than other life experiences. The stress response and the reward networks in the brain are shaped in healthy and unhealthy ways by relationships in early childhood. These relationships have a key role in global health, creativity and productivity of a group.

The stress response is activated during traumatic times. Since people's behavior is based on learned behavior, the longer a traumatic event occurs, the more it rewires the brain and alters the neural network.

"When you experience hard things in the middle of that development, it impacts the way you develop lifelong," said York.

Regulation and disregulation

York said heart rate can be used to gauge a person's physiological response to different situations. An adult is considered regulated if their normal resting heart rate is between 60-80 beats per minute. Children are regulated when their resting heart rate is between 60-100 beats per minute. If out of this range, the person is in distress. Understanding heart rate and ways to raise or lower is gives children and adults control over the body.

If the resting heart rate is above 80 for adults or 100 for children they are in an arousal response. They need to engage in a pattern repetitive activity that will lower their heart rate, such as tapping, walking or jumping.

A resting heart rate below 60 is called a dissociative response. Touch is a good way to bring someone's heart rate up when someone feels safe. Really strong mints, internal tastes and smells will also engage the senses and bring someone's heart rate up.

Both arousal and dissociation are state dependent and children and adults can fluctuate between the two.

York said the goal is to be regulated in the middle.

Brain Development

York explained the brain develops from the inside out and bottom up.

The first part of the brain that develops is the brain stem, responsible for the somatosensory system. It is fully developed by nine months and is responsible for sensation and spatial arrangement.

The regulatory part of the brain develops next. It deals with emotions and feelings. It is fully developed between the age of four to six years old.

Through the teenage years, the brain develops the limbic system which controls the social and relational part of the brain.

The final part of the brain to develop is the cortex. It does not fully develop until age 25. The cortex is the area of cognitive and abstract thinking and answers the questions why.

"It is our worst enemy because [adults] have one and [children] don't," said York. "So stop asking [children] why because the answer is always 'I don't know.'"

York said learning how to express emotions is not easy because everyone has their own way to express how they feel. Culture also shapes what is determined to be acceptable ways to express feelings in certain situations.

"That is not helpful because then we have a lot of adults that don't know how to express their feelings," said York.

York said that substance abuse is a pattern repetitive activity that engages the sensory system. Suicide is all about an emotional response, "I feel so strongly and I don't know how to get through it."

"If we want to solve all of those epidemics, we have to address the sensory and regulatory part of the brain and figure out how to do emotional development," said York.

York said there are only two ways to regulate people, either from the bottom of their brain up or top of their brain down. Children must be regulated starting with the sensory system up since the top of the brain doesn't fully develop until age 25.

"I'm not saying don't ever ask 'why,' but don't explore why when they are disregulated," said York. "I don't ask the question 'why.' I say tell me what happened."

York said once someone is regulated, relate to them before reasoning. If someone tries to reason before they relate, their child's response is often "You're not listening to me."

Relating is about empathy.

"Empathy is about understanding where the person is coming from. It does not equal agreement," said York. "That is really important because adults withhold empathy because we don't want to perpetuate bad behavior."

Empathy only happens when someone feels safe and he/she is developmentally in a place where they can care about other people.

Once a child is regulated and the adult has related, then an adult can reason with them. If any one of the steps is skipped, York said the situation will keep escalating.

Trauma and Healing

York said that children that are regulated can access the developing parts of their brain, they can reason and have deeper thinking. However when a child experiences a trauma event, their brain development is affected during the stage when the trauma occurred.

"You can't skip development. So we need to keep working through whatever those needs are developmentally," said York. "They may be in a 13 year old body but if the trauma happened at age seven, then developmentally and emotionally you are dealing with a seven year old."

When taking steps towards healing, adults need to be crisis responders.

"Our goal is for our kids to become self-regulating but the reality is it is not going to happen until much later so we need to co-regulate with them," said York.

However only regulated adults can regulate kids. York said sometimes the best option is to remove oneself from the situation so the situation doesn't escalate.

During crisis response, parents feel a lot of pressure from other people to manage their children. York said adults need to meet children's emotional needs and sometimes that may be at the expense of other's comfort. However if parents don't allow emotional situations to play out, then they lose the lesson.

"Emotional regulation is hard work. If you have kids that have been through hard things and a lot of trauma, they are storing lots of feelings that need expressed. They are going to come out as behavior if we don't talk about the hard stuff. You need to have the time to heal, connect and feel together," said York. "If you want to raise healthy, emotionally stable children you have to be in it for the long haul."

York came up with the acronym H.O.P.E. – Hold On Past the Emotion.

"Most people are scared to feel their feelings," said York. "However once you start feeling your feelings, it is like an ocean wave, it will wash over you and it always recedes. But if you don't ever feel it, you can never let it out. Most people hold feelings inside and the body keeps the score."

Another strategy is building trust and safety in relationships. York said building trust is one of the first developmental stages that a child experiences. If that trust is fractured, adults will have to work harder to build trust.

"The only way to build trust is time. I call it money in the bank. The more money you put in the bank of relationship, the more you are building that trust," said York.

York said everyone is a resilience factor during community trauma. Being proactive and building community and relationships before a crisis is essential to community resilience.

"The way that community healing happens is for more people to hold space while people process what they need to process," said York. "We need to make sure people in our community have support and they don't feel lonely and isolated. We build that tribe."

York has been a licensed, clinical social worker for more than 20 years. She is certified in the Neurosequential Model of Therapeutics developed by Dr. Bruce Perry with the ChildTrauma Academy. York said Perry helped her understand that the most effective interventions and interactions have to do with brain development and where children are at in their development. For more information email stacy@bewhatsright.com. She can also be found on Facebook at gobeyoullc, Instagram: gobeyoullc and Twitter

@stacyyork.