Richmond Ambassador’s ‘Resilience’ Screening Event is a Hit!

Richmond Ambassador’s ‘Resilience’ Screening Event is a Hit!

WAVE Trust 70/30 Ambassador, Daphne Cotton, hosted a hugely successful awareness-raising event on Adverse Childhood Experiences (ACEs) at The Exchange in Twickenham on 19th September.

‘Resilience: the Biology of Stress and the Science of Hope’ (Director James Redford) was seen by a packed audience, including policy makers from Richmond Council. Health leads, health professionals, headteachers and a variety of public and voluntary sector workers were amongst those attending. The screening was followed by a Q & A discussion with Twickenham MP Sir Vince Cable and a panel of experts comprising George Hosking (WAVE Trust), Dr Sarah Temple (Ehcap Ltd) and Shabira Papain (Best Beginnings)

The science of ‘Toxic Stress’ and the major findings that came out of the ACE Study (published 1998) are only now coming into the public domain, thanks in part to James Redford’s film. When children experience high doses of stress in their lives, the impact on their brains and their bodies can be devastating, often leading to lifelong health and social problems which tend to pass from generation to generation. Toxic stress is now understood to be one of the leading causes of everything from poor academic performance, substance misuse, mental ill health, heart disease and cancer, to violence and criminality.

The power of the film is that it demonstrates the possibility of breaking the inter-generational cycle of damage by the healing effects of trauma-informed practice. Babies and children suffer ACEs, not because of bad parents but usually because of bad things that have happened to the parents themselves when they were young. It is time to really tackle the root causes of society’s problems and break this inter-generational cycle of violence, addiction and disease. This is what Daphne is hoping will happen in Richmond and elsewhere. Already the response from key people in the borough, including Cabinet Members from Richmond Council, has been very positive indeed.

Since the Twickenham event, Daphne has been to Glasgow where she met Dr Nadine Burke-Harris, the paediatrician featured in ‘Resilience’. Dr Burke-Harris was the keynote speaker at a conference in the city on 26 September, “Making Scotland the first ACE-Aware Nation”, which was attended by over 2000 delegates.

As a direct result of the Twickenham event, local Police Inspector Ed McDonagh, along with Detective Superintendent Tor Garnett of the London Met Training and Transformation division, have organized a screening of ‘Resilience’ at Cineworld, a 700-seat cinema in Leicester Square on 29 November. These were Tor’s words in an email to Daphne the morning following the Twickenham screening: “Huge congratulations on such an inspiring event . . . I would very much like to explore how we could spread this within the Met so that we could become a trauma-informed police service – following on the heels of Scotland, South Wales and Ayrshire”.

Daphne will be on the Q & A panel following the Leicester Square screening, along with two of the Met’s top brass, Commander Richard Smith, Safeguarding Lead and Commander Mark McEwan, Head of Profession, Crime Prevention, Inclusion and Engagement. Also on the panel will be Rachel Egan, Assistant Director Early Help, Wandsworth.
As Daphne said “The knowledge is catching fire, it is having an impact and there is a sense of momentum and a sense of hope that we might at last be able to put in place, right across the country, what is needed to make a real difference.”

If you would like to get involved in helping to create an ACE-aware trauma-informed community in Richmond and neighbouring boroughs, get in touch with local Ambassador, Daphne Cotton, daphnecotton26@gmail.com.

How to stop involuntary recall, or flashbacks, of PTSD

How to stop involuntary recall, or flashbacks, of PTSD

Our subconscious, like a library of DVDs

As a new guest blogger for the 70/30 Campaign I have been asked to share with you my most recent blog on my own website about the involuntary recall, or flashbacks, of PTSD.


Imagine a library. Full of DVDs. With information on just about every subject you could possibly imagine. If you take out one DVD, you have access to the information contained in that DVD. All the other DVDs still contain the information they hold, but you are only looking at the information in the DVD you have in your hands.

The way our brains store memories

The memories of everything you’ve ever experienced are stored in your own internal library of DVDs, your subconscious mind. You can access any of those films whenever you wish. But if you took out all the DVDs at one time you simply couldn’t deal with them all at once, could you? So, your subconscious mind files all the DVDs away for access only when required.

Some of the DVDs are fantastic, enjoyable films that you like to watch often. They are filed on the easiest to reach shelves at the front. Some DVDs are really heavy going documentaries that you are not so keen on. So they are filed on the back shelves that you only access if necessary.

However, sometimes there are DVDs that are horror stories so awful that you put them in a box and tape it up before putting it down in the basement. And you choose when, and how often, you go and get any of these DVDs out of your library.

That’s how I like to see the way our brains store memories.

Sometimes something triggers a memory and you go running to your library to get out the DVD. Your senses often remind you of memories. You might smell a perfume, or hear a song, or see a particular scene and you rush to the library to get the DVD out which tells the story of the time when a sense was connected to a pleasurable activity. But sometimes it’s connected to a time you’re not quite so keen to remember. If it’s a really bad memory it will have been placed in the basement and locked away to protect you from going back there.

Traumatic experiences

However, perhaps something happened to you and you can make no sense of it. It is just too awful to comprehend. You can’t figure out how to file this film, so it sits there in the DVD player on the front desk. Always right in reach. Or perhaps, someone unlocks the basement and an awful DVD is brought back up to the front desk for sorting.

You see the images in those films whether you want to or not because they are not filed away. Many things might trigger you to watch clips from those films at all sorts of times. You really wish you could just file them away on a shelf and be able to choose if, and when, you watch them.

This is what it can be like for people who have experienced trauma. For some it gets easier after a while and they can categorise and file the DVD. Perhaps they have support to decide upon the category and help in getting the DVD put away on the appropriate shelf. But for others it just seems impossible. No-one seems able to help them. This awful film doesn’t fit any category. So it’s always there. We’re supposed to recall memories voluntarily. When appropriate. That’s why we have a ‘library’ in our subconscious mind.

Flashbacks

But if the DVD is always right in front of you the recall is involuntary. You can’t escape it. You can’t get on with the rest of your life if you keep being made to watch that film, can you? Going back to a place or seeing the person can be very triggering. But it’s not just things which are obviously related to the trauma. It might seem random. But if you experienced something as traumatic during a rain storm you might find that you have flashbacks when it rains. It happens when you least suspect it and are unprepared for it.

Involuntary recall is commonly referred to as Flashbacks. And it’s one criteria included in a diagnosis of Post Traumatic Stress/Post Traumatic Stress Disorder. Every time you are taken back to the traumatic memory you might see, hear, feel, smell or taste everything just as though it was happening right now.

Release yourself from flashbacks

treatment form for Rewind for PTSD

Do you want to file that film away on to a shelf, anywhere you wish, in your library? You will still have access to it, if needed. Sometimes you might still be reminded of it. It could still make you sad, or feel bad, for a bit but you can quickly put it back on the shelf. You can get on with living your life, doing things that you enjoy.

Contact me if you’d like me to help you Rewind that DVD so that you can easily and quickly file it away on to a shelf in your library and release yourself from the flashbacks and intrusive thoughts.

You will not need to tell me anything about the trauma. I will just need to know how it is impacting on your life on a daily basis through a simple form and we should only need 2 or maybe 3 sessions.

Don’t let the flashbacks rule your life any longer.


I am an Ambassador for the 70/30 Campaign, a founding member of the Dundee and Angus ACEs Hub, and a self employed therapist based in Angus offering massage, hypnotherapy, the Rewind Technique, childbirth education and doula support. I have two children, two dogs, two cats and notice that I typically lose about two years of memories following traumatic experiences. 

ACEs and mental well being – how education must respond

ACEs and mental well being – how education must respond

The movement to increase recognition of mental well being – its significance, its effects and its pervasiveness – is going strong. More than ever before, it is seen as of high importance and consequence.

While we should be grateful for these forward steps, though, there remains work to be done. Doing so entails a deeper look at Adverse Childhood Experiences, or ACEs, a set of 10 childhood adversities which have been shown to cause numerous physical and mental health difficulties throughout life. Given that ACEs affect around 50% of the UK population (and an even higher number in less affluent areas), their relationship to mental health issues in this country is likely to be a strong one.

Their effects take hold from early on in life, going on to impact behaviour, aggression and ability to form positive relationships. As the child grows up, these effects are amplified. Because of this, the education system is a prime site for the trauma of ACEs to be observed and responded to. Schools are well-placed to look at behaviour, performance and social ability through the lens of childhood adversity. By doing this, they will better understand each student’s mental state and its determinants. This represents an early step in approaching education in a ‘trauma-informed’ way.

What is trauma-informed education?

Trauma-informed education is part of a wider trauma-informed movement, which calls for a heightened understanding of people’s experiences of trauma – and the effects thereof – across different domains of society. A trauma-informed school system would focus on students’ sensitivity to past trauma, as well as how their experiences determine their response to different teaching styles and learning environments.

These responses differ because our brains develop according to formative experiences in the early years. People whose brains have adapted, or maladapted, as a result of adversity will interpret events and feelings in different ways. For example, a child who has experienced fear or violence may become hyper-alert, over-reactive and highly oppositional in the face of discipline or restrictions. Similarly, a child who has experienced neglect may struggle to form trusting relationships with school staff.

A trauma-informed education system could hugely benefit children with such adaptations. Comprehensive implementation would likely result in improved wellbeing, more complete social and emotional development, and a system which better involves families and the surrounding community (because understanding a child’s experiences necessitates connecting to their wider life, rather than siloing their schooling). On top of this, evidence suggests that students’ attainment would greatly improve. Indeed, it makes sense that a child who feels safe, looked after and appreciated would also feel more able to learn.

Becoming a trauma-informed school

A move to a trauma-informed approach to schooling now would be a timely one. Increasingly, schools face the difficulties of disengagement from students and their families. This, combined with a governmental fixation on attainment, has led to a culture where school exclusions are common. As WAVE’s recent report has shown, school exclusion very often condemns children to a life of social exclusion. Similarly, schools risk re-traumatising children who have faced adversity by failing to respond to their individual needs. So how could these be avoided?

There is no standard template for becoming trauma-informed: just as traumatised children have individual needs which must be responded to, schools have their own specific circumstances and challenges. That said, we can identify a few key foundational steps on which this transformation can be built.

For example, we can shift how professionals see and deal with ‘bad’ behaviour. Currently, children with challenging behaviour tend to be seen as problematic. Often, though, they are behaving in a way that is symptomatic of past trauma. Understanding that a child’s behaviour is a response to past experiences – and a way of communicating their feelings and needs – will encourage teachers to see them as needing help rather than being deliberately disruptive.

We can also ensure that staff are appropriately trained and educated. Doing so would mean training them to identify relevant issues and risks. These would include existing mental health issues, which may present in different ways. Beyond this, professionals should be able to identify any causal factors in a child’s life which indicate the presence of ACEs (or the risk of them occurring). We can also help staff understand what kind of delivery styles may trigger issues or exacerbate their negative effects. 

Finally, certain principles must be adopted. Focus must be given to the primacy of emotional wellbeing, both as a determinant of and additional to educational attainment. The importance of stable and trusting relationships with adults must be recognised and considered foundational to all school activity. Behaviour must be seen as a symptom of earlier or current trauma and considered a reflection of a child’s life, both in and out of school. Finally, linking with this, no child should be seen as a problem rather than a product of their experiences.

Through implementing these initial actions, a huge difference can be made. We would begin to see more schools linking with services and families. This enables better understanding of children beyond their school experience, as well as enrichment of their wider lives. Such care would surely result in students with enhanced emotional and academic development. The mental well being of our citizens would stand to improve greatly as a result.

I wish my teacher knew….

I wish my teacher knew….

Last week I attended a mental health first aid course run by Mental Health First Aid, (https://mhfaengland.org/) it was excellent and covered everything from – What influences mental health, Depression, Anxiety, Suicide ideologies, Psychosis, Self-harm and Eating disorders. As I was driving home I realised that as a school Health Mentor I have deal with all of these this school year (except psychosis) the school I work in is an outstanding school (in every sense of the term) in an affluent area.

 

The part of my role I cherish most is the 1-1 mentoring where I get to use my training, qualifications and experience to devise bespoke worksheets and activities which help young children to understand why they behave and feel the way they sometimes do. Some days I am humbled to the point of tears at the progress made my some of my mentees. Other days I am enraged, to the point of tears, at the position children find themselves in.

 

One of the mentoring sessions I use around family tensions includes –“This is what I want to tell you…” and “This is what I want to hear from you……” It can be a very powerful tool in communication.

It’s surprising how many parents can hear but not listen.

 

This week I will be working with children moving from our primary school, where every member of staff knows them, their backgrounds and family history to their secondary schools where they will be just one of hundreds of the ‘new kids’ for some this will be a chance to turn over a new leaf, a blank canvas and a fresh start. Sadly, for others it means leaving the care and support of the school ‘village’ that have raised them so far into a new, bigger, scarier village without the care and support network they have known since day one in reception.

 

In preparation for this I have designed an activity worksheet “I wish my teacher knew” and then contemplated the various back stories, traumas and difficulties already encountered by these young boys and girls. I considered how I have been able to support them because I both know of their problems and have been trained to help. Who will continue that work in September?

 

Most schools do not have the luxury of an Evolve Health Mentor, (www.evolvesi.com) trained in mentoring, counselling and mental health first aid. So how do other schools provide exceptional support for their pupils who need specialised support? The answer is in most cases, they don’t.

 

They have fantastic staff, naturally supportive, caring and giving their absolute all to help the children living with trauma and Adverse Childhood Experiences, but the lack of understanding and training in how trauma interrupts brain development and triggers a fight, flight or freeze response which manifests itself as poor behaviour means that despite the best efforts of wonderful good-intentioned teachers, teaching assistants, support staff and pastoral workers the pupils’ traumas remain untreated which can cause long term problems.

 

A movement to have all schools ‘trauma informed’ is gathering pace – the 70/30 campaign aims to reduce child abuse by 70% by 2030. https://www.70-30.org.uk/ this is vital in ensuring that the children who have the toughest start in life get the best help.

 

As part of my research on ‘I wish my teacher knew’ I came across this article from the New York Times


It’s global and needs addressing.

 

Trauma-Informed Schools are needed
Attachment

Attachment

I was 38 when I had my son – plenty of time then to sort my shit out – 20 years later than my mum – you’d think that by then I would have half a clue – you’d be wrong of course. I was clueless.

Because you cannot know what you haven’t been taught or more importantly be aware of what just isn’t in your consciousness. I have heard many people working in the public sector make proclamations like “but everyone knows this stuff” or “it’s really obvious” along with eyes rolled and they just don’t “get it“.

I had half an idea about attachment from a midwifery course I had done so I knew it was important but I didn’t really know what it meant in any meaningful way because some things you just have to feel. How do you know what love feels like? I thought that I could read about it.

I grew up in a family surrounded by alcohol abuse, my father was away a lot and my mother had mental health problems, which manifested in bi-polar type behaviour. She would be okay some days but on other days drunk, depressed, manically cleaning, destructive to herself or the environment (overdoses, paint thrown around, disappearing for the night, progressing to more serious overdoses, self-harm cutting her wrists, setting fire to the house) before eventually leaving and remarrying (phew).

We were teenagers by then but my younger sister was still at school and already drinking and falling. My mum did have one mental health assessment that I recollect and my older sister went with her. All of this was in the 80s and she was, is very strong willed, and lacks insight into her problems.

In the midst of all of this my sisters and I tentatively negotiated the tightrope of our lives never doing anything to upset the delicate balance, helping her when we needed to and doing everything for ourselves. It was never a good idea to ask for anything as it just caused too much pressure in an already fraught situation. My older sister was the surrogate parent and my younger sister the lost child. I am somewhere in between those two and have always naturally taken the caretaking role.

When I was 15, a neighbour who had hit my dad over the back of the head on the way from the pub and left him in the road unconscious sexually assaulted me. My parents had been drinking all night with the man whom my dad had upset by mocking his disabled daughter. He came to seek his revenge after he had told my mum where my dad was and she fled leaving the front door open. I was quite savvy even then and although sleepy I managed to fight him off before he could actually do anything more than grope, suffocate and try to strangle me.

My dad came back from the hospital the next day and I was hysterical because I could not sleep in the house and the GP came to sedate me. We had to be rehoused as the man lived in our street. My dad left home for good shortly after that. There was a court case and the man got community service because we were poor and they did not let me testify. I went back to school the following Monday with strangle marks still visible on my neck, my mum wrote a letter to the headmaster who said it was best not to give me any special treatment because people “might ask questions“.

I am aware that this event taught me several things at a very young age. The first that I had to be ready for anything and that there was no justice and that I was completely and utterly on my own and therefore had to protect myself.

Sometimes if I feel particularly upset I will sit in the house with my coat on, sleep fully clothed, and this gives me enormous comfort.

When I was pregnant, one of my biggest fears was that I couldn’t leave, that I had to depend on someone else. I had been pregnant before and miscarried, I had also had terminations and I think these all stemmed from that same feeling of fear. I didn’t labour and my cervix only dilated 1cm, I felt like a wild animal with its leg in a trap.

I was under the GP in pregnancy and was being signed off from work and I had my health visitor about my mums drinking. The health visitor asked if social services had been involved and I said no and that seemed to appease her. No one asked for any more details and because of my history I often cannot articulate what I am feeling so I just shut down. My mother did not talk to me at all throughout my pregnancy. It was not a nice experience and I felt like a burden to my partner because I was not working. By this time, my dad had left his partner and I found him somewhere to live near us so I saw him quite a bit.

I felt overwhelming emotion when I first saw my son; I had waited so long for him and was thrilled the second that he arrived. He was a chunky 10lb 9ozs which was good because if he had been tiny it would have scared me even more.
I honestly thought that if I stayed with my son 24/7 he would attach to me like osmosis. I did not understand that when he looked into my face he was looking for me to mirror back to him that the world was a safe and trusting place. I was not aware that a lot of the time he probably just saw confusion, fear – terror sometimes, loneliness, worries, tiredness and a complete lack of support.

He was hospitalised at 10 days old – I had blocked his nose when trying to breastfeed him with milk (all that nose to nipple malarkey) and his breathing was affected. My mother had visited me the day before and said “jokingly” that I would not be able to look after him – I was panic-stricken. I sat in the hospital sobbing and said I was giving up breast-feeding (which everyone thought was a great idea!) – Then the next day my milk flooded in.

I soon picked it up and felt quite good about myself. My partner, although initially not understanding how much support I needed because of my own lack of mothering, soon stepped up to his role. This has meant that he is much more hands on than most dads and has helped me massively with things like routines which would not have even occurred to me. I enrolled on some studies at the local university, as I was desperate for someone to mirror back at me that I was doing the right things, as this is what I needed the most and lacked. I went to baby groups that I found excruciating but did meet one nice mum who I am still friends with and has helped me massively.

At 6 months, I went to my GP because I was “worried that people were judging my parenting skills“. The GP sent me for counselling which was helpful and the counsellor referred me for physiotherapy, the referral was for 18 months’ time and never materialised and so I struggled on feeling increasingly anxious. When my son was two, I went back to work as a nurse. I hated it -the anxiety was awful and I felt pressured into it because we had no money. I had to leave him at a nursery where there was one really nice nursery nurse who looked after him but the rest I felt were just judging me and I still feel bad about leaving him there.

This unfortunately set up a pattern of behaviour in myself that has lasted 11 years. The year my son started school my uncle was killed outside a pub and that too was a massive trigger for me. I have paid so much for private therapy and desperately tried to get help with this constant feeling that I am doing it wrong alternating with we are not safe. The result of this is of course that my son is really anxious and that really is the killer blow for me. I have tried talking to the school but it is hard to explain all of this to people who just do not understand trauma. In my experience professionals are obsessed with knowing the salacious details and deciding if people are worthy for them to help. Unfortunately many professionals don’t actually have any solutions, are cynical about real change because it means that they have to stop blaming and labelling people and change their own behaviours, and approach the problem differently and a lot of them just don’t have that range of vision.

What I would really like people to take away from this is the following:

Everyone is worthy of our help – stop “othering” and using “they” statements think “We” as trauma ultimately affects all of us.

Professionals need to know how to get someone out of their (old, reptilian) trauma brain and into their new (frontal) thinking problem solving brain BEFORE they do anything else. This could be as simple as finding a quieter place to talk, smiling or changing their tone. Traumatised people do not do “neutral” – we read this as hostile.

If you do not think you can help someone signpost them to someone who is better able to help – do not ignore requests because it’s “not your job“.

Trust is really important – have integrity when people share their story with you.