Trauma and Peer Engagement


Hello I’m Ivette Torres.
Thank you for joining us today as we talk about trauma and peer engagement, the intended
and unintended impact of trauma on individuals and those who witness traumatic experiences.
This webcast will explore media portrayals and stories as we see them today and how media
can present authentic stories of people who have experienced trauma and are recovering
with the support of peer engagement. Stories have the ability to motivate people
to respond to what we hear and what we see. They actualize the reality that prevention
works, treatment is effective, and people can and do recover.
Journalists and entertainment creators have a unique ability to tell stories that inspire,
encourage, and elevate conversations around important health and social issues.
Storytelling about substance use disorders is strengthened by including lived experiences,
non-discriminating or prejudicial language, an accurate depictions of helping help seeking
behaviors. Hearing about trauma about one who has lived
experience gives insight beyond a textbook definition.
It engages us in a way that moves us in a way to understand and connect to the common
emotion and challenges faced by individuals and groups who have, or are
experiencing, trauma. Whether you’re a storyteller or have your
own story to tell, encourage accurate portrayals of the individuals’ experience, not the disorder.
Refer to someone as living with a disorder, not as being defined by the disorder.
This webcast will explore the power of language and portrayals and their power to improve
public health. Today we are joined by Mary Blake who is a
Public Health Advisor at the Center for Mental Health
Services, Substance Abuse and Mental Health Services Administration within the U.S. Department
of Health and Social Services. Mary is a member of the Core Trauma Team within
SAMHSA’s Trauma and Justice Strategic Initiative and is the Federal Project Officer for SAMSHA’s
National Center for Trauma-Informed Care.
Mary is also the co-chair of the Federal Partners Committee on Women and Trauma.
Father Ragan Schriver is the Director of the Masters of Science in Social Work program
at the University of Tennessee.
Father Ragan also serves Catholic Charities, USA, as a consultant for their trauma informed
approach to working with clients. David Washington is an individual with lived
trauma experience, an advocate and trauma specialist.
He works to advance the field of trauma services in the criminal justice system and has extensive
experience on trauma-informed care and services. Mike Walter is a member of the Radio, Television,
Digital News Association and is the general News Anchor and co-host of Full Frame at CTGN
America. His award-winning documentary, ‘Breaking News,
Breaking Down’ solely focuses on trauma. Mike is a person with lived trauma experience.
Welcome to all of you. Thank you.
Thanks for having us. You know, trauma has many, many realms to
it and many arms to it, so why don’t we start, first of all, by really delineating
some of the areas where trauma could exist. Mary.
Thank you, Ivette, and thank you, it’s wonderful to be here.
SAMHSA has provided a definition of trauma in its concept paper on trauma and guidance
for trauma informed approach, and basically we talk about the three E’s of trauma.
We talk about the events, or the event, or the set of circumstances that happened, so
it could be a natural disaster, it could be physical violence, it could be intimate partner
violence, it could be war, combat, so we have the event.
And then we have the way that event is experienced. So in the context that it is emotionally or
physically threatening, harmful, and then we talk about the effect, has a long lasting
adverse effect on the person’s ability to cope, to engage in life, to function, so we
have the three E’s, the event, the experience of the event, and then the effects.
So when we talk about trauma, we’re not just talking about symptoms and we’re not just
talking about bad things that happened but we’re talking about all three of these things
that create ongoing problems for people for a person in their life.
I love that definition because I feel like it gives, kind of breaks it apart but allows
everyone’s individual experience to define their own understanding of what the circumstance
is for each person because I could do something to each person or talk to each person differently
and everybody would respond to that differently and I just think that’s the same with a traumatic
reaction. Here’s the event but it’s separate from the
person but the person is responding to that. It’s not like that’s a thing, and there’s
not a uniform response to every single person. I think, to kind of piggyback off what you’re
talking about, what’s interesting to me, having covered traumatic events, I mean,
I covered natural disasters, fires, accidents, homicides, you name it, I think that people
generally are enormously resilient, and I think that sometimes you can go in to an incident,
in my case, I talk about traumas as at least in my particular instance, I’ve covered so
many bad events, I’ve been in war zones, I’ve covered all of these things.
9/11 for me, I see it as these bricks that go into a wall and this was a brick that went
in the wrong way and the wall came tumbling down.
And for me, I couldn’t understand it, because I had covered so many things, it had never
really impacted me that way, and I know other journalists who were there on 9/11 and it
didn’t impact them but it did me.
That’s the story. David, I want to ask you a question.
In terms of trauma and its effect, does one feel the effect right away or it can be delayed?
Can the reaction be delayed? I think it can delayed, and I think when we
looked at that definition, what I love about it, it takes it out of the pathology
of the event and the consequences but it allows us to step back and see, years later, my dad,
who had a second grade education, experienced things that related to his race and how that
transcended the different generations in our family.
I think that the concept of the delayed reaction or sometimes like years later people
have a response, a response to a trigger to something that happened much earlier in their
life. It’s just a thing on how our physiology response,
what is our body doing to try to react whatever this adverse event that happened in their
life. It is so physiological.
For many people they may not make the connection from how they feel today or what they’re issues
are that they’re experiencing in today’s life to events that happened some time ago, and
so I think that’s another important piece, and the other thing I wanted to say is that
we don’t exactly know always why some people can leave really bad things and be able to
move on in their lives and not be hampered or not have impairments in how they’re functioning.
But we do know that there are certain factors that can help protect a person, good social
relationships, good connections, and other types of things.
We also know that historical issues can also impact the cultural narrative and that also
can impact how people view or experience the things that happened to them in their own
individual lives. Let’s talk about families.
I know we’ve talked about external factors, and I see Ragan, how you’re shaking your head,
tell us a little bit about trauma within a family structure.
I think this is the tough thing, you mentioned like these public events or public traumas
that occur everyone is seeing or watching on the
news. So many traumas occur within in the privacy
of someone’s life or in the privacy of a family. I think when there’s perpetrators within a
family system, it’s a trust, a boundary of trust that’s been violate so deeply, it�s
so tough, that’s a very, very deep violation, and I think it effects, throughout childhood,
you know, these things that we know. I think that’s why sometimes when we talk
about helping people recover, like, if we’re a friend or a peer or if we’re a therapist
or however we’re communicating to people, I think sometimes
our first sort of knee jerk is hey, trust me, you can trust me, but if violence or a
trauma occurs within a family, trust has been violated from an early age and so I think
sometimes the request should be, hey, I would like to earn your trust, can I do that?
Can I earn your trust? Will you allow me to do that, if I’m a peer
or a friend or someone communicating like that.
Are there differences between the types of trauma that one experiences, I know, Mary,
you started to touch on it, and the reaction from the individual who is receiving that
traumatic experience? So I think that we know that women are more
inclined to experience intimate partner violence, interpersonal violence, and that,
in the context of person to person violence or abuse can really change the way the person
views themselves in the context of their relationships, so going back to what you were saying in terms
of trust, in terms of how I view myself in relation to other people.
And some of it happens in a way that you can’t really make sense of it.
You don’t necessarily, again, tie that back to what actually happened.
When trauma or abuse happens under wraps, in secret, there are issues of shame, humiliation
that can come out and the person doesn’t feel comfortable talking about it, even if they’re
asked. They may not feel safe to say what happened,
they’re afraid they won’t be believed, they’re afraid it might be their own fault, and this
can be very difficult to seeking help. I think a lot of people I should never say
a lot of people. I hate blanket statements.
But I think some people feel like there’s something wrong with them.
And I think that, you know, I see this word behind you keyword.
I think it is key that we’re talking about this because I think trauma a lot of times
is compartmentalized, I think people think, I know in my case, I felt like there was something
wrong with me, I cover all these things.Why am I crying, why am I in this deep funk, why
am I in this depression, there is something wrong with me, my colleagues are doing fine,
there is something wrong with me. And I think the more we talk about it, and
that’s why I think it is so important to have programs like this.
Yeah. It’s vitally important.
Because, you know, if I broke my arm and I went to work, people would want to sign my
cast but if I go to work and say I’m having a tough time and I have to see a therapist,
there’s like, there’s something wrong with you.
We’ve got to get past that. The stigma is still there and it shouldn’t
be. And the more we talk about it, the more it
goes away. And Mike, you’re in the media business.
Is it important for the media to really begin to address this?
I agree. Totally.
You know it’s interesting, I think if we tell stories, you know, I’ve been a broadcast journalist
for years, if we tell a story that David was shot and killed on 19th Street last night,
we tell a 20-second story like that, we’re not doing justice to his life, we’re not doing
justice to what this, you know, you talked about the tentacles of trauma.
It’s right through the community. The Detroit Free Press did a piece, back in’a
series on homicide in Detroit in 2005, and they won an award for it.
They didn’t go in and say oh, this guy was shot to death.
They went and they followed the homicide detectives. They told the homicide detective’s stories.
They told the community’s story. They told one story about a guy who had crawled
to the back porch of this house, looking for help, and died on this porch.
These elderly people holding him, they called 911, and the guy dies and then his body is
taken away and the police are ready to leave, and this elderly couple say, who’s going
to clean up the porch? And they say, well, you’re going to have to.
And so the reporters broke away from the homicide detectives and stayed with that couple and
went with them as they bought the materials, and they told the story, a whole rich story
about trauma and community and it was a much different way of telling the homicide story.
And I think journalists have got to do that. I’ll never forget reading a story about Tom
Petty, the rock star, his house burnt down in 1987 and it was an arson case.
And this was in a Rolling Stones piece, and I’ll never forget this.
He said the reporters all showed up in their live trucks when my house burnt down and they
did a story about it. And he goes when I rebuilt my house, they
came back, they had the live trucks out there and they said Tom Petty has rebuilt his house.
They tell the beginning and the end. There’s a lot of stuff that happens in the
middle, and it is really important. And I think when you’re telling stories, you’ve
got to start hitting the middle, a lot is going on there.
I think earlier, Mary, you were talking about the human factor.
Yeah, no, I think that’s so important. I think that people have to understand that
bad are bad things happen to us and they can really impact us in our lives but they need
to know that there’s hope and that recovery is possible but you can’t just cut
away from the devastation to the recovery. People want to know what does that look like?
How can how can I move forward? Well, let’s talk about now I’m glad that you
mentioned that because moving forward for some people is a lot easier than for others,
and let’s talk about the areas where trauma has been a factor in those that are experiencing
mental and substance use disorders. Do you want to start, Mary?
So I just want to make sure I understand The correlation between having experience
trauma and the incidents of mental and substance use disorders.
So we know that the prevalence rates of the experience of violent or abuse and the
co-occurrence of mental health and substance use challenges is very, very high.
It is not that it is always addressed, though, in treatment.
So we have the data. There’s the adverse childhood experiences
study which really showed the correlation of adversity in childhood with a whole host
of chronic disease and social issue. That goes beyond mental and substance abuse
disorder. Absolutely.
Gets into heart disease, high blood pressure. Exactly. Diabetes, so on and so forth. Right,
Ragan? Mortality rates are affected by people’s life.
It’s a public health issue. People’s reaction to trauma and events of
trauma in someone’s life is truly a public health issue.
I think the question about what about association of disorders and substance use disorders
with trauma, I think, kind of the question, is what you were saying, is that, rather than
asking what’s wrong with this person, it’s what happened to this person?
That can be kind of our starting point with, you know, like you have a trauma, you fell
down, you broke your arm, you put a cast on it.
Okay. Here’s the issue.
Here’s what happened to you. How can we help you recover from this?
And I think the one thing that we see is that frequently people are seen for a medical
or mental health or substance use disorder and no one asks them their story around trauma.
I’ve worked in the field for 17 years with men and women behind the walls and they’ve
each had substance use treatment or mental health treatment but no one has said, what
are your traumas, how have they played a part in the person you became the person you are
today? And it’s like the Oprah Winfrey moment, that
ahha, that’s the connection. When I was 7, these things happened, and I’ve
been trying to find some way to get through this life, and I keep ending up in jail and
in jail. Let me ask you this.
I know some of you have lived experience with trauma.
Does anyone care to share their story? You know, mine was simple.
I mean, I covered traumatic events all the time.
On 9/11, I was driving in to work, and instead of getting there at the aftermath and covering
somebody else’s story, it became my story. I watched the jet as it banked over my car
and dove into the Pentagon and basically watched a mass murder.
And as I was saying to you before, you know, for me, normally I can I approach this thing,
I’m objective, I tell the story, but I found that when I would talk about it to somebody,
I just burst into tears. And I was ashamed.
I kind of thought I was a wimp. And I would immediately say, no, I was in
Somalia, I covered this, I’ve done this and that, I’m really, I’m a tough guy, I don’t
know what is wrong with me. And I remember saying that to somebody at
the Pentagon that day and a guy was in uniform and I started, I started weeping and he threw
his arms around me and he said, this is perfectly normal, you’re in a state of
shock, this is. And that affirmation, that was that meant
wonders to me. I think some people could respond differently.
But that meant a lot. And, you know, you look at the Pentagon, it’s
brimming with testosterone, this guy showed so much compassion and it really made a difference.
But I went into a deep depression. You know, you talk about self-medicating.
I don’t think I got to bad state, but it was just, I felt like I was under this
weight of this fog and When did you realize that you had this issue
and how did you seek help? No, no, no, I was in total denial.
Everybody around me knew it. My boss said they’re offering counseling,
you should go to it. My wife knew.
I mean, everybody was kind of pushing me. I remember my boss saying, you’ve got to you
should go to this group counseling, just go to it, you should just go.
And I said, you can’t take me off this story, you know, I’ll go only if I can do a story
on it. So I didn’t want to take that step.
I was invited to a conference about post traumatic stress disorder and journalists, and the person
who invited me, knew. And I was like oh, I guess I can go, there
might be something that I could learn about, that you know, maybe I could talk about some
people I’ve worked with. And I was in so much denial, the guy got up
and started talking about trauma and I was like oh, my god, that’s me, that’s me, that’s
me. And then that was the first time I really
acknowledged it. And does it happen that easily in families,
Ragan, you work with families, and so can you talk to us about not only identifying
what the issue is within a family but also what types of services are available to the
families? What you’ve just said, I think the compassion,
is a key component to this, and I think that sometimes people that have lived
with abuse that they’ve experienced for years, decades, and then maybe hit a midlife thing
and then it comes out, again, and so I think just the understanding of the compassion is
just a gigantic part of it, of being able to say, hey, look, you’re not alone.
You’re not alone. You’re not the only one that has had this
experience here. There are many people that have had this same
experience. That’s significant.
There are, if people are looking, there’s trauma informed providers that offer different
types of trauma informed. There’s bilateral stimulation, which is a
EMDR, which is a tremendous, a thing that began in 90s as a response to helping people
recover from trauma within families. It is also, I feel like that a lot of times
I think we look to PTSD and think oh, that’s strictly to the military but it isn’t, it’s
me and you, it’s us. We have this.
And it often gets engrained in our response to everyday activities.
I think the one thing also that is really important to understand is that, you know,
trauma can often run through the lifespan so if I’ve experienced trauma in childhood,
my risk for experience of violence or abuse or whatever goes way up.
Explain that a little bit more, Mary. So let’s say I’ve experienced abuse as a child,
say I have experienced sexual abuse, and I’ve learned certain ways to cope with it, right.So,
I don’t disobey somebody’s orders around sexual interaction
because that’s the way I learned how to survive as a child, so I might very well get into
a similar situations as an adolescent or as a young adult which kind of replicates what
I what I experienced in childhood and it is a coping strategy.
And it’s a higher degree of vulnerability for that individual .
Exactly. So there’s the lifespan but there’s also there’s
also kind of the inter-generational aspect, so we learn our coping strategies to survive
and those can be translated to our offspring and to our offspring.
So one thing that I think is very important is raise awareness that these kind of things
exist and there’s things that can be done about it and to understand that in a family
context, people are kind of operating off of what they’ve learned and there are things
that can be done to help the families and individuals recover.
I think I was raised near the Smokey Mountains and I’m very comfortable in the environment
of the outdoors. I just feel right at home there.
But if I had been raised in a situation where there was consistent violence or consistent
issues that I was facing each day, then I would be
more comfortable in that as an adult. It is like the environment in which you live
in where you feel comfortable. So you sort of gravitate to things which are
harmful to the body, are harmful to the spirit, you know, I think that’s a big deal.
And I think also, I feel like as far as communication of things, they’re triggering events are a
big deal for people in long-term recovery from
trauma, and I think oftentimes like how TV or how the news portrays things really can
do a trigger or spark something in somebody as a reliving of an event.
David. How difficult it is, I think they’ve just
mentioned that trauma can have an effect throughout the lifespan of an individual, more than one
person has mentioned that now. How difficult is it really to let go of what
has traumatized you into reach, ‘normalcy?’
And normalcy is the key term? [ Laughter ] If you got the secret for that,
I want to know.
[ Laughter ] As a survivor of rape when I was seven and
then perpetrators in my neighborhood sexually abused me until I was about 15, it has been
extremely difficult to let go of some of the pain because of the stigma associated with
being a man and being sexually abused, and it has been peer engagement that has really
helped keep me grounded and knowing where I’ve come from, where I’m at, and where I
want to go. And by having a group of men that saying,
when I’m beating myself up, because I think it should be this way, they say, look at where
you’ve been and what you’ve gone through. And like how you were saying, like the anniversary
dates that happened in October when, it gets close to October, I get a little
squirrely. When it snows, one of my triggers are snow
because when it snowed frequently school was closed, and is school was closed that means
the perpetrator had access to me all day. I’m 51 now and can still have moments when
they say the schools are closing that my inside gets a little stirred.
But with good treatment and my resiliency I can say I’m going to be okay today. I know
what to do to take care of myself. I’m going to go to Mary right away because
you mentioned something that we need absolutely to cover which is the peer support.
Mary, do you want to take us into the realm of support for those individuals?
How important is peer support? Peer support is invaluable.
Peer support are provides an opportunity for people to exchange information with others
who have been through similar experiences. It�s a way to say you’re not alone.
I’ve been through it too. It is a way to provide hope.
I’m able to move forward in my life and I know you can.
And it is a way to provide ongoing strategies, listening, and encouragement.
Peer support really balances out any potential for power differential because we’re operating
on the same level of we’ve been through this, we’ve been through similar experiences, and
we’re here to take, help each other out. So peer support is huge.
SAMHSA has done a lot of work around peer support for addiction recovery.
Also in the context of trauma. And I’d like to pass it off to some of my
colleagues here. Ragan. I feel like what you’re saying is that
many people who have experienced trauma, sometimes feel like life is being looked at through
a glass, like they’re on one side of the glass and everybody is over there, why can’t I be
in there, but when you’re experiencing a discussion with peers that have understood what trauma
is, wow, you’re on the same side of the glass, you get each other.
We have a program at Catholic Charities which is a peer to peer case management program
for people who have experienced post traumatic stress from the military, so it is veterans
working with other veterans. We understood that about 40% of veterans don’t
access services because of fear of stigma but here they’re with someone else that speaks
the same language, saw what they saw, it is unspoken, like they kind of get it, they don’t
have to talk to each other or use words, they use other methods and they understand
that and they’re able to support each other. And there’s been some significant responses
to that peer to peer interaction that we’ve seen over the past three years.
If I could just say, you know, I was talking about my situation, I got a Dart Ochberg Fellowship
who brings journalists together who have gone through the same thing and being in a room
where basically it is like five or six of us, just like here, and hearing other journalists
talk about it, it did wonders for me and the Dart center
in at Columbia University is very active in this sort of thing and not just from the standpoint
of helping journalists but helping journalists understand victims of trauma and how to tell
those kind of life affirming stories. You know we’ve been chatting about this, the
journey itself, how people end up here, you know, your story and then end up here, that’s
a life affirming story.
The documentary I made, people ask me, what it is about?
I tell them about it is about permission because usually what ends up happening is after you
screen it, people start talking about their own experiences.
A lot of people have kept it bottled up for decades, never felt like they could talk about
it. Suddenly it’s okay to talk about it.
Mike, we do have a clip. I know you’re a reporter and have expressed
your experience with trauma, and we do have a clip that we want to show right now related
to that experience. I’ve been a broadcast journalist for more
than a quarter century. That means I’ve covered breaking news too.
These are the stories I’ve covered, images I carry with me.
I’ve covered every kind of accident you could imagine.
And you can see the plane perched above me. More fires than I care to count.
More murders than I care to remember. But none of it prepared me for the biggest
breaking news story of my career. I saw the plane, the jet, the American Airlines
jet coming and I thought this doesn’t add up, it is really low, and I saw, it just
went, I mean, it was like a cruise missile with wings, it went right there and slammed
right into the Pentagon. I found on September 11th is the day we’re
on when I saw it began to wear on me. I was surprised at my emotions.
I’ve got a 14yearold daughter, and a lot of her friends have parents who work in the
Pentagon, and I just talked to her on the phone, and those kids are going through agony
tonight. They don’t know if they’re okay.
I thought I was a jaded journalist. But I kept fighting back tears.
I don’t know how I’m going to sleep tonight to be honest with you.
That’s the toughest part. The jet slammed into the Pentagon once but
for me, it never stopped crashing. Mike, that is a very moving clip, and can
you talk to us, why is it important for journalists to understand this and for them to be able
to portray this in a way that will help individuals who are watching these events cope with that
trauma? Yeah, it’s funny that you say that because
we’ve shown this at a lot of journalist conferences, this documentary, and I remember a therapist
was there and he said, you know, what about putting that clip in the film?
Should he have put it in there, him being torn up like that?
And one of the journalists said no, no, it’s terrible, he never should have put that in
there. And he said, well, don’t you ever cry?
Yes, but I always make sure I go and hide behind the satellite truck and do it there
you know? And I think if it almost kind of tears away,
like if it tells the story that, you know you can’t see sure we observe it
but we absorb it, and it is important to tell that part of the story.
Also important in the documentary is to kind of talk about how I struggled with this but
that the journey is really important, that, you know, if I could go back and change 9/11
and save all of those lives, I would do it in a heartbeat.
But in some respects my life is richer now because of that.
I think I’m a better journalist now because of it because I think it I think you’re
empathetic, any of us sitting here, you’ve got have a certain amount of empathy, but
to be on the other side and see it with those eyes, you know, going through it yourself,
now, when I sit down to talk to somebody like David, I think I’m more understanding, when
he’s telling his story, and I think that that’s what people who were telling the stories,
they’ve got to have that piece of it. I think that’s such a powerful thing that
you say said, and it goes back to the theme that keeps coming up in our discussion is
the human story. You know, I think it’s important also to recognize
that journalists are impacted by what they see.
Just as behavioral health providers are, just as so these things can elicit feelings
for journalists, either drawing upon their own past experiences in their personal lives,
or just in a vicarious way, and so being able to understand that what you’re observing impacts
you as well as trying to draw out the human story and build in that empathy even though
you have that stance of journalistic integrity I feel is important.
I think that, also I feel you telling the story like that in such is a way is a way
to have control over the event again. I think that’s a thing for many of our people
that experience trauma in their lives that it is out of their control, this thing happens
to them or it happens in their life and it is out of their control, and I feel like what
are way that is we can give people back control? I think you took control of that event and
then I think, like, David, your story is amazing to say how you’ve taken control and being
able to say, look, I’m going to take this horrible thing and I’m going to make it for
good, you’re in control of it.
I think it is so interesting you say that because that’s what changed me as a journalist.
If I’m sitting there and I’m talking to David, I’ll say to him, look, I want you to tell
your story, but if there’s at any point you want to stop or you’re in control here.
Giving the person who’s gone through it some control when you feel like you’re life
is spiraling out of control, that’s a huge piece.
Very good. Let me let me go back a little bit to talk
about peer to peer again. Mary, how does one become a peer support?
Is it natural because I’ve experienced trauma or are there other areas that I need to look
into before I can become a peer support specialist? There are many ways that is peer support happens.
It happens naturally in communities. It happens naturally even in families that
have endured bad things where people come together around these hard things that have
happened and try to find way to make meaning collectively and to move forward.
Peer support can also happen in a more organized way so in behavioral health we have peer support
that occurs and mutual self-help so things like Alcoholics Anonymous or other recovery
support groups where peers are sharing experiences and strategies for coping.
We also can find peer support in the context of services and service delivery, so people
can be trained as peer supporters, and they’re part of the team that provides treatment and
support to people. Recovery coaches, certified peer specialists,
there are many different ways that peer support can be provided.
Very good. I know, David, that you said that your fellowship
that you have with the group of men that come together.
Is there a particular way that one can encourage people who have experienced
trauma to seek that type of connection and get help?
Yes, and I think I would take it from the standpoint of what I do for a profession,
and I run trauma groups at a local detention center and we have men that complete the program
and it is called the TAMAR program, then they become peer advocates.
And they have a lived experience of incarceration, and trauma, and then they can let other men
on the pods know, there’s a group upstairs that is safe, that’s led by us, and a facilitator
where we can go and talk about what we’ve been through and how it has impacted us, and
what we’ve seen is that we have more men involved in our program with the peer advocates than
we have women who don’t have peer advocates at this point.
Very good. Excellent.
Ragan. I think this is a time where I feel like our
faith community, whatever perspective, could really step up, to be able to have things
like this, have support groups or have peer to peer kind of activities.
I think it is a great opportunity. I want to bring my own personal experience,
my brother really experienced trauma early on.
My brother’s relationship with his father was God plus one, and that was the universe.
And my father died when is he’s around 12 or 13 years of age, and at that point he starts
drinking at that early age. Becomes an alcoholic and always goes back.
I mean, his whole life he’s been going back and back to all these experiences and then
his relationship with his mother, and I try to, you know, as a sister, I’m not a therapist,
but I I’m in the business but, you know, in the field, but I really try to get him
to reflect and to understand that all of those experiences really need to be explored and
talked about. How can we, I’ve had minimal success, but
how can we actually begin to do I don’t want to call it an intervention, but how can
we help individuals who are in a scenario like the one I’ve just mentioned, Mary?
And everyone else. Well, it’s interesting.
Just drawing upon my own life history of having experienced sexual abuse as a child and having
kind of internalized messages, number one, it was normal.
So it happened in secret. And so I didn’t know that it wasn’t what should
happen, even though it felt really bad and then starting to blame myself.
And all of these things. There are many factors that kind of influence
how a person makes sense of what happened to them.
The first place that I would start is really to kind of is the awareness raising which
is really these things are more common than you think.
A lot of people say what happened to me wasn’t bad enough to count as trauma, and they don’t
really understand it. So helping people understand how things that
happened to you can impact you, and then, you know, the other side of it is that you’re
not alone, and making available different points of entry for seeking help.
Because it’s not just one way to do it. There are many different ways.
So for some people it’s really engaging in activities that are more common for their
interests and then having those opportunities lead you to more deep conversations with
your peers. It could be through treatment.
Ragan. I love what you’re saying, and I also love,
what you said earlier, to bring back in. Sometimes our society, something negative
happens, or we realize something negative is happening, we have a bad reaction to the
event, whatever it, that I’ve got to feel better
right away so therefore I go to whatever is at my hand ‘alcohol’ like mentioning your
brother, or sex or food or whatever, I got to feel better
right away and I think we lose the journey like what you’re saying, there’s this long
journey, it could be years, or months, or whatever, for each individual person.
And I feel as far as telling the story, I love your idea that we forget the middle part,
the important, essential part of the journey of saying hey, look, here I am as a friend
realizing somebody I know had a trauma, hey, talk to me, you don’t have to feel better,
you can feel whatever want to feel, just feel it, and I’m going to accept that.
I’m going to accept how you are right now. And to be it there in the middle of the gunk,
you know, I like that. You know Ivette, it’s interesting, you were
talking about your brother, I remember interviewing a women who was a heroin addict for years
and she talked about all of the things that she did that she felt so bad about in her
lifetime and she said, you know, my mom took money and put me through rehabilitation and
tried to save me and my daughter urged me to and my boyfriend and she goes, you know,
it was when I decided I was going to change my life, when I took control, and it is so
funny that you’re talking about your brother, I kept thinking about that, it really it’s
and it gets back to this whole journey question. It’s when does this person take control and
actuality do it. All of us can try and intervene but it is
up to the person. And getting back to the peer support, one
of the things I found interesting as we showed the documentary around the country, I showed
it in Southern California and this guy was here from KABC, the ABC affiliate, the reporter
and he, you know I was going out on these stories, it was getting to me and then one
time I was talking to the photographer and it was getting to him.
So we were just shooting the bull and back in the photo lounge one day, a couple of otherguys
came in, and it became an every Friday and you don’t have to go but it was an organic
thing, and it was total peer support and people would come and it was a safe place where you
can unload, and you could get all of that stuff that weighed down on you during the
week, and he said, you know, I’m not shouting at my kids on the weekends now, I get in
my car after that bull session, basically, drive home, I take the side streets so it
is a little longer, listen to classical music for about 45 minutes, unwind, let it all,
when I hit the door, I’m ready for the weekend and
all of that stuff for the week is gone.
I really think we have to think about no wrong door to recovery.
And quite frankly, sometimes our resistance is the one thing that we’ve learned that keeps
us safe, at least that has been our experience of it.
So really looking at all opportunities that can help people start on that road to recovery
and healing. Well, let’s talk about faith based Ragan.
Within the faith based community, when should the clergy or the minister or the rabbi or
anyone else who is a leader of their church, I want to include all churches.
Worship, yeah. Denominations.
What sign should they be looking for and when should they intervene when trauma is present?
Wow, that’s big. I think that, like, when someone is presenting
themselves, again, to just be there. I feel like that the role of the church leader
or the synagogue leader or worship house leader plays a significance in representing
a powerful representing God in a lot of ways and many times unfortunately the trauma
has come from the church or there’s spiritual trauma or that is so entangled because
it’s kind of your soul, you know, and if that abuse comes from within a church context or
within a spiritual context, it’s a significant Yeah.
It is significant damaging. And I think that the concept about how does
the church leader get involved, I feel like it begins sort of like what are you saying
from your pulpit or from your platform, are you saying things that are encouraging or
strength building or hopeful and healing? I think that’s the message of kind of saying
that and creating a welcoming, supportive, you are who you are, I accept you, God accepts
you message. That is kind of where it begins, from my perspective.
Can I say something? Absolutely.
I was a deacon and part of the services was to greet people and I would hug people
as they come to church and that’s kind of what we do, we hug everybody, and I notice
that there were women that I would hug that would tense up, and because I have this awareness
of trauma informed care I was able to step back and go, I don’t realize these women
are coming with the history of trauma and here I am a male hugging them and we step
back and in the congregation, I said, maybe we should ask people, would you like
a handshake or a hug. And that for us was becoming trauma informed.
It is cool because it gives that person control over how you relate to me.
Yes. I also think that faith leaders can really
take advantage of where they stand in their communities by raising awareness of the issues,
domestic violence. They can do it in a variety of ways.
They can do it in their sermons or however they speak to their congregation.
They can do it by having materials available. They can do it by having, you know, worship
groups that are tackling specific issues around suffering.
So I think there are many different ways, and a very powerful role that they can play
to raise awareness. A friend of mine at his parish, has they have
a I think I forget what they call it, it’s more I forget what the name
of it is, but it’s a more somber Christmas service that they have, where it
is people who have had death or loss or trauma in that year or in their life, when everybody
else is so happy and saying yeehaw, they’re able to say, this is a peaceful place, people
are suffering, let’s connect that to the Risen Christ or
whatever. And I know it is in retreats.
I went once to a retreat and the retreat leader had us write down anything caused any trauma
and then we burnt in a little fire. Mike, I want to go back to you.
I want to ask you about the portrayal of help seeking behavior in the media, how can the
media help in terms of dispelling some of the negative attitudes that there are, that
really exist out within the broader community related to help seeking behaviors?
Yeah, I think that’s really important. I think that, you know, I think it kind of
got back to what I was saying about the telling the middle of the story.
You know, I think all too often we want to go in and have somebody be a victim
and to cry and it is not a it may make for great television and really, one of the
things is, it you’re telling a story in a minute and a half and these are so nuanced
and complexion, but wouldn’t it be more helpful to tell the story of the person crying and
then maybe check back in with them in three months later and see that now, because of
what happened to them, they started a non profit that’s actually helping other people?
There are so many life affirming stories out there.
I mean, that was the goal when I put this documentary together was not to tell oh, geez,
whoa is me, I went through this terrible experience. It was to tell that I’m not the only journalist
that this has happened to, that other journalists have gone through this, and that the profession
itself, you know, there’s one of the journalists I interviewed is from Australia, and he said,
you know, look, there are a lot much people in our business who go through really traumatic
experiences and it impacts them, and he goes and so what ends up happening is they drink
themselves to death and so the bosses feel kind of bad about it so they’ll let Bill finish
out his career here until he’s 65 drinking himself to death instead of trying to figure
out how can we help Bill? And that is sort of our profession has been
for a long, long time. And I think it is no different than where
the military was at some point. I think the military actually has actually
turned the corner a lot better. And if journalists don’t understand that piece
of it, how can they tell the story of somebody who is going through that, in a positive way?
Very good. Getting back to what Mary said of no wrong
door. Let’s talk a little bit about the primary
healthcare setting, and what role should physicians be playing, nurse practitioners and others
in identifying helping their patients identify trauma and doing the correct referral,
and I’m going to go down the line because I see all of you shaking your head.
Mary. Wow, that’s a loaded question, and that’s
actually something that I’m working on at SAMHSA right now.
I think that the first thing that really needs to happen is to raise awareness in medical
education on the impact of trauma, violence, abuse, witnessing violence, and other traumatic
events has on physical health. The ACE study which I mentioned, the adverse
childhood experiences study, showed strong correlations to a number of co-morbid health
conditions like cardio pulmonary disease and obesity and addictions.
So raising awareness in medical education is very important.
And then helping doctors know, well, what do I do with this?
So there’s kind of an impetus to tell people you should screen for it, but doctors don’t
want to screen if they don’t know what to do with what they hear.
So SAMHSA is working right now on a project related to educating primary care so thanks.
I think that’s awesome. I think the primary care physician is oftentimes
the open, the first door for many people with whatever issue,
you come in, you’re suffering with COPD but you’re
smoking to try to numb yourself from whatever, etc., etc.
So I feel like be this could be a commercial for healthcare integration and how to make
the primary care physician could work seamlessly with the behavioral healthcare provider, the
pharmacist and the spiritual component of that person’s life, I think that’s an important
thing for pastors and people that are church leaders, how to make a good referral and have
a good warm handoff, have a bank of referral people that you know understand trauma and
you can refer people to. I feel like the integration and viewing people
as a whole. I think, often times as maybe a medical prior
might view you as a shoulder, as your eye, as your knee, whatever, but if is a whole
person, and this these traumatic responses comes from the whole body.
David. As a person with the lived experience, one
as an addictions counselor, we used to tell people not to talk about your traumas until
you have five years clean or sober, and I have a lot of gray hairs
so this is when I started.
And I think about how many people relapse and died as a result of us not being able
to hear their stories. So trauma informed care is more about than
just about the policies and the practice, it is
about the philosophy of the agency. And I got the training at an organization
in Boston and they called the individuals that they worked with guests.
And can you imagine going to an agency that calls you a guest, not a patient or a client
or a customer, and if I had been greeted with that type of philosophy early on, my life
might have been different, I might have entered treatment quicker.
But we need to start by agencies that are not only practicing trauma informed care but
not giving lip service to it. And how has the criminal justice system itself
been dealing with providing interventions for trauma?
I know you that work in a criminal justice setting.
Are we doing enough, David? Are we doing enough?
We’re doing better because we have groups like the TAMAR program which looks at safety,
remembrances, and mourning, and connection, looking what is trauma, what can you do about
it and can we get you involved in treatment.
But there are still a lot of prisons and detention centers that don’t have trauma programs.
But I think SAMHSA and NASMHPD. What is NASMHPD that?
National Association of State Mental Health Program Directors that travel around the country
educating people on trauma informed care and how everyone,
the cook, the person who is cutting the grass, everyone can have an impact on a person who
has a lived experience of trauma. And I do want to put in a plug because the
Road to Recovery is a television show that we can see at RecoveryMonth.gov and we
have also done programs on trauma in the past.
Mike. Can I touch on the medical professionals piece,
because I think it is really, really good question.
Frank Ochberg is at Michigan State, and he invited me out years ago, and we did this
session for all of the med students and they came and they flooded this whole auditorium
and it was a panel of, like, five people up there, and all of them had had traumatic experiences,
all of them had ended up in the ER, all of them had basically not been treated for that
piece of it. They had been treated for this or that.
And so it was talking about how do you how do you, as a medical professional, one of
the first person that sees them after they’ve gone through this traumatic experience, not
just treat the arm or, you know, the elbow, whatever, talk to them in a way that kind
of elicits or that you’re there for them, and it was so interesting because you see
all of these students and it was like a light bulb went on, they were, like, fascinated,
and they came up and talked to the panelists afterwards and they were like, you know, what
I never would have thought of this. And I think that’s really important.
Absolutely. And it’s better to get them at the beginning
before they enter the profession. It’s like I talk to a lot of journalism students,
they don’t see trauma as an issue that might impact them.
It’s good for the students to get, to wrap their arms around it, as well.
Well, I’m going to give you I’m sorry, Mary. No, that’s okay.
I’m going to give you about three quarters of a minute, we’re going to take questions
at in about three minutes, and so I want to get some final thoughts from each one of you.
Mary. Final thoughts are that the experience of
violence, abuse, and other traumatic events is a major public health issue and there is
a ground swell of activity that’s happening to make a change across the country.
Helping people understand that they’re not alone and that there are things that they
can do and help that they can get will make all the difference.
So telling the story from that lens is really important.
Ragan. I just want to kind of build on the strength
based idea that there’s so many strengths in the human spirit that how are we going
to build on those strengths?
And I love that you’re bringing up the idea of the vicarious trauma whether they are providers
or reporters telling the story that these traumas
impact us. It can impact us deeply as someone hearing
it or taking it in. And I would say that these spiritual wounds
that we have experienced can be healed and that everyone has a role in helping someone
recover. And I just would I would finish with it is
so great to have all of us here talking about it because I think, one of the things
I learned when we took the documentary and showed it in this city or that city or that
country or that country is how many people came up afterwards and I wanted to talk about
their own experiences. I think this is an epidemic.
It’s a silent epidemic. People don’t know it’s going on.
And I think people are dealing with it don’t want to acknowledge that they’ve got this
problem, and it is so great that the more we talk about it, the more it’s out there,
I think the more the more people will be able to say, hey, you know, I’m not I’m
not messed up, I’m not screwed up, this is normal, and it is okay to talk about it.
Very good. Thank you very much.
Mary, I have a question for you. What do women say to other women who feel
overwhelmed by personal trauma trying to maintain a balance between coping and caring for their
children? Wow, that’s a really that’s a deep question.
Well, I would say a couple of things. Number one, is that it’s very important to
learn about what helps you care for yourself. So understanding how you react in the face
of the traumatic experiences that you’ve had can be very helpful.
Seeking an avenue for peer support or for other types of services can help you learn
how to manage what is going on for you. And then second, in terms of caring for your
children, when you can start to interrupt the cycle in your own life, that is a prevention
strategy that helps you learn how to help your child learn healthy coping mechanisms.
There are things that you can do. Very good.
And they can go to SAMHSA.gov perhaps? Yes.
They can go to SAMHSA.gov and check out our trauma web page.
Very good. Ragan, in terms of the faith leaders who find
themselves in the role of first responders to any natural disaster emergencies, what
should we what should they be ready to do?
Well, in the back of the mind, how am I going to get this person to the appropriate person
that really knows this and understandings this.
What’s going to be my referral path? But I think just and also, I feel like sometimes
I know as a faith person that I think the first thing is to jump to tell them everything
is going to be okay, or to tell them that God does love you.
Where I think often people that have experienced trauma don’t believe that and don’t want to
trust that or whatever, and I think, like, again, that whole thing of accepting the person
where they are, at that point in their journey, the fact that they’re reaching out to you
is gigantic and to accept that gift. It’s a gift that someone has reached out to
you and that there’s a level of trust there, I think to be able to receive that gift is
a really, really big, big deal and to respond to that appropriately.
And then refer. And David, I’m going right down the line.
David, you deal mostly with men and you did mention something about the women as well.
How does the services for men and women differ or should differ?
One of the differences we see with men is that need to pull the family in.
If we have the family support, men are more likely to be engaged in treatment, again,
because of some of the stigmas associated with I’m a man, I have to talk to somebody
with these feelings, if their partner, male or female, is a part of the treatment process,
they’re more likely to stay engaged than not. Very good.
And Mike, we really haven’t brought the television and movie industry into this but
what is important for them to also realize as they tell their
stories and also to present these stories to the general
public? I think stay away from sensationalizing things
obviously is the first thing. And tell the whole story, the complete story,
if you can. I mean it’s much more nuanced.
It needs to be more contextualized and I think this, you know, A, B, C, rote kind of way
of telling a story, it doesn’t benefit the viewer, and
it doesn’t benefit the persons that you’re telling their story.
I mean, I always say, it is sort of like, you know, a journalist is almost like a doctor
in a sense. Somebody’s, when you sit down and you’re telling
their story, they’re giving you their story, and you’ve got to do it justice and I think
all too often we don’t. Should they include issues relating to substance
use disorder or mental health as they’re telling some of those trauma stories
to educate the public I think it gets back to some of the things
we’ve talked about control. If the person is okay with that piece of it,
I mean, if they’re not, they feel like their whole life is spiraling out of control, you
have to be sensitive to the person that you’re telling their story, I think.
Well, I think this has been a great dialogue about trauma.
You have given our audience an incredible insight into this subject matter, and I want
to thank you for being here, for being a panelist. I also want to remind everybody that SAMHSA,
you can go to the SAMHSA website for more information
not only about this webcast but for resources and to joins again on March 23rd for ‘Treatment
and Recovery, Research to Practice,’ that will be our next webinar, and I also want
to encourage you to go to the website and put in some new
questions if you wish to ask the panelists more questions, we’d be happy to refer the
questions to them. Thank you for being here.
It has been a great experience. Thank you.
It’s a pleasure. Thank you.
Wonderful people. Absolutely.

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