CORE SKILLS CURRICULUM

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CORE SKILLS CURRICULUM

• Understanding the Complexity of Traumatic
  Experience(s)
• Gateway to Intervention

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The Complexity of Traumatic Experience(s) The
Gateway to Intervention

• Objectives
• Enhance understanding of the complex components
  of child and adolescent traumatic experiences.
• Increase capacity to listen, using a systematic
  framework
• Increase recognition of omissions and difficult
  moments
• Enhance clinical confidence to engage children in
  trauma narrative work
• Appreciate the capacity and courage of children
  in meeting the challenge of trauma narrative work

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Danger Apparatus

• Traumatic experiences need to understood within a
  broader context of danger.
• The human brain and body are geared to recognize
  and respond to dangers.
• Danger takes a priority over normal activities of
  daily functioning.
• There is a developmental ontogenesis of danger
  and response.
• Culture helps define appraisal of threat and
  possible responses.
• Experience molds expectations of danger and
  selections of interventions.

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Danger Apparatus

• Appraisal of the Magnitude of External and
  Internal Danger.
• Emotional and Physiological Activation
  Valence, Intensity,
  Acceleration.
• Efforts at Emotional Regulation, including
  Suppression or Override of Inhibitions.
• Estimation and Efficacy of Protective
  Intervention by Self/Others/Social Agents.

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Danger

• Secondary Appraisal of the Magnitude of External
  and Internal Danger (Actualized threats,
  near misses and false alarms).
• Secondary Efforts at Emotional Regulation.
• Reconsiderations of Preventive and Protective
  Intervention by Self/Others and Social Agents.

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When Danger Becomes Trauma

• Failure of the danger apparatus to prevent an
  injurious outcome.
• Moment(s) of true physical helplessness.
• Convergence of external and internal dangers.

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The Complexity of Traumatic Experiences

• Context
• Multiple traumatic moments occur, even within a
  relatively circumscribed situation.
• Changes foci of attention or concern.
• Radical shift in attention or concern when
  physical integrity is violated.
• Additional traumatic moments after cessation of
  violence or threat.
• Additional dimensions to traumatic experiences.
• Disturbances in evolving developmental
  expectations regarding danger.
• .

Pynoos, Steinberg Aronson, 1997
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The Complexity of Traumatic Experiences

• CONTEXT
• A. Circumstances
• B. Affective state
• C. Cognitive preoccupations
• D. Developmental concerns

Pynoos, Steinberg Aronson, 1997.
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The Complexity of Traumatic Experiences

• MULTIPLE TRAUMATIC MOMENTS Even within a
  relatively circumscribed situation.
• Moment-to-moment perceptual, kinesthetic and
  somatic registration.

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The Complexity of Traumatic Experiences

• MULTIPLE TRAUMATIC MOMENTS Even within a
  relatively circumscribed situation.
• B. Ongoing appraisal of external internal
  threats.

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The Failure Of Developmental Expectations

• Alarm Reactions
• Social Referencing
• Searching
• Protective Shield
• Resistance to Coercive Violation
• Basic Affiliative Assumptions
• Emerging Catastrophic Emotions
• Socially Modulated World
• Surrender Moment of Unavoidable Danger

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The Complexity of Traumatic Experiences

• MULTIPLE TRAUMATIC MOMENTS Even within a
  relatively circumscribed situation.
• C. Ongoing efforts to address the situation in
  behavior, thought and fantasy

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The Complexity of Traumatic Experiences

• MULTIPLE TRAUMATIC MOMENTS Even within a
  relatively circumscribed situation.
• D. Continuous efforts to manage emotional and
  physiological reactions.

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The Complexity of Traumatic Experiences

• CHANGES IN FOCI OF ATTENTION OR CONCERN
• Attention drawn away from ones own safety out of
  concern for danger or injury to other.
• Moment of estrangement from others when immediate
  threat or injury to self.
• Sudden preoccupation with concerns about severity
  of injury. Rescue or repair after injury to self
  or other.
• Inhibition of wishes to intervene or suppression
  of retaliatory impulses from fear of provoking
  counter-retaliatory behavior.

Pynoos, Steinberg Aronson, 1997.
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The Complexity of Traumatic Experiences

• RADICAL SHIFT IN ATTENTION OR CONCERN WHEN
  PHYSICAL INTEGRITY IS VIOLATED
• Attention directed towards fears/fantasies about
  nature/extent of psychic/physical harm.
• Engagement of self-protective mechanisms to meet
  internal threats and pain (including
  Dissociative physiological responses and
  fantasies).
• Efforts to invoke or disclaim of affiliative
  needs/desires in order to mitigate fear or ward
  off sense of active participation.

Pynoos, Steinberg Aronson, 1997.
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The Complexity of Traumatic Experiences

• ADDITIONAL TRAUMATIC MOMENTS AFTER CESSATION OF
  VIOLENCE OR THREAT
• Efforts to aid injured or attend to dead family
  members or friends.
• Efforts to seek outside help (e.g., police,
  paramedics).
• Experiences during acute medical or surgical
  care.
• Acute separation from significant others,
  including injured or dead family members or peers.

Pynoos, Steinberg Aronson, 1997.
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The Complexity of Traumatic Experiences

• V. ADDITIONAL DIMENSIONS TO TRAUMATIC
  EXPERIENCES
• Worry about safety of significant others whose
  well-being is unknown.
• Reactivation of previous danger/fear/anxieties
  from prior experiences.
• Acute grief reactions to witnessing death or
  destruction even while threat to self continues.

Pynoos, Steinberg Aronson, 1997.
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A "Worst" Moment The Convergence of External
and Internal Threats (Layne, Saltzman, Pynoos)


Individual efforts or ability to take protective
action fail

• Efforts by the individual and/or others to take
  protective action fail, including attempts to
• Prevent/avoid the trauma before it occurs,
• Protect/defend oneself and/or others during the
  trauma,
• Repair or reverse injury/damage/loss after it has
  been inflicted.
• This leads to the subjective experience of
• defenselessness, vulnerability, helplessness.

Others efforts or ability to take protective
action fail
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• WEAKENED VERSION
• Proximity to the Violence
• Lethality of the Instrument
• Intentionality
• Object of Violence
• Seriousness of Injury

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Intervention Fantasies

• To Alter the Precipitating Events
• To interrupt The Traumatic Action
• To Reverse The Lethal or Injurious Consequences
• To Gain Safe Retaliation (Fantasies of Revenge)
• To Prevent Future Trauma

Pynoos, Steinberg Aronson, 1997.
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National Child Traumatic Stress Network (NCTSN)

• WEBSITE
• www.NCTSNet.org