Enhance Trauma-Informed Care by Harnessing Neuroplasticity

By T. D. Loftus | Posted on 06.02.2017 | 0 comments
“Everything is created twice: first in the mind, and then in reality,” wrote Robin S. Sharma in one of his most famous books. I recently shared this quote in a staff newsletter that discussed the relationship between trauma, triggers, and treatment. 

As a Senior Level CPI Certified Instructor, I coordinate and teach the Nonviolent Crisis Intervention® training program at my community mental health agency, and many of our clients—youth and adults—have a history of trauma. As a licensed clinician, I’ve seen firsthand that the footprints of trauma can be long lasting. They are etched deeply into clients’ physical and mental health, stretching from youth to adulthood, and can trigger a range of reactions that have the potential to escalate into crisis.

Trauma-informed care is defined as a framework of thinking and interventions that are directed by a thorough understanding of the profound neurological, biological, psychological, and social effects trauma has on an individual, while recognizing that person’s constant interdependent needs for safety, connections, and ways to manage emotions and impulses. This is an incredibly broad concept that we can understand more concretely by briefly identifying key brain functions and applying them to the CPI Crisis Development Model
 

The Role of Biology


The limbic system is associated with the emotional part of the brain, but it also drives our primal fight/flight/freeze responses. When a client experiences trauma, this part of the brain reacts first—well before their neocortex, which handles reasoning. And this same limbic system can be activated not only by trauma itself, but by the stimuli that trigger traumatic memories—a smell or a sound, for example. This means that the limbic system can fire off the same response to a trigger that it does to trauma, before the brain has a chance to evaluate whether the person is truly in danger. This is known as hypervigilance. But on a biological level, it is essentially one part of the brain shutting down another part of the brain, and limiting a client’s ability to reason their way through a trigger instead of instinctively reacting to it.

Numerous studies on the relationship between brain and body confirm that what happens to you in life can form lasting neural connections in your brain, and thereby affect your quality of life. The ACE Study is just one example of how scientists have been able to connect the footprints left by adverse childhood experiences with mental or physical health difficulties in adulthood.
 

Following the Road Map From Trauma to Recovery


These neural connections are pathways in the brain formed by life experience, and just like a trail becomes more beaten down the more times it is traveled, repeated trauma can reinforce these pathways’ construction, forming the groundwork for PTSD, depression, or addiction. 

But there is hope. Just as traumatic events can forge neural pathways, so can positive and constructive therapeutic experiences. We can harness this phenomenon—called neuroplasticity—to help clients build new and better pathways in their brains that give them a chance to identify, support, and practice coping skills. It requires being present and mindful—no easy task—but the outcome means hope for our clients. 

For me, learning that neuroplasticity can empower clients in their recovery, particularly through the emerging practice of neurocounseling, established the crucial connection between the Nonviolent Crisis Intervention® training I teach and the trauma-informed care that my agency provides. 

How can clients move from being at the mercy of profoundly toxic emotions to actively living healthy and happy lives? Staff can facilitate this transition by taking a mindful, person-centered approach to trauma-informed care when clients are in crisis. This can set the stage for more effective, safe coping with the volatile and intense emotions that somebody with a trauma history may experience, and ultimately, establish a course for recovery.


Trauma-Informed Care: The Integrated Experience


Here are a few key insights for integrating trauma-sensitive care with Nonviolent Crisis Intervention® implementation: 

1. You can help your clients begin to identify, tolerate, and develop more adaptive responses by engaging mindfully in the earliest steps of the Crisis Development Model.
Think of the first behavior level, Anxiety, as a redirection zone. If we’re effective at this point, we can provide the needed support before a client loses rationality, and attempt to inhibit that hair-trigger response of the limbic system. 

We know that mindfulness, particularly when employed as a meditative practice, can empower clients to form new neural pathways that can lead away from their trauma and toward recovery by helping them learn to self-regulate. One can’t be relaxed and triggered at the same time—these are incompatible states.

2. You can learn to identify defensive behavior as trauma-reactive behavior, not a deliberate outburst.
Being mindful of trauma as a Precipitating Factor can help you focus on Rational Detachment, rather than taking a client’s actions personally. Knowledge of nonverbal and paraverbal behavior can yield a more sophisticated understanding of baseline behavior, and allow for an earlier read of defensive behaviors. A faster read ideally leads to a faster therapeutic reaction. 

3. You can also discover the triggers of risk behaviors by remaining rationally detached.
The moment of crisis is a key opportunity to uncover what might be triggering a client’s behavior. Risk behavior could well be rooted in trauma. The rapid firing of the limbic system when triggered can result in “flashbacks” or dissociative reactions in clients, to name a few possible scenarios. Implementing the team approach recommended by CPI training ensures that you’ll have the supervision necessary to do this safely, and inform more effective treatment interventions.

4. Take a trauma-sensitive approach and pave the way for positive recovery during Tension Reduction.
When helping de-escalate a crisis, the goal should be to not only prevent the crisis from happening again, but to reconstruct those neural pathways that have previously triggered this acting-out behavior. This is where the principles of neurocounseling can help clients gain constructive coping skills—and where Therapeutic Rapport can help clients recognize maladaptive responses in the aftermath of acting out, and determine new strategies to prevent future occurrences.

5. Always take the opportunity to debrief with the COPING Model.
For clients, this is a time to actively and safely participate in their own recovery. For staff, debriefing provides essential protection from secondary trauma, or compassion fatigue, and can be the cue to implement appropriate and effective self-care strategies. As a Certified Instructor, I encourage staff to not only use debriefing to establish a relapse prevention process, but to also make sure that they are on the lookout for vicarious trauma in the aftermath of a crisis. 

The result of pairing Nonviolent Crisis Intervention® training with trauma-informed care is that clients can plug into the world around them, rather than withdrawing from it. Recall the quote I offered: everything is created twice. By taking a mindful, person-centered approach, you first help a client re-pave the paths trauma laid in their mind, and secondly, you empower them to consciously engage in recovery.

About the author
T. D. Loftus is a Senior Level CPI Certified Instructor. With a Master of Science degree from Northeastern University in Counseling Psychology and a BA in Psychology from Boston College, he’s a Licensed Mental Health Counselor (LMHC) in the Commonwealth of Massachusetts and a quality management and compliance officer in a community mental health agency. T.D. is also a Reiki Master Level II and a Kettlebell Instructor through the International Kettlebell and Fitness Federation.
 
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