# data[].attributes.attachment_link.title
Understanding Trauma: Learning Brain vs Survival Brain

# data[].attributes.attachment_link.readable_text
Published by Penguin Random House

A Conversation with Bessel van der Kolk
Q. You've been working with traumatized children and adults for many years and have seen significant changes in how mental illness and trauma are treated. What have you learned from neuroscience, attachment research, and interpersonal neurobiology about how to help children and adults recover from toxic stress?
A. Trauma is ubiquitous in our society. Over 500,000 children are reported for abuse and neglect each year. One out of four Americans reports having been left with bruises after having been hit as a child, one out of five was sexually molested, one out of eight has witnessed severe domestic violence, and a a quarter grew up with alcoholism or drug addiction. Almost every inmate in our prison system, by far the largest in the world, has a serious history of prior trauma. Half a million women are raped each year, half of them before they are adolescents.

These experiences leave traces on people's biology and identity and have devastating social consequences-medical illnesses, problems with school and work performance, drug addiction and a variety of psychiatric illness. In fact, the Centers for Disease Control and Prevention calculate that childhood trauma is our single largest public health issue-more costly than cancer or heart disease-and one that is largely preventable by early prevention and intervention.

In order to overcome trauma people need to feel safe enough to open up their hearts and minds to others and become engaged with new possibilities. This can only be done if trauma survivors, and their communities, are helped to confront and confess the reality of what has happened and are helped to feel safe again. In many non-Western cultures this involves communal rhythmical activities, such as dancing, athletics, and collective prayer. Communal rituals of acknowledgment, support, and repentance can play a substantial role in healing from trauma.

Treatments that focus solely on decreasing a few PTSD symptoms, or on drugs to obliterate feelings, ignore the importance of integrating the traumatic experience in the overall arc of one's life, and they fail to help survivors reconnect with their communities. The scientific evidence for the efficacy of these therapies, while widely promulgated and practiced, is, in fact, quite disappointing.

Probably the most important challenge in recovering from trauma is learning to regulate oneself. We can activate this innate capacity by utilizing breath, touch, movement, and rhythmical engagement with one's fellow human beings, such as yoga, tai chi, and dancing, methods that are not widely utilized in medical settings or in school systems.
Q. In your book you talk about the effect of trauma on the brain. What changes occur in the brain in response to trauma? What happens when someone experiences a flashback?
A. Neuroscience research has shown that traumatized individuals are prone to activate brain areas involved in fear perception, and to have deficits in the areas involved in filtering out relevant from irrelevant information, as well as in the perception of bodily sensations. These changes do not occur in the rational part of the brain, and do not really seem to benefit merely from being aware of the error of one's ways.

The impact of trauma is located in the survival part of the brain, which does not return to baseline after the threat is over. This part of the brain is by definition unreasonable-you do not stop being hungry by reminding yourself how fat you are, and it's pretty difficult to talk yourself out of being angry, shut down, or in love.

One of the most devastating effects of trauma is that people's biology changes into a biology of threat; this is expressed on multiple levels, in stress hormones, immunology and what the brain selects to pay attention to. The intrinsic reward system changes, as do "attractors"-what turns you on or leaves you cold. As a consequence, traumatized people stay on hyper alert; they feel chronically unsafe and in danger, and they have problems feeling calm and enjoying the moment and they are out of touch with their surroundings. Trauma can make it difficult to have comfortable reciprocal relationships with one's children, partners, and coworkers.

Through brain imaging technology, we can visualize how traumatized people even have problems processing ordinary, nonthreatening information, which makes it difficult to fully engage in daily life and to learn from experience. As a result, they are frazzled, unfocused, and tend to repeat the same nonproductive behavior patterns, with the same miserable results.

Trauma affects the entire human organism-thinking, feeling, relationships, and the housekeeping of one's body. Trauma survivors are vulnerable to a host of medical illnesses and chronic pain syndromes, insomnia, drug and alcohol addiction, depression, obesity, and other issues related to optimal functioning of the entire organism, and the capacity for self regulation and self-care.
Q. What do you wish more people understood about trauma?
A. First of all, is important to understand is how ubiquitous trauma is in our society, what devastating effects it has on family life, workplace productivity, the facility to learn and take initiative, the ability to stay calm and focused, and the capacity to be compassionate with one's fellow man.

As a society we cannot afford to ignore trauma and keep our heads in the sand. There are, in fact, countries where governments have taken the science of trauma (and its prevention and treatment) seriously, with results to prove how well that works. For example, Norway has fifty-one citizens per hundred thousand in jail; the US, 951. Their students also have higher test scores and higher graduation rates from high school and college, and their society has a fraction of our crime rate.

I think that the general public tends to associate trauma with the military and terrorism, but the vast majority of traumas occur within families, schools, and neighborhoods, the very people whom they depend on for safety and security. Most traumatized women and children, for example, are traumatized by their intimates. Another important issue is that trauma has a different impact, depending on the age and relative maturity of the affected individual. The brains of traumatized kids develop in a "use-dependent" manner-they become experts in dealing with threat, and have problems with self-regulation, play, and the sort of imaginative creativity that is necessary to become productive members of society.

Trauma is a deeply communal problem: we are fundamentally social animals, and trauma profoundly affects people's capacity to get along with others and be a cooperative and enjoyable member of the tribe.
Q. You have worked with war veterans and at the beginning of your career worked with Vietnam vets before PTSD was an official diagnosis. What do you think of the current prescribed treatment by the Veteran Affairs office for trauma?
A. I currently treat only a few veterans and I am not intimately familiar with what is happening at the Veterans Administration. The VA is a pretty closed system-people who work at the VA rarely attend my workshops or lectures, or those of my close colleagues.

I hear that their main focus is on cognitive behavioral treatments, and on desensitizing people to their memories. These treatments, research shows, are not particularly effective. That is not surprising, given that being traumatized is not an issue of faulty cognition-the problems emanate from parts of the brain that have little to do with cognition.

The biggest problem for veterans is to fully engage in their current lives. The Body Keeps the Score provides a number of ways to reengage - some are ancient, like yoga, theater, and martial arts, while others, like neurofeedback, are based on the latest advances in neuroscience.
Q. What benefits does yoga offer patients in treatment? Are they universal?
Doctors at the VA and the DoD prescribe vast amounts of drugs, even though there is scant evidence that drugs significantly help traumatic stress. Drugs can obscure posttraumatic symptoms but not resolve them.

This issue is even more concerning in the treatment of traumatized children. The poorer you are the more likely it is that you will be given psychiatric drugs to control your behavior. These drugs can have devastating effects on children's capacity to learn, engage and feel good in their bodies.
Q. What do you hope to accomplish with The Body Keeps the Score? What do you want readers to take away from it?
A. Yoga is just one of many time-honored ways to help people experience ownership of their bodies and to feel safe and in control. Our most recent research study on this subject showed that yoga had better results than any drug studies so far for PTSD. That is not to say that everybody should practice yoga-one size never fits all-but every trauma survivor would do well to engage in practices that increases their inner bodily sense of control, safety, and flexibility.

In order to overcome trauma we have to befriend and be in touch with ourselves-our sensations and our emotions. Neuroscience research has shown that the only way we can consciously access that disturbed survival brain is through our interoceptive pathways - through the part of the brain that helps us to feel what is going on deep inside of ourselves.

A. I hope that all traumatized individuals, and their loved ones, will find this book helpful for comfort, understanding, and guidance. That politicians and policy makers will read this book to help them understand the devastating effects of early deprivation and punitive school systems on the health and welfare of our country, as well as the predictable consequences of putting our young men and women in harm's way.

That parents of adopted kids will understand what their children are dealing with, and serve as a guide to solutions.

That educators and school systems will implement trauma-based interventions for children who come from abuse and neglect, and thereby become agents of change to help all children become productive members of society. My greatest hope is that all school systems will teach the four R's: reading, writing, rhythmatic, and self-regulation. That from K to 12 all kids will be taught to experience how they can regulate themselves though their breath, movements, and synchronized interactions with others, and learn how their bodies, brains, and minds react to overwhelming stress with recognizable patterns that can be managed through self-regulation practices, more than with drugs or alcohol.

That it will inspire our armed forces to become as expert in helping returning warriors to once again become peaceful and productive civilians, as they are in transforming adolescents into members of magnificent fighting units.

That physicians will appreciate the role of trauma in the disintegration of bodily systems, and learn what they can do about it.

That mental health professionals will acknowledge the relationship between trauma, drug addiction, and numerous psychiatric "disorders" and incorporate effective trauma treatments in their practice.

That law enforcement and criminal justice personnel will read it to understand their own responses, and that of the people they are dealing with.

That psychiatrists will integrate the scientific knowledge that our brains are meant to help us cooperate and thrive in a community, and realize that their job is to help patients deal with the devastating effects of trauma on mind, brain, and body.

I hope that this book will help us all acknowledge the fact that our zip code has a more profound effect on health and well-being then our genetic code. In short, the goal of this book is to help us to become a trauma-informed society that will confront and deal with our largest public health issue: psychological trauma.

# data[].attributes.attachment_link.description
Published by Penguin Random House Q. You've been working with traumatized children and adults for many years and have seen significant changes in how mental illness and trauma are treated. What have you learned from neuroscience, attachment research, and interpersonal neurobiology about how to help children and adults recover from toxic stress?

# data[].attributes.attachment_link.readable_text
Being a black man in America means being my brother's keeper. Being a black man in America means being my brother's keeper while keeping a distance from my brother because I don't trust him further than I can see him. It's believing the cops don't care about you. It's learning how not to doubt yourself because when you're born everyone else already does."
-Poet Prentice Powell, written following the fatal police shooting of Michael Brown in Ferguson, Missouri, in 2014
2020 was a year of reckoning about many things, but one central theme centered on police brutality toward Black men, sparked by the murder of George Floyd under a White officer's knee.

For psychologists who work with, study, and support Black men, that incident and the resulting protests were an added call to find better, more effective ways of promoting Black men's mental health, said Howard C. Stevenson, PhD, director of the Racial Empowerment Collaborative at the University of Pennsylvania and a national expert in helping people of color address and heal from racism.

"We should place less emphasis on whether Black men are resistant to therapy," said Stevenson, "and more on understanding the contexts in which they already feel comfortable talking about their feelings and traumas. If a Black man is able to find a treatment that is culturally responsive, that he understands, and that embraces the uniqueness of his difference, he is more likely to use that service."

There is a long way to go toward making such mental health care universal, Stevenson and others say, but psychologists are crafting several promising interventions that address issues that Black men face. Besides adaptations of individual therapy, these include community programs in barbershops and other local venues, outreach through technology and social media, and national networks devoted to facilitating Black men's mental health and well-being.

The more that systems, programs, and providers find culturally relevant ways to foster Black men's mental health-including directly addressing racial trauma and its effects-the more society will benefit, added Wizdom Powell, PhD, an associate professor of psychiatry at the University of Connecticut and director of the university's Health Disparities Institute.

"Interventions shouldn't be just about healing and restoring Black men, though that would be enough," she said. "We also need to think about how much talent we're hemorrhaging" by not providing Black men with the proper support. "Think of all the innovators, entrepreneurs, scientists, and physicians there would be if Black men weren't being killed with impunity by police officers and if we were creating spaces for them to heal, grow, and thrive."

Statistics, realities

While Black Americans experience similar rates of mental illness as other Americans in general, there are contextual differences. For example, Black adults living below the poverty line are more than twice as likely to report serious psychological distress as U.S. adults who enjoy greater financial security, according to the U.S. Department of Health and Human Services' Office of Minority Health. As another example, depressive symptoms among Black people are more disabling, persistent, and treatment-resistant than they are among White people (Bailey, R. K., et al., Neuropsychiatric Disease and Treatment, Vol. 15, 2019).

And Black men are not receiving the help they need for these problems. For example, only 26.4% of Black and Hispanic men ages 18 to 44 who experienced daily feelings of anxiety or depression were likely to have used mental health services, compared with 45.4% of non-Hispanic White men with the same feelings ( NCHS Data Brief No. 206, 2015). When Black men do seek help and would prefer a same-race provider, it can be difficult finding Black psychologists, since they still make up only about 4% of the doctoral-level psychology workforce (though that number is growing, according to 2018 APA Center for Workforce Studies data).

At the same time, Black men's mental health is more complex than statistics or clinical diagnoses indicate, according to subject matter experts. Because of structural racism and Black men's unique history in this country, their mental health and treatment are intimately tied to factors such as implicit bias on the part of medical providers, high poverty rates, and low access to quality psychological and psychiatric services. Compared with White people, for example, Black people are less likely to receive guideline-consistent care or to be included in mental health research. They are also more likely to use emergency rooms or primary care for mental health problems because they have not received appropriate preventive services. (For a summary of these findings, see the American Psychiatric Association's fact sheet on mental health disparities among African Americans at Psychiatry.org.)

Given such factors, it is not surprising that many Black men also harbor feelings of mistrust toward medical and mental health systems, Powell added. For instance, in a study reported in Behavioral Medicine (Vol. 42, No. 3, 2016), Powell and colleagues found that everyday and perceived racism along with internalized masculinity norms influenced Black men's reluctance to seek medical help. A history of racism within psychology and psychiatry likewise plays a role, she said. For example, in 1851, physician Samuel A. Cartwright floated the idea of drapetomania, "an uncontrollable or insane impulsion to wander" among enslaved people who expressed a desire for freedom. In a similar vein, as racial protests began heating up in the 1960s, diagnoses of schizophrenia among Black men became far more common, a phenomenon highlighted by psychiatrist Jonathan M. Metzl, MD, in the book The Protest Psychosis (Beacon Press, 2011).

"Black men today might not know that specific history," said Powell, "but it lives in their spirit a little bit. And it gets transmuted into practices like withdrawing from systems, having a mistrust of systems, and feeling like systems don't have your best interests at heart."

Building blocks for interventions

Culturally competent treatments for Black men take these realities into account and, as such, share certain ingredients, say psychologists involved in this work. These include:

Addressing masculine norms: Black men are even more likely than White men to endorse aspects of traditional masculine ideology, such as the need to act tough and in control and to avoid emotional expression, research finds. According to Baron K. Rogers, a psychology doctoral student at the University of Akron in Ohio, that is because they have additional reasons beyond those of White men to assume these stances-namely, "to stave off societal pressures and oppression," he said. The idea that racial factors intersect with unhealthy masculinity norms is also highlighted in the book Cool Pose: The Dilemmas of Black Manhood in America (Touchstone, 1993) by psychologist Richard Majors, PhD, and sociologist Janet Mancini Billson, PhD. They argued that poor, urban Black men sometimes assume a stance of "aloof swagger" to defend against the harsh realities and racism they encounter in daily life, which wears away at their physical and mental health.

In fact, such internalized views of masculinity "make a lot of Black men resistant to therapy and more likely to seek informal ways of addressing their mental health through barbershops, church, religion, or talking to family members," said psychologist Erlanger "Earl" Turner, PhD, an assistant professor at Pepperdine University in Los Angeles. So when a Black man does enter therapy, "it's important to tread lightly as he starts to open up and share his emotions," he said, "because if you push to discuss emotions too soon and he isn't ready, he may decide not to return." (Turner's podcast, The Breakdown With Dr. Earl, destigmatizes mental health treatment for Black men and boys in an engaging manner, using a psychological science focus.)

Jessica L. Jackson, PhD, a counseling psychologist in Houston and global diversity, equity, inclusion, and belonging care lead at the mental health tech firm Modern Health, has done some of this work with Black men in settings including the VA Greater Los Angeles Healthcare System, the Harris Health System (Texas), and private practice. To help these men identify and become more comfortable with their emotions, she uses a tool called the Feelings Wheel, which labels the spectrum of emotions from the most basic to the most nuanced.

When Black men start to gain a more extensive emotional vocabulary, it provides fuel for the next stages of therapeutic work: addressing past traumas and learning how to communicate more effectively in relationships, Jackson said. She knows they are making progress when they start to bring what they have learned home-for example when they begin communicating with their partners about their feelings instead of brooding or responding with anger. "It's like they're getting unstuck," she said.

Addressing racism: Culturally competent treatment for Black men also involves directly and therapeutically addressing issues of racism, said Rogers, who is on internship at the counseling center at Penn State University.

That means making space for clients to identify racist incidents that they have experienced and the feelings that arise because of them, and, more important, to understand and work toward overcoming internalized racism. The many facets of internalized racism include believing negative racial stereotypes, adopting White cultural values while undermining one's own, and denying that racism exists, Rogers explained.

For White psychologists to work effectively with Black male clients, it is imperative that they develop a deeper understanding of racism and its impacts by keeping abreast of the latest scholarship, taking continuing-education classes, and getting training in the area. (In fact, for license renewal, several state licensing boards specifically require courses in cultural diversity.) White clinicians should also become familiar with the APA Guidelines on Race and Ethnicity in Psychology, approved by the APA Council of Representatives in 2019. Among other points, the guidelines state that psychologists should consider their own biases, privileges, and socialization in relation to race and ethnicity and work to address organizational and social inequities and injustices inside and outside of the field.

In addition, therapists should be aware that issues of racism and masculinity can intersect in complicated ways, added Rogers, who is working on a scale to identify and understand how and where these domains overlap. That scale, which has now been tested on some 600 Black men, explores what he calls "racist gender role strain"-the idea that if you endorse specific views of manhood but cannot meet them, it creates internal conflict and stress. For example, some Black men may internalize ideas that they should be good protectors, providers, or role models. But, Rogers said, "if you're in a system that oppresses you or makes you internalize these beliefs but doesn't give you access to fulfilling them, it causes stress and frustration."

In a general sense, encouraging clients to talk about racism opens the door to more fulfilling therapy overall, Turner added. "It allows clients to feel that they can talk about anything in this room," he said. "For me, that's a really important piece about having that conversation."

Addressing within-group differences: Working in culturally responsive ways with Black men also means understanding individual differences in terms of socioeconomic status, age, education, U.S. region, country of origin, belief systems, level of acculturation, sexual orientation, and more, Turner said.

On a broad scale, it is helpful to recognize that Black men born in the United States probably incorporate some version of both African-American cultural values-which emphasize the importance of extended family networks, interdependence with groups and relationships, spirituality, and flexible notions of time, for example-and Eurocentric values-which emphasize individuality, nuclear family structure, and competitiveness, Turner noted.

It is also important to understand the complex issues of intersectionality that Black gay, transsexual, and bisexual men face, said Lisa Bowleg, PhD, a professor of applied social psychology at The George Washington University in Washington, D.C. Her research shows that gay Black men often experience racial discrimination from gay men who are not Black, for example, while bisexual Black men experience race and sexual orientation discrimination in both gay and heterosexual communities (, Vol. 68, No. 11-12, 2013).

"Any effective mental health programs need to work with these men holistically and intersectionally," she said. She also recommends focusing on these men's strengths and assets-because many of their problems arise from external factors, not internal ones-and holding therapy groups specific to the sexual orientation and race of the men served.

Clinicians also need to be aware of differences in Black men's backgrounds and countries of origin and incorporate that knowledge into therapeutic work, Turner emphasized. For example, 8% of Black people in the United States are immigrants from countries in the Caribbean, Africa, and elsewhere, and there are significant differences among them. Those who grew up in predominantly Black cultures, for example, are less likely to view themselves as inferior because they have not been exposed to historical racism in their home country. Hence, their cultural identity may serve as a buffer, he noted.

There are many other cultural differences among these groups as well. For example, Jamaicans often identify themselves first as Jamaican and tend to frame mental, psychological, and psychiatric issues as medical or spiritual conditions that need interventions from spiritual healers such as shamans, said Turner, who discusses these topics in his book Mental Health Among African Americans: Innovations in Research and Practice (Lexington Books, 2019).

"As a mental health practitioner, you should be aware of these different cultural and spiritual values," he said. "But you should also avoid overgeneralizing this information."

Incorporating group work: Working with Black men in group formats can also be a powerful intervention, thanks to the sense of camaraderie these groups foster. Seeing that other men have similar difficulties can make care less stigmatizing, Jackson explained.

When she was doing her postdoc at the Los Angeles VA, for example, Jackson and a colleague launched a racial trauma support group for veterans of color. That arrangement proved at least as effective as one-on-one therapy, she said.

"Even after they finished the group, the biggest feedback we received is that they continued to meet outside of that setting," Jackson said. "They became friends, and they wanted to continue. They knew they had a language [for their emotions], and they were able to use it with each other."

At Penn State, Rogers provides group trainings to students of color on how to address racial microaggressions at the time that they occur. Part of that training includes a series of questions he developed that helps students consider details of the event itself, possible responses, possible consequences and how to handle them, and how their own values and supports can serve as protective factors.

"I felt that it was important to empower students beyond just self-care-to be directly proactive," he said.

Expanding the treatment lens

Meanwhile, other psychologists are leaving standard treatment modalities and venues behind entirely and bringing interventions into communities that embrace the background, culture, and challenges of men of color, including Black men. Stevenson and Powell, for example, are both well known for their research and interventions in barbershops, which demonstrate that these central social meeting places and their staff can be powerful vehicles for encouraging healthy and help-seeking behaviors. In a similar vein, mental health advocate Lorenzo Lewis leads the Confess Project, which seeks to promote a mental health culture among boys and young men of color and their families by training barbers as mental health advocates.

Among the country's most innovative and comprehensive programs is the National Compadres Network, founded in 1988 by psychologists Jerry Tello and Ricardo Carrillo, PhD. At the time, they and like-minded providers were fed up with the mass incarceration of men of color, feeling that alternative culturally based supports and interventions were desperately needed.

"It was really just throwing men away because there was no proper therapy for them," said Tello, who is Mexican and Native American and grew up with many Black peers in Compton, California. "The therapy they received just did not fit-there was no understanding of what was really going on."

The first meeting included a small group of mental health providers, lawyers, teachers, advocates, and others who worked in communities of color. The men soon realized they had their own racial traumas to address before they could help others. After an emotion-packed gathering, "we made a commitment that we first had to recover our own sacredness as men and heal from generations of wounds due to racism and oppression," Tello said.

The group has since blossomed into a major national network that includes hundreds of providers in more than 40 U.S. cities who have worked with thousands of men of color, including a large proportion of Black men. It has satellite offices around the country and a variety of programs and trainings that cover topics including parenthood, teen fatherhood, relationships, addiction, rites of passage, acclimating to society after leaving prison, and more. Since 2011, the group has also collaborated with the Brotherhood of Elders Network, an organization that creates programs and interventions to impact the lives of Black boys and men in positive ways. Together, the organizations have launched the Healing Generations Framework, which fosters family and community healing by incorporating Indigenous, culturally based practices.

A central format for these programs is extended kinship circles, where men and boys-sometimes from multiple generations-come together to talk, share in communal ceremonies, and heal racial wounds, said Tello. The circles create a space for honest sharing about life's realities, including the internalized experiences of racism, its emotional and psychosomatic effects, and how these problems can affect members of the group as well as their community and family members.

"Black and brown people kill ourselves because we've been indoctrinated [about how bad we are] and now we believe that," said Tello. "So that woundedness is very deep."

To counter these traumas, group leaders hold that all men-like all beings-are sacred and have a sacred purpose. When men or boys have trouble believing this because of internalized self-hatred or actions they have taken because of it, program guides underscore that it is their wounds that are talking, not their authentic selves. For example, a man may confess that he has harmed his wife, taken drugs, or acted out in another way. But leaders do not chastise him. Instead, they ask him to take responsibility for his actions, and then they support him in exploring the underlying trauma and sometimes intergenerational wounds that led to those actions and drew him out of his sacredness.

Thanks to this deep, community-oriented support, members eventually see themselves more clearly and gain insights that lead to healthier behaviors, Tello said. The overall aim, he added, is to help men of color make positive choices despite their lived experiences and traumas.

"Yes, we experience racism," he said. "But the choice is, do you transform it, or do you transfer it? If you want to transform it, come sit with us. If you want to transfer it, then keep doing what you're doing."

# data[].attributes.attachment_link.description
Being a black man in America means being my brother's keeper. Being a black man in America means being my brother's keeper while keeping a distance from my brother because I don't trust him further than I can see him. It's believing the cops don't care about you.

# data[].attributes.attachment_link.title
REL West - Addressing Trauma and Fostering Resilience

# data[].attributes.attachment_link.description
Share your videos with friends, family, and the world

# data[].attributes.attachment_link.readable_text
Adverse childhood experiences (ACEs) can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. CDC works to understand ACEs and prevent them.

Adverse Childhood Experiences (ACEs) Prevention Strategy Plan [3 MB, 20 Pages]
This resource outlines CDC's specific goals and objectives for ACEs prevention and response. The goals and objectives aim to prevent ACEs before they happen, identify those who have experienced ACEs, and respond using trauma-informed approaches in order to create the conditions for strong, thriving families and communities where all children and youth are free from harm and all people can achieve lifelong health and wellbeing.

# data[].attributes.attachment_link.description
Adverse childhood experiences (ACEs) can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. CDC works to understand ACEs and prevent them. Adverse Childhood Experiences (ACEs) Prevention Strategy Plan [3 MB, 20 Pages] This resource outlines CDC's specific goals and objectives for ACEs prevention and response.

# data[].attributes.attachment_link.readable_text
Trauma is Ubiquitous

The first thing I want to impress upon professors is that trauma is everywhere. The recent global pandemic and protests against systemic racism and racial policing, mass shootings, and climate change, and the past few years of social and political events and movements like #MeToo and #BlackLivesMatter, have brought trauma and mental health into the spotlight. On top of that, our college students have been coming into Minnesota State University for years - decades - with prior trauma histories. The Adverse Childhood Experiences (ACEs) studies show us that around 65% of the general population in the United States has had at least one adverse childhood experience, such as violence, abuse, or neglect, a family member attempting or dying by suicide, or growing up with a mentally-ill or substance-addicted parent; and over 12% experienced more than four ACEs. Women and people of color are at a higher risk for ACEs. There is also evidence that students are at a higher risk of experiencing new trauma in college (e.g., sexual assault) than the general population (Galatzer-Levy, Burton, & Bonanno, 2012). Therefore, it is not only important to understand how these recent and collective traumas are currently impacting our students (and ourselves or loved ones), but also that these recent events might be compounding on top of pre-existing traumatic experiences and subsequent trauma responses.

There are a number of different definitions of trauma. A traumatic experience can be simply defined as an event that "overwhelms one's capacity to cope". More than that, though, "trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present. Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think." (Bessel van der Kolk, pg. 21, book cited below)

The terrifying, possibly life-threatening situation an individual endures highjacks the higher-order functions of the brain - the area responsible for logic and reason and planning - and the individual is instead operating purely on an emotional and survival brain. And it has long-lasting impacts on things like emotional regulation, memory, concentration, self-image, and even relationships. These recent state, national, and global events have not only disrupted our emotional or cognitive functioning, but individuals may now face things like illnesses, public safety concerns, or financial, food, or housing insecurity. Maslow's Hierarchy of Needs reminds us that when physiological and safety needs are not met, higher-order processes and goals cannot be obtained.

To more fully understand our students and their learning - and then how to implement trauma-informed and trauma-responsive practices - we must learn a little bit about trauma and toxic stress, and its impact on the mind and body. You don't have to become an expert in trauma, post-traumatic stress, or mental health. Instead, the goal here is to help you start seeing some of the learning, emotional, and behavioral problems going on in your classrooms and with your students from a more holistic, trauma-informed lens. And then use that knowledge to adapt your teaching practices.

An Introduction to the Brain and Trauma Responses

Short video: "A Quick and Simple Way to Think About the Brain"

This infographic (in OneDrive) and video briefly explain the structures of the brain. Learning about the brain can help us better understand the areas and functions most affected by trauma.

Short video: "Understanding Trauma: Learning Brain versus Survival Brain"

This video specifically helps teachers understand, in simple terms, what the difference is in your students who are able to be present in class in their "learning brain" versus students who have experienced trauma and are instead in a "survival brain" having a survival response.

Short video: "Three Ways Trauma Can Change the Brain"

Bessel van der Kolk describes the three ways trauma can change the brain: 1) threat perception is heightened and therefore the individual is more primed to be triggered, 2) the filtering system is disrupted, making it harder to focus and engage, and 3) the self-sensing system changes the way the person feels about themselves.

Short video: "Recognizing the Symptoms of Trauma"

Bessel van der Kolk describes the three main life areas affected by trauma: 1) attention, focus, and concentration, 2) affect regulation, or the ability to identify and respond to emotions in a balanced way, and 3) interpersonal relationships.

Book: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk

If you were interested in Dr. van der Kolk's explanations of how trauma affects the brain and the individual, his book is a must-read. He delves into and synthesizes decades of research on the neurobiological, psychological, and psychological disruptions that trauma causes - and therapeutic approaches to address such problems.

Childhood Trauma and the Developing Brain
Adverse Childhood Experiences (ACEs)

This is the study mentioned previously about the pervasiveness of childhood adversity and toxic stress.

TEDTalk: "How Childhood Trauma Affects Health Across a Lifetime"

Nadine Burke Harris shares her journey of discovering and understanding the physical toll that toxic stress (trauma) has on an individual across the lifespan and her contributions to what we now know as the ACEs study.

Book: The Deepest Well by Dr. Nadine Burke Harris

If Dr. Burke Harris' TEDTalk grabbed your interest, her book is even better at describing adverse childhood experiences (ACEs) and how toxic stress affects the individual across the lifespan. Her own preliminary research uncovered that her pediatric patients with four or more ACEs were over 32 times more likely to have been diagnosed with learning and behavioral problems like ADHD (p. 59), which has significant implications for teaching and learning.

Trauma-Informed Teaching Resources

What educators have done is to try to apply the key principles of a trauma-informed care approach to teaching. Not surprisingly, there are not a lot of research articles on trauma-informed practices in higher education. [If anyone is wanting to research or write something, I am eager to collaborate!] There are a number of articles for children and secondary education that may be relevant. And of course, there are so many resources about the origins of trauma-informed care and applications in the public health and mental health arenas. However, I did find a number of useful articles and guides (all PDFs in the OneDrive folder) and online training videos.

A timely article that outlines a few basic things professors can do to prepare for the fall semester, with additional resources and readings listed at the bottom.

Janice Carello has a website with articles, websites, videos, presentations, and other useful resources that will introduce anyone in higher education to trauma-informed principles. More specifically, she has a number of posts and training related to times of crisis and COVID-19. Subscribe to receive updates.

Alex Shevrin Venet is an expert in trauma-informed teaching and learning. She writes articles, summarizes resources, and offers trainings, workshops, and consultations. Visit her "Getting Started with Trauma-Informed Teaching" post (2016).

Carello's presentation is a must-watch/listen. She outlines basic definitions of trauma, the importance of avoiding re-traumatization, the origins of trauma-informed care, and then shares practical strategies for college educators.

This video was linked in the above Chronicle article as an additional resource by Mays Imad. Like Dr. Carello, Mays Imad does a great job of outlining the basics of trauma consequences, the main principles of a trauma-informed practice, and also shares some specific examples and strategies for teaching.

This podcast does an amazing introductory job of introducing trauma, talking about the prevalence of trauma in higher education institutions, defining how trauma and toxic stress impact learning, and providing simple strategies for what faculty/professors can do to be trauma-aware and trauma-responsive in the classroom and with their students - especially now.

A useful podcast that outlines trauma-informed teaching as a "universal approach" to be taken with all students. Her DOs and DON'Ts with K-12 "kids" can be easily applied to college students.

Articles and Guides (PDFs)

SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach (2014). This is a good background article that outlines the trauma-informed framework, and key practices and principles.
6 Guiding Principles to a Trauma-Informed Approach (Infographic)

Trauma-Informed Practices in Postsecondary Education: A Guide. Davidson, S. with Education Northwest.
This is an incredible resource that starts with how to understand and recognize trauma in learners, outlines higher-risk groups, and details campus-level and classroom-specific strategies.

Trauma Informed Care in the Classroom: A Resource Guide for Educators in Higher Learning. Smith, J with Trauma Informed Oregon Brief tip sheet.

Practicing What We Teach: Trauma-Informed Educational Practice (2015). Carello, J. & Butler, L.

The How and Why of Trauma-Informed Teaching (2018). Shevrin Venet, A.

Four Core Priorities for Trauma-Informed Distance Learning (2020). Newhouse, K. (summarizing Alex Shevrin Venet)

Trauma-Informed Positive Education: Using Positive Psychology to Strengthen Vulnerable Students (2016). Brunzell, T., Stokes, H., & Waters, L.

Shifting Teacher Practice in Trauma‑Affected Classrooms: Practice Pedagogy Strategies Within a Trauma‑Informed Positive Education Model (2019). Brunzell, T., Stokes, H., & Waters, L.

How to Respond to Students in Distress - Recorded PowerPoint

Lindsay Murn developed and recorded this presentation to help professors (and other university staff who have regular interactions with college students) learn active listening and responding skills to help students who are struggling with any issue - recent trauma, COVID-19 pandemic, mental health issues, etc. (in OneDrive)

Referrals

Again, professors should not have to take on the role of trauma professional or mental health therapist and instead should become familiar with the resources on (and off) campus to point students in the right direction. Making changes to your classroom or delivery will be extremely beneficial for ALL students - not just the ones with trauma histories. But then knowing how they can get additional support beyond your classroom is the next biggest step.

Counseling Center

507-389-1455 | mnsu.edu/counseling

We provide a range of mental health and wellness services for students.

Our website has a number of self-guided resources, peer supports, and on-demand presentations on a variety of topics like mindfulness, finding balance, self-care, etc.

Counselors are available for university faculty and staff consultations, or for psychoeducational and mental health-related presentations in your classroom.

Student Health Services

Minnesota State University Mankato Campus Services and Supports
There are a number of other campus offices that can help students, including Accessibility Resources, the Women's Center, the Center for Academic Success, the Multicultural Center, and so many others.

Self-Care

Compassion fatigue in higher education is real (Raimondi, 2019). Professors take on a lot already, and although adding this knowledge and these strategies to your toolkit is tremendously helpful for your students and yourself, it can be mentally and emotionally draining.

Remember to practice good boundaries with others (especially students), invest time and energy into hobbies and non-work interests, and engage in daily mindfulness or other practices that relieve stress and foster feelings of calm.

# data[].attributes.attachment_link.description
The first thing I want to impress upon professors is that trauma is everywhere. The recent global pandemic and protests against systemic racism and racial policing, mass shootings, and climate change, and the past few years of social and political events and movements like #MeToo and #BlackLivesMatter, have brought trauma and mental health into the spotlight.

# data[].attributes.attachment_link.readable_text
This resource was developed by Anita Chari, Associate Professor of Political Science, 2020-21 Provost's Teaching Fellow, and the Trauma-Informed Pedagogy CAIT (Communities Accelerating the Impact of Teaching) facilitated by Dr. Chari.

Trauma-informed pedagogy

by Dr. Anita Chari, Associate Professor of Political Science

2020 witnessed some of the most passionate protests for racial justice seen in the US and globally since the Civil Rights movements, awakening a new consciousness of the depths of structural anti-Black and racist violence. In the past year we also collectively bore witness to an unfathomable number of incidents of violence against communities of color, from the brutal murder of George Floyd by a policeman to a series of shootings of unarmed Asian women in Atlanta. And all of this has taken place amidst the backdrop of a global pandemic that has heightened inequalities in educational access and severed students from the contact with campus that anchored learning and social contact, as well as a level of political polarization in the US greater than we've seen since perhaps the Civil War.

To say that this constellation of events has been traumatic is only to state something that we all know: students, faculty, and campuses as a whole are collectively overwhelmed. The result has been that students are challenged in their learning process, and that together we face a crisis in higher education's approach to learning itself, which tends to conceive of education as a disembodied, highly rational process.

Trauma-informed pedagogy is an approach to education that recognizes that collective overwhelm lives in the body and the nervous system, and that when unaddressed impacts our ability to learn and to engage in transformative conversations about the most pressing issues of our times. Undischarged trauma reduces our window of tolerance for discomfort, healthy conflict, and trust amidst diversity. When we do not acknowledge the presence of trauma, both present-day and historical, we are bound to repeat and recapitulate it in our classrooms. Bodily awareness and social connection are the portals through which trauma can be discharged and resolved in the context of learning environments in higher education. We don't need therapeutic practices in our classrooms, but rather a recognition of the power of an educational approach in which overwhelm is named and acknowledged in the context of learning itself.

The Trauma Informed Pedagogy CAIT

The Trauma-Informed Pedagogy CAIT (Communities Accelerating the Impact of Teaching) was facilitated by Anita Chari, Associate Professor of Political Science, 2020-21 Provost's Teaching Fellow, and co-creator of Embodying Your Curriculum, a program that teaches trauma-informed pedagogy to faculty. The CAIT consisted of 11 faculty drawn from various disciplines and schools on-campus who engaged in a 4 Module training. Through the modules and conversations, CAIT participants explored:

Tools for nervous system regulation, as well as ways to practice them within a relational and societal context.

Learning how to recognize nervous system activation and overwhelm in ourselves and in others, and understanding the relevance to creating an inclusive and anti-oppressive classroom space.

Cultivating resources based on the Social Nervous System and Mirror Neuron System for working with these dynamics.

Working with intersectional oppression at an embodied level, including skills for making repair in the classroom when ruptures occur.

Examples of Practices from Faculty in the CAIT

Below you can read about some of the practices participating faculty used or adapted that fit their goals and contexts, and what they experienced as the impacts of these practices. We are grateful to faculty for both trying practices that may have been new to them and for sharing those experiences with the broader teaching community.

Practice as support for both faculty and students (with example grounding practice for classroom)

Dr. Erin Hanna, Associate Prof Media Studies, Department of Cinema Studies
Reflection: My goal going into this CAIT was to develop strategies that would allow me to meet my students where they are and support them, not just as learners, but as whole human beings, with all the complexity that entails. In the past, I have experimented with and explored different pedagogical approaches that align with these goals by promising to improve learning and create more inclusive and accessible classes. What was often missing from these approaches, however, was the basic acknowledgement that in order to do this work in a meaningful and sustainable way, faculty also need access to resources and support (both internal and external). We, like our students, are whole and complex human beings and when we enter the classroom, we bring the whole of ourselves into that space, too. Trauma-informed pedagogy is the first approach I've encountered that feels like it genuinely addresses both the need for inclusive and accessible learning environments for students and the reality that this cannot happen without faculty who are supported in developing the tools and skills to care for and resource themselves, both inside and outside of these spaces. On a fundamental level, that validation and perspective shift, paired with some concrete tools and practices I have learned, have helped me to recognize where and how I can support and care for myself and my students, where and how institutional structures have historically made this challenging, and where and how change might be possible.

I have already incorporated trauma-informed pedagogy into my teaching and find the grounding and containment practices particularly useful, both inside and outside the classroom. I use the containment practice on my own, before I step into the classroom. And in some classes, I now begin by leading the group in a short grounding practice. Since I began incorporating these practices, my experience navigating challenging discussions or moments of tension in the classroom has started to shift. Whether I do these practices alone or with my students, I find that I am better able to resource myself in the classroom because the act of slowing down before lecture begins helps me to feel more centered and focused as I teach. And when difficult situations do arise in the classroom, I feel better equipped to see these discussions through with confidence and empathy. Similarly, I've observed that my students seemed better able to work through and move on from moments of conflict or controversy when they arise.

In many ways, however, the work of trauma informed pedagogy is about more than implementing a set of practices or working with a particular set of pedagogical tools. It is about shifting our relationship to our students, ourselves, and our work by recognizing that our intellectual pursuits are not separate from, but ultimately depend on, our ability to consistently return to and learn from the wisdom deeply embedded in our own bodies.
Short Grounding Practice
Note to instructors: Move slowly through the instructions and don't be afraid to include long pauses after each step. Slowing down is an important part of calming and regulating the nervous system. Keeping this slow pace is also important because it enables you to participate in this practice as you guide your students through it, without feeling rushed or overwhelmed. I try to spend about 5 minutes on this practice at the beginning of class, but the pacing and steps can be adapted to be longer or shorter. Before beginning the practice, remind students that while they are all included, no one is required to participate. To reinforce this, I include the following text on my slides during our grounding practice: "This short grounding exercise is completely optional. If this doesn't feel helpful right now, you can simply sit quietly and do anything that feels relaxing/comfortable for you. Please know that whether or not you participate in this exercise, you are included."
Find a comfortable position with your feet on the ground and close your eyes. Take a few deep breaths and just check in with your body. Notice any sensations that arise and where you are feeling them in your body. Where is your energy right now-do you feel like your nervous system is sped up? Or moving more slowly? Where do you feel those sensations in your body? What do they feel like? Now take a few more deep breaths and start to move your attention down your body and concentrate on the contact between your body and the chair. Feel where your back is making contact with the chair. Try to focus on that sensation for a few moments. Now move your attention down to your sitz bones-the bones at the bottom of your pelvis that are making contact with your chair-notice if one side feels heavier or like it is making more contact than the other. Is it the left side, or the right side, or just an even feeling of contact with the chair? Do you feel more weight or heaviness on the front or the back of your sitz bones? Does the quality of contact feel like more wide contact or more narrow contact? Now take a few more deep breaths. Slowly open your eyes but keep your eye muscles relaxed and your gaze soft and just take a few more seconds to bring your awareness back into the room and the space we are sharing with each other.

Relevance for students in clinical practice

Emily Adler Mosqueda M.S., CCC-SLP, Assistant Clinical Professor/Supervisor
Engaging in the Trauma-Informed Teaching CAIT has given me the opportunity to deepen my personal self-regulation practices of grounding, orienting, naming, and resourcing. Slowing and grounding are practices I am implementing into my clinical instruction along with information on the social nervous system, polyvagal theory, and the Window of Tolerance at it applies to working with children and families receiving speech-language services.

My clinical instruction now includes teaching students how to slow down, ground and orient. I chose this practice to share with students as it is foundational to other trauma-informed pedagogy I mention throughout the term and was my personal access practice to deeper experiential knowledge of my own nervous system. I invite students to participate in this practice a few times throughout the term. We engaged in a guided practice of noticing one's breath, body scanning and awareness to lower parts of their seated selves, and upon completion a slow orientation to their physical space. The first few times I did the practice with students, I was nervous there would be low participation. I have adjusted the length of the practice and believe that has increased the level of participation. After the first time sharing this practice, a few students commented to me that they felt calmer. Another student shared later that they'd continued the practice when they noticed they felt stressed and took the 60-90 seconds to slow and ground which resulted in a calmer state to engage with their tasks. My hope is this practice will support students while in graduate school, and once they're professionals.

I appreciate this practice because it allows me to engage with students wholistically. The more I use the practice personally, I've found I'm more attuned to subtleties of group dynamics and therefore needs of my cohorts of students. I'm now able to respond to the group or an individual with more care and curiosity to their experiences and how they're intersecting with me and the content I share. Students comment that they feel calm in my office space and come to office hours 'to feel better' about school and life.

I also teach students what observable behaviors from their pediatric clients might indicate a need for slowing and grounding so the clients can better engage with their speech-language therapy services. The CAIT training provided me with clear tool kits, application examples, and supports to ensure accurate transfer of skills to students and then by extension to the community. I now have a deeper purpose to incorporate my personal practices of nervous system familiarity into my work as it is imperative to connecting with students and the clients they're working to serve.

Slowing down in the classroom

The practice I plan to implement more in my teaching is the simplest: the skill of slowing down. I have already used this in one of my classes, but I want to integrate it into the other classes I teach as well.

In the class where I used this practice, I invited the group to take a few minutes to close their eyes and then walked them through focusing first on their breathing, then their bodies, then their emotions. I suggested they just notice, rather than trying to shift anything.

Overall, it felt quite successful, and students reported that they enjoyed this practice and wished to do more of it throughout the term. I don't think anything was challenging about it, other than making space for it in a busy class agenda.

I really appreciated how the room felt different - calmer and more centered - after the practice. And I liked having the moment of stillness, too. It allows me to calm myself and focus before embarking on class.

Working with student teams in conflict

Aniko Drlik-Muehleck, Portfolio Manager, Institute for Policy Research and Engagement, PPPM
Situation: I work with team-based classes. This year, due to a perfect storm of factors, almost all the teams in one class are fraying: some are on the verge of disintegration, some have already disintegrated. Frustrations are high, and students are seeking outlets for their frustrations. Sometimes this means disengaging, sometimes it means behaving passive-aggressively towards others, and sometimes it means needing to vent to me or someone else.

Naming: acknowledging the mess of a situation in multiple ways

Full-Class Journalizing Activity - Acknowledging our circumstances at the beginning of a class, accompanied by a journaling exercise asking them how they resource themselves in stressful times, followed by a full-class share-out

After this class, a student reached out to let me know that even if other people thought the activity was silly, they thought it was incredibly important and they were grateful for the space to take this pause

Naming: acknowledging the mess of a situation in multiple ways

Mid-Term Written Reflection - Acknowledging our circumstances in writing as the set-up to a written mid-term reflection asking students to name how they were currently feeling and what they're learning about their ability to work through difficult situations (See assignment text below)

This gave students an opportunity to share how burned out they were feeling - I think expressing this in words was important so that they knew they were suffering alone

I tried to provide comments about additional resources, although I don't know if/how they found this helpful

Naming: acknowledging the mess of a situation in multiple ways

Prefacing Team Meetings - In team meetings, acknowledging our circumstances as a set-up for why I'm making a decision to take a project/group in a different direction, asking how this sits with them, and having a group discussion about these decisions

I have been able to have empathetic, rather than adversarial, conversations with small groups

Teams have understood my decisions (even if they didn't like it), and this has allowed everyone to keep moving forward in some form

Slowing Down: listening to students individually and prompting them with questions:

"I wanted to check in to see how you are doing. I've noticed [name behavior that we're trying to address]. I'd like to know more about why this is happening."

I have been able to have empathetic, rather than adversarial, conversations with individuals and we have built shared understanding about the circumstances we're in

*Mid-Term Reflection Assignment Text
Please take a moment at the middle of the term to pause and reflect on your project, yourself, and your team experience.

Instructions: Please reflect on the following prompts and document your answers. You can do this in writing, as a video, or through some other medium that helps you reflect (for example, I've had some students that prefer to do some kind or annotated drawing/diagram). I just need enough information to understand your thinking around each prompt. I expect you to spend about 30-60min on this assignment.

Project:

You are about five weeks out from a final deliverable. What are feeling most confident about and what are you feeling most daunted or challenged by?

What would be most helpful from your coach and/or the instructor in terms of feedback and support as you approach the finish line?

Yourself:

Describe your general level of motivation and engagement right now (please be honest) - are you feeling pretty burnt out and ready to be done, are you feeling engaged and excited, or are you somewhere in between?

If you are feeling pretty low motivation and engagement: What are some strategies that have worked in the past to keep you moving forward? What new strategies might you try to keep yourself moving forward?

If you are feeling higher motivation and engagement: What factors have contributed to putting you in this place? What takeaways do you have for how to set up projects in the future to maintain momentum for yourself?

Teamwork can be fun and engaging, teamwork can by challenging, teamwork can be bang-your-head-against-the-wall frustrating...each of you are having your own unique experience of teamwork through Capstone. Whatever the experience has been for you, please take some time to solidify some learning for your future self:

What do you need most from team members to feel supported, engaged, and productive?

What steps can you take during the team formation phase to ensure you'll get what you need from your team?

What steps can you take after the team formation phase (when you team actually starts working together) to ensure you'll get what you need from your team?

Exploring and holding our own boundaries

Sarah Ebert, Senior Instructor, Dance
I joined the Trauma-Informed Pedagogy CAIT this year thinking I would learn new pedagogical strategies for supporting students in these extraordinary times. What I hadn't fully considered was how my own state of activation was an important part of the pedagogical equation. Anita Chari's somatic offerings helped me develop a personal practice that aided me in settling my own nervous system before engaging with others - a necessary step in developing a thriving and sustainable teaching/learning community.

I want to share the relief and comfort I felt when I learned about the "cycles of completion," which describe the non-linear process of activation and digestion. Essentially, physical sensations I feel when activated (rapid heartbeat, shallow breath, nausea, dizziness, general jitters) will come and go and eventually lessen over time. In these moments of activation, it's easy for me to lose my sense of time because everything seems so urgent, and then I feel like I haven't made "progress" in my healing when those uncomfortable sensations return. The cycles of completion are a critical reminder that progress is not always linear. My thoughts and sensations will arise intermittently as I digest them, and understanding this helps me to be more patient and forgiving with myself and others. It's important to remember that my students experience this as well and are in their own cyclical processes of activation and digestion.

I also appreciated the practice of containment or setting boundaries. As an empath, I find that I am very sensitive to students' feelings - almost as if I am feeling them myself - and must work hard at meeting but not merging with the students. Having clear boundaries is an intellectual and emotional task, of course, but I also appreciate the opportunity to embody my physical container in the Trauma-Informed Pedagogy CAIT. This has been a beneficial practice in preparation for discussing challenging content in the classroom with a group of students as well as one-on-one conversations. I even brought this concept into my course DANC 270 - Contemporary II (a dance technique class for undergraduate dance majors, minors, and any UO student that fulfills the prerequisite), where students shared that this exercise instilled agency, trust, and respect:
I look around the studio at the top of class. It's Wednesday of Week 3. Spring term. I sense a deep fatigue in myself and see it reflected back to me in the faces and bodies of the student dancers, and so I invite everyone to find a comfortable place on the floor. Stillness and movement are both acceptable as dancers shift from an external focus to an internal survey. I personally pause as I settle myself. [comfort lives in the spaces in-between] I encourage dancers to allow the past and the future to flood their thoughts, as if they are playing a movie in their mind, before letting it all recede - much like the oceanic tides. They are left with cellular presence, a sensation enhanced by the metaphor of innumerable grains of sand on the beach. Unlike grains of sand, though, our cells are fluid-filled, contained by a membrane that is both a protective boundary and a receptive point of exchange. I bring our attention to the sensation of the cellular membrane. Time stretches in this state of listening and feeling. When ready, I invite them to sense their skin as a container, creating a boundary between themselves and the world around them. Stillness morphs into movement. The 'mind of the room' reflects the focus, the buzz, the permission to yield. The cool factor is shed as dancers care less about how they look and more about what they're experiencing. Sensation is the guide. We move from skin as the container to two inches above the skin - a kind of force field that serves as a container or boundary. Which is it? These feel like two different experiences. We expand to six inches, two feet, six feet, twelve feet. Finally, we explore which boundary feels the most comfortable at this moment in time (knowing that it is likely to change). Movement morphs back into stillness for a moment before we take a walk while maintaining our current boundaries. I encourage dancers to sharpen their gaze just enough to make eye contact briefly with another dancer as they pass. Then we pause our walk at the moment of making eye contact, holding the integrity of our own personal boundary and simultaneously sensing and respecting someone else's boundary. After 5-6 exchanges we take our final pause with a partner, and I call for a break. We all emerge from this practice as if we have been deep sea diving for pearls; our smiles radiate sunshine at the surface.

Using grounding exercises with graduate students (including during comprehensive exams)

Dr. Maile Hutterer, Associate Professor, History of Art and Architecture
My introduction to trauma-informed pedagogy coincided with a terms that were focused on graduate seminars and graduate student advising. In particular, all of the students for whom I serve as primary advisor were going through program milestones.

Talking about trauma-informed pedagogy with this group of students allowed me to normalize feelings of overwhelm that are woven into our current model of graduate education. We practiced visualization and embodiment together in group meetings.

I also found embodiment practices to be helpful tools during points of high stress. For example, I integrated a short grounding exercise into a student's comprehensive exams. This is a tool that I will definitely use again as I work toward finding ways to decouple assessment from anxiety.

I imagine myself also integrating short visualizations into undergraduate classes, potentially as a way to come together at the start of each class period.
Description of grounding practice, used during comprehensive exams
I used a grounding practice to mitigate feelings of overwhelm during a doctoral student's comprehensive exams. In essence, this was a 5-minute guided exercise, that can be used to reduce anxiety through an intentional slowing down of the nervous system by drawing attention to the body. I used this practice as a break between the minor and major examination areas. My intention was to give the student an opportunity to refocus, center herself, and the return to the exam with an enhanced sense of ease.

I began the practice by congratulating the student on making it to the midpoint in the exam. I then informed her that I was going to give her the opportunity to recenter herself before moving to the next session. I invited her to close her eyes with me, and I asked her to bring her attention to the lower part of her body, focusing on the contact between her back and the chair. I then slowly drew her attention down the lower part of the body, ending with her feet and the pressure between her feet and the floor. This took about 3 to 4 minutes. I then asked her to open her eyes with a soft focus and awareness of the space between objects. After 30 seconds or so I thanked her for participating in the grounding exercise and asked if she was ready to resume the exam.

In an subsequent debrief of the oral exam, the student reported that the grounding exercise was helpful in two ways. First, it affirmed that I, as examiner, was attuned to the stressful nature of the examination process. Second, it allowed her to detach from the previous minor field section of the exam so that she could be more fully present and focused on the major field section. As the examiner, I observed a reduction in the anxiety of the student following the grounding exercise. Ultimately, I found it to be helpful and I plan to repeat this practice in similar circumstances (oral examinations and defenses). In the future, I will forewarn other committee members of this practice so that they can choose to participate or abstain.

Becoming more aware of our own--and our students' sensory experiences during class

This post describes using two grounding practices in two different contexts:

1. Practice used during in-person meetings with individual students before anxiety-triggering situations and in the classroom: Grounding practice

2. Practice used during Zoom class meetings: Grounding and Orientation-in-Space practice

I implemented those practices that have felt both beneficial to myself, and simple enough to be easily done without my needing a lengthy 'script' to lead them. Because I initially felt anxious about the reaction of an entire class to the introduction of any practice, I first experimented with a grounding exercise when meeting with teams of students who were about to lead class discussion. They reported that the practice made them feel less anxious while still allowing them to acknowledge their own state of activation (nervousness). I had the impression that the practice made them feel comfortable in their own skin as discussion leaders. In Fall quarter, I would like to implement this practice before every student-led discussion, and do it with the entire class instead of only with the discussion leaders.

The second practice I implemented was a grounding and orienting-in-space exercise during one week of class meetings on Zoom. It is so easy to forget our physical body and its positioning in an environment during Zoom meetings... I have found it particularly rewarding to be aware of my entire body during a virtual meeting, to be allowed to close my eyes for a few minutes and then orient myself in the physical space around me afterwards. I am planning to integrate this practice into every synchronous Zoom meeting of my summer class.

On a more general note, I would say that engaging in the Trauma-Informed Teaching CAIT has increased my awareness of students' bodies: the way they sit, move across the room, hold their head, gesture when speaking, and much more. I have been more aware of the physical needs of students without them needing to express those needs explicitly themselves. For example, I had a student who cannot process information in an environment with auditory overload, so they often had to leave the classroom during group discussion. While in the past, I would have been mostly focused on maintaining the intellectual quality of the discussion in the classroom, I regularly went to see that student outside the classroom for a few minutes, or asked whether another student would like to join them in the hallway.

Spiral journaling exercise for classroom mindfulness, reflection, and brainstorming

Dr. Kristy Bryant-Berg, Senior Instructor, Department of English
Instructor Planning: Decide whether or not you will ask your students to share their journaling (either in small groups or with the whole class) at the end of this activity or not, and let the students know before they begin; also, when it comes time to share, give students the option of taking a pass on reading their writing to the class since this journaling can tap into more private feelings and experiences than most academic writing. Remind students who opt out that they are still included and the journaling they did is valued. Create four simple questions about a single topic/moment that you would like your class to reflect upon. Strive for balanced combinations of questions so that they help students observe your chosen topic/moment from four different angles, like the four directions found on a compass. Dedicate these questions to observations rather than analysis and craft them to help students consider your topic/moment more fully, authentically, and openly.

Suggestions for Balancing Questions: If one question asks about an obstacle currently being faced, include another question about a resource that might help address this challenge. If one question asks for personal perspective, offer another focused on the larger community. If one question prompts consideration of a regret or feeling of discomfort, create another question sharing a gratitude or feeling of comfort. If one question asks for recollections about influences from the past, include another question describing experiences in the present, and a third question inviting anticipations for the future. Including a prompt that allows students to pose their own questions is also a helpful choice for one quadrant of the page; like drawing spirals, our questions can keep our focus going and growing.

Tools Students Will Need: Piece of paper (preferably unlined), a writing implement of their choice and proximity to a writing surface, like a desk or table.

Initial Prompt: Once you have your piece of paper and writing tool at the ready, find a place at a desk or table where you can sit with both feet firmly planted on the ground and lean into your writing with comfortable posture. Then, fold your piece of paper in half twice, smoothing it flat each time to form two creases in your paper. For example, if you have a rectangular piece of printer paper, fold lengthwise and widthwise making clear creases as you fold. Unfold your piece of paper and find the natural center, the place where the two creases intersect, and mark this center with a dot.

Spiraling Prompt: Next, starting from your dot, draw a deliberate and even spiral, noticing the spaces in between each line and focusing on keeping them clear and even. No need to rush, take your time drawing this steady spiral. Feel your writing tool in your hand, and watch your lines gradually build on your paper, moving from the center of your paper slowly toward the edges. Taking your time, keep your gradual line growing outward, until you sense you have reached the outer edge of your paper. (You may want to pause your instructions here for three to five minutes for spiraling.) Once you run out of room to draw, stop there to observe your spiral. No two hand-drawn spirals are exactly alike, so pause a moment to notice this spiral.

Writing Prompt: (Remind your students about whether or not and how they will be asked to share what they write before asking them to start journaling.) Notice that in addition to your spiral, the creases divide this piece of paper into four sections. Dedicate each of these sections to answering one question. These responses can be single words, bullet points, full sentences, even whole paragraphs, whichever best your ideas and most comfortably fills the spaces on your page.

Tips: This spiral journal writing feels especially helpful when starting out on a new topic, class or undertaking and when classroom discussions or work have come to a sticking point. It can help broaden the scope of discussions, acknowledge ideas and experiences coming from outside the classroom, add further perspectives, and encourage reflection. This experience will be most effective if the instructor joins the students in the drawing and journaling, modeling focus and openness rather than watching or judging.

Acknowledgements: This spiral journaling concept derives from combining an exercise demonstrated by Maha Bali and Mia Zamora of Equity Unbound on the OneHE (a global collaborative of educators) website along with mindfulness exercises in the Trauma Informed Education, Accountability, and Antiracist Practice CAIT led by Anita Chari at UO in Spring 2022.

# data[].attributes.attachment_link.description
This resource was developed by Anita Chari, Associate Professor of Political Science, 2020-21 Provost's Teaching Fellow, and the Trauma-Informed Pedagogy CAIT (Communities Accelerating the Impact of Teaching) facilitated by Dr. Chari.

# data[].attributes.attachment_link.readable_text
Download Infographic PDF pdf icon [PDF - 600 KB]
6 Guiding Principles To A Trauma-Informed Approach

The CDC's Office of Public Health Preparedness and Response (OPHPR), in collaboration with SAMHSA's National Center for Trauma-Informed Care (NCTIC), developed and led a new training for OPHPR employees about the role of trauma-informed care during public health emergencies. The training aimed to increase responder awareness of the impact that trauma can have in the communities where they work. Participants learned SAMHSA's six principles that guide a trauma-informed approach, including:

1. Safety

2. Trustworthiness & transparency

3. Peer support

4. Collaboration & mutuality

5. Empowerment & choice

6. Cultural, historical & gender issues

Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity, and possibly a cultural change at an organizational level. On-going internal organizational assessment and quality improvement, as well as engagement with community stakeholders, will help to imbed this approach which can be augmented with organizational development and practice improvement. The training provided by OPHPR and NCTIC was the first step for CDC to view emergency preparedness and response through a trauma-informed lens.

Page last reviewed:

# data[].attributes.attachment_link.title
Infographic: 6 Guiding Principles To A Trauma-Informed Approach

# data[].attributes.attachment_link.description
Download Infographic PDF pdf icon [PDF - 600 KB] The CDC's Office of Public Health Preparedness and Response (OPHPR), in collaboration with SAMHSA's National Center for Trauma-Informed Care (NCTIC), developed and led a new training for OPHPR employees about the role of trauma-informed care during public health emergencies.

# data[].attributes.attachment_link.title
My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies a book by Resmaa Menakem

# data[].attributes.attachment_link.description
The body is where our instincts reside and where we fight, flee, or freeze, and it endures the trauma inflicted by the ills that plague society. In this groundbreaking work, therapist Resmaa Menakem examines the damage caused by racism in America from the perspective of body-centered psychology. He…

# data[].attributes.attachment_link.readable_text
transcript

This Conversation Will Change How You Think About Trauma

The author of "The Body Keeps the Score" on how trauma transforms the body and the brain.

[MUSIC PLAYING]

ezra klein

I'm Ezra Klein, and this is "The Ezra Klein Show."

So one of the things I do for the show is I try to keep an eye on the best seller lists. And a few months ago, I began to notice something strange. "The Body Keeps the Score," which is a book about trauma from 2014, was back up near the top of the New York Times list. It's number one, as I write this, the book's 147th week on the paperback nonfiction list - 147th. And if you know what this book is, that is wild.

"The Body Keeps the Score," it is a searing read about the way trauma disconnects our minds and our bodies. And it's pretty clearly written with a professional audience in mind. This is a book very largely aimed at other psychiatrists. That so many of us are turning to it, it says something profound about where the national psyche is in this moment of, yeah, trauma.

I'll be honest of my own history of it here. "The Body Keeps the Score" is one of those books people have told me to read for a long time. But I thought I knew what it was about. I'd heard it discussed so many times, and I'd read it written about. So even though I hadn't read it, I thought I knew it: trauma lodges in the body, we carry a physical imprint of our psychic wounds, it's all very hard to heal. Got it.

But I was really wrong about that. The core argument is - I want to use the word "subversive" here. Certainly subversive in how it will leave you thinking about yourself and those around you. It is about traumatic experiences: sexual assault, incest, emotional physical abuse, war and much, much more. They can disconnect our body and our mind. That is when an experience becomes a trauma - when it disconnects us.

And this is a part I didn't understand from the way the book is talked about. The devastating argument it makes is not that the body keeps the score, it's that the mind hides the score from us. The mind - it hides and warps these traumatic events and our narratives about them in an effort to protect us. Human beings are social animals. And our minds evolve to manage our social relationships.

So when we face an event that could rupture our relationship with the community or the family, particularly for children of the family that we depend on, the mind often talks us out of it. It obscures the memories or convinces us our victimization was our fault or it covers the event in a shame so thick, we refuse to discuss it. But our body - and that's an imprecise term here. But the parts of us that are more automatic that manage and respond to threat - our body doesn't forget that. Our mind can't talk that part of us into feeling safe again. And it's this disconnection of mind and body where trauma lives.

So how do you reconnect them? Bessel van der Kolk is the author of "The Body Keeps the Score." He was a leading researcher and psychiatrist active in many of the early battles to understand post-traumatic stress syndrome. But more recently, he co-founded and leads a trauma research foundation and has been studying ways to try to heal these deeper parts of our psyches, everything from movement therapies like yoga and dance to E.M.D.R. to internal family systems therapy to MDMA treatment. We talk about all of it in here.

But I do want to offer a disclaimer: the research on some of these novel treatments, it is really promising. But these are often new studies with pretty small sample sizes. So I don't want anyone to mistake this conversation for direct advice from a psychiatrist who knows your situation and psyche. So if anything in here connects for you, talk to a professional about it. Don't just drop the treatments you're using or the medications you're taking and run to something new.

But with that said, there is so much to learn from in this conversation. I really haven't stopped thinking about it since we recorded. As always, my email, ezrakleinshow@nytimes.com if you want to send me further guest suggestions or recommendations for things we should read or look at. Again, ezrakleinshow@nytimes.com.

Bessel van der Kolk, welcome to the show.

bessel van der kolk

Hi, good being here.

ezra klein

You have this very powerful line in the book from the writer Jessica Stern where she says, quote, "Some people's lives seem to flow in a narrative. Mine had many stops and starts. That's what trauma does - it interrupts the plot." Tell me a bit about how trauma interrupts the plot.

bessel van der kolk

Well, trauma is really a wound that happens to your psyche, to your mind, to your brain. Suddenly you're confronted with something that you are faced with horror and helplessness. That nothing prepares you for this and you go like, oh, my God. And so something switches off at that point in your mind and your brain. And the nature of trauma is that you get stuck there. So instead of remembering something unpleasant, you keep reliving something very unpleasant.

So the job of overcoming trauma is to make it into a memory where your whole being knows this happened a long time ago, it's not happening right now. But the nature of traumatic stress is that you keep reacting emotionally and physiologically as if these events are happening right now.

ezra klein

What is trauma? Is it the event itself or is it your reaction and processing, or I guess lack thereof, of the event?

bessel van der kolk

It really is a reaction that you have something horrible that's going on. And different people have different responses. Although I must say, having done this work as long as I have, I don't recall ever seeing somebody in my office coming for traumatic stress that I go, oh, this seems like a trivial issue. Like having your child run over by a car, you go like, oh, my God. And usually my response to hearing about people's trauma is, oh, my God, are you still here?

ezra klein

I'll say that, for me, was the hardest part of reading your book was just being faced with something I already know, but being faced with how much pain people are simply carrying around with them every day. It's one way reading the book made me just look at the world a little bit differently. It's just this reminder that you have no idea what somebody is carrying.

bessel van der kolk

That is so true. And of course, we do need to wear our blinders, and we cannot face up to all the bad stuff that's happening in the world. But to give an example to what you're saying here: when we first put this diagnosis of P.T.S.D. in a textbook, we said, this is an extraordinary event outside of the usual realm of human experience. That is the official definition. Nobody talked about how common incest is, nobody talks about how common child abuse is, how common domestic violence is. And it's really quite startling when you get to see how much people actually are coping with.

ezra klein

At various points in the book, you argue that trauma is the most costly public health problem that we are dealing with. This is before the era of Covid, of course. So let's keep that to the side. But do you want to talk for a minute about that at scale, what it means that so many people are holding these kinds of experiences and pain?

bessel van der kolk

ezra klein

Tell me a bit about the conditions under which an event that could be traumatic becomes a trauma. And in particular, I was very struck by how much of your research suggests that trauma is an event plus a kind of instigated social crisis. There are objectively catastrophic events, like 9/11, that were less likely to cause trauma because they were shared by the community. Where, on the other hand, things like child sexual abuse is very reliably traumatic because it disconnects you from your family. So could you talk a bit about the social structure of trauma?

bessel van der kolk

Yeah. So what we tend to leave out of most of our discussions about human functioning is to what degree we are primates. We have brains in order to get along with each other, to be with other people, to connect with other people. That's really what we are fundamentally all about. And so, much of trauma is about a rupture of the safety of the people who are supposed to protect you and the people who are supposed to come to your help.

So basically, the way that we are wired is that we are wired to not be able to do everything by ourselves, but to be able to look for help and for other people to take over when we can no longer do the job ourselves. And that's perfectly normal. But if, at that point, the people you can count on most are not there for you, let you down, have been killed, or whatever, then it's entirely up to you. It's a much harder thing to deal with terrible situations.

ezra klein

I just want to tag something you said there for the audience, because we're going to come back to quite a bit, which is we have brains in order to get along with other people. I think that's going to be really, really, really important to this conversation. But this gets to something that I found really rich in the book. So "The Body Keeps the Score" has - I mean, as a book, it's a phenomenon, as a social meme, it's a phenomenon. So I felt like I knew what it said even though I hadn't read it until recently.

But then when I read it, what really struck me about it is how much of the book is about not just how the body keeps the score, but how and why the mind hides the score. Can you tell me a bit about that?

bessel van der kolk

Yeah, brilliant. We are created to survive. We're also created to be loyal and to be part of a group. And sometimes, in order to survive, you need to keep your realities [INAUDIBLE] the people around you. And so when you go through a terrible reality like 9/11 in New York or terrible natural disasters, oftentimes people get very close together because it's out there, everybody can see it, people help each other. Part of our nature is to be altruistic and to be generous when people are in distress.

But if your feelings conflict with your loyalty - let's say, if your own mom or dad beat you up and you don't feel safe with them - you cannot tell other people about it either because you're supposed to love your mom or dad. And so you need to keep it to yourself. And then it starts festering inside of you. So the reason why you do psychotherapy is mainly to help people to find words for the reality that they have dealt with. And oftentimes, those are realities that are not acceptable for the people around you.

ezra klein

You talk about the difference between the parts of the brain that create the autobiographical self and the parts of the brain that create the experiencing self. Can you discuss that a bit?

bessel van der kolk

ezra klein

It was astonishing to me, reading some of the stories in the book. I think all of us have the experience of telling a story about ourself that is not true to how we feel. But you treat patients who, the stories their minds have told or the memories their minds have hidden are really shocking. So why do victims of abuse, particularly child abuse, so often either forget what happened to them or blame themselves for it?

bessel van der kolk

ezra klein

This was a real epiphany for me in reading your book, because you read about cases like this. You read about false memories or you hear about or even know people who blame themselves for horrible things done to them - child abuse or rape or a beating or whatever it might be. And you think, what would happen that brains would be defective that they would do that? That doesn't make any sense.

But the point of your book, I think, in part is that it does make sense. There's an evolutionary fitness reason for the brain to do that, which is that it's a story that allows you to maintain within a family, or maintain within a workplace or maintain within a community. Because if you told the real story, it would rupture your family, it would rupture your community, it would rupture your workplace.

bessel van der kolk

Exactly. These thoughts didn't come from me, of course, originally. All these thoughts have been thought before. But the great hero here is John Bowlby, attachment researcher, who really showed how children really need to cling to their caregivers and will do anything they can to keep a semblance of connection going so they don't die or get totally abandoned. And the price they pay for that is very much this very profound sense of self loathing, oftentimes despising yourself, getting into a lot of difficult behaviors because I'm no good anyway. And it's a deep sense of, I may as well put myself in danger, I may as well take drugs because I'm no good anyway.

ezra klein

So then you get into these cases where people are telling a story about something - either telling a story that admits something or telling a story that normalizes something - that their body doesn't believe. And so you have these kind of two systems, like the kind of cerebral system of what somebody is sitting in front of you saying, and then the fact that they collapse into a ball at the touch of another human being or hide in drugs or have all these other coping behaviors. So can you talk about why the system that is rationalizing isn't able to convince the body? Because you would think maybe that would be just one system all the way through. You got to live the lie. But part of what you're getting at is you don't live the lie, you just tell the lie.

bessel van der kolk

Yeah, you live the lie. You really believe that I'm fundamentally defective and that's why this happens to me. So people really very deeply come to rationalize their very bad feelings. And that actually allows them to continue to survive to some degree. And that's a different part of the brain.

But of course, your core survival part of the brain picks up the danger signs and keeps continuing to secrete stress hormones, immunological abnormalities, muscle tension, fibromyalgia - a whole bunch of physiological systems where the body continues to behave as if it's in great danger while the mind says, don't pay attention to him, he's lying, he's a terrible person. So it's really the conflict between the body feeling very unsafe and the mind not wanting to accept the reality of what has happened to you is at the core of this, yeah.

ezra klein

This is a strange idea to wrap your mind around. How is it possible that your body - which on some level is controlled by your mind. I mean, it's getting electrical signals from the brain. How is it possible that you can have such disagreements within one system?

bessel van der kolk

Well, because they are somewhat different systems. The system that helps you to sleep, for example, is a system that most of us have very little control over. And so you may rationally know that it's important to go to sleep now and life is safe and I have nothing to worry about. But something in the back of your brain, your survival brain, seems to give you messages of, I'm in danger.

Very commonly, when people have had sexual molestation or issues like that early in their lives, they are with somebody, they have a sense of desire, and suddenly their body shuts down. And they become very angry or very frozen. And they say to themselves, there's something deeply wrong with me because I really like this person that I'm with and I'd really like to have a good time. But my body won't let me because the primitive survival part of the brain is still stuck back then, when they felt in danger. But the frontal lobe may not register that.

ezra klein

One of the main ways you say the mind hides the score is through applying shame. You write at one point that for trauma survivors, quote, "Shame becomes the dominant emotion and hiding truth a central preoccupation." Can you talk a bit about what shame is, what it is as an emotion, and then the role it plays for people after trauma?

bessel van der kolk

Yeah, shame is really a feeling of wanting to hide how you don't want anybody to see you. Shame comes from having feelings that are fundamentally unacceptable. Like if you're talking very nicely to me, and I may have a feeling that I'd like to kill this guy, and you think to yourself, what a terrible person am I to want to kill somebody who's very nice to me. And then you say, I must be crazy, there's something wrong with me.

As it happens to be, maybe you have a particular accent or a way of talking that may remind me on a very deep level of somebody who beat me up when I was a kid, and I have this intense emotional reaction to you, and I feel like, what's wrong with you, Bessel, that you have such a terrible reaction to this nice person, and he probably already has picked up that I'm trying to hide something from him because I feel so angry with this person who's actually being very nice to me. So that's the confusion and the shame that traumatized people live with.

ezra klein

One thing that struck me about that passage is - and I apologize because I can't remember where I read this distinction. But I once read that guilt is an individual emotion and shame is a social emotion. Guilt is, I feel bad about something I did, and shame is that I am afraid the community will look bad upon me for something I did. And within this context of trauma often relating to things that happened that would create rupture of the community, it seems interesting and also profoundly sad that shame is such a constant companion to that, because it's a way of fearing that your community will turn on you potentially if the truth were to be known.

bessel van der kolk

ezra klein

I want to put a pin in New York in 9/11 because I want to come back to that and the question of whether or not there are things we can learn as a society, whenever it will be the case that we can begin to recover as a society from Covid and whether or not there are things we can learn in that experience for how to do it well. But I want to ask about another way that we end up hiding what we feel, which is that trauma has a way of numbing people to their feelings, to their emotions, even to very basic physical sensations. And something you talk about, which I didn't realize, is that when that happens, it becomes hard to construct a coherent sense of a self. Can you talk about how that works?

bessel van der kolk

Yeah. When you are involved in your trauma and you are continuously reacting to stuff, you can't trust yourself. And you don't really know what's right because you keep sort of getting into trouble again, you try something and you freeze, and you try something and you explode. And you do something and you feel terrible about yourself. And you don't know where that comes from. And so you try to make sense out of this turmoil that's going on in your sensory system. And if you're lucky, you are talented and you're a good basketball player, a good guitar player, a good accountant, and you can hide yourself in your particular talent where you can find a safe area for yourself. But when it comes to the complexity of dealing with teenage children or relationships, that may be too much for you and you keep falling apart. And so your identity becomes like, I cannot be with other people, I'm no good. And so that sense of trust in yourself, predicting yourself, knowing who you are, knowing how you react to things becomes very damaged.

[MUSIC PLAYING]

ezra klein

You have an interestingly complicated relationship to language in the book. You talk about it as both a miracle and a tyranny, and the ability to both put words to things you've experienced and also put words to things maybe we haven't or ways we don't feel about how we've experienced them. And so I wanted to ask it this way, because a lot of us have had experience with therapy have primarily had experience with talk therapy, where you go and you sit in a room and you get asked questions about your parents and you try to answer them. What can that do, and then what can language not do in these cases?

bessel van der kolk

ezra klein

We're going to go through a bunch of these therapies. But one thing I want to ask about them as a group is that one thing lurking around your book, and certainly that I felt reading it and that I felt in my own life as I've looked at various modalities for things that I've struggled with, is that there's a hierarchy of status to different treatments. So it's very accepted at this point, very rational, to take a pill for depression or anxiety. Talk therapy has a very long history. Nobody looks askance at that. That's something intellectuals do in New York, and they sit in a chair and talk about feelings. And I don't want to say anything bad about either of those. But then you start looking some of these other things, like E.M.D.R. which we can talk about, or dance therapy or yoga. And it feels soft. You're like, well, that's silly, that's holistic, that's - and something I think the book is trying to get at is that maybe we have come to overweight certain kinds of approaches to how we feel and underweight others. So before we get into how these therapies work, can you talk about that meta level of coming to respect therapies that maybe don't have a lot of social status right now?

bessel van der kolk

Very important point you make. It's a cultural issue. You hear from my accent, I'm northern European, and North America is still very northern European. The world and northern Europe developed two ways of dealing with bad stuff. One of them was to drink. And so taking a pill is a respectable thing in Western culture to do, and normal people ingest stuff to make themselves feel better.

Nobody feels bad about it. Other places in the world may say, that's weird. Then the other thing that Western people are very good at is talking. We're not very good in singing together and moving together. You go to China after a disaster and people are doing qigong together, and so that's interesting, or tai chi.

And you go to Brazil in [INAUDIBLE] area, and you see people practice capoeira. You go, are they practicing capoeria because it looks good to the tourists, or are they practicing capoeira because it does something to the way they relate to their bodies and their sense of self-control?

So I think to some degree, we are trapped in this post- alcoholic paradigm that the only way to change is through taking pills or by talking. But of course, once you raise kids and you hang around with kindergarten teachers, they don't do a lot of talking. They'd also do a lot of singing together, and a lot of moving together, and a lot of tossing balls together. And a lot of things that help you get in tune and in rhythm with each other.

And that's not really the strong point of Western culture. So it all depends on the cultural assumptions you have about what's helpful to people.

ezra klein

bessel van der kolk

ezra klein

That point about the dark side of institutions is very important, and very well taken. But let's talk about some of the things that you explore in the book and that people are exploring. And why don't we start with one that folks may have heard of, but even if they have, even when I had, it's very alien, which is E.M.D.R. Can you talk a bit about what E.M.D.R. is?

bessel van der kolk

EMDR is a very simple and weird technique. It is that you ask people to call up the images in their mind about horrible things that have happened to them, and to remember what they felt like in their bodies, to remember what they saw, what they heard, but you don't talk about it. Because the moment you start talking to people, you change your story according to what you think that person wants to hear.

Talking always becomes the interpersonal process, and talking makes you adjust your reality to what people are able to listen to. So in E.M.D.R., you keep it to yourself, you see these things, and then you ask people to move their eyes from side to side in response to your fingers.

The first time I heard about it, it sounded like crazy. And my patients started to come back saying, I resolved things, I was able to just leave the memory behind. I did the first National Institute of Mental Health- funded research on E.M.D.R. Our adult onset P.T.S.D. people had like, a 78 percent cure rate. So clearly it had major positive effects.

And so that was my introduction, which I'm very grateful for, of seeing something that's just on the surface bizarre, but has a very profound effect, that gets us out of this post-alcoholic paradigm of talking or drugs. I said look, this is interesting, this is weird. And so I got very interested in how does it work.

And so two years ago we finally did a study where we looked at what these eye movements cause. And what we saw, it changes the connectivity between different parts of the brain. And so what we saw is that it affected neural networks. And that for me was just so cool, because this really opens up the frontier of where our treatments need to go, is how do we repair these networks where the different parts of the brain are disconnected from each other.

But the result is that when people have this inkling of trauma, they feel it as if it's still happening now. And what we saw in our neuroimaging study of E.M.D.R. is that the circuits of the brain change, so it allows the mind to go, oh yeah, this has happened to me, but it happened back then, a long time ago. It's not happening right now. So the E.M.D.R. was my opening that there's ways of switching neural circuits so your perspective on the issue becomes very different.

ezra klein

Why would moving your eyes back and forth open that pathway?

bessel van der kolk

That's the question we don't know, except you go back to what Darwin wrote about and Pavlov wrote about it, about conditioned responses of the brain, start to react with how you move your eyes in a certain direction when there's danger. And there's maybe some evolutionary circuits involved with moving your eyes in the direction of threat. We don't know, because research funding would not really allow people to go into asking these questions at this point. I wish we would.

ezra klein

bessel van der kolk

ezra klein

There's a fascinating study you bring up, which relates I think to this very, very famous study where they are still following, actually, but this one class of men from Harvard from decades, and decades, and decades ago. But something the study found is that in the people who were traumatized by their experience in war, their memories never really changed.

They told the same story 40 years later that they told right after it happened. Whereas the people who weren't traumatized by it, their memories kept changing. The imagination was telling and retelling the story, right? The cliché of the old war stories that never quite happened, or the fishing stories where the fish keeps getting bigger. So if you could you talk a bit about that? About the way weirdly, a healthy memory is actually a less accurate memory? Because what you need in life is not accurate memories but a story that works for you in the world.

bessel van der kolk

ezra klein

Speaking of family reunions, can you talk about internal family systems therapy? I had never come along this until the book, but it's fascinating.

bessel van der kolk

Oh well, internal family systems is not about families. It's about how we all have families living inside of ourselves. It's a very important evolution, the past 30 years or so. Jung already talked about the same thing, William James talked about the same thing: that we have a multiplicity of minds. Walt Whitman wrote a poem about it, said that "I contain multitudes."

You strike me as a very loving, and kind, and intelligent, and attuned person.

ezra klein

Oh, thank you.

bessel van der kolk

ezra klein

bessel van der kolk

ezra klein

The single best piece of advice I ever got on marriage is that there is no use in thinking of your partner as a single stable entity that exists separate from you. There's only your partner in a dynamic with you. There's only who you also bring out in your partner, that they'll be somebody totally different with other people. But so the question always, if things are going right or wrong, is, like, which parts of the two of you are being brought out in relationship? Not just, who is this person and do I like them?

bessel van der kolk

See, and Dick Schwartz extended what you just said in your relationship to yourself. And to really understand that you may have very different reactions at different times, and to really get to appreciate that certain things make me very upset, and to really start making decisions about do I want to give in to that, or do I want to do something about it? Or how to really start getting a perspective on this landscape, and make a discovery inside of yourself.

ezra klein

An intervention you discuss glancingly in the book, but it sounds from something you said earlier like you've been doing more work on, is psychedelic therapy. It's been a lot more research since you did the book, it sounds like you're actually behind some of it. So given what we know now, I'm curious how you understand the role of psychedelics potentially in helping people deal with trauma?

bessel van der kolk

ezra klein

bessel van der kolk

Well, certainly Carhart-Harris has done more work on it than any of the rest of us. And I think his formulation approximates what we see here. I think the big thing in terms of trauma, is that when you're traumatized you live in a very narrow world. A world of fear, and trying to stay under control, and being afraid to get out of control, or being afraid to get overwhelmed.

So your world becomes more and more constrained. Pierre Janet already wrote it about 150 years ago. How you get narrow minded, and what Janet said back then also, he says, when you get traumatized, the mind has a hard time continuing to grow. The mind gets stuck in its effort to try to control itself, it becomes very hard to open your mind up to new things.

So when you're traumatized, you oftentimes tend to have the same patterns over and over again. You have a hard time learning from experience. Your mind closes down. I think what psilocybin, ayahuasca, LSD do is they open up a new universe inside of yourself that somehow you need to cope with.

The way you phrased it is a little bit too deliberately cognitive for my mind. The mind does something to become aware - but even aware is too conscious - of that I'm a much smaller piece in the much larger universe, and a universal experience through these substances, which Carhart-Harris and Pollan and those people who also write about, is how you get to see your relative position in the universe.

At the same time as you experience yourself as quite unique and special, you also get to see the rest of the universe as also being unique and special. And universally, regardless of the culture, you always end up with a feeling of, I'm a part of a much larger universe. But I'm an essential part of that part of the universe.

Which is, of course, the opposite of being traumatized. When you're traumatized, you go, I'm messed up, nobody else is, everybody's having a life and I don't, and you feel alienated. And that sense of what all these mind altering substances do, of opening yourself up, being a part of a larger whole, is very significant also.

ezra klein

So MDMA combined with therapy is now in phase III trials in the F.D.A. for treating post-traumatic stress disorder. You have psilocybin at other levels of the regulatory process. There's very much a vogue for all this. Do you worry that it has risks we're not paying attention to?

bessel van der kolk

I think societies have had a very difficult time legalizing and dealing with the outflow of these massive mind-expanding agents. And I'm very curious to what degree we're able to stay reasonable about it, to be careful about it, to not have it get out of control. And I'm really delighted with Rick Doblin, who runs the Multidisciplinary Association for Psychedelic Studies, M.A.P.S., which forms part of his studies. He is working very hard to keep it very careful. But I'm very worried that things will get out of control, yeah.

ezra klein

You were very much part of the rise of just pharmaceuticals to treat mental illness. You did one of the early studies on Prozac. And in the book, you have a very complicated relationship with these drugs, which you prescribe and believe they can help people. But you also worry that we overuse them, that we use drugs to ignore signals, or numb signals the body is sending, so that it becomes easier to not do things. How do you think about that space now?

bessel van der kolk

So I was a very young person. So I worked in the hospital and did a lot of the early studies and did some myself, and there was an enormous promise that chemicals were the answers. And people said, mental illness is a chemical illness, and if we just find the right chemical, we'll cure it.

And billions of dollars on the chemical studies really haven't yielded all that much in terms of understanding or treating mental illness. But the sad thing is that psychiatry as a profession became addicted to drugs. And so the notion that oh, if you just find the right symptom, you'll find the right drug, still prevails among many professionals.

There are chemicals that can be somewhat helpful. They can help you to sleep better, to be less uptight. But they're chemicals that really interfere with your natural capacity to deal with these things. And for me, very quickly after I did these early studies with not bad results, they certainly did not promise total happiness, really started to concentrate on what inborn mechanisms we have to deal with our own anxiety, and with our depression.

And so I really discovered the world of the body and tantric traditions, the yoga traditions and breathing traditions, and musical traditions that show that we actually are capable of rearranging our own internal physiological systems. And I wish that in every classroom in America they would teach the four Rs: reading, writing, arithmetic and self regulation, from kindergarten through 12th grade, of what can we do to calm ourselves down, to stay focused? What sort of activities can we engage in to feel in control of ourselves?

And so that we get away from this culture of, if you don't feel right you take a drug, instead of if you don't feel right you go for a bicycle ride. If you don't feel right you go to yoga class. If you don't feel right, you may need to do some body work to help your body to calm, or you need to go to do some tango dancing, or you need to do something to rearrange your relationship to your internal physiological state.

ezra klein

bessel van der kolk

All of the above, and none, to some degree. I don't think we are throwing everything against the wall. We're doing actually the opposite. We're looking for yet another drug doing the same old stuff that we have done. We are looking at yet another talk therapy that will make people into sensible human beings.

We have, as a discipline, completely ignored our early data, when we first started to image trauma in the brain, that trauma sits on the right side of the brain. And so these right brain phenomena are lasting phenomena. And so the time has come to really start looking at what else can we do, because basically the funding has been very much focused on talking therapies and drug therapies.

So no, we haven't thrown things against the wall. I'm still waiting for the study of comparing tango dancing with cognitive behavioral therapy. I'm a scientist, it's an empirical question. But I put my money on tango dancing over C.B.T., by and large, for some people. So I think we need to explore much more.

Is the world open for it? Yes and no. For example, I was able to start a foundation, and rather than become a recipient of funding, I'm able to fund some studies. Now the very first study we are funding is a study of touch and trauma. Everybody who knows anything about trauma, is that some of these people have very varied and oftentimes very anomalous responses to human touch.

People have won Nobel prizes about vision, Nobel prizes about audition. Touch is basically off the wall. The main way that people get comfort in life is through being touched. Once you have been touched inappropriately, touch maybe can defeat this. Let's study touch.

We are synchronous human beings. The source of pleasure in our lives is to be in sync with each other. The reason why I like talking with you is because, whenever you ask a question, I go, "Boy this guy really gets it." I feel you're in sync with me, which gives me a tremendous sense of pleasure. So being in sync with people is critical for our sense of fun, of feeling alive. So how can we increase people's sense of synchronicity with other human beings?

So I don't know how it will work itself out, because in the world we live in, everything gets monetized. And so we tend to be able to study very expensive technical treatments more than simple treatments. And so where things will go, God knows. But boy, are we missing the boat on exploring a much larger number of options. Yes, up to now we have.

ezra klein

On the point of touch, that there are a couple lines in your book that have really etched themselves in me. And one in particular here where you say that "the things that calm adults are the same things that calm children. Being held, being rocked, and being shushed." And I don't know. I just found that very moving.

bessel van der kolk

It's true! You see it through to have your own kid go - yeah, he's very young. But I need to do the same thing for him as I need myself.

ezra klein

But at some point, we make it very difficult for adults to ask for those things. You can maybe ask your partner, and that's it. Particularly, I'll speak more for men here, because I understand male relationships a little bit better, but you really, as a man, you can't go to your male friends and ask to be rocked and shushed. [LAUGHTER]

bessel van der kolk

Yeah, a little bit, the culture has something to do with it.

ezra klein

Yeah, and it just strikes me as a shame. To the point you were just making, we spend so many billions of dollars, and so much effort to get the medications we think will help, and to see psychiatrists. And we've also cut ourselves off from a lot of just very cheap things, right? We have culturally cut ourselves off from a lot of touch, right? We often live in very atomized ways.

I mean there's very kind of cheap, natural things that are part of our deep history that we give to our children, or at least in many homes, that, I don't know, we've just decided are a little somehow uncouth, and we suffer for it.

bessel van der kolk

A very big part of what you're talking about is our socially stratified system, and our humongous income inequality. I sent my kids to schools where there was a lot of theater, music, dancing, creative writing, sports. They were always moving and creating things. The poorer you are, the less you get any of these things.

ezra klein

We're going to come back, we're definitely going to come back at the end to the bigger question of inequality. But before we do that, I want to reverse the way we've been looking at this. We've been talking about the way traumatized people are disconnected from their communities. And I want to talk a little bit about what it means to be in community with somebody who is traumatized.

A lot of the patients you talk about in the book, a lot of the behaviors that traumatized people exhibit, they're very alienating to those around them. They're difficult, they can be dangerous. Can you just talk a bit about what trauma is like for those who love someone who is traumatized?

bessel van der kolk

ezra klein

How do you advise people to deal with the very difficult question of what you can ask of someone they love? I mean, the tension between recognizing the reality that people's actions are often largely out of their control. They don't want to treat us badly, they don't want to disconnect, they don't want to pull back, and also that we don't want to be mistreated, or taken advantage of, or hurt.

And that there is something you can ask of some people, right? Sometimes you can ask somebody to treat you better. And then sometimes you need to recognize that there is healing that has to happen before they're going to be able to do that. But it's often hard to know which situation is which. Do you have advice for people who feel like they're in that situation?

bessel van der kolk

ezra klein

So I want to go back then to this question of the broader society that you were talking about a minute ago, with schools and inequality. On one level, it's clear I think that providing child care, and pre-K, and well funded schools, and universal health care, and better access to mental health services would help make a society that is better at helping people.

But on some level, that also can't be the whole answer, because a lot of middle and upper class people's lives are full of trauma, too. So I'm curious what you think are the structures and institutions, or even just social mores, that would help us become healthier, and help people either be traumatized less often or help them more once they are?

bessel van der kolk

It's of course, very complex, and nobody has the answers. But creating situations where parents can safely take care of their kids is terribly important. And of course, that is much easier when you have money than if you don't have money. So almost every other society has universal health care and has support, which we lack.

So for me, this is really a very big issue. Yes, it's because of the system we live in, the majority of people I treat are people who come from relatively fortunate circumstances. Because if you come from very low education and you don't have a high school diploma, there's no way you will find a way of getting to see an experienced mental health professional.

ezra klein

What interventions for kids do you think would do the most good? I mean, if you could wave your wand and put some new structures into law that they have elsewhere, or that they don't have elsewhere, what would the first couple of them be?

bessel van der kolk

ezra klein

And it sounds to me like you think the same is actually true for adults, that you need space to play, to move, to be in synchronicity with others, to sing, to dance, to have what gets called collective effervescence.

bessel van der kolk

Absolutely. Of course, you get more frozen as we grow older. But cooking with people, serving meals to people, pouring that wine to other people, still that moving together is a terribly important way of feeling our communality with other human beings.

ezra klein

And then I want to return to a question I said we'd tackle here at the end, which is you talked about the ways in which the post- 9/11 period in New York City was actually well handled from the perspective of trauma. One thing that led to us doing this podcast is your book has been back up, all the way up on the bestseller lists.

And I don't think that's an accident. I think that has to do with people sensing a lot is wrong in themselves and in society, as we do and, in some cases, don't recover from the coronavirus. So we've just been through a society- wide trauma, we are still going through it. But at some point, there's going to be the potential maybe for recovery. Are there lessons from New York City after 9/11 for countries when they finally can turn to trying to recover from this pandemic?

bessel van der kolk

ezra klein

I think that's a good place to end. So always, our final question. What are the three books that have influenced you that you would recommend to the audience?

bessel van der kolk

ezra klein

Bessel van der Kolk, your book is "The Body Keeps the Score," it's remarkable. Thank you very much.

bessel van der kolk

Thank you. It's a pleasure.

"The Ezra Klein Show" is a production of New York Times Opinion. It is produced by Jeff Geld, Roge Karma and Annie Gelvin. Fact checking by Michelle Harris, original music by Isaac Jones and mixing by Jeff Geld.

The author of "The Body Keeps the Score" on how trauma transforms the body and the brain.

"Trauma is much more than a story about something that happened long ago," writes Dr. Bessel van der Kolk. "The emotions and physical sensations that were imprinted during the trauma are experienced not as memories but as disruptive physical reactions in the present."
[You can listen to this episode of "The Ezra Klein Show" on Apple, Spotify, Google or wherever you get your podcasts.]
Van der Kolk, a psychiatrist by training, has been a pioneer in trauma research for decades now and leads the Trauma Research Foundation. His 2014 book, "The Body Keeps the Score," quickly became a touchstone on the topic. And although the book was first released seven years ago, it now sits at No. 1 on the New York Times best-seller list, a testament to the state of our national psyche.

The core argument of the book is that traumatic experiences - everything from sexual assault and incest to emotional and physical abuse - become embedded in the older, more primal parts of our brain that don't have access to conscious awareness. And that means two things simultaneously. First, that trauma lodges in the body. We carry a physical imprint of our psychic wounds. The body keeps the score. But - and I found this more revelatory - the mind hides the score. It obscures the memories, or convinces us our victimization was our fault, or covers the event in shame so we don't discuss it.

There's a lot in this conversation. We discuss the lived experience of trauma, the relationship between the mind and the body, the differences between our "experiencing" and "autobiographical" selves, why van der Kolk believes human language is both a "miracle" and a "tyranny," unconventional treatments for trauma from E.M.D.R. and yoga to psychedelics and theater, how societies can manage collective trauma like 9/11 and Covid-19, the shortcomings of America's "post-alcoholic" approach to dealing with psychic suffering, how to navigate the often complex relationships with the traumatized people we know and love, and much more.

You can listen to our whole conversation by following "The Ezra Klein Show" on Apple, Spotify, Google or wherever you get your podcasts.
(A full transcript of the episode is available here.)

Image

Credit... The New York Times

"The Ezra Klein Show" is produced by Annie Galvin, Jeff Geld and Rogé Karma; fact-checking by Michelle Harris; original music by Isaac Jones; mixing by Jeff Geld; audience strategy by Shannon Busta. Special thanks to Kristin Lin.

# data[].attributes.attachment_link.title
Opinion | This Conversation Will Change How You Think About Trauma

# data[].attributes.attachment_link.description
transcript The author of "The Body Keeps the Score" on how trauma transforms the body and the brain. [MUSIC PLAYING] ezra klein I'm Ezra Klein, and this is "The Ezra Klein Show." So one of the things I do for the show is I try to keep an eye on the best seller lists.

# data[].attributes.attachment_link.readable_text
Maybe you have already experienced this in your classroom; students are exhausted, struggling personally or academically, while others aren't responding altogether. It is no surprise that the current transition to remote learning formats has intensified the stress and anxiety experienced by all students. According to a 2020 study by Active Minds, 80% of college students reported that COVID-19 has negatively impacted their mental health. Some examples of the challenges that contribute to trauma are mental health status, isolation, uncertainty, poverty, and racism. Traumatized students, who are grieving the loss of in-person experiences, familiar routines, and campus social life, may find it challenging to balance the psychological impact with their schoolwork. Of course, while some students may be academically thriving in this new format, others may struggle to be good students while processing all the changes happening around them. As professors, we can alleviate the stress and anxiety our students are experiencing by employing Trauma-Informed Pedagogy practices.

Why Trauma-Informed Pedagogy?

The term trauma refers to "an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being" (SAMHSA, 2019). Trauma differs from normal stress in that it persists and causes more serious negative effects. As we are living in a time where multiple traumatic events are happening one after the other, our capacity to process all the trauma our bodies are experiencing is severely compromised.

In our Fall 2020 Teaching and Learning survey, our students expressed the sense of being overwhelmed, some of them said:

"I think that this mode of learning is working well, especially since this is the first run, but more emphasis must be put on mental health. Many people have had to deal with increased stress from the pandemic, whether it be family getting sick or financial struggles, and I do not feel like it is getting the attention and action it warrants."

"Honestly, this sucked. It was awful. It's not Wake's fault. It's not the faculty's fault. But this was absolutely terrible. The amount of anxiety that I faced daily just being a student was overwhelming. I love Wake. I love my professors. I feel like I got robbed of everything I actually enjoy about being a student. Sitting in the same room all day every day staring at the same screen was unbearable. I'm upset that I have to do this all over again next semester."

"Obviously I never signed up for this, and no one wanted it to be like this. I just wanted someone to know how difficult this has truly been for us students."

So there is trauma in your classroom. What should you do?

Trauma-Informed Pedagogy refers to using the knowledge of trauma to adapt our pedagogy to best support the well-being and success of both teachers and learners. It is not about trying to become counselors for our students, but becoming more empathetic and effective teachers. The following practices can help you in cultivating a learning environment that is mindful of the role trauma plays in students' lives (Imad, 2020; Renda, 2020).
Welcome students radically

Welcome the students with an intentional invitation in the syllabus rather than a contract. (e.g. "Know that in this course, you are more than a number. I see you and you matter. I ask you to bring your own experiences to enrich one another. Let us begin this journey of learning together.")

Provide concrete options for how students can "take care of themselves" if they feel triggered by a topic or conversations (mute your video, send me a private chat, take a break, do a breathing exercise, get a drink of water, take a walk outside, etc.).

Remind the students that you want them in your class and care about their wellbeing.

Foster building connections

Explicitly talk about the importance of community building, learning from each other, and supporting each other within your class.

Begin class with asking students about how they are doing, how their week has been going, or with a temperature check about their mood (discussion question, anonymous poll, etc.).

Approach questions or concerns from a class/community perspective. For example, "How do we as a class want to address this?", "What does this mean for us as a community?", or "How can we all support each other through this?"

Encourage students to build connections with each other through forming study groups, sharing support resources, and checking in on each other.

Impart purpose

As an assignment, ask students to describe a better world for them and their fellow human beings. Ask them to consider what role they play in moving toward that future. This helps them imagine and enact the future.

Invite students to identify/reconnect with their sense of purpose.

Foster metacognition and encourage students to make connections between the course and life.

Empower and co-create

Explicitly state the value of students' knowledge, insights, and expertise within the course.

Ask students about their preferences around topics, participation, and assignments through an individual form and/or through a class discussion.

Encourage students to notice what they need in order to take care of themselves and be successful in their learning, expressing their needs, and meeting their needs.

Provide frequent opportunities for student feedback about how the class is going and students' experiences with the material and the course structure.

I invite you that while you reflect on these recommendations and how you can incorporate them in your teaching to also consider how you are taking care of yourself first and foremost.

References

Receive CAT blog posts in your inbox.

# data[].attributes.attachment_link.title
Trauma-Informed Pedagogy : Center for the Advancement of Teaching

# data[].attributes.attachment_link.description
Founded in 1834, Wake Forest University is a private university located in Winston-Salem, N.C. We are a vibrant and diverse academic community where our students study in one or more of the 42 majors and program we offer within our six colleges and schools.

# data[].attributes.attachment_link.description
Thriving - in college and in life - requires taking care of every component of your well-being. See how Barnard helps you do wellness your way.

# data[].attributes.attachment_link.readable_text
Responding to Trauma in Your Classroom

Bad Behavior or Reacting to Trauma?

Think of a student who challenges you. Have you observed any of these behaviors in that student?

Excessive anger

Unusual startle reactions

Loss of appetite

Extreme fatigue

Physical or verbal aggression

Regular tardiness or absence from class

Perfectionistic, controlling or anxious behavior

Difficulty concentrating

Frequent headaches or stomachaches

Low self-confidence

Irritability

Clinginess

Trouble making friends

Self-harm or suicidal ideation

Hoarding

Risky behaviors (including drug or alcohol abuse or sexual acting out)

Panic attacks

Extreme self-reliance

Running away

Defiance

Alienation from peers

If you've observed even some of these behaviors (or other troubling symptoms), you may have a student who is directly or indirectly experiencing trauma. Trauma can be defined as the reaction to a shocking or painful event or series of negative events. Some traumas require immediate intervention and court-mandated reporting; others go by unmarked. Regardless of whether or not you are aware of the details, there are things you can do to mitigate the effects of trauma for individual students and for all students in your classroom.
Source: Mental Health Connection of Tarrant County
What Causes Trauma?

Trauma affects the ways individuals feel, think and behave. It influences self-perception as well as beliefs about other people and the world.

Though this list is not exhaustive, traumatic experiences can include:

Medical crises

Accidents or injuries (like a house fire or car collision that threatens the student's safety)

Bullying or harassment

Family separation (due to incarceration, deployment, divorce, foster placement or death)

Natural disaster

Abuse (emotional, physical or sexual)

Neglect

Observation of domestic, community or school violence

Substance abuse

Mental illness

Terrorism and war

Instability due to being unhoused

Poverty

Overt discrimination or constant microaggressions

Refugee or undocumented status

More students may suffer trauma-or suffer more trauma-than you can see or know. Trauma is difficult to assess and identify; it's also specific to the individual. An event that may traumatize one person may not traumatize another person. Moreover, the same event may lead to different trauma symptoms in different people.
Source: The National Child Traumatic Stress Network
Responding to Trauma

Proactively applying trauma-informed classroom strategies benefits all students. Students respond positively when educators get to know their individual circumstances, affirm their identities and cultivate empathy in the classroom. Here are some ideas to consider incorporating in your teaching practice:

Establish social and emotional safety in your classroom.

Social and emotional safety is the cornerstone of positive classroom outcomes. Research shows that students need to feel both physically and emotionally safe to learn. Students experiencing trauma, including bias, bullying and social isolation, are more likely to feel unsafe.
Strategies

Classroom contracts

Explicit anti-bullying or community-building curricula

Timely interventions in conflicts and hurtful exchanges

Teaching and modeling of empathy and active listening skills

Create a behavior-management plan that focuses on positive reinforcement.

Discipline and behavior management are central to classroom culture and often present unique challenges for students responding to traumatic events or experiences. Foster compassion for and among your students. Focus on praising students for appropriate classroom behavior, not on punishment.
Strategies

Implement student-generated agreements and contracts

Adopt "zero indifference" (NOT zero-tolerance) policies

Seek out training in restorative justice techniques

Explore stress-management strategies to diffuse tense situations and help students process feelings in the moment

Give students opportunities to demonstrate their strengths

Increase your self-awareness and trauma competency.

Increase your knowledge about trauma and how it may manifest for your students. Remember, students respond to trauma in different ways, and their responses may be influenced by cultural traditions, religious beliefs or familial relationships. Connect with students and their families to identify resources and services that can inform how best to support students who experience trauma.
Strategies

Seek professional development on working with specific identity groups

Share support resources with other educators

Connect with community organizations

Engage in ongoing self-assessment and reflection on your trauma responsiveness

# data[].attributes.attachment_link.description
Trauma can have significant and lasting effects on students. This PD Café will help you learn how to recognize the signs of trauma, better understand the causes of trauma, and take steps to establish social and emotional safety in your classroom.

# data[].attributes.attachment_link.description
Trauma-Aware Teaching Checklist This doc lives at: https://bit.ly/traumachecklist. This checklist has been prepared for higher educators as a tool to reflect on their teaching and courses, regardless of modality. The six principles of trauma-informed care developed by SAMHSA (Substance Abuse and...

# data[].attributes.body
Students can record their names and add information about them to use for email signatures, etc.

# data[].attributes.attachment_link.readable_text
Full name or your name as you would like it said/announced

Phonetic spelling of your name

Please audio record the pronunciation of the full name you wish to be called by others.

You can record your name by having the NameCoach system call you, or by using the Web recorder, or by uploading a file from your computer
Having trouble recording? Phone option Web recorder option Uploader option

# data[].attributes.attachment_link.description
Stanford, USC, University of London, and high schools across the country have discovered the ease of NameCoach. Share a link, have your students record their name, and allow faculty and staff to easily say their names perfectly.

# data[].attributes.attachment_link.readable_text
The U.S. has a new mental health crisis line - 988. It's intended to replace the national suicide hotline, but funding issues could mean it takes a while for the line to be up-to-speed.

SCOTT SIMON, HOST:

Beginning today, anyone in the country having a mental health crisis can dial a three-digit number for help. The new 988 Suicide and Crisis Lifeline replaces the existing 10-digit number and will respond to all mental health emergencies. But as Rhitu Chatterjee reports, the number will only be as good as the resources behind it.

RHITU CHATTERJEE, BYLINE: Until now, the vast majority of people with mental illness didn't have many choices to get help during crises. Psychologist Ben Miller is president of Well Being Trust.

BEN MILLER: There's really very few options for an individual who's experiencing those crises. They go to the emergency room, or they call 911. And both of those are fraught with challenges that rarely end with the individual receiving what they need.

CHATTERJEE: With emergency rooms, it can take hours or even days for someone in a mental health crisis to get help. And 911 often leads to interactions with the police.

MILLER: Unfortunately, a lot of our police officers, they are not trained in mental health. And so we have unfortunate tragedies that occur because they just simply don't know how to respond to individuals that are experiencing mental health crises.

CHATTERJEE: He says over 2 million people with serious mental illness got booked in jails last year, and about 25% of fatal shootings by the police involved folks with mental illness - people like Miles Hall, a 23-year-old African American man who was shot by the police in 2019.

TAUN HALL: He was just a great kid. He was just the kind of - you know, he'd walk in a room, and he had this infectious smile.

CHATTERJEE: That's Taun Hall, Miles's mother. She says Miles was diagnosed with schizoaffective disorder, and one day back in 2019, when he had a breakdown, the family called 911.

HALL: I'm telling them Miles is in a mental health emergency. We need help. We need an ambulance.

CHATTERJEE: And yet her son was shot and killed by the police just outside their house.

HALL: I had a false expectation that if law enforcement knew him and they knew he just had a mental health condition that he would be treated with compassion and he wouldn't be gunned down in the middle of the street on a bright, sunny day in our cul-de-sac. There is no reason Miles should have been killed that day.

CHATTERJEE: Hall is among the many mental health advocates who hope that 988 will be a safer, more effective alternative. Angela Kimball is with the advocacy group Inseparable. She says many communities across the country have been adding mental health services in preparation for 988, things like mobile crisis teams.

ANGELA KIMBALL: That's really encouraging news, because more and more communities will have that as a potential response, and that makes a huge difference.

CHATTERJEE: And she's personally seen what a difference that can make for families. Back in 2017, her son, who was living in Portland, Ore., had a major manic episode.

KIMBALL: He was talking about how soap was poison and how he felt like he was being surveilled and then accusing me of conspiring with the government to watch over him.

CHATTERJEE: She says she reached out to a local crisis center who sent a mobile crisis team to her son's house. She says they spoke very gently to her son.

KIMBALL: They just said, hey, Alex, we hear that you haven't been sleeping for a few days. How are you doing? He says, yeah, I can't go to sleep. You know, my head is hurting, and I just want to fall asleep, but I can't.

CHATTERJEE: Kimball says her son willingly went with the team to a crisis stabilization unit and was able to get care right away. Mental health advocates hope that 988 will make that kind of care more common around the country. But it may take a while to get there because the nearly 200 local call centers that make up the national network have primarily depended on local and state funding and have been struggling to survive.

JOHN DRAPER: They've been operating on a shoestring for many, many years.

CHATTERJEE: John Draper is with Vibrant Emotional Health, which operates the lifeline. In 2020, the National Suicide Hotline received nearly 2 million calls but was only able to respond to 85% of callers. The federal government has just invested over $400 million to expand the network's capacity, as calls and texts are expected to double in the next year. And Draper says he's already seeing an impact.

DRAPER: Right now, we're answering over 90% of our chats. Back this time last year, it was closer to 22, 23%. So that gives you a sense of what happens when you're able to provide a significant amount of funding.

CHATTERJEE: But states have a lot more to do in supporting 988. Only 16% have budgeted for the service, and only one state, Rhode Island, is able to respond to 99% of callers. But mental health advocates hope today is just the beginning of a new era for mental health. Rhitu Chatterjee, NPR News.

(SOUNDBITE OF MUSIC)

Copyright © 2022 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR's programming is the audio record.

# data[].attributes.attachment_link.title
Calling 988 in the U.S. will now get you help for a mental health crisis

# data[].attributes.attachment_link.description
The U.S. has a new mental health crisis line - 988. It's intended to replace the national suicide hotline, but funding issues could mean it takes a while for the line to be up-to-speed. SCOTT SIMON, HOST: Beginning today, anyone in the country having a mental health crisis can dial a three-digit number for help.

# data[].attributes.attachment_link.readable_text
Engaged readers in every content area

"The amount of both growth and confidence that students in our school have displayed as a result of Reading Apprenticeship has been absolutely stunning."

- Alicia Ross, teacher at Blue Ridge High School, PA
See Reading Apprenticeship in Action

See how 7th graders unlock science text using Reading Apprenticeship

Our approach: why it works

Educators today face the challenge of meeting rigorous standards. Increasingly, students must be prepared with high-level literacy skills, including the ability to think critically, synthesize information and construct evidence-based arguments.

Reading Apprenticeship is a professional learning model that meets these challenges. Our approach is proven to develop student academic identity, engagement, subject-area knowledge and disciplinary literacy.

Reading Apprenticeship engages students through four interacting dimensions of learning. These dimensions are developed through Metacognitive Conversation that explores students' thinking processes.

Learn more about our approach

Credible data. Proven results.

Over 25 years of research, including multiple randomized controlled studies, demonstrate that Reading Apprenticeship yields marked positive outcomes for students in literacy, content area learning, and academic success. These studies consistently show students in Reading Apprenticeship classrooms out-perform peers in 'business as usual' classrooms.
Explore our evidence base

How Reading Apprenticeship can help:

Administrators
& Principals

Improve college and career readiness through professional learning that works for all teachers.

Teachers

Engage students in disciplinary literacy practices. Connect social-emotional learning to academic growth.

Researchers
& Thought Leaders

Engage with us in continuous improvement and field leadership through active research, development and publication.

College Faculty

Engage with communities of practice to accelerate and deepen student learning in all disciplines.

Begin transforming instruction with Reading Apprenticeship professional learning See our services

# data[].attributes.attachment_link.description
A professional learning model that works for all teachers-improve college and career readiness by helping students become stronger readers and writers.

# data[].attributes.attachment_link.title
Childhood Trauma and the Brain | UK Trauma Council

# data[].attributes.attachment_link.title
Trauma Informed Pedagogy/Social-Emotional Learning Practices Exercise - Google Jamboard

# data[].attributes.attachment_link.readable_text
The slides and transcript from a recent keynote, which was part of the Texas Peer Mentor Network's series on "Transforming Crisis into Critical Opportunity."
Pivot /ˈpivət/
: to turn on or as if on a pivot

We need to be thinking about how we respond in the moment to this emergent crisis, but it's just as important that we talk about sustainable ways forward. What we are facing right now will have an effect on education that lasts years (or longer), and it's exposing inequities and systemic injustices that many students have faced all along.

There has been much talk over the last several months about maintaining 'continuity' of instruction and assessment, but less discussion about how we maintain the communities at the heart of our educational institutions. This is the design challenge before us.

"There is consensus in the literature about the benefits of a student's sense of belonging. Researchers suggest that higher levels of belonging lead to increases in GPA, academic achievement, and motivation." ~ Carey Borkoski, "Cultivating Belonging"

There is no one-size-fits-all set of best practices for building a learning community, whether on-ground or online. We have to start by looking to our own existing communities for expertise. Who at our institutions is already doing this work and doing it well? And who has figured out how to do it effectively online? How can we better support those efforts? And we have to start by finding out who our students are, what they need to be successful, and how our institutional mission does (and sometimes doesn't) align with our practices.

"Today's college students are the most overburdened and undersupported in American history. More than one in four have a child, almost three in four are employed, and more than half receive Pell Grants but are left far short of the funds required to pay for college." ~ Sara Goldrick-Rab and Jesse Stommel, "Teaching the Students We Have Not the Students We Wish We Had"

According to the Hope Center's National #RealCollege Survey, out of 86,000 students surveyed, 56% were housing insecure in the previous year, and 17% were homeless.

LGBTQ young adults had a 120 percent higher risk of reporting homelessness compared to youth who identified as heterosexual and cisgender. (voicesofyouthcount.org)

Some Data About Bias in education from Soraya Chemaly's " All Teachers Should Be Trained to Overcome Their Hidden Biases ":

Black girls are twelve times more likely than their white counterparts to be suspended.

While Black children make up less than 20% of preschoolers, they make up more than half of out-of-school suspensions.

Teachers spend up to two thirds of their time talking to male students; they also are more likely to interrupt girls. When teachers ask questions they direct their gaze towards boys more often, especially when the questions are open-ended (In STEM fields).

"We need to design our pedagogical approaches for the students we have, not the students we wish we had. This requires approaches that are responsive, inclusive, adaptive, challenging, and compassionate. And it requires institutions find more creative ways to support teachers and prepare them for the work of teaching. This is not a theoretical exercise - it is a practical one." ~ Sara Goldrick-Rab and Jesse Stommel, "Teaching the Students We Have Not the Students We Wish We Had"

We have to design for the least privileged, most marginalized students, the ones more likely to have felt isolated even before the pandemic: disabled students, chronically-ill students, black students, queer students, and those facing housing and food-insecurity. We need to write policies, and imagine new ways forward, for these students, the ones already struggling, already facing exclusion.

Inclusivity on a college campus starts with small, human acts:

Walk campus to assess the accessibility of common spaces and classrooms. An accessible desk in every classroom doesn't do much good if students can't get to that desk because the rooms are overcrowded.

Invite students to share their pronouns, model this behavior, but don't expect it of everyone. Not all students will feel equally safe sharing pronouns.

Make sure there is an easy and advertised process for students, faculty, and staff to change their names within institutional systems. Make sure chosen names are what appear on course rosters and ID cards.

Regularly invite the campus community into hard conversations about inclusivity. For example, a frank discussion of race and gender bias in grading and course evaluations.

What does it look like to do this kind of work online? How do we walk our virtual campuses to address accessibility concerns? Where do we hold the necessary town hall meetings to address hard questions about inclusivity? How do we connect students learning on-ground to students who can only learn online? What kinds of decisions must we make now to ensure access for students or teachers who become sick?

The key failure of online learning has been its attempt to duplicate, replicate, or simply port into an LMS the content and strategies of on-ground education. But online learning uses different platforms, builds community in different ways, demands different pedagogies, has a different economy, functions at different scales, and requires different curricular choices than does on-ground education. Even where the same goal is desired, very different methods are necessary.

The rhetoric of a physical classroom - its pedagogical topography - can dictate how we teach within it: where the seats are, which direction they face, whether they're bolted down, what kind of writing surfaces are on the walls, how many walls have writing surfaces, whether there are windows, doors that lock, etc. The same is true of the online spaces: are they password protected, what kind of landing page welcomes us to the space, how many pages allow interaction, can students easily upload and share content. Physical spaces can usually be rearranged (to some extent) on the fly. Most online learning platforms make customization slow or difficult enough to deter responsiveness or impulsivity.

Designing for Care

Flexibility and trust are key principles of any pedagogy, but they are particularly important when we're in crisis.

Start by Trusting Students.

Online learning doesn't require video, synchronous meetings, formal expectations, or extrinsic motivators. In fact, these can frustrate efforts at creating community and a sense of belonging.

Not all students, faculty, and staff will be able to meet synchronously, and different students learn in different ways at different times.

Online education should be designed for collaboration, where possible drawing together local communities, disciplinary communities, and broader publics.

"Critical formative cultures are crucial in producing the knowledge, values, social relations and visions that help nurture and sustain the possibility to think critically, engage in political dissent, organize collectively and inhabit public spaces in which alternative and critical theories can be developed." ~ Henry Giroux, "Thinking Dangerously: the Role of Higher Education in Authoritarian Times"

We must be willing to acknowledge trauma members of our community have and will experience.

"There is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators." ~ Julianne Holt-Lunstad, et. al., "Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review"

"A Trauma-Informed Approach to Teaching Through Coronavirus" from Teaching Tolerance:

Establish a routine and maintain clear communication.

Relationships and wellbeing should take priority over assignments and compliance.

Actively encourage and support a sense of safety, connectedness, and hope.

Acknowledge that trauma is not distributed equally.

"From everything we know about learning, if the trauma is not addressed, accounted for, and built into the course design, we fail. Our students fail." ~ Cathy Davidson, "The Single Most Essential Requirement in Designing a Fall Online Course"

Our ability to develop community will depend on our willingness to continue feeling joy, having epiphanies, asking hard questions, and sharing our curiosity with one another.

"As a classroom community, our capacity to generate excitement is deeply affected by our interest in one another, in hearing one another's voices, in recognizing one another's presence." ~ bell hooks, Teaching to Transgress

To create a sense of belonging, we need to:

* build a community of care
* ask genuine, open-ended questions
* wait for answers
* let conversation wander
* model what it looks like to be wrong and to acknowledge when we're wrong
* recognize that the right to speak isn't distributed equally
* make listening visible
A revised version of these slides with some additional thoughts.

# data[].attributes.attachment_link.title
Designing for Care: Inclusive Pedagogies for Online Learning

# data[].attributes.attachment_link.description
We need to be thinking about how we respond in the moment to this emergent crisis, but it's just as important that we talk about sustainable ways forward. What we are facing right now will have an effect on education that lasts years (or longer), and it's exposing inequities and systemic injustices that many students have faced all along.

# data[].attributes.attachment_link.readable_text
Mays Imad discusses trauma-informed teaching and learning on episode 335 of the Teaching in Higher Ed podcast.

Quotes from the episode

I am able to recognize when they are triggered and when they feel disengaged. I also am able to recognize it in myself. We can't give what we don't have.

-Mays Imad

I want to acknowledge that we can heal from trauma.

-Mays Imad

My goal is to engage students and help them feel empowered and liberated.

-Mays Imad

We are not just thinking machines; we are feeling machines capable of thinking.

-Mays Imad

Resources Mentioned

Trauma-informed teaching webinar

Leveraging the Neuroscience of Now, by Mays Imad

# data[].attributes.attachment_link.title
‎Teaching in Higher Ed: Trauma-Informed Teaching and Learning, with Mays Imad on Apple Podcasts

# data[].attributes.attachment_link.description
Mays Imad discusses trauma-informed teaching and learning on episode 335 of the Teaching in Higher Ed podcast. Quotes from the episode I am able to recognize when they are triggered and when they feel disengaged. I also am able to recognize it in myself. We can't give what we don't have.

# data[].attributes.attachment_link.readable_text
This week, Dr. Mays Imad joins to discuss holistic approaches to teaching & learning. This is a deeply informative, surprisingly refreshing, and highly relevant conversation for all - especially those involved in formal and informal education, training or mentoring. Dr. Imad, a nationally recognized leader in trauma-informed teaching and learning, discusses the importance of investing ... Continue reading Trauma Informed Teaching & Learning with Mays Imad →

# data[].attributes.attachment_link.keywords[]
trauma informed teaching & learning with mays imad

# data[].attributes.attachment_link.title
‎Addy Hour: Trauma Informed Teaching & Learning with Mays Imad on Apple Podcasts

# data[].attributes.attachment_link.description
This week, Dr. Mays Imad joins to discuss holistic approaches to teaching & learning. This is a deeply informative, surprisingly refreshing, and highly relevant conversation for all - especially those involved in formal and informal education, training or mentoring. Dr. Imad, a nationally recognized...

# data[].attributes.attachment_link.title
Episode #63:  Zaretta Hammond - Trauma Informed Educators Network Podcast

# data[].attributes.attachment_link.title
Designing for Care and Embracing Ungrading with Jesse Stommel