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Trauma being triggered?

2015

Hi everyone,

I am currently working with a beautiful 9 year old who experienced early childhood sexual abuse. She is strong, outspoken and sure of herself on the surface. All of these qualities we both identify as being helpful and positive for her to have.

One of the emotions that is very difficult for her to experience is the feeling of vulnerability. She tends to respond to situations where she feels vulnerable with an overwhelming amount of anger, which is understandable, given her past (horrific) experiences. Often when she is triggered, she loses her ability to self regulate and calm herself down.

We have been working together for a while, and have a great amount of trust between us. During regular day to day life she is learning to manage emotions, communicate how she is feeling, and is doing really well. She loves bright, powerful symbols and colours, enjoys art and anything messy, and feels comfortable speaking her mind (she is even developing tact with that, which is amazing).

I'm looking for some ideas on calming techniques that we can develop together so that when she is triggered she can stay in the present moment and not get caught up in a flashback, and be able to calm herself down. Breathing exercises have not worked for her, unfortunately, and that is a common part of grounding.

I would love to find a way of helping her realize that the present moment is different from the past. She is safe now, and protected from the perpetrator, and being vulnerable is not the same as being abused. This message will take some time for her to grasp.
She is also extremely sensitive to any constructive feedback, so I work at being gentle and validating of her experience before attempting to introduce changes to behaviours and thought patterns.

Any thoughts or ideas would be very helpful

Miranda Conley
...

Hello,

First of all kudos to you for working so hard to help this young lady. Something I have used for not only myself, but also for a few kids I have had the opportunity to work with is a grounding technique. This technique does not have the breathing exercise in it, which I find helped with those who didn’t like or appreciate the breathing practices (trust me I have had many not like that part). Have her sit down, or stand, whichever is most comfortable for her. Have her list 5 things she can see, 4 things she can touch, 3 things she can hear, 2 things she can smell, and 1 thing she can taste. This can help to ground her, and bring her back to the present. I have found this works great for younger kiddos, as they can focus on their senses, as opposed to controlled breathing exercises. Hope this helps!!!

Samantha Harris
...

Miranda,

She will not stop raging until she has something to take her rage out on. I would suggest that you find her someone that has some skill around boxing. Get her some boxing gloves and get someone to hold boxing pads that she can punch. You can learn this skill from any boxing instructor. If she is up to it take her to a boxing club. Don't teach her how to fight, just get her to hit the pads. Judo is also a great sport for kids that have anger and abuse issues. She will learn how to have close up contact with people that she most likely craves, in a safe manner!

Good luck,

Clayton Ellis

P.S, Let me know if it works!
...

Hi Miranda,

There are a wide variety of grounding and orienting approaches that can be used. I would suggest starting with those that are external (outside of her body) for example when you see or sense she is reaching the edge of the limits for her distress tolerance asking her if she can visually focus on and describe one thing she sees to you. You can use techniques like 5,4,3,2,1 or asking her if she is able to notice her feet on the ground, back against the chair etc.

Sensory based resources and activities (including those which are messy:) are also great for grounding. Some ideas might include:

The use of a mini trampoline, sensory shaker (modified ball pit), weighted blanket, exercise ball (throwing against wall, squeezing and releasing exercises, kicking, sitting on and gently initiating movement, rolling the ball back and forth to one another etc.), exercise bands, stepping stones etc

Creating various messy concoctions out of corn starch and water, flour, shaving cream, clay etc. Engaging the tactile system can be a powerful regulator.

Please keep in mind that with any of these strategies monitoring the clients affect (eye contact, vocal prosody, facial tonus, speech, posturing and movements, breath etc) is critical. This will help you to observe what seems to be effective as well and tailor exercises accordingly. These activities can be grounding or stimulating depending on the person. As such they are good for working with hyper and hypo arousal levels but you need to ensure that you are bringing the client back to a more regulated state rather than further overwhelming their system.

You can help build competency by asking clients to reflect on how various experiences, resources, and activities feel for them...what do they notice in their body, what emotion are they feeling, where in their body are they feeling it etc. Often clients who has experienced trauma do not naturally have this capacity so we typically need to build it by observing and prompting reflection and by sharing your observations "It looks to me like this feels calming for you, would you agree?" "I wonder if you're able to notice where in your body you feel the calm feeling?" Etc. Over time this will help them to increase emotional recognition / awareness and and increase ability to regulate these physiological and emotional felt states.

I hope this helps. Please let me know if you have any questions.

Kindest Regards,

Lori Gill
...

Hello Miranda,

I just wanted to say that it sounds as if you have made great progress with this child already. 9 years old is still so very young and I know first hand that sexual abuse and it’s effects are very, very damaging and long lasting.......

Keep going patiently. Is she, or are you aware of her triggers? Again, for 9 years old, she sounds as if she is managing and communicating exceptionally well considering all factors. If she is in fact aware, perhaps a “code word” to visualize calming down or redirection would work. You could work together to “prepare for calm” by talking about what triggers her, how she reacts and how she could respond differently. If you are not yet aware of specific triggers, perhaps observation and charting could help you both determine them and work towards avoiding or handling them healthily.

Otherwise, keep doing what you are doing. I love that she loves messy art....it truly is soooo therapeutic (even for a 40 year old!)
From experience, I can say that even when you know you are in the present, and in a situation nowhere near or nothing like the traumatic one.......responding and reacting are extremely difficult to manage.....it takes a long, long time....but it sounds like this child is well on her way with an excellent support system.

All the very best,

Ally

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