Educator Insights #2: Revolutions in Understanding the Brain

Educator Insights breakdown theory and research to give teacher practical advice and strategies. In his book, The Body Keeps Score, Dr. Van Der Kolk, one of the leading researchers in the area of psychological trauma, uses recent scientific advances to show how trauma literally reshapes both body and brain. Click on the picture below to check the book out on Amazon.com. Keep reading for the summary of chapter 2: Revolutions in Understanding the Mind. 

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Chapter #2 of 20: Revolutions in Understanding Mind and Brain.

The chapter outlines the advances in psychiatry in the treatment of mental illness, including post-traumatic stress disorder. Dr. Van Der Kolk highlights the disadvantages of the narrow focus of the medical model to thinking about mental illness. He highlights the insufficient consideration of the contextual, psycho-social factors that may have been impacting his traumatised patients.

 "I was struck by how little attention was paid to their accomplishments and aspirations; whom they cared for, loved or hated; what motivated and engaged them,what kept them stuck, and what made them feel at peace - the ecology of their lives" 

Educator Insights: Reading this for the first time, I found myself scoffing at the reductionist view of the medical model to such complex issues like mental health. It was only after some reflection that I realised that as educators, we are guilty of this as well. Overwhelmed by all the tasks we have to complete, we too seem to have forgotten the need for a wholistic understanding of our students. That they are more than their reading levels. More than a data point on standardised tests.  

I often hear teachers and educators talk about focusing on 'what they can control and influence' when it comes to supporting traumatised students. Although this is a completely legitimate and realistic point, this line of reasoning, when used rigidly, gets in the way of educators learning more about the learners context - at school and at home - so as to be able to think more broadly about what can be done to support traumatised students. Unfortunately at times, focusing on 'what we can control and influence' becomes another way of saying 'there is nothing else we would like to do to help'. Having not understood child trauma in the past, I am guilty of being part of schools that ascribed to such attitudes. 

Its time to get back to the old ways of relating to our students - to understand their interests and preferences, what motivates them and what upsets them. Although such information is vital for working with traumatised students, it is the foundation of all good student-teacher relationships. At the end of the day, good relationships are all about learning - kids don't learn from teacher they don't like, and students don't like teachers that don't take the time to know them well.

For a practical way to learn about your students, check out this article on Hack Learning's '360 Spreadsheet' tool.

For a practical tool to understand a students emotional triggers and preferred ways of calming down, click here to check out my podcast on the 'Safety Plan' tool. 

Dr. Van Der Kolk gives an a honest insight into his experience as a young psychiatrist of what it was like to deal with violent and distressed patients.

 "I usually followed the lead of experienced nurses, who signal when to back off or, if that did not work, to restrain a patient. I was surprised and alarmed by the satisfaction I sometimes felt after I'd wrestled a patient to the floor so a nurse could give an injection..I gradually realised how much of our professional training was geared to helping us stay in control in the face of terrifying and confusing realities"

Educator Insights: It is a product of a post-industrial way of thinking about education that we have come to view students and their learning as 'products' and us teachers as the 'tools' that help them get what they need. The school becomes a factory, where the products are one dimensional - easily measured through grades and the demonstration of appropriate behaviour, and the 'tools', the teachers, designed uniformly, designed to reach the same results. Insidious to such beliefs is the complete lack of acknowledgement to the unique emotional lives of both the students and the teachers. We are all expected to teach and go home everyday like robots - when in fact we all have strong emotional reactions to our students - both positive and negative - that we have no one to talk to about. In some schools, requesting such support from fellow teachers or senior staff members is viewed as a sign of weakness or incompetence.

Helping traumatised student build up courage to engage in difficult work or build a relationship with us is hard work. One with ups and downs, small wins and steps backwards. Identifying a trusted colleague to speak to, broking a way to get quality feedback on your classroom management, and advocating for formal peer support systems in the school are all worthwhile strategies in sustaining inclusive school culture. 

A nice quote from the psychiatrist, Elvin Semrad

 "...people can never get better without knowing what they      know and feeling what they feel"

Educator Insight: This quote nicely encapsulates what has taken me a while to understand about traumatised children - that their rage and anger is ultimately an attempt to avoid the acknowledgement of being abandoned and rejected by their parents and significant caregivers in some way. An attempt to avoid their feelings of grief and terror of being all alone in the world. I recall a student telling me that letting himself feel all these emotions felt like stepping into a black-hole. Like falling into a abyss. Letting yourself feel the enormity of such feelings was like falling into a abyss - one you didn't think you could come back from. But letting go - feeling the grief, acknowledging the loses - is what leads to recovery. Its when I have a child disclose to me the horrors of their past, or their struggles with their family, that I realise how much courage it has taken for them to do this. As a teacher, there truly is no bigger privilege and honour to support students in these moments. 

Describing the seminal psychology experiments of Maier and Seligman on learned helplessness, Van Der Kolk return to a key theme of the book.

"Scared animals return home, regardless of whether a home is safe or frightening. I thought about my patients with abusive families who kept going back to be hurt again. Are traumatised people condemned to seek refuge in what is familiar? Is so, why and is it possible to help them become attached to places and activities that are safe and pleasurable?"

Traumatised children are stuck in such cycles of inescapable violence, pain and suffering. But such processes occur mentally for these children as well - they are drawn towards anti-social peers and adults who seem familiar in their manner and behaviours - despite being dangerous and hurtful. It is the misunderstanding of this dynamic that lies at the heart of 'victim blaming'. As an educator, it was important for me to understand that it is hard for children to take responsibility for their behaviour.  Instead of being helped to learn from their mistakes, traumatised children are either punished harshly, or at times evening inadvertantly rewarded, by adults caring for them. Discernment and problem-solving capacities break down when you are conditioned to choosing what is familiar. Choosing what is predictable, despite it being unsafe. 

Dr. Van Der Kolk describes the role of Cortisol and Endorphins to further validate this point by showing how the social environment interacts with brain chemistry.

"...strong emotions can block pain" was the result of the release of morphinelike substances manufactured in the brain. This suggested that for many traumatised people, re-exposure to stress might provide a similar relief from anxiety"

Educator Insights: In the TIPBS program we speak a lot about the timing of behavioural interventions. Consequences, when delivered after the child has had a chance to calm down, are more successful in helping the student learn from their behaviour. The design of consequences for traumatised students is one that is worth taking the time to consider. Traumatised students are stuck in the cycle of resolving conflict by either feeling unfairly victimised or victimising others. To break this cycle, and offer a new learning experience, consequences can be a chance for students to make amends for their behaviours. For example, if there has been a hole in the wall, the consequence could be fixing the wall up with teachers involved in the incident. Perhaps even doing a painting together to hang over the damage. 

By enacting such consequences in the context of a caring, and forgiving relationships with the adults in the school environment, we slowly being the process making new reinforcement links - the release of endorphins and cortisol, in response to positive experiences. We begin to contrast unsafe but familiar experiences in their past, with an experience of relationships that is safe, inclusive and caring. 

Next, the success of using psychiatric medications to treat mental illness is discussed. Dr. Van Der Kolk offers a balanced view of the risks and benefits of using medication, with some staggering stats on the use of medications with children in foster care - children frequently experiencing trauma. 

"...12.4 percent of children in foster care received antipsychotics, compared with 1.4 percent of medicaid-eligible children in general.....these medications make children more manageable and less aggressive, but they also interfere with motivation, play and curiosity, which are indispensable for maturing into well-functioning and contributing member of society..."

Educator Insights: Its hard in this day and age for teachers to be ignorant of the medications their students are on, and not understand the effects of these medications on their learning and mental state. This is particularly true for traumatised students, as they are often on a cocktail of medications linked to their diagnoses. I have found that the interaction of these medications can be complex and reaching out to the medical practitioners to understand its implications for the student is the best way to understand this.

Practically, as a teacher, it becomes about finding time to fit it all in. I have found that notes in class diaries to parents requesting information about medications and doses is a good start at the beginning of a school year. I also contract with parents to let me know about any changes to dosages or medication types. A short email to a parent is often handy if I notice any major changes in the student in the classroom. From having attended several professional development sessions on psychiatric medications for children, it has occurred to me how important it is for us teachers to be vigilant for side-effects of these medications in children. Given how much time we spend with traumatised students, we are often the first to notice these. Sometimes, we notice these changes even before the parents or carers do. Such observations may signal a need for a review of the medications with a medical professional.

The chapter ends with the four draw-backs of the brain-disease model of trauma.

"(1) our capacity to destroy another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being"

"(2) language gives us the power to change ourselves and other by communicating our experience, helping us define what we know and finding common sense of meaning"

"(3)we have the ability to regulate our own physiology, including some so-called involuntary activities such as breathing, moving and touching"

(4)we can change social conditions to create environments in which children and adults can feel safe and where they can thrive"

Educator Insights: Its from my reading of the literature on child trauma that I have learnt on intimately connected our relationships and emotions are to our physical health. I have witnessed first hand how children become physically and emotionally stable when linked to a capable and resilient teacher. To learn more about the influence of physical health and adverse childhood relationships, click here to read about the seminal CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study.

My most satisfying work has been with teachers and parents who have supported their children at school to help them reduce or completely stop their medication. While such psychiatric medications have their place in helping students, true recovery and healing lies in restoring the capacity to learn, in context of caring relationships.

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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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