Health Care Journals | Open Access - Edelweiss | Edelweiss Publications

Edelweiss: Psychiatry Open Access (ISSN 2638-8073)

Case Report

Healing and Growth after Trauma in a Rural Australian Community-A Case Study

Jennifer O Connell

DOI Number: https://doi.org/10.33805/2638-8073.123

PDF

Published on November, 2019


Abstract

Introduction and Background Information

This community case study outlines the development of a small group trauma recovery program (Leading from within), after several suicides created widespread community trauma. My training and almost 30 years experience as a Clinical Social Worker and my personal experience of trauma provided the impetus for this program which developed 20 years ago. The theoretical underpinnings include behavioural, depth, positive and energy psychology, trauma theory and the neuroscience of stress and trauma, attachment theory, family theory, wilderness theory, mind/body medicine, human potential theory, metaphysics (the science of Mind to Matter) [1], psychosynthesis and epigenetics (including the predisposition to transgenerational trauma).

Some individual practitioners have also influenced the thinking behind the program development: Viktor Frankl, a Jewish Psychiatrist developed Logotherapy, lost family members, his thesis and all of his possessions during the holocaust and spent considerable time in Auschwitz [2]. He observed people in the camp and saw a demonstration of his theory. His observation was that those who made some meaning for themselves in the situation of utter privation were the ones who seemed to survive the best. He noticed, for example that people who gave their last piece of bread to help someone else seemed to do better than others, even those who seemed physically stronger.

Another formative experience was my own therapy with a Psychoanalyst, in my late twenties. I learnt that I could overcome a lot of previous trauma, change some dysfunctional patterns and experience unexpected growth. Alice Miller was also influential with her ideas. She argued that Hitler was convinced to his dying day that only the death of every single Jew could shield him from the fearful and daily memory of his brutal father [3].

She believed what epigenetics, Sensorimotor Psychotherapy and trauma theory now confirm, that information about abuse inflicted in childhood is recorded in our body cells as a sort of memory, linked to repressed anxiety. If, lacking the aid of an enlightened witness, these memories fail to break through to consciousness; they often compel the person to violent acts that reproduce the abuse suffered in childhood, which was repressed in order to survive. The aim is to avoid the fear of powerlessness before a cruel adult. This fear can be eluded momentarily by creating situations in which one plays the active role, the role of the powerful, towards a powerless person [4].

Through work with the Indigenous community in Northern Victoria I came to understand the idea of transgenerational trauma and I met (now Emeritus Professor) Judy Atkinson in the 1990s. Her desire to understand violence in her family and community led to her developing a profound healing model We A Li. She identified as symptoms of trauma, mental health issues, substance abuse, violence against self and others and sexual assault.

This concept assisted in the development of Leading from within and in my work as a Clinical Social Worker. The trauma lens has been vital in promoting healing because the behaviour and issues people demonstrate can be understood in a more coherent way. This, and understanding the neurobiology of stress and trauma, helps people to recognize they are not crazy. People suffering from a trauma legacy which triggers reactions now that are a result of previous events, particularly adverse childhood experiences [5] often fear theyre going mad and/or that there is something seriously wrong with them. Training in Sensorimotor Psychotherapy and professional supervision from Dr Janina Fisher has increased my clinical capacity to use a range of somatic resources and other strategies, including Internal Family Systems, for helping people to overcome their trauma legacy.

The Case Study

In June 1999, Michael, an 18 year old star footballer, mentor to younger people and extremely popular young man took his life, seemingly without warning. His family and the broader community of his small rural town, Mooroopna were utterly shocked. So much so that the human service sector decided to mount a first ever response. At almost the same time another, 17 year old, young man took his life in a town an hour south. The sector provided a response there too. They used a process recommended after two youth suicides in another rural area not far away, in 1998.

However, within 11 weeks another youth suicide occurred in each location resulting in questions about whether the response had played a part in these deaths. My Consultancy was asked to evaluate the response. My husbands background in business and training, his intuitive nature, experience as a youth sports coach and capacity to connect easily with people made him the ideal co-researcher.

He was willing to work with me to interview over 100 affected people and has also became the co-facilitator for Leading from Within. We identified a number of significant impacts: young people had started self harming, risk taking-with substances, cars, sexual activity and in other ways including disengaging from school; parents had become very anxious and were fearful about creating boundaries. There were also many adults who cared deeply but didnt know what to do.

It became clear that the impact was far greater than the service sector would be able to manage and more significantly, that people were not confident in, or willing to seek help from public or private mental health services. Knowing the potential harm that could come from unresolved trauma, we made a recommendation for a process to promote recovery from trauma. We reported our findings to the committee overseeing the Evaluation and they implemented a number of the recommendations.

However, they referred back to us the task of developing a process to assist in recovery from trauma. We were ready to begin the process, when an adult mentor in the Mooroopna Cricket Club took his life in September, 2001. This impacted on the same families causing significantly increased distress. Invited by the Club to assist them in helping their members, we subsequently offered affected members the opportunity to be part of the recovery process. In 2002 we established 17 small groups with almost 100 people. The majority was young people aged 12-24 and 38 people were older adults. Our agenda was to create a positive ripple to counter the negative ripple caused by the traumatic losses and to embed people in the community as Mentors.

The program has been ongoing ever since. Groups of people with similar issues have met regularly for approximately a year, to support each other in the process of recovery. Leading from within has been a dynamic process and the 60 hour program has evolved over time. The research and clinical work of many of the leaders in the trauma and neuroscience fields, including Daniel Siegel and Allan Schore has informed our work in the past decade.

Embracing the concept of Allan Schore and Daniel Siegel of Interpersonal Neurobiological Regulation we have encouraged participants to understand the importance of this for their own development and their relationships. In particular we have encouraged parents in the Leading from within parenting program to be extremely aware of the impact of parenting on the developing brains of their children. The principles which underpin the program include the concept that growth can come after trauma, which is foundational.

At the time of the impact, almost 20 years ago, the idea of Post Traumatic Growth was not well developed. It is, thankfully, now a commonly understood concept. With traumatic attachment and the development of implicit memory, many of the survival states of human beings become automatic. It can be argued that human beings become a set of unconscious automatic patterns, as if we are asleep. Paradoxically, although it might be developmental trauma which creates the protective patterns in the first place, it is trauma or serious adversity which can help to wake us up.

Other principles include the idea that connection is vital for human wellbeing; small groups provide a container, witnesses, support and perspective, for growth; human systems are designed for survival and healing; leadership comes from being authentic and living from passion and a sense of place and purpose in the world. Finally, once healed, people often want to give back or pay forward. Because of the widespread impact in the community (in which there had also been several fatal car crashes including young people) we were aware that it was important to create a community development process in which community members became up skilled and developed capacity to assist others.

Program Elements

The program is conducted by a male and female facilitator. The elements of the program are addressed in small groups, through a range of experiential activities based on the theoretical underpinnings. The key elements are: Self-awareness, Self-expression, Self-development, Self-Acceptance/Compassion, Authenticity, Resilience, and Optimism. The activities provide the springboard for participants to reflect, become conscious and make meaning of the traumatic experiences they have had. We also use poetry, inspirational sayings and stories to inspire development. Participants are provided with a range of skills and knowledge from which to increase their capacity to develop new patterns.

One of our findings has been, along with the discoveries in the trauma field, to recognize that for many people, especially those with repeated patterns of trauma, there has been attachment trauma or developmental trauma. The connection provided during the group process provides a vehicle for creating a new set of neurobiological patterns and therefore capacity to form healthy attachments. Leading from within (Greater Shepparton) incorporated as a not for profit organisation in 2003. The mission is: To assist in recovery from trauma and adversity and, through recovery and leadership development, to encourage contribution to the wellbeing of others in the community.

Based on the idea of promoting expansion of human potential we encourage participants to develop in five major areas to create development and balance. These are Social, Emotional, Intellectual, Physical and Spiritual. Our aim is to promote development in all these areas and to create Consciousness. I think at a level, in all of us, is a sense of destiny. My early life as the first child of two adults who saw active service during World War 2, prepared me in ways I didnt understand until much later. My father was a prisoner of war in Changi, Singapore for three and a half years; my mother was with Red Cross as a nurse in the Solomon Islands. Both saw the horrors of war and were changed in ways that led to violence and eventually to marriage breakdown.

My youngest brother died in a car crash when he was 19. I saw the impact not only on our family but on his close friends, many of whom started to abuse alcohol and drugs. My husbands youngest brother took his life when he was 45, after many troubled years, three weeks after their mothers death. Again the negative ripple throughout the family and friendship circle was obvious. The development of meaning from various life experiences has continued to evolve, has included learning from having our own children and continued clinical work. These are some of the factors which have also helped inform the work we have done through Leading from within, which have played a part in the conception of the program and the recovery of its participants.

Essential to the success of the program are the following features: the creation of a very safe psychological container; participants sign, on their first meeting, to agree to the group rules-Confidentiality, Safety, Participation and Commitment, Respect; participants are encouraged to do all the activities, to be aware that the more they put into the program, the more they gain but only to share what feels comfortable at any given time. It doesnt take long for people to share things never previously shared and it becomes a very sacred process which raises consciousness and unsurprisingly has not suffered from breaches of confidentiality.

There are also expectations of participants to extend the positive ripple to others. These include learning to take full responsibility for their feelings, thoughts and actions; sharing the skills and knowledge they learn with at least 10-15 other people during the program; supporting the development of others in their group and committing to giving back, paying forward and actively supporting others in the wider community.

After hearing the stories of some program participants a leader in the Mental Health field offered to fund an Evaluation of Leading from Within. The University of Melbourne School of Rural Health was contracted and completed the work in 2017 [6]. The outcomes included validating the success of the program; identifying the group process was strength; that going to people who had been affected by trauma was significant and that many people would not have used other services; people had significant connections still existing 15 years later.

Some Quotes from the Report

·       A few people described it as lifesaving; several others described major life changes.

·       25% said it completely changed their life; almost all strongly disagreed that things were better for a while but not now; 96% agreed I know myself better; and 91% agreed my overall life is better. All indicated they would recommend it to others.

·       Had its strongest impact on those who were at a very low point in their lives.

·       Some were identified as suicidal at the time of entering.

·       The group was a powerful form of support, learning, forgiveness, and pivotal to developing trusting relationships.

·       It is recommended that the program considers being outreach and going to community settings in times of crisis…..To provide the program to those who need it the most.

·       Had a powerful impact of engaging participants who reported they would not go to a service.

Participants have included people who have been suicidal, on medication, addicted to substances, suffered from sexual abuse, family violence, come from families with generational trauma, suffered from a range of mental health issues, become perpetrators, bereaved through suicide and/or car crashes (often multiple times) and suffered from family breakdown.

Summary

Hundreds of people have now participated in Leading from Within, proving that when a safe container is provided people can recover from trauma. The evidence indicates, and Leading from Within demonstrates that when people get the opportunity to process trauma at a deep level, with the power of strong connection and enlightened witnesses, as well as making meaning of their experiences, old patterns can be overcome and a new life path can be forged with successful relationships, meaningful activity and trauma patterns ceased. The program has been validated and demonstrates that growth can come from trauma.

Creating connections is a significant part of the process; internally creating health and wellbeing, externally as Mentors, promoting community connection and wellbeing. We have seen that Resilience and Growth can occur in what can seem like very unlikely places. In many ways the poem from Rumi reflects a core idea: Out there beyond ideas of wrong doing and right doing, there is a field. Ill meet you there. It inspires us to always look with our common humanity at everyone with whom we are in contact. Now that the model has been validated by the University of Melbourne as a process that really works for recovery from trauma, we are open to the idea of training appropriate people to use it.

References

1.        Church D. Mind to Matter: The Astonishing Science of How Your Brain Creates Material Reality (2018) Hay House Inc., California, USA.

2.        Frankl VE. Mans Search for Meaning (1946).

3.        Miller A. The essential role of an enlightened witness in society (1997).

4.        Miller A. The roots of worldwide violence. An Essay-The essential role of an enlightened witness in society (1997).

5.        Cronhold PF, Forke CM, Wade R and Bair-Merritt M. Adverse Childhood Experiences Study (1998) Am Prev Med J 14: 245-258.

6.        Bourke L and Hamilton A. Review of the Leading from Within Programme (2017).

*Corresponding author:

Jennifer O Connell, Clinical Social Worker in Victoria, 112 The Boulevard, Shepparton Victoria 3630, Australia, Tel: +61 421 160 688, Fax: (03) 58311997, E-mail: emmakate2@iinet.net.au  

Citation:

O Connell J. Healing and growth after trauma in a rural Australian community-a case study (2019) Edelweiss Psyi Open Access 3: 33-35.

Keywords

Trauma, Psychology, Epigenetics, Mental health and Consciousness.