Case Report :
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. 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. 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. · 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. 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. 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). 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 O Connell J.
Healing and growth after trauma in a rural Australian community-a case study
(2019) Edelweiss Psyi Open Access 3: 33-35. Trauma, Psychology, Epigenetics, Mental health
and Consciousness.Healing and Growth after Trauma in a Rural Australian Community-A Case Study
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