Karen Wilcox Australian Domestic & Family Violence Clearinghouse

1. Working with children affected by domestic violence: good practice and the new evidence base.Webinar July 2013 Karen Wilcox Australian Domestic & Family Violence Clearinghouse

2. This morning’s workshop • The ‘new’ evidence base and a lay person’s ‘neuroscience and trauma 101’ • Practice Implications • Further research, further training options • Questions and discussions

3. Latest Findings from the Literature • Effects • Exposure of children to dfv • Impacts on healing and resiliency • Trauma triggers, abuser contact and shared care • Mother/child relationship – protective cocoon • Belonging • System-created trauma

4. From the new evidence base • Neuroscience - 3 key points • Sequential development • Impacts of DFV as complex trauma • Plasticity

5. Sequential development • Bruce Perry • Neuro Sequential Model of Therapeutics (NMT)

6. First three years – rapid development of brain synapses in healthy child • Develops from experiences, particularly attachment experiences • Brain develops sequentially

7. ‘ (c) 2012 Karen Wilcox

9. cognitive • includes pre-frontal cortex • cognitive • includes pre-frontal cortex • ‘primate’ • ‘primate’ • ‘mammal’ • ‘mammal’ • emotional • attachment, relational • Includes limbic • emotional • attachment, relational • Includes limbic • ‘reptile’ • (brainstem) • ‘reptile’ • (brainstem) • Survival - ‘safe’ or ‘unsafe’ • Basic functions – heart, breathing, temp, etc • Survival - ‘safe’ or ‘unsafe’ • Basic functions – heart, breathing, temp, etc

10. Trauma & Brain development • Three ways: • Limit experiences for healthy brain connections/wiring • Over-active alarm response • Impacts of cortisol

11. Trauma, impairment, brain development:1 • Disrupted healthy growth • Effects depend on when child exposed • which part is developing • Damage at earlier stages effects growth of later stages • Negative/disrupted attachment experiences (emotional regulation)

12. Impairment of brain development:2 Alarm response over-activated • Baseline arousal level is higher and more easily triggered ‘on the lookout’ for danger

13. Trauma and the Alarm System • Freeze • Fight or • Flight • Fight response - ?temper tantrums • Dissociation – inner flight • Freeze – can look oppositional

14. More frequent activation of alarm response = More frequent bypassing of higher brain –> child functions in lower levels

15. cognitive • includes pre-frontal cortex • ‘primate’ • ‘mammal’ • emotional • attachment, relational • Includes limbic • ‘reptile’ • (brainstem) • Survival - ‘safe’ or ‘unsafe’ • Basic functions – heart, breathing, temp, etc

16. Lower parts of brain activate • Repeated/constant activation in infancy – pathways formed • –> becomes automatic • non-conscious • Window of feeling calm and ok is narrowed • adaptive – we’d all do it

17. ‘trauma triggers’ • Constant arousal of alarm system Baseline state is already aroused Diagram used for presentation purposes, not for publication Adapted from Perry 2012

18. Impairment of brain development:3 Cortisol production • toxic to brain if too much • mechanisms for activation/ deactivation damaged by overload As if the ‘Switch’ doesn’t work properly

19. Domestic Violence is complex trauma Attunement – mother’s emotional response = child’s “even where the violence is not physical or visually witnessed”(Morgan 2011) -> threat to the attachment figure = threat to baby -> alarm response activated

20. Trauma is most damaging when… “ 1. Trauma occurs at a young age and cannot be consciously remembered 2. Trauma is repetitive, not just one-off 3. Trauma is severe and terrifying 4. Trauma is unpredictable 5. No support or comfort is offered to the child afterwards” Morgan 2011

21. constant and overwhelming threat constant emotional arousal impairs brain development

22. Living with DFV – children need to be: “ - Hyper-vigilant (Alert to cues signalling threat) - Screen out other cues (not listening) - Hyperaroused (Respond quickly to threat) - Able to act quickly and impulsively - Agitated, impulsive, poor concentration” • Morgan 2011

23. DV Trauma impacts - Relational issues – • identity • Emotional ‘intelligence – identifying own and others feelings • expressing feelings verbally - ‘act out’ • attachment – relationships and friendships -rejecting, over-attaching • empathy • responsibility/guilt – right/wrong • stress mg’t– impulsive reactions, dissociation, numbing (drug and alcohol)

24. Impacts cont’d • Behaviour - externalised • Aggression, antisocial behaviour • Internalised • Anxiety (including separation anxiety), depression, generalised distress, sleep disturbances • Feelings of sadness, confusion, fear, anger • Infant behaviours: • Crying, unsettledness, irritability • Eating and sleeping problems • Developmental impairment

25. Impacts cont’d • Gender of child - boys more likely externalise; girls more likely internalise (including dissociation) • neurobiology underpins the behavioural impacts –> need to explore underneath the behavioural presentation • Culture - Aboriginal children – greater risk of harm • Layers of trauma • Tactics – cultural isolation, deprivation

26. Living with DFV • ‘Living with’; ‘affected by’; ‘witnessing’; ‘exposed’; ‘experiencing’...? • ‘co-morbidity’ of domestic violence and child abuse • 1 in 4 • 2006 – almost 823,000 women who had experienced DFV had dependent children • 239,000 during pregnancy

27. Plasticity • Brain forms depending on how it is used • Changes through repetition, • Skills, emotional responses, thought processes etc become ‘hardwired’ through use • Higher parts more ‘plastic’, so easier to change • Good News Story: • healing and recovery of children - thru repetition and healthy stimulation of region affected by trauma

28. Huge implications for educators, carers, services working with mums and kids • learning • behaviour management • relationships

29. More from the evidence base...resilience • Attachment + belonging = resilience • ‘Sage warning’ – ‘resilience training’ is no substitute for • trauma-informed interventions, and • protection from ongoing harm

30. System-created victimisation • Or ‘secondary victimisation’ • For children: ‘behaviour management’ that re-traumatises or heightens fear response • Blaming mothers/victims, not holding perpetrators accountable • Support service gaps or ‘hoops’ • Legal abuse, financial abuse – system aiding an abetting • Service ‘silos’

31. Practice Implications • Screening and Risk Assessment • Training in understanding DFV - particularly DFV and trauma; post separation exposure; abuser tactics – • attacks on mother/child bond; • parenting time; • financial abuse and impacts on children’s wellbeing

32. What works... Children exposed to dv can recover when: • Their primary protective attachment is preserved and strengthened; • Their primary attachment figure is safe and supported; • Specialised, trauma-informed programs are available and provided for long enough; • System supports child/family need for protection from ongoing exposure to abuser

33. Further Training • Australian Childhood Foundation www.childhood.org.au • Berry Street (Childhood Institute) www.childhoodinstitute.org.au • Child Trauma Academy www.childtrauma.org • ASCA (Adult Survivors of Childhood Abuse) www.asca.org.au

34. Questions?? Email for reading list clearinghouse@unsw.edu.au And subscribe... to the ADFV Clearinghouse www.adfvc.unsw.edu.au