Changing the Tools for Home Intergenerational Visitors Pathway - - PowerPoint PPT Presentation

Changing the Intergenerational Pathway of Trauma

Tools for Home Visitors

Barbara Jessing, MS, LIMHP, LMFT

Fontenelle House Consultation and Training

Barbara Jessing

bejessing@cox.net 402-981-6727 www.fontenellehouse.com

Welcome and Introduction

• Reflection:
• A parent you are thinking about

today

Trauma Informed Early Childhood Practice

• Recognize adult manifestations of

past and continuing trauma including triggering situations

• Adopt a trauma sensitive, relational

approach to carrying out early childhood services

• Apply principles of attachment to our

work with parents

• Connect parents to trauma-informed

resources

Mapping the Pathway: Parent ACES lead to Child ACES

What are the mechanics of intergenerational transmission? Historic and cultural trauma Framing Parent Behavior in Attachment Terms Identifying and matching parents’ attachment styles Parallel Process

Adverse Childhood Experiences pass from one generation to the next…. Until they don’t Studies show that about 30% of adults maltreated as children will repeat the pattern 70% do not What’s the difference?

The ACES PYRAMID

ACES Overview

The ACES PYRAMID

https://www.nicabm.com/

https://www.nicabm.com/

https://www.nicabm.com/

Children Carry On the Pattern

Parenting Capacity is impaired; Children Exposed to Adverse Childhood Experiences

Adoption of Maladaptive Coping Mechanisms: Substances, Mental Illness, Instability, Violence

Brain is Wired for Threat and Survival; Emotions dysregulated Capacity to Protect, Attach and Nurture is Stunted

Parent History of Adverse Childhood Experiences

The Adverse Childhood Experience (ACE) Pyramid

The Blind Spot: How Trauma History Affects Parenting

• Difficulty regulating emotions
• Difficulty with concentration, attention, and

decision making

• Maladaptive coping such as substance abuse

can impair judgment

• Difficulty making and keeping close supportive

relationships

• Difficulty in accurately assessing danger or

safety

Second, Third, Fourth and Fifth Chances

We Can’t Change Parent ACE Score…

• But we can intervene to help

parents protect children from ACE exposure

• And we can build resiliency in

parents

The Trauma Informed Lens: Parent Attachment Styles

. The “WHY” Behind the Behavior Effects of Trauma

• n Attachment

Style Persistence of Attachment Style Your Attachment Experience

Attachment

“Early attachment is the affective child- mother bond that promotes survival through the child’s reliance on the adult for protection” Alicia Lieberman

Progression

• f

Attachment

Four Attachment Classifications

Secure (responsive and sensitive caregiving) Avoidant (caregiving is chronically rebuffing) Resistant (caregiving is inconsistent) Disorganized (caregiving is at times frightening

• r frightened)

Secure Attachment

• Caregiver is safe base for exploration of the

world

• Parent is attuned to inner experience of child

and responds flexibly

• They are comforted by the parent and show a

clear preference for the caregiver (for example, by protesting or avoiding the unfamiliar person).

Avoidant Attachment

• Parent is emotionally unavailable
• r rejecting; child adapts by

avoiding closeness and emotional connection

• This child may appear to be very

independent but their self reliance is a cover for insecurity.

Resistant/Ambivalent Attachment

• Parents’ communication is

inconsistent and at times intrusive. This may be mild to severe

• Because the child can’t depend on the

parent for attunement and connection, he develops a sense of anxiety and feelings of insecurity. This too may be mild to severe

Disorganized Attachment

• Parent behavior frightens or terrorizes the child
• Child is emotionally aroused and alone – no comfort,

no containment, no emotion regulation

• Child shows approach- avoidance pattern
• Child may show trance like state or “freeze” response
• Mental models of parent remain un-integrated
• Irresolvable paradox -- parent is feared and needed

Attachment Styles Tend to Persist Throughout Lif ife

But with healthy, corrective experiences, they can change or at least be modified

Taylor- Seehafer, Jacobvitz, and Holloran Stiiker; Family and Community Health; 2008

…Unresolved loss and trauma tends to affect the way social behavior is organized later in adulthood, including how individuals cope with extreme stress….

The Intersection

• f Ghosts

and Trauma

• Parent experiences traumatic event in

childhood

• Parent develops traumatic expectations

as a result of the event

• Parent’s personality develops in line

with defenses and expectations based

• n trauma
• Early trauma becomes a ghost in the

nursery

Childhood Attachment

• Secure:
• Distress when mother leaves
• Greets Mother when she returns
• Co-regulation
• Avoidant:
• Does not seek Mother when she returns
• Focuses on environment
• Ambivalent/Resistant:
• Very upset at departure
• Explores very little
• Clingy and anxious
• Disorganized
• Dysregulated
• Mistrustful
• Hostile; aggressive

Adult Attachment

• Secure:
• Comfortable in relationships
• Able to seek support from partner
• Self Regulation
• Avoidant:
• Isolates; seems autonomous
• Tends to cut off emotionally from others
• Ambivalent/Resistant:
• Fears rejection from partner
• Strong desire to maintain closeness
• Disorganized
• Mood and behavior swings; unpredictable
• Difficulty trusting others
• Hostile

Categories of Adult Attachment Style Correlations Between Children’s and Parents’ Attachment Styles

• Dismissive of the importance of

attachment relationships

• Preoccupied – confused, non-objective

and preoccupied by past relationships within the family; passive, vague; fearful; overwhelmed

• Autonomous – sees attachment

relationships as important and influential; able to explore thoughts and feelings about attachment experiences

Stratetgies

Mindful Self Regulation Find Angels in the Nursery Horizon Questions Watch for Ports of Entry Build Attachment with Parent Teach about ACES “Serve and Return” Moments “Speaking for Baby”

Mindful Self Regulation

Hold Contradictions Keep Showing Up! Precontact Routine Reflective Practice for the ARC of your work

What is Your Repertoire for Reducing Physiological Reactivity?

Pre-Contact Routine: Prepare to Be Present

• Walk to the door with hope AND
• Be aware of pressures and frustrations –

breathe to release

• Take time to mindfully regulate as you approach
• Feel your sense of balance and be ready to shift

as needed to hold the situation steady

• Open to the experience of this family on this

day

Hold Contradictions

The haunting experiences, the breakdown

• r disruptions of attachment that the

parents carry forward leaving gaps in what they can offer their child in the present

The benevolent experiences that parents have to draw on from the past/in the present

GHOSTS ANGELS

ANGEL QUESTIONS

• Do you have a memory of a time when

you were little when you felt especially loved, understood or safe?

• What is the content of the memory?
• How old were you at the time?
• Do you remember any smells,

sights, sounds or other sensations that are connected with the memory?

How do you feel now as you speak about these memories? Is there anything about these memories that you use to sustain you as you raise your child? Or that you use to help you raise your child? As we work together, is there anything about your memories that you want to use in raising your child, to help you bring that kind of feeling to you and your child? If I were to see your child 20 years from now, what would you like him/her to tell me about you?

Horizon Questions: When You Have Done Your Work as Parent

• If I were to see your child 20 years from

now, what would you like him/her to tell me about you?

• What hopes do you have for this child?
• What kind of person do you hope she

will be?

• What skills does your child need for the

kind of world you expect him to live in?

Building Attachment with Parents

Be Trustworthy Keep showing up Maintain attunement with the parent Co-Regulate Follow through -- do what you say you will do Help meet basic needs Help surmount crises Watch for turning points

“The Roots

• f Empathy”

Mary Gordon

• Children learn to

empathize with others if they receive empathic, attuned care from the adults around them

“PORTS OF ENTRY” Opportunities for Intervention in the Moment

• The child’s behavior
• The parent’s behavior
• The parent-child interaction
• The child’s representation of self
• The child’s representation of parent
• The parent’s representation of self
• The parent’s representation of child

Pre-contemplation Contemplation Preparation Action

“Five Steps for Brain Building Serve and Return”

Teach Parents About ACES

“ACE Module Added to “Nurturing Parent” Curriculum”

“A father in county jail is ordered to take a parenting class, but isn’t too enthusiastic about it. As part of the class, he learns about the ACE Study, and does his own ACE score. “Oh my god!” he announces to the class. “I have 7 ACEs.” His mother’s an alcoholic. His dad’s been in and out of jail. He himself started dealing drugs at age 11, and doing drugs at 14. “I’ve got two kids at home experiencing the same things I did,” he says. The light bulb goes on”

• Jennifer Martin, The Family Center, Nashville, TN

“Speaking for Baby”

• Narrate the child’s inner

experience to promote parent insight and understanding

• Serve as conduit or “translator”

between parent and child

• Help parent become better

attuned to child

Parent Turning Points

• Often unexpected
• Clearer in retrospect
• Watch for small signs of

progress

• Build on what works
• Ask what made a difference

Questions and Discussion