Episode Transcript
[00:00:05] Speaker A: Welcome. I'm Alyda Murray, executive director of the Adams County Children's Advocacy center. And this is the brighter tomorrows, a podcast about mental health, resilience, creating authentic connections, and how we can build and strengthen our community. We hope you will join us. The Adams County Children's Advocacy center is an independent, nonprofit organization serving Adams County, Pennsylvania, whose mission is to work towards a community where children are safe, families are strong, and our child victims of abuse can become children again.
So as an organization who every day supports children who have experienced trauma, it's important for us to support and promote activities that help build resilience to stress and to maintain mental wellness for everyone. So today I'd like to introduce Amanda Raspoli. Today's episode is about building connections, which is about bringing comfort, especially after someone has experienced trauma.
We're talking with Amanda Raspoli, LPC. We call her Spoli, who is the in house therapist at the Adams County Children's Advocacy center.
So welcome, Spoli, and thank you for joining us today. Can you tell us a little bit about yourself and how you came to work as a trauma therapist at RCAC?
[00:01:23] Speaker B: Sure. Thank you, Elida, for the chance to talk to you and the community about these topics today.
I have had quite the journey to end up back in Adams County. I was actually born here in Gettysburg, and we moved around a good bit when I was a kid and ended up in the midwest.
And then after graduate school, where I got my degree in counseling psychology with a specialization in expressive art therapy, I ended up living in Arizona for quite a while.
And I noticed that when I started working as a therapist time and time again, I was kind of ending up working with people who had trauma histories.
It didn't seem to matter what agency or population I was working with. It kept coming up. And so I did do some extra coursework so that I could become a certified clinical trauma specialist who works with families. So that's that part.
And when I was thinking about moving after the pandemic, a lot of people kind of reassessed their values and what they wanted, and I wanted to move closer to home. So I was talking with my grandma, actually, and she had encouraged me to look at the Adams County Children's advocacy center, which I didn't know existed. And we happened to be looking for each other at just the right time.
[00:03:08] Speaker A: So big shout out to Spoley's grandmother for bringing her to us. And also kind of, it's my belief system that the universe brings us what we need. So we're grateful to have you. We're grateful that you're here to work with us and work with our kids. So people use the word trauma all the time, and many times we use it incorrectly. Can you tell us a little bit what trauma really is and what it means to us mentally, emotionally, and physiologically?
[00:03:34] Speaker B: Sure.
I really like the way that doctor Robert Macy explains trauma, and he describes it as an overwhelming demand placed on the physiological human system. And what that means is that it's an appropriate reaction to an event or multiple events that somebody should have never had to live through normally. That's what we would call a traumatic event. And traumatic events can include everything from natural disasters to accidents to acts of violence or abuse. But the main factor in all of those events is that the event itself felt or was life threatening.
There are three different types of trauma. We know that there's acute trauma, complex trauma, and chronic trauma. Acute means that there was one incident that we can point to. Chronic means it was repeated, so it happened multiple times, often things like dv or witnessing domestic violence.
And complex means that it occurred multiple times in different events. That said, trauma reactions are absolutely correct. Life saving responses to threats and danger. When these events take place, it doesn't always result in acute stress disorder or PTSD.
A lot of people ask about that. But the reason that some folks develop long term traumatic stress reactions is due to their ability to get safe and reregulate after the event. If we're able to, and safe enough to take some action and receive some support, there's a significant decrease in the risks of lifelong impacts. However, when it's not acknowledged or addressed, what we see is long term effects on people's mental and emotional wellbeing, as well as their physical health, their relationships, and their overall functioning.
[00:05:35] Speaker A: Yeah. So, at the center, we talk a lot about aces. And back in the 1990s, there was an important research study done by the Centers for Disease Control and in partnership with Kaiser Permanente, which, for those of us who've been on the West coast, is a huge medical organization.
And the study focused on traumatic childhood incidences and how they can negatively affect a person's health and well being long term, well into adulthood. So examples of aces can be the things that we deal with at the center, like violence, abuse, and neglect. Witnessing violence, either in your home or in the community. It can be having a family member attempt suicide or die by suicide. It can also be surrounding aspects of the child's living environment, be it anything that undermines their sense of safety and stability. It can be food insecurity, homelessness, drug use in the home, mental health problems in the home, anything that deals with instability of their parental or their caregiver supports, even as much as household members being in jail or a prison. And aces are common. Most of us have an ace or two by the time we get to adulthood. But what we see for children at the center is we see children who be there three years old, up to age 18, sometimes as young as three.
Our average aces score for our kids coming into the center is between five and six, which to think about aces means between five and six times already. Even if they're three years old, they've experienced five to six adverse childhood experiences.
So what we know about this is that what the research has proven is that some people or groups also have a greater risk of experiencing one or more aces simply because of inequities in our environments, whether it be a racial inequality or something that's historical. When I say historical, I really mean like generational.
Maybe generations of trauma have occurred in a family or in a neighborhood or in a community setting, and also the economic environment in which some families live. So what we know is that aces are costly in terms of individual lives. They're costly in terms of families, they're costly in terms of communities, and they bring in a tremendous economic burden, both to individuals, to families, but to the community at large. So when children grow up with that toxic stress, they may have difficulty forming healthy and stable relationships, and that's going to carry them through into adulthood, too. They may also have unstable work histories as adults. They struggle with finances, jobs, depression, other mental health concerns.
More recent research has also proven that these effects can also be passed on to your own children if you are suffering, and that some people, some children may face even further exposure to toxic stress from whatever is going on in that family or in that community in terms of their generational, historical, and ongoing trauma, racial discrimination, again, plays a. It can play a factor. The impacts of poverty resulted in limited educational and economic opportunities. So in light of these facts at the Children's advocacy center, as you well know, what we believe is that our in house trauma therapy program is more important than ever getting kids this good. Trauma therapy is critical. So in talking about that, Spoli, can you tell us a little bit more about your work in our prompt trauma therapy for child victims of abuse, but also how everyone in our community can work to build connection and feel comfort through an increased understanding of the stress, trauma, physiological reactions to stress, and what we can do to support one another through difficult times. I mean, that's a lot. So there's a lot to unpack there.
[00:09:24] Speaker B: Yeah, yeah, multiple things.
So trauma therapy is really about helping people get into more regulated bodies while supporting them and gaining the knowledge and the skills to ease any current distressing symptoms with the option of at some point, processing what happened and what it means for the client that is completely dictated by the client.
So we never force kids to process when they're not ready.
We need to be in a calm and safe regulated body in order to start processing, or it can be re triggering.
So often when we see people participate and engage consistently, we definitely notice significant impacts and improvements in the well being of our clients lives and the lives of those in their support systems.
When people come in for trauma therapy, there's usually a few misconceptions about what that looks like and what it's for.
The first one I hear a lot is, are you going to make me sit on a couch and cry while you stare at me uncomfortably and write stuff?
And the answer is no.
Short answer. And the second type of thought or statement or belief that I hear a lot about therapy is that it's for, quote unquote, bad kids or crazy people, or that the focus is to punish or fix kids. And my goal as a therapist is not to make you cry, but rather to give you the space you need to express whatever feelings you may be having in a safe and non judgmental way.
At the CAC, that means that I use a lot of different tools with my clients based on what they feel comfortable with, what they like, and how they prefer to express themselves. So I often will use a combination of things like expressive art therapy, which might include music or art or storytelling.
I use sand tray or play therapy, as well as some psychoeducation.
Psychoeducation is when we're looking at and learning about why the brain and the body react to trauma the way that they do.
And lastly, of course, we use evidence based treatment.
And those modalities are very.
[00:12:06] Speaker A: Well, they're very well researched.
[00:12:08] Speaker B: They're very well researched, but they're also very wordy.
[00:12:13] Speaker A: We're not going to throw a lot of acronyms at you about the different kinds of trauma therapy, but I think the important thing is the thing you said first, which is there are a lot of tools that you bring to bear for this work.
And because we're working with kids, especially kids with trauma, one size does not fit all. And so your approach in terms of treatment planning is very, very specialized. So when you talk about trauma therapy, there are parts to that.
[00:12:41] Speaker B: So I do want to make sure that I talk about the second misconception that happens a lot.
And that's the misconception about that therapy is for bad kids or is some sort of punishment.
But my job as a therapist isn't about fixing anybody. We're not broken. We've adapted to our situations and the events that we've lived through as a way to protect ourselves. And so, trauma therapy does have like, three main parts. They don't always happen in a sequence of. So sometimes we go in and out of those parts, depending on what people need. But the first part is safety and stability. So that's creating safety and consistency, not just in the therapeutic sessions, but in your home, your relationships, everywhere else that we can.
The second part is regulation and relaxation.
We're learning how to calm our nervous system, and we're practicing that as much as we possibly can. So that way we can increase our ability to manage any stress and frustration that we come up against, so that we can go into the third part. And the third part is processing and cognitive restructuring, which is a fancy way of saying, kind of looking at thoughts and beliefs that have changed due to trauma.
So it's really about being able to process what occurred in whatever format feels safe for the client and address any of those negative belief systems that we've developed from the experiences, so that we can live healthy lives.
Throughout all three parts, I think it's absolutely crucial to provide psychoeducation. That's that learning piece, skill building, where we're getting extra tools for our toolkit and empowerment, so that we feel like we can use those tools. We've got the people in our corner on our team, and we're able to create that long lasting change in the short term.
My goal is always to help people ease current distressing symptoms. So if you're feeling really anxious, or you're having a lot of panic attacks, or there's a lot of sleep disturbances, we're going to address those things first.
So it's kind of like a mental health first aid. And in longer term work, once we're able to get into calm, regulated bodies, that's when we would go into processing our feelings and our thoughts while empowering our clients.
Because trauma is a physiological response to an extreme amount of stress or threat, there are a few things that we can absolutely predict we'll see in the time after trauma occurs.
For all human beings, that means that we tend to see less ability to regulate our behaviors. So we're having a harder time managing our stress that quick, like knee jerk reactions are a lot quicker.
It's more difficult for us to use logic and reasoning skills. So we aren't doing as much future thinking, we're not doing as much reality checking. And we also see increased challenges with forming memories. So people tend to be more distracted, they tend to have a harder time staying present in the moment, and we can expect less distress tolerance. So my window of stuff that I can put up with has gotten way smaller and a lot more dissociation. So checking out, zoning out, daydreaming.
A lot of people get really frustrated and have less tolerance for being frustrated. And then lastly, we see a decreased amount of ability to communicate well. So a lot of times people feel like they don't have a voice, right. The words get stuck or the feelings are too big or the beliefs are too big for us to feel like we can express ourselves.
So we of words, we often also will see more things like anxiety, fear, anger and aggression, increased worrying and hyper vigilance.
Hyper vigilance is where we're checking our P's and Q's. We're making sure we know where everybody's at at all times. We know where the exits are. We're really paying attention. Yeah. And all of these symptoms, again, are absolutely appropriate given the changes that are going on in our bodies due to increased stress hormones.
[00:17:44] Speaker A: I think that's really important to kind of emphasize again, because we're talking about, we're doing trauma therapy with children. So all of these things that spolia that you're talking about are happening to children and have they even had the opportunity in life experience to develop enough coping mechanisms for all of this stuff? No. So that's part of this piece is helping with that. But also, like, as the caregivers and the adults in a child's life, understanding that because you alluded to these bad, like, people think these are bad things or bad behaviors, and therefore it might be a bad kid, but that's not the case. This is a kid who's managing trauma in the only ways they know how. And so our role is to try to help them find new ways to do that.
Okay. So when we go forward in all of these things, knowing that these symptoms are absolutely appropriate, now that we understand about that and what trauma is and what trauma can look like in terms of behavior, can we talk about and explain a little bit more about how trauma therapy can help and how it all works? Because that piece is like the big unknown for us.
[00:18:54] Speaker B: Right?
So regulation, co regulation and stress is really where a lot of our power is going to be.
Everybody everywhere has experienced stress, right? And there's definitely healthy types of stress, and then there's toxic or chronic stress. And healthy stress is really that motivator, right? That little flag or warning bell in our bodies that's telling us, hey, I need to get off the couch and go get a snack.
Hunger is a type of stress, but then toxic or chronic stress is really where the stress keeps going for an extended period of time, or we're unable to get back into our baseline, our regulated state. So regulation and co regulation are key to managing stress and to living our best lives.
In a situation where someone hasn't faced a single traumatic event, it takes their body about 20 to 30 minutes to get reregulated. So that means their body's able to process those stress hormones. Whereas for somebody who's faced a traumatic event, it can take anywhere from 6 hours to four days. And it can be pretty complicated because that's without any additional stressors.
But the most important thing is that in order to help our kids get reregulated, we ourselves have to be in a calm and regulated state. And body co regulation is where we regulate our systems together.
And I know that there are so many ways to do that, but everybody has experienced somebody coming in the room, and I, that person, you can tell, is just like really hyped up, they're really frustrated, and the energy of the room kind of shifts, whereas we've also all had those people in our lives who had a calm presence, and you can really feel that in a very visceral way.
My recommendation is to find activities that help you already feel relaxed and calm, and to take those same activities that you're already doing, do them more, and model them for those around you. So we'll definitely explore that more in a future podcast in more detail.
But if I could give you a few takeaways, I would encourage you to practice the life you'd like to see your kids living, and your community members, too, giving yourself and those around you patience, compassion, and self awareness that you deserve. As human beings, we're supposed to respond to our environment, so our behaviors are not failures of who we are.
They're just signs that something is going on. And we're able to see that it's connected to what's going on around us.
We're not broken, we don't need fixed. We're definitely doing exactly what our bodies believe they need to do in order for us to survive. So my main question for people is always, are these things still necessary for us to survive? And if they are, are they helping us more than they're hurting us? And then depending on your answer, I would explore that further, right?
[00:22:41] Speaker A: Definitely. So thank you, Spoli. So this information is so important for everyone to understand and to remember. And there are things that each of us can do to support one another and especially to support the children in our lives and in our community.
So this has been a great discussion, and we're so happy that you were able to share so much with us about this important topic of trauma, and most especially the trauma when it's experienced in childhood. So we want to thank you again for that information.
It's important for everyone to understand and remember we can all support each other, and we can always do better in supporting one another and especially doing this in our community. So what I want to do is to thank you to our listeners also for staying with us throughout this episode to summarize what we've said and what Spoli most especially has said. Remember, we're not broken. I love that you say that. I've heard you say that many times, and I really appreciate it. We are not broken and we do not need to be fixed. We're doing exactly what our bodies believe we need to do to survive. And so give yourself and those around you the patience, compassion and self awareness that you deserve. Hallelujah. And practice living the life you'd like and would like to see your children living. I swear to you, as a mother of four children, if I had had that on my refrigerator on day one, I would have been a better mommy, I can guarantee you.
So I invite you to learn more about Spoley's work and that of the Adams County Children's Advocacy center by visiting our website, kidsagaincac.org and following us on social media at kidsagaincac.
I want you also to know that we'll be back together again to work together to make our communities safe for children and for families. Spoli will be back again with a future episode to talk about ways to help you manage your stress by de stressing your home. So we hope you will join us. And thank you again.
[00:24:38] Speaker B: Thank you.
