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Trauma Informed Care: Using the SELF Model To Gain Awareness


crying photoTrauma is a complex, but necessary subject. For the month of June and July I spent the majority of time writing articles on childhood trauma. It’s a known fact that many people fail to recognize how common and pervasive it is. Our society tends to believe that trauma is only for those individuals who have experienced a terrible life event. But that is not all trauma is. Trauma, as noted in previous articles, can be secondary or vicarious. You only need to listen to a host of detailed stories to feel the effects of trauma. In fact, research suggests that trauma can affect all of us and it doesn’t have to be us experiencing the event ourselves. For example, imagine that you are being told about a close friend’s sexual and physical abuse as a child.  Every detail, every emotion, and every sensory experience (smell, sounds, sights, tactile, etc.) are being described to you at great length. You might find yourself feeling overwhelmed, depressed, or even stressed. Perhaps you went to bed that night and had a dream about it. Or maybe you become hypervigilant in your own relationships to ensure that you avoid being abused. In a sense, you are becoming just as emotionally vulnerable as your friend. This is called secondary trauma, or, as in the previous article, compassion fatigue. Secondary trauma occurs when you have empathy and concern for the person who is sharing their traumatizing story with you. This article will explore a trauma-based model known as the SELF model and provide tips on how you can engage in introspection about the trauma you may have experienced in your life.

After 8-10 years of working with children, adolescents, and families who experience traumatic life events (such as abuse, neglect, domestic violence, a car accident, an unexpected death, etc.), I found myself beginning to conceptualize the traumatic histories of all of my cases as having a “rooted evil.” Trauma is convoluted and many professionals must obtain months to years of training in order to treat it appropriately, protect themselves from it, and help their clients deal with it. Trauma is primarily complex because of the physiological, emotional, neurological, and psychological effects that it has on humans. Any traumatic experience that we encounter has an influence on how our brain and body responds. Various chemicals in the body, primarily cortisol (a stress hormone that gets released from the pituitary gland in the brain and secretes a chemical substance that influences how our body will respond to stress) influences the physiological symptoms we often experience when stressed (i.e., muscle tension, headaches, chest tightness, etc). But not only is the body affected by trauma, but so too is emotions and psychological functions.

Sadly, most parents and families recognize that trauma is bad, but sadly fail to recognize just how bad. For some of my parents, they don’t believe that multiple incidents of domestic violence or physical abuse can affect the children in the home environment. Some parents believe that since the abuse or domestic violence happened to them and not the child that the child should not be affected. But that is far from the truth. Any kind of physical abuse or domestic violence affects the entire household, even if a child hasn’t visually witnessed the abuse. Just knowing that the abuse occurred, hearing about it, or one day seeing mom or dad bruised and harmed because of the abuse, is enough to trigger trauma symptoms. Trauma symptoms, which tend to be triggered by another traumatizing event, memory, or repeated event (such as repeated domestic disputes), often include flashbacks, increased heart rate, muscle tension, nausea, shakiness, night terrors, heightened startle response, and sometimes paranoia. The body is in “ready mode.” Any event that forces the body to go into “ready mode” (i.e., fight or flight mode), the event is traumatizing.

 

As a result, many individuals are referred for trauma informed therapy to help them work through their trauma. For children and adolescents, the Sanctuary Model of Trauma Informed Care and Trauma Focused Cognitive Behavior Therapy is often used in clinical settings to help families explore the effects of trauma on their lives. One model that I enjoy using with families in order to promote introspection, insight, and awareness is the SELF Model. The S.E.L.F Model stands for:

  1. S: SAFETY: When working with families using the SELF model, I encourage the family to explore and identify things that interfere with emotional safety, psychological safety, social safety, and moral safety and that exacerbates or adds to one’s history of trauma.
    • Emotional – verbal abuse/aggression, anger management difficulties, domestic violence
    • Psychological – psychological safety could include challenges with self esteem and self-image.
    • Social – relationship to others (bullying, harassment, ostracizing, etc)
    • Moral – derogatory statements about one’s religion or culture that may occur in school, in the community, or at home.
  2. E: Emotion Management – this typically involves things the client can learn to do to manage emotions appropriately. Some examples include healthy coping skills (things you can do to distract yourself or help yourself cope with pain), attending therapy, talking with a coach or supportive person, etc.
  3. L: Loss – This part of the activity is geared toward identifying various things in the client’s life that they have lost. Loss has great influence on how we perceive our ability to cope and heal. Loss may include: a divorce, death, separation, moving to another state or region, loss of friends or family, getting married and moving out of parents home, buying a new home and leaving a previous residence behind, getting new neighbors or co-workers, changing jobs, having a baby and becoming a mother or father, etc. We lose many things throughout our lives – some big and some small.
  4. F: Future – this part of the activity focuses on where the client would like to be in the future. I typically have my client’s focus on college, getting a new job, moving out from parents home, getting good grades, becoming independent, etc. Whatever you would like to achieve in your future should go here.

Using the SELF model to gain awareness is a great way to put everything in perspective. I encourage clients to engage in this activity in order to identify safety issues that make moving forward difficult, ways to manage emotions appropriately, ways that loss has negatively affected them, and ways to make the best out of what they currently have. I encourage you to use this yourself or with your own loved one or client. It’s a nice way to put things in perspective and encourage insight.

Why don’t you try it now? Start at Safety and work your way down. What did you find out about yourself? Do you think this could  be a useful to that you can use at different points in your own life?

As always, I wish you well

 

Tomorrow we will end Personal Stories Week by discussing compassion fatigue.

 

 

Photo by ePi.Longo

Trauma Informed Care: Using the SELF Model To Gain Awareness


Támara Hill, MS, NCC, CCTP, LPC

Támara Hill, MS, NCC, CCTP, LPC, is a licensed therapist and internationally certified trauma professional, in private practice, who specializes in working with children and adolescents who suffer from mood disorders, trauma, and disruptive behavioral disorders. She also provides international consultations and works with some young and older adults struggling with grief & loss or life transitions. Hill strives to help clients to realize and actualize their strengths in their home environments and in their relationships within the community. She credits her career passion to a “divine calling” and is internationally recognized for corresponding literary works as well as appearances on radio and other media platforms. She is an author, family consultant, Keynote speaker, and founder of Anchored Child & Family Counseling. Visit her at Anchored-In-Knowledge or Twitter and Youtube Youtube If you are interested in scheduling a telehealth family consultation, feel free to let me know. *Ms. Hill has moved all content to her other social media platforms. Take care!


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APA Reference
Hill, T. (2015). Trauma Informed Care: Using the SELF Model To Gain Awareness. Psych Central. Retrieved on November 26, 2020, from https://blogs.psychcentral.com/caregivers/2015/08/trauma-informed-care-using-the-self-model-to-gain-awareness/

 

Last updated: 19 Aug 2015
Statement of review: Psych Central does not review the content that appears in our blog network (blogs.psychcentral.com) prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on PsychCentral.com. All rights reserved.