Don’t Exclude Me

A New BBC Docuseries

I love watching documentaries. Especially in the autumn, when it’s raining outside and I’m cosy in my tiny-campervan-home. Last night, I discovered a new two-part documentary on BBC iPlayer, ‘Don’t Exclude Me’, in partnership with the Open University.

With school exclusions at their highest in a decade, this series features Milton Hall Primary School in Southend, where teachers recognise exclusion isn’t the best option. In desparation, they ask behavioural expert Marie Gentles to visit the school and help them manage their most challenging children’s behaviour. Marie was previously a headteacher for 10 years at a PRU (Pupil Referral Unit), so she brings great experience with her.

A Trauma-Informed Lens

I’m interested in watching this documentary from a trauma-informed perspective. Trauma is overlooked across the whole of society. Not only is it misdiagnosed within the mental health system, but it also needs far greater recognition in schools, hospitals, the justice system – in fact, any other social system you can think of.

Schools and exclusions are particularly relevant. I am sure that we will look back on exclusion as an awful practice to still be carrying out in 2021. Why? Because the behaviours which lead to exclusions are likely a manifestation of childhood trauma, which is often overlooked. Instead a child is excluded, their path negatively set for life. They are punished when what they really need is trauma-informed help.

I also write this as a 31-year-old who experienced early childhood trauma, which manifested as extreme behavioural ‘meltdowns’ throughout my childhood. Teachers at my primary school also tried their best to help me, but the root trauma was never identified or dealt with, and it has since cropped up again and again. I am still experiencing and learning how to manage these ‘meltdowns’ – which I have since discovered are emotional flashbacks – as an adult. And that’s 100000x worse.

I was excited to see ‘Don’t Exclude Me’ shares the view that exclusions are to be avoided. But will it actually go where it needs to go, identify the problems at the root cause, and give the children the trauma-informed support they need?

Children’s Extreme Behaviour

The teachers at Milton Hall are regularly challenged by extreme behaviour, shown by a small number of the very young pupils. This behaviour includes disruption, aggression towards teachers & other pupils, self-harm, inability to focus, and all of the other undesirable & unsafe behaviours you can imagine in a school setting.

Beyond school, these sorts of problems can set off a chain which leads to a lifetime of struggles – with mental health, phsyical illness, unemployment, addiction, homelessness, prison, which can even lead to early death.

The sadness was poignantly captured in one frame: a young boy, head down and kicking the ground, alone in the playground whilst his peers played happily around him. His teacher explained that, no, he doesn’t have anyone he identifies as a friend.

His challenging behaviour alienates not only his teachers and parents, but his peers too. Humans are social animals, needing connection with their ‘tribes’ to feel safe and purposeful. Trouble forming childhood friendships can be the beginning of unhealthy relationship patterns across all areas of life, manifesting as bigger problems and Complex PTSD in adulthood. It’s sad to think of children starting their life like this.

Tackling the Problem

So, we need to solve it now, before it becomes a problem for life. And the teachers at Milton Hall want to do exactly that. They are brilliant, recognising the children are struggling with their emotions. It’s wonderful to see their compassionate attitude towards the children, and how much they truly want to help them.

But teachers are just like the rest of us. They are human. They have their own emotional skillset, their own unconscious triggers, and are pushed to their limits when trying to deal with children whose behaviour quickly becomes extreme. The teachers at Milton Hall refer to these as ‘meltdowns’.

‘Meltdowns’

When I was a child, I had extreme meltdowns which the adults around me called ‘tantrums’. I think meltdowns is a little more compassionate, so we have made some progress. But three years ago, whilst researching complex trauma, I discovered even better language to use: emotional flashbacks. Wow. It explains everything. And yes, I admit it, I started shouting at the screen whilst watching the program. Because they didn’t know either.

To me, and other trauma-informed experts, it’s now clear that challenging behaviour stems from emotional trauma. These ‘meltdowns’ are in fact emotional flashbacks. This is the language we need to be using, so we can compassionately validate the real problem and find a trauma-informed solution.

When children have extreme ‘meltdowns’ like this, it’s a sign of unprocessed trauma stuck in their bodies. Something overwhelming has happened which has caused a disconnection from the self and others. Because this was never dealt with and they don’t have the skills to cope with it on an emotional level, it will keep manifesting in bodily and behavioural ways until properly addressed.

Emotional Flashbacks

The program gives further evidence of these emotional flashbacks. We think of trauma as some big, scary, complex thing that only ‘the professionals’ know how to deal with. In fact, it becomes quite simple to identify and to work with, when you know what to look for. (And pssst, many professionals don’t know about this – yet! Help us spread the word!)

At one point, during a ‘meltdown’ where he was hitting a wall in the corner of the classroom, a teacher tried to comfort a young boy and asked him to talk about his feelings. He snapped back, “No we don’t talk about emotions.”

From a trauma-informed perspective, it’s clear that the child is having an emotional flashback. The emotions are still trapped in his body from a previous overwhelming experience, and manifest as these behaviours when triggered by something in his environment. The instant retort sounds like repetition of the words an adult said to him during a prior traumatic event.

During an emotional flashback, the primal centre of our brain takes over and the rational, cognitive areas go offline. Logical communication doesn’t work. This sends us into fight-or-flight mode, appearing as the hypervigilant and aggressive behaviours seen in the children on this program.

When children are having a ‘meltdown’ and say “I don’t want to talk anymore,” this often frustrates adults trying to help, who respond with “We can’t help if you don’t communicate with us.” Actually, the child is already sending a clear sign of communication – they are having an emotional flashback, and cognitive communication is not what they need right now.

They need a safe attachment and safe space to sit with their emotions. These extreme emotions already come from a place of feeling alone, scared and disconnected. Excluding them is punishing them for what they have already experienced all over again.

Marie understands the concept of safe attachment brilliantly, and recognises it is what these children are struggling with. She empowers the teachers (and parents) to practice making safe attachments with the children in a simple yet effective way, with quick results.

These are the kinds of interventions the children need, but I’m worried this is still only dealing with symptoms: the children also need trauma-informed help to get to the bottom of the emotions hiding there.

But What Is Trauma?

When I talk about ‘trauma’, I ask you to open your mind to its definition. Any overwhelming emotional or physical experience can be traumatic. We often think of trauma and PTSD as something only veterans experience, or car accidents, terrorist attacks, etc. – this is ‘Big T trauma’. But anything that overwhelms the nervous systems and disrupts our connection to ourselves and the world around us – ‘small t trauma’ – can be considered traumatic. This is more likely if we are left alone to deal with an overwhelming event and don’t process the incident afterwards, or if the traumatic circumstances persist.

There are many, many things a young child can already have been exposed to which cause trauma, just within a home and family environment. We are aware of how things like parental addiction, being in care, having a parent in prison, etc. (Big T) can be traumatic for a child. There are also many other things (small t) that can have equal traumatic impact, which are often overlooked, especially if the rest of the child’s environment and family is otherwise loving.

For example, domestic violence doesn’t have to mean physical abuse. Overwhelming emotional events can be equally as traumatic. My parents didn’t physically hit each other, but witnessing my father screaming at my mother until she cried was traumatic for me. Being sexually molested, even if it is ‘above the clothes’ (a categorical definition the police use) is traumatic, especially for a child and especially if they can’t tell anyone, or they tell and nothing happens.

Even being sent to boarding school, caring for younger siblings, comforting a parent who cries a lot, spending your childhood away from a parent, having a parent who always works or is simply unable to meet your emotional needs… if it’s overwhelming, physically or emotionally, disrupts our connection to self or others, and we feel alone dealing with it, then anything can be traumatic.

Trauma knows no barriers. Traumatic experiences affect all ages, races, genders and classes. Yes, distinct experiences are often culturally and socially mediated across these categories. But overall, trauma is an inherent part of human life. We are all likely to experience it. It’s how we deal with it, that can turn it from a post-traumatic stress disorder to a post-traumatic growth experience.

The saying goes that ‘it takes a village to raise a child’ – I think there is a lot of pressure on parents to be the entire village today, as we live in ever more socially isolated worlds. This program beautifully demonstrates how it’s so important for a child to be supported by multiple healthy adult influences, with the children’s parents, teachers and Marie all coming together to support each other.

Marie’s Expert Input

Marie Gentles spends valuable time at the school working with the pupils and teachers. She is very empathetic, quickly recognising that the children are overwhelmed with their emotions, and need a safe attachment to help cope with those feelings.

She works with the teachers to help them build these attachments with the children, giving them simple practical skills to do so, starting with a basic intervention to get a child’s attention straight away when they say their name. By creating safety in the small moments like this, the foundation is there for a secure attachment to develop.

Marie also visits the children’s families at home to make sure the good work can continue and be supported out of school. It’s clear that the children’s mothers love their children and are doing the best they can with the skills they have. They are grateful for the help, and positively surprised by the difference it is already making.

What About the Root Cause?

But still, I’m worried that the root cause hasn’t been mentioned. Marie so rightly identifies these children have trouble with safe attachments. Why is nobody asking what happened to these children to cause this trouble with attachment & emotions in the first place?

Because it’s a scary question to ask. Because the sad truth is that 1 in 4 children will experience sexual abuse in their childhood. Many others will experience other kinds of abuse and trauma. Where are these children? Well, they are the ones having the meltdowns. But maybe that’s too taboo for a TV series. Or maybe it’s finally time we get rid of this taboo, once and for all, and actually give people the trauma-informed help we need.

Nobody ever means to cause harm to those we love. Especially parents, who are only doing the best they can with their own emotional skills. Most parents would be absolutely devastated to know of the harm they have often unintentionally caused their children. Many parents are willing to try and do better, armed with the right skills and support. Some parents are unfortunately unable to face this guilt and can continue to be in denial over the harms their children face – these are the children who need our voices the most.

So, sadly, this will have been the experience of some of these children. And unless we have the courage to ask, the courage as parents to face up to mistakes and the courage as society to face this final taboo, it will keep happening.

The Journey Continues

After successfully navigating a ‘meltdown’, thanks to his teacher and Marie’s support, the young boy was happy to rejoin his peers in class. With his hands still over his face, he sheepishly walked back in again. I know it well: the hangover feeling of shame and not-quite-ready-to-make-eye-contact, another telltale sign of an emotional flashback.

I can’t wait for the second episode. I’m really hoping they address trauma – they haven’t said the word once yet – otherwise it’s another missed opportunity and more shouting at the screen for me.

I often wonder what life I would have led, had somebody identified my trauma and emotional flashbacks for what they really were. And that’s why I’m so passionate about what I’m doing now, raising awareness for trauma-informed care & practice, and in particular raising awareness of emotional flashbacks.

And some good news already – the boy in the playground has made his first friend.

New Page: Healing & Therapy

Just a short blog update to let you know I’ve been working on the Healing & Therapy page today. It was just a skeleton page before with some bullet points about different types of therapy I was going to introduce, in relation to healing from complex trauma.

Instead, I have re-written the page into three sections:

  1. Therapy
  2. Alternative Therapy
  3. Community & Nature
  4. Peer Support

I talk about each of these and their role in healing from experiences of severe mental distress and complex trauma.

I also changed the name of the page – it was previously called ‘Healing & Recovery’.

I realise that I have become particularly sensitive to the words used to talk about trauma and the journey around it. It took me nearly three decades to find the right words to use about my own lived experiences, and I realise that not knowing these words to use was all part of the problem.

And now, I have a particular problem with the word recovery!

For many people with lived experience of complex trauma, we don’t have a pre-trauma-self to ‘recover to’. If we experienced childhood trauma at a very young age, our brains will have been wired differently our whole lives. We don’t have a pre-trauma-self to go back to. We have to start from scratch, often whilst already well into our adulthood, a lifetime of distress already behind us.

So, welcome to the Healing & Therapy page.

Pilot Workshop – Dental & Mental Health in Young People

This afternoon I took part in a pilot workshop for a research project at Queen Mary University of London’s Institute of Dentistry. It seeks to explore needs and set research priorities for dental health services, focusing on young adults with depression.

I discovered the opportunity through TRIUMPH, which is a transdisciplinary network aiming to improve youth mental public health, based at the University of Glasgow.

The National Survivor User Network (NSUN) email newsletter is also a great place to find opportunities like this. I would recommend signing up with these networks if you want to find out about current research and lived experience opportunities related to trauma and mental health.

Whilst I was outside the criteria of young people aged 18-25 – I have just turned 31 – I emailed the lead researcher anyway. Accessing dental healthcare can be impacted by complex trauma, and I can see how my own lived experiences have made it hard for me to look after my dental health.

I’ve wanted to talk about this subject for a while, so this seems like a great way to have my voice heard and see if there is further potential to be involved as a lived experience expert.

In the end I was welcome to contribute, and took part in an hour-long workshop with the lead researcher, Dr Easter Joury. We were joined by another service user whose lived experience was also valued.

I focused primarily on talking about what a trauma-informed approach is, and how this is relevant to dental healthcare.

I explained how a trauma-informed model of mental health explains depression as a symptom of misdiagnosed and unprocessed complex trauma. Therefore, many people would benefit from a trauma-informed approach to healthcare like this, including young people with depression.

I talked about how people with lived experience of complex trauma need specific trauma-informed care, especially in settings like dental healthcare.

I also shared my insights into the wording and language used in research questions, and suggested further questions which need researching from this trauma-informed lens.

“This was one of the most productive workshops ever – it really shows the value of lived experience. You are the expert, not us. Thank you!”

Dr Joury’s comments at the end of the session

It feels great to be valued like this, and to have the potential to really shape the kind of research which will impact people’s lives for the better. I hope there will be the chance to be involved as a lived experience expert as this research project develops, because trauma-informed dental care is definitely something I’m keen to raise awareness of.

I also think it’s important that research participants are valued for their time spent in workshops like these. I will earn a £20 voucher for my time, and was given a range of choices for this, which I appreciate.

If the researchers want to embed lived experience into the next stages of their project, the INVOLVE lived experience/co-production guidelines are a great framework. In recognition of the great value we can bring to projects, this also includes payment for our work – the only way we can sustainably and fairly continue to progress towards the change we need.

Thanks for the opportunity Dr Joury, and I hope I can continue to be involved as your much-needed research project evolves.

P.S. And a bonus outcome for me – I was empowered to book a dentist appointment for the first time in many years!

Book Review: Knots – R. D. Laing

Not what you’re expecting… well worth reading. Perhaps my favourite book ever.

Title:Knots
Author:R. D. Laing
Year:1971
Importance:4/5
Accessibility:5/5
Recommended:5/5

OK, disclaimer. I think this might be my favourite book ever.

The love affair started off a bit rocky, though. I’m a keen sailor, and I thought this was going to be a book about, you know, knots. I thought I couldn’t believe my luck – a book written by an interesting psychiatrist, and about boats.

Alas, it was knot to be. The knots Laing writes about here are instead the emotional ones we tie ourselves up in, when we communicate with our loved ones. OK… equally as interesting!

This is a strange book, written entirely in long poems and dialogue. It’s really easy to read. And it’s really weird. I love it. Laing takes us round these poetic emotional circles, showing us the core fears and wounds often at the root of our struggles.

I found it particularly relatable when I read it during a tough time when my own complex childhood trauma was unravelling all around me.

It also inspired me to be creative with my own healing process, inspired me to work on Eyes On Trauma, and to write these very words you are reading now.

R. D. Laing’s work with ‘Knots’ is an incredibly creative way to explore the subject, and was surely pushing the boundaries back in 1971 when it was published. Maybe a psychedelic trip inspired it?

Either way, I have taken a leaf out of this book and will continue on my journey raising awareness of complex trauma in my own creative way. And I recommend getting your hands on an original copy of this gem – I hope you treasure it as much as I do.

In fact, I love this book so much, I have two copies. I managed to find the paperback in a charity book shop in Brighton, and the hardback in a second hand book shop in the Netherlands! I guess it really is my favourite book ever.

Have you read this book too? Share your thoughts in the comments below.

Book Review: Sanity, Madness and the Family – R. D. Laing & A. Esterson

Title:Sanity, Madness and the Family
Author:R. D. Laing and A. Esterson
Year:1964
Importance:5/5
Accessibility:4/5
Recommended:5/5

This book is one of the most eyeopening things I have ever read. It was written in 1976 and is just as relevant today. In fact, I can’t believed it’s been so overlooked.

It is based around 11 vivid case studies and transcripts from interviews with people who have been diagnosed with severe schizophrenia, and their families.

When viewed objectively like this, and through a trauma-informed lens, the power dynamics in these families is obviously unhealthy. It soon becomes clear that much of the behaviour labelled as symptoms of clinical schizophrenia can otherwise be explained in light of the family dynamics, and complex trauma, at play.

This book made me question the validity of all mental health labels, and even the construct of mental health itself. It’s clear to me that many behaviours which are otherwise labelled as mentally ill by our society can otherwise be explained by the emotional and familial systems individuals have grown up in, and the complex trauma they have experienced within these.

As more and more evidence begins to emerge about the effects of trauma on brain development, attachment, etc. especially within our formative early childhood years, we cannot keep ignoring the fact that maybe there is an answer to “mental health”, but it doesn’t lie within problem individuals. Labelling people with disorders whilst their trauma goes invalidated and unprocessed is not the way forward.

This book was written in 1976. It’s now 2021, we’ve created the fastest vaccine ever to cure a global pandemic, but we’re still treating people who’ve experienced trauma like there is something wrong with them. Come on science, sort it out.

Have you read this book too? Share your thoughts in the comments below.

Book Review: The Brain That Changes Itself – Norman Doidge

Title:The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science
Author:Norman Doidge
Year:2007
Importance:5/5
Accessibility:5/5
Recommended:5/5

This is another of my very favourite books I read when I began learning about the brain and trauma.

Doidge uses inspiring evidence and examples of people overcoming debililtating conditions such as dyslexia, dementia and physical injury – all through the power of neuroscience, and creating new neural pathways.

An easily accessible introduction to neuroplasticity – the way our brains can continuously change and adapt – it gives lots of inspiring examples of how people have already used this knowledge to improve their lives.

It’s immediately obvious this is also empowering for those of us on our trauma healing journeys, as it compassionately shows us how we can heal. Combine it with epigenetics, and you suddenly have scientifically proven answers, and evidence to move forward. Reading this book really helped me see an evidence-based light at the end of the tunnel!

I recommend this book for anyone with an interest in mental or physical health, especially when in the context of overcoming debilitating challenges – both emotional and physical.

Have you read this book too? Share your thoughts in the comments below.

Book Review: Sextant – David Barrie

Title:Sextant: A Voyage Guided by the Stars and the Men Who Mapped the World’s Oceans
Author:David Barrie
Year:2014
Importance:5/5
Accessibility:4/5
Recommended:5/5

Now, I bet you weren’t expecting to find this book here amongst the rest. I read it during a tough point in my life, right when my complex childhood trauma was unravelling and I was reading a lot of trauma books. This was a much appreciated change in subject from the heavy trauma books I was reading at the time.

And it meant just as much to me as the other books I read on my healing journey.

‘Sextant’ talks all about the ocean explorers and adventurers of days gone by, and really opened my eyes to what we take for granted these days. I’m a keen sailor who has worked on traditional ships in the past, but I learned a lot of things I had no idea about in this book.

Did you realise that most ocean explorers didn’t even have an accurate clock or watch onboard their ship until relatively recently? And without knowing the time, it’s impossible to determine your accurate location. It’s nice to be reminded of how far we’ve come in society – and how far we still have to go.

Reading about the massive risks people took back then to advance human knowledge was incredibly inspiring. The risks might be different now, but they can feel just as scary. It gives me hope that we can do the same with changing our mental health system towards the trauma-informed approach we so desperately need.

This book also made me realise we are still living in bodies with nervous systems designed for these dangerous, survival-based kinds of situations, rather than the current ones many of us now face.

Our bodies weren’t built for Zoom calls and spending our lives alone inside central-heated houses. Technology has revolutionised developments in society over even just the last decade, but our brains developed over thousands of years to a completely different environment which was based around community, connection to the earth, survival mode, and living in the present moment.

Realising this can be empowering, allowing you to be more compassionate with your struggles. It’s not us that’s ‘broken’ – it’s the world around us, so out of tune with our innate connections to each other and nature around us, which we used to have in the times of the Sextant. Now it’s up to us to rediscover that and break the cycle of trauma so many of us face, and whose families have faced for generations.

Have you read this book too? Share your thoughts in the comments below.

“What happened to you?”

Instead of “What’s wrong with you?”, we should be asking, “What happened to you?”

whats-wrong-with-you-what-happened-to-you

It’s time for a paradigm shift away from individualised concepts of mental illness. The problem is never solely within the individual. It is within the family, interpersonal relationships, communities and society.

Friends, family & professionals always asked what was wrong with me. If one person had instead asked what happened, I could have found the help I needed and been saved from a lot of unnecessary pain. 

I’ve struggled my whole life with “severe ill mental health” & chronic suicidal feelings. I’ve sought help from medical & mental health professionals over my lifetime. Sadly, as these services aren’t trauma-informed, this caused me more harm. I’ve since found many others with lived experience of complex trauma who have also felt this.

Still desperate for answers, I took my healing journey into my own hands. I finally discovered that my experiences can be explained by the complex trauma that began in my very early childhood.

I realise that my “mental health symptoms”, “personality disorder”, and “unacceptable behaviour” are in fact reasonable expressions of the trauma still painfully held within my body. 

In hindsight, many of these obvious warning signs have been missed since my early childhood. Instead, the people supposed to help made it worse. A trauma-informed approach is what’s missing, and something we are finally beginning to work towards.

Asking “what’s wrong with you?” implies the problem is with you, adding to the overwhelming sense of shame and guilt many people with lived experience of complex trauma already feel. Instead, “what happened to you?”, can begin to validate our experiences compassionately and help us heal. 

The next time you see someone in distress, instead of asking “what’s wrong with you?”, try “what happened to you?”. It might be the first time they’ve ever heard that question.


Originally posted by Eleanor on the @EyesOnTrauma Instagram page on 04/05/2021.

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Website update

Hi folks

Just a short note to say that I’ve been working on the website today, and have updated some of the content.

The About page has been given a complete overhaul; I re-wrote the entire page and have added some new links to the bottom, helping readers to understand how Eyes On Trauma is useful to them. I have also shared some extra information about my own lived experiences – and taken some away. It always feels hard for me to know how much or how little to share, and from what sort of perspective or voice to write it from.

In fact, that’s why I decided to start a blog on this website too. I have always been a keen writer, but one thing I have struggled with is knowing how much or how little emotion to include. I now see this is just another result of my childhood trauma, leaving me feeling unsure about the validity and appropriateness of my emotions. I also struggle a lot with the inner critic’s constant strive for perfectionism and feeling like I’ve said the wrong thing (I wonder where that comes from!) or have made a mistake.

So I decided to create a blog. The website is for the static resources, and this is for… well, writing things for fun, like I used to do and haven’t done for years. Here I can be imperfect. Here I talk about emotions. Here I don’t have to write a masterpiece every time.

Hear hear to that!

Eleanor

Book Review: Field Guide to Lies and Statistics – Daniel Levitin

Title:A Field Guide to Lies and Statistics
Author:Daniel Levitin
Year:2014
Importance:4/5
Accessibility:4/5
Recommended:4/5

This book is a ‘popular science’ type read that you find in the non-fiction bestseller charts at airpots. That means it’s a pretty easy, entertaining read, and you’ll might learn a few things which make an impact.

Reading this helped me begin to be more critical of the things I am conditioned to believe as facts by science. It helped me see the mental health system in a different light, when I began to read academic papers and uncover the truth for myself about the different labels I’d been given.

One part of the book stood out for me amongst all others. Levitin uses an example of when we bump into somebody we know, seemingly out of pure coincidence, somewhere totally out of context. It feels like the chances of that happening were so small, we are both absolutely amazed to see each other there – “Wow! What are you doing here? What are the chances?!” Yet, it’s happened to all of us.

From a statistical point of view, yes, the chances of meeting that person in that spot at that exact time, are very small. But when you look at the bigger picture, the chances of meeting anybody that you’ve ever met before, in any location and at some point in time, are very high.

Reframing this was a big lightbulb moment for me.

I have since used it as a way to remind myself there might be another side to the statistic, a bigger picture we’re not seeing. And that big-picture thinking allowed me to see beyond the current mental health system which is failing and harming so many of us, and instead recognise complex trauma for what it is, something so big that it emcompasses every aspect of our lives, and needs a trauma-informed approach across the whole of society.

The chances of that positive change happening? 100% if it has anything to do with me!

Have you read this book too? Share your thoughts in the comments below.