Val LougheedNorthern Lights Canada

Real Work * Real People * Real Results

Trauma, Rehabilitation and Recovery

~ Keep your Fork ~

1-800-361-4642 * www.northernlightscanada.ca * vlougheed@northernlightscanada.ca

“You don’t want your impairments to define you – you want them to inform you.”

(Hanita Dagan, personal communication, 2005)

www.slideshare.net/vlougheed

#NLCAN

www.northernlightscanada.ca/our-company/

our-president/be-still

Agenda

•Beginning …

•Middle …

•End …

HOPE AND PLANNING

1. What does it mean to recover?

2. What can I do to recover and return to a life that includes work?

3. What can we do to facilitate recovery and a return to work?

Rated PG-113

People Strongly Cautioned!

May contain bad language, brief nudity, sexual overtones, and drug usage.

Beginning

1978

VIDEO CLIP Val being

interviewed in Minden

Sept. 9, 2003 - morning

Sept. 9 – p.m.

Sept. 15 2003 – Jan. 19 2004

Journey Back to Life

February 2004 – Present

Starting Point

The

Re-organization

of Self

March 2004

“In the aftermath of traumatic life events … [the] sense of self has been shattered.”

(Herman, 1992, p. 61)

“An existential crisis …”

(Hanita Dagan, personal communication, 2005)

Sliding Down the Slope

Sliding Down the Slope

A Foothold

• Mild – moderate ABI

• Depressed (dysphoria)

• Working memory problems

• Hiding pain

1st Neuropsychological Assessment

June 2004 -- Results

ABI – Measuring Loss

Subjective Report – difficulty retrieving words and communicating ideas

Objective Report – above-average performance on neuropsychological measures

(Prigatano, 1999; p. 59)

Losing My Grip

My IWRPAugust 2004

Video of Borg

Rescued in the Valley of Despair

Head Injury ProgramOct. – Dec. 2004

GRTW – The Plan

Jan. 3 – Feb. 7, 2005

(5 weeks)

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

GRTW – The Reality

WSPE

Work-Site Performance Evaluation©

Sue….with the graph pic

Sliding Back Down Into The Abyss

• Non-compliance

• Malingering

• Trying too hard

• Not trying hard enough

2nd Neuropsychological Assessment

May 2005 -- Edmonton

Test Results• Mild to Moderate ABI

• Pain?

• Depression?

• Motivation?

• “a high flyer”

• “phobic avoidance”

• Future plans – “live off dividends” [from company]

Lesson

ASSUMPTIONS

REVEAL BIAS

• Mild – moderate ABI

• Good prognosis

• Post-Traumatic amnesia

• Pain?

• Depression?

• “Adjustment Disorder with Anxiety and Depressed Mood”

3rd Neuropsychological Assessment

August 2005 -- Calgary

Symptom Overlap

(co-morbidity)

(Michael Sullivan, Centre for Research on Pain and

Disability, McGill University, September, 2006)

Pain, Trauma, Depression, ABI

Oct. 3 – Dec. 11

Pain Research

1600’s – Rene Descartes (philosopher)

Pain Research

1950’s – Wilder Penfield (brain surgeon)

Pain Research

Patrick Wall (physiologist)Ronald Melzack (psychologist)

Pain – The Future

SCN9A(Globe and Mail, March 24, 2007)

Glia Cells(Scientific American, November, 2009)

Poppy Genes(U of Calgary -- Calgary Sun, March 15, 2010)

“In every encounter, basic trust is in question.” ( Herman, 1992, p. 92)

“Survivors feel unsafe in their bodies – and in any relationship with other people.” (Herman, 1992, p. 160)

Rehab & Recovery

DISSOCIA

TION

Trauma Research

VIDEO CLIPAdrenaline: Flight or Fight Response

Trauma Research

Fight

Freeze

“Survival Central”(Rothschild, 2000, p. 46)

•Amygdala - Implicit memory• storage of emotions and sensory

reactions (Rothschild, 2000, p. 20)

•Hippocampus – Explicit memory• creates memories of actual sequence

of events(Rothschild, 2000; p. 28)

Trauma ResearchLimbic System and Memory

Stress Hormones

•Amygdala - Implicit memory• storage of emotions and sensory

reactions (Rothschild, 2000, p. 20)

•Hippocampus – Explicit memory• creates memories of actual sequence

of events(Gunnar & Barr, 1998)

Trauma ResearchLimbic System Under Threat

TraumaPersonal Experience

• Dissociation & Cocoon = Safety

• System on High Alert Always = Survival

• World is black & white = Trust

Trust (Safety) = Love

No Trust (Life Threatening) = Hate

TraumaPersonal Experience

• Listen to me

• Understand me

• Respect me

• Are competent

I trust (love, feel safe with, will try hard for) people who:

“… depression [caused by trauma] is not the same as ordinary depression.”

( Herman, 1992, p. 118)

Depression

Candace Pert, 1997; pp. 171 -- 179

Psychoimmunoendocrine Network

Affects more than IQ ….

Touches core … of a person’s self-esteem

(Prigatano, 1999; p. 58)

ABI

Back to Wilder Penfield – 1950’s

ABI

Localizationist

VIDEO CLIP Story of Paul Bach-y-Rita’s dad

Paul Bach-y-rita Neuroplasticity Video Clip;

link to Neuroplasticity – YouTube; bren49764

00 – 2:20

Paul Bach-y-Rita – 1934 – 2006

Scientist and Rehab Doctor

Neuroplasticity - 1969

METHODS OF HELPING

“The words and attitudes of others … are potent. They help or hex healing and recovery.”

“ Expectations are powerful.”

(Bolen, 1996; p. 94)

Body-Mind Connection

SCARF MODEL (Rock, 2008)

•Hypothalamus

•Peptides

•Receptors

•Biochemical Events

Video clip Addicted to Love song

VIDEO CLIP Esther

SternbergDr. Esther Sternberg Demo

Reel – YouTube; 00 -- .36

Quantum Connection The Living Matrix

(Braden, 2007; p. 45)

Cortisol and Immune Cells

Sternberg, 2001; p. 112

“Loss of identity can evoke a personal crisis, creating a need for change.”

(Ornelas, in Smith & Johnson (Eds), 1997; p. 172)

The Re-Organization of Self

Identity Research

Scaling the Canyon

Sept., 2005

Waskesiu

Breast Cancer Reconstructive Surgery

March 2006

Convocation M.Ed. -- June 2006

Back in “a” SaddleSeptember 2007

• Officially change role/ title

• Re-organize NL

• Home Office

Hope and PlanningResilience

Ability to return to original form after being bent (bounce back)

Thriving in constant change, ability to be:

• Flexible

• Creative

• Adaptable

• Learn from experiencehttp://www.resiliencycenter.com/articles/5levels.shtml

Hope and Planning

Rehabilitation (habiter – to live inside)

“Rehabilitation is the learning to live inside not only one’s body, however it is after an injury or illness, but inside one’s very being.”

(Kabat-Zinn, in Meili, 2003; p. 241)

Hope and Planning

RecoveryCuring Focus on the illness/

impairment [outside]

Healing Focus on the person [inside]

(Crombez, October; 2003)

Be Still

HOPE AND PLANNING

1. What does it mean to recover?

2. What can I do to recover and return to a life that includes work?

3. What can we do to facilitate recovery and a return to work?

Keep Your Fork

Northern Lights Canada is a person-centred organization committed to providing innovative, responsive links to real work.

We offer 4 major divisions of service: • Vocational Rehabilitation Services • Employment Services • Employer Services• Corporate Training

For more information, please contact us: 1-800-361-4642

www.northernlightscanada.ca

Voc Rehab Canada (VRCAN) is a national consortium of experienced regional vocational rehabilitation companies. VRCAN provides customers with single-point access to VR services anywhere they are needed in Canada, whether on an individual service or contract basis.

Member companies include:Argus Management Consultants,

Inc. Sandra Preeper & Associates

Advantage Rehabilitation Consultants Ltd.

Rehabilitation Alternatives Limited / Vocational Alternatives Software

OPTIMA Rehabilitation CVE Inc.

Northern Lights Canada Occupational Rehabilitation Group of Canada (ORGOC)

Western Rehabilitation Specialists Inc.

Diversified Rehabilitation Group

Genesis Rehabilitation Ltd. Rehabilitation FocusFor more information, please feel free to contact us at 1-800-361-

4642