Val LougheedNorthern Lights Canada
Real Work * Real People * Real Results
PUTTING THE PIECES TOGETHERTrauma, Rehabil i tation and Recovery
~ Keep your Fork ~
1-800-361-4642 * www.northernlightscanada.ca * [email protected]
“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.northernl ightscanada.ca/our-company/our-
president/be-st i l l
Agenda
• Beginning …
• Middle …
• End …
Putting the Pieces Together
1. What does it mean to recover?
2. What can I do to recover and return to a l i fe that includes work?
3. What can we do to facil i tate 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 l i fe 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
Subject ive Report – diff iculty 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
Work-Site Performance Evaluation©
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 – “l ive 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 Research1600’s – Rene Descartes (philosopher)
Pain Research1950’s – Wilder Penfield (brain surgeon)
Pain ResearchPatrick Wall (physiologist)
Ronald Melzack (psychologist)
Pain – The Future
SCN9A(Globe and Mail , March 24, 2007)
Glia Cells(Scienti f ic 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
DISSO
CIA
TION
Trauma Research
VIDEO CLIP
Adrenal ine:
F l ight or F ight
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, wil l 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;
l ink 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 att i tudes of others … are potent. They help or hex healing and recovery.”
“ Expectations are powerful.”
(Bolen, 1996; p. 94)
Body-Mind Connection
Cortisol and Immune Cells
Sternberg, 2001; p. 112
SCARF MODEL (Rock, 2008)
VIDEO CLIP Esther
SternbergDr. Esther Sternberg Demo
Reel – YouTube; 00 -- .36
• Hypothalamus
• Peptides
• Receptors
• Biochemical Events
Video clip Addicted to Love song
Quantum Connection The Living Matrix
(Braden, 2007; p. 45)
“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
• Off icial ly change role/ t i t le
• Re-organize NL
• Home Office
Putting the Pieces TogetherResil ience
Abil ity to return to original form after being bent (bounce back)
Thriving in constant change, abil i ty to be:
• Flexible
• Creative
• Adaptable
• Learn from experiencehttp://www.resiliencycenter.com/articles/5levels.shtml
Putting the Pieces Together
Rehabil i tation (habiter – to live inside)
“Rehabil itation is the learning to l ive inside not only one’s body, however it is after an injury or i l lness, but inside one’s very being.”
(Kabat-Zinn, in Meili, 2003; p. 241)
Putt ing the Pieces Together
RecoveryCuring Focus on the i l lness/
impairment [outside]Healing Focus on the person
[inside](Crombez, October; 2003)
Be Sti l l
Putting the Pieces Together
1. What does it mean to recover?
2. What can I do to recover and return to a l i fe that includes work?
3. What can we do to facil i tate recovery and a return to work?
Keep Your Fork
Northern Lights Canada is a person-centred organization committed to providing innovative, responsive l inks to real work.
We offer 4 major divisions of service: • Vocational Rehabil itat ion 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 consort ium of experienced regional vocational rehabil i tat ion 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 Rehabil i tation Consultants Ltd.
Rehabil i tation Alternatives Limited / Vocational Alternatives Software
OPTIMA Rehabil i tation CVE Inc.
Northern Lights Canada Occupational Rehabil i tation Group of Canada (ORGOC)
Western Rehabil i tation Special ists Inc. Diversif ied Rehabil i tation Group
Genesis Rehabil i tation Ltd. Rehabil i tation Focus
For more information, please feel free to contact us at 1-800-361-4642