Trysh Huntington, MA, LMFT, a therapist at SUWS Carolinas Therapeutic Wilderness Program, delivered her presentation, entitled Teens and Trauma, at the National Association of Therapeutic Schools and Programs (NATSAP), held in Asheville, North Carolina in October 2014.

Trauma, Huntington informed, refers to a deeply distressing or disturbing experience after which emotional and/or physical shock follows. According to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), trauma would include direct exposure to death, threatened death, actual or threatened serious injury or actual or threatened sexual violence. Exposure might be directly experienced or witnessed. Exposure can involve indirectly learning of another's trauma or undergoing repeated or extreme indirect exposure to aversive details of an event.

Since trauma has been coined as "a normal response to an abnormal situation", Huntington proffered that trauma begins as a biological response to an abnormal event. Utilizing the work of Dr. Peter Levine, Huntington demonstrated the effects of trauma on the mind and body by way of a slinky toy. Without significant stress, an individual, metaphorically the slinky, is loose and malleable, yet keeps its integrated form. When one perceives threat, there is an increase in energy that mobilizes to prepare for fight or flight. At this point, the slinky would look stretched. When overwhelmed, one becomes incapacitated and very frightened. The slinky would look bound up, without capability for stretching at all. At this point, it takes an enormous amount of strength to hold all that energy in the body, contributing to painful emotional and physical symptoms. If this energy is released all at once (and the slinky is stretched and tangled), such as when trauma is triggered, that physical and emotional energy becomes unmanageable and chaotic, perhaps causing harm to self or others. In healing from trauma, Levine suggests that sensory experiences be brought together in a coherent way while still discharging this energy slowly.

Huntington has been working with adolescents since 1992. In her work, she has noted a host of traumatic events that teens may encounter. These include bullying and cyber bullying, child abuse and neglect, rape and date rape, gang violence, violence in the home, witnessing domestic violence, divorce, having a parent with mental illness or substance issues and natural disaster. With this in mind, she took the audience through the biological responses to these abnormal events using Dr. Paul MacLean's model of the Triune Brain, in which the brain is actually viewed as being three brains in one, each of which evolved in response to an evolutionary need.

Foremost, the Reptilian Brain lies at the brain stem. Its role is survival and maintenance of the body. It controls primal bodily functions such as sleep, appetite and procreation, and it executes the fight/fight/freeze response to stress. In response to the development of emotions, the Limbic Brain evolved, allowing for the association of events with emotions. The Limbic Brain allows decisions to be made based on the reptilian brain's responses. Ultimately, traumatic memories may be stored in the Limbic Brain. Lastly, the Neo-Cortex Brain, the largest part of the brain, allows for higher levels of thinking, and it houses language ability and decision making processes. One portion of the Neo-Cortex Brain allows for the processing of sensory information. All three brains interact and ongoing communication between the three links thinking, memory and emotions which are integral to one's personality development.

With respect to a traumatic event, danger is sensed by the Reptilian Brain which sends a message to the Limbic Brain for response. As a response to the sensory input from a trauma, adrenaline is released into the body. While adrenaline may improve memory function, it shrinks the Limbic System to that information is blocked from reaching the Neo-Cortex Brain. Therefore, only more primitive responses (fight, flight or freeze) to dealing with trauma, as a result of the Reptilian Brain coming to the forefront of decision making, are available rather than higher level coping skills, and traumatic memories become stuck in the Limbic Brain. When the Reptilian Brain prepares the body to respond to threat, the sympathetic nervous system prepares the body for action. There is an increase in breathe and heart rate, sweating, the release of stress hormones, and a decrease in digestion and saliva. The Reptilian response, then, is to discharge the energy built up from the threat and give it an outlet; either fight or flee. Freezing, as in the case of the slinky, does not dispense the energy and can even lead to more significant symptoms, making it more challenging to resolve them. While this response may promote survival and serve as a distraction to a predator, unless there is resolve, the Reptilian Brain may adopt maladaptive behavior in response to its basic functioning. Sleep may turn to insomnia, feeding may turn into an eating disorder, procreativity may turn into promiscuity. Other physical symptoms of repressed trauma might include nightmares, startle responses, aches and pains, muscle tension, fatigue and poor concentration. Emotional symptoms might include shock, disbelief, shame and self-blame, depression, helplessness, hopelessness, confusion, fear, withdrawal from others and dissociation or feeling numb.

In closing, Huntington discussed several therapeutic strategies that she has found very beneficial in her work with adolescents. Of utmost importance is that the therapist assists in the process of grief by holding a space for healing and creating a safe place for feelings to be expressed and explored. Believe that the individual is resilient, and like the slinky, has the capacity to recover from having "spaghetti brain" to a place where the Triune Brain functions more adaptively.

Huntington pointed out that while the stages of grief (Elisabeth Kubler-Ross) include denial, anger, bargaining, sadness and acceptance, one does not necessarily move through them in that order, which contributes to feelings of confusion and loss of control. Huntington is also a proponent of using artwork as a strategy to uncover and release emotions, or in the words of Levine, discharge bound energy slowly in a coherent framework. For example, the use of Mandalas and Masks are an integral part of Huntington's work. Mandalas are symbols drawn in a circular frame to promote a shift of one's attention from external preoccupation and concerns to internal experiences, discovering where energy is blocked or where one is stuck. Masks are used as a metaphor for the persona one reveals or conceals from the world. Journaling is another modality for one to tell their story. Once feelings are addressed, this allows room for the development of coping strategies to develop so that an individual can respond effectively to stress despite feeling afraid.

Trysh Huntington began her career working with adolescents at the North Carolina Outward Bound School (NCOBS) and Hurricane Island Outward Bound School (HIOBS). She began as a NCOBS student, moving to the roles of field instructor and then course director at the Table Rock, Cedar Rock and Everglades locations for NCOBS. She then became the program director at the HIOBS STEP program for adjudicated youth in Florida, in which capacity she worked for 6 years. She continues to do consulting for these schools. After completing her master's degree, she worked in the community mental health field as an Intensive In-Home team lead prior to working with adolescent girls for SUWS of the Carolinas where she has been for four years.

Trysh Huntington, MA, LMFT, is a therapist at SUWS Carolinas Therapeutic Wilderness Program. For more information, contact Roslyn Walker, MA, LPA, Marketing Director and Clinical Outreach Services.

About the Author: Roslyn Walker is currently the Director of Marketing and Clinical Outreach Services for SUWS of the Carolinas, a therapeutic wilderness program in Old Fort, NC. In this capacity she is able to bring her clinical background and experience as a business owner to promote education about the various principles and therapeutic interventions that guide SUWS’ interactions with its students.

Roslyn received her Bachelor of Arts degree in Psychology at Wake Forest University, and her Masters of Arts degree in Clinical Psychology at East Carolina University. As a Licensed Psychological Associate in the state of NC, she has worked as a psychologist in several settings including the NC Department of Corrections, community mental health centers and NC school systems. In 2006, she founded Piedmont Performance Evaluations, PLLC, a psychological assessment business in Charlotte, NC, and she continues to be the clinical director for this company.

After realizing her dream of moving to western North Carolina in March, 2014, Roslyn began working for SUWS. She and her husband enjoy hiking, biking and skiing. Their two English Golden Retrievers are never far behind.
For additional information, contact Roslyn Walker at 828-668-7590 ext. 243 rwalker@suwscarolinas.com, www.suwscarolinas.com