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What Happens When a "Behaviorist" has Dinner with a "Trauma-Informist"

 

Let me tell you, dinner with a behaviorist is an experience, a somatic experience.  Lily (name changed to protect her ;-) ) and I shared Indian food two nights ago in Keene, NH. 

As I shuffled into the restaurant ten minutes late (typical me), I rounded the corner and saw her sitting at a table for two. I beamed; I knew I was in for some rich discussion and a total "nerding out" session. 

Lily and I are former colleagues. We worked together for only a year, but it was my first year in a new school. Lily was there — someone safe whom I could confide in. She is a school psychologist by training, but a self-proclaimed hard core "behaviorist." She even holds that title in her current job. 

The year we worked together, I often burst through her door, flopped on her couch (psycho-analytic style) and proclaimed, "God damn; these kids are killing me!" I was drowning in my new role as a teen crisis counselor. Furthermore, I was working in a school that wasn't familiar with unconventional means of counseling — like mindfulness and aromatherapy.

Lily listened to me bitch — a lot — about frustrations with trying to help kids in a system that relished the status quo. One of the biggest struggles was whether or not I was allowed to "service" special education students because I wasn't a school psychologist. I was like, "who gives a crap — kids should work with who they connect with."  See...that was trauma-informed thinking before I even knew what trauma-informed was. Lily always listened to me and in those days, we worked on crafting behavior plans together. We were both supporting some of the toughest kids — kids with entrenched patterns of truancy or substance abuse or high levels of aggression. We really cared and wanted to help our kids in the form and fashion they needed. Which is why I was eager to have the conversation with Lily about how behavioral approaches ARE NOT trauma-informed and how much of what we did together did not help our kids and may have even hurt them.

As Lily begins to explain her perspective on behaviorism, I feel my insides start to tremble. I can feel my nervous system activating. I am trying really hard to pay attention to what she is saying while being mindful of my body's stress response. Lily contends that behaviorists are only concerned with "surface, observable" behaviors. They identify the function of the behavior and determine how to reshape the behavior to meet the the function in a more adaptive manner.

"We all do what we do because we have been reinforced to do it," Lily said. "If someone irritates someone to gain attention, we just have to teach him to get his need met in a more adaptive way and reinforce that positively." 

I tell Lily the story of a kid that had been ignored by a teacher (on purpose — per his behavior plan) because he was asking her questions that were off topic to the task. The teacher ignored the boy and he asked louder and louder and began shouting. She turned her body away from him to "withdraw attention further" and he began to scream and eventually struck the teacher. Lily explained that this was likely an "extinction burst." 

I was quiet. I was really listening to what she was saying.  But I was shaking inside. Of course nothing she was saying was new to me; I had a shit ton of  behavioral training in my 15 years as a counselor (I chaired PBIS in one of my first schools). What I was trying to do was reconcile the behavioral perspective with my trauma training.  THEY DON'T. They don't align. 

That kid I was describing was a special education student with a history of trauma. The teacher's effort to reshape his behavior may have triggered a body memory of neglect or abuse. Whether that is what happened or not, it doesn't matter. The teacher did not feel good doing what she was doing and neither did the kid. In some ways, trauma-informed is really simple: human beings are human. We need to treat each other humanely. When we all become robots or some product of artificial intelligence, then a behavioral approach may be appropriate. Otherwise, we need to hang it up and be human instead. 

And just so you know, Lily acknowledges the limitations of behaviorism too.  She says she thinks it's probably not an appropriate modality for most kids with a trauma history. I wish she could announce that to all our area school districts that have multiple behaviorists on staff to deal with challenging classroom behaviors. Fortunately her saying that ushered in my settling response — she regulated me. I was able to embrace her with much warmth as we departed.  I can't wait till I get her more trained in practicing from a trauma-informed paradigm. Then she can become a "behaviorist in recovery."

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Thank you, Emily.  How very right on you are!  I have had the exact kind of gut wrenching  (where is could literally feel my insides jumping) conversations with behavioralists both in the school setting and also in Team meetings with Dept. of Child Services.

Thanks for posting this, Laura. There are still people who think that skipping over what happened in your childhood to just acting differently is a better path than understanding and talking about your childhood. Once you know about ACEs science, that just doesn't make a lot of sense, as you explained so well. 

Boy, does this hit home—the part about the gulf between cognitive behaviorism and a trauma-informed approach, that is. Forgive me if my understanding of any of this is rudimentary — I’m not a clinician. And I’m not trying to start any wars .

When I was in college in the 1980s, I was diagnosed with anxiety/depressive disorder and referred to a psychologist. This was a brand new world to me, so during my first appointment, one of my first questions to the doctor was, “aren’t we going to talk about my childhood”? Now, that expectation may have been based in part on stereotypes reinforced by the entertainment industry, but in retrospect, I know that it’s because even if I couldn’t articulate it at the time and didn’t yet know the first thing about trauma or ACEs (a phrase/acronym that wouldn’t be coined until a decade later), my adverse childhood experiences were at the root of my depression/anxiety. In fact, I’d hasten to add that the depression/anxiety were symptoms of C-PTSD (which I wouldn’t get diagnosed with for 20 more, very long years) as much as they were problems themselves. But the doctor’s response to my question? He laughed and said, “We could talk about your childhood for years and never get anywhere!”

So, together we applied cognitive behavioral approaches (again, I didn’t know anything about cognitive behaviorism or any other schools of psychology until years later) to try to resolve my depression/anxiety disorder. It did help, and I improved. I was able to function much better than I had previously, with fewer panic attacks and fewer overt symptoms of depression. And I finished that year of therapy with several therapeutic tools in hand that I use to this day. But I knew something still wasn’t quite right, that I wasn’t quite well. I wasn’t depressed, exactly, but I wasn’t exactly NOT depressed, was about the best I could come up with. So I lingered in limbo for a couple more decades until someone finally “got it”.

Turns out I was right — I did need to talk about my childhood, or at least address in one way or another certain aspects of it. I don’t blame the psychologist — this was the 1980s. I wasn’t presenting with substance abuse issues or run-ins with the law or difficulties holding down a job or suicide attempts. (Then again, I did admit to “cutting”, back then still known as “self-mutilation”, and his response was to sarcastically joke about it ...) I’m not sure where the understanding of trauma/PTSD was in the 1980s, especially in regard to people who hadn’t seen combat and were not “acting out” but instead internalizing, so I don’t know if there was anyone out there at the time who would have seen my case any differently or tried any more effective treatments. And I'm sure I'm one of millions with similar stories (and luckier than many of them, since I was able to get help). I’m grateful that the understanding and awareness of trauma and ACEs are as relatively advanced as they are today, though. We’ve come along way, baby.

Last edited by Laura Pinhey
Steve Brown, Psy.D. posted:

My apologies for anything redundant I said in my post. I didn't read the stream of comments below. Steve

Definitely no redundancy...it's always great to hear things stated a little differently. Thanks!!

Emily Read Daniels posted:
Anne Katona-Linn posted:

Last comment for clarification...Emily, saying that "behavior strategies don't work" is not only incorrect...but I feel that such a bold statement has a lot of implications that you may not realize and isn't really "productive". It creates an "us" vs "them" in an already traumatic world in which we live. I'm going to quote Rodney King here..."can't we all just get along?!!" 

I am MORE than happy to discuss and problem-solve how behaviorism and other approaches can work together to create a holistic framework for addressing ACES. From all of my years dealing with my own trauma, I've learned that just ignoring the problem doesn't make it go away. In fact, it can get worse. It takes facing it and reframing it so it isn't so "scary" anymore. I know this may sound like a "Mission Impossible"...but I am here if "you choose to accept this mission". 

Hi Anne...Thank you for your reply.  I certainly DO NOT want to create "us" versus "them."  We don't need to be divided.  At the heart of who I am, I am a convener.  And I like rich discussion with varying view points. 

I also think It's important for us ALL to recognize that this movement challenges our current ways - current ways of thinking, doing, etc.  And it should.  But that isn't comfortable for any of us.  Whether you believe that my statement unfairly maligns behaviorism, it's my experience.  I think the one thing we can all agree on is that behaviorism has dominated the way in which we view and try and reshape behavior (at least in the public education realm).  We have done it;  we have implemented it;  we have tried it.  We still have LOTS and LOTS of behaviorally challenging students in public education.  How we handle that can make a big difference.  Honestly, I think this small blog exchange is just the tip of the iceberg in a much bigger cultural discussion about what we believe is the human condition and how do we support one another in the face of adversity. 

There is much we are challenged by (with the science behind ACES/trauma).  We are just beginning to have the "hard conversations."  But I welcome it...  I hope this feels like a better response for you.  XO

Emily,

Thank you...I appreciate your willingness to talk more about it! I think the key is that there is "no one size fits all" approach to ANYTHING.  Ultimately it comes down to what works...my experience is that behavior principles work but we need to allow for flexibility and make changes when something isn't working. I've had plenty of "talk-therapy" that did nothing to address my trauma. Until I identified that I needed "trauma-specific" therapy, I was spinning my wheels and very frustrated. I could say that "it didn't work"...but I won't because I received some benefit but it wasn't exactly what I needed. 

I've seen amazing things with behavior strategies through both SW-PBIS and PW-PBIS when it is done with fidelity, with coaching, support, buy-in, commitment, and love of the kids. I have seen things go bad when they are done with fidelity. You're right...this is the tip of the iceberg. 

Because behavior principles are so ingrained in education (and in the law), it's not likely to go away anytime soon. It DOES need to evolve and grow to integrate with other practices to create a more effective continuum of options for children and the teachers/staff who support them. I think it's a perfect opportunity with the momentum of the ACES/Trauma Informed Care movement right now. 

As a professional in this field, my own personal mantra is that "I don't know everything and I can ALWAYS learn from others"!! This is a great conversation and a learning opportunity for me...so I'm grateful!! 

PS. Yes, I like this last response better. I'm a convener too...so we COMPLETELY agree on one thing for sure!! Oh and that we are passionate about the kids we support!! 

Anne Katona-Linn posted:

Last comment for clarification...Emily, saying that "behavior strategies don't work" is not only incorrect...but I feel that such a bold statement has a lot of implications that you may not realize and isn't really "productive". It creates an "us" vs "them" in an already traumatic world in which we live. I'm going to quote Rodney King here..."can't we all just get along?!!" 

I am MORE than happy to discuss and problem-solve how behaviorism and other approaches can work together to create a holistic framework for addressing ACES. From all of my years dealing with my own trauma, I've learned that just ignoring the problem doesn't make it go away. In fact, it can get worse. It takes facing it and reframing it so it isn't so "scary" anymore. I know this may sound like a "Mission Impossible"...but I am here if "you choose to accept this mission". 

Hi Anne...Thank you for your reply.  I certainly DO NOT want to create "us" versus "them."  We don't need to be divided.  At the heart of who I am, I am a convener.  And I like rich discussion with varying view points. 

I also think It's important for us ALL to recognize that this movement challenges our current ways - current ways of thinking, doing, etc.  And it should.  But that isn't comfortable for any of us.  Whether you believe that my statement unfairly maligns behaviorism, it's my experience.  I think the one thing we can all agree on is that behaviorism has dominated the way in which we view and try and reshape behavior (at least in the public education realm).  We have done it;  we have implemented it;  we have tried it.  We still have LOTS and LOTS of behaviorally challenging students in public education.  How we handle that can make a big difference.  Honestly, I think this small blog exchange is just the tip of the iceberg in a much bigger cultural discussion about what we believe is the human condition and how do we support one another in the face of adversity. 

There is much we are challenged by (with the science behind ACES/trauma).  We are just beginning to have the "hard conversations."  But I welcome it...  I hope this feels like a better response for you.  XO

Great piece. I have struggled and thought much about this trying to adapt our staff trauma 101 training model Risking Connection to agencies serving the developmentally disabled. In one setting, some hard core behaviorist with authority in the setting killed the initiative resoundingly. They weren't having it. Concepts related to attachment, object constancy, countertransference that are core to our training did not go over well as you can imagine, yet there was many staff in the room that really felt receptive to this approach. I think this is a critically important divide to bridge and there are ways to do so. TIC concepts like symptoms are adaptations are actually quite easy to bridge with behaviorists -- they totally agree with the ideas that clients are doing the best they can and act in a way that is adaptive that comes from their history of reinforcements. Other concepts not so much. This work I did on this was 4 or 5 years ago. I wonder if there has been more work done on this divide recently as the TIC tidal wave spreads to many sectors including the DD universe.  I wonder what thoughts your friend would have about areas for overlap and dialogue. I'd love to hear more about her reactions and thoughts to your challenge of her. Thanks, Steve Brown, PsyD.  Traumatic Stress Institute of Klingberg Family Centers.

Last comment for clarification...Emily, saying that "behavior strategies don't work" is not only incorrect...but I feel that such a bold statement has a lot of implications that you may not realize and isn't really "productive". It creates an "us" vs "them" in an already traumatic world in which we live. I'm going to quote Rodney King here..."can't we all just get along?!!" 

I am MORE than happy to discuss and problem-solve how behaviorism and other approaches can work together to create a holistic framework for addressing ACES. From all of my years dealing with my own trauma, I've learned that just ignoring the problem doesn't make it go away. In fact, it can get worse. It takes facing it and reframing it so it isn't so "scary" anymore. I know this may sound like a "Mission Impossible"...but I am here if "you choose to accept this mission". 

Christine Cissy White posted:

Emily:
I'm glad you dared to blog because this post is fabulous and the discussion it's caused is fantastic as well! Thank you. Also, how close are you to Keene because there's a new community forming in Monadnock and someone local (ish) to you I'd love to connect you with (and her with you) if that is o.k. Cis

Hi Cis!!  Hook me up, girl!  I am a half hour from Keene...I wonder who it is.  I may very well know him/her already!  Can't wait to find out!  Maybe it's Natalie Neilson ;-)

Emily:
I'm glad you dared to blog because this post is fabulous and the discussion it's caused is fantastic as well! Thank you. Also, how close are you to Keene because there's a new community forming in Monadnock and someone local (ish) to you I'd love to connect you with (and her with you) if that is o.k. Cis

Karen Clemmer posted:

Emily I love your writings!  

As a parent of two kiddos that were in special ed with behavior plans- I can recall being in IEP meetings and asking how my child could be academically and socially (very important!) successful if he was stuck in fight/flight/freeze.  They folks around the table responded in a way that made me feel likeI might benefit from a plan!  

Fast forward 12 or so years - this week (coincidental timing!) my son and I were reflecting on his elementary school experiences and he shared how he was feeling when he would refuse to go to school or bolt from class.  He explained that at the time he was scared, didn’t know if or when he would see us again, couldn’t understand what was happening “it was like a blur - I couldn’t really focus I was just scared” and he said he didn’t understand what was expected of him in class and was so overwhelmed with all the sensory input that he needed to get away to some place that felt safe.  

BTW school refusal is NOT as simple as just bringing your kiddo to school, ideally on time!  

So this is my long-winded way of saying thank you, thank you, thank you!  

I hope all the well meaning behaviorist will someday proudly proclaim themselves to be “behaviorists in recovery”! 

In the mean time, I’ll hold onto your quote, “In some ways, trauma-informed is really simple: human beings are human. We need to treat each other humanely...”.

Thank you, Emily.  I appreciated your writing on so many levels!  I’m looking forward to reading your next insightful post!! 

Karen...I'm so sorry for your experiences. If so-called "behaviorists" aren't treating you humanely...then there is something wrong! This is not OK! They may be responding out of their OWN trauma (from bullying or peer pressure by higher-ups). As a "Board Certified Behavior Analyst"...I am BOUND to very high ethics standards. If "behaviorists" are using "extinction" (bringing your kiddo to school is an example) ALONE, or even at ALL without addressing the root cause then they are not true "behaviorists". All of these types of experiences break my heart, which is why I have also advocated for families and children so often. Thanks for your post.

Emily Read Daniels posted:
Anne Katona-Linn posted:

Emily,

I have to tell you that I laughed out loud when I saw the title of this in my e-mail!! THANK YOU SO MUCH for posting this discussion!!! Truly, it is something we need to talk about so all of those people traumatized by "behaviorists" can support each other and learn. (I am NOT being sarcastic!)

I have a confession...I'm a Board Certified Behavior Analyst, Special Education Teacher, and an Educational Psychologist. Not only that, I am a complex trauma THRIVER!! But WAIT...I'm currently a grant director helping to put mental health supports in schools using the School-wide PBIS framework...yadda, yadda, yadda!

With all that said, I respectfully disagree that the Trauma-Informed Care and Behavior Principles cannot be aligned or reconciled. In fact, I would argue that they help to strengthen each other. I see being "trauma-informed" as a critical piece of more successfully implementing positive behavior supports through a "trauma lens". The PBIS "framework" in particular gives the ADULTS the tools to help support the children in more effective and caring ways. 

I think the first thing is to actually address the definition of a "behaviorist". Many people have a limited scope of "behavior principles" being about rats, m&m's, planned ignoring, tokens, etc. Yes, they are often associated with "behavior management" but it does not really give the whole picture. It would be the same as me saying that a social worker is someone who gives families in need clothes or food. They DO, but that is one VERY small role that a social worker plays.

There are SO many ways in which TIC and Behavior principles are compatible: Applied Behavior Analysis (I'm sure you already know this but for the sake of the rest of the people) involves completing an assessment (gathering data or "information") to determine the function (the "why" or the "what happened to you") of a behavior, identifying antecedents ("trauma triggers") and consequences of this behavior (what do I get out of or get from the behavior...likely escape "trauma triggers" or get access to "safety"), and utilizing data to test and frequently retest hypotheses to help understand why individuals are doing what they do and improve their care in a socially significant way. This is VERY simplified, but it is the core of a LOT of behavior strategies.

When we apply this process to focus on supporting the adults and teaching them skills to be more proactive and not just "changing the child", they are more likely to be successful. If the adults feel "safe" by having more structure and feeling more competent, then they can more effectively support children who have been through trauma. I actually became a behavior analyst so I could understand my own trauma and the behaviors I've had over the years from not being treated for PTSD.

After 17 years of research, self-reflection, counseling (talk-therapy mostly and CBT), learning self-management/regulation skills, education (informal and formal), etc...the treatment that has been the most successful in my experience was EMDR. My counselor first "collected data" to identify the specifics of my trauma history in great detail. I had to identify the situation (people, places, things that trigger my response), my physical symptoms and mental self-talk as part of the "response"("Private behavior" which are thoughts, feelings, bodily reactions, etc.) so I can bring them to focus in order to "observe" them more objectively. These are all principles of applied behavior analysis.

"Behavior" strategies are like any other "tool" that we have...in the wrong hands, they can be dangerous and even deadly! This is why my mission in life is to understand my own experiences of both trauma and human behavior and use them for "good" and not for "evil". I hope this sheds some light on how both trauma-informed care and behaviorism can co-exist...and even get married to create a safe, positive, proactive, and supportive environment in our communities!! (mic drop) lol

PS. Disclaimer-I have seen PLENTY of "bad" Behavior Analysts and they do NOT represent ALL of us!! 

Hi Anne, Thank you so much for your lengthy and thoughtful response.  Although you articulate your position beautifully, I respectfully still disagree.  I am keenly aware of PBIS - having championed it in two of my previous schools.  I have extensive training in RENEW and functioned as a RENEW facilitator for four years. I literally built the system of RTI for behavioral interventions - and provided universal supports in all the schools I have worked in.  I lived in realm of "behaviorism" as the primary modality of social/emotional intervention.  Here's why I am in recovery from it: 

- first, it's artificial.  It's applying a linear, mechanistic model to human behavior which has complexity that isn't even fully captured in language.

- second, labeling the function of behavior in a behaviorist perspective is narrowly defined (i.e. to get attention, to avoid a task, to exert power/control, etc).  This titrated view of behavior assumes the person has some semblance of conscious control over his/her stress reaction - while it is happening.  

- third, the mechanistic manner of the behaviorist approach erodes the human context of connection.  We are biologically hardwired to connect - it's about physical proximity, tone of voice, gesture, prosody of speech, energy in the body, etc. When you are studying stimulus and response instead of resonance of another, you are no longer engaging in relationship.  You are engaging in research.  When you are looking to reshape a child's behavior because you deem it inappropriate, you aren't considering that the child may need that stress reaction to survive in another setting.  Furthermore, you aren't really considering the child - wholeheartedly.  

- Lastly, it doesn't work (can I get an "amen"?)  And even when it does, the behaviorist doesn't consider at what cost.  A disassociative state is a form of coping that looks a lot like compliance to many behaviorists.   

I would never say that all behavior is acceptable and should be tolerated.  But I have spent my whole adult life supporting challenging children.  The children that grew the most in their capacity for self regulation did so because I set healthy boundaries with them, meditated with them, "Reiki d" them, sang with them, listened to them, walked with them, played basketball with them, hiked with them...basically loved the hell out of them.  That's what kids need.  

Sorry for the quote within a quote...I appreciate your response. I completely understand where you are coming from and can appreciate your opinion. I also know that teachers as a "whole" (in general, though I don't like to generalize) do not get the training and background on mental health, trauma, etc. even though it is such a huge influence on their work. There are big gaping disconnects between the education field and the mental health field in schools. I see behavior strategies in the area of supporting teachers (ie. data collection, using data to make decisions, progress monitoring, etc.) as a way to bridge the gap between education and mental health best practices. 

In my experience, I don't see an "either/or" between behaviorism and other modalities. It does sound like many of your experiences have been with behaviorists who are "purists" in that they don't SEE how they could be connected. All of the things that you mentioned...setting healthy boundaries, singing with children, walking with them, etc. could all "behavior strategies" as you are pairing yourself with reinforcement, modeling behavior, building rapport, etc. by "loving the hell out of them"!! I LOVE that by the way!

As part of a functional behavior assessment, we SHOULD be looking at the WHOLE child including MH, trauma history, family dynamics, etc. If we are NOT, then we are doing a disservice to the children we work with and their families. I think the Social Learning Theory is more of how current (and more "enlightened" lol) behaviorists function (I know...not ALL, but SOME).

It saddens me when people have so many bad experiences with "behaviorists" because I know so many of us who are NOT that bad stereotype and we HAVE changed kids' lives for the better...not just "changed behavior". I'm hoping that I can help change peoples' perceptions of "those people". 

Love it!  Once we understand...it does seem so simple doesn't it?  People who attend our training's say, "we now just live a trauma informed life."  We are grateful to encounter open minds in our educational systems locally.  Recently the Associate Chair from the university's College of Education attended one of our SAMHSA Trauma Informed Approach training's.  Within 24 hours she contacted us asking to help her train 175 education students this spring before they do their student teaching as well as to set training in place for their department to train every education student in the future.  We were overjoyed.  I read somewhere early on in this work that a group presented ACE's science to elected officials who didn't take them very seriously...so instead the presenters went out and created a "movement."  I'm so glad to be part of it

Connie Orr posted:

Emily,

As a "behaviorist in recovery," I can say that trauma informed approaches and "behavior approaches" do NOT go together.  As a behaviorist, I trained rats to run in a wheel and monkeys to play video games.  Fast forward to post-grad school, where my job was to "train" individuals with intellectual disabilities to have "good behavior."  I immediately saw the problem with this - human beings are not rats or monkeys.  They deserve more than a functional behavior assessment that is limited to the four basic "functions" of behavior.  People with intellectual/developmental disabilities have a very high rate of abuse, and to subject them to a "behavior management plan" is adding more trauma.  Finding out what happened to them (and we often assume trauma when people can't tell us) and finding strategies to help regulate their nervous systems is far more effective than star charts and token economies.  Finding connection, healing the soul, and providing compassionate care is far more effective.  My team and I sometimes fight an uphill battle, but it's one worth fighting.

I look forward to enjoying more of your writing.

Connie...you're my new "BFF."  Lol...kidding, but yes, thank you for sharing...preach!!!

 

Emily,

As a "behaviorist in recovery," I can say that trauma informed approaches and "behavior approaches" do NOT go together.  As a behaviorist, I trained rats to run in a wheel and monkeys to play video games.  Fast forward to post-grad school, where my job was to "train" individuals with intellectual disabilities to have "good behavior."  I immediately saw the problem with this - human beings are not rats or monkeys.  They deserve more than a functional behavior assessment that is limited to the four basic "functions" of behavior.  People with intellectual/developmental disabilities have a very high rate of abuse, and to subject them to a "behavior management plan" is adding more trauma.  Finding out what happened to them (and we often assume trauma when people can't tell us) and finding strategies to help regulate their nervous systems is far more effective than star charts and token economies.  Finding connection, healing the soul, and providing compassionate care is far more effective.  My team and I sometimes fight an uphill battle, but it's one worth fighting.

I look forward to enjoying more of your writing.

Karen Clemmer posted:

Emily I love your writings!  

As a parent of two kiddos that were in special ed with behavior plans- I can recall being in IEP meetings and asking how my child could be academically and socially (very important!) successful if he was stuck in fight/flight/freeze.  They folks around the table responded in a way that made me feel likeI might benefit from a plan!  

Fast forward 12 or so years - this week (coincidental timing!) my son and I were reflecting on his elementary school experiences and he shared how he was feeling when he would refuse to go to school or bolt from class.  He explained that at the time he was scared, didn’t know if or when he would see us again, couldn’t understand what was happening “it was like a blur - I couldn’t really focus I was just scared” and he said he didn’t understand what was expected of him in class and was so overwhelmed with all the sensory input that he needed to get away to some place that felt safe.  

BTW school refusal is NOT as simple as just bringing your kiddo to school, ideally on time!  

So this is my long-winded way of saying thank you, thank you, thank you!  

I hope all the well meaning behaviorist will someday proudly proclaim themselves to be “behaviorists in recovery”! 

In the mean time, I’ll hold onto your quote, “In some ways, trauma-informed is really simple: human beings are human. We need to treat each other humanely...”.

Thank you, Emily.  I appreciated your writing on so many levels!  I’m looking forward to reading your next insightful post!! 

Thank you, Karen, for your kind words.  They literally just made my week!  I must admit that before launching my business, I never blogged. 

Believe it or not, most of my opinions I want to keep private - because I fear sharing them may create a chasm between myself and someone I want to be in relationship with.  But in this movement, there is just too much still left unsaid and it's hurting us - our culture, our children, ourselves.  If behaviorism and prescriptions worked, we would be the most "well adjusted" society on the face of the planet.  But we're not...and we have to consider that may be what we are doing or were doing is actually damaging.  I say that as part of the guilty party.  

Again, thank you for sharing your experience and your kind words.  It's already lifted my spirits at 6:47am.  

Emily I love your writings!  

As a parent of two kiddos that were in special ed with behavior plans- I can recall being in IEP meetings and asking how my child could be academically and socially (very important!) successful if he was stuck in fight/flight/freeze.  They folks around the table responded in a way that made me feel likeI might benefit from a plan!  

Fast forward 12 or so years - this week (coincidental timing!) my son and I were reflecting on his elementary school experiences and he shared how he was feeling when he would refuse to go to school or bolt from class.  He explained that at the time he was scared, didn’t know if or when he would see us again, couldn’t understand what was happening “it was like a blur - I couldn’t really focus I was just scared” and he said he didn’t understand what was expected of him in class and was so overwhelmed with all the sensory input that he needed to get away to some place that felt safe.  

BTW school refusal is NOT as simple as just bringing your kiddo to school, ideally on time!  

So this is my long-winded way of saying thank you, thank you, thank you!  

I hope all the well meaning behaviorist will someday proudly proclaim themselves to be “behaviorists in recovery”! 

In the mean time, I’ll hold onto your quote, “In some ways, trauma-informed is really simple: human beings are human. We need to treat each other humanely...”.

Thank you, Emily.  I appreciated your writing on so many levels!  I’m looking forward to reading your next insightful post!! 

Anne Katona-Linn posted:

Emily,

I have to tell you that I laughed out loud when I saw the title of this in my e-mail!! THANK YOU SO MUCH for posting this discussion!!! Truly, it is something we need to talk about so all of those people traumatized by "behaviorists" can support each other and learn. (I am NOT being sarcastic!)

I have a confession...I'm a Board Certified Behavior Analyst, Special Education Teacher, and an Educational Psychologist. Not only that, I am a complex trauma THRIVER!! But WAIT...I'm currently a grant director helping to put mental health supports in schools using the School-wide PBIS framework...yadda, yadda, yadda!

With all that said, I respectfully disagree that the Trauma-Informed Care and Behavior Principles cannot be aligned or reconciled. In fact, I would argue that they help to strengthen each other. I see being "trauma-informed" as a critical piece of more successfully implementing positive behavior supports through a "trauma lens". The PBIS "framework" in particular gives the ADULTS the tools to help support the children in more effective and caring ways. 

I think the first thing is to actually address the definition of a "behaviorist". Many people have a limited scope of "behavior principles" being about rats, m&m's, planned ignoring, tokens, etc. Yes, they are often associated with "behavior management" but it does not really give the whole picture. It would be the same as me saying that a social worker is someone who gives families in need clothes or food. They DO, but that is one VERY small role that a social worker plays.

There are SO many ways in which TIC and Behavior principles are compatible: Applied Behavior Analysis (I'm sure you already know this but for the sake of the rest of the people) involves completing an assessment (gathering data or "information") to determine the function (the "why" or the "what happened to you") of a behavior, identifying antecedents ("trauma triggers") and consequences of this behavior (what do I get out of or get from the behavior...likely escape "trauma triggers" or get access to "safety"), and utilizing data to test and frequently retest hypotheses to help understand why individuals are doing what they do and improve their care in a socially significant way. This is VERY simplified, but it is the core of a LOT of behavior strategies.

When we apply this process to focus on supporting the adults and teaching them skills to be more proactive and not just "changing the child", they are more likely to be successful. If the adults feel "safe" by having more structure and feeling more competent, then they can more effectively support children who have been through trauma. I actually became a behavior analyst so I could understand my own trauma and the behaviors I've had over the years from not being treated for PTSD.

After 17 years of research, self-reflection, counseling (talk-therapy mostly and CBT), learning self-management/regulation skills, education (informal and formal), etc...the treatment that has been the most successful in my experience was EMDR. My counselor first "collected data" to identify the specifics of my trauma history in great detail. I had to identify the situation (people, places, things that trigger my response), my physical symptoms and mental self-talk as part of the "response"("Private behavior" which are thoughts, feelings, bodily reactions, etc.) so I can bring them to focus in order to "observe" them more objectively. These are all principles of applied behavior analysis.

"Behavior" strategies are like any other "tool" that we have...in the wrong hands, they can be dangerous and even deadly! This is why my mission in life is to understand my own experiences of both trauma and human behavior and use them for "good" and not for "evil". I hope this sheds some light on how both trauma-informed care and behaviorism can co-exist...and even get married to create a safe, positive, proactive, and supportive environment in our communities!! (mic drop) lol

PS. Disclaimer-I have seen PLENTY of "bad" Behavior Analysts and they do NOT represent ALL of us!! 

Hi Anne, Thank you so much for your lengthy and thoughtful response.  Although you articulate your position beautifully, I respectfully still disagree.  I am keenly aware of PBIS - having championed it in two of my previous schools.  I have extensive training in RENEW and functioned as a RENEW facilitator for four years. I literally built the system of RTI for behavioral interventions - and provided universal supports in all the schools I have worked in.  I lived in realm of "behaviorism" as the primary modality of social/emotional intervention.  Here's why I am in recovery from it: 

- first, it's artificial.  It's applying a linear, mechanistic model to human behavior which has complexity that isn't even fully captured in language.

- second, labeling the function of behavior in a behaviorist perspective is narrowly defined (i.e. to get attention, to avoid a task, to exert power/control, etc).  This titrated view of behavior assumes the person has some semblance of conscious control over his/her stress reaction - while it is happening.  

- third, the mechanistic manner of the behaviorist approach erodes the human context of connection.  We are biologically hardwired to connect - it's about physical proximity, tone of voice, gesture, prosody of speech, energy in the body, etc. When you are studying stimulus and response instead of resonance of another, you are no longer engaging in relationship.  You are engaging in research.  When you are looking to reshape a child's behavior because you deem it inappropriate, you aren't considering that the child may need that stress reaction to survive in another setting.  Furthermore, you aren't really considering the child - wholeheartedly.  

- Lastly, it doesn't work (can I get an "amen"?)  And even when it does, the behaviorist doesn't consider at what cost.  A disassociative state is a form of coping that looks a lot like compliance to many behaviorists.   

I would never say that all behavior is acceptable and should be tolerated.  But I have spent my whole adult life supporting challenging children.  The children that grew the most in their capacity for self regulation did so because I set healthy boundaries with them, meditated with them, "Reiki d" them, sang with them, listened to them, walked with them, played basketball with them, hiked with them...basically loved the hell out of them.  That's what kids need.  

Emily,

I have to tell you that I laughed out loud when I saw the title of this in my e-mail!! THANK YOU SO MUCH for posting this discussion!!! Truly, it is something we need to talk about so all of those people traumatized by "behaviorists" can support each other and learn. (I am NOT being sarcastic!)

I have a confession...I'm a Board Certified Behavior Analyst, Special Education Teacher, and an Educational Psychologist. Not only that, I am a complex trauma THRIVER!! But WAIT...I'm currently a grant director helping to put mental health supports in schools using the School-wide PBIS framework...yadda, yadda, yadda!

With all that said, I respectfully disagree that the Trauma-Informed Care and Behavior Principles cannot be aligned or reconciled. In fact, I would argue that they help to strengthen each other. I see being "trauma-informed" as a critical piece of more successfully implementing positive behavior supports through a "trauma lens". The PBIS "framework" in particular gives the ADULTS the tools to help support the children in more effective and caring ways. 

I think the first thing is to actually address the definition of a "behaviorist". Many people have a limited scope of "behavior principles" being about rats, m&m's, planned ignoring, tokens, etc. Yes, they are often associated with "behavior management" but it does not really give the whole picture. It would be the same as me saying that a social worker is someone who gives families in need clothes or food. They DO, but that is one VERY small role that a social worker plays.

There are SO many ways in which TIC and Behavior principles are compatible: Applied Behavior Analysis (I'm sure you already know this but for the sake of the rest of the people) involves completing an assessment (gathering data or "information") to determine the function (the "why" or the "what happened to you") of a behavior, identifying antecedents ("trauma triggers") and consequences of this behavior (what do I get out of or get from the behavior...likely escape "trauma triggers" or get access to "safety"), and utilizing data to test and frequently retest hypotheses to help understand why individuals are doing what they do and improve their care in a socially significant way. This is VERY simplified, but it is the core of a LOT of behavior strategies.

When we apply this process to focus on supporting the adults and teaching them skills to be more proactive and not just "changing the child", they are more likely to be successful. If the adults feel "safe" by having more structure and feeling more competent, then they can more effectively support children who have been through trauma. I actually became a behavior analyst so I could understand my own trauma and the behaviors I've had over the years from not being treated for PTSD.

After 17 years of research, self-reflection, counseling (talk-therapy mostly and CBT), learning self-management/regulation skills, education (informal and formal), etc...the treatment that has been the most successful in my experience was EMDR. My counselor first "collected data" to identify the specifics of my trauma history in great detail. I had to identify the situation (people, places, things that trigger my response), my physical symptoms and mental self-talk as part of the "response"("Private behavior" which are thoughts, feelings, bodily reactions, etc.) so I can bring them to focus in order to "observe" them more objectively. These are all principles of applied behavior analysis.

"Behavior" strategies are like any other "tool" that we have...in the wrong hands, they can be dangerous and even deadly! This is why my mission in life is to understand my own experiences of both trauma and human behavior and use them for "good" and not for "evil". I hope this sheds some light on how both trauma-informed care and behaviorism can co-exist...and even get married to create a safe, positive, proactive, and supportive environment in our communities!! (mic drop) lol

PS. Disclaimer-I have seen PLENTY of "bad" Behavior Analysts and they do NOT represent ALL of us!! 

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