Vajra Blue

Mindfulness and Compassion. Understanding trauma in young people.


Trauma Informed Care: Changing the culture to help the client.


Some years ago a professor of oriental religion went to see a Zen master. “Please teach me about Zen,” he said. The Zen master was busy making tea, and when all was ready he started to pour the clear, steaming, green liquid into the professor’s cup. He poured til the cup was full, and then went on pouring, and the tea went all over the table, and onto the floor. “Stop!” said the professor, “The cup is full and there is no room for more tea.” “My precise point, ” said the master, “How can I teach you anything new when your head is already full.”

Zen story.

In the same way that different societies have their own ways of doing things, the habits and practices that make up the unique culture of that society, organisations also develop their own individual ways of coping with the work that they undertake. They too have their cultures, some of which are helpful to clients, some are neutral, while yet others are actually unhelpful.

All cultures are based on one simple idea, the idea that this is how we do things around here. Sometimes the mental models that a service holds at the centre of its treatment approach, and which underpin its entire philosophy of therapy, seem to work against the best interests of the group it was set up to help.

This may happen because the latest research has moved the story on, and the changed paradigm that has resulted has yet to trickle down, or sometimes such a state arises due to the aberrant beliefs, or long term practices of one or more charismatic staff, often seen as representing the culture holders of the organisation.  Many of the worst abuses in social care homes seem to have resulted from this kind of situation.

Trauma Informed Care is one of these newer paradigms.  A positive model that is being seen as a useful guide to inform the provision of services for those who have suffered developmental, attachment, or other complex traumas during their development. Such traumatic experiences interfere with the victims’ ability to regulate their emotions and automatic behavious, to form secure, reciprocal relationships and to think effectively when under stress.  This represents a group of people who have very well-developed fight or flight responses, that have arisen through living in physically, or emotionally dangerous environments, at crucial stages of their development.  People whose survival mechanisms continue to work too well.

When abuse occurs, the result is often hyperaroused people who show dramatic responses to what appear to the rest of us to be insignificant events.  Neglect, on the other hand, can produce underaroused people who are less emotionally responsive than might otherwise have been expected. In either situation they show reactions to events that lie outside the norm for most people, and they can subsequently be seen as either uncaring or over-emotional, manipulative and attention seeking.  They attract diagnostic labels such as Borderline or Antisocial Personality Disorder, which can all too easily becomes  pejorative labels that prevent access to care, and not ones that should facilitate their help seeking behaviours.

One of the main problems for services and those who work in them is that, to some extent, they have to go through the same processes as their clients when they attempt to change how they work.  Unlearning their current behaviours and the belief systems that underlie them, and then to replace them with new, more helpful way of understanding their clients’ difficulties.  Like our clients the services have to learn to use this new vision to develop new ways of living  in an altered world, ways that free them up and not ones that tie them down. We have first, to imagine that things can be different if we are to be able to work towards a more fruitful future.

For unlearning to occur, a participatory process is needed that enables a group to decide what is important to remember and what it is safe to forget. Sandra L Bloom

One of the key things here is to help the process of unlearning move forward.  Giving up the hard-won knowledge (often over many years) about ourselves and our world, and then being able to start to challenge this world view and to replace it with something new, something fresh, something more helpful.

Moving away from a  damage model to one based on the concept of the trauma organised brain, introduces a more fluid set of possibilities into the treatment interaction.  We can move from the idea of “fixing” something, to the concept of using the construct of neuroplasticity to bring about a lasting transformation for our clients in a collaborative partnership.  A process that requires us to develop new ways of thinking about and applying our hard-won skills to an altered therapeutic environment.

 A recovery model demands that we reassess our assumptions about how we choose to define success.

We may be doing the same thing but thinking about it differently.  No longer seeing ourselves as people who cure, but instead as facilitators, allowing the client to develop their own path to recovery within the therapeutic setting. A recovery model demands that we reassess our assumptions about what defines success.

There are advantages for both the client and the organisation in going through this process of thinking aobut how to change the way that we work together. The client comes up against a service that is more flexible, and better able to adjust to the changing nature of their presentation, often ins way that allow the right intervention to be offered to the client almost before it is needed. Services in their turn develop staff that are able to manage their client’s strong emotions more effectively, and without developing burning out to the same extent.

Trauma Informed Care also exposes us to the possibility of learning from vicarious resilience, the chance to witness, and then to learn from our client’s increased ability to bounce back from the vagaries of life in the twenty first century, as we help those in great distress to cope better with whatever life throws at them, and to live increasingly fulfilling and enjoyable lives.



If you are interested in these concepts I would be glad to hear your views and to read your comments.

I would also recommend the work of Sandra L Bloom and Brian Farragher, summarised in their trilogy of books on the Sanctuary Model.

Creating Sanctuary.

Destroying Sanctuary.

Restoring Sanctuary.


All published by Oxford University Press


Trauma Informed Care: Dissociation for beginners.

ssafe place

We use the terms trauma, crisis, major stressor and related terms as essentially synonymous expressions to describe circumstances that significantly challenge or invalidate important components of the individual’s assumptive world.

Calhoun and Tedeschi: The Foundations of Post Traumatic Growth


Dissociation is a symptom this commonly seen when a complex trauma pattern of brain functioning is present. It indicates an altered state of awareness.  The narrowed field of consciousness that is present is often accompanied by amnesia.

Repression, on the other hand, occurs in a normal state of consciousness.  This involves an active process of pushing memories, thoughts and emotions out of conscious awareness.

When our social environment is good enough during the period when we are developing, and growing up, then we are able to rapidly, and fluidly, change between the various emotional states that are needed if we are to respond appropriately to ever-changing environmental triggers.

When this developmental environment has not been good enough, we can become overwhelmed by the constant change in our emotional state and a protective state of dissociation can become a part of our emotional repertoire.  Continue reading

Mindfulness: guarding the gates to our senses.


In 122 CE, Hadrian, the Roman emperor, drew a line in the sand, and set limits to the size of the Roman Empire.

This step was necessary as the Empire had become increasingly unwieldy to administer. Instead of throwing even more money, and yet more troops at the problem, as many suggested, Hadrian determined on a different solution.

Boundaries were marked around the Empire, and although the walls and defensive works that he ordered to be built, did serve a military purpose, the main idea seems to have been to control what came in, and what went out of the Empire.

For many of us, deciding what we allow into our inner world is a major problem.

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Mental health: taking a BET on treatment.

Mental health has become a major concern of the modern world.

There are rising levels of depression.

Ever increasing numbers of work hours are lost to stress and related disorders.

There seems to be an epidemic of suicide and self harm among the young.

Current treatment regimens seem to rely too much on medication, often as the only intervention, and fail to address the holistic picture.

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Depression: the effects of mindfulness.


Your mind is not a cage.
It is a garden.
And it needs cultivating.
Libba Bray

The incidence of depression is rising rapidly, at least in the western world.  It has been described as the common cold of psychiatry and psychology.

Depression is a common disorder, but this does not make it either inevitable, or an acceptable part of modern life.  The lifetime incidence of depression continues to show a steady rise, with each succeeding generation having a greater risk.  For people born before the First World War, the lifetime risk was about 3%, for Americans currently in their midtwenties, current estimates put their lifetime risk to be approaching 25%. This rapid increase shows little sign of slowing down.

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Attention and focus: the complications of trying to stay alive


Challenge is the pathway to engagement and progress in our lives. But not all challenges are created equal. Some challenges make us feel alive, engaged, connected, and fulfilled. Others simply overwhelm us. Knowing the difference as you set bigger and bolder challenges for yourself is critical to your sanity, success, and satisfaction.
Brendon Burchard

Staying alive has always been the greatest challenge for any creature. All species have developed systems to detect danger and potential threats. One of the most effective of these, is the appropriately named “fight or flight response”.  This prepares us to do exactly that, fight or run for our lives.

We detect threat by analysing the incoming data from our environment, both from the external world, and from our inner world of thought, emotion, and knowledge. Our conscious brain can only manage a tiny percentage of the information that we receive from our senses, the rest is processed at an unconscious level.

Our focus is constantly drawn to the events in the world around us. However, the systems that we use to assess threat are designed for a different world. A world in which we were prey animals and not the top predator on the planet.  They are certainly not designed for life in a modern, technological, stimulus rich world, and not for a self-aware creature, whose own thoughts and emotions can be mistaken for a threat. Is that tiny spider really a danger to life?

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Suicide: Taking up arms against a sea of troubles…..

The game of life is hard to play
I’m gonna lose it anyway
The losing card of some delay
So this is all I have to say
Suicide is painless
It brings on many changes
I can take it or leave it if I please
And you can do the same thing if you please.

The theme from MASH

As a teenager I loved the programme MASH.

The adventures of the staff of a mobile army surgical hospital in the Korean War.

I particularly liked the theme tune and used to hum and sing it to myself. 

One day my mother heard me singing the words of the chorus, and became angry with me. It wasn’t for several years afterwards that I fully understood why.

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