Trauma-Informed Care for People with Intellectual Disabilities 
February 12, 2019 
1:30 p.m. EST 


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>> ASHLEY BROMPTON: Good afternoon, everyone. Thank you for joining us 
our webinar today. My name is Ashley Brompton with the Center for Victimization and 
Safety at the Vera Institute of Justice. I would like to welcome you to today's webinar 
where we will be discussing trauma in the lives of people with intellectual and 
developmental disabilities. We are pleased to bring you this webinar as part of our 
2019 End Abuse of People with Disabilities webinar series. We have just a few quick 
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PowerPoint and transcript and ending survey will be emailed to all participants following 
the webinar. This will be published with a link. Our presenter today is Karyn Harvey. 
Karyn Harvey has worked as a clinician in the field of intellectual difficulties for over 30 
years. She has a Ph.D. in applied developmental psychology from the University of 
Maryland. She has published articles about therapeutic interventions with individual 
with intellectual and developmental disabilities, workbooks for individuals with I/DD and 
two books. Her first book positive identity development was published in 1999 and 
trauma informed interventions was published in 2011. She is currently consulting with 
the developmental disabilities department of Connecticut and Maryland. She is in 
addition director of program development and training for the park Avenue group 
practice. She regularly conducts trainings for state level and individual agencies on 


trauma informed care and positive identity development throughout country. In 2016 he 
she received the Earl Lotion award from NADD for excellence in clinical practice. Shaw, 
Karen, for being with us today and I am now turn the presentation over to you. 

>> KARYN HARVEY: Thank you so much, Ashley. I really want to just express 
my heartfelt appreciation, first, to the Vera Institute of Justice for this very important 
series, as well as the amazing work that you do. It is just so important, and it's really a 
privilege to be a part of this series and your entire institute. I thank you so much. And 
then I also really want to thank from the bottom of my heart all of the participants today. 
I see just all of your backgrounded, just a wonderful, wonderful group of people, people 
working with folks with intellectual disabilities, people working with victims of sexual 
abuse, people working in all kinds of capacities, researchers. I just am so honored to 
be presenting today and also just really, really impressed with this group of people and 
grateful. Because, honestly, folks with intellectual disabilities are often marginalized, 
they're often invisible to the rest of the world, and this is a giant problem, and the more 
that we bring folks out of the shadows and into the light, the more that we can really see 
the beauty of people's lives and the support they need as well as just all that they have 
to give, I think the further along we're going to be as a civilization. You know, we've 
come from institutionalizing almost everybody with a disability to now trying to integrate 
people into the community and yet we still have so far to go. So today what I really 
want to talk about is what I consider to be the elephant in the room, and that is the 
trauma that folks with ID have experienced, and when I say ID, of course, I mean 
intellectual disabilities, which I delineate intellectual and developmental and I really 
focus on intellectual disabilities when I speak about this topic. The trauma is profound. 
The amount of abuse is unbelievable. And now we're seeing the statistics that show us. 
So today I'm going to be talking about the sources of trauma in the lives of people with 
ID, and then I'm going to talk about the effects, and I believe that we have often --not 
you. You're an enlightened group of people. Me, before I got it, and, you know, 
sometimes a lots of folks in the field in the earlier days, we blamed the victims. We 
said, oh, look at their behaviors. Look at their behavior problems. Look at what's wrong 
with them. We have to force them to do things the right way. They have to become 
more like the rest of us, et cetera. When, in many cases, we were looking at the 
symptoms of posttraumatic stress disorder and they were manifesting themselves and 
people were crying for help and we were trying to change the way they cried. So I'm 
here today to really illustrate that point and talk about the healing, because that's the 
important piece, right? How can we help people who have been so damaged, have 
been so hurt in so many ways to really heal, to get into that light, to get into a place 
where they can move forward and get out of that emotional and psychological pain? So 
that's kind of the overview of today, the sources of trauma, the effects of that trauma, 
and how people heal. And I just want to thank you all again for listening. It means so 
much to me that you're here and you're spending your time with me today. Thank you 
so, so much. 

So when we look at the sources of trauma, we got some interesting reports. The 
spectrum institute published a report in 2013 surveying over 7600 people with 
disabilities and asked them have you been sexually, physically or financially abused? 
This is the magnificent work of Nora and her folks, and 70% said they had been abused. 


90% said the abuse had been ongoing. And only 37% said they had reported it to the 
authorities. What does that tell us? You know, I know I've been involved in many cases 
where people did not report --where we reported and the police came and because the 
victim did not use words, the whole situation was discounted, and I would love to say 
that that was a long time ago, but actually last summer I was an expert witness in a 
case where someone did not use words and they were sexually assaulted multiple 
times and it was blamed the person had cerebral palsy and people blamed the bruises 
on the Hoyer lift, on the wheelchair, on this, on that. It wasn't until the fourth time that 
the abuse was dealt with. These things still occur. These things still happen. So this is 
a real, real problem we have to look at, and folks who do use words are often not really 
listened to and not always really valued or validated. So this is something that I know, 
and you all know, we have to change right away. There was a really wonderful NPR 
special done, Joe Shapiro did an amazing project looking at abuse of people with 
intellectual disabilities, and it was done in January of 2018. It aired. And he went to the 
bureau of statistics in Washington and he asked them to publish a report seeing, you 
know, of the reported sexual assaults and sexual abuse, will you please just let us know 
about --what are the statistics of people with disabilities being abused, and they did. 
They gave him a report, and the results were that people with intellectual disabilities and 
developmental were seven times more likely to be abused than those without 
disabilities. So, oh, my goodness, right? And I know for those of you out there, many of 
you work with folks with ID, and I bet every single one of you has heard a story of 
abuse, has heard a tragic story, and sometimes you know people for a long time before 
you hear the story. Sometimes it comes out in all kinds of crazy ways, but it's so, so 
tough. It's so tough. And it's so prevalent. The bureau of justice reported in 2017 the 
people with disabilities are 2.5 times more likely to be the victims of violent crime. 
That's another tragedy. And on top of that they're 40% more likely to have known the 
perpetrator. So, you know, sometimes it's a caregiver --and we have such wonderful 
caregivers and great people in this field, but sometimes it's something behind closed 
doors. Sometimes it's a relative. There are so many situations. And people who are 
the most vulnerable have the least voice, tragically. So we really have to shine the light 
on this and change that. 

And we were looking at big traumas. We know there's sexual abuse, physical 
abuse, but the little traumas also accumulate. We talk about bullying, talk about being 
around violence. The bullying itself is so profound. If you think back, I hate to 
traumatize anybody here, but if you think back on 6th or 7th grade, maybe there was 
someone that picked on you. So I have some good news for everyone here, those 
bullies in middle school and high school, they all peaked in high school. The rest was 
downhill. They're sitting on the couch drinking beer and talking about the good ol' days 
in high school. But you guys are professionals. But yet I you remember that bullying. 
That person that used to laugh at me with her girlfriends in the hall, talking about my 
hair having split ends, a big thing in the '70s, things about me being Greek because I'm 
Greek American. We all have our stories. Now, can you think of the person in your 
class or school with a disability, can you think of somebody? Now, what did they go 
through on a daily basis, some with an intellectual disability who was called the R word, 
who was laughed at, maybe somebody bumped into them on purpose. There are so 


many ways in which people were bullied. I do therapy with folks with ID for most of my 
career I have been really focused on doing therapy with folks, and I have heard horrific 
stories of bullying, and I see people with just full-blown PTSD as a result of bullying 
experiences. So now we're starting to understand the effects of that social trauma. 
There's many stories around that, and they're all going to get us all depressed so I'm not 
going to tell you. But you all have your own stories and we think of people who could 
not defend themselves, people who felt very vulnerable and would often do anything to 
have a friend. So that's how some folks ended up getting arrested or getting into bad 
situations. But the reality of the little T traumas are just as big and Francine Shapiro 
talks about the fact those little traumas, seemingly little, are really large and can cause 
posttraumatic stress disorder, which I'll refer to as PTSD from now on just to make it 
easier on the interpreter. Thank you. 

So effects of trauma on the brain. Very important study was done recently by 
Nathan Fox out of University of Maryland. He partnered with Boston children's hospital, 
a number of different places, and they went to Romania to look at the effects of neglect. 
If you think about the people you know that you have supported, you have worked with, 
think about the stories of neglect you know, you know, people who were just bounced 
around or raised by some one who had serious problems themselves, alcohol, drugs, 
whatever. So neglect is rampant. Neglect is really a reality. So Nathan Fox went to 
Romania and they went to the orphanage in Bucharest. They took half the children and 
they created a foster care system where there would be a lot of nurturing. They 
paid --at least one parent had to stay home. They paid the parents to stay home. They 
had to be there. They trained them in being very nurturing. They took the children from 
six months to 4-and-a-half years old. So many attachment therapists and psychologists 
would say there is already profound damage done in those first weeks or months, let 
alone years. Some of the children were much older but they put them in a nurturing 
situation. And there is the website for the study. The results are really rifting. So we 
see that those children left in the institution, 55% qualified as having some kind of axis 1 
disorder, whereas those raised in foster care it was down 20%, 35% had some kind of 
thought or mood disorder. So really a radical decrease, radical decrease in emotional 
disorders, 49% to 29%. Behavioral disorders not as much because I think a lot of times 
we see people shut down. I think probably many of you working in the disabilities field 
know somebody who does not use words or maybe who you thought did not use words 
and then all of a sudden began talking. Right? Selective mutism is a symptom of 
trauma, and I know I have worked with several people where they didn't use words and 
come to find out when they started speaking again, after they didn't use words for years, 
that something really horrible happened the last time they spoke. And that's what the 
mutism is a real symptom. So sometimes people shut down. Of course, we know 
people dissociate. They try not to be present in their reality oftentimes. That's a 
response to trauma. So we don't see as much of a behavioral difference. I know I see 
in many day programs that I go to people that are frozen, people shut down. But finally 
the last statistic to me is the most important, and that's the statistic --it's all important, 
but in terms of our field of intellectual disabilities, the average I.Q. of the children left in 
the institution was 73 versus those children placed in the foster care. Their average I.Q. 
was 85. Of course, they were randomly selected, and then the control group on the 


side is those children from Romania raised in their biological homes. So that I.Q. was 

110. So trauma lowers I.Q., and I would like those of you who are in the field to think 
about people you know with an intellectual disability who are really, really smart. Right? 
I knew this one guy, he was a wonderful guy, and his name was Michael, and the first 
time I met him I was working in this program for people with a dual diagnosis of 
intellectual disability and a mental health issue, and he said to me, I am only here 
because of evil psychologists. I'm, like, really? What do you mean by that? He said, 
yeah, I'm smart but they gave me blocks and tests and made me answer questions, and 
then they said I was --he used the R word --he said that's why they stuck me here and 
I don't belong here. It was so, so poignant. And he said to me, what's your job here. 
Of course, I was the psychologist. Oh, I'm just staff, hanging out, I'm here to help. But 
he was right. He said, I got so frustrated and so upset, because his whole --he melted 
down with any kind of stress because of all the trauma he had. And as I started working 
with him, I came to learn that he was passed around as a sex toy between his mother, 
his stepfather and his uncle for much of his early life. And his brain was --he was so 
smart, and yet he was so traumatized and his brain had a hard time working, and he 
was diagnosed as having paranoid schizophrenia because he didn't trust anyone and 
he would often have elaborate delusions people were trying to hurt him. When you are 
raised not being able to trust the people you are supposed to trust and they horribly 
abuse you, that's what happens, you become full of all kinds of ideas about everybody, 
and 9 medication --and the medication never worked for him. So that trauma has a 
very profound impact on the brain on so many levels, right? Emotional health, of 
course, we know, psychological health, but I.Q. as well, which is not to say that people 
aren't vastly intelligent, but their brain cannot organize itself, it doesn't form those neural 
networks when it's in a constant state of fear. So that trauma affects the brain. 
And, actually, in this study, Nathan Fox saw that the gray matter in the brain 
actually shrunk. It was smaller in the children left in the institution. There was lower 
brain activity measured by the EEG. There was impairment in executive functioning, 
increase in adrenaline. Here is where --the wonderful psychiatrist Jessica Heinz who 
talks a lot about the fact we overdiagnose ADHD and we're looking at that heightened 
state of hyperarousal that's a symptom of trauma which fills the brain up of with 
adrenaline and cortisol and manifests as hyperactivity, but it's really trauma. So she 
saw that as well. People were --the ones left in the institution were very frequently very 
small, abnormally small. It impaired physical growth and then tragically there were 
more premature deaths among that were left in the institution. 

So the brain, you know, we are set up to survive, and we had to survive in the 
jungle, right? We have three aspects to our brain. This is an easy way to talk about the 
brain. It's just so loose. Of course, our brain doesn't look like this, but we have systems 
in the brain, the survival system, and we have our reptilian brain, or that brainstem, 
which just causes the blood to keep pumping and everything to keep going, we keep 
breathing, but it's not really responding. We have our limbic system. That's what we 
often refer to as our animal brain. That's where we --where we are able to survive. 
That's our survival system. That's where we have the sympathetic nervous system and 
parasympathetic nervous system, which basically means we have --we have part of our 
brain that says, okay, I'm in danger, I've got to respond, I've got to fight or flee or freeze 


and then we have the other part that calms us down, and then we have our smart part 
of you on brain when I know that there are some people sitting there listening right now 
with their bosses, so I don't want to stir anything up, but when your boss says 
something to you that you find particularly dumb, instead of saying that's really stupid, 
you say, okay, you're smart part of your brain stops you before those words come out of 
your mouth and you say, maybe, okay, catch you later, talk to you later, because your 
smart part of your brain reminds you of your car payment, how much you love your car 
or mortgage. And you pull yourself back in. Now, when you are in danger, that smart 
part of your brain goes off line. So when we were animals in the jungle, let's say, we 
were antelopes, I love saying this, and we're out in the jungle eating grass and telling 
jokes and all of a sudden there is a furry thing a and that furry thing eats our friend of Ed 
and said a pile of bones after that and we're running in a state of panic. So that yellow 
part, that limbic system, has the amygdala. The amygdala takes a picture of that furry 
thing and goes, oh, that's a lion. I have heard of lions. That's what they look like. Next 
time we are in the jungle and eating grass and Ed was the greatest guy and can't 
remember the punch line to the jokes Ed told, and another line comes, we don't wait to 
see which one is going to get eaten. We run. Because we know now the amygdala 
starts flashing, warning, warning, warning, danger, danger, danger, there is a lion and 
he is going to eat somebody. Now let's say we are a bunch of gorillas and that lion ate 
one of our babies. We're going to say, let's get him boys and we're going to attack that 
lion. Or if we're an anteater and we can run because we have short legs, we're going to 
say, I'm dead, I'm a dead anteater so the lion won't eat us, that freeze response. So 
these are kind of universe E&L responses to danger. Let's say you're driving down the 
road, driving down the highway, and a Walmart truck comes and tries to run you off the 
road. I always pick on Walmart. I just can't help myself. And a Walmart truck tries to 
run you off the road. At that moment you're not looking to call that 1-800 number 
because your smart brain has to go offline when you're in danger so you can respond 
and your brain gets filled with chemicals, you get clarity, you get away from that truck as 
quickly as you can, and you save your own life. Now, when you're on the side of the 
road and you're breathing and trying to calm down, you're still not thinking I need to call 
those Walmart people and report about their bad driver who almost killed me. You're 
just like, oh, my goodness, you know --if you're like me you might pick up that cell 
phone with your handshaking and call your husband and say, "I am died. What would 
you do if I do if I did? Would you miss me?" Because that's how I am. I have attention 
seeking behaviors. Or maybe you pray, but you still have to calm down. That's your 
parasympathetic nervous system. And now, let's say that --so that was your trauma 
response, right? Because that was very scary. Then finally you start thinking, you get 
yourself back together and you get back on the road. So let's say three weeks later 
you're driving down the highway and another Walmart truck comes along. Now, the 
way the amygdala works is that it's right below the conscious level, and that amygdala 
will send warning signs. The amygdala will say, oh, you have to move, you have to do 
something. You're in danger. Oftentimes you won't even know why. So you see that 
Walmart truck and your amygdala is sending you all kinds of signals and you cut over 
three lanes. You start cutting people off. People are making all kinds of hand gestures 
at you. God forbid you're not somewhere where there is open carry and people are 


pulling their guns out. Who knows what happens when you cut somebody off. You've 
actually placed yourself in more danger was you thought you were in danger, because 
you thought, oh, no, I'm going to get hurt again because your amygdala sold you so. So 
many times people who have had a lot of trauma are placing themselves in way more 
danger because their amygdala is firing and telling them they've got to be careful. I 
have worked with folks who they would see or hear a certain person who reminded 
them of someone and they'd run into the road right into traffic. And you couldn't even 
understand why they were doing it until you finally realized, okay, it's this one person, 
every time they see this one person who has done nothing to them but that must be just 
like someone who abused them. So many times we're not going to know the trauma 
story. So many I have worked with have had trauma responses we have never entirely 
understood but we have understood that they had triggers, and once you can get what 
those triggers are, once you can help create a safer environment and help them identify 
and respond to triggers differently you can help that person. 

Now, with those who can't express it, I firmly believe in doing therapeutic work 
because therapy can be done very effectively with folks with intellectual disabilities, and 
I am going to be talking about that today. 

So but when my boss who used to yell at me, we'll call him Bob, when Bob used 
to yell at me, he said I need to talk to you and he would yell and scream and say all 
kinds of things, and I would get totally traumatized, and then I eventually quit. But then I 
had this wonderful boss, her real name was Kathleen, and she was my friend and so 
sweet, but she would say the same thing that Bob used to say. She would say, I need 
to talk to you. But Kathleen would say I need to talk to you. But I would hear it and I 
would say I got a meeting, I have sessions, maybe next Thursday. I would escape in 
every way I could because those words triggered me and I wouldn't realize I was doing 
it. But that was my trauma response. We all have that and we all have our modes. My 
brother is a fighter. So he has that five different lawyers on retainer and anything you 
say to him that he finds threatening, you're hearing about one of those lawyers. One 
time he said to me I'm going to qual my lawyer. I said, I am your freaking sister. You 
cannot say this to me. But necessary fight mode. 

Then my husband is a freezer. So he has had a really good life. He married 
very well, I have to say, and but his idea of trauma --he has been through some things, 
but, really, my idea for home improvement projects are traumatizing for him. I will say, I 
know we can just knock this wall down and we can rearrange things and then he will 
freeze and be on his computer and pretend he doesn't hear me because he goes into 
freeze mode. We all have our tendencies. So folks with ID are the same. Like they 
have their modes. Oftentimes we are misinterpreting their trauma response as a 
behavioral response. We're thinking they're doing something deliberately when in fact 
their brain is telling them they're in danger and they have to protect themselves because 
these trauma responses are only for self-protection. They're not to hurt anyone. 
They're not to manipulate their situation. They're not to create problems. They're to 
protect themselves because safety is the key issue when folks have experienced 
trauma. When you have gone through trauma, when trauma is still in the forefront in 
your emotional life, you are constantly thinking about how to be safe. And safety 
becomes a primary motivator. Interesting fact, the amygdala for folks that have had a 


lot of trauma actually becomes enlarged. So a study was done in Bosnia with children 
that were --grew up in war-torn Bosnia and they did brain scans --these are children 
who saw their homes burned down. They were growing up inside a war. Parents killed. 
All of them had enlarged amygdalas. Which means they had so many warning signals. 
They were constantly filled with chemicals and constantly triggered. Then if something 
in the brain is enlarged, something else has to shrink and what shrank is the 
hippocampus. So it makes it harder to learn. So I had one of those ah-ha moments 
when I was able to --I had the fortunate to hear Temple Grandin who has autism. She 
is brilliant. She talks about the experience of having autism, experience of being 
bullied, so many difficulties constantly, being overstimulated, all the sensory issues 
difficult to negotiate her way through, and she showed us the scan of her brain and she 
said, see my amygdala is enlarged and my hippocampus has shrunk. So that was such 
an ah-ha moment for me because she was saying this is the brain of someone with 
autism that's exactly the same profile as a brain with someone with severe trauma, and 
it is trauma. It is trauma to have autism. Having autism is difficult and the brain proves 
it. So much material about that and so many heroic wonderful people fighting their way 
through to be heard and seen and to teach us how to really support people with autism 
who have great sensory difficulties but also have so much more to give and so much to 
teach us all. So --but that's trauma. It's very difficult. People need to feel safe. They 
need to have relationships because it can be very isolating. All kinds of disabilities. 
David talks about loneliness being the core issue and the most giant problem. It's a 
mental health issue for people with disability issues not having friends. And that 
physical difference --they saw the same thing --they replicated the study with children 
who grew up in gang-infested areas and they, too, had enlarged amygdalas and 
shrunken hippocampus. I just heard an interesting TED Talk by a woman named 
Abigail Marsh and wrote the book "the fear factor," and here is an interesting twist. She 
found people who had more compassion had larger amygdalas. So doesn't that make 
sense? And they found that psycho paths, people who had history, serial killers, had 
actually small amygdalas. Isn't that interesting in I'm just throwing that in because I just 
found it out. But I believe people who have been through a lot of trauma have a great 
deal of compassion. I'm going to share on a personal note, years ago when I had a 
tragic loss in my life of a parent very sudden, my friends tried to understand, my 
husband was great, but they weren't really there for me. They were wonderful, but no 
one had been through anything like that. But it was amazing, so many of the folks that I 
work with, so many of my great friends with intellectual disabilities cave Guy emotional 
support on such a profound level without even knowing what had happened. I felt like, 
oh, my gosh, these are my real friends, everyone is wonderful and supportive in their 
way but these people sensed what I was going through. I can name 10 people who just 
showed me so much kindness and I know for those of you that workday in and day out 
with folks with I.D. you know what I'm talking about. The profound compassion. I think 
that comes from having experienced a lot of trauma as well. Not to overgeneralize, but 
she did find people who were more compassionate and showed more acts of caring 
actually had enlarged amygdalas. Interesting fact. 

But moving back to my agenda, again, trauma lowers I.Q. Here is the brain of 
somebody who is normal. Brain scans of two people doing puzzles. The normal brain 


is completely lit up. That brain is communicating with itself. A lot of intelligence is not 
just like this one factor that we can measure. Intelligence has many, many facets, but 
intelligence performance has to do with how well your brain can communicate with itself, 
right? All the neural highways, all the connections that are made. And you can see in 
the brain of the person with PTSD there is only two small spots that are lit up. So that's 
kind of like being in one lane. It's very difficult to connect with your own brain, to have 
those neural networks firing and working, when you're in that constant state of trauma 
and you have those symptoms of PTSD. So it lowers your ability to function cognitively. 

A lot of times we look at the tip of the iceberg as the behavior but underneath is 
the emotion, and in the intellectual disability field we isolated behaviors and dealt with 
behaviors and missed the core of it, which was the emotion underneath and even more 
fundamentally that trauma that folks had been through. You know, blaming people for 
their symptoms. So I like to distinguish between the trauma response and a behavioral 
response. I'm going to tell you a little story about a woman that I worked with who was 
just such a wonderful woman. We'll call her Linda. But she had had such a trauma 
history, such a difficult life. She was raised in a very rural area, and she had a little bit 
of an intellectual disability and had really been looked down upon by her family and had 
been sexually abused by her brother. And then at one point her brother started bringing 
his friends around and in more than one incident she was gang-raped, and that was 
horrific, and she was not listened to, not believed, and she set that barn on fire and 
started a very serious fire. So then she became labeled as a firesetter, quote-unquote. 
So many times again the victim is blamed. And that was just her --she wanted to burn 
that barn down, understandably. I probably would have, too. And no one was listening. 
So that was her trauma response. And she then was placed in an institution. She was 
in an institution for years. And then she was --she came to an agency where I was 
working and she was placed in --we had three --not group homes. We called them 
ALUs, alternative living units. We had three people. She had a staff person who was 
very, very close to one of the other people, residents in the home, and they would kind 
of laugh at Linda and make fun of her, and Linda hated her, and she also talked down to 
Linda, and Linda had this horrible history of marginalization and not being validated for 
her terrible abuse and not getting support. Linda kept saying she wanted to move, she 
wanted to get out of there. We went --we didn't really listen as much. We advocated 
for her. I should have advocated more. And someone I was supervising was doing 
therapy with her and started learning of the abuse, started learning of all these --this 
horror and we started doing trauma work for her. And one day she just couldn't take it 
anymore. So the staff person was teasing her and the other resident was laughing at 
her, and she just lost it. Her amygdala started firing and said I can't take one more 
minute, and she broke so many things in that house. She broke the lamps. She broke 
the TV, the --they had just --it was when we first started getting big TVs. They had just 
gotten a big TV. Broke that and completely lost it. And that's when the administration 
listened to her and said, oh, okay, we'll move her. Sad that that's what it took. But she 
had a trauma response. Those buttons were being pushed and these bringing this 
horrible history to the table and we were just starting to scratch the surface and trying to 
help her, but she got moved to a better setting, and through the years she did so much 
better. She has a boyfriend now. She's doing really well. And she has a part-time job, 


and she's been able to get therapy and really heal. But what she did, which is 
wonderful, right after she had her issue and then got moved, I was at the day program 
and I saw her gather many people around and tell them how to get moved. Mike 
basically she held a little workshop for the participants in the program because 
everyone wanted to be moved. And we never moved anyone. It was horrible. Just get 
used to it. We'll write a behavioral program for you and it will be better. 20 years ago 
they said they wanted to live with those other two people when we all went to TGIFs or 
ruby Tuesdays, but that was 20 years ago. They want to move. She told them, you 
want to move, just break your TV. So true story, within the next four months, three TVs 
got broken, and all those people got moved. So those broken TVs were the behavioral 
responses --those folks said, oh, I am breaking my TV now. I told you I want to move. 
Look, I just broke the TV. There it goes. It's broken. And they did get moved. But that 
was a deliberate act. We know what that was. That was being smart because if you 
don't have a lot of resources and a lot of power you have to find a way to impact your 
environment. But oftentimes we think that people's trauma responses, people's 
emotional responses are in that category of being of manipulative behavior, and we get 
it all wrong, all wrong, and, you know, people get shamed for the ways that they're trying 
to express themselves. Lately, people have been --I've heard, really the last 10, 15 
years, you know, and books have come out, that all behavior is communication. Well, 
that's true, with you I think it's a horrible shame people should have to reduce --be 
reduce to do using their behavior in order to communicate. I think we need to get better 
at listening and stop thinking that they have to change and we change. I know I'm trying 
to get better, and I have light-years to go in order to really support and understand 
people, but I'm trying every day to figure out how I can listen better so that people don't 
have to use their behavior. 

So I want to go quickly over the four symptom areas of PTSD but I also want to 
get to healing. So I'm going to try and go fairly quickly here, but the four is symptom 
areas, the first is reexperiencing. I don't know if you work with someone who talks 
about over and over again about somebody who died. A lot of people I know will tell me 
over and over their mom died or 30 father died and I am sure the way they talk about it 
just happened because it's present for them. And then it turns out that person died 20 
years ago. But they are reliving that grief and loss and that is a symptom of PTSD. So 
if you know people talking about something devastating as though it is happening, that's 
someone with PTSD, because it is alive, and grief is often a core issue of trauma. Grief 
is trauma. When you have had so few people in your life that really cared about you 
and were not paid, and you lose one of them, some people feel as though their own 
value was lost with that and it's devastating. Folks have nightmares. Folks have 
flashbacks. I have seen many flashbacks where someone will see a certain object or 
see a certain person and get a glassy look and just start freaking out, maybe throwing 
things --and I finally have come to understand what a flashback looks like, particularly I 
saw a lot of that with many of the folks that we brought out of the institution. I was 
involved with bringing many people from rosewood into the community and working with 
them and we would see those responses over and over again. They were not rational. 
They were triggered in an irrational way. That's always a clue. 

Avoidance, we see people avoiding things, becoming safety about safety and 


safety details, knowing who their staff is, knowing what's happening and obsessing over 
and over and over, and sometimes people get diagnosed with obsessive compulsive 
disorder, but when, honestly, we are looking at symptoms of PTSD because there is 
that hypervigilance, that hypervigilance to stay safe. Tragically I'm working with a 
number of people who have been sexually abused. There is so much sexual abuse as 
we said earlier, and I will see people do whatever it takes to avoid contact with males or 
to --or to people that protect themselves by becoming as unattractive as possible, 
gaining as much weight, having bad hygiene, doing they can to stay safe. 

I am going to tell a quick story. This one guy I worked with years ago when I was 
hired as a behavior specialist, it turns out I was also the janitorial instructor and house 
manager, back in the early days when we were starting community agencies and we all 
have like six jobs, but I was told to write a behavior plan for this guy because his 
hygiene was so bad. And so I --we set up a plan where we would get a soda for taking 
a shower, and that didn't work, of course. Then --he would take his dirty clothes and 
put them back on out of the hamper. He wouldn't wear clean clothes. I said, okay, we 
will reward you --he liked money. Like, who doesn't. He didn't even care. Huh-uh. Did 
not care. And did not respond. And all of my plans failed. Then I finally just started 
talking to him and listening to him, and that's when I really started to realize that, wow, I 
wanted to dedicate myself to learning how to do therapy with folks and really helping 
them on a much deeper level. So I started really talking with him and listening to his 
story and trying to help him through things. What did I hear? First of all, he said some 
genetic disorder. He also had an arm that was twisted. So I thought that harm was part 
of his genetic issue. It wasn't one I could have identified back then. And he told me, no, 
that back when he was in Rosewood he was placed in the institution, an older 
gentleman, when he was a toddler, and he never saw his family again, and there was 
total chaos all the time, very few staff to many people. The boys were always fighting 
and beating each other up. And he and a kid were in a horrible fight and everybody 
heard a crack, and that crack was his arm breaking. And the staff said to him --oh, I'm 
sorry, the staff grabbed him by the arm and that's when it cracked. I forgot that 
important piece. So actually the staff did it. But everyone heard that crack. He was 
trying to get him out of the fight. So the other boy didn't break the arm. It was the staff 
that did it. And that staff broke his arm at that moment and then said to him, you're not 
going to the doctor because I'll get in trouble. And so his arm healed in that twisted way 
because it was never set. And what he also shared with me was why he didn't like to 
take showers was --why he didn't like putting on clean clothes, because at Rosewood 
they would line everybody up at the end of the night in a large gymnasium, and I saw 
this gymnasium when I was taking people out of there and we would come and meet 
people and try and get them placed in our agency, and there was a big drain in the 
middle of it, and he said every single night everyone would be lined up, there would be 
several stations, there one station where they would put their dirty clothes, they would 
be stripped naked, then they would have to walk around in a line and they would get 
hosed down every single night in front of each other, just hosed down, all of them, and 
then they would get at another station get dried off, and then they would get their clean 
clothes and assisted to put their clothes --their night clothes on. And that was what 
happened every night. And on top of that, he told me story upon story of the older boys 


sexually abusing the younger boys and all kinds --he said, you know, you just tried to 
do whatever you could to make sure no one would want to get near you. So, of course, 
my behavior plans didn't work because I got it totally wrong. And I didn't know what to 
do except to give him as much support, as much therapy, and, you know, really help 
him. But he taught me --he taught me several things. Number one, he taught me what 
a true behavior plan was, and that was a girl named --a woman, sorry, a young woman, 
named Sara. He came home one day and he said to me --he was --they lived in kind 
of a complex with many apartments, and I was there, and he was like, I found the love 
of my life and I'm going to marry her and her name is Sara and I'm getting a ring and 
going to marry her. I said, why don't you try dating her first. No, I'm getting a ring. This 
is the love of my life. He asked Sara the next day to marry him. She said, no way, you 
stink. So after that, he, what do you know, he took a shower, he started wearing clean 
clothes, he started shaving, because staff helped him, he learned to do it himself, he got 
married. They did get married finally. And he lived with her for 20 years. They were 
married for 20 years. And she had Down syndrome and she had early onset of 
Alzheimer's so she died after 20 years. But instead of being devastated by it, that love 
healed him. That relationship healed him. That's what truly heals people, relationships 
and connections and hope and being able to be engaged in a wonderful and present 
life, being able to be engaged in the present and to have relationships and love. So 
after that he became a ferocious advocate for disability rights and he was fantastic, and 
he was one of the critical people involved in shutting Rosewood down. He was on the 
front page with the Governor the day it closed, of the Baltimore Sun. I always think of 
James because James taught me two important things. He had horrible, horrible 
trauma, but what healed him was love and mission and purpose, having that purpose as 
an advocate instead of just being Dave stated boo her death, it hurt him, it was difficult 
but he knew he was going to advocate for every other person left in an institution, and 
he just was a hero, a true hero. So I learned so much from him. 

Negative alteration cognition and mood. We also see that sense of impending 
doom. People feeling hopeless all the time, no matter what's going on, nothing is going 
to be good, nothing is going to work out, everything is horrible. You can't cheer them 
up. That's a symptom of trauma, that sense of doom, everything is going to fall apart, 
everything is horrible. Then finally that agitated state of hyperarousal. We see that a lot 
with people that have patterns of property destruction, impulsive, reckless or 
self-destruction. Amygdala is always flashing saying you're in danger. What people 
need is to know that they're safe. That's how they heal. So PTSD, let's look at it as a 
spectrum disorder. It isn't just an all or nothing. We all have different degrees, and I 
believe that just having an intellectual disability in this world that is full of difficult 
situations and exclusion, exclusion physical pain. Studies show that. Being excluded 
and being hurt, being bullied, all these things actually create trauma in different 
degrees. So most of the people that I've worked with have had a certain degree of 
PTSD on some level and many of them have worked through it but many have not. So I 
think that's what we need to focus on, how can we help people to heal. And I know that 
those of you working with sexual abuse victims, you know 24 this, and you know the 
profundity of it. There is often a double whammy of people who have been sexually 
abused and ID. I am doing therapy with someone who was raped and the double 


whammy is that, number one, there is a sexual assault, but number two, they're told I'm 
your boyfriend. So part of the grooming is that --I will be your boyfriend. We're going to 
get married. Or I'm going to be going out with you. And so they think they have a 
boyfriend, they get sexually abused and the person is nowhere to be found. So this 
woman I am working with now is not only dealing with the physical and emotional pain 
of the abuse, this incredible realization that wasn't her boyfriend and that was actually a 
crime is so devastating to her because she has only wanted a boyfriend and she 
struggled so much to find that love in her life and thought this random guy off the street 
who brutally raped her was going to be her boyfriend. You know, so much of the 
healing work we do is on so many levels because of the --that loneliness, that pain, that 
need on top of the trauma. So people say, well --in fact, someone even said in her 
team, well she has a disability, so she won't be as impacted as someone without a 
disability by this rape, which is so horrific. It's the opposite. The opposite is true. She 
is more impacted. And people are more complex who have intellectual disabilities, and 
their trauma is more devastating because they're carrying that devastation of not being 
included in this world, not being able to be part of so much, being marginalized and 
often not validated. So there is so much therapeutic work to do. 

So how to do it. Right? We have to look more deeply. We have to see how we 
can help people. I believe that the expressive --we have to go deeper. There was a 
wonderful book "the body keeps the score," that the body itself stores that trauma, and I 
think it's very important that we make sure that we do bodywork with people, we do 
yoga, we do --we help with expressive therapies, and programmatically, we need to 
look differently at the placements that we make and how we support people. People 
need to perceive they're safe. You know? We have many fire drills. We have all kinds 
of safety procedures, but do people feel safe emotionally? And that's a big key. If 
you're with somebody that hits you every couple weeks you're not feeling safe but 
everyone says, don't worry about that resident, they have a behavior plan. They're fine. 
And just ignore him when he hits you. No, that's not okay. If you were living with 
someone you could to a wonderful thing called divorce, yay, get away. But oftentimes 
we have people who are not feeling safe and we don't realize what their emotional 
experience is. We're not always seeing things through their eyes. They need 
connections. The more isolated people are the more impactful the trauma is. So the 
more connections we have, the more relationships we have, the faster we heal. And 
people need to be empowered. You know, it's funny, I have had --Michael Small who is 
so wonderful, who is a great pioneer of really honoring people with ID and 
person-centered practices, pioneering person-centered practices, says I have to change 
this slide to slide to say power, because we're not empowering people, which is so true, 
but I think we have to start by knowing what --we must empower then and then hand 
the reins over because people need real choices in their life, not fake choices. And if 
you think about your own life, if all the choice you had in your life was all wrapped up in 
one meeting once a year, and it was all written up in a plan that went in a book 
somewhere and that ended up not even being real, you might be frustrated and have a 
few behaviors. So we want to have real choices and real power in our lives. I think 
that's so critical. People need that sense of safety, they need the understanding, the 
support, the kindness and empathy. That's what being trauma informed is. You know, 


it's really like what have you been through? Not what are you doing right now? When 
someone is having a behavioral crisis, an incident, it's not the teachable moment. It's 
not the time to correct them. It's not the time to really shame them about what's wrong. 
I know I have written plans that did that, that told staff that said tell them not to throw 
that soda because they will lose their soda. They would throw the soda and punch the 
staff. They didn't care about the soda when their amygdala was firing. What's going on 
with you. Getting them away from the triggers. Walk with me, talk with me. And then 
let's look at ongoing treatment. That's really critical. As I said, I think the body --the 
people have it all stored up in their body. We see it manifest, people have 
gastrointestinal issues, they have phantom pains, pain responses. Often we can't find 
what's wrong about but they are suffering. We have found that doing yoga with folks is 
incredibly successful. Research has been done with children with behavioral issues in 
school and when they do yoga, it goes down to zero. We found the same thing. Yoga, 
dance, youth massage in one program I worked in. We found people just chilled. Oh, 
my gosh, people that had been having chronic problems, completely just calmed down if 
they could get a massage two times a week. So the body is storing that Bain and we 
need to do that bodywork to release it. That's an important part of the treatment. 
Dance. Dance therapy. We got rid of dance therapists years ago but I think movement 
and dance is very therapeutic. We have to understand people can't always express 
their emotions with words and often they don't even when they use words have the 
words. But the expressive therapies help people to express through their body. There 
was a study done with people in Iraq who had --they had groups of people who had 
gone through the same trauma. Some had really, really severe PTSD to the point 
where they when they came back they couldn't hold jobs, they couldn't sustain 
relationships. And others were able to come back with maybe some help or some 
support, really reenter their life, maintain relationships, work, and they looked at all the 
factors, and they said what are the determining factors that really can kind of predict 
who is going to get PTSD and who isn't from the same events, like having their 
Hum-Vees blown up, suicide bomber. They looked at education, socioeconomic status. 
None of that made difference. There were two things that made a difference. 
Relationships, people who had lots of people they were face timing with and Skyping 
with who had many friends panned family had way less PTSD. Relationships heal and 
they also inoculate you. And people who had few friends and very little interaction were 
more vulnerable and more likely to develop PTSD. Number two was the closeness of 
their relationships within their unit. People who felt like everyone had their back were 
way less likely to develop PTSD versus those who felt like they couldn't trust anyone 
around them were more likely. It's horrible but very important documentary "the 
invisible war," about people sexually abused by people they were supposed to trust in 
the Armed Forces and if you want to see the profiles of PTSD and trauma responses, 
and, oh, my goodness, it's very heartbreaking, but it's all there, and we can see that 
relationships are everything. When the person you're supposed to trust hurts you, it's' 
so devastating. What heals people? Relationships, support, safety, power, having 
some agency in their life and some control. So that's programmatically. Therapeutically 
we want to look at using alternative therapies. I have done EMDR now for about 18 
years. That's eye movement, desensitization reprocessing developed by Francine 


Shapiro and it's a type of trauma work and we did a study at the Arc Baltimore. 
Dr. Lynn Buehler headed it up. It was --we saw incredible results. We did --actually 
she did all the work. I say we. But I was on her dissertation committee and I took 
credit. But we also set up the study and found the --we picked eight people with severe 
PTSD where we knew they had trauma histories and they were all having active 
symptoms of PTSD and every single one of them no longer manifested their symptoms. 
So we had person after person just --and interestingly enough the symptoms were 
often manifested as, quote-unquote, behaviors. So this one fellow was very aggressive 
and was about to lose his job. He got a year of EMDR, and my experience it doesn't 
take a year but he got that intensive trauma work, and he is doing great. He hasn't had 
any aggression now in over five years. Because he used to be so easily triggered. It 
wasn't because he wanted to hurt someone. It was because he thought he was being 
attacked and the best defense is a good offense and your amygdala is firing and the 
world is falling apart and you are having a trauma response. Another person was crying 
every day. In fact, she would cry and run out into the road and she got hit by a car on 
three separate occasions. It was just terrible. But she continues to get the EMDR. She 
has been doing EMDR for about seven years, but after the first six months she stopped 
crying, she stopped getting so easily upset because anytime anyone said anything to 
Hershey thought she was being teased. She had had been horribly bullied, teased by 
her mother, had fetal alcohol syndrome and always made fun of. It's amazing. She is 
working in a job, doing so well, she is engaged, I'm happy to report. Because people 
are healing, people are healing through this --I feel that we can do just about any type 
of therapy that we already do with folks. We just have to take it to a little slower pace 
and a little bit lower level, use language that's understood, but the more we do 
expressive therapy, I think, and integrate that I think the more it helps as well. So we 
have the healing center at the Arc Baltimore that we started. I just left there. But we 
have been doing it for about seven years. It's fantastic. So we do the yoga. We do a 
bunch of art projects that help build a positive sense of self. We also do a lot of grief 
work. I really belief that grief therapy has healed many people I work with. They had so 
many unresolved losses, that doing the actual grief work really helped to heal on such a 
deep level. So I have a little workbook called my "good-bye book" that we do these 
memory boxes where they honor someone who they lost and they also on their own 
identity of who they were to that person and we try to build up that sense of self on top 
of it. We have seen a number of people who weren't working, didn't want to do 
anything, didn't even want to attend their day programs or go anywhere, seen several 
get community jobs. We've seen one guy who wouldn't go anywhere, do anything, 
would often attack his staff, is doing great. He has a girlfriend. He's going out all the 
time. He goes to his program all the time. He's applying for jobs. So we have seen 
real programs when people have done number one the trauma work, number two the 
expressive therapy, we also do music therapy, lucky to have a certified music therapist, 
all kinds of art projects and art therapy, movement, and a drum circle. So that's been 
very effective. On the individual level the EMDR there is a memory box and we 
decorate it and honor the person they have lost and they make a gingerbread person 
that epitomizes who they are and share with everyone who they are and here is this 
young woman who was a row Juan done refugee who has --Rwandan refugee who had 


her small drum she liked to play when she was younger and when we started a drum 
circle and got the small drum, she started dancing. Was healed so much. We also do 
EMDR for her --she was in the forest for --it was horrible for seven years when they 
were run out of a refugee camp, and so she had so much trauma. But when she first 
came to us, every time the van went over a bump she would start screaming and hitting 
people, and no one knew why until her mother told us when they were driven out of the 
refugee camp they were driving in a van over dead bodies. That's why bumps triggered 
her. She was able to get so much out through the movement, dance, singing. Now she 
continues to get EMDR. She will say, "I want the tapping," so we do it. So there is the 
grief box, the memory box, and this is a wonderful woman who used to just scowl and 
tell us she wouldn't sing, wouldn't do anything, because she witnessed her stepfather 
stab her mother and she has given me permission to share her story and she is now 
working and doing so well. She had to really work through that grief and that loss and 
that trauma and amazingly --you see her smiling. We never saw her smile. Now she 
smiles all the time. I know that's a simple thing but for me it's so giant. So we have to 
work deeper and we have to work differently. 

We have to build up a sense of self. I really believe strongly that people with 
disabilities are often told what they're not at the critical time when their identity is 
forming. We're talking about who you're not. You're not going to get a job, you're not 
going to get married. This is so devastating. We have to build up who you are. That's 
a big part of healing. It's having a positive sense of self and identity. But what matters 
most is how you see yourself. So I really believe that when we do that trauma work we 
have to process the grief, we have to work on the trauma, but we also have to build up a 
positive sense of self, a positive identity, and a great scholar talks about the fact that a 
strong sense of self is so important to healing. When you really want to move toward in 
your life and you have a sense of who you are and then a sense of purpose behind that 
really activates that healing process, which is so important. And so rather than focusing 
on behaviors, wherever I go, I've consulted at many different places, but I have actually 
worked in house over 32 years --I usually am the psychology person because I found 
that if I'm inside of an agency I can do a lot more good, and when I'm a consultant I get 
very full of myself and I blame the staff and say, oh, my behavior plan is great, they just 
don't follow it, but actually that is so wrong, and I have learned. So I have worked inside 
of many agencies, and we often have to write behavior plans, but what I was learned is 
to write a more holistic healing type of plan. We have --you have to target a certain 
behavior but what we also do, we have a functional assessment to talk about behavior, 
and we also really highlight trauma history. What has someone been through? What 
does safety mean to them? What do they need to be feeling safe, truly safe? What do 
they need to have relationships and be connected to other people? And what do they 
need to have power over their life? And we look at that. We look at what they've been 
through and what kind of supports they need, and then we've looked at what will make 
them happy? Because everybody's happiness is different. So rather than focus on that 
difficult behavior, which is often a symptoms of PTSD, this person is in a hyperaroused 
state, so they're breaking things or running away or self-injurious. So we look at 
therapeutic treatment and then we look at, so that's always something we put in addition 
to whatever plan we have, and then we look at what will make this person happy? 


Because everybody's happiness is different. So according to Martin Seligman, there is 
five levels of happiness and after our functional assessment we have a happiness 
assessment and SOPs critical because we have to actively pursue our happiness. This 
is a human right. When you are engaged, living your life looking forward to things and 
engaged in the pursuit of your happiness, it's the pursuit that makes you happy, not the 
end result. So we analyze and go through this assessment figuring out what makes 
each person happy, what do they love, what's their bliss, and then we have a happiness 
procedure where we explain in detail how to help this person pursue their happiness. 
So we look at pleasure, like what do they really like to eat and drink. Sometimes in the 
past we've kind --we've thought if we just have that positive re enforcement and stop 
there people are good. No, no. Martin Seligman spells out in his book "flourish and 
authentic happiness" that happiness has many different levels. It's important to be fully 
engaged. Being active in your pursuit of happiness is important. Not everybody with a 
disability likes to bowl. I know it's a radical statement. People have hobbies that they 
might love, if we can help them to engage every day, every moment and just finding 
their bliss that helps them to stop remembering over and over again the horrible things, 
being so easily triggered and having difficulties. Positive relationships is the theme for 
today. Engaged in relationships. This is so important. I have a singles group I have 
run for years where I really try to help each person find that special someone, because I 
believe in love and sex --yes, safe sex, but sex. It's a human right. But relationships 
and friendships. All kinds of relationships that we saw in the Iraq study, they are both 
inoculation to trauma and a critical aspect of healing. Achievement, Martin Seligman 
says having a sense of achievement you have done something, that you feel good 
about yourself in some way is so critical to happiness. We work on goals a lot in our 
field. We don't always celebrate achievements. Sometimes the achievement is, hey, 
you haven't put a hole in the wall for six months. Let's have a party. And that's a 
serious achievement. Let's start celebrating. I believe in celebration more than 
rewards. Let's have a party. 

And then finally, another important theme for today is meaning and a sense of 
purpose. So people heal when they can find that mission and that purpose. Like 
James. What a wonderful advocate he was. What a great hero. And he helped so 
many people. He taught other people how to be advocates. He stood up for what was 
right. He went to the legislation every year and spoke and shared his own difficult 
experience and life. He was just a man of courage. And he found that meaning, and he 
healed through that. So how can we help people to find that sense of purpose and that 
meaning? On every level. Sometimes it's just helping someone who needs help who is 
maybe sitting in a day program looking up to you or maybe it's helping an animal. 
Whatever it is. That's what we should be engaged in, what we should put our energy, 
rather than stopping negative behaviors, the pursuit of happiness, per suited of a 
meaningful life, and healing and joy, and I feel like this is the direction we need to go in 
rather than trying to change people. We can change ourselves. We can change our 
approach. We can learn the true, true keys to healing and start creating programs that 
really help people to actively engage in pursuing their own joy. 

So that's my presentation. And at this point I would love to open it up for 
questions. 


>> ASHLEY BROMPTON: Thank you so much, Karyn. We have some questions 
that people have been kind of holding for throughout the webinar. So I have those here, 
and I'll start reading them and then you can respond and we'll go through it like that. If 
anyone else has any other questions, please feel free to type them in the chat pod or 
the Q&A pod and we'll try to get to as many as we can in the time that we have left. We 
do have quite a few. 

The first question goes back to the slide you had on differentiating between big T 
trauma and little T trauma and the question was, why do you consider family violence 
little t trauma as opposed to big T trauma? 

>> Thank you for asking that question. Actually, I don't. I just kind of randomly 
put things up there. I actually consider most traumas big T traumas. I was just putting 
in examples. I actually agree with you. I think family violence is horrible, and I have to 
apologize. I don't think it's a little t trauma. It's just my example. Honestly, every 
trauma is a big T trauma on some level, but my purpose in having that slide is that I feel 
I need to validate all levels of trauma. 

>> ASHLEY BROMPTON: Great. Thank you. 

We have a couple of questions around how can we make the service users we 
work with feel more comfortable with talking to us about trauma or disclosing they have 
experienced trauma. 

>> KARYN HARVEY: That's a wonderful question. I think having a therapeutic 
approach is so important, and to be able to engage the mental health community in 
understanding that they should work with folks with ID, because you may not know their 
trauma, they may not even be able to talk about their trauma until a year or two of 
getting therapeutic support. Like there are people I work with are for over a year who 
didn't really reveal their stories of abuse until after a year or maybe two years or there 
was a triggering event. Oftentimes people --it's so painful that they're not willing to pull 
it up a and don't want to. So a lot of it is about creating trust, creating closeness, and 
then trying to get therapeutic supports for people that are much more long term. 

>> ASHLEY BROMPTON: Thank you. 

We had one question about --one of the participants is supporting a person who 
pressed charges against their alleged perpetrator and their alleged perpetrator was 
found not guilty, however, it's fairly well-known there is trauma that has occurred for the 
survivor in that instance and they're wondering if you have any tips on how to support 
the survivor through the process of understanding a not guilty verdict and moving 
forward beyond that. 

>> KARYN HARVEY: Oh, my God, that's so devastating. I have seen that 
happen so many times. I think you have to be completely honest with that person that 
sometimes justice isn't served, but they did the right thing by pressing those charges 
and that the perpetrator will at least be more careful the next time that they do think 
about hurting anyone or doing anything and at least they put light on it so they know 
they're being watched. I am of the school of being completely honest about the reality 
of life and it's tough, and that person did the right thing, and the more validation you can 
give people for their trauma and for the importance of what they're doing and the 
courage it takes, I think the better, and, you know, sometimes life is horrible and 
sometimes people get away with things they shouldn't get away with and just being 


honest about that but really supporting them and validating them and their experience 

makes a tremendous difference. 

>> ASHLEY BROMPTON: Absolutely. Thank you. 

I know this is something you wanted to talk about, and unfortunately we kind of 
ran out of time at the end, do you have any resources or information for family members 
who maybe have discovered that their loved one is dealing with trauma and how --how 
for family members to best support that individual. 

>> KARYN HARVEY: Thank you, Ashley. I really wanted to talk about that. 
Trauma to the family system, and I'm so glad you asked that question, because that is 
something we talked about talking about but didn't have enough time. The impact of 
trauma on the family is really --cannot be underestimated. First of all, the trauma starts 
with the diagnosis of disability, and then knowing that that child who then becomes the 
adult is so vulnerable. And then when there is actual trauma or an actual abuse case 
the entire family is impacted. I strongly believe in family therapy, including the person 
who was the person, but including the family as well and I think that's very healing and 
very important and understanding that no one is experiencing trauma in isolation. It 
impacts the entire family system. 

>> ASHLEY BROMPTON: Thank you. 

We also had a question, if you could just talk a little bit more about the particular 
type of therapy, EMDR, that you were speaking about. Is there something that there's 
inform readily available on? How could someone find out more information about that 
particular style of therapy. 

>> 

>> KARYN HARVEY: Thank you so much for that question. Yes, you can go 
online and you can find therapists trained in EMDR. I have actually even done with it 
people that don't use words when I knew what their trauma was and we were to really 
help them and process so much to the point where this one woman who we knew was 
sexually assaulted was having horrible stomachaches and the stomachaches went 
away after six months of doing the EMDR. It's really amazing. Of course, we got her 
checked out medically. But even to the point of people that don't use words, you can 
look online. There's a an organization EMDRIA that also offers many trainings, but 
there's therapists listed who are trained in EMDR, and I have worked in training 
therapists that do EMDR with --up in New Hampshire to do it with folks with intellectual 
disabilities. It's so easy and wonderful. So there is a whole network there of people 
trained in it. You do have to get pretty extensive certification. So you can find those 
therapists who are certified online in your local area. 

>> ASHLEY BROMPTON: And if any of you are interested in finding more 
information about that, Karyn's email address is on the screen and she has indicated 
she's welcome --she's interested in getting any emails from you for follow-up 
information if you would like. 

We have time for maybe one or two more questions. So we have a question 
about the typical trauma responses, fight, flight and freeze. You mentioned that you 
identify as a flight person, meaning that you escape social situations you may find 
punishing. Do you have any input on how to differentiate between an impulse or 
learned or unlearned response -



>> KARYN HARVEY: I'm -


>> ASHLEY BROMPTON: Because they learned that's what works for them? 

>> KARYN HARVEY: That's a great question. I'm working on myself. I'm trying 
to become braver and more courageous. You know, earlier time I might have done this 
whole webinar and lot left any time for questions because they're so intimidating but 
now I am brave and I'm not fleeing from these questions. But I believe that, yeah, when 
you see somebody really advancing themselves, when they have a very clear gain from 
a behavior that you can see that they're deliberately doing it over and over again, that's 
an escape response, yeah, that's clear. But frequently people are placing themselves in 
more harm or they're working against themselves in other ways with their flight 
behavior, and when you see that they are clear that they're not --and they're 
apologizing a lot afterwards, if it's not something that they're gaining from or they're 
wanting to do or they're doing it in a calculating and deliberate way, you know you're 
seeing a trauma response. And I believe that we have way more trauma responses 
than we have behavioral responses and I've just come to see that, that that learned 
responses, often people aren't as in control of their ability to act as we might think. 

>> ASHLEY BROMPTON: Thank you. We have time for one last question. 
Then if there are any other questions that we did not touch on today, we go we'll follow 
up with Karen, send them to her via email and get responses for all of you. 

There was a slight that wasn't discussed on supporting staff and making sure that 
you're dealing with vicarious or secondary trauma. Could you touch on that very briefly? 

>> KARYN HARVEY: I'm so glad you said that. I apologize for not getting to 
everything. I was trying to be mindful of the time but I couldn't help myself from telling 
stories. I believe the stories are so important and we all have them. 

This staff had their own trauma and that's a critical aspect. I have been working 
with the wonderful organization of the national DSP foundation which joke McBeth and 
John. They're fantastic. NADSP. And we've written some articles about this that staff 
bring their own trauma to work, so they need support as well. And in addition to 
sometimes experiencing vicarious trauma when they have to deal with crises and 
incidents and people who are traumatized. So you have the vicarious secondary 
trauma that comes from doing this work, and then you also have the history that many 
folks are bringing to their job, and so I'm actually working now on a piece on 
trauma-informed management because I think we have to acknowledge that and give a 
safe space to staff so that they know how to work with themselves and how to ask for 
the support that they need, because it's very difficult to do this work, and many people 
have been through a lot of things. I worked with one man who one day an individual 
came up from behind him and attacked him from behind and he had been in Iraq and he 
completely flipped out. That was a big trigger foam him being attacked from behind. 
And they wanted to fire him. And we sat down and made a case like that was a trauma 
response and this is what happens with people that are vets or just bring PTSD with 
them and he was --he was able to keep the job and able to get help, but it's tragic, and 
that's an extreme example, but it's actually pretty frequent that people have their own 
stuff. And somehow we have to have trauma-informed environments and 
trauma-informed management as well. 

>> ASHLEY BROMPTON: Thank you so much, Karyn. We really appreciate you 


taking the time to present for us today. For all of those of you who are interested in 
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For those of you interested in downloading a transcript of the webinar you may do so by 

going to the captioning pod at the bottom of the screen and clicking on the button that 
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download any materials you would like to download. Again, thank you so much for 
joining us today, and thank you again, Karyn, for this great conversation that we've had. 
The webinar recording, transcript and PDF of the PowerPoint will be emailed to you and 
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great afternoon, everyone.