 Hello and welcome to Abledon Arnair, this 9-11 pre-tape special. 9-11 is the anniversary of the terrorist attacks in New York City. As you know, as everybody knows, it was a horrible situation to deal with. We're here today to put everyone at ease and talk about how to deal with trauma. My wife, Arlene Seiler, is not here today. Normally she's here to host a show with me, but she's off because she was in the 9-11 terrorist attacks, but survived it. With us to discuss the 9-11 terrorist attacks and how to deal with trauma is... Margaret Joyle. ...from Washington County. Welcome to Abledon Arnair, this special of 9-11. Thank you. 9-11 was a horrible situation for anybody. What exactly is trauma and how does your office deal with it? So trauma or a traumatic event or events is any event that does two things. It overwhelms our capacity to cope. It overwhelms our usual ways of functioning and it results in an experience of threat to our innermost safety. Experience of threat, how so? So when we're experiencing a traumatic event, we often think that we often believe, we don't think, we believe, we experience that our lives are in danger. Or that the life of a loved one is in danger. And traumatic experiences almost all are unexpected. And they take away our sense of control and sort of the order of our universes. And 9-11 is a great example of that. Well, horrible example, not great. Fine. It's a perfect example, how about that? There were people there who were going about their business, they were working, they were doing all the things that people were doing in the towers, and all of a sudden their entire world's changed. The same thing is similar, the Holocaust, 6 million people plus died at the hands of somebody, they, and you're dead, you know, so. And traumatic events can be like that, they can be mass casualties, they also can be single events, they can be child abuse, they can be domestic violence, they can be school shootings. Columbine and some others. We had an experience a couple of falls ago here in Vermont where five kids were killed on the highway by a wrong way driver. That was a traumatic event for that whole community, for their families, for their friends, but really for the whole community. So that's, one of the things that happens in traumatic events is that they rarely affect just one person. There's typically a community around, even if it's an individual, around the people. And people are affected sort of like in concentric circles, sort of, you know, there's the direct effect and then there's the associated effects. Yeah, well, associated effects example. There's a lot of public service announcements sometimes if a parent is in jail or incarcerated. I'll give you a prime example, Sesame Street deals with this sometimes. They have puppets that go through some situations. Yeah, if a parent's in jail, the whole family is affected, or if a parent's on drugs, the whole family is affected. Does counseling services help all the time with things like this, or is there ways around it in different ways? So sometimes psychotherapy is important, sometimes treatment is important. Sometimes having a good support system around you and having friends and adequate supports is enough. So a lot of people don't come to therapy. After an acute event, like a one-time thing, terrible car wreck, something like that that's traumatic, more than half of the people don't develop sort of ongoing problems as a result of that. So in the support of their families and their friends and whatever other supports they have in their community, they recover. Sometimes events change us in such a powerful way that all those supports are not enough. How so? And sometimes we don't have enough support. So very often the people who come to Washington County Mental Health Services really don't have adequate supports in their lives. They don't have enough resources. They struggle with housing and adequate work. And they may not have supported friends and families around them. Being homeless sometimes is a traumatic event because I've been, I mean, you know, my wife and I were displaced. There was an organization in Vermont called Samaritan who's helped us. But, you know, if you don't know those services, you know, you're like, oh my God, oh my God, I'm homeless. Yes. I lost everything. You know, I mean, it's just stuff. So if you lose everything, like clothes, furniture, you can get it back. You can't get your life back sometimes, especially in traumatic things like 9-11. A lot of people did lose their lives. So people that did survive are now getting cancer or have died from cancer. From the environmental effects, yeah. Environmental effects of, what are some ways that if you're in a traumatic situation, you know, how does one really deal with it? I mean, what are some of the things to tell families who are listening, you know, how do you deal with trauma in certain ways? So the most important thing to do when someone's experienced a traumatic event is to get to a safe, secure setting as soon as possible. When people have experienced trauma, it changes our world. We're changed by trauma in ways that are irreversible. And so the most important thing we can do is connect with our friends and family and make sure that we're safe and that the other people who are involved in a situation are safe. And so that's sort of the first. People need to take care of themselves in a really intentional way. They need to pay attention to how much they sleep. They need to pay attention to what they're eating. They need to make sure that they're getting exercise. Because often when we experience a traumatic event, we want to just curl into a ball and hide, right? And that might be a good thing for a minute, but it's not really going to help us recover. So we have to make those connections back again. Expand on that a little bit, if you don't mind. So when people, and so that's any of us, experience a traumatic event, there are a couple of different ways that we respond. We fight back, we run away, or sometimes we try to hide. We try to curl into a ball. And so if those effects are ongoing, you can see people having hypervigilance. They're fighting all the time. They're irritable. They can't connect with the people who they love. You can see people who are fleeing. They're running away. They can't be in their homes. They can't come to work. They're too anxious. Or you can see people who just really retreat. They try to avoid anything that reminds them of the trauma. And sometimes that means even the people who are the closest to them. I mean, for example, during 9-11, elevators stopped. Transportation stopped. I remember that time I was living in the Bronx where I was living. It was one way in, one way out, one bridge. I was living in a city at the time. And things were closed down for weeks when my wife came home. She had all that stuff in her hair and took her four hours to get home off that bridge. Off the Brooklyn Bridge. So, you know, I'll give you an example. My parents thought it was a movie. Oh, a movie's on TV. There's no movie. So when all of this is going through someone's head, they're excited. They're hyperventilating. Expand on that a little bit. Besides counseling, are there other services that can really help? Yes. I think for people who have spiritual connections, often being more involved in our churches and our synagogues can help. I think people have to reach inside themselves and re-establish a sense of meaning. And so that can happen in a lot of ways. That can happen through one spiritual practice. It can happen through the way that people connect with each other. It can happen certainly through psychotherapy. But there are a lot of ways to do that. To do a cooking class. You could take a cooking class. The most important thing is to reconnect. To reconnect with that sense of meaning and of stability and of safety. Because when we experience a traumatic event, and I'm sure your wife could speak to this, we have that sense of safety and order in our lives. We all like to have order in our lives. It all gets pulled out like a rug from under us. And so we have to find ways to put that rug back. And usually again and again and again. So exactly how does your office help with this? So we have a program called the LINX program. And LINX is linking community supports. We also have a child and family trauma treatment program. And they were developed in, we started changing the way we practice really in the late 90s and established the program in around 2000. Our trauma treatment program is based on what we believe to be and what the research shows as the best practice, the standard of care. So we start with stabilization. We make sure that people have safe housing. That they have a food source. That they know that they have the resources that basically take care of themselves. And then we provide group therapy. And our group therapies as you're sort of alluding to are many things. We have psychoeducation groups. We have support groups. But we also have a wellness collaborative. And so we have mindfulness groups. We have mindful cooking. We have mindful gardening. We have yoga groups. And those are all ways that people can start to re-establish. Is this program only available to people who get services through Washington County or can it be available to the community? It is available to the community, people who come to links, become clients of Washington County mental health. So it's an outpatient program. And for us, that means really that anybody can access our services. Okay. So you've been in existence since 2000? Mm-hmm. Now, the counseling part, is it... Now, obviously we're not mentioning names. So is it a counseling group for a particular length of time? Or how does that work? So we have really several different modalities of treatment. We have groups and people often are part of our trauma treatment groups. And then we also have individual psychotherapy. And we also have people called treatment resource coordinators who can help in that first stage of treatment to help people stabilize. What is the first stage? The first stage is stabilization. What it really is about helping people sort of reset, to reset the button, whether it's in their physical lives, in their actual lives, or in terms of their internal lives managing their symptoms, their reactions, the things that they're having a hard time managing, teaching people skills to take care of themselves. That's the first step. So you teach them, basically, what have they gone through trauma? Well, do you teach them ADL skills like how to cook, how to clean an apartment, and how to do certain things? If they needed that. Now, knowing that, because trauma is a very strange thing. It can happen at any time. Has your program always been in existence? Like you said, since 2000. But has there ever been a trauma program before that? Or this is the only one that has? So before, really, we started changing things in the late 90s. Before then, we certainly saw lots and lots of people who had experienced trauma. But we primarily saw them in individual psychotherapy, in a more traditional psychotherapy setting. So there wasn't a program. So what we found is that we really needed to get more training. And we needed to take the things we were learning and apply them to community mental health. And so we set about doing that. It was really a cross-agency effort. We met with all the different programs and tried to make a program that would address the process of recovery from trauma. And so the LINX program is really one of a kind. We developed it at Washington County. There are lots of other places where people treat trauma. We have sort of a particular way we do it. And the particular way is finding alternatives to medication and other situations. Sometimes people take medication, but that's not by any stretch the majority. I don't encourage people to take or not to take medication. That's between them and their physician or their psychiatrist. But what I do encourage people to do is to really learn skills to take care of themselves so that maybe they don't need medication. Now, in terms of, how can I put this? There are certain words that shouldn't be, that have been taken away from medical jargon as far as, you know, such as the words retarded, certain mental, you know, between mentally ill, mentally sick, that type of thing. You know, people's ways of viewing other people with mental or physical disabilities. What is your opinion on the way things have changed over the years and have we made any leeway to changing things? I think we've made those changes you're talking about. If you're asking me if I think stigma still exists. Yes, that's my point. I think stigma still exists. I think people can get caught in thinking of somebody as... They automatically think, okay, somebody's mentally... For example, I'm originally from New York. They had hospitals like Bellevue and hospitals like... Originally, Willowbrook State Hospital and some others that have closed. But, you know, we have a long way to go. Yes, we have a long way to go and we've made really good strides. So our state hospital here, when it was in Waterbury, initially was thousands of patients. And we took most of those people into the community so that when the flood happened, another traumatic event was Irene, there were 50 patients there. And that's still... A lot of people would say that's still too many. Yes. But it's a lot different than 3,000. People were stuck there? They were warehoused. Warehoused in the... I mean, warehoused, how so? What exactly was the setup? Well, I think for a lot of people, they once admitted to the state hospital, it was hard to get out. Parley was hard to get out because there weren't enough supports in the community to help people make that transition. It's often a big transition. And so people could get really stuck in that system. And then that stigma thing comes up again, right? So somebody comes out, they've got a diagnosis, like schizophrenia or borderline personality disorder. And instead of having a diagnosis like borderline personality disorder, they're labeled that. So somebody's suddenly a borderline... The label's up for medication bottles, not people. Right. That's right. That's a beautiful saying. So people get labeled borderlines. They get labeled schizophrenics. And then what happens to the human? None of us are one thing. I might have a heart condition. That doesn't make me a heart attack. I mean, we're a bunch of things. And so one of the things about trauma treatment actually is that it recognizes that good trauma treatment recognizes that we don't have to be defined by one part of ourselves. And so often people who have experienced trauma, it envelops them, it becomes them. And so they are trauma survivors or they're trauma victims instead of people who have experienced trauma. And so recovery is about, it's not about forgetting, but it's about remembering that I'm a person who's... You can survive, you can survive this. And then I can get to a place where I'm a person who's experienced a traumatic event or events. I'm not that trauma. That's one of the things that affects me. Or for example, I don't have CP. I'm a person who has cerebral palsy and I deal with it. So my question is, in your opinion, what are the misconceptions around people with special needs or mental and physical? For people who first meet, if someone meets somebody for the first time, what is their way of looking at that? Well, I think we're experiencing it a lot right now in our media. We imagine that people who have significant mental health challenges are dangerous. They're going to hurt us. We imagine that people who are differently abled can't live fulfilling lives. For example, in terms of trauma, you automatically think, because you see a Muslim person who would say, a head covering on their head. Oh, they're dangerous. I know a lot of Muslim people that are just wonderful people. That's right. I know a lot of... I mean, just because you see an African-American or a black person, you automatically think that, oh, they're a drug addict. They're no good. The stigmatisms of her keep continuing. They do. So you're part of your agency. How many clients do you serve now? So last year, we served around 1,300 people, just an outpatient. And we provided over 20,000 services. We're a very busy program. So this is outpatient. This is not a crisis center where you can get a bed. If you need a bed, you help them find it, or how does that work? No, that's exactly what happens. So if somebody needs what I call a higher level of care, if they need an emergency bed, if they need to see a psychiatrist, if they need more services than we can provide, then we make sure they get those services. Are you guys screeners in itself, or is it separate? The screeners are a separate program. Our emergency services are very, very closely connected to us. But they are their own division. And we work hand in hand. They refer people to us who are ready to have more and need more ongoing services. We refer people to them when we're afraid that they're not safe. Your history in mental health, how has that been? What did you do before Washington County? I went to school. I started at Washington County Mental Health as an intern. Oh, wow. And I've done other things, but I haven't ever left Washington County Mental Health. Because you like Oregonian. Because I believe in our agency. I think we run a very high quality and exciting and innovative agency. I think we really work at engaging in recovery and in a strength-based approach, regardless of the issues that people come in with. In our current administration now, they're cutting left and right. How do you see the field of mental or physical challenges, physical disabilities, or special needs? Because they're cutting all over the place. How do you see that within a couple of years? Improving, non-improving? Well, when you say our current administration, do you mean in the state or on the federal level? Federal level. Yeah. So I think on the federal level... Do you think there can be improvements? I think there can be improvements. And I can only hope that this four years is four years and not eight. Yeah. And that's probably my biggest hope. Because, yeah. Now, because we don't want to see the situation go backwards, because throughout history, for example, people put in institutions because you had a mental challenge. People were given lobotomies. They were in trauma such as the Holocaust, if you had a mental challenge, you were killed. So your opinion on that and how we have gone from that to the future? Like, you know, how do you see things changing in certain ways? Well, if they were going to change in a positive way, we would continue to develop programs that serve people in their homes and in their communities. We would continue to work to develop thriving, resilient communities. And we would provide services to kids in the schools and in their homes and certainly in offices, but in the community. Do you go to people's homes? Yep, we go to people's homes. How does that work within your agency as far as... Well, we're a big agency, so different programs do it differently. We have three of our programs, including our Trauma Treatment program, that have staff that will see people in their homes. Because they can't get to you? Because they can't get to us usually, because maybe they're afraid to come into an office. So maybe it's part of the work itself that they get to a place where they feel okay coming in, but they might not feel okay or they might not have transportation. And so those are issues we can work on with them and sometimes really the best place for them to be seen is in their home. Future goals of your agency, all right? Your agency's been around for a while. What do you see going forward that we're in the 21st century? Because we don't want to go backward. No, we don't. I want to talk about going backward just for a second, because I'd like the viewers to know this. Last year there was a bill that didn't go through to build a huge facility in the way up in the Northeast Kingdom. Northeast Kingdom is where, exactly? Barton, Orleans, Derby. Out in the middle kind of of nowhere in terms of access, in terms of people being able to see their families or have their families come and see them. That would have housed kids, the elderly, people with developmental disabilities, people with what we call the forensic unit, people who are... What's the forensic unit? People who are involved in criminal justice and that have committed crimes that are maybe connected to their mental health problems. And they were all going to be put together in one gigantic building. And that would be going backwards. Wow. That would have been institutionalization. Terrible. Terrible. And so we should pay attention to that and make sure that nothing like that goes through our legislature. In your opinion, when you say that, I'll give you an example. New York had something called Willowbrook. Okay. Where it housed 6,000, 7,000 people. Building A, building B, building C, building 1, 2, 3, whatever. They were unclothed. They weren't fed well in their own feces, et cetera. And then Robert Rivera broke that with parents. And then the Willowbrook consent decree came into being. And then Vermont had the Brandon State School. The Brandon School, which was just as not good. Yeah, because if you put people in one building, for example, if I was put into a building with someone that was criminally negligent or something happened within the criminal system, it's not good. So how do you see that? Explain a little bit more on that. How do you vision that being as bad as the other way? Well, I would hope that we would never go back to the days of the state hospitals that really were their own creators of trauma, right? So you have people who have survived institutionalized trauma, whether it's on the Brandon Training School or the Weeks Training School or our state hospital or the state hospital you're talking about in New York. I would hope we would never go back to that. But I think when you have large institutions, you invite isolation for one thing. And then in isolation, bad things happen. We shouldn't live in isolation. That's not what we're built for as human beings. We need to live in community. And there's lots of research that supports that. They're also trying to get rid of Rikers Island, too. And they're trying to make it smaller facilities. So that's another big thing. So explaining a little bit more, we have some time, of the staff that work with you, are they social workers, clinicians? How is your staff comprised? Sure. So our outpatient program is comprised of psychologists. I'm a psychologist. Social workers, mental health counselors. We also have case managers. And we have that entity called treatment resource coordinators. They're typically, they have a master's degree. They might not be licensed yet. We have some access to psychiatry, though that is a small part of our program. And so that's kind of it, I think. So as far as 9-11 is concerned, it was horrible. Now we're moving to the future. Now, as far as trauma, if someone stuck in a traumatized situation, what should they do, number one? What should they really concentrate on? I guess calling someone you know, explaining a little bit. So if somebody's experienced the trauma and they're recovering, they're trying to recover from that trauma, then they should watch themselves. They should watch their sleep and their eating habits. They should watch their temper. They should pay attention to how their dreams are. And then, right, the first thing that we should do is reach out to the people who we know and trust. It's kind of hard these days. It's kind of hard to trust somebody you don't know. That's true. But if, at the end of a month, you find that you're still being haunted by nightmares of the event, or you're still unable to go back to work in a regular way, or you're still sort of replaying the memory of the trauma over and over again, then it might make sense to reach out to somebody who you don't know. And that would mean, in this area, potentially calling Washington County Mental Health. And the way that that happens is you call our main number, which is 229-0591, and you ask to do a telephone intake. And then that happens within the next couple of days. And if people want to come into our links program, then they ask for that. Or they say that they've experienced the trauma and they're not getting better. Well, I would like to thank you for joining us on this 9-Eleven Anniversary Special. This concludes Abledon Air's 9-Eleven Anniversary Special. We thank Washington County Mental Health for their insight on how to deal with trauma. Again, I'm Lauren Seiler. My wife Arlene is not here, but we leave you with this image. Back on 9-Eleven, there was a gentleman that fell from the towers. Time Magazine took that photograph. We leave you with that image, and we leave you with a couple of minutes of silence for the victims, the families, and the people who survived. Thank you for joining us on this 9-Eleven Anniversary Special. See you next time.