0:00

I don't know. If it were my children, it would not have been. It would

0:03

not. My microphone does a pretty good job to it, like cancel.

0:07

Well, that and zoom zoom does a good job too, at noise

0:10

canceling out, too. Okay, so we are

0:14

officially recording. Just hit that blue button that says okay,

0:18

and I'm going to start my timer,

0:22

and we can go ahead and get started. All right,

0:30

Dr. Park. Welcome to the OT schoolhouse. Podcast. How are you doing

0:34

today? Thanks, Jason. It's really nice to be here. Thank you for having

0:38

me. Yeah, I'm excited to have you here. We're going to be talking a lot

0:41

about trauma and aces, and we'll get deeper into

0:45

aces in just a moment, but I'm really excited to have you on. I

0:48

know you are in that professor role now and

0:52

director or I think it's doctoral coordinator over at

0:56

the University of St. Augustine for Health Sciences.

1:00

And you work a lot with that college age student.

1:03

Now. However, I know what we're going to be talking about today can also

1:07

be somewhat relevant to maybe some of those students who are in high

1:11

school and going through adolescence or in a

1:14

transition type of program. So I'm just excited to talk to

1:17

you today and talk a little bit about trauma Aces and how we can overcome

1:21

that. So, yeah, thank you so much for being here. Thank you. I'm really excited

1:25

too. This is one of my favorite topics to talk about. Awesome. Well,

1:29

before we dive into all of that fun stuff, I just want to give you

1:33

just a moment to kind of share where you are in your occupational therapy

1:37

profession right now. Yeah. So I'm currently a doctoral

1:40

capstone coordinator and assistant professor at the University of St. Augustine for Health

1:44

Sciences. I'm on the San Marcos, California campus. So our West Coast

1:48

campus. And in this role, I support

1:51

doctoral students in their capstone process as they work through their

1:55

projects. And also I've been doing some

1:59

mentorship related to kind of understanding the experience of

2:02

trauma. So a lot of the students that maybe focus on

2:06

children with the experience of trauma in their background or history,

2:10

mentoring the students to really understand kind of the complex,

2:14

holistic experience that children and youth may experience

2:17

and so really focusing on helping supporting them understand

2:21

that process and to be able to obviously create

2:25

programs or conduct research in a way that's really going to be supporting the

2:28

population. Wow, that's a very

2:32

unique position to be in, not just the larger the broader aspect

2:36

of doctoral coordinator, but also really honing in on that

2:39

trauma for not trauma for the

2:43

students necessarily, but kind of overseeing that area a little

2:47

bit. So does that mean that there are quite a few students

2:50

that are looking more into trauma, whether it be school age students

2:54

or otherwise? Absolutely. So I used to

2:58

be also a fieldwork coordinator, academic fieldwork coordinator at a previous

3:01

institution. And so I think there has been kind of this emerging

3:05

interest in looking at the experience of trauma in children and youth.

3:09

And a lot of our students come with a background, maybe with

3:13

experience working with children in general and then are noticing that maybe

3:17

there are some negative experiences that they've had in their past.

3:20

And thinking about as an occupational therapist, how do we really focus

3:24

on the occupational impact of this for the child and also

3:28

the family, the community as a whole? And so I do feel like that

3:31

has been a topic that more students have been interested in.

3:35

And so as we've gained more interest from our students, we've also then been

3:39

able to partner with different community settings. And once we establish these

3:43

partnerships, the settings are telling us there's a need here

3:47

and we don't have this perspective from an occupational therapist

3:50

necessarily. And so it's been a really nice partnership or a

3:54

match for our students to be able to step into some of these spaces

3:57

where maybe there aren't established OT services and they're able to address

4:01

some of these areas that I think we really

4:05

do have a really nice role for. Perfect. I'm excited

4:09

to dive into that. However, there was

4:12

one more thing on the personal side that I wanted to get into first, and

4:16

that is that you're also the Vice President of the Asian American Pacific Islander

4:20

Occupational Therapy Association. And I kind of wanted to mention that

4:23

and also ask you a how's it going? And also

4:27

what are some of the responsibilities and priorities that you have in that?

4:31

Yeah. Yes, thanks so much for mentioning that. So I was recently

4:35

elected earlier this year, so I've been in this role for maybe six months, so

4:38

it's still pretty new for me. And we sort of had a

4:42

rebranding the association, it was previously

4:45

called Asian

4:48

Pacific Heritage OT Association.

4:52

And so it's been around actually for a few decades and it's been a part

4:56

of the multicultural diversity,

5:00

oh gosh, I'm going to mess that up. MDI network through AoTA.

5:04

And so within the MDI network, we've been a part of this network for I

5:08

think almost three decades, but we're in this process of kind of

5:11

rebranding the association. We did come up with a new name, so now we're the

5:15

association of Asian Americans and Pacific Islanders in Occupational Therapy,

5:19

or Aapiot. And I think along with the Asian

5:22

American experience, really emphasizing how

5:26

there are some unique strengths within our community, obviously

5:30

some unique challenges. I think there were some

5:33

challenges and some concerns that came up especially during the

5:36

pandemic with some anti Asian hate crimes and such. And so really trying

5:40

to increase the visibility of dissociation within the profession because

5:44

we do have a good number of Asian American practitioners in our

5:48

community across the country. And so really wanting to support Asian American

5:51

therapists, asian American Pacific islander therapists

5:54

who are kind of experiencing some of these unique challenges,

5:58

whether it's in practice or within OT communities and spaces.

6:02

And so we've been creating some different initiatives.

6:05

We have a really great series on Instagram right now, looking at

6:09

just kind of different occupations within different cultures within the Asian

6:13

diaspora. So we've had students and practitioners that have been

6:16

providing some different posts that we've been able to highlight.

6:20

So definitely if you're interested in learning more, follow us on Instagram

6:24

and our other social media accounts like LinkedIn and Facebook.

6:27

And there's some really great stories on the post.

6:32

A lot I've been spending a lot of time on LinkedIn, so I've been seeing

6:35

it over on LinkedIn. And, yeah, it's just been a lot more

6:39

present than I know it was even maybe six months to a year ago. So

6:42

that's awesome. Great. It's working. We want to

6:46

mention also that we want to get individuals engaged. We want to make sure that

6:50

people know that we are here. We're an established association. We are

6:53

here to support the Asian American Pacific Islander

6:57

community in occupational therapy. And so if there

7:00

are projects or programs or research that people are

7:04

interested in that we'd love to connect, a lot of the leadership were connected

7:08

with different universities or different areas of practice within the country.

7:12

And so there's a lot of interest to kind of growing these other aspects

7:16

to be able to support our community. Great. Well, thank you for sharing.

7:20

Thank you. All right, well, let's go ahead and

7:23

dive into our main topic for today, and that is talking about that

7:27

experience of trauma. As I mentioned, you are now at

7:31

that college level, but a lot of this

7:34

information, this research that we're going to be talking about today, I really think can

7:38

apply to that adolescent age and transition age

7:41

period. So I want to ask you, from your perspective, why is

7:45

it so important to address the trauma and mental health of teens

7:49

and young adults? I know this is a little loaded, but I'll let you share

7:52

kind of your response. Right? So I think I've been

7:56

working in this area looking at childhood trauma and

8:00

complex trauma in different populations for a while

8:03

now through my practice and also

8:07

through field work experiences. But I think the COVID-19

8:11

pandemic really placed this increased focus on this discussion of

8:14

trauma right. In children and adolescents. The disruptions that were caused by

8:18

the pandemic, school closures, the isolation that children were

8:22

experiencing, the fear and the grief that

8:25

we all felt because of the virus, it really exposed

8:29

many of our children and youth to potentially these traumatic

8:32

experiences. And so I think since the pandemic, there's this growing

8:36

discussion about the impact. And I don't know if we really understand

8:39

even the long term impact right from what happened during those

8:43

years. And so kind of understanding there's a

8:47

broader picture going on. I think previously there's been more of

8:51

this I don't want to say simplified, but this kind of

8:54

narrow understanding of trauma that it's very individual and it's

8:59

abuse and these really super what I call big T

9:02

trauma. And so I think since the discussion

9:06

of trauma came about during the pandemic, we're really starting to understand some of

9:10

the really subtle ways that maybe our children and youth are

9:13

experiencing some negative experiences in their world and within their

9:17

context with our students. I do work with

9:20

graduate students and I actually recently completed a chapter on adolescence

9:24

and adolescent development for an OT textbook. And there's

9:28

this emphasis in this time period around identity formation.

9:32

And so there's an author, his name is Jeffrey Arnett. He talks about

9:36

this period of emerging adulthood. And before it

9:40

was thought that adolescents, they just become adults, they turn

9:43

18, they get a job, they go to college. And so there

9:47

was a different shift from

9:50

adolescence to adulthood. But now we're starting to

9:53

consider this period of emerging adulthood which is really kind of

9:57

encompassed by this developing self identity, kind of

10:01

this feeling of in between and kind of this uncertainty

10:05

too, of I'm not exactly sure where I'm going.

10:08

Adolescents and young adults are taking a little bit longer figuring out their

10:12

careers. They're not settling down in committed

10:15

relationships as frequently or as early as in the past.

10:19

And so really kind of thinking about this emerging adulthood and that identity

10:22

formation and how potentially kind of

10:27

everything that's happening in the world that is challenging, that

10:30

is really difficult to understand and to manage,

10:34

how that really impacts the way that we might develop and form that

10:38

identity is something that I try to really emphasize in the work we do.

10:42

Absolutely. I mean, developing your self identity is just huge, especially

10:46

for that adolescent, young adult age. And there's a lot

10:50

of things that we're seeing at high school that's very different from when I

10:53

was in high school, 20 years now or so. And we're seeing

10:57

teens get much more involved in politics. We're

11:01

seeing a lot of policies put in

11:04

place that they don't necessarily agree

11:08

with and we're just seeing them take on more of that activist

11:12

role. And part of that is that self identity that they're starting to see

11:16

the impact that they can have on politics. I think a lot younger, which I

11:19

know again, when I was younger, they were like begging us to get out, to

11:23

do more political type of things, get out and

11:26

vote. But I think nowadays we're seeing, like

11:30

you mentioned, maybe they're not getting into their career as early,

11:33

but they're still starting to be much more of an advocate for

11:37

themselves and individualized,

11:41

but also as a community. And they're coming together as a

11:44

community to self identify as well.

11:48

Are there any other things you want to share a little bit about

11:52

addressing trauma with this age group? Right. I think

11:56

the point that you bring up about kind of these social justice movements within

12:00

the adolescents, currently young adults. I think that it's so wonderful

12:04

to see people getting so engaged in causes

12:07

and speaking up and voicing concerns

12:11

about some of the problems that our country and our world is

12:14

facing. So I wrote a little bit about this

12:18

in the chapter, too, the increase in social media,

12:22

the access that we have now to news

12:26

and kind of varying perspectives and

12:29

just more information that comes from social media. And

12:33

so I think that's something that's so interesting to see young adults, even

12:37

my own children, I have teenagers, I have a 13 year old, a 16 year

12:41

old, and an 18 year old. And sometimes they'll share something with me that they

12:44

learned on social media. And I'm like, Where did you learn that? And they'll say,

12:48

oh, I read that, I heard that on TikTok. I'm like, oh. And they always

12:51

say, See, TikTok can be educational.

12:55

But also, because of the social media presence, especially

13:00

in the youth and adolescents, we also see

13:03

them having that exposure to some of the really traumatic

13:07

experiences happening around the world. So the images of violence and

13:11

images of these really terrible events that are

13:14

happening, there's so much more exposure to those kinds

13:18

of events and also just the emotions that come

13:22

about from that exposure. I think it's really important to be

13:26

able to communicate with the youth and to be able to process

13:29

through, because sometimes the experience of just being exposed to the

13:33

images can be also seen as a somewhat traumatic event.

13:37

Yeah, I mean, social media is huge, right? You

13:41

think about even ten years ago,

13:45

much more so 2030, 40 years ago, parents and

13:49

adults had much more say, much more control over

13:52

what teenagers were exposed to. And now with social media, you're

13:56

just getting so much more information. And we're hoping that social media

14:00

is starting to, in a way we want them

14:04

to filter, but we don't want them to filter. It's a hard balance. I know

14:07

it's hard for social media, right? But they can get the

14:10

information from any side, from any point of view, rather than

14:14

just getting the point of view of the adults in their life.

14:19

And also being able to critically think too critically

14:23

analyze and see. Different perspectives and to really kind of

14:26

decide for themselves, like, what is important to them, what is a value for

14:30

them, and to be able to support some of the causes

14:34

that they really find value in. Yeah, and there was one other term

14:38

that I wanted to mention before we move on to talking more about aces and

14:42

trauma was the age of feeling in between. That

14:45

was something that you've mentioned in the past. Can you explain what that means for

14:49

this? That's another that's part of the concept of emerging

14:53

adulthood that Arnett has talked about, where, again, in the

14:57

past, there was kind of this more clear path that our adolescents would take. They

15:00

would graduate high school. They would get a job, go to

15:03

college. And now we find that emerging adults

15:07

are kind of choosing very different paths. And so you

15:11

mentioned the activism piece, but people are taking gap

15:15

years and traveling more and just kind of taking more

15:18

time to decide for themselves what really is

15:22

important to them. Is it really important to settle down

15:25

and be in a committed relationship or partnership more long

15:29

term? Or is it more important to kind of explore different

15:32

thoughts, different causes in the world? And so I think

15:36

that's something that we're seeing more of, especially in this phase

15:40

of emerging adulthood. And so it's interesting to see with our OT students

15:43

because obviously they're in a program, a rigorous graduate program,

15:47

and they've chosen this path. But I think at the same time,

15:51

in the process, especially of the Capstone, we're still trying to

15:54

facilitate kind of this thought process, this

15:58

critical analysis, this critical thinking of all kind of the events that are happening

16:02

in the world and how it relates to them and how they connect with their

16:06

communities. Great. Well, thank you.

16:09

Let's go ahead and move on to asus I kind of

16:13

brought it up in the intro, but I think a lot of us understand the

16:17

term Aces. But you also kind of mentioned a capital T, so maybe there's a

16:20

lowercase T. So I want to give you an opportunity to kind of

16:23

explain Aces to your understanding and how you

16:27

define it. Yeah, so Aces, for those that may not be

16:31

familiar, it's adverse childhood experiences. And so

16:34

this was a study conducted in the 90s by a physician through

16:38

Kaiser. And he started to find that a lot of the patients that he

16:42

saw, adult patients that maybe had these

16:46

ongoing health concerns, chronic health conditions, he started to just

16:49

ask some questions, just in conversation and then starting

16:53

to identify this pattern that a lot of these individuals that

16:57

had some of these ongoing, chronic health conditions later in life

17:01

had very similar negative experiences in childhood or

17:04

toxic experiences or toxic stress. And

17:08

so based on that initial observation, he conducted this study

17:11

where he created, like, this ten item questionnaire

17:15

asking, have you had exposure to childhood physical

17:18

abuse? Sexual abuse, emotional neglect, physical neglect?

17:22

Did you have a person in the home that had a mental health condition?

17:26

Was there a person in the home that was a

17:29

substance user? Did they witness domestic violence?

17:33

And so based on that, the responses he found this relationship

17:36

between Aces and later health concerns, that

17:40

the more Aces you had, the more that you reported these negative experiences in

17:44

childhood, that it turned out that

17:48

these individuals struggled with more of these conditions later on. And

17:52

so that's something that he published in the there's been so much

17:55

discussion around this, and I think initially there was

17:59

I think this kind of doom and gloom sense of like, oh my gosh,

18:03

well then if this is the trajectory, then oh my goodness,

18:07

these individuals are just going to have all these problems. And one of the

18:11

findings was that there was also early death some of these

18:15

individuals. But as an OT, I think really kind

18:18

of criticizing the whole notion that

18:22

this is the only trajectory for individuals, for all of our kids that

18:26

maybe do experience some type of traumatic event or pervasive

18:30

trauma in childhood, that as OTS, we

18:33

argue that there is a way to really turn the ship around. And

18:37

so there have been some criticism of the

18:40

Aces, especially because initially the study was

18:44

done through Kaiser, and so it certainly included a certain

18:47

demographic of patients. And so it didn't really take into

18:51

consideration multiple socioeconomic classes

18:54

or ses status levels.

18:59

And it really kind of negated an understanding

19:03

of some of these other traumatic events that now we're a

19:06

little bit more attuned to. So that includes like, systemic racism and oppression,

19:10

the global pandemic. So the pandemic is definitely an ace.

19:14

All of our children, we can count that. And

19:18

also the experience of collective trauma. So maybe it's not something that we as an

19:22

individual may experience directly or individually, but

19:26

as a community, I think there's a lot of communities that have been targeted

19:29

in our country that have experienced violence. And so this collective

19:33

trauma of having an identity with a certain community and

19:37

feeling this fear and feeling the sense of loss from

19:41

that, I think a lot of people are now arguing that there is

19:44

a need to really think about all of these other factors too,

19:48

and also really understanding the value of trauma informed

19:51

care. So, again, not to paint this

19:55

picture of doom and gloom, if you have these aces, you're headed down

19:59

this path of having all these health conditions. But there's this

20:02

value in really thinking about trauma informed care as protective

20:06

factors for our kids. So there's literature about

20:10

how a stable, consistent caregiver in the

20:13

life of a child is going to be that protective factor buffer

20:18

the environment, the social, cultural context,

20:21

it could either be a buffer, it could be also a barrier or a cause

20:25

for more negative experiences too. And so there's been kind of this need or

20:29

push to redefine aces. And there's this one resource through the

20:33

Paces connection. So paces being positive and adverse

20:36

childhood experiences. And there's a really nice website that has a lot of information

20:40

on this. So Paces being that we want to consider all of these

20:44

things, it's a very holistic picture of not just here are these negative

20:47

experiences which leads down this terrible path,

20:51

but how do we also support the

20:54

buffering of our children, right? How do we now think about how to

20:58

increase those positive experiences to then

21:02

support our children in their development? Very interesting.

21:06

I had not heard of paces yet. So thanks for sharing about that. And

21:10

earlier. One thing that I'm really interested in, and you kind of

21:14

alluded to it earlier, is that capital T? Because I think when a lot of

21:18

us think of trauma, we think of the household, right? Things that happen in the

21:21

household. A lot of those Aces that you mentioned earlier were like

21:26

experiencing and or witnessing domestic abuse

21:30

or whatever it might be. It's usually in the household, but obviously

21:34

trauma doesn't just happen in the household, right. So what are some

21:37

other factors outside of the household? You mentioned a little bit with society,

21:41

but I think environmental was one of those that you wanted

21:45

to discuss. Yes, absolutely. So environmental factors, I think the

21:49

Pandemic is a great example of that. But in certain areas of the world,

21:52

natural disasters, the climate crisis, access to

21:56

resources or not, or having some of that

21:59

deprivation, when it comes to resources, there's also community

22:02

factors too, that wasn't really

22:06

addressed or explored in the original Aces study. So

22:10

thinking about poverty and food scarcity and housing instability,

22:13

I think with the understanding of more structural racism and

22:17

oppression, all of these things within the community

22:20

environment, I think those are factors that we're starting to understand a little

22:24

bit better and how that may impact a child. And I also want to bring

22:27

up kind of this idea of ambient trauma. So ambient trauma is

22:31

this term where it may be a very seemingly

22:35

insignificant event. So that's what I call the little t.

22:38

So a really minor event, but as they accumulate over

22:42

time, that can create a more

22:46

negative impact on the child overall. And

22:50

so I talk about my youngest child, Amelie. Omali is gender

22:53

diverse, has a more masculine gender expression. And so

22:57

when they're in their middle school, they signed up for the girls

23:00

volleyball team. That's something that they're really interested in. And

23:04

comments from the leadership and

23:07

other girls like, oh, this is the girls volleyball team, this is

23:11

for girls. And having those are like little

23:15

events that they'll come home and talk to me about.

23:18

And as that accumulates over time,

23:22

getting looks when they go into the bathroom, the women's restroom, things like that,

23:26

those kinds of things can again have this greater

23:29

traumatic impact over time. So I think those are things that I also want to

23:32

point out that it may not be these big traumas that

23:36

we are more aware of and are knowledgeable about, but it

23:40

could be these really seemingly insignificant minor

23:43

events that kind of target a certain identity

23:47

as well that over time can really

23:51

contribute to a sense of not belonging

23:54

and exclusion. Basically.

23:58

Yeah, I'm glad that you used that example, just

24:02

kind of because this is a school based occupational therapy podcast, right?

24:05

And to hear a little bit about your child's

24:09

experience in school, one of the things that I'm seeing a

24:13

rise in with school based occupational therapy practitioners is the

24:17

idea that OT practitioners should be supporting in some way

24:21

bullying. And I agree with that.

24:24

There is that traditional thought of school based occupational therapy

24:28

only focusing on an IEP and students with special education. But I think we can

24:32

definitely move more broad and support the other realm

24:36

of general education students. And I think that bullying can be a part of

24:39

that. And we should absolutely be on different teams at

24:43

schools to potentially support or

24:47

improve bullying on campus. So I think that that is something that we can use,

24:50

this trauma informed practice, this trauma informed idea.

24:55

We might be the profession to bring it to the rest of the school

24:59

campus. Like, teachers might not hear about trauma informed practice, but that's just something

25:02

that maybe we can bring to the table and support the team with.

25:08

I want to reference Dr. Susan Basic. Who's? From

25:11

Cleveland. Cleveland area. I'm sure a lot of people are familiar with her

25:15

work, but she looks at it from a public health

25:18

perspective, the three tier perspective, and thinking about larger

25:22

promotion of mental health. Right. Positive mental health.

25:26

And so when you bring up bullying, it's not necessarily targeted interventions,

25:30

but can we do school wide programs related to that? I think there's absolutely a

25:33

hugely valuable role for OT, and I think considering

25:37

students with very diverse identities and

25:40

intersectional identities, and I think OTS have an understanding of that

25:44

as well and can contribute to that sense of belonging for our kids.

25:48

Absolutely. And while you were talking, I was trying to look it up, and I

25:51

can't remember susan Basic has been on the OT schoolhouse podcast. I can't remember what

25:55

episode it was. Yes, she is amazing.

25:59

She has several programs that are designed to be school wide programs, from a

26:02

recess program to a cafeteria program. There's probably a specific

26:06

bowling program. I'm not sure if they got that yet. But

26:09

everymomentcounts.org, I believe, is the website. If it

26:13

isn't, we will link to the Real website in the show

26:16

notes. Yes. I recently saw a post. She's doing

26:20

something with something new with every moment count. So it's continuing to

26:24

expand. So a great, great program. And yeah, definitely

26:27

needed in our schools. Episode 36. That's what it

26:31

was. All right, so episode 36 if you want to learn more about Dr.

26:35

Susan Basic. Great. All right, so we

26:38

talked about some of the trauma that can

26:42

impact our students. Let's talk about some of the outcomes. You've

26:46

done some research into this and have learned what some of those

26:50

long term outcomes may be. So I'll give you an opportunity to

26:53

share a handful of what those outcomes can be for

26:57

our students who do experience trauma. Absolutely. Yeah.

27:00

So kind of going back to the neurobiology of trauma,

27:04

I'm just fascinated with the brain, and I feel like when I learned about

27:08

neuroscience, maybe I wasn't paying attention, but I don't remember

27:11

learning about the limbic. I'm sure we learned about it. But, like, the

27:15

limbic system processes and kind of the physiological processes

27:19

of how trauma affects our brain, which is so critical

27:23

for our children and youth and adolescents, because their brains are

27:27

still developing, their brains are still continuing

27:30

to be constructed. And every experience, positive and negative,

27:34

is going to change the trajectory of that brain development slightly, too.

27:38

And so I can go a little bit through the neurobiology. That's okay.

27:42

Yeah. And so, yeah, the limbic system

27:46

is where trauma lives. And I want to credit actually one

27:49

of my friends and former colleagues, Stephanie Bodison, I took a course with

27:53

her on sensory integration, and she kind of frames

27:57

the limbic system in four different processes, and

28:01

she uses the acronym Move So M being Memories.

28:05

So memories are really stored in our limbic system, in our

28:08

hippocampus. It could be positive memories. It could be negative memories.

28:12

I use this example of when I went to Sonoma

28:16

and I was in a lavender field. And now that every time I smell

28:19

lavender or see lavender, that always takes me back to that beautiful and positive

28:23

memory. But in the same way, when there's a negative

28:27

memory, there's some type of memory that we store in our hippocampus and

28:30

something triggers it, right? Whether it's a smell, whether it's the

28:34

sight of something, whether it's a comment that

28:38

someone makes that can be triggered in our hippocampus.

28:42

And as I have mentioned, smell. So that was the second part of

28:46

Move So olfactory. So the olfactory bulb is also part of the

28:49

limbic system. And so the way that we process

28:53

smells, sometimes it goes straight to our brain. It

28:57

doesn't get filtered like other sensations do. And so that may

29:00

be the first sign of something negative, like the smell

29:04

of smoke or fire. It could be the smell

29:08

of alcohol. It could be something that they smell

29:12

that to someone else may not seem very negative, but is

29:15

associated with a negative interaction with another individual. Right?

29:19

And then another part of the limbic system is the amygdala. And that's where the

29:23

emotional responses live. And so that's where we store emotions, and

29:26

that's where we process some of these emotions, especially when

29:30

we experience these negative

29:33

experiences. How we process the emotions is such an important piece for our kids

29:37

because we see moments where

29:42

they're being challenged to kind of regulate in a classroom and they're

29:45

trying to regulate in a certain setting where maybe learning needs to be

29:49

happening. Right? And so how do we regulate these emotions? And then

29:53

the last one is the visceral experience. The somatosensory

29:56

experience. I kind of went out of order for Move

29:59

M-O-V-E but the somatosensory or visceral

30:03

experience, Karen, memories that we hold in our bodies. And there's so many books on

30:07

this. The trauma keeps a score. I'm sorry, the Body Keeps the Score

30:10

talks about how we store this. Trauma in our bodies and it really

30:14

does live within us and we carry it throughout our life.

30:17

And so we're really thinking about how those visceral

30:21

memories can also be triggered is something that's really important.

30:25

And I think what's also really important to point out is that the limbic system

30:28

has kind of this inverse relationship with the frontal lobe. So

30:32

there's this really interesting connection there where the

30:35

more active our limbic system is, right. Again,

30:39

trauma lives in our limbic system. So the more active it is, the more that

30:42

we are stressed because of something in our environment or

30:46

some type of trigger that we're experiencing in the moment, our frontal

30:50

lobe is less active. And so frontal lobe I always say, is where

30:53

executive functioning lives. So that's where tension comes from, that's where

30:57

regulation comes from. That's where processing and problem solving

31:01

and judgment all of these important skills that our children

31:04

are learning to develop. Right. And so if our children are in

31:08

environments where there is a very active limbic system that

31:11

they're trying to manage the frontal lobe development, executive

31:15

functioning development is not going to be as optimal. And so that's something

31:19

that we need to really take into consideration in some of these environments and

31:22

settings that we may think. Again, going back to ambient trauma,

31:26

oh, that seems like such a minor thing. Not really

31:30

significant, not a big deal. But for that child in that

31:33

moment, they're processing this trauma now in their limbic system

31:37

and now they're not able to pay attention. They're not able to

31:41

engage in whatever they need to be doing in the classroom. They're not able

31:44

to transition between activities. They're not able to regulate

31:48

their emotions. And so that's a really important piece to understand kind of that

31:52

relationship with the limbic system and frontal lobe. Great.

31:56

I'm glad you got Move in the right order. Sorry. I know you said a

31:59

lot after that I was fixated because at first I wasn't sure if it was

32:02

move or mose and I was like, all right, it could be either or the

32:05

way you're going through it. But it worked out well. Yes, move. M o

32:08

ve? Yes. Perfect. And I wrote it down. Memory for everyone out

32:12

there listening. Memory, olfactory, visceral and

32:16

emotion. We got it. Very cool. All

32:19

right. Kind of while we're on the topic of the brain,

32:24

the polyvagal theory, I know that polyvagal theory and

32:27

asus kind of go hand in hand a little bit and so I want to

32:30

give you that kind of opportunity to share how the polyvagal theory kind of fits

32:34

in with understanding the experiences of trauma

32:37

and right, right. So the polyvagal theory was developed by

32:41

Dr. Stephen Porges and it's a neurobiological

32:45

framework and it really considers how individuals behave and act and

32:48

respond to stress or just experiences in the

32:52

world. Sorry, really quickly I'm going to ask you that question. You're

32:56

not doing anything wrong at all. It was a good time for me to

33:00

stop, so I remember exactly where we're at. Jenna, are you

33:03

there? Yep.

33:07

My EarPods died on me. Have you heard any

33:11

feedback or anything coming through either person's microphone for the last

33:15

few minutes? Nope. You guys supposed to OK, that's what I thought. I just wanted

33:18

to double check. Thank you. I appreciate it. They did

33:22

not charge when they were supposed to charge this morning, apparently. I did want to

33:25

talk about the HPA access, too, so I don't know if that okay. Well, let's

33:29

take a step back, then. All

33:32

I have here is HPA access. Does kind of relate to the neurobiology, and so I can talk a little bit

33:40

more about impact.

33:46

Modulates response to trauma. Okay, so the limbic

33:49

system is where

33:53

the trauma lives, and then the hypothalamic HPA is

33:57

more what? Modulates the trauma. Okay, I got it.

34:00

I got a question for this. Okay, cool. All right.

34:09

So the limbic system, as you mentioned, is what kind

34:13

of it's where trauma live? That's kind of how you mentioned it. Now,

34:16

the hypothalamic that is not how I wanted to word that question.

34:20

This is what happens once you stop. Things get weird. That's okay. All

34:24

right. Make sure I'm on the right track. Sorry. Go

34:31

ahead. Go ahead. All right. So the

34:35

limbic system is where trauma lives, as you mentioned.

34:39

But what is the part of the brain that can kind of

34:42

maybe help us overcome that side of

34:46

the brain? If there's a lot of trauma living in the limbic system, is there

34:49

another part of the brain that kind of helps to potentially modulate that a little

34:53

bit, overcome those right. Right. So there is

34:57

the HPA access, which is the hypothalamic

35:01

pituitary adrenal access. So this is kind of our

35:04

alert system that's activated in our brain, in our body, when we

35:08

perceive any type of stress or trauma. When people talk about the

35:12

HPA axis, a lot of times they'll use the example of seeing a bear. Right?

35:15

You see a bear, you react, your fight or flight kind of

35:19

goes activated, and

35:23

we respond to that. Right. And so the hypothalamus

35:27

is where hypothalamus is where we kind of

35:30

perceive that stress initially. And so once it perceives that stress, it

35:34

sends a signal to pituitary gland that signals kind of this trigger a

35:38

release of the I want to get this right corticotropin

35:41

releasing hormone. That's what I which is a lot easier.

35:45

And so once the pituitary releases CRH into our system, then the

35:49

pituitary gland receives that signal and is alerted. Okay. Danger.

35:53

Danger. And then releases the

35:55

adrenocorticotropic hormone

35:58

ACTH into the bloodstream. And then once ACTH

36:02

is released into the bloodstream, that reaches the adrenal glands, which are

36:06

located above the kidney. That tells our adrenal glands basically help.

36:09

SOS, right. We're stressed here. We need to do something about this.

36:13

And so that creates this process of releasing stress hormones

36:17

into our system, typically cortisol. And so cortisol is a

36:21

major stress hormone. It increases our heart rate and our blood pressure.

36:24

It kind of provides this burst of energy that prepares us for that fight or

36:28

flight response. And a little side. Like, I really enjoy

36:32

backpacking. And so when I'm in the woods, maybe I backpack for

36:35

10 miles. I'm exhausted. I'm settling down, setting up my tent, and I'm

36:39

laying down to relax at the end of a long hike. And then I hear

36:42

a rustling, right? And you think, oh, my gosh, there's a bear. And no matter

36:46

how tired I am, no matter how I feel like my muscles are

36:49

not on my side anymore, and I quickly

36:53

jump up, right? You quickly jump up and you respond. The cortisol in our system

36:57

really alerts us in a way that makes us respond

37:00

for our sense of safety. And so, related to the

37:04

HPA axis, the concern with our children is that when there is the present, we

37:07

want cortisol to help us respond to stress. That's a good thing.

37:12

But when we have children that are experiencing ongoing abuse,

37:15

maybe witnessing ongoing violence in the home or community,

37:19

whatever, it may be ongoing traumatic experiences. What happens with the

37:22

HBA access is that the cortisol is being consistently released over

37:26

and over, and that can create a sense of hyper vigilance

37:30

for our kids. So they're on high alert all the time. They're not always

37:34

able to discern what truly is safe, what's not

37:38

safe. And so especially as the brain is

37:41

developing, that's a really big piece of we need to be able to

37:44

identify, okay, what's truly a safe space for me, or what

37:48

is something that is truly dangerous that I need to respond or my body needs

37:52

to go into that response mode. And so that's a big

37:55

concern with young children, again, as their brains are developing,

37:59

because the more cortisol is kind of left in our

38:02

system, we could see decreased immune

38:06

system processing or function. We might see changes in

38:10

metabolism, differences in glucose levels. And that's why we

38:13

see kind of this connection of early childhood stress causing

38:17

some of these conditions later on, like diabetes or health condition or

38:21

heart conditions and et cetera. I hope that makes sense.

38:25

Yeah, absolutely. And you mentioned flight or

38:28

fright. I can never say that correctly. And I know you also can have

38:32

freeze, right? Flight, fright, flight or

38:35

freeze. And when I hear those, I often think of the polyvagal

38:39

theory. Do you kind of reference the polyvagal theory

38:42

in the work when you like to talk about this? Definitely. Yeah. So the

38:46

polyvagal theory, for those that may not be as familiar, was developed by Dr. Stephen

38:50

Porges. And it is a neurobiological framework, and it really helps us to

38:53

consider how we respond or act based

38:57

on stress in our environments or in our world. And

39:01

so, as you mentioned, the fight

39:04

flight or freeze. So that was

39:07

previously identified as being the sympathetic nervous system versus

39:10

the asympathetic parasympathetic.

39:14

Sorry. Okay. Yeah, let me say that again. Go ahead. Now I start over.

39:17

Okay, so you mentioned

39:21

fight or flight and freeze. And so, traditionally, what we

39:25

believed in the past was that this is a very dualistic system,

39:29

the sympathetic nervous system, which activates fight or flight, and then

39:32

parasympathetic nervous system, which activates kind of that freeze

39:36

and shutdown. And so Porges

39:40

challenged that duality of the autonomic nervous

39:44

system and identified that there are actually two pathways down on

39:47

the vagus nerve. So there's the ventral vagal pathway, and this

39:51

pathway actually responds to cues of safety. It

39:55

really supports feelings of being engaged and socially

39:58

connected. And so it's a positive

40:02

pathway that we want to be able to support and facilitate for our clients and

40:05

for our children. And then there's also the dorsal vagal pathway,

40:09

which is what we typically would see as kind of

40:13

that protective state of collapse that freeze or shut

40:16

down. And so understanding that there are these

40:20

different pathways on the vagus nerve is really important

40:24

to kind of promote opportunities to

40:28

pursue the ventral vagal pathway or those experiences

40:31

that really can promote that safety and connection. And so Deb Dana,

40:35

she's an occupational therapist. She created this visual. It's called the

40:39

polyvagal ladder. So if anyone's interested in looking that up, it's

40:43

a really nice visual that kind of talks about

40:47

the different levels of how we may respond. And so at the very top of

40:50

the ladder is safety or psychological safety and connection.

40:54

And that's where we hopefully want our children and students to be at. This

40:58

is kind of what we call the optimal level of engagement. That's where

41:01

we learn best. That's when we feel most connected with educators,

41:05

peers, et cetera. And so that's something that we want to

41:09

be able to support our children, to be at the top of that ladder and

41:13

to explain a little bit more about that ladder. For those that are interested

41:16

in viewing it, the next step down is the sympathetic nervous

41:20

system, which we're again familiar with as it relates to fight or flight. And then

41:24

at the bottom is that parasympathetic shutdown. And so it's a nice

41:28

visual, kind of explaining there are these different

41:31

experiences that we can support to get our children and our

41:35

clients in a space where they feel that connection and that optimal

41:39

level of engagement. And then one other piece that I think is really

41:42

important from Porridge's work was this idea of neuroception.

41:46

And so my background is sensory integration, so all the different

41:50

senses. And so he kind of brought out this idea of

41:53

neuroception, that it's this feeling of danger

41:57

and kind of paying attention to the signals, right? And so maybe

42:01

there's something that I feel crawling up my arm, right? And so I've got to

42:05

respond, like, what is that? What is that? Is it a spider? Is it a

42:08

bug? What is it? Or oh, it's just my shirt. There's just a little thread.

42:11

Right. And so that neuroception that we maybe experience

42:15

multiple times during a day, but it mobilizes us to

42:18

respond and really take action when we maybe don't feel safe to get

42:22

us to a place, back to safety. So it's kind of that listening to our

42:26

gut so that we aren't

42:31

placing ourselves in these dangerous situations. And again, going back to the

42:35

HPA access, we need to be able to differentiate what is safe,

42:39

what is not safe. And again, some of our kids may have some

42:42

difficulty with differentiating that. Absolutely. And if our

42:46

kids aren't moving up that ladder to the safe area, to the

42:50

socially engaged area, and they're somewhere near the bottom

42:54

or maybe they're in the middle today, I'm sure that can have an impact

42:57

on their occupations, on what they have to do every single day

43:01

at school. So, again, I know you're kind of at the college

43:05

level now, but a lot of times high schoolers and

43:08

college kids, there's some overlap there. So what are some

43:12

things that you have seen, that you have identified

43:16

that this type of transitioned age

43:19

person can exhibit difficulties with

43:22

when trauma is kind of in their

43:26

background? Right. There's

43:30

so many ways that it can impact occupation. I think we're talking a lot about

43:33

occupations related to school and so important things like paying

43:37

attention, being attentive attuned

43:41

being engaged even for a longer period of time.

43:45

I think that's so important. That self regulation piece too. And I think we talked

43:48

a little bit about that emotional regulation when there is something that

43:52

happened maybe an hour ago or happened to our community

43:55

last week that we're still processing, that our body is still kind of

43:59

working through in terms of our physiology, that there may be this increased

44:03

fear, increased anxiety. It can also absolutely impact

44:07

sleep. So insomnia, especially in young children,

44:11

we may see that somatic pain, somatizations

44:14

where maybe they're really nervous about a test or maybe they are experiencing

44:18

bullying at school and so they start to have stomach

44:21

aches where there's nothing really wrong with their GI system,

44:25

necessarily. But that fear, anxiety, that worry

44:29

is now being stored kind of in that gut and so presenting

44:32

in a way that feels like a physical manifestation when

44:36

it may ultimately be something related

44:40

to a traumatic event. Yeah, I

44:44

know from my own personal experience in

44:47

my realm of life that that is definitely something that has impacted

44:51

people that I know. And it's something that

44:56

they almost feel sick when they're invited to do something that has an

44:59

experience related to some of their trauma. And that can

45:03

impact a lot of things. It's not just that they're feeling sick, but it's also

45:06

impacting their entire day, their entire week, potentially. So that's

45:10

hard. All right,

45:18

we had that question. We already did that one.

45:22

Did you want to go into more of that, or was that enough for the

45:26

associations with occupations? I

45:30

think that's good. Okay. Yeah, that's really fun. I think that's enough, too.

45:35

I have a lot for the trauma in the classroom. One,

45:39

I don't know how. I know. We talked a little bit about that one. I know you shared the

45:47

story with your daughter, so we shared a little

45:51

bit, but let's go ahead into that one,

45:54

too. Okay, let me read this

45:58

really quickly. All right,

46:10

so taking a step back, you mentioned a little bit

46:13

about one of your kiddos and how on the

46:17

volleyball team there's just those little ambient traumas, I think you

46:21

called it, inside of school, maybe in the classroom. What

46:24

experiences that the students that we as school based OT

46:28

practitioners maybe can have an impact

46:31

on? How are students maybe even

46:35

experiencing trauma on campus? Yeah,

46:38

so I think that's something we need to be aware

46:42

of attuned to that this is possible.

46:47

We want to believe that our environments, our communities, and our school settings

46:51

are safe, but we have to also be aware that there is this potential

46:55

for some traumatic experiences that our students are experiencing. So there are

46:59

some specific ways that there may be trauma in the classroom. One

47:02

experience is through curriculum violence or just the

47:06

programming or the curriculum that maybe

47:10

is. And I want to relate this also to OT education,

47:13

too, where maybe there's something in the curriculum that

47:17

is misrepresenting their identity. Maybe is

47:21

racially profiling a certain community or group gender

47:25

profiling? Or maybe some stereotypical portrayals of certain cultures

47:28

and groups. And so I know in OT education, in

47:32

academia, we have so many discussions about case studies. How can we

47:35

get more inclusive case studies that are not

47:38

stereotypical, that really do portray different

47:42

identities and experiences in a very positive light without

47:45

misrepresenting them? And so that's something that we might see in the

47:49

classroom, especially in higher education related to

47:53

case studies and such. But there also might be some,

47:57

again, I don't know, ambient trauma or big T trauma

48:00

related to this underrepresentation of

48:03

identities. So we know within our profession we are lacking diversity and

48:07

representation for individuals from diverse

48:10

backgrounds. But when a student shares a story

48:13

in an institution and maybe

48:18

okay, I'm struggling with this one. Sorry, let

48:21

me start again. Would you like me to re ask

48:25

all the way back to that question, or do you want to start somewhere in the middle? Yeah, do you mind if I start back with this one? Yeah, I'll

48:30

start back with this one. Okay. I'll re ask the question then, really quickly.

48:34

Okay. I don't want to go back to curriculum violence, though, but I'll

48:37

start. Okay, I get what you're saying then. Yeah, go ahead. Then you can start

48:40

whenever you're ready. Okay. Yeah. And

48:44

also the underrepresentation of identities. So we know that our profession is

48:48

lacking diversity and representation from diverse backgrounds.

48:52

And so when we think about a student walking into the classroom,

48:55

do they see faces? Do they see others that may share

48:59

a similar identity or experience? Or do they feel like they're

49:03

already underrepresented in this

49:06

environment? And so that can be something that our students have to navigate

49:10

this social climate where they may feel possibly

49:13

invisible, like no one really is understanding their experience that

49:17

may be very unique from others. Maybe they feel very

49:20

disempowered, they don't feel like they have a sense of

49:24

confidence to speak up about certain things or challenge certain ideas or

49:27

perspectives that may be different. Or

49:31

sometimes we may experience this like tokenization

49:35

of well oh, you're

49:41

struggling with. This one a hard one to talk about.

49:45

I know it is. Okay, I don't want to start again, so

49:49

I'll go back to the tokenization. Yeah, that's fine. Right, okay.

49:53

Or we might feel a sense of being

49:58

tokenization, the words, okay, let me start again.

50:02

Or we might feel this sense of being tokenized

50:06

where maybe we're being put on the spot to share

50:10

experience because we may be the only individual with a diverse

50:14

identity. Or we may be asked to participate in

50:17

marketing campaigns and be in those photo shoots to

50:21

potentially represent a diverse

50:24

community that may not necessarily be

50:28

representative of the actual

50:31

setting. So that's another concern that we might see with

50:35

students. I think we're really familiar with microaggressions, so these

50:39

oftentimes very unintentional interactions and

50:42

behaviors that communicate some sort of bias towards a

50:45

marginalized community. I've also

50:49

seen this experience also with graduate students tone

50:53

policing, where maybe there's a discussion or a debate happening

50:57

and maybe an individual that has greater privilege, maybe

51:00

an instructor. It could also be another student from a more privileged background,

51:04

maybe dismisses or invalidates the thoughts

51:08

or opinions of another student based on the reaction to the emotional

51:12

tone. Well, I didn't like the way you said that, you just seem very

51:15

angry right now. So instead of listening to the message

51:19

and the point that the individual was trying to

51:22

communicate, the other individual maybe invalidated

51:25

that because of the tone. So that's something that may be

51:29

considered to be tone policing. I think another thing

51:33

that we might see also with students is code

51:37

switching. So maybe a student comes

51:40

into an environment that they see that their identity is not well

51:44

represented. They do feel like they are part of a minoritized group

51:48

and they walk into an environment and they feel like, well now I have to

51:51

adjust my speech, I have to adjust my behavior,

51:54

my appearance, my expressions so that

51:58

other people don't misinterpret my behavior.

52:02

And so that could be cone switching that we see between different

52:06

classroom settings. It could be with peers, it could be with teachers,

52:09

instructors, educators and such. And I think this is something that comes

52:13

up a lot in OT education, in particular around

52:16

professionalism because professionalism historically

52:20

has been related to Eurocentric values.

52:24

Right. It's very role dependent. And in

52:27

an OT education, there is kind of this sense of gatekeeping

52:31

where, well, if you don't act or look or talk like me, you don't

52:35

belong. Right? And so that's something that's come up a lot with students, where students

52:38

have felt marginalized when they're in maybe a fieldwork setting.

52:42

And the fieldbrook educator is reporting a concern about

52:46

professionalism because

52:49

of the way that they may have expressed

52:52

themselves. And I was actually at SSO, the study

52:56

for sorry. I was actually at SSO, the Society for

53:00

the Study of Occupation, this past week in St. Louis, and I was at

53:04

a presentation talking about the experience of belonging for black

53:07

students in PhD programs in our profession.

53:11

And one of the presenters had talked about being an academic field

53:15

coordinator and getting more calls about

53:18

professionalism for black students. Right. And so because

53:23

they may not speak the same way or behave in a way that

53:27

the site is deeming to be professional, that they are now being called

53:30

out about some concerns that may not

53:34

be valid. Yeah. And I think we could see that

53:38

on a high school campus, a middle school campus, even an elementary

53:41

campus to some degree. So I think those are all very important factors to

53:45

keep in mind. And I know that you kind of have gone the next

53:49

step to kind of make sure that you

53:52

yourself are engaging in trauma informed teaching. And I want to give

53:56

you a moment to talk about that. But as I do, I just think

53:59

that this is something that it's not just about

54:03

teaching, it's about being a practitioner as well. Everything you're about to

54:07

say, this is kind of just front loading everyone that's listening. I think

54:11

what Dr. Park is about to say, even though she's kind of going to be

54:13

saying it in the realm as a college professor, I think this

54:17

is actually completely applicable to us as practitioners in the

54:21

school as well. So tell us about trauma informed right.

54:25

Right. So it's grounded in the principles of trauma informed care. So for

54:28

those that may not be as familiar with trauma informed care, safety

54:32

is so critical. Safety, trust, transparency, that

54:36

peer support, having peers that really see them and understand

54:39

them, collaboration, mutuality,

54:43

other principles, empowerment, voice and choice, and also considering

54:47

cultural, historical, and gender issues where those

54:50

identities have been historically marginalized. And so those are the principles

54:54

of trauma informed care. And so those are the principles that we want to

54:58

make sure that we're grounded in in teaching as well. But in terms of trauma

55:01

informed teaching, we want our classroom or learning environments to be inclusive and

55:05

transformative, and we want to also share or center our

55:09

shared humanity. And so as an instructor, I really do try

55:12

to dismantle the hierarchy in the classroom. A lot

55:16

of instructors may try to establish that hierarchy of, well, I'm the

55:20

teacher, I have the knowledge and that I grade you.

55:24

Right. But I think especially as a doc coordinator,

55:28

I try to really establish a space where we can all grow as a community.

55:32

So I always share with my students. I am also here

55:36

learning from you. Some of our students who are their

55:39

capstone topics are topics that I may not be as knowledgeable about or

55:43

familiar with. They may become experts on these

55:47

topics and these projects much more than I am I may be.

55:50

And so I always emphasize that we're all learning together.

55:55

And so the more we can understand our humanity, that we're not

55:58

asking our authentic selves to be left at the

56:02

door, our humanities being left at the door, but that we establish a

56:05

space where all of these factors are really welcome and all of

56:09

our identities and positionality are embraced as a community is

56:13

really important as well. Another principle that I think

56:17

is really important is equity and social justice focused.

56:20

And I don't mean that to say everyone needs to know about

56:24

all the events happening in the world and we need to talk about it all

56:28

the time. I know there isn't a lot of time and space for that, but

56:31

I think it's really important to have some awareness of it, to know that our

56:35

students may be carrying some of that grief and that pain. I

56:39

think about the violence happening right now in the Middle East and Gaza

56:43

and having students that are really

56:46

struggling, that maybe have family in the region that they're worried about.

56:50

I can't ask them to leave their humanity at the door

56:54

so that I can give my lesson. Right. And so I think that's

56:57

so important in a therapeutic relationship, too, or within

57:01

classrooms in elementary, middle school, and high school,

57:05

where we have to understand that all of our students are kind of

57:08

bringing these world experiences into the classroom,

57:12

and we have to allow space for that

57:16

to happen. Allow that for gosh, why am

57:20

I struggling so much? Sorry. You're doing fine.

57:24

I thought. Okay, I'm going to start again. I'll keep going.

57:28

Okay. I hope you can piece these things together. Oh,

57:32

definitely. Trust me. My brother in law is like a film major or

57:35

he's already a film. Yeah, he's a good editor. Fantastic.

57:39

Okay, so let me go back. Okay.

57:43

So we want to make sure that we have some awareness of the issues that

57:46

are happening in the world that may be impacting our families.

57:49

Sorry. Okay. We want to have some awareness of

57:53

the issues in the world that may be impacting our students and

57:57

the pain and the grief that they may be carrying so that we don't ask

58:00

them to leave their humanity at the door. Right. So learning is the

58:04

primary goal in all of our settings. Right. In all of education, learning

58:08

is a primary goal, but psychological safety is truly a necessary

58:12

condition. There has to be a sense of psychological safety in the

58:15

classroom for our students to be in that optimal range, right.

58:19

Optimal level of engagement, of learning, to be at that

58:23

top rung of the ladder, to be able to engage with the

58:26

curriculum. And another really important piece is that it needs to be

58:30

universal. This goes back to this idea of code

58:33

switching, right. If one teacher, or

58:37

maybe this teacher is super empathetic and

58:41

is super invested in dismantling these hierarchies, and then you

58:45

go to another teacher and that teacher is not the student is now having to

58:48

code switch between classes as they're moving throughout their day.

58:52

And so it needs to be universal approach across campuses,

58:55

across programs so that there is, again,

58:59

a sense of safety universally throughout the

59:02

institution. Yeah. And there's just so much going on.

59:06

I don't want to get into specific examples. I know you mentioned

59:10

what's going on with War in the Middle East right now. There's a lot

59:14

of gender issues going on right now within individual schools and

59:18

districts that are impacting

59:22

the students and the adults on campus. This is

59:26

tough, and we all need to be mindful of that going on

59:29

in order to practice this trauma informed teaching, trauma

59:33

informed occupational therapy, trauma informed care.

59:37

As we get closer to wrapping up, I want to ask you

59:41

for the occupational therapy practitioners that are working on a high

59:45

school. Maybe they're working with an individual student, or maybe they have

59:48

the opportunity to go a little bit more broad and

59:52

support the entire school. Do you have

59:56

one, too? Just a few strategies that you might want to

59:59

pass off to them that maybe they can try using in their school

1:00:03

to make it a little bit more inviting, more

1:00:07

friendly for students on campus. Right,

1:00:10

yeah. I think that psychological safety is such a

1:00:14

critical component of that because psychological safety really does kind of pave

1:00:18

the way for a sense of belonging. And so belonging, inclusion, all of

1:00:21

these things are where we can bring our authentic selves to the table.

1:00:25

Right. And to be able was that your. Computer or my computer? Oh, never

1:00:29

mind. Sorry. The 1 hour timer went off and it

1:00:32

wouldn't have impacted anything. I'm sorry. I realized what it was

1:00:36

right after started to talk. Otherwise I would not have cut you off. I'm sorry.

1:00:41

Okay. We're okay, though, because we kind of stopped and paused. Yeah.

1:00:45

We're wrapping up, though. Yeah, we're fine. Okay,

1:00:48

so let me start again. Psychological

1:00:52

safety is definitely an important factor because psychological safety really

1:00:56

paves the way for belonging. And belonging leads to inclusion. And

1:01:00

inclusion means that we can bring our whole Selves

1:01:03

and our authentic Selves in these settings

1:01:07

that we can comfortably and safely voice opinions and challenge

1:01:11

ideas and thoughts and bring different perspectives that

1:01:14

others may learn from and may not fully understand.

1:01:18

And so I think fostering. That environment where students can be

1:01:21

authentic is a really important component that we can do across all of

1:01:25

education. And so this idea of not

1:01:29

having to worry about being found out that

1:01:32

I'm actually neurodivergent and I learn differently, I process information

1:01:36

differently. And so students, especially in middle school at that

1:01:40

really critical age of development, identity formation,

1:01:43

at that age where they fear how other people may think of them, right?

1:01:47

They may be worried about being found out that I learned differently, or that maybe

1:01:51

I'm a first generation college student and I may not have the

1:01:54

educational privileges or generational legacy of my peers,

1:01:58

or maybe I have caregiving responsibilities as well. My husband's actually a

1:02:02

high school teacher, and he does talk about some of his students where they're

1:02:06

tired, they're sleeping in class sometimes. And again, we can

1:02:09

perceive that as, oh, this student is a bad student, they're lazy, blah, blah, blah.

1:02:13

We have all these negative labels that we can attach.

1:02:17

But once he really talked to the student, he realized that

1:02:22

this student, as a junior in high school, has to work, has

1:02:25

to work on weekends, has to work in the evenings to really support their family.

1:02:29

And so taking all of those factors into consideration allows us

1:02:33

to see the entire person. And so that's something

1:02:36

that's super important, too. I do want to touch a little bit

1:02:40

on belonging. I've mentioned that I was

1:02:44

at SSO, which is the study for this. I always mess that

1:02:47

up. I do want to touch upon belonging.

1:02:51

I was at SSO, which is the Society for the Study of Occupation in St.

1:02:55

Louis this past weekend. And we had this conversation about

1:02:59

belonging. And we were debating

1:03:02

Wilcox framework of doing, being, becoming

1:03:05

belonging. And know what type of belonging did

1:03:09

Wilcox intend for us to understand in that

1:03:12

framework? And was it like belonging, oh, you fit in, and that's how you belong?

1:03:16

Or was it this sense of liberatory belonging where you could

1:03:20

bring your full self, your whole self, as authentically

1:03:24

as possible, and to show up in these

1:03:28

spaces and still feel like, oh, I'm accepted I belong here.

1:03:32

And so I think about middle school age where that's such

1:03:36

an awkward period. When I think about my middle school years, I cringe a little

1:03:39

bit, not feeling super confident in

1:03:43

myself, still figuring out myself. I think these

1:03:47

are the spaces that we want to be able to allow our

1:03:51

children, our adolescents, to explore, explore identities and to

1:03:54

challenge what they're learning as well.

1:03:58

And I think that takes a lot of critical reflection on our part as

1:04:02

occupational therapists. One of my Capstone students,

1:04:05

she did a research study on OT's understanding of

1:04:09

trauma and how they use trauma informed care and practice.

1:04:13

And she continued her study after she graduated. And we worked with her

1:04:16

in identifying some codes and themes, and we're hoping to get it

1:04:20

published. It's in review right now. But one of the themes that she

1:04:24

identified was this idea of reckoning with self. So being

1:04:27

grounded in this reflection of our

1:04:31

own regulation, really decentering ourselves in our

1:04:34

therapeutic interactions with clients, students, et

1:04:38

cetera. And that's so important so that we're not

1:04:42

potentially causing retraumatization to our clients and

1:04:45

students. And so this

1:04:49

reflection that we have to go through or we should be going through

1:04:52

to say I do have best intentions, but I may not always get it

1:04:56

right. Right. And so I hear sometimes in our classroom settings

1:05:00

where people just say, well, it's safe here,

1:05:03

this is a safe space. And despite best intentions, we can't

1:05:07

always assume that our classrooms are safe. And so we want to make sure that

1:05:11

we are not misunderstanding trauma symptoms in the classroom that may be

1:05:15

showing up again. Labeling the student that was sleeping in class

1:05:19

with negative labels, but understanding their experience that they've got a lot going

1:05:22

on in their life and they have a lot of other responsibilities that

1:05:26

their family is depending on them for. And then so really kind

1:05:30

of centering empathy, having that

1:05:33

empathy, that awareness of self and how we show

1:05:37

up is just really important in establishing these

1:05:40

relationships and connections which can really support more

1:05:44

empowered healing in the work that we do. Great.

1:05:48

Well, I just have one more question for you. And this

1:05:51

comes directly from questions that I get all the time from school based occupational therapy

1:05:55

practitioners. So I want to ask you,

1:05:59

if you talk to a principal and they're like, hey, Dr. Park, we would

1:06:03

love for you to give a 30 minutes training to our teachers,

1:06:07

something related to trauma informed care,

1:06:12

what topic would you go with that you would want all the teachers on

1:06:16

campus to? What would be the goal, I guess, for the teachers

1:06:19

to take away from a talk that you give that maybe another school based

1:06:23

OT who is listening to this could also give at their high school. Oh gosh,

1:06:27

there's so many right? There's so many topics.

1:06:34

I am really kind of a neuroscience nerd, so

1:06:37

really understanding the neurobiology I think is so important. And

1:06:41

sometimes I do presentations when I talk about trauma and I always have a piece

1:06:45

where I discuss neurobiology and I worry kind of people tune out. Not

1:06:48

as interesting talking about the brain, but I think it's so

1:06:52

important to understand how the limbic system works and that connection with the

1:06:56

frontal lobe because again, that inverse relationship of if a

1:07:00

student is struggling with something that we know nothing about, right? And

1:07:04

that's usually the case. We know nothing about what they may be going

1:07:07

through or what trauma they've been experiencing or what

1:07:11

trigger they just may have just experienced in the moment. And so

1:07:15

again, we can really misinterpret behaviors really quickly.

1:07:19

And there's this really great article, I'm blanking on the

1:07:22

author's name, but there's this really great article that talks about

1:07:26

secondary microaggressions. And secondary microaggressions are kind

1:07:29

of that process of where we misunderstand a behavior

1:07:33

or maybe we misunderstand something, because that's not our experience,

1:07:37

so well, that's not my experience, so I don't understand it. So

1:07:40

almost invalidating the student's experience. Like, well, that can't be

1:07:44

true. That can't be real, because I haven't experienced that, and I don't understand

1:07:48

that. So there are these multiple ways that we might enact these secondary

1:07:52

microaggressions because of our misunderstanding of potentially

1:07:55

what may be a trauma symptom. And so I think going

1:07:59

back to the neurobiology and understanding how all of that is related

1:08:03

and how we show up in the world, how we may

1:08:07

behave and respond to interactions that we have with

1:08:11

other individuals, I think that would be absolutely

1:08:14

core. All right, everyone, you got that? You just have

1:08:18

about 30 minutes to present that to all your teachers, though. You got to keep

1:08:20

it short. But no, I think that's great. I think a

1:08:24

lot of people, occupational therapy practitioners, teachers,

1:08:27

educators, they understand trauma

1:08:31

informed practices. But I think having

1:08:35

that neurobiological side of it, neuroanatomy side to

1:08:38

really kind of sometimes use pictures when you're talking about the brain, right?

1:08:42

So you show them those pictures, it just makes it a little bit more real

1:08:46

sometimes to better understand how the brain is processing the trauma and

1:08:49

how the limbic system is working and how the HPA is all

1:08:53

working. So thank you so much. I really appreciate that. And

1:08:57

before I let you go, where can anyone who's interested in

1:09:01

learning a little bit more about you and maybe the St. Augustine

1:09:04

program go to learn more? You

1:09:08

can find more information about me on our USA website. So our

1:09:11

homepage is Usa.edu, and we do have faculty profiles

1:09:15

on there. So if you search faculty, you can learn a little bit about

1:09:19

more about my background. But I'm also on social media. I do have a

1:09:23

public Instagram profile. It's Karen Park OTD.

1:09:26

That's my Instagram profile. And then I'm also on LinkedIn, too, so you can find

1:09:30

me on LinkedIn. And I do try to

1:09:34

share kind of different thoughts and ideas, know, work that

1:09:37

I'm doing. I think that came about actually, during the

1:09:41

pandemic, where I started to share some things,

1:09:45

and people really resonated with it, and it's a very vulnerable space for

1:09:48

me being so public. But I'm there,

1:09:53

and I really do love to engage with the

1:09:56

community. I think we have just such a wonderful community of OTS,

1:10:00

and students start following me, and we become friends after they

1:10:04

graduate. And I just really love to stay connected and be able to support

1:10:08

others in their journeys. I think I really

1:10:12

do find the work as a doctoral coordinator to be super

1:10:15

meaningful. And so when I'm able to stay connected with our graduates

1:10:19

and see just wonderful things that they're doing in the community

1:10:23

sorry, it's a proud moment. For me. That is awesome. That's great.

1:10:27

Yeah. It's always great to see all of our hard work be

1:10:31

rewarded, in a way. And maybe it's not in accolades, but to

1:10:34

see the people that we mentor and just improve

1:10:38

themselves and become an occupational therapist or an

1:10:42

occupational therapy assistant or whatever they're aiming for. So, yeah, it's always

1:10:45

nice. Speaking of mentor yeah. If you connect with me on

1:10:49

social media, I may ask you to be a mentor for one of my capstone

1:10:52

students. If anyone's looking connected with

1:10:56

the university, especially alumni. We love to connect with alumni and have them come

1:11:00

back and mentor our yeah. So that's one thing. If you connect with me, I

1:11:03

might ask you to be a mentor. You're not the first one on the

1:11:07

podcast to say that, so people yep. All righty. Well, Dr.

1:11:11

Park, thank you so much for coming on. It's been a real pleasure. And I

1:11:14

know that a lot of school based OT practitioners, karen going to walk away from

1:11:17

this episode with a better understanding of aces and the experience of

1:11:20

trauma and how they can make the world a little bit more friendly, a little

1:11:24

bit more tolerable for everyone that they work with. So thank you so much. I

1:11:27

really appreciate it. Thank you. I appreciate it. Jason?