Clinical Value of Camp Wonderment
Corry Hawkins, LCSW
August 26, 2020
What is Trauma?
If you try to find a definition for trauma from a clinical perspective, you will be surprised how difficult it is to narrow down. In fact, some of the researchers and authors I rely on the most to guide my understanding of the impact of trauma have never truly provided a working definition that can be applied to even most circumstances. When parents look at me with an exasperated expression, wondering how their child could have been so impacted by what seemed like a normal life event, they will say things like, “But that wasn’t even real trauma!” What is traumatic to one person may not be traumatic to another.
The reality is that trauma is an experience that becomes locked in the nervous system. Despite common vernacular, trauma is not an event. In children and teens, causes of trauma range from seemingly common accidents, surgeries, and loss to the more readily acknowledged violence, abuse, and ongoing distress. When any of these events occur, the child has a stress response to survive the perceived threat. When this stress response is unable to protect the child, the brain decides to encode that memory in a way to prevent this experience from happening again. This results in regular reminders of the event (flashbacks), constant preparedness (hypervigilence), and in some cases, a lack of trust in oneself and others (distancing from a threat). Feelings of overwhelm, anxiety, and depression often come quickly when someone has been traumatized, adding to the emotional turmoil stirred up by the nervous system response. Some even completely disconnect from this overwhelming experience, resulting in dissociation in order to survive extreme emotions.
My personal work with children and youth has resulted in working with a “specialized” type of trauma. Most of my clients have experienced trauma in their relationships with early attachment figures (parents, guardians, etc) or experienced constant distress in their environment. This can result in something called complex developmental trauma. (Some refer to this in adulthood as Complex Posttraumatic Stress Disorder, or CPTSD.) These children often present for treatment as ADHD, oppositional, defiant, aggressive, withdrawn, anxious, depressed, manic, dissociative, or even showing early signs of psychosis. Teens may even have disordered personality traits starting to present that are causing problems in their interpersonal (others) and intrapersonal (self) relationships.
Why Should We Care?
What is so incredibly sad is that I was taught in my graduate studies how to convince people to care. When I say this statement, I can hear all my professors saying it with me: “Look at the ACEs.” In 1995, Kaiser Permanente started a study looking at the relationship between adverse childhood experiences (ACEs) and current adult health and behaviors. It was conducted on an incredibly large scale for a study of its kind, and as a result, it is almost always accepted as valuable research evidence. In other words, doctors listen when you mention the ACEs.
This was the study that finally provided conclusive data that childhood trauma (I’m editorializing) causes long lasting effects on both emotional and physical well-being. If you want more info, the CDC has a great webpage with reliable links to resources:
https://www.cdc.gov/violenceprevention/acestudy/index.html
Dr. Karyn Purvis is credited for inventing “The Five B’s” of trauma as a way of identifying the ways in which trauma impacts a child: Brain, Biology, Body, Beliefs, and Behavior. Trauma is pervasive and if untreated, leads to a trajectory of mental illness and difficulty in adulthood.
The point is, childhood trauma locks itself in the nervous system and without treatment, it doesn’t let go. In fact, it often gets passed on to the next generation as absent fathers produce absent fathers, addictions produce addictions, and parents that lack emotional regulation simply cannot teach their children how to regulate themselves. Trauma is a cycle with large reaching societal implications.
Bessel van der Kolk, M.D. stated in The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, “We are on the verge of becoming a trauma-conscious society.” If anyone wants to invest in struggling youth and the future of communities, this is it.
(And everyone should read The Body Keeps the Score.)
Why Summer Camp?
Perhaps this is a little finicky of me, but the questions “Why a summer camp?” and “Why Camp Wonder?” are very different. So let’s start with camp as a treatment model. There are plenty of studies on the benefits of summer camp across various domains. The most recent and most thorough summarization of these benefits that I could find is in this chapter from Shaping Summertime Experiences: Opportunities to Promote Health Development and Well-Being for Children and Youth: https://www.ncbi.nlm.nih.gov/books/NBK552656/
Summer camps can be tailored to just about any population, process, theme, activity, and level of need. The chapter in the link explores these domains of growth and development for children and teens who participate in summer camps: safety, risk-taking, and pro- and anti-social behavior; physical and mental health; social and emotional development; and academic learning and enrichment. The evidence indicates that summer camps are impactful! What’s more, if you have any personal experience with camp, they are fun! We are designed to learn and develop best when having fun.
There is significantly less research on therapeutic summer camps, specifically. (Although the research referenced above reviews outcomes of mental health-focused camps as well.) As someone who has developed and run a TBRI (Trust-Based Relational Intervention®) therapeutic camp for children and their families, I can tell you that therapeutic camps are HARD. But if they remain true to their goals, such camps can be a valuable springboard for families taking the first steps in treatment as well as a helpful tool for those already in the healing process.
Why Camp Wonder and the Hero’s Journey?
Camp Wonder has the potential to use the Hero’s Journey to meet children and teens who have experienced hardship wherever they may be in the healing process. Joseph Campbell’s hero’s journey offers an opportunity to look inward by “looking out” at heroic stories that inspire and empower us. Looking inward is often a terrifying experience for people who have experienced trauma. By externalizing not just a narrative but also the problem, campers can begin to feel safe enough to explore their inner world through what Camp Wonder has to offer.
Let me explain.
In my work and training, I have come to know the pillars of trauma treatment to include connection (to self and others), regulation, and felt-safety. Because the brain stores trauma in the nervous system, being safe and feeling safe are often two very different experiences. The journey back to feeling safe requires connection and regulation. I could talk for days about these two concepts alone. (Seriously… days.) So that can wait for another time.
Bessel van der Kolk discussed the journey from trauma to healing in The Body Keeps the Score:
“Trauma robs you of the feeling that you are in charge of yourself… The challenge of recovery is to reestablish ownership of your body and your mind - of your self. This means feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed, or collapsed. For most people this involves (1) finding a way to become calm and focused, (2) learning to maintain that calm in response to images, thoughts, sounds or physical sensations that remind you of the past, (3) finding a way to be fully alive in the present and engaged with the people around you, (4) not having to keep secrets from yourself, including secrets about the ways that you have managed to survive.”
The Hero’s Journey as it will be implemented in Camp Wonder supports these important tasks in recovery from trauma. First and foremost, the hero is never alone. Campers will have a mentor, guides, and allies with them every step of the way. This supports the development of connection to others and self, promoting felt safety for the journey ahead. Preparation for this journey teaches regulation, skills necessary for the tasks ahead. Trials and challenges create a sense of agency and resilience by drawing attention to the relationship with our bodies and minds. (The partnership with occupational therapists and/or psychomotor therapists is crucial to implementing this well.) Externalizing the problem in an enemy allows campers to project their inner world and face the problem without feeling shame… even while having fun and feeling safe!
Victory at the end of the story is perhaps the most crucial moment in our camper’s journey. Through physical feats and mental resilience, they will be able to harness the instinctual powers they already possess to defeat an enemy. This lays down a neurological foundation to apply these skills to future threats and challenges. Remember, if trauma “robs you of the feeling you are in charge of yourself,” then empowering yourself allows you to regain control. Connecting with others and your own mind and body to feel safe and victorious is the unique source of healing Camp Wonder can offer.
Where’s the Support?
The more you look, the more you can find mental health clinicians using expressive arts to treat the symptoms of trauma. These clinicians seem to operate out of so many different treatment modalities, it would take a book to explain them all. There are few, however, that seem to dovetail with the Hero’s Journey that I can expand upon here: Narrative Therapy, Psychodrama, and Psychomotor Therapy. It’s important to note that most therapy models rely on core components that have already been mentioned: developing skills for emotional regulation and interpersonal relationships, increasing mindfulness and the ability to remain present, and externalizing the problem to allow for improved perspective taking and problem solving.
Narrative therapy encourages the client and the client’s family system to tell their story. The therapist facilitates this telling over time, helping the system externalize the problem, reframe events, and make sense of experiences. In narrative therapy, people are not the problem. This allows otherwise anxious or “resistant” client systems to face problems with optimism and develop empowering internal stories of themselves. Psychodrama takes a similar approach, encouraging clients to see new perspectives and learn more about themselves through acting and enacting stories and events.
Trauma treatment through a form of theater is not a new concept. Some programs that treat trauma through theater are the following: Urban Improv in Boston, Trauma Drama in Boston public schools, the Possibility Project in New York City, and Shakespeare and Company in Lenox Massachusetts. The latter also runs a program called Shakespeare in the Courts for juvenile offenders. This is by no means an exhaustive list, but they are well studied and have published data supporting their treatment modality. Bessel van der Kolk explains:
“...all these programs share a common foundation: confrontation of the painful realities of life and symbolic transformation through communal action. Love and hate, aggression and surrender, loyalty and betrayal are the stuff of theater and the stuff of trauma. As a culture we are trained to cut ourselves off from the truth of what we’re feeling. In the worlds of Tina Packer, the charismatic founder of Shakespeare & Company: ‘Training actors involves training people to go against that tendency - not only to feel deeply, but to convey that feeling at every moment to the audience, so the audience will get it - and not close off against it.’”
Acting out narratives is also the practice of psychomotor therapy. Allowing a client to create “structures” of their past through psychomotor therapy externalizes a problem, reframes events, changes perspectives, and provides a medium in which to express secrets often kept from the self, all while allowing the client to be the “protagonist” of their narrative. In other, more polished words: “Structures harness the extraordinary power of the imagination to transform the inner narratives that drive and confine our functioning in the world. With the proper support the secrets that once were too dangerous to be revealed can be disclosed not just to a therapist… but, in our imagination, to the people who actually hurt and betrayed us.”
Final Thoughts
I personally think that Camp Wonder is a unique opportunity. It’s easily applied to so many different populations, locations, and levels of need. It can be short or long. The creative resources are so spectacular that children and teens with an interest in creation, writing, and film will have the opportunity to address healing while learning a new art. It seems like a lot in a small package, but that’s what summer camps have always been. That’s why summer camps are a unique resource in clinical treatment.
What will be critical is the maintenance of ethical clinical input and leadership. From first contact with campers to the final referral, clinicians need to have a hand in how and why things are done. For instance, letters from camp staff following camp are important and supported by narrative therapy founders, but without proper training, a letter can trigger abandonment and resentment.
Finally, I want to leave you with this quote from Peter Levine in his book, Waking the Tiger. He is a prolific writer in the field of trauma and I highly recommend this book. He acknowledges the crossing from the known to the unknown, as healing from trauma can often bring us to a “strange new land.” Wouldn’t it be something if that land could also bring a little wonder back to our lives?
“Trauma can be healed, and even more easily prevented. Its most bizarre symptoms can be resolved if we are willing to let our natural, biological instincts guide us. To accomplish this, we need to learn a whole new way of understanding and experiencing ourselves. For most of us, it’s going to be like living in a strange new land.”
Valuable Contributors
Bessel van der Kolk NICABM bio
References
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk
Trauma Through a Child’s Eyes: Awakening the Ordinary Miracle of Healing- Infancy Through Adolescence by Peter A. Levine and Maggie Kline
Waking the Tiger: Healing Trauma by Peter A. Levine with Ann Frederick
The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind by Daniel J. Siegal
Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience through Attachment, Self-Regulation, and Competency by Margaret E. Blaustein and Kristine M. Kinniburgh
The Connected Child: Bring Hope and Healing to Your Adoptive Family by David R. Cross, Karyn B. Purvis, and Wendy Lyons Sunshine