Episode 22: Building Resilience in Children With Hearing Loss
Episode 22 Show Notes
On episode 22 of All Ears at Child’s Voice: A Hearing Loss Podcast, Tatum and Wendy interview psychotherapist, Jessica Dallman, about building resilience in children with hearing loss and their families. Jessica is a licensed professional counselor who received a master's degree in transpersonal counseling psychology, wilderness therapy from Naropa University as well as the Deaf and Hard of Hearing Infants, Toddlers and Families Interdisciplinary certificate from Gallaudet university. She is trained in EMDR therapy, gestalt equine psychotherapy and infant early childhood and family mental health. She founded her practice, Natural Wisdom Counseling, in order to bridge nature education, holistic health, trauma informed care, intercultural healing research and social justice through counseling, coaching, consulting, and collaboration. She additionally launched the Wisconsin Hawthorne Project in the fall of 2018 which provides free trauma-informed trainings to professionals serving children and families in Wisconsin.
Where to Find Us
Special thanks to John McCortney for his work recording All Ears at Child’s Voice episodes. Episodes of All Ears at Child’s Voice are graciously edited by John McCortney.
On episode 22 of All Ears at Child’s Voice: A Hearing Loss Podcast, Tatum and Wendy interview psychotherapist, Jessica Dallman, about building resilience in children with hearing loss and their families. Jessica is a licensed professional counselor who received a master’s degree in transpersonal counseling psychology, wilderness therapy from Naropa University as well as the Deaf and Hard of Hearing Infants, Toddlers and Families Interdisciplinary certificate from Gallaudet university. She is trained in EMDR therapy, gestalt equine psychotherapy and infant early childhood and family mental health. She founded her practice, Natural Wisdom Counseling, in order to bridge nature education, holistic health, trauma informed care, intercultural healing research and social justice through counseling, coaching, consulting, and collaboration. She additionally launched the Wisconsin Hawthorne Project in the fall of 2018 which provides free trauma-informed trainings to professionals serving children and families in Wisconsin.
Tune into episode 22 to learn…
- What resilience means in the context of mental health and counseling and why fostering resilience is important for children with hearing loss and their families
- A four-tiered approach to helping children with hearing loss and their families build resilience
- The types of grief families of children with hearing loss can experience and how their experiences with grief may change over time
- Tips for practicing self-care and developing resilience in yourself, either as a caregiver or as a provider
- And more
Jessica referenced two articles she’s co-authored that are relevant for this episode’s discussion:
- Click here to read Preparing for Relational Audiology: Things I Wish Somebody Told Me Before I Started Working in Pediatric Audiology by Elizabeth Seelinger AuD, Jessica Dallman, & Leigh Hardin
- Click here to read What It Means to Hold Space: Applications for EHDI Providers by Leigh Hardin, Elizabeth Seeliger, & Jessica Dallman
Where to Find Jessica:
- If you would like to contact Jessica, you can find more information about her and her email at naturalwisdomcounseling.com.
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Special thanks to John McCortney & Michael McCortney for their work recording All Ears at Child’s Voice episodes. Episodes of All Ears at Child’s Voice are graciously edited by John McCortney.
Disclaimer: Child’s Voice is a listening-and-spoken-language program for children with hearing loss. All Ears at Child’s Voice: A Hearing Loss Podcast is a resource provided by Child’s Voice. Reference to any specific product or entity does not constitute an endorsement or recommendation by Child’s Voice. The views expressed by guests are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Views and opinions expressed by Child’s Voice employees are those of the employees and do not necessarily reflect the view of Child’s Voice.
Elise: Welcome to All Ears at Child’s Voice, a podcast discussing all things hearing loss. We aim to connect parents of children with hearing loss with the professionals who serve them. I’m Elise Sundberg and I help with the Podcast and work in The Learning Center at Child’s Voice. If you haven’t yet, check out last month’s episode where Wendy & Tatum had a great discussion with Valli Gideons from My Battle Call. There were so many awesome takeaways from that episode! As always, we love hearing feedback from our listeners so please fill out the survey found linked in the show notes and episode description! Thanks! And now, to start the show….
Wendy: Welcome to another episode of All Ears at Child’s Voice. We aim to connect parents of children with hearing loss with the professionals who serve them. We’re your hosts. I’m Wendy Deters.
Tatum: And I’m Tatum Fritz this week on the show we are joined by Jessica Dallman. Jess is a licensed professional counselor who received a master’s degree in transpersonal counseling psychology, wilderness therapy from Naropa University as well as the Deaf and Hard of Hearing Infants, Toddlers and Families Interdisciplinary certificate from Gallaudet university and is trained in EMDR therapy, gestalt equine psychotherapy and infant early childhood and family mental health. Jess integrates human development, attachment, neuroscience, nature and the body into a relational approach to counseling. She founded natural wisdom counseling in order to bridge nature education, holistic health, trauma-informed care, intercultural healing research and social justice through counseling, coaching, consulting, and collaboration. She additionally launched the Wisconsin Hawthorne Project in the fall of 2018, which provides free trauma-informed trainings to professionals serving children and families in Wisconsin. Jessica joins us remotely today from Mount Horeb, Wisconsin. And today we will be talking to Jess about resilience in families of children with hearing loss as well as building attachment between young children and their caregivers. Before we jump into the conversation today with Jess, Wendy and I just wanted to inform listeners that today’s episode will be a little different than some of the episodes that we’ve done in the past and we may be delving into some topics that may be more emotional for our listeners to hear. And we just want everyone to be prepared for what they’re about to hear. We may be talking a little bit about grief, trauma. We just want to inform everyone what they’re about to listen to in case you want to maybe listen at a different time or make sure you’re ready to listen to an episode that’s going to talk about maybe some heavier topics.
Wendy: So, Jess, you have such an interesting range of skills. We’re really excited to dive into all of this with you. We’d like to start by having you tell us about natural wisdom counseling.
Jess: Sure. Natural Wisdom Counseling is more than just a counseling practice. It is my private practice counseling practice. It is also an agency designed to provide mental health related coaching, consulting, and training. In Natural Wisdom Counseling, I really took the opportunity to develop my private practice so that I could incorporate nature-based practices, equine therapy, mindfulness and body awareness strategies for supporting mental health and well-being as well as being able to have the liberty to work with a wide range of clients, including working with families with deaf and hard of hearing kids.
Wendy: Yeah. So what is your connection to families of children with hearing loss? How did that all start?
Jess: Great question. I started taking American Sign Language classes in undergrad and just started picking them up pretty quickly and my professor connected me with Deaf clubs in the area and I got to meet some Deaf adults and develop some relationships there and hear their stories. And I was studying psychology during my undergraduate career and ended up getting connected with a mentor. Lynn Kester is her name and she was my advisor for my senior thesis project in which I studied and reviewed videos from the Gallaudet infancy study and looked at dyads of deaf parents with deaf kids and hearing parents with deaf kids and hearing and hearing dyads and all of the different variations and looked at the intuitive motherese that deaf parents were using that sometimes hearing parents missed and made those teachable. Of course it was just an undergraduate project, so it’s nothing that I’ve ever released but that really kind of launched my interest and work in the field and ended up teaching for a couple of years before pursuing a graduate degree in counseling and getting involved with the Early Hearing Detection and Intervention programs.
Tatum: Yeah, that’s really interesting cause Wendy and I work with young children and their families and we coach families and help them learn ways to interact with their children. And sometimes we see families it is awkward for them. Especially post the hearing loss diagnosis to build that relationship and like, you know, interact with their children in a positive way that will help with language development and also emotional connection. So even though we’re speech therapists, I feel like we do some of that. But the knowledge that comes from the field that you’re in definitely really like helps us foster that. We are so excited to have you on today. As you may know, we like asking our guests every week for a story before we get started. Something from the past week. It could be anything, something cute, something funny, something heartwarming and we just do this as a way to give listeners a sense of who our guest speakers are. So do you have a story that comes to mind?
Jess: It’s been an inordinately stressful week for me, so my perception is skewed. I’m like, “Oh, what’s cute or funny from this week?” I think the main thing that’s coming up for me is that my parents came to visit to meet my horses for the first time. And it was fun for me to watch my mom really connect with one of my horses and get really excited about her. It’s always nice to feel affirmed and see that connection happen.
Wendy: Cool. How many horses do you have?
Jess: I currently have two horses, but I work with all of the horses at the farm that I collaborate with.
Wendy: Wonderful. Well we’ll get into the equine therapy a little bit later, but one of the things we really wanted to discuss with you today was the topic of resilience. So we might all be familiar with that vocabulary word, but what does that mean in the context of mental health and counseling?
Jess: Yeah, great question. Resilience is often framed as the ability to bounce back. I have the visualization in my mind that when a pebble hits upon that there’s a ripple effect that there’s an impact but it goes back to its original state. And I think that is often how resilience is talked about, which can be the case in some cases. But when it comes to humans, we’re not like a pond, we’re much more dynamic and we integrate our experiences over time. So resilience in the case of humans and mental health is much more about adaptation and the ability to integrate and incorporate our experiences and our learning into how we move forward. The idea of resilience as bounce back can often be kind of a fantasy in that we don’t get the chance to go back to the life we had before significant experiences in our lives or significant impacts that we are forever changed by them. And that’s where the adaptation comes in.
Wendy: Yeah, I like framing it in that way because like you said, if we think about resilience in terms of bouncing back, then the expectation is to sort of go back to who you were before, what you thought before. And that doesn’t allow for any evolution of your thought process or how you’re feeling or anything. So I like that. I like the word adaptation.
Tatum: Yeah, me too. Or we had our last speaker was an anthropologist and she talked about the concepts multiple normals. I know a lot of people, and our guest speaker included, don’t like the word normal, but people tend to use it. So, the concept of bounce back is like going back to your normal life. Like, like what was before. But I feel like you could develop a new normal, a new sense of what is normal now with the adaptation too.
Wendy: If you think about adaptation, like especially in early intervention, that’s a great word to keep at the front of our minds because children in this birth to three time, they change constantly. I was talking with one of our other therapists today and she noted that one of the children on her caseload wasn’t responding to this phrase that she was saying and the mom was getting a little frustrated and I just sort of brought up, well, the child’s 14 months old, they’re not going to do anything consistently all the time, which is so frustrating. But we have to sort of adapt to that when we’re working with young children because they do not stay consistent.
Tatum: S we wanted to talk about resilience today ‘cause we know it’s important for our families to develop. So why do you think resilience is so important to consider in general and then when it comes to working with families of children who are deaf and hard of hearing?
Jess: Yeah, resilience is important for everybody. Because change is inevitable. Even when we try to protect ourselves from change or create really predictable routines or lives that we are still impacted by change that’s close to us by virtue of aging for example. But also the reality that our nation is changing, our communities are changing. The world is changing. That adaptation and resilience is necessary, maybe even more intensely now than in previous generations because of how much change and how much information we’re exposed to with the time of technology. With deaf and hard of hearing families, it kinda depends on why resilience is important. I think there’s multiple places where resilience is particularly important in cultivating through early intervention ideally that we can support and teach people and families how to do that. One reason is that for many families, not all of course, but for many families that initial diagnosis is a stresser. And might even be experienced as traumatic and shocking, right or overwhelming to somebody’s system. And even if it’s on the lower end of the spectrum of just being a stresser, resilience is one of our capacities as humans to deal with stress. Resilience engages the parts of our brain that use creativity and problem solving and can be innovative, even amidst stress. Because stress has a tendency to shut us down and make us think more rigidly. Whereas resilience will counteract those stressers. So that stresser might be a diagnosis, it might be facing bullying for the first time. It might be facing a change in hearing status over time. It might be dealing with the change of going from an IEP to a 504. You know, all of those things are stressers in families with kids who are deaf and hard of hearing. And so resilience is something that these families in particular have to revisit more often than an average family might have to.
Tatum: You mentioned that the diagnosis could be experienced as a stresser or even a trauma. Could we talk maybe just briefly about the difference between a stresser and a trauma and maybe the types of traumas that our families might experience? We know some of those might come from something that doesn’t even have to do with hearing loss. So often our families have NICU experiences or they have other experiences outside of the child’s hearing diagnosis.
Jess: Okay. Yeah, I can definitely talk about that. So the difference between a stresser and a trauma is really about how acute the experience is, to what degree do you experience this stress. So a stresser is like an argument with your partner. Maybe you forget about it and you don’t even know what you were arguing about later. You know that it happened and your blood pressure went up a little bit and you were impacted, but you don’t necessarily keep ruminating about it or thinking about it. If you go back into the room where you had the argument, you don’t immediately like have a response like, “Oh my gosh, this is going to happen again to me” sort of thing. Whereas a trauma overwhelms somebody’s ability to cope and it’s a much higher stresser that can make somebody fight, flight or freeze. It is something that stays with somebody generally that, you know, diagnostically the clinical term of posttraumatic stress disorder for example, or acute stress disorder. In that case, you might go back into the room, in this case like the audiologist’s room and immediately feel yourself getting sweaty or stressed or checking out a little bit. You might have other stress indicators before anything else stressful is even happening because you’ve associated that place with something very highly stressful and there’s a lot of anecdotes. There’s a lot of stories out there of families receiving a diagnosis and leaving the room, literally fleeing or yelling at the person doing the screening or the diagnostics or never going back to that audiologist again, that those are indicators that somebody’s nervous system, their ability to cope got overwhelmed and they no longer want to have to cope or deal with that stresser. Does that make sense?
Tatum: Yeah, that’s interesting too. Just to think about that the actual audiology booth could become a source of like future stress.
Jess: It can be associated with the source of stress.
Tatum: And our families have to return to the audiology booth so often. And the other thing, I’ve worked with a lot of families, they start with one audiologist who I’m sure was great, but just whatever that initial first experience is, they end up moving to another audiologist. And often I’ve thought, it’s the grief from the initial diagnosis rather than anything specific that the audiologist might’ve done.
Wendy: And then I wonder how much kids perceive the stress of their parents in those situations. I know personally my kids know when I’m stressed out and I wonder if just subconsciously sometimes that’s what contributes to the difficulty of testing a really young child in a sound booth because they feel that very understandable anxiety from their caregivers that are with them.
Jess: Absolutely. And that goes back to Tatum’s comments that the stressers or the things that might be experienced as traumas might not even be related to the diagnostic experience or to any process around hearing loss. And it might have to do with the stress of the NICU, it might have to do with previous grief experiences. I think people who have experience and exposure to grief and loss earlier in their life might be a little bit more prone to experiencing a diagnosis of hearing loss as a grief or as a loss of that idealized child that they were planning for or imagining. And that plays a role in what you were just talking about, Wendy.
Wendy: Yeah. So it sounds like building resilience can be so helpful and important for families, but how do we do that? What are some ways to strengthen resilience both in general and then specifically when it comes to the families of young children with hearing loss or really any challenge?
Jess: Yeah, I would say that we have a three-tiered approach and maybe even four, four tiers as far as what we do to really help families build resilience in the face of the different systems that they have to navigate and the stressors that they have. The first and most obvious place to do this is by teaching kids resilience, supporting kids in being resilient. And Wendy, you had just said, “I wonder how much kids are perceptive to their parents’ stress.” And the reality is that we’re all perceptive to everybody’s stress to some degree, but we’re especially perceptive to our parents’ stress. And even more so the younger we are because the younger we are the more dependent we are on our parents for safety and the hormones and the stress indicators in our parents that go up indicate to us that there might be something stressful that we might need to prepare ourselves for. And some of the research, especially for really young ones, shows that newborns through the age of six months actually have identical stress hormone levels to their birth parent for six. That they don’t actually produce their own stress hormones and have their own regulation system until about six-months post birth again, because they are so dependent on their immediate caregivers for perceiving what is stressful, what is not stressful, how do we respond to stress, how do we keep ourselves safe?
Wendy: That that gives me a stomach ache.
Tatum: Yeah, that is like stressful to think, I mean I’m not a parent, but I could imagine that would be stressful for parents hear listening to the show, just thinking of our listeners. And Wendy herself as a parent.
Wendy: My palms are sweaty now.
Jess: Yeah. So I just want to pause there and say it is both a great opportunity and a great responsibility. And I think when we really focus on the responsibility, it can make us nauseated for sure. And when we think about it as an opportunity that brings us to that second tier that teaching kids resilience is about supporting parents and family members in their own resilience. Because there is this parallel process inherent to not only how we manage our own stress hormones, but how we literally role model behavior. Under stress, what do I do? If I’m stressed, do I yell at my partner? Do I yell at my dog? Do I pout, do I slam doors or do I say, “I need a break?” Do I say, “I feel myself getting really frustrated right now and I’m going to go get a drink of water and I’m going to come back when I’m cooled down.” How do we role model our own resilience, our own stress management so that our kids can learn that as well?
Tatum: Something we’ve been working on, here at Child’s Voice that I feel like is somewhat related to that is fostering theory of mind in our kids. We’ve been coaching families and also, our staff has learned as well to like incorporate more mental state words. And I feel like that just goes hand in hand with that. We’ve talked a lot about turning inside out where you’re constantly talking about what’s going on in the inside of your head, which is great for our children’s language development, but also I could see it being a great way to like model those behaviors for your child.
Jess: Absolutely. The reality is that we teach this to the kids, we teach this to the parents. Ideally siblings are getting some support in this as well. Siblings can often feel really neglected in this process. And then parents feel guilty and have other responses to that as well. The more we are explicit and role model our thinking process and are transparent, the more that they benefit from this instead of feeling left out of it. Tier one being the kids, tier two being the, the caregivers, that puts it at tier three, which would be us, the people providing direct services. So whether it’s a counselor, whether it’s an SLP, whether it’s the audiologist doing diagnostics that teaching essentially trauma informed care and self-care capacities and things that support resilience in our own selves also ends up translating to the parents and how intensely they experience the services that we provide them with. That’s where… Sorry, go ahead.
Wendy: I have a question about that and it might be a little bit off topic, but I struggle with honoring where a parent is in their journey at the moment, which is sometimes a really difficult, challenging place where it’s just like, this is so hard. This is where I’m at. And I want to honor that and be okay sitting with that. But then we also have this thought, that we’re talking about, which is building resilience. You probably can’t answer that very simply, but what are some thoughts on how to balance those two things?
Jess: My first response is a little bit of a cop out. I would say go read the articles that I co-wrote with Elizabeth Seeliger and Leigh Hardin. One is about holding space and how do we hold space and what does it mean to hold complex emotions, which is the example that you just gave. And then the other one is geared a little bit more for pediatric audiologists or people in similar professions or overlapping professions as far as like “things nobody told me.” Like nobody told me that I was going to be sitting in such close proximity to pain when dealing with this diagnostic process. And nobody told me that knowing how I manage my own pain, even vicarious pain has an influence on how people experience the services that I provide. Am I minimizing the pain? Am I escaping from it? Am I justifying things, you know, like at least we haven’t seen any reductions in hearing loss in six months. That’s great. Well that might negate somebody’s experience. And that that might be more about us feeling better than actually meeting the family where they’re at. So that’s, that’s my short like kind of a cop out answer.
Tatum: We’ll read those and also link them in our show notes so our listeners can read them as well.
Wendy: But maybe it’s even just important for families to know that like we, we think about that and we, you know, something that we’re constantly pushing ourselves to be able to navigate better.
Tatum: And I know personally as a speech pathologist, it varies week by week for me how well I am able to hold that space. Cause sometimes you’re in a room with a parent who’s going through a lot more than just me getting through the daily tasks of my job.
Jess: We can’t predict the intensity of what people are going to come in with week by week, but we also can’t really predict the intensity of our own lives. And what you might be coping with one week outside of your work might be taking a bigger toll on your resource bank and your energy levels, which will inevitably have an impact on how well you feel like you’re doing that at work.
Wendy: Maybe that’s a good reminder for younger clinicians just starting out too, that it’s a process that you continue to go through throughout your career and you don’t have to know all the answers right away and it’s something to just continue being aware of so that you can build that resilience over time. Because it does get, I feel, not easier by any means, but more familiar and more comfortable to navigate some of these more traumatic and stressful situations.
Tatum: But at the same time, I feel like you can have highs and lows of yourself like there’s weeks that I do better and there’s weeks that I need to keep working.
Wendy: Totally. Totally. Oh, what was tier four?
Jess: So tier one would be directly supporting children. Tier two would be supporting their families and especially their caregivers. Tier three is supporting providers. And tier four would be how we structure our institutions differently. How do we create policies, practices, and procedures inside of our own organizations so that we don’t create dynamics in which people already feel a baseline stress level before they even receive services. So for example, one of the things that institutionally has been enforced in a lot of different places is really short appointments. And so not only can that create a dynamic where families feel rushed to get everything in, providers can feel rushed and when we feel rushed, we are increasing our own baseline stress levels. And sharing that kind of sense of urgency that can at least put a little bit of a yellow flag up for people as far as like, do I need to be, do I need to be worried? Am I missing something? And can set us up for failure sometimes.
Wendy: I think all the audiologists just clapped for you.
Tatum: I’m just thinking about like in our system in the US like paperwork, the insurance process, all these extra things that we can’t control as an organization. But on a wider system is probably playing a role.
Jess: Right. And, families might not have any idea what that looks like logistically or systematically, but they feel the impact of it. That transfers down the line pretty rapidly.
Wendy: It’s interesting to bring up the paperwork issue. Tatum and I at this time last year were in Israel, visiting a program for children with hearing loss in Tel Aviv and we were astounded and so interested to hear about their documentation process and how totally different it is than what we do. And it seemed like such a nice way to provide services because there’s just less data collection and it did really seem to take some of the stress out of…
Tatum: They were a very relaxed culture. I don’t know if that was the only thing that played a role, but…
Tatum: And I think too, the way that they access services was very different. A lot more like government funded services, but I think also took away some of that stress that is just inherent to our system.
Wendy: Yeah. And I’m sure they have other stress. I know they have other stressors that we don’t, but it was just an interesting comparison.
Tatum: There is a follow-up question I have. I’ve heard this phrase a lot and I feel like I sorta know what it means but could not describe it to anybody. What does trauma-informed care mean?
Jess: Oh, this is such a great question. There’s quite a bit of controversy around trauma-informed care and what it is and what it’s supposed to be. I’m going to say that generally trauma-informed care is about the research on adverse childhood experiences. If you’re not familiar with adverse childhood experiences, it’s the research study that the Center for Disease Control and Kaiser did that showed a dose-response correlation. So like with each stressor that somebody experiences during childhood, they have an increased connection which indicates causality, right? It shows it’s not just coincidental that these things increase. And so with the more traumatic or adverse childhood experiences that somebody has, the more likely they are to have negative health outcomes in the future. Having a family member with an addiction, having a family member, incarcerated, experiencing abuse, those sorts of things. Only 10 questions were studied for that. And what they found is that when you were exposed to those things, when a person is exposed to those things they are more likely to have heart disease, kidney disease, they’re more likely to be smokers. They’re more likely to have unintended pregnancies. They’re more likely to attempt suicide. They’re more likely to experience addiction or use drugs in different ways. Right? So a lot of the things that societally we’ve kind of learned are flaws in character or problematic in different ways are actually highly correlated with degree of trauma exposure in childhood. So trauma-informed care is really in response to that research. And it’s about saying we need to inform people that trauma exposure during childhood changes people and predisposes them to these different health risks. So we need to have more compassion for them. We need to understand the impacts of trauma on the brain and the body. We need to be prepared for the different reactions that people have as a result of trauma so that we can behave more as providers more compassionately and provide better services. And that’s the idea. For the most part trauma-informed care initiatives have been about education and not so much about action. So a lot of people have felt kind of disenchanted with like, “Okay, I get it. Trauma makes life hard, now what?” And so the way that I work with trauma informed care is really about the now what, or the how, how do we address it? And, that comes more into systems change, that comes into this kind of philosophy of transform yourself and you can transform the world, which is actually Naropa University’s motto. And more about what are the little things that we can do, right? Of we know that under stress, our bodies naturally start to hold our breath. What does it mean to practice breathing in between appointments even if we’re still rushing in between appointments. If the time we’re saving running from room to room is literally saving split seconds. What does it mean to my body and my own stress level to decide to walk and breathe and take that extra one and a half seconds to get to the next room and be more humane with the people in my office? It’s some of those actions and that’s really where I incorporate nature-based work and body-based experientials like principles from aikido, as in martial arts or equine therapy. And I do a lot of that work again with Elizabeth Seeliger and Leigh Hardin, who is a parent in Colorado, to drive home what it feels like to do this differently, not just how to think about it differently, but how to live that experience.
Tatum: Yeah. That, that makes sense. It almost seems like a buzzword to me. So, what does this actually…
Jess: It really is a buzzword and I think people have a hard time with it sometimes because it isn’t creating systems change. It’s creating some individual change. And part of what we need to see is that it creates system change. And I say that because one of the things that we know from ACEs and trauma research is that, for example, one of the likely things that happens, as a result of trauma that if you know you’re going into a stressful situation, you are more likely to avoid it or be late for it. Or you might have transportation difficulties, you might have financial difficulties, you might have other barriers. So, institutionally a lot of programs have policies that say, you know, once you no-show three times you are banned from our services. That can be related to people assuming judgment, people experiencing stress the first time that they came into the office and not knowing how to metabolize it or how to be resilient in the midst of it and struggling to get themselves back in. Whereas a trauma-informed care approach might remove that sort of hard line barrier and say, “Okay, what are the ways that we can support this family and what are the adaptations we can make?” Because oftentimes multiple agencies will have that same policy and then people who need services are banned from getting services at every single possible venue in a community. That’s not helping anybody.
Tatum: That’s so interesting. It’s difficult to balance as an organization what’s necessary from like a business perspective and then what’s possibly more appropriate and compassionate for our families. I’m thankfully not in charge of private practice, but how to juggle that must be difficult.
Wendy: It just brings up different ideas of how to incorporate more compassion and more of a thought process into some of the things that we do.
Jess: Does that answer your question, Tatum?
Tatum: Yes. Thank you. I feel more informed.
Tatum: So we just talked a little bit about trauma-informed care at the start of our conversation. We also touch pretty briefly on grief. I wanted to go back to that. So in graduate school, and I feel also in our field we talk a lot about how the grief around the diagnosis could be cyclical or families can experience grief in a cyclical way. Could you talk a little bit about what that means and if that’s the most appropriate analogy for that?
Jess: Sure. Some of the popular models for grief are not the ones that I use for a couple of different reasons. But, when it comes down to it, grief can be cyclical in the fact that years are cyclical. So we revisit anniversaries, we revisit themes, there can be a sense of a circular motion with that. I like to think of a spiral in how we deal with grief because we do revisit things, but when we revisit an anniversary a year later, we’ve potentially gone through a whole assortment of different experiences that might make us feel more resilient or they might make us feel more timid or you know, we are essentially a different person a year later. And so dealing with how we revisit that stressor or that memory might present different themes or different issues for us at that time.
Wendy: I like that cause using the cycle analogy, you’re ending up in the same place every time.
Jess: Right, you’re starting back from square one and that can happen. That tends to be a little bit more of like a clinical complex grief sort of experience of people really feel like they’ve made no growth and that they’re just spinning their wheels. And that would be a place for bringing a therapist, a mental health professional in to support getting that unstuck. Not as often with the type of grief that we talk about in the deaf and hard of hearing world with mitigating diagnostic trauma or the trauma or grief that comes with a diagnosis for some families. That’s more along the lines of death and how we deal with death and can spin our wheels with that. I think there’s a little bit of a different hue of what grief means for dealing with a diagnosis, whether that is a personal diagnosis of cancer or something like that, or a diagnosis of a family member or sibling with something like a hearing loss.
Tatum: And then could you talk briefly about how the source of grief itself could change over time just in relation to the hearing loss itself. So you mentioned this a little earlier. I’ve had families that have had the initial grief and then there’s a change in hearing and something comes up again, moving from early intervention into an IEP and losing your support system or part of your support system. Hopefully you can build a new one. But could you talk a little bit about that?
Jess: Yeah, this is where grief can get kind of messy with these families because grief can be a barrier for families and connecting with their children, but grief can end up being really motivating or actually about justice and being protective of their child. So sometimes with the documented types of grief that families might have early on that might be the experience of the loss of their idealized child or the fantasized child that they thought they were going to have. That might be a sense of grief or loss around feeling like their support system understands them or still is supportive of them. People can get pretty tired of explaining what it means for their kid to be deaf to other people. And some community members can step into that and some have a harder time with that. And so there can be a loss of social support that can be a grief source for families. Over time though, as we support families in developing a relationship with their child and loving their child for who they are the grief can become more about how they witnessed their child experiencing the world. Because oftentimes these children do experience the world in a pretty radically different way than how their parents experienced it. Because there can be some vicarious pain that comes from realizing, “Oh my gosh, the things that I assumed my kids would get, my kid has to work so hard for.” So for example, recognizing that if a kid is feeling self-conscious or being bullied at school for the use of their FM system or their hearing aids, they might turn them off or take them off or not use them or not remind the teacher to put on the microphone or do some of those things. And they can pass often times. But they experience pretty substantial fatigue and exhaustion as a result of how much more effort they have to put into keeping up with lessons when they’re not getting adequate or appropriate services and as a result can have more behavioral issues at home than at school. And, as families realize like, “Oh my gosh, this is because my kid is so exhausted because they’re trying so hard. They’re trying so much harder than anybody else.” There can be a grief about how the education system is not meeting their child’s needs or when it comes to getting accessible services at faith-based programs or churches or temple or medical appointments or different things, getting the accommodations that people need and struggling to get them can also bring up a different kind of grief as far as accessibility issues go, which again can become a barrier between a parent or a family member and a child or it can really unite them as far as what solidarity and fighting for your child’s rights can look like.
Tatum: That reminds me of a previous episode we had where I feel like it was Clara and Julie. We interviewed a mom and a daughter and the mom had always advocated for her daughter’s rights, which empowered her daughter to be ready to do that early like in high school and college. And it was a positive experience that taught her daughter how to be empowered and speak up for herself.
Jess: Right. And that connects right in with the concept of fostering positive identity and fostering joy. There’s this new fostering joint initiative in the Early Hearing Detection and Intervention world. And connects back to the topic of resilience as well that families who get support or intuitively go, “Okay, this is not what I planned for. This is not what I thought I wanted, but this is what I have and I love my child and I’m going to embrace it. I’m going to adapt to it to the best of my ability” are inherently adapting and modeling resilience in a way that will foster that positive identity that you were just describing in that example.
Wendy: Are there any other examples or I don’t want to say tips, but any other short things that you can share with us? And then if you also have resources where we can learn more about that, if you can either mention those or we can also link to them in our show notes as well.
Jess: So as far as resources for building resilience and our ability to cope with the stressors that we’re facing in this work or as parents and caregivers of these kiddos, it can be as simple as just starting with yourself and micro practices breathing, for example. Often I use my sense of urgency or my sense of pace as a barometer that if I feel myself going faster or wanting to talk to faster or wanting to move faster that might be a sign that my stress level is up. And so starting to practice checking in with myself or checking in with yourself, how fast am I going? And then you can have any assortment of practices that work for you to go, Okay, I’m going faster than I want to be. Or maybe faster than is necessary. That’s a sign of a stress response. And so I can practice slow breathing. I can practice moving my body slower. I can take a drink of water, I can do something that makes me take a moment of a break, like going to the bathroom or getting a drink of water or eating a snack. Those really simple practices can be profound in how they change the way that people perceive the stress around them. On another level, one of the things that I’ve found to be most helpful for agencies, for providers is developing some degree of buddy systems that self-care and resilience often is talked about such a personal thing. But again, they’re systematized, right? Like systems, like organizations can accidentally encourage people to never take a bathroom break because there’s so much to do and that’s obviously not good for us and will increase our stress levels so having some sort of buddy system or way to, to say, “My goal today is to actually stop and take a 30-minute lunch break. Hey Tatum, do you want to take a lunch break with me?” Being more engaged with each other as colleagues around like, “Oh no, like I haven’t been taking care of myself in this way. I’m going to try this.” In that way you also get to hear like the innovative and creative ways that other people are coming up with for taking care of themselves. For people who do home visits, they can use guided mindfulness activities while they drive to help them slow down or help them center and do that sort of thing as well. And then I think the last tier of it is potentially getting mental health support, getting a therapist that is on your team because we are getting a high level of stress or even trauma exposure in the work that we’ve chosen. And maybe even surprised by how stressful it is by our clients or participants in our programs. And mental health therapists used to be mostly for working with mental illness but they’re really trained to help us deal with stress as well. And getting somebody on our side where we have a place where we can vent, where we can express our problems and also get a little bit of professional support in feeling better can go a long way as well.
Wendy: That’s fantastic advice. Thank you. So I think that seems like a good place to wrap things up. Jess, thank you so much for joining us. We learned so much from you today. I think you’re right. We could talk for hours about this. Thank you for your time and for being here with us.
Wendy: If you feel comfortable sharing your contact information, how can our listeners get in touch with you?
Jess: Yeah, the easiest way to get in touch with me is through my website, naturalwisdomcounseling.com and my email address and a contact form is on that website.
Wendy: Great. And we’ll share that as well as perhaps some other resources that maybe Jess can point us towards about resilience in the show notes.
Tatum: Yes, as well as those articles you mentioned earlier. So yeah, thanks for joining us. I do feel like I learned a lot too. Thanks everyone for joining us for another episode of all ears at child’s voice. Be sure to join us for our next episode. As a reminder, we release episodes every month on the second Wednesday of the month.
Wendy: If you’d like to reach out to us, you can find us on Twitter and Instagram. I’m @wendydetersSLP and you can find Tatum @tatumfritzSLP.
Tatum: You can also email us at email@example.com And if you’d like to hear your voice on the show, you can send in a voice memo using your phone’s voice memo app. If you need help with that, there is a link in our show notes to show you how to do it. And you would just email that voice memo to firstname.lastname@example.org. You can also find show notes and episode transcripts on Child’s Voice’s website, childsvoice.org/podcast.
Wendy: And if you’re interested in learning more about Child’s Voice, we are on Facebook as well as Twitter and Instagram with the handle @childs_voice. No apostrophe.
Tatum: We’ll see you next time. Bye.
Elise: Thanks for tuning in! We really hope you enjoyed this episode! Stay tuned for our next episode which will be a family spotlight featuring a mother and grandmother of a child with hearing loss. That will be released on the second Wednesday in April. We’ll see you then!
CV Students: BYE THANKS FOR LISTENING!