// Dr. Isaiah Pickens

Dr. Isaiah Pickens


051917

Dr. Isaiah Pickens, a clinical psychologist who provides trauma-informed training for juvenile justice agencies, here frames the use of narrative and peer to peer support for the treatment of trauma. An initial goal in most treatments is for people to identify the reminders of their trauma so they can manage them. Once they are able to manage initial trigger stimuli, the second piece in overcoming trauma is exposure to the story of what happened. He speaks about facilitating means of empowerment that are actually possible, such as peer work. It can be powerful for people to understand how issues affect not only them, but others, and to understand coping skills well enough to teach others and make them feel safe.

Bio: Dr. Isaiah B. Pickens, Ph.D. is a licensed clinical psychologist in New York City who provides trauma-informed training and consultation to foster-care and juvenile justice agencies. He is also founder of iOpening Enterprises, a multi-media company providing mental health education workshops and online resources for teens and the adults in their lives.

Melanie Crean: Tell me a bit about what you do. How does the justice system relate to people’s emotional health and how have you been using narrative and storytelling to address this? How do the mechanics work?

Isaiah Pickens: I think the angle in your project on how people heal from trauma align with a lot of the evidence-based practices that we know. When we talk about treating trauma, there are a couple key components that most treatments have. One is being able to help people identify things that are reminders of trauma because those can set them off and send them back to that place ... Becoming more aware of that gives them the ability to manage it when they start feeling themselves get out of control. Sometimes when people get really emotionally dysregulated from being reminded by a trauma, it’s better for them to learn how to calm themselves down before going into the narrative piece, because the narrative can be too activating for them and can re-traumatizes them in the worst case scenario. We like to teach people self-soothing, how to calm your senses down when you are feeling stressed out.

Then once they have been able to really practice those skills, getting into the narrative is great because a big part of overcoming that trauma is exposure, exposure to that story, and to make it so that that story doesn’t become their entire story, but just a part of their life story. … It can be just as unhealthy trying to forget what happened to you as well and that being your sole focus.

As for self-perception theory and also the hero narrative, being able to distance yourself from the trauma and to observe objectively how you’re responding ... when it’s integrated with an overall goal to have greater clarity around your narrative can be very effective. But it’s also important to understand how people respond to trauma, because some people can respond with dissociation. We see that a lot of sexual abuse survivors have this kind of response, to mentally separate yourself from your body and observing what’s happening around you; it almost sounds like self-perception theory. But if this becomes a natural way for you to respond to stress, then you get stressed out and block out everything around you and you lose twenty minutes of time.

We also see this connected with self-destructive behavior, with people cutting themselves, because people want to be present, they want to feel like they’re alive. sometimes people disassociate to the point that they feel like they’re not there, they’re not present, and so they want to bring themselves back or they want to feel something and express that pain. With those types of people, mindfulness may not be the primary way. They might need to do more active things so that they can fully be present and do other kinds sensory coping strategies like where you’re playing with sand or things that are more tactile so that you’re present and you’re here and you’re using your body in a healthier way.

For your second question in terms of the hero narrative, we especially see this in children. When they’re traumatized, they usually replay it in their play, and someone comes and saves the day or someone comes and changes the situation so that it doesn’t hurt them as much. We help them understand that this actually did happen but it gives them a sense of hope that if it were to turn out that way again, then they would be able to manage the stress.

One thing we talk about when it comes to the criminal justice system is the social contract being broken particularly as it relates to trauma. When I say social contract, I just mean if I do certain things in society, then I’m supposed to be taken care of. If I do what I’m supposed to do in school, the schools should educate me. It shouldn’t be that I get arrested or or all these things that happen in traumatizing situations that can break that social contract. My boss here did a lot of work with teens in Bosnia and so many of them wanted to be doctors. They saw so much destruction around them that they wanted to feel empowered to do something about it if it happened in the future. But there was also a young, impoverished black kid he was working with in the States and he wanted to be a doctor but there just wasn’t the social capital around to even get him an internship or working in a hospital. I think that a hero narrative can be really effective.

But pairing it with practical steps, to allow people to actually engage with some of these hero behaviors so that they can have a sense of agency is important so that it won’t feel like another betrayal, breach of that social contract. We’re putting these narratives together, but are they actually realistic in some way?

It’s important to be clear about the intention because you also don’t want in the exercise people to get the sense that the victim is being blamed. You know, “You could’ve changed this but you didn’t do this.” If you couch it as being able to develop coping skills for really difficult life situations and not just in that scenario, but when things can remind you of that scenario, then that can be really empowering. I think it's really effective when people get out of their own head about how this impacts them but also how it impacts others. Because if they’re learning a skill that they are then able to teach someone else or that they can help someone else feel safe, it empowers them and it gets them beyond. “This narrative is the only narrative I can have.” You can change your narrative, but you can also change the narrative of other people. I think that adding some kind of piece of connectedness to others in the frame can help that.

MC: There’s another thing I want to ask you about disassociation. Dr. Wendy D’Andrea, who we also interviewed for this project, describes how trauma is remembered, where the cognitive part of where language is formed and stored might be different from where the emotional part is stored, and that’s the part that gets triggered by association later. You described that if something happened to someone who was sexually abused they might just feel shut out from their body. She said that sometimes people don’t necessarily have verbal language to describe what happened to them. Some people she worked with could not verbalize it. Does memory relate to language in different ways, so you might use different forms of treatment to access it?

IP: You should read a book called The Body Keeps Score. Van der Kolk is one of the trailblazers who created the diagnosis of PTSD, and he has story after story about people who couldn’t articulate what the trauma was that they’d experienced, because of the trauma itself, and also the processing of information once you’re in that state of heightened alert. You see some detail, but you only see certain details vividly, so you’re missing other details that are happening around you and it might be hard to describe all the pieces of the puzzle. That’s where his book talks about using the arts: to draw, do yoga, or use mindfulness to start to really bring some expression to the emotive process because the emotions are so intense it’s hard to process them at times and then later make sense of them. In a way, what that art does is it to help you make sense of what you’re experiencing in that moment, and then you can start to bring some words to it.

MC: Are there other ways that these events are stored in the body?

IP: Yes, another thing to look into is epigenetics. It is a relatively new form of research that’s been around for 10/15 years. We have believed historically that our genes are what they are and that’s it. But what we’ve learned is that that’s not the case. The environment can turn on and off certain genes, and epigenetics is about this process. They’ve looked at survivors of the Holocaust and their descendants and they’ve found that the traumatic experience that the grandparents had, actually lead to certain genes being turned on in them and passed down, so that their descendants had a heightened stress response. They replicated this with rats, where they made the rat very fearful of something they weren’t normally afraid of at all, and they show it being passed down multiple generations.

From a genetic standpoint, we’re starti