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Monthly Archives May 2023

SANE Spotlight: Remember the SANEs during National Nurses Week

by brian in HEALTH

SANE Spotlight: Remember the SANEs during National Nurses Week

By Marina Sampanes Peed
Executive Director of Mosaic Georgia

Mosaic Georgia SANEs in action. From left to right: Melissa Drinkard, Kathy Carter, Teresa Bullard

As National Nurses Week is upon us, we call attention to a small but mighty forensic nursing specialty: Sexual Assault Nurse Examiners (SANEs). SANEs are specially trained registered nurses who provide compassionate care to survivors of sexual violence including assault, abuse, and sex trafficking.

The SANE practice is at the intersection of health care and criminal investigation. Their patients are both people and evidence. They collect evidence, document injuries, and provide treatment and support to survivors in a way that is trauma-informed and respectful. When cases proceed to court, SANEs are often called to testify in proceedings.

Kathy Carter, director of Forensic Medical Services, is often asked why she chose to practice as a nurse in such a difficult specialty. Kathy shares her Why: “While I cannot end sexualized violence, I can offer trauma informed care to patients after an assault or on-going abuse which promotes a feeling of safety, empowerment and healing. This level of care can make a HUGE difference in the trajectory of the patient’s journey.”

Victims of sex crimes are more likely to report the assaults and participate in investigations after receiving trauma-informed care from SANE and advocates. Like all people who seek medical care, the experience is more effective when the care providers lead with listening and believing.

Mosaic Georgia was the first Sexual Assault Center in Georgia to develop the community-based SANE/medical forensic program. In 1993 (then Gwinnett Rape Crisis), we treated our first patient/victim of rape in our center. Over the last 30 years, our SANEs have provided more than 6,000 medical forensic exams to people ranging in age from 3 months to 90 years. The medical care is enhanced with victim and family advocacy, mental health services, and other supports in one location.

To respond to calls 24/7, the community relies on committed SANEs who go on-call after hours and weekends and respond to our center when needed. These are special people. If you meet a SANE, let them know you appreciate their dedication.

Mosaic Georgia’s SANE Success Institute professional education, peer review, and an online community for SANE practitioners. It is a lively forum of support and connection for SANEs across Georgia and nearby states. For more information, https://www.mosaicgeorgia.org/education-training/

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Gen Z And Self-Esteem: The Kids Are (Gonna Be) Alright

by brian in HEALTH

Gen Z And Self-Esteem: The Kids Are (Gonna Be) Alright

By Ashia Gallo
Wholeness Collective Coordinator at Mosaic Georgia

May is National Teen Self-Esteem Month!

What better time to raise awareness on the importance of our youth feeling self-aware, confident, and healthy as they grow to rule this world someday. It’s been a few decades now since an iconic diva instructed us to teach children well, let them lead the way, and to hold up a mirror for them to see their own beauty. But in order to guide, we must understand Generation Z, or Gen Z, which comprises those born between 1996 and 2015.

As a 30-year-old Millennial, it blows my mind to watch my “Gen Z” nieces whose diapers I changed evolve into young womanhood. It’s fascinating to see their growing awareness of their own bodies, opinions, and talents. Especially in a world that continues to change at a mind-numbing rate!

Each generation has its gripes with authority and the stack of cards they feel they were dealt – it’s a natural rite of passage! Gen Z, however, is determined to break generational limits like injustice, intolerance, and bootstrap myths. On a large scale, their worldview seems to encompass inclusivity, sensitivity, and a refusal to shy away from tough societal realities.

A major strength of the Gen Z generation includes their willingness to accept all layers of their identities (think gender and sexual fluidity), despite outdated “social norms”. This openness applies to how mental health and self-esteem is discussed in youth culture today. Gen Z is open and eager to explore their struggles with anxiety, depression, trauma, and triggers. They also seem to not only question authority, but understand the unresolved issues of previous generations in order to break the proverbial chain.

Studies show Gen Z to be the least confident generation. Their progressive political and social views are challenged by the intense pressures of being a young person in 2023. Causes include: grossly skewed coming-of-age milestones interrupted by a global pandemic; very real struggles with anxiety and depression; lack of close family units and community; and less enthusiasm about the future than past generations.

The impacts of the Internet and social media have also been discussed since their inception in the 2000s. However, I’m afraid we are just touching the surface of the long-term effects of our (now portable) 24-hour news cycles and problematic portrayals of false, flawless on-screen lifestyles.

For school-age Gen Zers, the pressure of perfection runs deep. When I think of my own self-esteem struggles during teen years, the constant threat of permanent exposure of my most painful experiences existing forever on the Internet is unfathomable. The darker sides of technology – mob-like bullying, sexual exploitation, cancel culture, and abuse – have impacted our kids’ self-esteem deeply. Swiping, liking, and canceling at will is not only limited to Gen Zers. The increased dependence we have on our screens has led to a decrease in face-to-face human interaction and ease of conversation – especially for our youth.

Self-esteem is dependent upon having a sense of belonging, identity, and self-confidence. While Gen Z does struggle with these areas, not all is lost. This new generation is full of hard-working, pragmatic fighters. Even when their voices shake, they believe in activism and being advocates for human rights, in both large and small ways. They take up for themselves and their peers. They demand historically accurate classrooms, socially aware campuses, and respectful workplaces, despite age or skill level.

It gives me hope that this generation is willing to take a stand on anything and everything, from racism and transphobia, to climate change and equal pay. Their ability to survive and thrive will surely shape the future of society in ways that will move humanity onwards and upwards.

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Trauma and the Brain: A Look at How Traumatic Events Shape Memory and Perception

by brian in HEALTH

Trauma and the Brain: A Look at How Traumatic Events Shape Memory and Perception

By Kendall Wolz
Mental Health and Wellness Manager at Mosaic Georgia

At the age of 13, I disclosed years of sexual abuse by my stepfather. Unfortunately, the rural area I lived in did not yet follow the robust Child Advocacy Center model that is the protocol today. This meant that I had multiple interviews by various investigative parties. I can recall extreme frustration when I was asked “when did the abuse start, how old were you, how many times did it happen?”

I felt intense fear that people would not believe me because I could not give the answers to those seemingly simple questions. The reality is that my brain did not file the memory of the first incident, or subsequent incidents of abuse as a biographical memory where the date and incident number were important.

Instead, what I could tell investigators included: the show, Who Wants to Be a Millionaire, was playing in the background, what my favorite pair of pajamas I wore most frequently looked like, what the abuse felt like to my body, and the fear that swept over me.

This is an example of how trauma memories are often stored.

Let’s explore how this happens.

The Brain: One Fascinating Organ

Weighing on average 3 pounds, the brain is the most complex organ within the body. It processes every piece of information received through the five senses and communicates with the rest of the body to keep us safe and alive.

How do experiences impact our brains?
Decades of research have shown that trauma has a significant negative impact on various structures within the brain. Before discussing those impacts, here is a look at the healthy brain functions that are harmed by trauma.

  • Brain Stem: Responsible for our survival instincts and functions such as heart rate, respiration, blood pressure, consciousness, and sleep.
  • Midbrain: Stores memory, processes emotions, and serves as a connection between our cortex and our brain stem.
  • Cortex: The most highly evolved structure of the brain, responsible for cognitive processing, decision making, and controlling thoughts and emotions.

Fight or Flight Leads the Way

When a person experiences an actual or perceived threat to their safety or wellbeing, the lower part of the brain, the brain stem, becomes highly activated to ensure survival. It may respond to the threat in a variety of ways.

An event like seeing a bear on a hike, witnessing a crime, or experiencing a sexual assault may elicit a desire to either fight with intensity, get away from the situation as quickly as possible, become frozen or paralyzed, fawn (go along with what is happening), or faint.

If the traumatic or threatening event is survived through a fight/flight/freeze/fawn/faint response, the brain has performed its job well.

How our brain responds to trauma is not a cognitive choice.

Temporarily Turning Off the Lights

Decision making happens in the prefrontal cortex, near the forehead – sometimes referred to as the “thinking area” of the brain. When a threat is perceived and the body goes into survival mode, the cortex essentially goes offline, halting its ability to communicate with other parts of the brain. This conserves energy and allows the body to focus on survival, until the perceived threat is gone. For example, during a traumatic event the brain would not have the ability to think through and solve a word problem, or the body would not put effort into digesting food. Until the threat subsides, the brain and body direct their many resources strictly towards survival.

The Brain’s Megaphone

What alerts the body to go into fight or flight mode? A small, almond shaped structure deep within the midbrain called the amygdala is responsible for sounding the alarm. The amygdala sends messages to other parts of the brain that activate various elements of the fight or flight response when a potential threat is present. Functions like increased heart rate and the release of stress hormones allow the body to get itself to safety.

It is in this part of the brain where memories are attached to emotion. Traumatic memories get stuck in the emotional memory of the amygdala rather than reaching the hippocampus, the area of the brain that records the details – like the what, when and where of an event.

So for survivors the “memory” of a trauma often emerges as a strong emotional or sensory experience. Unfortunately, trauma shuts down our ability to integrate events episodically which creates a barrier to recalling things like dates and locations.

This is why trauma survivors often keenly remember a smell, like the smoke of a house burning or the cologne of a rapist, but not what time it was when the trauma occurred.

The Trauma of Disclosing Trauma

Without understanding what happens within the brain during a trauma, there exists a risk of doing more harm to people who have experienced horrific events. When survivors are expected to recall the traumatic event in an episodic manner (the when, where, why), they become set up for judgement, disappointment, frustration, and even disbelief despite the reality that the memory is not consolidated and stored in a way that can be recollected.

However, opportunities for people to disclose their memory of what occurred can be provided by eliciting the information they can recall – how they felt, what their senses noticed – while assessing whether they can also access any of the biographical data.

As this information becomes more accessible and understood by the general population, an opportunity presents to move away from some of the stigmas and widespread misconceptions that plague survivors.

Helpful and Informative Sources

A video illustrating how trauma affects the brain can be seen here. 

The Body Keeps the Score by Bessel van der Kolk 

Dr. Seigel’s hand model of the brain: https://www.youtube.com/watch?v=f-m2YcdMdFw 

https://www.verywellmind.com/the-effect-of-ptsd-on-the-brain-2797643 

https://www.psychologytoday.com/us/blog/the-mindful-self-express/202106/understanding-the-trauma-brain 

At the age of 13, I disclosed years of sexual abuse by my stepfather. Unfortunately, the rural area I lived in did not yet follow the robust Child Advocacy Center model that is the protocol today. This meant that I had multiple interviews by various investigative parties. I can recall extreme frustration when I was asked “when did the abuse start, how old were you, how many times did it happen?”

I felt intense fear that people would not believe me because I could not give the answers to those seemingly simple questions. The reality is that my brain did not file the memory of the first incident, or subsequent incidents of abuse as a biographical memory where the date and incident number were important.

Instead, what I could tell investigators included: the show, Who Wants to Be a Millionaire, was playing in the background, what my favorite pair of pajamas I wore most frequently looked like, what the abuse felt like to my body, and the fear that swept over me.

This is an example of how trauma memories are often stored.

Let’s explore how this happens.

The Brain: One Fascinating Organ

Weighing on average 3 pounds, the brain is the most complex organ within the body. It processes every piece of information received through the five senses and communicates with the rest of the body to keep us safe and alive.

How do experiences impact our brains?
Decades of research have shown that trauma has a significant negative impact on various structures within the brain. Before discussing those impacts, here is a look at the healthy brain functions that are harmed by trauma.

  • Brain Stem: Responsible for our survival instincts and functions such as heart rate, respiration, blood pressure, consciousness, and sleep.
  • Midbrain: Stores memory, processes emotions, and serves as a connection between our cortex and our brain stem.
  • Cortex: The most highly evolved structure of the brain, responsible for cognitive processing, decision making, and controlling thoughts and emotions.

Fight or Flight Leads the Way

When a person experiences an actual or perceived threat to their safety or wellbeing, the lower part of the brain, the brain stem, becomes highly activated to ensure survival. It may respond to the threat in a variety of ways.

An event like seeing a bear on a hike, witnessing a crime, or experiencing a sexual assault may elicit a desire to either fight with intensity, get away from the situation as quickly as possible, become frozen or paralyzed, fawn (go along with what is happening), or faint.

If the traumatic or threatening event is survived through a fight/flight/freeze/fawn/faint response, the brain has performed its job well.

How our brain responds to trauma is not a cognitive choice.

Temporarily Turning Off the Lights

Decision making happens in the prefrontal cortex, near the forehead – sometimes referred to as the “thinking area” of the brain. When a threat is perceived and the body goes into survival mode, the cortex essentially goes offline, halting its ability to communicate with other parts of the brain. This conserves energy and allows the body to focus on survival, until the perceived threat is gone. For example, during a traumatic event the brain would not have the ability to think through and solve a word problem, or the body would not put effort into digesting food. Until the threat subsides, the brain and body direct their many resources strictly towards survival.

The Brain’s Megaphone

What alerts the body to go into fight or flight mode? A small, almond shaped structure deep within the midbrain called the amygdala is responsible for sounding the alarm. The amygdala sends messages to other parts of the brain that activate various elements of the fight or flight response when a potential threat is present. Functions like increased heart rate and the release of stress hormones allow the body to get itself to safety.

It is in this part of the brain where memories are attached to emotion. Traumatic memories get stuck in the emotional memory of the amygdala rather than reaching the hippocampus, the area of the brain that records the details – like the what, when and where of an event.

So for survivors the “memory” of a trauma often emerges as a strong emotional or sensory experience. Unfortunately, trauma shuts down our ability to integrate events episodically which creates a barrier to recalling things like dates and locations.

This is why trauma survivors often keenly remember a smell, like the smoke of a house burning or the cologne of a rapist, but not what time it was when the trauma occurred.

The Trauma of Disclosing Trauma

Without understanding what happens within the brain during a trauma, there exists a risk of doing more harm to people who have experienced horrific events. When survivors are expected to recall the traumatic event in an episodic manner (the when, where, why), they become set up for judgement, disappointment, frustration, and even disbelief despite the reality that the memory is not consolidated and stored in a way that can be recollected.

However, opportunities for people to disclose their memory of what occurred can be provided by eliciting the information they can recall – how they felt, what their senses noticed – while assessing whether they can also access any of the biographical data.

As this information becomes more accessible and understood by the general population, an opportunity presents to move away from some of the stigmas and widespread misconceptions that plague survivors.

Helpful and Informative Sources

A video illustrating how trauma affects the brain can be seen here. 

The Body Keeps the Score by Bessel van der Kolk 

Dr. Seigel’s hand model of the brain: https://www.youtube.com/watch?v=f-m2YcdMdFw 

https://www.verywellmind.com/the-effect-of-ptsd-on-the-brain-2797643 

https://www.psychologytoday.com/us/blog/the-mindful-self-express/202106/understanding-the-trauma-brain 

Read More