Val's presentation at University of Calgary in the Social Construction of Disability and Health course; August, 2013

1. Val Lougheed
Northern Lights Canada
Real Work * Real People * Real
Results
Social Construction of
Disability and Health
Trauma, Rehabilitation
and Recovery –
~ Keep Your Fork ~
1-800-361-4642 * www.northernlightscanada.ca * vlougheed@northernlightscanada.ca

2. “You don’t want your
impairments to define
you – you want them
to inform you.”
(Hanita Dagan, personal communication, 2005)

3. www.slideshare.net/vlougheed
#NLCAN
www.northernlightscanada.ca/our-company/our-
president/be-still

4. Agenda
• Beginning …
• Middle …
• End …

5. Social Construction of
Disability and Health
1. What does it mean to recover?
2. What can I do to recover and
return to a life that includes
work?
3. What can we do to facilitate
recovery and a return to work?

6. Rated PG-113
People Strongly Cautioned!
May contain bad language, brief nudity,
sexual overtones, and drug usage.

7. Beginning
1978

10. VIDEO CLIP
Val being
interviewed in
Minden

12. Sept. 9, 2003 - morning

13. Sept. 9 – p.m.

14. Sept. 15 2003 – Jan. 19 2004
Journey Back to Life

20. Dominant Themes
• Narcotic Pain Killers
• Pain
• Trauma
• Depression
• ABI
• Methods of Helping
• Return to Work
• Life

21. February 2004 – Present
Starting Point

23. The
Re-organization
of Self
March 2004

24. “In the aftermath of traumatic
life events … [the] sense of self
has been shattered.”
(Herman, 1992, p. 61)
“An existential crisis …”
(Hanita Dagan, personal communication, 2005)

25. Sliding Down the Slope

26. Sliding Down the Slope

28. A Foothold
• Mild – moderate ABI
• Depressed (dysphoria)
• Working memory problems
• Hiding pain
1st
Neuropsychological Assessment
June 2004 -- Results

29. ABI – Measuring Loss
Subjective Report – difficulty
retrieving words and
communicating ideas
Objective Report – above-average
performance on neuropsychological
measures
(Prigatano, 1999; p. 59)

30. Losing My Grip
My IWRP
August 2004

31. Video of Borg

33. Rescued in the Valley of
Despair
Head Injury Program
Oct. – Dec. 2004

35. GRTW – The Plan
Jan. 3 – Feb. 7, 2005
(5 weeks)

36. GRTW – The Reality

37. GRTW – The Reality

38. GRTW – The Reality

39. GRTW – The Reality

40. GRTW – The Reality

41. GRTW – The Reality

42. GRTW – The Reality

43. GRTW – The Reality

44. GRTW – The Reality

46. WSPE
Work-Site Performance
Evaluation©

47. Sliding Back Down
Into The Abyss
• Non-compliance
• Malingering
• Trying too hard
• Not trying hard enough
2nd
Neuropsychological Assessment
May 2005 -- Edmonton

49. Test Results
• Mild to Moderate ABI
• Pain?
• Depression?
• Motivation?
• “a high flyer”
• “phobic avoidance”
• Future plans – “live off
dividends” [from company]

50. Lesson
ASSUMPTION
S
REVEAL BIAS

51. • Mild – moderate ABI
• Good prognosis
• Post-Traumatic amnesia
• Pain?
• Depression?
• “Adjustment Disorder with
Anxiety and Depressed Mood”
3rd Neuropsychological
Assessment
August 2005 -- Calgary

52. Symptom Overlap
(co-morbidity)
(Michael Sullivan, Centre for Research on Pain and
Disability, McGill University, September, 2006)
Pain, Trauma, Depression,
ABI

54. Oct. 3 – Dec. 11

56. Pain Research
1600’s – Rene Descartes (philosopher)

57. Pain Research
1950’s – Wilder Penfield (brain surgeon)

59. Pain Research
Patrick Wall (physiologist)
Ronald Melzack (psychologist)

61. Pain – The Future
SCN9A
(Globe and Mail, March 24, 2007)
Glia Cells
(Scientific American, November, 2009)
Poppy Genes
(U of Calgary -- Calgary Sun, March 15, 2010)

65. “In every encounter, basic trust is in
question.” ( Herman, 1992, p. 92)
“Survivors feel unsafe in their bodies
– and in any relationship with other
people.” (Herman, 1992, p. 160)
Rehab & Recovery

67. DISSO
CIA
TION
Trauma Research

68. VIDEO CLIP
Adrenaline:
Flight or Fight
Trauma Research

69. Fight

70. Freeze

71. “Survival Central”
(Rothschild, 2000, p. 46)
• Amygdala - Implicit memory
• storage of emotions and sensory reactions
(Rothschild, 2000, p. 20)
• Hippocampus – Explicit memory
• creates memories of actual sequence of
events
(Rothschild, 2000; p. 28)
Trauma Research
Limbic System and Memory

72. Stress Hormones
• Amygdala - Implicit memory
• storage of emotions and sensory reactions
(Rothschild, 2000, p. 20)
• Hippocampus Explicit memory–
• creates memories of actual sequence of
events
(Gunnar & Barr, 1998)
Trauma Research
Limbic System Under Threat

74. Trauma
Personal Experience
• Dissociation & Cocoon = Safety
• System on High Alert Always =
Survival
• World is black & white = Trust
Trust (Safety) = Love
No Trust (Life Threatening) = Hate

75. Trauma
Personal Experience
• Listen to me
• Understand me
• Respect me
• Are competent
I trust (love, feel safe with, will
try hard for) people who:

78. “… depression [caused by
trauma] is not the same as
ordinary depression.”
( Herman, 1992, p. 118)
Depression

79. Candace Pert, 1997; pp. 171 -- 179
Psychoimmunoendocrine Network

82. Affects more than IQ
….
Touches core … of a
person’s self-esteem
(Prigatano, 1999; p. 58)
ABI

83. Back to Wilder Penfield – 1950’s
ABI
Localizationist

84. VIDEO CLIP Story of Paul
Bach-y-Rita’s dad
Paul Bach-y-rita
Neuroplasticity Video Clip;
link to Neuroplasticity –
YouTube; bren49764
00 – 2:20

85. Paul Bach-y-Rita – 1934 – 2006
Scientist and Rehab Doctor
Neuroplasticity - 1969

88. METHODS OF
HELPING

89. “The words and attitudes of
others … are potent. They help
or hex healing and recovery.”
“ Expectations are powerful.”
(Bolen, 1996; p. 94)
Body-Mind Connection

90. VIDEO CLIP
Esther
Sternberg
Dr. Esther Sternberg Demo
Reel – YouTube;
00 -- .36

91. Cortisol and Immune
Cells
Sternberg, 2001; p. 112

92. • Hypothalamus
• Peptides
• Receptors
• Biochemical
Events

93. Video clip Addicted
to Love song

94. Quantum Connection
The Living Matrix
(Braden, 2007; p. 45)

95. “Loss of identity can evoke a
personal crisis, creating a need
for change.”
(Ornelas, in Smith & Johnson (Eds), 1997; p. 172)
The Re-Organization of
Self
Identity Research

97. Scaling the Canyon

98. Sept., 2005
Waskesiu

103. Breast Cancer
Reconstructive Surgery
March 2006

104. Convocation M.Ed. -- June
2006

105. Back in “a” Saddle
September 2007
• Officially change role/
title
• Re-organize NL
• Work part-time

107. Social Construction of Disability and
Health
Resilience
 Ability to return to original form after
being bent (bounce back)
Thriving in constant change, ability to be:
• Flexible
• Creative
• Adaptable
• Learn from experience
http://www.resiliencycenter.com/articles/5levels.shtml

108. Social Construction of Disability and
Health
Rehabilitation (habiter – to live
inside)
“Rehabilitation is the learning to live
inside not only one’s body, however
it is after an injury or illness, but
inside one’s very being.”
(Kabat-Zinn, in Meili, 2003; p. 241)

109. Social Construction of Disability and
Health
Recovery
Curing Focus on the illness/
impairment [outside]
Healing Focus on the person
[inside]
(Crombez, October; 2003)

110. Be Still

111. Social Construction of
Disability and Health
1. What does it mean to recover?
2. What can I do to recover and
return to a life that includes
work?
3. What can we do to facilitate
recovery and a return to work?

112. Keep Your Fork

113. Northern Lights Canada is a person-centred
organization committed to providing innovative,
responsive links to real work.
We offer 4 major divisions of service:
• Vocational Rehabilitation Services
• Employment Services
• Employer Services
• Corporate Training
For more information, please contact us:
1-800-361-4642
www.northernlightscanada.ca

114. Voc Rehab Canada (VRCAN) is a national consortium of experienced
regional vocational rehabilitation companies. VRCAN provides
customers with single-point access to VR services anywhere they are
needed in Canada, whether on an individual service or contract basis.
Member companies include:
Argus Management Consultants, Inc. Sandra Preeper & Associates
Advantage Rehabilitation Consultants
Ltd.
Rehabilitation Alternatives Limited /
Vocational Alternatives Software
OPTIMA Rehabilitation CVE Inc.
Northern Lights Canada Occupational Rehabilitation Group of
Canada (ORGOC)
Western Rehabilitation Specialists Inc. Diversified Rehabilitation Group
Genesis Rehabilitation Ltd. Rehabilitation Focus
For more information, please feel free to contact us at 1-800-361-4642