Trauma Without Injury A feature by Elaine Wang

Before entering the playspace of Truman School, the clinician asked Ronnie*, an 11-year-old with a timorous smile, what was on her mind that day. She shuffled her feet on the glossy, marble-tiled hallway. “I’m worried that my dog will die,” Ronnie said.

“Have you had one that died?”

“Last year.”

The two entered a small room with blue foam mats padding the concrete floor and surrounding walls. The space was devoid of sharp angles; two fluffy pale-yellow pillows lounged in the far corner.

The clinician had 15 minutes with Ronnie. She was a professionally trained drama therapist at Animating Learning by Integrating and Validating Experience, or ALIVE, a school-based socio-emotional program. The clinician began by imitating her partner’s movement — lengthening her arms and scuffling her feet as they began chasing each other imprecisely, running in a circle and then suddenly kneeling, hands clasped behind their heads.

Suddenly, the clinician’s brows furrowed. She began whimpering.

Ronnie understood. “Fetch!” she laughed, throwing an imaginary ball. The clinician rolled across the floor. She mock-carried the ball between her teeth and launched it back to Ronnie. She was loud, too — grumping, sneezing — until Ronnie suddenly lurched as if she were driving an automobile.

The clinician raised her eyebrows briefly, then groaned. “No,” she said, and her body went limp.

The scene culminated in what drama therapists would characterize as a moment of recognition, when the student realizes that the play is familiar to their own life. “This realization is accompanied by a sudden relaxing or releasing in their bodies,” according to the 2014 essay “Trauma-centered Developmental Transformations.”

“Ring ring, this is the hospital,” the clinician said in an authoritative tone. “You have to come say goodbye to your dog.”

“No.” Ronnie backed across the room. “No.”

“It’s OK.”

The clinician took Ronnie’s hand. “Let’s do a little magic. Woof!” The clinician barked and went down to the ground again.

She looked up. “Say hello to your new dog.”


ALIVE was created by the Foundation for the Arts and Trauma Inc. in 2007 to implement a preventive, trauma-informed, arts-based approach to facilitate student success. The program has been adopted in six elementary schools in New Haven, one in Bridgeport, one in New Britain and four in Minneapolis.

“We believe that the primary cause of the achievement gap is not in the conditions of schools, but in the conditions of students, who have been exposed to toxic levels of psychological stress,” explains ALIVE’s 2015–2016 annual report. Childhood maltreatment is easily evaluated in allegations of abuse and neglect — throughout 2016, 4.1 million cases were filed involving approximately 7.4 million children, according to the U.S. Department of Health and Human Services. In Connecticut, there were 40,187 allegations, equivalent to 53.3 maltreatment allegations per 1,000 children.

As a public health program not singularly focused on mental health, ALIVE counteracts the behaviorist model employed in most U.S. school systems. The model assumes that student behaviors are produced by environmental factors in the school. The U.S. Department of Education, for example, offers “Supporting and Responding to Behavior” — an evidence-based classroom decision-making flowchart — as a guidance resource for teachers. Teachers, they say, should begin by reflecting on whether the classroom interventions — such as predictable classroom routines, constant supervision and specific corrections to misbehavior — are implemented with consistency. They are asked to consider whether problematic behaviors are major or minor and how many students are involved. If there are only a few students involved, teachers should simply request additional support for those students. If there are many, teachers should “review, adjust and intensify practices.”

By contrast, ALIVE seeks to promote awareness of the significance of childhood trauma to students’ behavior. According to the organization’s mission statement, “Current teachers, principals, and social workers are spending much of their time attending to the many students who are disruptive during the school day. They are not, however, attending to those students who might be disruptive tomorrow.”

“The society understands that kids cannot verbalize the things that are going through — you’re losing access to a whole lot of information,” explained Cat Davis, the director of ALIVE. The organization strives to find the language to understand childhood lived experiences. “The behaviorist perspective tries to extinguish the perverse,” Davis continued. “It’s not as much looking at the reasons why they’re behaving they are but simply trying to alter it.”

“People often use the metaphor of Pandora’s jar,” said Dr. David Johnson, who is the supervisor of ALIVE and the co-director of the Post Traumatic Stress Center in New Haven. In the Pandora myth, Epimetheus, disregarding the warning of his brother Prometheus, took Pandora as wife; it was then that she opened the fatal box that let out all the evils and plagues that man had previously been free of. “People forget that, at the end of the story, there’s also hope.”


The structure of ALIVE follows the response to intervention model, a multitiered approach to behavioral and academic intervention in U.S. schools. The method was invented in the 1970s as a screening model to identify students with learning disabilities. Instead of using the “discrepancy model” that compares students’ IQ scores to determine eligibility for special education, response to intervention is an accommodating approach that closely monitors the students’ learning rate and level of performance. In 2004, the Individuals with Disabilities Education Act included the model as a way for districts to identify students with learning disabilities and provided funding to start programs.

The response to intervention model includes three tiers: The first, prevention, involves screening struggling learners by comparison to an established academic and behavioral baseline; the second, intervention, requires supporting students unresponsive to classroom strategies in tier one with intensive instruction; and the third, intensive intervention, provides individualized interventions that target the student’s specific skill deficits.

Ronnie’s session was an example of the third tier, which offers the individualized setting necessary in order to most efficiently and accurately identify the stressors in students’ lives. Counselors employ a nonpsychotherapeutic version of a technique called developmental transformations, a drama therapy approach developed by Johnson.

Developmental transformations, Johnson contends in his 2009 article, do not attempt to perfect a person, eliminate neurotic conflict or repair character flaws. Rather, these pernicious aspects of living are revealed more fully.

Students in the third tier have a chance to describe, portray and play out elements of their actual traumatic personal experiences. The counselor acts out a number of roles or actions to place a demand upon the student, gently raising their anxiety to provoke their attention and protective defenses. No rules are applied to the play except a restriction from harm and a lack of real objects. As the counselor did with Ronnie, they begin by asking the student what is burdening them in their life. They then jump into an action initiated by the student, such as play-fighting or circling. The movements are closely tracked by the counselor as the basis for the student’s action responses. The sessions prompt students to engage in an embodied way. The goal is to find the situation that evokes the greatest amount of tension and stress in the student.


Individual students are referred to stress reduction sessions. All students of ALIVE, however, engage in second tier activities called “Miss Kendra time.”

As the counselors tell students, Miss Kendra is a mother who has lost her only child and can’t have another. Her life has been devoted to the safety and well-being of children, and she is always present to listen, vigilant in imagined space. Miss Kendra’s beliefs are outlined in a document titled “Miss Kendra’s List”: “No child should be punched or kicked. No child should be left alone for a long time. No child should be hungry for a long time. No child should be bullied or told they are no good. No child should be touched in their private parts. No child should be scared by gun violence at home or in school. No child should have to see other people hurt each other.” The philosophy of Miss Kendra is expanded on every week for 30 minutes.

Miss Kendra was invented by ALIVE as a pseudo–Santa Claus, except, instead of incentivizing children with performative “niceness” in exchange for Christmas presents, she believes all children have their own stories. “The story is based on what the kids were telling us,” described Johnson. “[Miss Kendra is] a kind of internal guardian figure that the children have inside them that is not located in any particular space or time.”

On Valentine’s Day at Truman School, a counselor addressed a pale-pink first-grade classroom. “I know today you will be with my friends at Truman,” she read from a two piece, broken-heart shaped card from Miss Kendra. “It’s wonderful to celebrate the love we have for each other — I know it can also remind us of people we love, who we have lost, who are far away.” She lifted her head: “Who have you lost, who are far away?”

In a different fifth-grade class, another counselor entered the room as if she were an enraged peer. “I’m breaking my computer to smithereens!” she exclaimed with balled fists. “Where is ‘Miss Kendra’s List’? I need some guidance, people!” A student gingerly asked, “Did your dad delete all the apps on your phone?” Another said, “Maybe, you told a secret to your mom and your mom got mad at you, and now you feel like you can’t trust her.” After the counselor explained that she was upset because “I can’t talk to my mom and I miss my dad,” a student told her, “You can write notes to him. My dad is in jail and that’s what I do.”

The counselor said she designed the performance because a student in the class had shared a similar experience with her privately the week before. She wanted the student to know they were not alone.

Clinically, the method is known as desensitization. Students are encouraged to formulate and express their traumas repetitively because the process of communication can not only show them the source of the worries but also discharge some of the emotions attached. “We don’t bring a snake in to heal the trauma from a snake bite,” explained Charlotte Steuter-Martin, a volunteer coordinator of ALIVE and a staff clinician at the New Haven Post Traumatic Stress Center. “We allow them to imagine a snake and to tell us their memories of the snake. Then they tell the memories of a stick. Then we do it over and over again until all the details about the snake are out, so they become able to differentiate.”

The legend of Miss Kendra also facilitates the first tier screening stage of the response to intervention model. Students are encouraged to convey every minute feeling of their day to Miss Kendra. In their weekly sessions, counselors provide them with special envelopes, paper and stamps, as well as mailboxes with her name in a floral cursive font.

In the 2016–17 school year, Miss Kendra received 24,000 letters. In the ALIVE office on 18 Nash St., each child has their own folder of past correspondences. The letters are neatly stacked by school, grade, class and name. “I’ve learned that kids are always trying to show you their truths and that they’re finding ways to tell you every day,” said Steuter-Martin.

The counselors are referred to as Miss Kendra’s helpers; they might change, but Miss Kendra will always be there to write and to listen. Her presence is manifested on paper by a team of 25 volunteers who reply to every received letter.

“The primary goal is to make sure that the children feel heard and see what feeling the child identifies or how we can identify it,” said Steuter-Martin, who trains volunteers in the letter-writing process. “And if we are good at this, [we] let them feel validated.”

“Dear Miss Kendra,

“I enjoyed the Super Bowel,” one student wrote.

“Dear Miss Kendra,

“One day my mom told me that before my sister was born I had a sister that died inside my mom’s belly. When my mom told my that I was so sad I was crying … I thout in my head ‘she would be pritty,’” said another.

“Dear Miss Kendra,

“Mommy and daddy … saved me when someone broke in.”

“Dear Miss Kendra,

“I’m righting to you because I just realized that my dad is going to stay in jail for a long time then he is suppose to I’m really sad because know I’m not going to see him for a long time the reason he went to jail is because he was delivering something he was not suppose too and my real dad is in jail too so know I have know dad. Can you tell me what to do?”


“Kids are getting messages every day not to talk about the bad things that have happened to them from various sources,” Steuter-Martin said. “We want to not only counteract any symptoms of PTSD that are developing post-trauma but also to counteract the robust societal level of avoidance that they’re exposed to every day.” The counselors at ALIVE, therefore, are very conscious of the way they respond to the students’ feelings. Steuter-Martin said, “In my response letter, I wouldn’t write, ‘I hope next time you’ll be feeling better,’ because this can be read as a signal that they shouldn’t be having any worries.”

The vision is supported by organizations with similar mission statements. Among the eight elementary schools implementing ALIVE, two are partnered with the New Haven Trauma Coalition, which was created by United Way after the shooting at Sandy Hook Elementary School in Newtown to “help students learn positive strategies to deal with anger, loss and conflict.”

In 2016, former Missouri Governor Jay Nixon enacted a law that required the state’s Department of Elementary and Secondary Education to create a website about the trauma-informed schools initiative, including information regarding the trauma-informed approach and a guide for schools about how to become trauma-informed. “A ‘trauma-informed approach’ is not a program model that can be implemented and then simply monitored by a fidelity checklist,” the website reads. “Rather, it is a profound paradigm shift in knowledge, perspective, attitudes and skills that continues to deepen and unfold over time. ”

The paradigm shift requires localizing individual traumas within its societal responses. “There’s a qualitative difference between fixing the symptoms of these kids and changing the norm of conversation,” added Davis. It is important to determine where the trauma ends. It also matters how it begins.

*Ronnie is a pseudonym used to protect the privacy of a child.

Minor alterations were made from the print version for clarity.


Elaine Wang

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