Download The Brain & Trauma

The Brain &
Trauma
June 11, 2014
Presented By:
Aaron Wiemeier M.S. LPC
The Brain & Trauma
Outline
I.
II.
III.
IV.
V.
VI.
VII.
Anatomy of Brain – 3 Divisions & Connection
to Trauma Symptomology
Brain Organization & Development &
Relation to Trauma
Trauma – Definitions/Facts & PTSD
Trauma Memory & Behavioral Symptoms
Healing Trauma & Trauma Development
Practical Applications & Interventions For
Healing
Case Example & Discussion
The Brain Short Course
• Lower Brain
• Ordered from most basic to
most complex
• Controls basic life functions
and relaying of sensory
information
The Brain Short Course
Lower Brain Structures
• Spinal Cord
 Relay
• Medulla Oblongatta
 Basic Function
• Pons
 Relay
• Cerebellum
 Basic Function
The Brain Short Course
• Mid Brain
 Reception and Filtering of
sensory information before it
reaches CONSCIOUS brain (5)
Structures:
Reticular
Formation
 Neurons extend from
medulla to lower regions of
forebrain (5)
The Brain Short Course
• Forebrain
 Relaying more sensory info,
primitive emotions, drives,
basic behavioral responses,
higher conscious thought and
executive functioning
Structures:
Thalamus
 Relay
Limbic System
 Basic Drives, Emotions, Behavior
Cerebral Cortex
 Higher Conscious Thought/ ”Filing
Cabinet”
The Brain Short Course
The Limbic System
Primary “Trauma” Center of the Brain
The Brain Short Course
Brain Organization
Perry, B.D. (1997)
The Brain Short Course
Brain Development
 Organizes & Develops from most basic to
most complex
 Needs based on Development (2 weeks
infant with touch vs. 12 year old)
 1st 3 Years  90% of how brain will
function is set
 In-Utero to 3 years  outcomes
dependent on combination of genetics and
environment
 Sequential  “must learn to walk before
you can run”
 10-18 months  infants emotions
(love/fear) developed
(www.growingchild.com)
The Brain Short Course
Brain Development
 14-15 years  critical age for
permanency of personality/language
 Times of rapid brain growth  1-3, 6-8,
10-12, 14-16
 Traumatized Children  Brain
development can be delayed 3-5 years
 Females  by age 6 years greater
sensitivity to non-verbal cues
(www.growingchild.com)
Trauma
What is Trauma?
Trauma
Definition:
Medical
 Injury or insult to
body/shock
Psychiatric
 Experience that is
emotionally painful or
distressing
Both can be Acute or Long Term
Trauma
Definition:
Psychiatric/Emotional
Subtypes:
 Developmental (1)
 Environmental
 Secondary
Trauma
Important Notes:
• Trauma is relative
• Body/Brain organized to heal trauma
naturally
• Developmental trauma as harmful as single
acute episode (1)
• Be aware  Perception of Trauma  What
one feels is traumatic another may not
Trauma
Posttraumatic Stress Disorder
Criteria: A)
Both 1) experience/witness/confronted  death/serious
injury/threat of
2) Response  fear/helplessness/horror
Trauma
Posttraumatic Stress Disorder
Criteria:
B) Recurrent thoughts/dreams/feelings
C) Avoidance of things associated with event
D) Persistent symptoms of increased arousal
E) Duration
F) Causes clinically significant impairment in social,
occupational or other areas of functioning
Trauma
Trauma Memory
Non-Declarative Memory
Trauma
Trauma Memory
 Stored as early as 6 months In-Utero
 Stored in Limbic System (Amygdala &
Hippocampus)
 Much more permanent
 Unconscious
 Similar to procedural memory
Trauma
Trauma’s Effect on the Brain
Trauma
Trauma’s Effect on the Brain
 Smaller Hippocampus (long term memory) (3)
 Short term memory deficits
 Dysfunctional Stress-Response System
(Cortisol) (1)
Trauma
Trauma’s Effect on the Brain
Behavioral
Because the trauma has
affected the structures our
brain uses to deal with
stress/hurt/pain emotional or
otherwise
We resort to
other less natural
and more
dysfunctional
patterns of
dealing such as:
Trauma
Trauma’s Effect on the Brain
 Anger  The “safest” feeling to express emotional dysregulation
Attention/Impulsivity Issues - Hyperarousal
 Emotional Withdrawal/Numbing
 Enuresis/Encopresis  primal soothing
mechanism
 Distraction: creating conflict/cutting etc.
 Delayed/Impaired Ability to recognize feelings 
categorical “fight or Flight”/all or nothing response
Trauma
Catatonia
Repression
Identity Disorder/Conversion
Regression
Rage
Anger
Denial/Avoidance
Hierarchy of Self-Protective
Brain Responses
Trauma
The Road Block To Healing
Negative Cognitive Message – I am powerless, I
deserve bad things, I am not worthy, I am not loveable etc.
Negative
Cognition
Trauma
Emotional
Response
Biological
Response
Trauma
The Aversive State
Outside does not equal inside
 Creates a state of stress that must be reduced eventually
 We reduce the stress on one side or the other (inside
traditionally is harder to “reduce” and because its tied to trauma
and is more permanent. Our environment and thoughts are not
nearly as permanent.
 Explains Self-Sabotage, Messy Rooms etc.
The Brain & Trauma
Practical Applications – General Overview
The Brain & Trauma
Practical Applications for Adults
Adult
Emotional
Regulation
• Our own negative cognitive
message = largest trigger
• Taking Care of Yourself
• Separate the action from the
person – right & wrong choice
• Time is your “ally”
The Brain & Trauma
Practical Applications for Adults
“It’s not how you feel but where you feel”
Non-Verbal Body
Awareness
• 75% of all communication
 Eye Contact
 Facial Expression
 Voice Tone
 Posture
 Gesture
 Timing & Intensity of response (1)
The Brain & Trauma
The Brain & Trauma
Practical Applications for Children & Families
Reframing
Behavior as
Fear-Based
• for self as well as child
(www.postinstitute.com)
• not focusing on surface
behavior but what is
underneath (Attachment
Disorder)
• Repetition
• Eliminate systemic fearSocietyAdminStaffChild
The Brain & Trauma
Practical Applications – Children
Coping Skill Development & Emotional Awareness
• Healing Hand
• Method of Loci (memory
strategy)
• Need to be different types (at
least one internal)
The Brain & Trauma
Practical Applications for Adults
Structure &
Discipline
• Discipline = “to teach”
• Consistency
•3 Levels of Choice: Open/You Choose
(weighted?) /”I action – base on
emotional needs of child at current
time
Love/Nurturing
•
Attachment Considerations hypodermic/good coach approach - how
much can they tolerate/grounding statements
• Chemistry of Connection/The Connected
Child
The Brain & Trauma
Other Intervention Ideas For Healing
The Brain Gym
Challenge Software:
www.cpschallenge.com
My Sensory Workbook: Lauren Kerstein
The Brain & Trauma
Other Intervention Ideas For Healing
-Bridges the gap between thinking mind and
emotional mind (trauma memory needs to
“MOVE”)
- Gets children out of categorical all or nothing
emotions
- Equips child with coping skills and discerns
between right and wrong choices
-Helps child rate feelings on a scale and learn
“where” they feel
- Teaches children different names and groups
of feelings as well as how to describe them
more vividly
www.myfeelingsworkbook.com
The Brain & Trauma
My Feelings Workbook - Populations
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Trauma/PTSD
Autism/Aspergers
Enuresis/Encopresis
Anger/Opposition & Defiance
ADHD
Chronic Stress
Depression
EMDR preparation
The Brain & Trauma
Family-School-Community = Healthy Resilient Children
Thank You
For All You
Do!
The Brain &
Trauma
References:
www.traumaresources.org (Trauma, Brain & Relationship DVD 2000) (1)
www.brainconnection.com (2)
www.leadershipcouncil.org (3)
www.growingchild.com (4)
http://library.thinkquest.org (5)
Perry, B.D. (1997) Incubator of Terror: Neurodevelopmental Factors in the
Cycle of Violence (6)
Other Helpful Websites:
www.postinstitute.com
www.attachment.org