1. The Brain & Trauma June 11, 2014 Presented By: Aaron Wiemeier M.S. LPC

2. The Brain & Trauma Outline I.Anatomy of Brain – 3 Divisions & Connection to Trauma Symptomology II.Brain Organization & Development & Relation to Trauma III.Trauma – Definitions/Facts & PTSD IV.Trauma Memory & Behavioral Symptoms V.Healing Trauma & Trauma Development VI.Practical Applications & Interventions For Healing VII.Case Example & Discussion

3. The Brain Short Course Lower Brain Ordered from most basic to most complex Controls basic life functions and relaying of sensory information

4. The Brain Short Course Lower Brain Structures Spinal Cord Medulla Oblongatta Pons Cerebellum  Relay  Basic Function  Relay  Basic Function

5. 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)

6. The Brain Short Course Forebrain  Relaying more sensory info, primitive emotions, drives, basic behavioral responses, higher conscious thought and executive functioning Structures: Thalamus Limbic System Cerebral Cortex  Relay  Basic Drives, Emotions, Behavior  Higher Conscious Thought/ ”Filing Cabinet”

7. The Brain Short Course The Limbic System Primary “Trauma” Center of the Brain

8. The Brain Short Course Brain Organization Perry, B.D. (1997)

9. 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)  1 st 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)

10. 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)

11. Trauma What is Trauma?

12. Trauma Definition: Medical Psychiatric  Injury or insult to body/shock  Experience that is emotionally painful or distressing Both can be Acute or Long Term

13. Trauma Definition: Psychiatric/Emotional Subtypes:  Developmental (1)  Environmental  Secondary

14. 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

15. Trauma Posttraumatic Stress Disorder Criteria: A) Both 1) experience/witness/confronted  death/serious injury/threat of 2) Response  fear/helplessness/horror

16. 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

17. Trauma Trauma Memory Non-Declarative Memory

18. 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

19. Trauma Trauma’s Effect on the Brain

20. Trauma Trauma’s Effect on the Brain  Smaller Hippocampus (long term memory) (3)  Short term memory deficits  Dysfunctional Stress-Response System (Cortisol) (1)

21. Trauma Trauma’s Effect on the Brain Because the trauma has affected the structures our brain uses to deal with stress/hurt/pain emotional or otherwise Behavioral We resort to other less natural and more dysfunctional patterns of dealing such as:

22. 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

23. Trauma Catatonia Repression Identity Disorder/Conversion Regression Rage Anger Denial/Avoidance Hierarchy of Self-Protective Brain Responses

24. 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. Trauma Biological Response Emotional Response Negative Cognition

25. 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.

26. The Brain & Trauma Practical Applications – General Overview

27. 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”

28. 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)

29. The Brain & Trauma

30. 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 fear- Society  Admin  Staff  Child

31. 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)

32. 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

33. The Brain & Trauma Other Intervention Ideas For Healing The Brain Gym My Sensory Workbook: Lauren Kerstein Challenge Software: www.cpschallenge.com

34. 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

35. The Brain & Trauma My Feelings Workbook - Populations Trauma/PTSD Autism/Aspergers Enuresis/Encopresis Anger/Opposition & Defiance ADHD Chronic Stress Depression EMDR preparation

36. The Brain & Trauma Family-School-Community = Healthy Resilient Children Thank You For All You Do!

37. The Brain & Trauma References: www.traumaresources.orgwww.traumaresources.org (Trauma, Brain & Relationship DVD 2000) (1) www.brainconnection.comwww.brainconnection.com (2) www.leadershipcouncil.orgwww.leadershipcouncil.org (3) www.growingchild.comwww.growingchild.com (4) http://library.thinkquest.orghttp://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