Elia Vecchione, Ph.D.

Neurological and Behavioral “Action” Systems   I. The Affiliation System :Proximity Seeking 1) Attachment- Safe Haven/Secure Base 2) Social Engagement 3) Communication II. The Defensive System: Protection & Avoidance 1) Affiliation-Proximity seeking 2) Mobilizing- Freeze, Flight, Fight, 3) Immobilizing- Dissociation, Submission, III. The Advancement System : Activation & Approach/ Inhibition of Defense 1) Care giving 2) Exploration 3) Socialization 4) Play 5) Physiological Regulation 6) Pair bonding

The Autobiography of the Autonomic Nervous System   Therapy and Treatment Trauma: It’s not about what happened. ________________________________________________________ It’s about how what happened effected the Central Nervous System, the body, and procedural memory. The most accurate record of experience is the organization of the Central Nervous System, procedural memory, body tendencies and finally Behavior.

States of Arousal Fight Flight Freeze The Zone Spaced out

Frontal Lobes Limbic System

Survival Responses of the Nervous System* Fight, flight and freeze are automatic survival actions. They are similar to reflexes, but are much more complex. If the perception of the limbic system is that there is not time to flee, then the body will fight. If the limbic perception is that there is not enough time to flee, but there is adequate strength to fight, then the body will fight. If the limbic system perceives there is neither time nor strength for fight or flight it will freeze. It is important to understand that these limbic system ANS responses are instantaneous, instinctive responses to a perceived THREAT. *“The Body Remembers: The Psychopathology of Trauma and Trauma Treatment” Babette Rothschild

The Autobiography of the Self, is inscribed by experience, on the central nervous system, and told and retold by its only language, Behavior

The Bipartisan Brain Feeling Limbic System Thinking Frontal Lobes

Functions of the Brain Systems ACTION! Limbic System Thinking Frontal Lobes

Stop, Think, Solve Problems Behaviors of the Systems Behaviors Freeze, Flight, Fight Behaviors Stop, Think, Solve Problems Behaviors of the systems

Turned off by Limbic System Triggering Events Limbic System Freeze, Flight, Fight Frontal Lobes Turned off by Limbic System

Turned off by Limbic System When something in the world is perceived as dangerous… Frontal Lobes Turned off by Limbic System Limbic System Freeze, Flight, Fight

Internal Triggers Frontal Lobes Stop and Think… Limbic System ACTION!

Something happens in the World OR in the Body… Frontal Lobes A Problem to Solve… Limbic System DANGER!

The Social Brain Engagement Approach… Disengagement AVOID!

Turned off by Limbic System Language Effects Limbic System Freeze, Flight, Fight Frontal Lobes Turned off by Limbic System Broca’s Region Language Production and Comprehension

Turned off by Limbic System Confabulation Frontal Lobes Turned off by Limbic System Limbic System Freeze, Flight, Fight Broca’s Region Language Production and Comprehension

The Brain is… The brain is an anticipation machine. It mostly anticipates what it has experienced. It gathers information from the perceived (and “remembered”) social and external world as well as conscious and unconscious memory and process. It then decides on, and prepares for, what it believes is coming next.

A TYPICAL STRESS RESPONSE Stressful Event ALARM Necessary survival response Deactivation Dissociation Activation F/F/F Return to Baseline

Necessary survival response Traumatic reorganization Stressful Event What happens when a person experiences inescapable, repeated, life-threatening, overwhelming stress ALARM Necessary survival response Captured and stored in embodied CNS Changes in Brain organization and function Lasting changes in social, emotional, cognitive, perceptual organization

Traumatic Re-enactment Event Similar facets to dangerous event (sight, sound, smell etc.) Time “over-reactive” Embodied CNS & neuroendocrine systems ALARM Unnecessary Survival response “BAD BEHAVIOR”

NORMAL STRESS RESPONSE TRAUMA Traumatic Re-enactment “BAD BEHAVIOR” Danger Event Inescapable Repeated Life-threatening Overwhelming Similar facets to dangerous event (sight, sound, smell etc.) ALARM Necessary survival response Necessary survival response Time “over-reactive” Embodied CNS & neuroendocrine systems Captured and stored in embodied CNS ALARM Deactivation Dissociation Activation F/F/F Unnecessary Survival response Changes in Brain organization and function Return to Baseline Lasting changes in social, emotional, cognitive, perceptual organization “BAD BEHAVIOR”

“Wrap the world around them” The State Or Stage model Stage 1 “Wrap the world around them” Stage 2 “Lay the groundwork for understanding themselves and the world” Stage 3 Goals Targets Treatments Outcomes Arousal regulation (Limbic System) Manage arousal/emotions (Body up) De-escalation Tools: Tapping, singing, drumming, breathing, meditation, exercise Ability to manage emotional responses Learn the process and the skills (frontal lobes) Trust the process and learn skills (top down) Communication, negotiation, problem solving and mapping (skill building) Ability to communicate, negotiate, and solve problems with increased emotional, perceptual, and thinking skills Rehabilitation of the self (frontal lobes) Process the content (top down) Co-create meaning. Mapping (for mutual understanding), develop social understanding. Storytelling Ability to create shared understanding, rehabilitation of the self, adaptive and pro-social behavior

Escalation Cycle Fight Flight Arousal Freeze Fear Time

Escalation Cycle Fight Flight Arousal Shame, Guilt Damage to the Self Freeze Fear Time

Escalation Cycle Fight Flight Arousal Shame, Guilt Damage to the Self Discharge Freeze Fear Time

Escalation Cycle Fight Panic Flight Arousal Shame, Guilt Damage to the Self Discharge Freeze Fear Time

How the Journal Works Decide on a daily check-in time Decide who you would like to check in with Circle the “before” thermometer to identify what your arousal level was For example, how activated, energized, or excited you were… Write how it felt in your body Make sure to be specific…Where did you feel it, for how long? Talk with staff about signals that both of you noticed on the outside, ( Like sweating, red cheeks, inability to concentrate) that let you know how you were feeling on the inside. Write about it. After you’ve used your calming tools, circle a number on the second thermometer to indicate how you were feeling after. Write about what you did to calm yourself Talk with your staff about what they did, or should do in the future, that helped you to regulate. Write about it. Pat yourself on the back! You did great!

What I feel like inside 10 9 8 7 6 5 4 3 2 1 What it looks like outside

What I should do 10 9 8 7 6 5 4 3 2 1 What Staff should do

How I Felt Before How I Felt After Circle one! Circle one! What I did Circle one! What I felt like inside Circle one! 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1 What I looked like outside What staff did Name_____________ Date____________

The Map of Strategic Self Regulation Background Noise Perception of Event Feelings Thoughts Behavior Consequence Proactive Strategies Problem Solving De- Escalation Causes Interventions