1. Illness or Injury?

2. The Event What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

3. L R Werneke’s Area Broca’s Area Implicit Memory Emotions + Images Narrative Memory Balanced and regulated Autonomic Nervous System Brain with no trauma Anterior Cingulate

4. Narrative or declarative memory (chronological encoded with language) Implicit memory (in matrix and connected to events) No Trauma Trauma Response

5. Threat avoidance & evasion (conscious) non-verbal thought (learned responses/ Classical & Operant Conditioning) Fight or Flight Freeze Human – Prefrontal cortex/Broca’s/We rneke’s Neomamalian – Limbic Paleomamalian - Basal Ganglia/Thalamic Reptilian – Brain stem Evolution Loss of Fx

6. The Event  What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

7. The Event  What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

8. The Event  What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

9. The Event  What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

10. Trauma Neo-cortex constricts ; altered state; implicit memory encodes trauma Neo-cortex becomes overwhelmed and shuts down – memory is encoded with sensory

11. The Event  What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

12. TraumaIntrusion + Arousal Avoidance + Arousal

13. The Event  What makes an event traumatic? The Instinctual Trauma Response The Instinctual Trauma Response (Tinnin, 2013, 1998)  startle  thwarted intention (fight or flight)  freeze  altered state (peri-traumatic dissociation)  body memory/automatic obedience  resolution

14. Trauma is encoded without narrative in Implicit Memory Trauma Trauma Response

15. Narrative Memory Trauma Implicit Memory Implicit Memory Narrative + Implicit Memory (no gaps) Completion of Trauma Narrative (with no gaps) resolves Intrusive Symptoms

16. Criterion B. Intrusion Criterion C. Avoidance Criterion D. Negative Cognitions and Mood Criterion E. Arousal & Reactivity 1 1 2 2

17. Intrusion of trauma memory fragments produce flash-backs and nightmares (Cx B) These intrusions cause the survivor to perceive a more dangerous world producing heightened arousal (Cx E) Chronicity and intensity of perceived threats produce an instinctual adaptation of avoidance and numbing (Cx C) Loss of neocortical functioning produces distorted perceptions self, the world, and causation of trauma (i.e., shame) (Cx D) Trauma PTSD Symptoms are adaptations to trauma and evidence of a self-healing system at work. As we help our survivor clients to regulate their fear, then the system can complete its healing and resolve PTSD. PTSD Symptoms are adaptations to trauma and evidence of a self-healing system at work. As we help our survivor clients to regulate their fear, then the system can complete its healing and resolve PTSD.