1. The Brain & Trauma October 5, 2013 – WINGS Foundation Presented By: Aaron Wiemeier M.S. LPC

2. Trauma What is Trauma?

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

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

5. 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

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

7. Trauma Posttraumatic Stress Disorder Criteria: B) Recurrent thoughts/dreams/feelings C) Avoidance of things associated with event D) Persistent symptoms of increased arousal  sometimes less environmental stimulation is better E) Duration F) Causes clinically significant impairment in academic, social, occupational or other areas of functioning

8. Trauma Trauma Memory Non-Declarative Memory

9. 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

10. Trauma Trauma’s Effect on the Brain

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

12. 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:

13. Trauma Trauma, the Brain & Behavior: Coping  Anger  The “safest” feeling to express - emotional dysregulation  PTSD/ADHD/SPD/ASD/RAD/ODD/DMDD Comorbidity  This new diagnostic category includes children exhibiting persistent irritability and severe behavioral outbursts 3 or more times per week for more than 1 year  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

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

15. Trauma Biological Response Emotional Response Negative Cognition The Road Block To Healing Negative Cognitive Message – I am powerless, I deserve bad things, I am not worthy, I am not loveable etc.

16. 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.

17. The Brain & Trauma Practical Applications – General Overview

18. 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”

19. 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)

20. 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/Reduce systemic fear- Society  Admin  Staff  Child

21. 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)

22. The Brain & Trauma Practical Applications for Adults Structure & Discipline Discipline = “to teach” Consistency/Follow Through 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

23. The Brain & Trauma: Resources The Brain Gym My Sensory Book: Lauren Kerstein www.laurenkerstein.com Challenge Software: www.cpschallenge.com

24. The Brain & Trauma: Resources www.myfeelingsworkbook.com

25. 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

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

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

28. 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