THE SENSORY, ATTACHMENT & TRAUMA TANGLE: MAKING SENSE OF THE INTERPLAY Stephanie Zimmerman, LMFT Zimmerman Marriage & Family Therapy Inc.
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1 THE SENSORY, ATTACHMENT & TRAUMA TANGLE: MAKING SENSE OF THE INTERPLAY Stephanie Zimmerman, LMFT Zimmerman Marriage & Family Therapy Inc. The Resilience Counseling Group
2 A Sensory Experience
3 SENSORY PROCESSING & THE BRAIN
4 THE 7 SENSORY SYSTEMS Visual Olfactory Pro- pioception Gustatory Tactile Vestibular Auditory
5
6 Sensory Integration is the ability to organize sensory information for use. Jean Ayres, 1972
7 SIGNS OF HEALTHY SENSORY Appropriate attention INTEGRATION Self-regulation skills Positive self-esteem and self-confidence Appropriate skills for learning and playing Play that is varied and creative
8 Normal sensory and motor development are connected and dependent on each other and develop both through the internal processes of the individual and the external processes of the caregiver
9 CLASSIC SIGNS OF SPD: THERE ARE NONE
10 SENSORY PROCESSING DISORDER: INEFFICIENT ORGANIZATION AND USE OF SENSORY INFORMATION RESULTING IN FUNCTIONAL LIMITATION
11 A WALK IN HIS SHOES
12 SENSORY PROCESSING DISORDER (SPD) Sensory Modulation Disorder (SMD) Sensory-Based Motor Disorder (SBMD) Sensory Discrimination Disorder (SDD) SOR SUR SS Dyspraxia Postural Disorders SOR = sensory overresponsivity. SUR = sensory underresponsivity. SS = sensory seeking/craving. Visual Auditory Tactile Vestibular Proprioception Taste/Smell Figure 1. A proposed new nosology for sensory processing disorder. Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., Osten, E. T. (2007). Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis. The American Journal of Occupational Therapy, 61 (2), 137.
13 ATTACHMENT AS A SENSORY SATURATED PROCESS
14 ATTACHMENT is the bond between the parent and the child. It creates for the child an idea or a model for how he/she can experience and relate to others
15
16 ATTACHMENT PLAYS A VITAL ROLE as it is a basic human need creates a safe haven establishes trust in the development of the brain in self-regulation in creating core beliefs in developing morality in creating resilience
17 The reciprocal relationship relies on the baby s ability to communicate needs, as well as the parents ability to accurately read their baby s signals and respond in a timely and sensitive way.
18 Virtually all children create a strong attachment by about 12 months of age, this attachment just varies in quality and can vary from caregiver to caregiver.
19 SECURE ATTACHMENT PATTERN If a parent is reliably emotionally available and sensitively responsive, infants will develop positive expectations and confidence in the parent which results in a Secure Attachment pattern.
20 ATTACHMENT SPECTRUM Insecure Attachment Secure Attachment
21 AVOIDANT/DISMISSIVE ATTACHMENT PATTERN Insecure Attachment Avoidant/Dismissive Attachment Secure Attachment Ambivalent/Preoccupied Attachment
22 AMBIVALENT/PREOCCUPIED ATTACHMENT PATTERN Insecure Attachment Avoidant/Dismissive Attachment Secure Attachment Ambivalent/Preoccupied Attachment
23 DISORGANIZED ATTACHMENT PATTERN Insecure Attachment Avoidant/Dismissive Attachment Secure Attachment Ambivalent/Preoccupied Attachment
24 PARENTS ATTACHMENT WOUNDS A parent will naturally pass on what he/she has been given unless there is an intentional shift towards an earned secure attachment
25
26 TRAUMA
27
28 WINDOW OF TOLERANCE Hyperarrousal Hypoarrousal Dissociation
29 HYPERARROUSAL Hyperarrousal may look like chronic hypervigilance, emotional tantrums, anxiety, preoccupation with a relationship, rejection sensitivity, over responses to perceived threats
30 HYPOARROUSAL Hypoarrousal may look like flat affect, numbness, disconnected feelings, passive-agressiveness.
31 DISSOCIATION MAY LOOK LIKE I m in a fog I m in a dream I m disconnected from my body I m zoned out/numbed out I m floating I m a robot I m split apart There is stuff I can t remember
32 NEGATIVE MEMORIES HOLD MORE WEIGHT
33 THE TRIAD Trauma Attachment Sensory
34
35 RESILIENCY Social support provides buffering that reduces stress hormones and prevents fear learning
36 The experience of our own bodies becomes the model for our connection, understanding, and empathy in relationship with others. Louis Cozolino
37 WHAT IS YOUR CHILD S SENSORY DIET NEEDS
38 IN GENERAL Movement generally alerts Deep pressure/ heavy work (proprioception) is universally organizing Oral outlets are calming
39 THE WORK OF SENSORY INTEGRATION IS FOR A TRAINED OCCUPATIONAL THERAPIST BUT THE WORK OF COREGULATION, USING SENSORY BASED TREATMENT, IS ESSENTIAL FOR PYSCHOTHERAPISTS AND PARENTS
40 REFERRALS FOR OCCUPATIONAL THERAPY HELP IMPROVE A CHILD S SKILLS FOR THE JOB OF LIVING. SO IF A CHILD HAS A HARD TIME WITH THEIR OCCUPATION (SELF- CARE, PLAY, EDUCATION, COMMUNITY INTEGRATION) PROVIDE/REQUEST A REFERRAL
41 SETTING UP A HOME TO BE SENSORY SENSITIVE
42 SETTING UP AN OFFICE TO WORK ON A SENSORY LEVEL
43
44 ATTUNEMENT is the process of being aware of your own inner experience while being able to notice and connect with the inner experience of the person in front of you.
45 ATTUNEMENT DEFICIT You can t create attachment cognitively. It is created somatically and interpersonally within a felt sense of safety over time
46 MODEL FOR YOUR CHILDREN
47 FIND A TRAUMA TREATMENT MODEL THAT WORKS FOR YOU AND HEAL YOUR PAST WOUNDS TO CREATE A BETTER FUTURE
48 WORKING WITH THE SCHOOL & OTHER PLACES OF CONNECTION FOR THE CHILD
49 engage & be curious
50 REFERENCES Aron, E. (2002). The Highly Sensitive Child: Helping our children thrive when the world overwhelms them. New York: Three Rivers Press. Bunim, J. (2013). Breakthrough Study Reveals Biological Basis for Sensory Processing Disorders in Kids. Retrieved from: Huges, D., Koomar, J. Safe Place DVD: Parenting Strategies for Facilitating Attachment and Sensory Regulation. Huntington, A. Sensory Integration: Developmental Foundations for Interaction and Play. Advanced Child Development Course: Family and Play Therapy Center Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., Osten, E. T. (2007). Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis. The American Journal of Occupational Therapy, 61 (2), 137. Orlans, M., Levy, T. (2006). Healing Parents: Helping Wounded Children to Love and Trust. Washington: Child Welfare League of America. Parnell, L. (2013). Attachment focused EMDR: Healing Relational Trauma. New York: W.W. Norton & Company. Karen, R. (1994). Becoming Attached: First Relationships and How They Shape Our Capacity to Love. New York: Oxford University Press. Kennedy, J., Lane, S. J. (2014). The Role of Tactile Sensation in the Neurodevelopment of Affective and Social Function. The American Occupational Therapy Association, Inc. 37 (1) Koomar, J. A. (2009). Trauma-and Attachment-Informed Sensory Integration Assessment and Intervention. The American Occupation Therapy Association, Inc. 32(4). Kranowitz, C., Miller, L.J. (2006). The Out-of-Sync Child. New York: The Berkley Publishing Group. Siegel, D., Hartzell, M. (2003). Parenting from the Inside Out. New York: Penguin Group Inc. Smith, K., Gouze, K. (2004). The Sensory-Sensitive Child: Practical Solutions for Out of Bounds Behavior. New York: Harper. Zaccagnino, M., & Cuisine, M. (2013). EMDR and parenting: A clinical case. Journal of EMDR Practice and Research, 7(3), Helpful Websites: Booklet with usable tools for parents:
51 LEARNING OBJECTIVES 1. attendee will be able to list and describe the 7 senses and the 3 prongs of sensory processing 2. attendee will be able to describe attachment as a sensory process 3. attendee will be able to describe the triad approach of treatment 4. attendee will be able to state at least 2 practical skills/exercises for the clinical or the parent
52 QUESTIONNAIRE FOR PARENTS: SENSORY-PROCESSING-DISORDER/ KIDSKORNER/ ASSESSMENT TOOLS FOR PYSCHOTHERAPISTS: 1. SENSORY PROCESSING MEASURE BY DIANNE PARHAM AND COLLEAGUES 2. SENSORY PROFILE BY WINNIE DUNN AND HER TEAM
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