Developmental Resources, May be reproduced by attendees of Engaging the Traumatized Child Webinar 1
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1 Developmental Resources Presents Presented by: Aaron Wiemeier, MS, LPC Please Ask Questions Via What is Trauma? Trauma Defined Medical Injury or insult to body/shock Psychiatric Experience that is emotionally painful or distressing Both can be Acute or Long-Term. Webinar 1
2 Trauma Defined Psychiatric/Emotional Subtypes: Developmental (1) Environmental Secondary 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. Post-Traumatic Stress Disorder Criteria A: Both 1. Experience/witness/confronted death/serious injury/threat t of 2. Response fear/helplessness/horror Webinar 2
3 Post-Traumatic 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 Trauma Memory: Non-Declarative Memory Trauma Memory Stored as early as 6 months In-Utero Stored in Limbic System (Amygdala & Hippocampus) Much more permanent Unconscious Similar to procedural memory Webinar 3
4 Trauma s Effect on the Brain Trauma s Effect on the Brain Smaller Hippocampus (long term memory) (3) Short term memory deficits Dysfunctional Stress-Response System (Cortisol) (1) Trauma s Effect on the Brain Behavioral Because the trauma has affected the structures our brain uses to deal with stress/hurt/pain emotional or otherwise, We resort to other less natural and more dysfunctional patterns of dealing such as: Webinar 4
5 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 Hierarchy of Self-Protective Brain Responses Catatonia Repression Identity Disorder/Conversion Regression Rage Anger Denial/Avoidance The Road Block To Healing Negative Cognitive Message: I am powerless, I deserve bad things, I am not worthy, I am not loveable, etc. Negative Cognition Trauma Emotional Response Biological Response Webinar 5
6 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 it s tied to trauma, it is more permanent. Our environment and thoughts are not nearly as permanent. Explains self-sabotage, messy rooms, etc. The Brain & Trauma: Practical Applications General Overview 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. Webinar 6
7 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) The Brain & Trauma: Practical Applications for Children & Families Reframing Behavior as Fear-Based For self as well as child ( Not focusing on surface behavior but what is underneath (Attachment Disorder) Repetition Eliminate/reduce systemic fear Society Admin Staff Child 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) Webinar 7
8 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 The Brain & Trauma: Resources The Brain Gym My Sensory Book Lauren Kerstein Challenge Software The Brain & Trauma: Resources Webinar 8
9 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 The Brain & Trauma My Feelings Workbook - Populations Trauma/PTSD Autism/Aspergers Enuresis/Encopresis Anger/Opposition & Defiance ADHD Chronic Stress Depression EMDR preparation The Brain & Trauma Family School Community = Healthy Resilient Children Thank You Thank You For All You Do! Webinar 9
10 References: (Trauma, Brain & Relationship DVD 2000) (1) (2) (3) (4) (5) Perry, B.D. (1997) Incubator of Terror: Neurodevelopmental Factors in the Cycle of Violence (6) Other Helpful Websites: Developmental Resources Presents Presented by: Aaron Wiemeier, MS, LPC Please Ask Questions Via Webinar 10
11 Trauma Symptom Checklist Put a check next to the applicable symptoms PHYSICAL REACTIONS: aches and pains like headaches, backaches, stomach aches sudden sweating and/or heart palpitations (fluttering) changes in sleep patterns, appetite, interest in sex constipation or diarrhea easily startled by noises or unexpected touch. more susceptible to colds and illnesses EMOTIONAL REACTIONS: shock and disbelief fear and/or anxiety grief disorientation denial. hyper-alertness or hypervigilance irritability and/or restlessness outbursts of anger or rage emotional swings.. like crying and then laughing worrying or ruminating - intrusive thoughts of the trauma nightmares flashbacks.. feeling like the trauma is happening now feelings of helplessness feelings of panic or feeling out of control increased need to control everyday experiences minimizing the experience attempts to avoid anything associated with trauma tendency to isolate oneself feelings of detachment concern over burdening others with problems emotional numbing restricted range of feelings difficulty trusting and/or feelings of betrayal difficulty concentrating or remembering increased use of alcohol or drugs and/or overeating feelings of self-blame survivor guilt shame diminished interest in everyday activities depression unpleasant past memories resurfacing loss of a sense of order or fairness in the world expectation of doom and fear of the future Adapted from The Trauma Response Copyright 1989 Patti Levin. Psy.D.
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13 Positive & Negative Cognitions List Negative (Lies) Positive (Truth) I don t deserve love I am a bad person I am terrible I am worthless (inadequate) I am shameful I am not loveable I am not good enough I deserve only bad things I cannot be trusted I cannot trust my judgment I cannot succeed I am not in control I am powerless I am weak I cannot protect myself I am stupid I am insignificant (unimportant) I am a disappointment I deserve to die I deserve to be miserable I cannot get what I want I am a failure I have to be perfect I am permanently damaged I am ugly I should have done something I did something wrong I am in danger I cannot stand it I cannot trust anyone I cannot let it out I do not deserve I deserve love; I can have love I am a good (loving) person I am fine as I am I am worthy; I am worthwhile I am honorable I am loveable I am deserving; I am a good person I deserve good things I can (learn to) trust myself I can trust my judgment I can succeed I am now in control I now have choices I am strong I can (lean) to take care of myself I have intelligence I am significant (important) I am okay the way I am I deserve to love I deserve to be happy I can get what I want I can succeed I can be myself I am (can be) healthy I am attractive/loveable I did the best I could I learned (can learn) from it It is over, I am safe now I can handle it I can choose who to trust I can choose to let it out I can have (deserve)
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