The Body Knows Best Adventure Therapy Best Practices Conference Jo Ann Orr, MSW, LCSW

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1 The Body Knows Best 2007 Adventure Therapy Best Practices Conference Jo Ann Orr, MSW, LCSW

2 Confluence of Ideas What we experiential practitioners have always known and practiced that we learn best at the edge of our comfort zones and including the body in learning makes the learning more powerful Recent advances in neuro-imaging, our understanding of brain biology and the impact of trauma on the body and brain

3 Reflection on Intentions, attunement, attachment, resilience If we attend to other s intentions, we create interpersonal attunement. As we attend to our own intentions, we create internal attunement. Intentional states integrate the whole neural state in the moment. Sharing mental states is the underlying experience within secure attachment between child and parent that promotes resilience. Mindfulness can be seen as a way of developing a secure attachment with yourself.

4 Goals for workshop Increase understanding of the foundations and applications of somatic awareness as it relates to learning and integrating experience. Reinforce the foundations of EE with empirically based research on the brain and trauma.

5 Overview Our context The Partnership Defining trauma and finding relevance to what we do Brain biology Comfort Zones and Modulation Model Somatic awareness through experience Mindfulness as a form of reflection Organization of Experience Activity based learning and application Brainstorming

6 Somatic Awareness Drop into your body Belly breath Visualization Happy face Synerjam

7 Who is here? Mental Health Professionals Therapeutic program staff Wilderness based program staff Universities, schools and therapeutic school staff Camps others

8 Definitions of Trauma Judith Herman s definition Acute vs. developmental Big T (life threatening-perceived or actual) and little t (typical life or family experiences) 911 vs. Sarah Factors affecting the assessment and resolution of trauma age, frequency, duration, degree, relationship to abuser, reaction to disclosure, did the abuse stop?, resiliency of child, resources available to help them, acknowledgement by abuser, timeliness of treatment, natural disaster or result of human behavior

9 Statistics of Abuse/Trauma 1 in 4 women have a history of sexual abuse before the age of 18 1 in 6 men have a history of sexual abuse before the age of 18 60% of the population will have some experience of trauma in their lifetime Some type of small t trauma is part of the human experience

10 The Brain

11 Brain Biology Basics Paul MacLean (1985) defined the brain as a detecting, amplifying, and analyzing device for maintaining an individual in his or her internal and external environment. BRAIN BIOLOGY ACTIVITY

12 The Triune Brain (MacLean) a brain with a brain within a brain.

13 The Middle Prefrontal Cortex functions that correlate with activity Body regulation balancing the brakes and accelerator functions of the autonomic nervous system Attuned communications Emotional balance monitors and inhibits limbic firing Response flexibility ability to pause before action Empathy Insight or self-knowing awareness Fear modulation fear is learned limbically but can be modulated by new learning Intuition or nonverbal insight developed from input via the viscera Morality the ability to take in what is good for the whole, not just oneself

14 Reptilian Brain (Brain Stem & Cerebellum) First to develop from an evolutionary perspective, governs arousal, homeostasis of the organism, and reproductive drives, and loosely relates to the sensorimotor level of information processing, including sensation and programmed movement impulses. - Ogden, Minton & Pain (2006, p. 5)

15 Paleomammalian Brain (Limbic System) Includes the amygdala, hippocampus and hypothalamus. Affective knowledge: Subjective feelings and emotional responses to world events. -Panksepp, 1998, p. 43 mediate emotion, motivation, and goaldirected behavior. - Siegel, 1999,p.10 maintaining the balance between internal world and external reality.

16 Parts of the Limbic System AMYGDALA Smoke detector of the brain Better safe than sorry Assigns significance to sensory input Guides emotional behavior

17 Parts of the Limbic System HIPPOCAMPUS plays a significant role in the capacity to recall specific life events consciously. - van der Kolk, 2003, p.305 thought to record in memory the spatial and temporal dimensions of experience and to play an important role in the categorization and storage of incoming stimuli in memory. - van der Kolk, 1994, p10 or organizes experiences in space and time.

18 Parts of the Limbic System HYPOTHALAMUS responsible for physiological homeostasis, or bodily equilibrium, established by way of neuroendocrine activity (neuronal firing and hormonal release). Stress is often responded to by the HPA Axis (hypothalamic-pituitary-adrenocortical axis). - Siegel, 1999, p.11

19 Neocortex enables cognitive information processing, such as self-awareness and conscious thought, and includes large portions of the corpus callosum, which bridges the right and left hemispheres of the brain. - Ogden, Minton & Pain, 2006, p.5 Constitutes 5/6th of the human brain. mediates more complex information processing functions such as perception, thinking and reasoning. - Siegel, 1999, p.10

20 The Sensorimotor Process of Change

21 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

22 The brain can take in new information and construct new realities only when our bodies feel safe. Bessel van der Kolk

23 Presence The quality of our availability to receive whatever the other brings to us, to sense our own participation in the interaction, and to become aware of our own awareness. Seigel 2007 p. 263

24 Presence the state of mind that comes with all the dimensions of reflection; the quality of our availability to receive whatever the other brings to us, to sense our own participation in the interaction, and to be aware of our own awareness. Presence allows for attunement Attunement allows an authentic experience of ourselves Seigel, 2007 p. 263

25 The Eight Senses The first five senses Sixth interoception- the sensations from our body including motion, tension or relaxation, our organs, etc. These are the foundational components of intuition and they shape our emotional state. Seventh mindsight awareness of our own minds and the minds of others Eighth a relational sense in which we have an awareness of feeling felt by another and that we are a part of a larger whole. Seigel, 2007 p. 122

26 Attunement to self to create safety Attachment repair for self and others

27 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

28 Comfort Zones Comfort zone Stretch zone Panic zone Nadler and Luckner, 1992

29 The Modulation Model High Activation A R O U S A L Low Activation Your Window of Tolerance Optimal Arousal Zone Ogden & Minton, 2000

30 Outside the WOT Unable to think Lost or impaired ability to access executive function of brain Behaviors become reflexive responses originating from the reptilian brain or brain stem Lost ability to integrate current experience

31 The Five Building Blocks of Experience (Ogden, 2003) Cognitive functioning of the mind, contains thoughts, meanings, or interpretations of stimuli and beliefs about ourselves and the world Emotions emotions such as fear, anger, or joy as well as subtle nuances such as moods Five sense perception basic inner and outer sensory functions such as smell, taste, sight, touch, and hearing

32 Movement actual movement of the body ranging from micromovements to gross motor Inner body sensation actual physical feeling which is created as the systems of the body monitor and give feedback about inner states; the realm of sensation extends from the proprioception of the cells and tissues of the body to a sensing of the body structure, energy, and function.

33 SATBF Model Thoughts Feelings Behaviors Somatic Awareness Adapted from Morton- Stanford and Dana (2007)

34 THOUGHTS FEELINGS BEHAVIORS SOMATIC AWARENESS Hyper-arousal THOUGHTS FEELINGS BEHAVIORS SOMATIC AWARENESS WINDOW OF TOLERANCE THOUGHTS FEELINGS BEHAVIORS SOMATIC AWARENESS Hypo-arousal Orr, 2007

35 Levels of Information Processing Cognitive Processing Conceptual information processing, reasoning, planning, meaning-making and decision making. Emotional Processing Expression and articulation of feeling and affect. Emotional processing adds motivational coloring to sensorimotor and cognitive experience Sensorimotor Processing Sensorimotor processing involves sensory, physiological and motor sequences associated with five-sense perception, impulses, movement, postural changes, orienting responses, defensive responses, inner body sensations and ANS arousal. Ogden & Minton, 2000

36 Putting on the Brakes Rothschild 2000

37 Neurobiological Regulators Two kinds of self-regulation Auto regulation the ability to calm oneself down when activation rises to the upper limits within the WOT. It also includes being able to stimulate oneself when arousal drops to the lower limit within the WOT. Interactive regulation the ability to utilize relationships in order to calm oneself or stimulate oneself so they return to the WOT Ogden 2006, PSI Training Manual

38 Dual Awareness A normal process among non-traumatized people in which one can maintain awareness of several experiences at the same time. Because of damage to the hippocampus in traumatized clients, the current physiological arousal cannot be accurately placed in time (in the past). The ability to keep both present day reality (grounding) awareness via the frontal lobes and awareness of the physiological and emotional arousal allows the client to process the experience. This is now, that was then.

39 Other Terms Triggers Resources Implicit/Explicit memories Fight, flight, freeze, submit

40 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

41 MINDFULNESS

42 is a skill.

43 It is a way of relating to all experience - positive, negative and neutral - such that our overall suffering is reduced and our sense of well-being increases. - Germer, 2004

44 The Fourth R Reading, Writing, and Arithmetic Reflection nurtures the brain s prefrontal region s capacity to be open, self-aware and meta-aware (the awareness of awareness). Ultimately these reflective skills harness our prefrontal capacity for executive attention, prosocial behavior, empathy, and self regulation. Seigel, 2007 p. 262

45 Mindfulness An operational working definition of mindfulness is: the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment. -Jon Kabot-Zinn 2003 pp

46 Reflective Experience Seigel p. 285

47 Seigel et. al. propose that relationships with secure attachment such as between a parent and child and an effective therapeutic relationship between a therapist and client - promotes the growth of the fibers in [the] prefrontal area.

48 Integration Within the Middle Prefrontal cortex Attending or focusing attention resilience Other s intention Secure attachment Interpersonal attunement Or presence

49 Mindsight Definition: the capacity to sense the mind in ourselves, and in others

50 Jon Kabat-Zinn Without mindfulness we reinforce the synaptic networks within the nervous system that underlie our conditioned behaviors and mindless habits

51 Daniel Siegel, M.D. Mindful awareness of the body enables the individual to move directly into previously warded-off states of activation, which left the body out of experience of mental life following acute or chronic traumatization.

52 By turning toward the body with mindful awareness of here-and-now sensory experience, the pathways to integration are open and healing becomes possible. - Siegel in Ogden, Minton & Pain, 2006,p.xv

53 Somatic basis of emotions Exteroceptors body awareness that comes from outside the body (touch, taste, smell, sound, sights) Interoceptors body awareness that originates from sensations from inside the body (connective tissues, muscles, and viscera) Emotions are identified by a combination of distinct body sensations: shallow breathing +elevated heart rate +cold sweat = afraid Rothschild 2000 (p.60)

54 Middle prefrontal regions of the brain, demonstrated through extensive research, are dependent on positive experiences with caregivers for proper development. p191

55 SATBF Model Thoughts Feelings Behaviors Somatic Awareness Adapted from Morton- Stanford and Dana (2007)

56 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

57 Corrective Experience New somatic experience of the body Eliminate/alter old belief systems Complete incomplete defensive action patterns Activate new defensive action patterns Ogden 2006, PSI Training Manual

58 Optimal conditions for building new connections in the brain Sense of novelty Optimal attentional arousal Emotional engagement Using reflection Seigel 2007 p. 262

59 The Psychology of Action The patients who are affected by traumatic memories have not been able to perform any of the actions characteristic of the stage of triumph [mastery]. They are continually seeking this joy in action...which flees before them as they follow. Janet (1925, p. 669) When neither resistance nor escape is possible, the human system of self-defense becomes overwhelmed and disorganized. Each component of the ordinary response to danger, having lost its utility, tends to persist in an altered and exaggerated state long after the actual danger is over. Herman, 1992

60 Sensorimotor Psychotherapy By using bodily experiences as the primary entry point in therapy, rather than the events or the story, we attend first to how the body is processing information and then afterward to emotional and cognitive meaning-making. Ogden, 2002

61 Bottom Up/Top Down Processing Bottom Up Motor patterns and emotions are activated from the reptilian and limbic brains The felt sense is the primary language Falling down the stairs, reflexes come into play before cortex Hijacking as in the case of chronically traumatized person Top Down Beliefs like I can t do this leave the person weak, collapsed with dull senses -- Conscious override of physiological arousal by distraction or behavioral discharge - Habituated traumatic reaction (amygdala overdrive) resulting in inhibited cognitions Ogden 2006, PSI Training Manual

62 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

63 State becomes Trait Systems that are repeatedly active at the same time tend to become associated, these states become more easily activated and become characteristic traits of the individual we simply enter the engrained states and experience them as reality of our present experience. (Siegel, 1999)

64 Neural Networks Hebb s Axiom neurons that fire together at one time will tend to fire together in the future Or said another way neurons that fire together wire together

65 Neuroplasticity Connections are continuously created throughout the lifespan. Networks are strengthened and pruned in an experience dependent process

66 Mirror Neurons Motor neurons fire for motor activity The same neurons fire if one imagines it AND if one observes someone else doing it. Allows us to resonate with each other s internal states, including intention. Seigel 2007, p.167 adapted from Gallese, 2000 and Fisher, 2004

67 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

68 Somatic Resources Somatic resources emerge from physical experience, but influence psychological health. They are the physical functions and capacities that support self regulation and provide a sense of well-being and competency. Somatic resources are thought to help clients to change maladaptive action tendencies. Ogden, 2005

69 The Dancing Feet Story

70 Sensorimotor Process of Change Fully embodied Safe place Somatic resource Body in WOT Brain on board New Neural networks Using mindfulness Corrective experience Orr, 2007

71 Embodiment Visualization of high moment What do you say to yourself as a result of that experience? What does that mean about you? How does that impact how you go about your day?

72 Now What?

73 Cautions These basic skills can be used by beginners and advanced practitioners The application to certain populations needs to be handled carefully Abreactions need to addressed immediately with the goal of returning the client to current reality by grounding Being in your body is not safe to some

74 Implications for practice Opportunity to shine a light on the somatic experiences of participants through mindfulness. An individual that has an increased awareness and an integrated sense of self has a greater ability to regulate their emotional states in the face of uncertainty and adversity.

75 Implications cont. Experiential Educators and Adventure-based practitioners are already creating experiences that engage individuals and groups in ways they are not used to, thus allowing for the formation of new neural networks. Reflection, or meaning making, is a cornerstone of EE and provides an opportunity to illuminate the cognitive, emotional and somatic experience of participants.

76 Tools Window of Tolerance Thoughts, Feelings, Body Sensations and Behavior Diamond Model. Mindfulness activities

77 What You Provide Safety Container Mirror neurons Interactive regulator Corrective experience

78 ACTIVITY

79 Brainstorm

80 Contact Info: THANK YOU!!! Jo Ann Orr, LCSW 14 Shaw Drive Rochester, NH (603)

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