SOMATIC APPROACHES TO TRAUMA TREATMENT - SECTION B

Somatic Approaches to Treating Biopsychosocial Impacts of Trauma Class II

Finding Our Cultural Location

The Coupled Pendulum... A little give

https://www.youtube.com/watch?v=Aaxw4zbULMs

It is not all in your head…

Picard, M. et al. (2014) Mitochondrial allostatic load puts the ‘gluc’ back in glucocorticoidsNat. Rev. Endocrinol. doi:10.1038/nrendo.2014.22

Clinical Review – The Human Impact

Trauma exposer increases the incident of paradoxical and complex reactions to medications.

DM-II: Hypothalmic-pituitary-adrenal activity is enhanced in patients DM-II related complications and the degree of cortisol relates to presence and number of diabetes complications. Journal Diabetes Care - Cortisol Secretion in Patients With Type 2 Diabetes - doi: 10.2337/dc06-1267

Clinical Case – Discussion

Nine Components of SE Therapy

Spirit: The spirit of SE is one of joining, connection and care. The client’s

experience is the organizing feature. The innate movement of the organism is to

health.

Somatic Experiencing Trauma is a Feedback Loop

High Arousal

Unsuccessful Escape

Experiencing

Fear and Hopelessn

essImmobiliza

tion

Trauma Based

Meaning/Cog

Chaos and Back

Figenbaum’s Constant: 4.66920

Three C’s of Trauma Healing

C(are): The experience of being seen, understood and being valued is an antidote to trauma symptoms.

Care Tools: Validation, Attunement, Interest, Affect Matching

C(onnection): The experience of being connected to others. Often after a trauma people can feel ‘terminally different.’ The ability to reconnect to community and tribe is healing.

Connection Tools: Imagery, Felt-Experience, Memory and Somatic Mindfulness

C(uriosity): Trauma is overwhelming and fight/flight turns a world of graded scale to one of simple good or bad reasoning. Curiosity is a hallmark of healing and reconnection.

Curiosity Tools: Joining, interest, attitude of exploration, making small tests, attending to even difficult sensations with interest

How to Stabilize a Resource1. Attend to a resource 2. Allow the resource sensations to be

present without working to increase or decrease them.

3. Be curious about any other place in your body that resonates with the sensations of the resource.

4. Allow those new sensations to be present and witness them without attempting to change them

Repeat the above for a cycle or two

https://www.youtube.com/watch?v=ByalBx85iC8

Exercise Tracking State Changes

Watch the video of Peter working with Ray. Observe the non-verbal conversation. Watch for changes in states or what Dr. Crane calls ‘Preparatory Set.’

1. Each member of the class take one state sign: Fight, Flight or Freeze.

2. Every time there is a change in state hold up the sign for the state change.

Payne, P., & Crane-Godreau, M. A. (2015). The preparatory set: a novel approach to understanding stress, trauma, and the bodymind therapies.Frontiers in human neuroscience, 9, 178.http://journal.frontiersin.org/article/10.3389/fnhum.2015.00178/full

Phase Model Phase 1 – Developing Somatic Resources

and Stabilization Phase 2 – Processing Traumatic

Memories Phase 3 – Integration, Development,

Normal Life M Linehan – Phase 4 – Sustained Joy

(DBT)

Nine Components of SE Therapy 9 Steps SE Session:

Establish ‘relative’ safety Build capacity to explore sensation Establish pendulation and containment Titration Corrective experiences (empowered defense) Separate/uncouple fear and immobility Resolve hyperarousal (discharge) Engage in self-regulation Orient to hear and now

Four Key Assessments Rate of Innate Pendulation: How quickly the system shifts,

how long a system is stuck in a channel and how easy it is to shift.

Self to Trauma (S:T) Ratio: The ratio of self awareness+presence+capacity+confidence to the intensity of trauma.

Pattern of Exceeding Window of Tolerance: This is the amount of time outside window of tolerance, amount of time with in, key factors that lead to exceeding window of tolerance (triggers inner/outer, channel etc.)

Attunement to Rupture Ratio (A:R): How much tolerance a relationship has for rupture, repair and how much attunement is needed to support relationship.

Somatic Experiencing Supporting the Innate Drive to Health

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Frontiers in psychology, 6, 93. http://dx.doi.org/10.3389/fpsyg.2015.00093

Polyvagal TheoryThe way it works… V.V.C. Brake

Disengages

Sympathetic Nervous system

Engages V.V.C Brake Engaged at rest and Socially Engaged.

DMNX EngagesShutting Down Consciousness

PACE Attitude – Quality of Contact Playfulness – A willingness to laugh, joke and play even in difficult

situations. Pulls an individual out of fight flight into frontal lobe and limbic connection.

Acceptance – Acceptance builds a context of safety and connection. Accepting is not agreeing or supporting but just recognizing reality when it is present.

Curiosity – Curiosity is the hallmark of social engagement. This pulls an individual out of fear or anger states and into the state where new possibilities can arise. It begins to support decreased stress reaction and increase parasympathetic tone.

Empathy – The experience of being understood develops the ability to care for one’s self. Creates a context of safety and understanding. This allows for an individuals guard to go down and the shift into more curiosity and possibility.

Sensory Motor Therapy Notices the three levels (or four if using

Perry’s system) of functioning how these are effecting function.

Adapts the intervention to the area of function most likely to produce integration.

Speaks the language of the brain system most likely to lead to integration.

Deer Orienting… https://www.youtube.com/watch?v=fUnX65RmPko

Coherence in Birdshttps://www.youtube.com/watch?v=DmO4Ellgmd0

Polar Bear Freeze State https://www.youtube.com/watch?v=eT4060GeodI

Opossum Freeze Statehttps://www.youtube.com/watch?v=sNNCBCqdHQs&index=3&list=PLKt47oQNSAs5AQSZtMt5Pv5oPXTkEJIl7

Gazelle Saved by Baboons: Comes out of Freezehttps://www.youtube.com/watch?v=xmF52x3EJso&index=6&list=PLKt47oQNSAs5AQSZtMt5Pv5oPXTkEJIl7