The Brain & Trauma

June 11, 2014

Presented By:

Aaron Wiemeier M.S. LPC

The Brain & Trauma Outline

I. Anatomy of Brain – 3 Divisions & Connection to Trauma Symptomology

II. Brain Organization & Development & Relation to Trauma

III. Trauma – Definitions/Facts & PTSDIV. Trauma Memory & Behavioral SymptomsV. Healing Trauma & Trauma DevelopmentVI. Practical Applications & Interventions For

HealingVII. Case Example & Discussion

The Brain Short Course

• Lower Brain

• Ordered from most basic to most complex

• Controls basic life functions and relaying of sensory information

The Brain Short Course

Lower Brain Structures

• Spinal Cord

• Medulla Oblongatta

• Pons

• Cerebellum

Relay

Basic Function

Relay

Basic Function

The Brain Short Course

• Mid Brain Reception and Filtering of sensory information before it reaches CONSCIOUS brain (5)

Structures:

Reticular Formation

Neurons extend from medulla to lower regions of forebrain (5)

The Brain Short Course

• Forebrain Relaying more sensory info, primitive emotions, drives, basic behavioral responses, higher conscious thought and executive functioning

Structures:

Thalamus

Limbic System

Cerebral Cortex

Relay

Basic Drives, Emotions, Behavior

Higher Conscious Thought/ ”Filing Cabinet”

The Brain Short Course

The Limbic System

Primary “Trauma” Center of the Brain

The Brain Short CourseBrain Organization

Perry, B.D. (1997)

The Brain Short CourseBrain Development

Organizes & Develops from most basic to most complex

Needs based on Development (2 weeks infant with touch vs. 12 year old)

1st 3 Years 90% of how brain will function is set In-Utero to 3 years outcomes dependent on combination of genetics and environment Sequential “must learn to walk before you can run” 10-18 months infants emotions (love/fear) developed

(www.growingchild.com)

The Brain Short CourseBrain Development

14-15 years critical age for permanency of personality/language

Times of rapid brain growth 1-3, 6-8, 10-12, 14-16

Traumatized Children Brain development can be delayed 3-5 years

Females by age 6 years greater sensitivity to non-verbal cues

(www.growingchild.com)

Trauma

What is Trauma?

Trauma

Definition:Medical

Psychiatric

Injury or insult to body/shock

Experience that is emotionally painful or distressing

Both can be Acute or Long Term

Trauma

Definition: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

Trauma

Posttraumatic Stress Disorder

Criteria: A)

Both 1) experience/witness/confronted death/serious injury/threat of

2) Response fear/helplessness/horror

Trauma

Posttraumatic Stress DisorderCriteria:

B) Recurrent thoughts/dreams/feelings

C) Avoidance of things associated with event

D) Persistent symptoms of increased arousal

E) Duration

F) Causes clinically significant impairment in social, occupational or other areas of functioning

Trauma

Trauma Memory

Non-Declarative Memory

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

Trauma

Trauma’s Effect on the Brain

Trauma

Trauma’s Effect on the Brain

Smaller Hippocampus (long term memory) (3)

Short term memory deficits

Dysfunctional Stress-Response System (Cortisol) (1)

TraumaTrauma’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:

TraumaTrauma’s Effect on the Brain

Anger The “safest” feeling to express - emotional dysregulation

Attention/Impulsivity Issues - Hyperarousal

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

Trauma

Catatonia

Repression

Identity Disorder/Conversion

Regression

Rage

Anger

Denial/Avoidance

Hierarchy of Self-Protective Brain

Responses

TraumaThe 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

EmotionalResponse

Biological Response

Trauma

TraumaThe 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.

The Brain & TraumaPractical 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”

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

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 systemic fear-SocietyAdminStaffChild

The Brain & TraumaPractical Applications – Children

Coping Skill Development & Emotional Awareness

• Healing Hand

• Method of Loci (memory strategy)

• Need to be different types (at least one internal)

The Brain & Trauma

Practical Applications for Adults

Structure & Discipline

• Discipline = “to teach”

• Consistency•3 Levels of Choice: Open/You Choose (weighted?) /”I action – base on emotional needs of child at current timeLove/

Nurturing

• Attachment Considerations - hypodermic/good coach approach - how much can they tolerate/grounding statements

• Chemistry of Connection/The Connected Child

The Brain & Trauma Other Intervention Ideas For Healing

The Brain Gym

My Sensory Workbook: Lauren Kerstein

Challenge Software: www.cpschallenge.com

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

The Brain & Trauma My Feelings Workbook - Populations

• Trauma/PTSD• Autism/Aspergers• Enuresis/Encopresis• Anger/Opposition & Defiance• ADHD• Chronic Stress• Depression• EMDR preparation

The Brain & TraumaFamily-School-Community = Healthy Resilient Children

Thank You For All You

Do!

The Brain & Trauma

References:www.traumaresources.org (Trauma, Brain & Relationship DVD 2000) (1)www.brainconnection.com (2)www.leadershipcouncil.org (3)www.growingchild.com (4)http://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